When you look back at the last 20 years of running Nordica, how would you describe how far you have come?
If I would describe the last 20 years, I will just simply say I am grace-personified. The Lord has been very graceful to me. When we started, we didn't know where we were going. I left the known for the unknown, I was already a gynaecologist at Lagoon Hospital where I had worked for 8 years with a decent clientele and I decided to say bye bye to everyone to go and start something I knew little about. There were very few people who could point you to the road. The ones who could point me to the road were not in Nigeria and internet was not as strong as it is now. So, looking back, I would say it has been God and God all the way.
Can you do a census of the babies you have assisted into this world for parents through Nordica?
Thousands I 'll say. Some people say over 5000. I don't look at the figures anymore because for me, I don't want to look at it from the point of view of how many children that have been brought forth. I like to look at it from the point of view of how many lives have I been able to impact. It is not only people who pay me to do something for them, but how many faces have I helped to put smiles on. Now, it is my work keeps me going. Yes, I am not saying that money is not important, but it is just an exchange for value. But for me, it is about how many people you have given smiles and hope. Also, what I am also more concerned about is customer's satisfaction. My principle is 'don't ever let anyone that comes to us leave the worst than they came. The more you are in this business, the more you see the anguish the people we serve are going through from the people who want to help them - but end up hurting them. Another thing that is important to us is how can we make a difference in the lives of those who come through our doors. How do we make a difference in the lives of the people of those who work with us? One of the most important thing to us is impacting lives. So when you see me talk to some of our patients, we want to ensure that when you leave, you are happier. I wish I could do a lot more, especially bringing people who are going through infertility together for them to break the stigma. So that people can see it as any other medical condition - that people can freely talk about their fertility challenge. When they do this, it exposes them to the best level of care, quackery will reduce , and baby buying will reduce.
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| Sen. Rashidi Ladoja and wife celebrates with Nordica at 20 |
After Nordica came on board, a lot of other fertility treatment clinics sprung up in the country. How were you able to cope with the competition they pose and maintain the momentum that has seen Nordica remain the leading light in that sector?
You should expect competitors in any business you do, especially in a country like Nigeria that is very competitive. We have very many intelligent people no doubt, but I think focus is what many people don't have. I tell people I have never taken a contract in my life. I am doctor for the sake of me! A Yoruba adage says 'a ki ru erin s' ori ki a tun ma fi ese wa iho ire (you don't put an elephant on your head and start using your leg to dig a cricket's hole looking for eat). I think that is what we should all look at. Whatever you are called to do, you should do it with all your strength and stop running around the whole place looking for other things. If you do it well, people will be happy to give you money in exchange for what you are doing. Any other thing that is not related to what I am doing , I am not interested! Being focused has been my secret in the last 20 years. Also, having good people to work with me has been of great help. No matter how good or gifted you are, you need good people around you . You also have to be good to be able to attract good people too and of course, a lot of patience is required. If you want us to do things together you should be ready to run the marathon .
So, what is your perception about the influx of fertility doctors/clinics in the country at the moment?
I don't think anything about it. There are over 200 million people in Nigeria. There is no point being unnecessarily competitive. The sky is big enough for several birds to fly . The thing is whatever you choose to be doing, please do it well, especially in the health sector. Don't deceive people. Once the standard of care is good, I have no problem (with whoever is doing it). In Lagos alone, we have over 22 million people, so how many cycles can you do alone. Just one person can't handle it all. Like I said, quality control is key. I am not saying IVF won't fail, it will fail, but will you be able to stand in front of your God and say what I have collected money for I have done it well. I don't think we are too many.
Despite having many fertility centres, treating fertility and doing IVF is still not cheap in Nigeria and most people can't afford it. Why?
Everywhere in the world, assisted conception is not cheap. For example, do you know how much the lastest iphone costs? And do you know how many people who use it in Nigeria? Technology is not cheap, especially in a country like ours. I don't want to mention the numbers of generators I run here, so you will know the amount we spend on diesel. People look at how much comes in, they don't look at how much goes out to maintain the standard. And if you convert what we charge to pounds or dollars, it is is peanuts. I understand that the GDP is not very high, but unfortunately, once it is technology it is likely to be expensive. For example we are bringing an expert from Spain to come spend a week with us, of course it will cost us over £20,000. So, the idea is whatever they are doing there, we want to be able to do it here too. And of course, we need to invest in such things. If you want to get quality, it can't be too cheap. Even healthcare generally is not cheap. I mean qualitative healthcare . Someone must be paying, it is either the government is paying (which in the case of Nigeria is neither here nor there) or there is health insurance to cover such. The thing is someone must pay for it to get quality.
Why did you decide to establish the Nordica Fibroid Centre where you treat fibroid without surgery?
As a young doctor, I remember when May Ezekiel died (of complications from fibroid surgery). I think since then, I have been interested in this fibroid thing. Then, I was just training as a gynaecologist. I was always asking myself why are women dying from fibroid surgeries? And when I started practicing, to the glory of God, I must have done over 200/300 cases over 8 years of my practicing as a general gynaecologist and I did not have any mortality. I will say it is the grace of God and case selection and then may be the back up of the hospital where I was working. Not many hospitals have that kind of backup in Nigeria. But even in the UK, patients die after fibroid surgery. Some things can just come out of the blues especially patients with obesity who may have some complications. So I have always been interested in how can we treat fibroid without surgery. I have been following up on that for a very long time trying to see what can be done. In the process, I had a personal encounter where my sister had fibroid and in the process of surgery, the urethra was injured. All these made me ask myself several questions about having treatments without surgery. So, for s very long time I have been following the techniques and different levels of development, until I saw that we could also have this in Nigeria. And fortunately, I have a good board. So I spoke to my board and told them I think this is what we should be doing .They said nobody has done this before. So, one thing led to the other and we have done the treatment for almost 300 women to the glory of God in less than 2 years.
This is the first in Nigeria?
It is the first in West in West Africa. There are only 3 of these machines in the whole of Africa. One is in Egypt, another one is in South Africa and we have the third here. There is no way a surgeon will do 300 women in less than two years! For me the machine makes a whole lot of sense. The process is seamless. It is just for you to lie down on the bed and after about 2 hours, they tell you to get up, it is as simple as that .We watch you for 2 hours and after that you go home. By evening of the same day, the patient would have started taking liquids and the next morning starts eating. I seriously see that it is the future of for fibroid treatment in most part of the world. People say if it that simple why don't we do more than that? I said no, it is gradual. Although the thing is it is the patient themselves who have done it talk about it to other people and they are the ones who bring other patients. The cheapest and the best of way of medical advertisement is the word of the mouth.
Is there a way women can avoid having fibroids?
No! Because most of it is genetic. You could probably do some things that maybe makes it not to grow fast. Most of it is family history. Obesity is another cause. Today, 7 out of 10 women may have Fibroid. It is now really very common. Another side of it is that people don't know is a component that is called adenomyosis. it is not fibroid. It is a form of endometriosis. It causes the patient to bleed into the wall of the uterus. It is not fibroid but the problem is that the doctor can not remove it unlike fibroid that can be removed. Even if when they try to do surgery, that is when the doctor says it can't be removed. Even when doctors try to treat adenomyosis, after one year or two, they say it has reoccur again. So, the best way to treat adenomyosis is HIFU (High Intensity Focus Ultrasound) because it just burns it off.
What is the tendency that the patient that goes through HIFU to eliminate fibroid will be able to get pregnant by herself?
The good thing about it is that since it is ultrasound that is converted into heat temperature, the ovaries are safe. It does not affect the ovarian reserve. You can get pregnant on your own if there is no other problem like tube blockage or low sperm count.
How affordable is the fibroid treatment with HIFU?
The thing is what is affordable to me might not be affordable to you. What I tell people is that it is the cost of doing fibroid surgery in a good hospital in Lagos. So, what we try to do is we make it cheaper than laparoscopy surgery (pin hole surgery) so as to introduce it to as much as possible people, and ensuring they will be able to afford it. Like I said, we have done about 300 now and by and large, I don't it is beyond the reach of people.
This interview cannot be complete without talking about your wife, Mrs Ranti Ajayi and her role in the journey of Nordica. What can you say about her?
Remember I said you have to be surrounded by good people. That has to start with your household. Your spouse is very important to you in doing anything. I am a very reserved, shy one, and she is the one out there. I am a very shy person, you will rarely see me out there except for business. I am my own friend . She is from a different planet. I call her the unpaid media consultant for Nordica. So she is the one bringing the feminine touch to Nordica. I probably would just say that I can be called the hardware while she is the software. She has done a lot for the growth of Nordica and we have probably one of the strongest family settings in the IVF industry. Our patients are part of the family and so are the staffs - and that is largely due to her. She is a mother hen. She gathers everybody together and I will say she has done a lot and she has done so very well .
In this part of the world, it is very hard to see couples running businesses together and doing it right for this long. Besides, you have been together as a couple for 35 years. What is the secret?
You must tolerate one another and choose your battles reasonablly. Whenever I see people say some things (especially the so-called motivational speakers), I smile. She is invidivual, let her do whatever tickles her fancy as long as it is not harmful to the existence of everybody. Then, the head is not supposed to be a monitoring spirit, he is only to give direction. So whatever she likes, she does as long as it is not harmful to others . And when I obstruct to a particular decision, she knows then we can't go that way. People just need to understands one another.
What will you say to a women/couples suffering from infertility and hiding away from it?
You know that others' knowledge is different from the person who are going through it. The first thing I try to do is put myself in their place and understanding how they feel. That is when you can now think of a solution . So, we have tried to do some things in Nordica that people don't understand why we do such. For example, we introduced accupuncture at a stage. My counselors are trained. I have seen that as a fertility doctor, you have to come in from the angle they are coming from even if you don't agree with them totally. Because sometimes, it is just a feeling not based fact . It is a feeling that can't be ignored but we have to see the best way to correct it. Sometimes the best people to talk to them under guidance are the same people going through the same condition. So, a professional must always be there. That is why we tell them that they must be able to come together as a forum. They must be able to different between myths and facts. The thing is, for anybody going through infertility, the first to do is to get knowledge, talk to the right people. Not every thing they see or read online is true. You have to choose where you read from. There are trash on the internet. Talk to a doctor who have a vast knowledge of what you are going through. So many doctors don't have knowledge about infertility and some of them give opinions that are worst. It is not every doctor that knows about IVF. Almost every aspect of infertility has one treatment or the other. So it is, first you are talking to the right people, and secondly, you are taking the right decision.
In the last couple of years you have talked so much about the problem of infertility in Nigeria, infact you raised a lot of alarms back then that it was going to get worse. Would you say day today that infertility has become a become a bigger problem than it used it be in last 20 years ago. And do you forsee a bleaker future or is there solution is on the way?
Don't let me sound like Jeremiah - the prophet of doom. Well, I will say male infertility is on the rise in Nigeria and it is getting worse today and in the world. We did a study here on sperm count 10 years apart and we found out that sperm parameters have decreased by 30 percent in the last 10 years. Recently, an European study shows sperm count have decreased by 50 percent in last 40 years . That is why I said it is a global problem. Lifestyle is a major issue. And there is alot of contaminations here and there. I don't know if you heard that is alot of plastics in the ocean (that we now consume indirectly) which also contribute to infertility. It is multi-factorial, but the one that we can control easily is probably lifestyle. The use of hard drugs is also on high side. Now we have couples using hard drugs as afrodiziac and so on. So, sperm count might continue to reduce, but I think the solution might get better. Now everyone is saying technology is making life more easier and infertility treatment might not also be speared . There is alot of work being done. So, there will be more possiblilities in the future.Now we are concentrating more on the men. Before, we were more concerned about the women.The attention is now on men. Now we are realizing that the sperm does more than just fertilizing the egg, there is now a whole lot to it.