Professor Ayodele Falase is the former vice chancellor, University of Ibadan. The foremost cardiologist who recently turned 70 in this interview with ADEOLA BALOGUN shares his life experiences
Even though you have formally left office as vice-chancellor, have you retired in the real sense of it?
Not in the real sense of it. You know I am an academic; I rose from being a lecturer to become a professor. I was also an administrator when I was in the university; I rose from being a head of department to a sub dean, dean, provost of the college of medicine and then the vice-chancellor. I have retired from all those ones but I have not retired from being a professor because I still do academic works like research, even teaching because many of my younger doctors still come to me and I guide them. That is what is called mentoring. For an academic, that is your real forte. The third aspect is clinical as you can see, I still see patients as a cardiologist. So if you say I have retired, yes, as an administrator. That is the only aspect but as for academics, I am still active. I have just completed the review of a book, A Compendium of Clinical Medicine, which we wrote as the standard text book for all the doctors trained in this part of the world.
How busy is a cardiologist here in Nigeria?
We are busy. The commonest problem of Nigerians in terms of heart disease is hypertension. We have evidence that the prevalence of hypertension has increased more than 100 per cent compared with the situation about 30, 40 years ago. The prevalence has increased phenomenally and it is causing a lot of heart problems in addition to things like strokes, kidney failure and so on. There were some heart diseases common 30 years ago which have almost disappeared as a result of an improved standard of living among Nigerians. But there is another heart disease that has started rearing its head here. They are prevalent in Europe, America, India and the Middle East. These are known as heart attacks. These are caused by blockage of pipes which carry blood to the heart. You might say it is an irony. The heart itself is a pump but it uses some of the blood for itself and if that pipe is blocked, the area that it supplies dies off and that is what is called heart attack. It is very common in Europe and America; in fact, it is the commonest cause of sudden death. It is now coming up in Nigeria where you hear of people slumping suddenly and dying. If you look at the factors, we are replacing heart disease of poverty of those days with heart disease of affluence. And that heart attack of affluence is being led by hypertension.
How?
In those days, we were eating our normal foods like eba, pounded yam, rice, pap and things like that. Those ones don’t contain fats. But now, the diets have changed; people now eat eggs, butter, margarine, cheese and full cream milk. Those days, Yoruba referred to anybody drinking milk as a baby. We never had something called cancer of the colon, it was very rare. But we now have it with us; people are able to afford eggs, full cream milk and butter and so on and they don’t exercise anymore. People are getting fatter; the cholesterol level is increasing and we now get what is called cholesterol trouble where arteries are blocked and people are slumping and dying suddenly. That is the area we are getting into; we are jettisoning our native food and embracing the foreign diet.
But some people believe that hypertension is caused by excessive intake of salt.
This is where academics come in. It has been the belief of many that it is caused by salt but some of us have not agreed with that. In the normal instance, if we eat salt (because every organ of the body needs salt), it is regulated by some hormones and the kidneys. If there is a problem with the hormones and the excess salt cannot be excreted, that will cause high blood pressure but that is very rare. If you now say adding salt to food is causing high blood pressure, I will qualify that by saying unless your kidneys are bad but it is a rare thing for that to happen. Some of us started looking for other causes and what research has discovered among Nigerians is that in those who are hypertensive, one of the stress hormones is being produced in excess. These are hormones that react to stress. What we are conjecturing is that if this stress hormone is being produced regularly everyday, you get into a chronic stage which will then develop into hypertension. We also have evidence of it from ordinary way of life. For instance, somebody was working in a bank. He was given a target and was running around the whole place to keep his job. He would not close on time, he lived in Lagos and his blood pressure was up and we found it difficult to control. Then one day, his blood pressure went down and we asked him what happened and he said he had left that job. You cannot say that is salt. As far as we are concerned, hypertension is being induced by the stress of modern day living.
Why did you choose cardiology when you could go for another aspect of medicine?
When I finished, I went to Britain for my post-graduate studies. In those days, we didn’t have any medical post graduate school in Nigeria and we all had to go to Britain to train as physicians. In Britain then, they regarded us as being primitive, coming from African medical schools and as far as they were concerned, we were not well trained. But when I got there, I blended with the medical practice and obtained my postgraduate at the first shot at it which shocked them. It looked strange to them that a young man coming from Africa could achieve the feat on record time. It was good for the University of Ibadan, Nigeria, Africa and black people at that time. They didn’t know then that there were very brilliant people from Africa. To be appointed a lecturer at the University of Ibadan at that time, you needed a specialty area and I went for cardiology.
Did you choose it because heart disease was prevalent then?
It was an exciting area of medicine for me. It is an area that demands calmness in the face of crisis and it is also an area where you can see the result. Most of us work in what is called coronary care unit. Don’t forget that heart attack is also known as coronary heart disease; the artery that carries blood to the heart is known as coronary artery and it is when it is blocked that you have coronary heart disease. Lay people call it heart attack. When somebody’s heart stops, it is your job as a cardiologist to restart the heart and it takes a lot of expertise to do that. I thought it was exciting in those days and that was why I chose it.
So it is possible to help somebody who suffers cardiac arrest?
Oh yes; in fact in Britain in those days, if you collapsed in the street, within a minute, there would be an ambulance that would pick you up. An ambulance in Britain or America is a mobile hospital. They would start treatment immediately; they would stabilise you while you are on the ground and then put you in the ambulance and then connect you with the gadgets, they would be treating you and at the same time relaying message to the hospital where you were being taken to. Those in the hospital knew what was happening and they might even advise. By the time the patient gets there, they take over. It was exciting in Britain in those days but we don’t have such things in Nigeria. We don’t even have ambulance service in Nigeria. An ambulance service should be organised by the local government but we don’t have it. And we need it urgently now for two reasons; we are having many people slumping nowadays and there is no way they can survive in Nigeria and if they survive, they will survive without any interference because the way we treat people who slump or who have an accident is horrendous. Some people just double them up and carry them and dump them in a taxi and rush them to hospital and by the time they get to the hospital, they are gone. We need a properly organised ambulance service for us to survive in Nigeria. You know some prominent people slumped of late and they died. They needed not to have died if we had well equipped ambulance service and hospitals. But in Britain or America, immediately you slump, people dial 911 and in a minute, the ambulance is there. In fact, if you don’t call 911, you can be sanctioned. You heard about a certain nurse who was a Nigerian and she had an emergency case on her hand and instead of doing the needful, she started praying and she was sanctioned.
Why didn’t you stay back after your training?
By that time, I was offered a job but I elected to come back. You see, one makes more impact when you are within your people and you let the world know about the disease condition of your people rather than being in an environment which is saturated. And all what you are doing is competition. Secondly, I prefer staying in Nigeria because of the environment; the only problem is mismanagement not natural disasters that are common over there.
How was Igbobi College when you were there?
Igbobi College was one of the topmost schools at that time but it has gone down after government took it over. For a young boy who was resident in a small town of Ikenne and a son of a priest, getting to such an expensive school at that time was the grace of God. For someone resident in a village to mix up with those who lived in a place like Lagos and blend was no mean feat. I first attended Remo Secondary School before my father utilised the offer by the church for his son to be admitted at Igbobi at a discount. For me to be there was God because if I had competed, I probably would not have been able to make it. I didn’t even know that such a school existed in the first place. Attending Igbobi helped and shaped my life because when I got to the school, I saw that everything was focussed on academics and morals. That is why their motto is ‘Every Igbobian is a gentleman’ and it is true. The way we were brought up, you can’t but leave the place being a gentleman. Take Bolaji Akinyemi for instance, you could see that his behaviour is different. He was my senior and that is how we were all brought up. Academics was emphasised, relaxation was emphasised, good behaviour was emphasised.
At Igbobi, was it just books, books, books for you?
Well, in fact you needed to look at how the whole place was configured. You had your classes and immediately in the afternoon, they allowed you to go and rest. We had what is called siesta and everyone cooled down. We had what is called prep for about an hour or so after which you were told to go to the field to play. You were on the field for different kinds of sports for about three hours or so. If you were caught reading then, it was a punishable offence. In the evening, there would be another prep and they allowed you to go to bed at about 8pm or so. It wasn’t stressful; they allowed you to have recreation. Things like being honest, being punctual and truthful were drummed into our ears throughout. So all these stay with you coming out of such school. Let me tell you a story, I was walking with some of my colleagues one day and they started crossing the lawn, I couldn’t do that. I went round until I found a place to pass because one of the things they taught you at Igbobi is that you don’t cross the lawn or see a litter on the ground and not pick it. All these were ingrained in us and they are still with us till now.
How was UI when you were admitted?
Let me situate it this way; I first of all wanted to go to Britain because most people were going but I knew there was no way my father could raise the money. So I took entrance examination to two medical schools, University of Lagos and UI. Unilag medical school was just coming up at that time and we were to be the second set. So, they offered you scholarship if you were taken and when I finished my HSC, I was taken by both schools. As young people, we decided to go and look at what the place looked like to be able to decide which place to choose. Unilag was good, well laid out area, we then travelled to Ibadan and immediately we entered UI, you would not believe it, all of us said no, this is the place. It was beautifully laid out, peaceful and serene; a proper academic environment. So you could see what UI was at that time and it is a pity we allowed it to degenerate.
What would you say you enjoyed at that time?
Well, we paid for our tuition, feeding and hostel accommodation. Everything was embodied in our fee but fortunately for me, I had a Federal Government scholarship based on my performance at the HSC level. In fact, I think I was number two in the entire federation when they computed my result. So, I was a Federal Government scholar. Then, they would send the money directly to the bursary and by the time they removed the fee, you were given the balance and that was how I went through UI but it was an excellent university. At that time medical students hardly had time for any other thing although I was a member of the school relay team that won laurels for the university. But one could not do too much of sports because of the rigours of academic works and that really helped us and that is why those of us who went for post-graduate studies abroad excelled. And that is why when we finished, most of us came back.
When you finished your studies, why didn’t you think of setting up a hospital?
That was an option; for one to really make money to be rich but one would have been academically dead if I did rather than go to area where you can do research and teach and rise to the top of your profession. So, I chose the latter and I have never regretted anything.
Was it a dream for you to be a VC of a university?
Well, if you become a professor within the university, everybody dreams of becoming VC but as you know, there is only one VC for five years and you have to weigh your chances. It takes the grace of God to get there because there are so many professors who are even better than you that didn’t get to that pinnacle of administration. Again, I thank God for making me the leader of the university and helping me to make a difference.
Having the opportunity of becoming the VC of UI where you trained, what was on your mind to do as VC?
You had nothing more on your mind other than to go in there and restore the lost glory, nothing more. You may think that the university was not like this when you were there, but whatever becomes of the university impacts on your certificate. If you carry your certificate to Britain now, they will judge you by what obtains at your alma mater at present; it is normal. So, my aim was to restore the university to what it was and I thank God I succeeded in doing that and I equally thank God that the person who came after me, Prof. Bamiro pushed the whole thing forward and today we now have a university we are all proud of.
But those who were there before you were professors too.
Of course they tried their best but don’t forget that they were working under military regime; I was lucky that I worked under a civilian regime and there are differences between them. There are certain things you can push under a civilian government but cannot do under the military. I couldn’t blame them because an academic community is a complex mix where one needs grace of God and goodwill to succeed. There are so many groups such as students, academic, non academic, technical and so on and one has to work and balance all areas because any of the groups can bring the entire system to a halt anytime.
Is it not possible to run a federal university like UI and charge fees to run it successfully?
Let me put it this way, the country itself has to decide what model to use in running its universities; there is no free lunch anywhere. If anybody comes in and says everything is free, somebody is paying for it. Or if somebody says everybody must pay, yes, those he is talking to are paying. It’s no use saying oh, it is free, it is not. Somebody is paying. Let us now look at the problems. There are two extreme models in the world. In America, you pay your fees in full and if you don’t pay, you can’t have your education. In Europe and Britain, there is partial free education where they give grants to their citizens to study in the university and the other model is where everything is free which is common in third world. Nigeria has to sit down and decide what it wants. In those days when we were there, we paid our fees and for everybody to be able to pay, we were given scholarships of many forms. What we have now is that there is no system at all. Government says don’t charge tuition which is what is used to run the various departments and if you put a stop to that, there is problem and that is why we now have dilapidated structures all over the place. And we warned government that that was not a good idea. But if you compare the universities in Europe and America with the ones here, there is a difference. Universities over there and even in South Africa are autonomous where they have freedom to set salaries, to bring in anybody they want and to charge fees. It is the business of governments to send their citizens to go and study in such universities by way of sponsorship. And some of us have said that government should allow each university to be autonomous while it can set aside a lump sum and use the proceeds to offer its citizens scholarships. Then, you have excellent universities and people will be assisted to go to universities. But our universities are riddled with strikes. To me, Nigerian university system suffers strike for six months because the universities are not being run by the governing councils. Governing councils are the most crucial in running any university because all members of staff are employed by the council. But nowadays, governing councils are populated by those who have no business being appointed at all. They are those who got compensated for maybe the money they spent in the process of electing those in power; you cannot run a university successfully like that. But if you set up a governing council with professionals, you get a quality university. That is one problem with us.
So the various governing councils are just there.
Of course, yes. They cannot set salaries and if a governing council cannot set my salary, what is the use of that governing council to me? Rightly, the unions just ignore the councils and the management and face government. If you go to government, it tells you it has no money but if you paralyse the system, then you get the attention of government. That is what is happening right now. And some of us are saying that it is unsustainable. If you want a permanent solution, the university system must be autonomous; the governing council must be professional and run the university professionally and the external members of the council must be in the majority. Presently, internal members of the governing councils are in the majority and these are the anomalies of the time and some of us are saying that you must correct this and leave the university alone so that they can run excellently and people can come and train in such university. But then, government should assist those coming because most people are poor. As a VC of a university in Nigeria I don’t have to spend the university allocation on water, electricity supply and if I cannot do all those things, I get riots on my hand and the whole place is turned upside down. But in Europe and America, infrastructure is taken for granted. Most of the money paid to the universities, supplying water and electricity. If all these are taken care of by government, the amount of fees charged will be minimal and we are capable of doing all these. That is why we are advocating that government should not start a university where there is no infrastructure. When quality people were in governing councils of universities, we had excellent universities. There is peace now, at least money has been thrown at people but in a year or two, the same problem will come back.
During your tenure, did you have any serious crisis on your hand?
Yes we had but 97 per cent of it was caused by government. Most of the problems we had was due to government/union battles. But we had other battles; we reformed the university and when you reform, certain vested interests are bound to resist change. When I got there, I didn’t want anything that had to do with the students union but we were sucked into it and it was difficult to get out of it. But we are grateful we were able to handle it without any bloodshed. It is a cycle; you are asking for salary increase, you cannot talk to your employer (the council) because it doesn’t have the power. If you talk to government that has the power, it doesn’t want to listen to you, you paralyse the system for it to listen to you. That is why we are advocating that universities should not be established without adequate infrastructure in place and without arrangement being made to pay lecturers adequately. Once you do those two, you only need a smaller amount to run the school. If the National Assembly can help us to enact a law that any university without adequate provision for the two should be closed down, you will see changes. If all universities are autonomous and allowed to compete, many universities would excel.
Can a university like UI be autonomous by charging minimal fees?
There are other things universities do to raise money; take for example distance learning. There is a problem of access in the sense that the existing universities cannot accommodate all those who are qualified. Many prominent people in Nigeria studied through correspondence. That is just one aspect. Research grants are there and other ways of raising money to make the university run effectively.
When you wanted to get married, were you looking for an academic?
No, my wife was not an academic when we married; she was an NCE graduate. She later on attended university and obtained a first class in guidance and counselling. She did her Master’s degree and her PhD. Even though she was a school principal, she later lectured in the university before she retired.
Do you have any of your children who is a doctor?
My children didn’t choose medicine; maybe they want more money.
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