The Oasis Reporters
September 29, 2018
Before an intending couple ties the knot in any Nigerian Pentecostal church, they are required to have gone through counselling, pregnancy tests, HIV tests, Blood group tests and genotype tests. Pastors are being careful to be more practical rather than being more prayerful, expecting miracles. Therefore an intending couple with each having an AS/AS, AS/SS or SS/SS genotype would be barred from getting married out of the fear that their offspring might be Sickle cell anemic children, difficult to manage and which may cause real crises in new families.
An unusual Nosakhare Bazuaye passed out of the University of Benin Teaching Hospital clutching an MBBS (Bachelor of Surgery and Bachelor of Medicine) in 1993. Dr. Bazuaye Godwin Nosakhare did not know he would be heading back to the school to help groom other doctors. He also had no inkling that 17 years down the line, he would lead a team to put the institution on the global medical map, enabling the University of Benin Teaching Hospital, UBTH make history with stem cell transplant.
University of Benin Teaching Hospital, UBTH, successfully pioneered stem cell transplantation surgery in the country and West Africa.
The successful cell transplant surgery was conducted by doctors in the hospital on a seven-year-old sickle cell anaemia patient.
Led by Dr. Nosakhare Bazuaye, the 18-man team successfully carried out the surgery on the male patient who had suffered a stroke, making the team, some kind of miracle workers by curing a patient of sickle cell.
Prof Bazuaye became a legend, because sickle cell was hitherto regarded as an illness that drained the purse of patients who regularly lapsed into bouts of illnesses whenever there was even as little as a change in weather temperature. And the professor offers proven cure.
The journey started on a long flight to Switzerland in 2009, four members of staff of the University of Benin Teaching Hospital, comprising two nurses, one staff in the haematology department, and the journey to history began for Bazuaye. At Basel, in Switzerland, they had an intensive one-year training in stem cell transplant, a relatively new branch of medicine that provides total cure for sickle cell patients, leukemia and other blood-related disorders.
When their trainers certified them fit, Dr. Bazuaye, Mrs. Imafidon Rose (pediatric nurse) Mrs. Ogunlere Beatrice (adult nurse) and Mr. Eguae Osaretin of the haematology unit returned to Benin to begin a process that makes the hospital wave the flag as a pioneer in bone marrow transplant in West Africa.
“I can tell you that we have successfully carried out bone narrow transplant here (in Benin) and the patient is alive and well. The World Health Organisation recognises it and verification teams from the Ministry of Science and Technology and Ministry of Health were here. Even the minister was here. We are not in any controversy. If anyone says he has done any such transplant, it will be nice to see the patient and see how well the patient is doing,” he says, preferring to discuss the job.
Ndik Matthew was five when his distraught parents brought him to University of Benin Teaching Hospital. He was a sickle cell patient who regularly fell ill. He was ‘problematic’ as described by the team that did the bone marrow transplant on him. He reportedly could not stand on account of stroke and paralysis. He was the shadow of a healthy boy when he was brought to the University of Benin Teaching Hospital.
Changing from SS to AA
Shortly after the trainees returned from Switzerland, Ndik became their first test.
‘It was a tough and rigorous process’ said Eguae Osaretin of the hematology department who carried out countless blood tests on the patient and his elder brother whose blood came to his younger brother’s rescue. The donor was admitted for weeks so that his blood can be certified fit for his brother through radiotherapy.
The process took the hematologist to Lagos endlessly given that the equipment in UBTH had not been certified at that time. But now it is. That will further simplify the process should the hospital undertake another transplant. After series of verification and a close watch that saw Dr Godwin Bazuaye living in the hospital premises for weeks, the bone marrow transplant tool place on September 28, 2011 and Ndik became free from sickle cell.
Dr. Nosakhare and his team were lent a hand by one of their trainers in Switzerland. The highly technical process simply meant that ailing Ndik’s blood was drained and replaced with that of his brother whose blood had no trace of sickle cell anemia. It is a rigorous process. Contaminated air must not slip into the patient and there must be 24-hour electricity supply, which made UBTH provide stand by power and inverter. There was no power outage, a tall order in Nigeria. But for Ndik to escape from the strangle hold of sickle cell the near impossible was done.
On completion of the transplant, things began to take a turn for the better. Twelve days down the line dramatic changes occurred in Matthew’s system. The change process had commenced. His blood began to change. The SS blood group was disappearing and the AA was taking root. Expectations were that after one hundred days the injected blood would have been fully engrafted.
‘In a successful bone marrow transplant such as we did here, it is expected that in one hundred days the new blood must have been fully engrafted into the patient. That is why the search for blood donor begins from a member of the immediate family. If non is found from the family then we look out. Ndik’s elder brother came to his rescue. I believe that must have helped matters because his rate of recovery was outstanding ‘ said the Hematologist.
Six months after the hospital re – presented Ndik to the public. He had virtually transformed. There was no stroke or paralysis. He had begun to walk around. His elder brother had come to his rescue. As the saying goes blood proved thicker than water. Ndik’s cure had a family touch. The family is better for it. They have their son back. He has become a far cry from the sickly five- year old, struck with paralysis.
A Nigerian newspaper, Daily Sun findings showed that bone marrow or stem cell transplant is racing ahead with fresh discoveries. These days transplants can be done without a donor. An enquiry at the Moyo clinic in the United States of America with outposts in Florida, Arizona and Minnesota showed that the patient could be his donor. The hospital wrote thus:
’A bone marrow transplant or stem cell transplant, also known as a blood and marrow stem cell transplant, is a procedure that infuses healthy cells, called stem cells, into your body after you receive a course of chemotherapy with or without radiation therapy.
Your doctor may recommend a bone marrow transplant or stem cell transplant if you have a certain type of cancer, such as leukemia, or a type of blood (hematological) disease, such as sickle cell anemia. The transplant may be performed using cells from your own body (autologous transplant) or from donors (allogeneic transplant).
The system to use is contingent on the disease and the diagnosis. The heart-wrenching situation is that University of Benin Teaching Hospital is stuck. It cannot proceed with more patients in spite of an avalanche of requests. There are no back up equipment. Dr Nosakhare Godwin Bazuaye confirms that the then Chief Medical Director had tabled requests to relevant authorities in the health sector to help procure those equipment to enable more Nigerians benefit from the institution. Nosakhare has extended his call to corporate bodies to bridge the yawning gap between Nigerians and bone marrow transplant.
The Chief Medical Director of the University of Benin Teaching Hospital (UBTH), Prof. Michael Ibadin, said a 7-year old sickle cell anemia patient who had suffered stroke was the first beneficiary of the transplant after he got a match from his 14-year old brother. This was in 2011.
“At the beginning, it was a daunting challenge because most people felt it was unassailable but the minister was convinced that we can do something when he visited last time. Here, we are looking at the beneficiary, we cannot count the cost because there is no way the patient can pay,” he said.
Ibadin said the treatment would cost between N2.5 million and N5 million for a patient, but the hospital would have to be very selective in its choice of patients to reduce expected pressure and work towards acquiring more equipment for the transplant.
“The day we started, the drugs that were given to this child cost N2.1 million. It is not something you do on emergency; it is something you have to plan for. The hospital will be willing within the limits of its resources to subsidise the cost of the transplant,” he said.
“The practice of stem cell transplantation, no doubt, is capital intensive and rested on hi-tech equipment. Investment in this regard would go into billions of naira. Just for a take-off, we are starting on a small scale and have acquired only basic equipment to commence the programme,” he added.
When The Oasis Reporters called at the University of Benin Teaching Hospital at Ugbowo in Benin City in the course of preparing this report, it was discovered that Professor Nosakhare Bazuaye had traveled out of the country on sabbatical leave. Meanwhile due to funding issues, as well as infrastructural issues like electricity availability, stem cell or bone marrow transplants have been suspended in the Teaching Hospital, but rich countries abroad keep inviting Professor Bazuaye outside for one thing or the other.
It will be recalled that in the mid nineties, Brig. Gen. (Dr.) Ovedhe a graduate from the same University of Benin Teaching Hospital invented an automatic blood purification and giving set that reduces the need for blood donations to patients since patients losing blood can have same collected, purified and re-injected into the same body. Rejections would drastically reduce.
Nigeria is the third in Africa, after Egypt and South Africa, to perform bone marrow transplants.
Information from UBTH