How pharmacists fought medical directors for professional recognition – Onwudike
Pharm. Nwakaku Onwudike is a former chairman of the Pharmaceutical Society of Nigeria, Imo State, and team leader of PCN inspectorate team to drug manufacturing companies in the southeast zone.
In this interview with Adebayo Folorunsho-Francis, the senior citizen relives how she pioneered the struggle for pharmacists in tertiary health institutions to rise to the peak of their career as directors . She also reveals why she feels there should be a dress code for pharmacists in different sectors of practice. Excerpts:Tell us about your early days, family and education
I am the fourth child in a family of 10 children. Before the civil war started on 6 July 1967, I was in Upper 6th form at Archdeacon Crowther Memorial Grammar School (ACMGS), Elelenwo, Port Harcourt, Rivers State. I had my secondary education at Union Secondary School, Ibiaku in Akwa Ibom State and got my B. Pharm. degree from the University of Benin (1970–1975). Thereafter, I obtained M.Sc. in Pharmaceutics from the Obafemi Awolowo University (OAU), Ile-Ife in May 1979.
What about your work experience?
I worked briefly with the Food Directorate Headquarters, Umuahia (1968- April 1969) as a clerical staff and equally worked as accounts clerk, Bank of Biafra (June 1969 – December 1969).
I had my pharmacy internship at OAU Faculty of Pharmacy as research assistant in Drug Research Unit. In July 1977, I became graduate assistant and, later (in May 1979), assistant lecturer in the same faculty. I later moved to OAU Health Services Department as senior pharmacist.
I was, on different occasions, the principal pharmacist, assistant chief pharmacist, chief pharmacist, deputy director pharmaceutical services and director of pharmaceutical services in OAU, before my official retirement on 6 July, 2008.
Four months after I retired from the civil service (that is November 2008), I established THELIA Pharmacy Limited in Owerri.
Was your decision to study Pharmacy personal or circumstantial?
Yes, it was circumstantial because I was admitted initially into the Midwest Institute of Technology. However I later changed to the University of Benin (UNIBEN) to study Medicine. Unfortunately, there was no facility for the Pre-clinicals; and as there was opportunity for only 20 students to go to Ahmadu Bello University, Zaria, some of us who qualified were dropped.
Looking back, would you say studying Pharmacy was a good decision?
Yes, I believe so.
While studying for your degrees in Pharmacy, were there some memorable intrigues or controversies?
I really cannot think of any intrigues during the course of my obtaining degrees in Pharmacy, especially the first degree, because we were the pioneer students of the university. We were treated very well, or rather, pampered, as we were only 14 students admitted to study Pharmacy in the University of Benin.
How would you compare pharmacy practice today with your day?
I feel there is a lot of difference. Pharmacy practice in my day was faced with the challenge of physical space. We used to operate from a small hole in hospital setups and clinics. However, there has been a lot of improvement on the appropriation of adequate space in some establishments, although a lot more still needs to be done to improve our work environment.
Also, in my day, medical directors hardly allowed pharmacists to practise the way they should, without a ‘fight’ from the pharmacists. That was what happened during my years of service both at Obafemi Awolowo University, Ife, and FUTO Health Services – for the purchase, storage and dispensing of drugs, or inappropriate prescribing by doctors.
For instance, the medical directors would sometimes want to dictate what type of drugs and other medicinal products pharmacists procured and where they procured them. In a worst case scenario, some might even attempt to buy the drugs themselves with or without the Drug Formulary, which professionally had been produced by the Drug Formulary Committee to be employed for such purchases in the hospitals or health centres. This is because the doctors were considered as the ‘be all and know all’ in matters concerning health – even with drugs, which is the main thrust of pharmacists’ education and knowledge.
This has changed greatly in present day practice, even though there is still much to be achieved. There will be a great deal of improvement if each profession in the health sector is allowed to function adequately within its area of study, practice and professional ethics.
Furthermore, during our day, pharmacists had no input whatsoever in decisions taken in the establishments that affected the pharmacist in his or her promotions and the needs of the pharmacy unit. This is because, prior to the training of pharmacist, the first practitioners in the hospitals/clinics or health centres were drug dispensers who were trained on the job by doctors in the hospital. At least now, Pharmacy is a department of its own and therefore has a head of department who can speak for the pharmacists whenever decisions concerning them and the practice are to be taken.
In addition, pharmacists in our time were not employed at the highest level of entry in the Health Service; if employed at all, they were engaged at the lowest level where they would not be able to check or challenge the excesses of the doctor/ medical director who in Nigeria is the administrative head in any medical setup, unlike in most countries of the world. In fact, in some cases, rather than employing a pharmacist, a pharmacy assistant or pharmacy technician whose scope of studies only qualified him or her to dispense drugs was employed.
What do you consider as your major contribution to the pharmacy profession?
Pioneering the struggle for pharmacists in tertiary health institutions (using FUTO Health Centre as a case point) to rise to the peak of our career as directors in the university sector of the practice in April 2008 is what I consider as my epic contribution to the pharmacy profession.
As at that time, any graduate in any other profession got to the peak of the service except for the pharmacist. By God’s grace, this ‘struggle’ came into fruition, even though I only benefited from it for less than three months before I retired from service. I also saw to it that pharmacists who worked in the Polytechnics rose in their jobs, according to the “Career Structure for Pharmacists” where initially, the rectors of the institutions did not allow a pharmacist to be promoted above the level of Pharmacist 1 in such establishments.
My other contributions include being a member, Privileges Committee of PSN (2006 and 2009); member, Local Organising Committee and Finance Sub-Committee for the 79th PSN National Conference (2006); member, Accreditation Panel of PCN to Schools of Health Technology to Delta and Cross-Rivers States (2005); Member, Pharmacists Council Investigating Panel (2004-2008); Member and Secretary, Pharmaceutical Reconciliatory Committee on conflict between PSN and NAFDAC (2002); Member, Appointment and Promotions Committee, PCN (2000-2002).
It was during this period (2000-2002) that many of the pharmacists who are now deputy directors were employed into the Council.
In 2000, I was the team Leader PCN Inspectorate Team to Drug Manufacturing Companies in the South East Zone in Enugu, Anambra, Imo, Abia and Rivers States. And as the Imo State PSN Chairman (February 1999 to February 2005), we were able to improve the remunerations of pharmacists who were working for non-pharmacist directors in pharmacies to be better paid and not be intimidated or mistreated by their employers.
Do you have any awards or recognitions for your achievements in pharmacy practice?
Aside from being a Fellow of both the Pharmaceutical Society of Nigeria (FPSN) and the West African Postgraduate College of Pharmacists (FPCPharm), I have been honoured with the following awards: Merit Award for Noble Contributions and Service to the Profession of Pharmacy and to the Association of Lady Pharmacists ALPS (MAW, 2003); Distinguished Service Award of the Nigerian Association of Hospital and Administrative Pharmacists (2004); and the Valuable Service Award by the Pharmacists Council of Nigeria (2002).
What is your view about pharmacists in politics?
If the pharmacist going into politics has the interest of the profession at heart and not a personal interest or ulterior motive, I think it will be a noble cause, especially if he can cope with the intrigues in politics. This is because he or she will be a reliable ‘platform’ to ensure and enforce favourable professional decisions concerning pharmacists and our practice in general.
What do you think is the future of Pharmacy in Nigeria?
I think the future of Pharmacy is very bright, if only pharmacists would be proud of the profession and face the challenges and intrigues affecting the practice currently – especially with doctors, medical laboratory scientists and, worst still, patent medicine vendors posing and doing the jobs of pharmacists; as well as the establishment of departments for the training of so-called “pharmaceutical technologists” in some polytechnics.
If there are some things you can change about the pharmacy profession in Nigeria, what would they be?
First, there should be a body to oversee all the activities affecting the practice of the profession, apart from the regulatory role of the PCN. The body should be such that it can look immediately into external matters that affect the practice of the profession and report to the PCN. This is because I think the PCN is handicapped by lack of funds since it is a government agency.
Second is the establishment of a dress code for pharmacists in the different sectors of practice, as many still dress shabbily to their offices.
What is your advice to pharmacy students seeking to follow your footsteps?
They should have integrity, maintain the ethics of the profession, and not be focused on making money at all costs to the detriment of the profession and practice. They should be courageous and not be intimidated by any other professions in the health sector within any establishment where they are operating.