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EMMF: Making a Difference in Nigeria

An address to the Friends of ENMC





An Address to the Friends of ENMC at St. John’s Episcopal Church, Ellicott City, Maryland on August 15, 1998, by Nlogha Enwelum Okeke, MD, LMCC, FACS, FWACS, FICS, Medical Director, Eastern Nigeria Medical Center, Enugu, Nigeria


The Reverend Daniel Crowley

Professor Rev. Canon Ilogu

Thomas E. Williams, M.D.

Distinguished Ladies and Gentlemen:


May I first express our gratitude to Reverend Crowley, Professor Rev. Canon Ilogu and Dr. Thomas Williams for sowing the seed for this meeting.  They have spent both their time, efforts and money to ensure that this meeting holds and that it yields positive results.  Mrs. Okeke and I are extremely grateful to all of you who responded to their invitations.


The topic of my speech today is “Eastern Nigeria Medical Centre - The Product of Destiny”.


On the day of my graduation from Bates College, Lewiston, Maine in 1951, a lady walked up to me and offered me accommodations in her home if I gained admission into any of the three medical schools in Boston, Massachusetts.  I jumped at the offer; she then introduced herself as the wife of the Episcopalian Bishop of Massachusetts, Rt. Rev. Norman B. Nash.  By December of 1951, I moved into the home of Bishop and Mrs. Nash in Boston.  My five years stay with them influenced my life greatly.  The Bishop officiated in my wedding in 1956.  I was then still living in his home.  When I completed my medical training and surgical residency in Boston, I returned with my wife and two children to Nigeria in 1960.


The seed of establishing a private non-profit hospital that could help to improve the standard of medical practice in Nigeria was sown in my mind by the late Chief Medical Director of Medical Services in the former Eastern Region of Nigeria.  This was when he visited Boston in 1957 while I was undergoing my surgical training in Boston.  When I met him, he had to introduce himself to me as I did not know him in Nigeria.  He requested that I promise him that on completion of my surgical training, I would return to Nigeria not to work for the Government but to build a hospital that would demonstrate to both existing Government and private hospitals that we could improve the standards of medical practice by laying emphasis on human values of sympathy, love and medical ethics.  Before he left Boston, I had to make the promise of taking on the challenge he posed to me.


Following the above promise, I made some contacts in 1958 of persons I felt would support a programme for establishing a good hospital not managed by the government in Nigeria.  As a result, a foundation--Nigerian-American Hospital Foundation was set up.  The Foundation was incorporated in Massachusetts on June 16, 1960 to provide for the building of a non-profit hospital in Enugu, Eastern Nigeria.


The officers of the Foundation were:


1.         Rt. Rev. Norman B. Nash, D.D., Episcopal Bishop of  Massachusetts: President

2.         John J. Byrne, M.D., Chief of Surgery, Third Surgical Service, Boston University: Secretary and Treasurer

3.         Nlogha E. Okeke, MD, Medical Director


Two years before I returned to Nigeria, the Nigerian - American Hospital Foundation was registered in Boston with the specific aims of:


a)         Collecting hospital equipment and funds to send medical equipment to Nigeria

b)         Encouraging American doctors to work in the proposed hospital in Nigeria.


On my return to Nigeria late in 1960, I presented my programme to the then Premier of the Eastern Region, the late Dr. M.I. Okpara.  The programme received the government’s support and it leased a 11.98 acres of land and also recommended a bank which gave me the loan to construct a 98 bed hospital.  It stood surety for the loan.  In 1963, the hospital was commissioned by the Premier of Eastern Nigeria, the late Dr. M.I. Okpara.  The hospital was registered as a non-profit hospital.  It still retains this policy.  When the hospital was opened, it received several donations from individuals, organizations and governments.


Various Ministers of the Government and individuals donated money to help me complete the essential buildings of the hospital.  The outpatient building was completed through the donations given by the Nigerian Government and the Cabot (ELLA LAYMAN) Trust Inc., Boston.  The basic hospital equipments were donated by the then West German government.  Seven other foundations from the United States donated various equipments to us.  The Nigerian Tobacco Company bought and equipped the hospital with different types of diagnostic equipment including a modern anaesthetic machine.  The Canadian Government sent a technician who supervised this department.  The foreign office of Her Majesty’s Government in Britain donated to the hospital a large blood bank.  The Shell Company in Nigeria visited the hospital between 1964 and 1965 and thereafter promised to build and equip the x-ray department.   This promise could not be fulfilled due to the onset of the Civil War in 1966.


Prior to the Nigerian civil war, the hospital gave orientation training to the first two U.S. doctors who took care of Peace Corps Volunteers in Nigeria.  Any sick Peace Corp volunteers were admitted and treated at the Medical Centre.  I was invited to the State Department in Washington to give my advice on the medical care of the Peace Corps Volunteers before they were sent to Nigeria.  We trained two Peace Corp doctors that took care of the health problems of the Volunteers.


Prior to the Nigerian civil war, groups of American doctors and nurses volunteered and worked in the Medical Centre during the summers.  Many American doctors worked at the hospital -- often for two years.  One of them Dr. Terence James Hadley, now at Louisville, KY, still keeps in touch with us.  The first dentists and first radiologist that worked with us were American citizens.  Many Phillipino and Indian doctors have also worked at the hospital.  They all gave very dedicated and committed service.  Unfortunately now that the Nigerian currency has been drastically devalued, very few Nigerian institutions can afford to hire foreign professionals.


On May 11, 1965, the Certificate of Incorporation under the Land (Perpetual Succession) Act Cap 98 was given to the hospital.  The registered Board of Trustees were:


a)  The late Dr. Samuel Onwu, Chief Medical Director of Eastern Nigeria

b)  The late Dr. Kenneth Dike, Vice Chancelor, University of Ibadan

c)  Mr. William Gordon, USIS, Enugu, Nigeria

d)  James Chukwura Okeke, Businessman

e)  Nlogha E. Okeke, MD, Medical Director, Eastern Nigeria Medical Centre

f)   Mrs. Ifeoma Okeke, Matron, Eastern Nigeria Medical Centre

g)  The late Mr. Godwin Onyemelukwe, Manager, Eastern Nigeria Medical Centre


The main aim and objective of the Medical Centre as is stated in the Certificate of Incorporation is to “provide for all manner of people a non-profit voluntary hospital to be established and managed at Enugu and known as ‘Eastern Nigeria Medical Centre.’”  The administration of the hospital has kept this policy up till today.


In 1966, the Civil War started in Nigeria and ended in 1970.  At the end of the Nigeria civil war, the then Military Government forcibly occupied the hospital until 1976 when the then Head of State, General Obasanjo, returned the hospital to us.  He believed that the hospital was rendering valuable service in its private capacity.  The hospital buildings were left in a dilapidated state and all the equipment unaccounted for by the Government when the hospital was handed over to the Board of Eastern Nigeria Medical Centre.  With the little compensation paid by the State Government, we started to rehabilitate the structures in the hospital.  The cost of rehabilitating the hospital was more than the cost of building it.  Again the Nigerian-American Hospital Foundation played a major role in the reequipping of the hospital.  The Presiding Bishop’s Fund for World Relief, the Episcopal Church, New York donated to us a blood bank (which is still in use) and later, a portable ultrasound machine.  Chief J.D. Okeke, a Trustee donated all the equipment in the Eye Clinic.


Up to 1985, there were twelve foreign doctors and six Nigerian doctors working in the hospital.  When the economy of Nigeria went sour in 1985, we lost all the foreign doctors and most of the foreign specialists in different departments of the hospital.


It is important to note the Medical Centre was the first private hospital in Nigeria approved by the Nigerian Medical and Dental Council to train interns.  We still train two each year.




When the hospital was returned to our control in 1976, we started a nondenominational Christian fellowship programme.  All the staff of the hospital and ambulatory admitted patients attend the fellowship programme every morning.  All admitted nonambulatory patients are visited for fellowship at the bedside by representatives of the fellowship programme.  Some patients and their relatives have publicly accepted Jesus Christ right here in the hospital.  Some have attributed their recovery to prayers of intercession received here.  This is one of the most encouraging programmes in the hospital.  Many hospitals presently are starved for patients because of the poor economy, but we still get patients from villages and towns.  We thank God.  This is all due to God’s support of the hospital.




Following the opening of this hospital to the public in 1963, we paid attention to having a well- equipped medical library to serve the needs of doctors and professional staff.  We subscribed to forty different medical journals and subscribed to pediatric, surgical, medical, and obstetrics-gynecological cassettes yearly.  Once a year, we organised seminars in which we chose specialists from all parts of Nigeria to present papers at the seminar.  We underwrote their traveling and hotel expenses in Enugu.  This we did to encourage participation.  The first seminar on carcinoma in West Africans was held in this hospital.  During the civil war, we lost all the papers on the seminars held here. 


Due to the downturn in the Nigerian economy, we cannot now afford the money to subscribe to medical journals and cassettes.  Of course we stopped the sponsorship of seminars very long ago due to cost constraints.  One of the deficiencies in medical education and training of doctors in Nigeria is the updating of their medical knowledge.


The Departments of the Hospital


a.  Male ward for medical and surgical cases.

b.  Female ward for medical and surgical cases.

c.  Pediatric ward.

d.  Maternity ward.

e.  Outpatient and emergency departments

f.   X-ray department

g.  Laboratory department

h.  Dental department

i.   Eye department

j.   Pharmacy department

k.  The kitchen - serves all admitted patients

l.   Ultrasonography department

m.  Cold body mortuary and embalming department


As early as 1989, we started HIV screening of all blood donors as well as patients.  The high cost of buying the lab reagents has not changed our policy.  But we are very much limited by funds in the volume of work done in this area.  General HIV screening service is hampered because of the high cost of the tests.  The service should be subsidized through making kits affordable and available.


Today in Nigeria, over 80% of patients seen in hospitals cannot pay any amounts however small for their medical treatment.  Many of them cannot boast of having three meals daily.  Many hospitals cannot replace any of the worn out equipment due to the poor economy.  The unemployment rate has been increasing making the situation worse.  The Government, including the Federal Government find it difficult to financially support public hospitals, let alone private ones.


There is no hospital in Nigeria including teaching hospitals that has a mammographic x-ray machine, yet breast cancer is steadily on the rise and unfortunately, not detected until after it has started to spread in the patient.  Other cases of cancers of different organs are also on the rise.  In the seven Eastern states in Nigeria wih a population of 20 million people, we do not have a C.T. scanner to confirm the diagnosis and follow patients’ progress during treatment.  There is only one hospital, in Lagos, that has an x-ray therapy unit.  It is unthinkable but a fact, that there is only one neurosurgeon in our own area of the country.  The ratio of medical consultants to the population is about 20,000 patients to one consultant.


With such dire conditions facing the medical practice in Nigeria, the Eastern Nigeria Medical Centre is fervently looking for existing foundation(s) to adopt our hospital.  The former Nigerian - American Foundation is no longer functioning.  This makes it difficult for any foundation in the Untied States to donate any equipment or monies to us.  We need such an adoption in order for the Medical Centre to continue to play a philanthropic role in Nigeria.


Today, we want the Eastern Nigeria Medical Centre to become primarily a diagnostic centre rather than a treatment centre in Enugu.  We urgently need the following equipment:


1.  C.T. scanner x-ray equipment.

2.  A radiotherapy unit

3.  An x-ray mammographic unit

4.  Diagnostic x-ray machine.

5.  Various laboratory equipment including:

            a)  Prostate specific antigen testing equipment and reagents.

            b)  EKG machine.

            c)  Spectrophotometer with U/V light source.

            d)  Machines for determining blood chemistries

6.  Laser ophthalmology equipment to treat cataracts and glaucoma.


And just as importantly, we need American doctors to volunteer to work with us in Nigeria.  It is now difficult to get specialists in Nigeria.


Distinguished ladies and gentlemen, we depend on you to get any of the existing Foundations in the United States to adopt the Eastern Nigeria Medical Centre.  This will make it possible to obtain funds and buy equipment for the hospital; and underwrite the travel expenses for American doctors wishing to volunteer their services.  We need your help so as to extend the basic medical facilities to Nigerians.  It is not an easy task, but we shall overcome and achieve the goals of Eastern Nigeria Medical Centre.  It is a hospital that has great ideas, a hospital that has had a good start, a hospital that was nearly completely grounded by circumstances, a hospital that is now inviting you to help resuscitate it.  I hope each and every one of you here will take up the challenge by submitting ideas, and giving moral and financial support.  And lastly but not least, by upholding it in your prayers.


I sincerely thank Reverend and Mrs. Crowley whom we first met when I was practising in New Bedford, Massachusetts in the mid 1970’s.  They have been the pillars supporting this bold initiative.  I decided to take a wild shot by writing to Reverend Crowley about our problems.  See what is resulting from that initial impulse.  May God direct it to hit home.  We cannot thank them enough.  Reverend Crowley was the vicar of my church--Saint Martin’s in New Bedford.  May God Almighty reward you and your charming wife Suki.


Our beloved professor Edmund Ilogu has joined the band wagon.  He knows first hand the problems that we have in Nigeria.  He was the vicar of my church in Nigeria--All Saint’s Church, Enugu for many years.  He is also a good friend of the family.  We are lucky that he has shown so much interest since we told him of our search for sources of support for the Medical Centre.


Ladies and Gentlemen, the ball is now in your court.  Thank you for patiently hearing me out.  May I introduce my wife Ifeoma who is a nurse trained in both England and the United States.  We will be happy to entertain any questions that you might wish to ask.


Nlogha Enwelum Okeke, MD FACS 




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