Ayanruoh

Ayanruoh And His Magical Hospital In A Box Machine

By SAMSON EZEA*

Many Nigerians do not know you or anything about . Can you tell us who you are and how you came about the machine?

Ayanruoh
Ayanruoh

I am from Jeddo in Okpe Local Government Area of Delta State. I was born in Okitipupa in Ondo State. I had my elementary education in Okitipupa, Lagos and Warri respectively, before going to Government College, Ughelli for my Secondary and Higher School Certificates.

When I was doing my HSC, I was confused about being a doctor or an engineer, even though my father of blessed memories always said I was going to be a doctor. I became infected by the chicken pox virus and I went to General Hospital in Warri. I was to be seen by this petite Japanese female doctor. As soon as she recognized the rash, she started screaming, “get out, get out, go to IDH”. I felt very humiliated and decided there and then to become a doctor.

I was admitted to study medicine at College of Medicine, University of Ibadan from where I graduated in 1984. I was posted to Ikwano – Umuahia Local Government Area for my National Youth Service.

After my service, I was employed by Aero Contractors as a medical officer at Warri airport. While there, I applied for a job at Nigerian National Petroleum Corporation (NNPC) as a medical officer. After the interview, I was informed by the personnel manager in Warri that I was the successful candidate and that my appointment letter would be coming from Lagos.  I am still waiting for the letter 27 years after.

A few weeks after the interview in 1989, a classmate of mine knocked on my door at about 8pm. I was surprised, though happy to see him in Warri since he was not from that part of the country. On further questioning, he told me he had come to resume at NNPC. I said I am waiting for my letter from Lagos. He said “so na you?” I replied, “wetin be na you?”

He replied: “They have removed your name and put my name because I claimed to come from Kano State”.

This was when I decided to leave Nigeria. When I arrived in the U.S, life was very tough for me. I sent pictures of my true situations in the U.S back home to Nigeria. I recall one incidence when my elder sister who was an accountant then in First Bank, Warri called after receiving my pictures. She was crying on the phone, saying nobody drove me from my country, and if I am suffering I should come back home. I remember telling her that she should not worry about me because I can see the light at the end of the tunnel.

After some hard work, I was able to pass the FMGEM now called USLME. I eventually got admitted to New York Medical College Lincoln Hospital where I did a residency in Pediatrics. During my training, I realized that healthcare delivery in the US is very different from what obtained back home in Nigeria. I started having some serious thought and I came to the conclusion that since all humans are equal before our Almighty God, then it is the right of every citizen of the world irrespective of colour, age, sex and social status to have access to basic comprehensive healthcare. I am very passionate about this and I will not stop until every person has this basic right.

What is Hospital In A Box?

Hospital In A Box is a machine that is big enough to change the world yet small enough to fit in a box. People get better health care with Hospital In A Box than from most hospitals built in developing countries. As for the fortunate ones in Nigeria who can afford to go to India, Europe, United States etc for their checkups, Hospital In A Box can do all the examinations that medical tourism provides.

The main advantages that Hospital In A Box has over those traditional hospitals in their current state are: It is cheaper than building the traditional hospitals as it is now. Most of those hospitals cost a lot of money and they are poorly equipped. The cost of one of these hospitals will buy several of Hospital In A Box that will better serve the people. The citizens will get the kind of checkups that the well to do travel out to get.

The hospital now goes to the patient especially in situations of bad roads, swamps etc. since the patient cannot go to the hospital. There are so many people cut from major cities and towns because of lack of roads that come in different forms and shapes. These people cannot go to the hospital in those big cities and towns. Now the hospital will go to them.

Only a small space is needed. In the traditional hospital you need separate rooms to perform each of the tests. With Hospital In A Box you need a minimum of two rooms, one being for taking care of the patient and the other for other patients to wait for their turn.  The machine is ideal tool for data collection. With the data collected using Hospital In A Box, one will be able to say, for example, “we had 1000 hypertensive patients in July from Abuja or in Delta State. We treated about five million cases of malaria in 2013 and over 60% was in those areas that had stagnant water”. This will help in formulating policies on how to reduce incidence.

It increases doctors’ productivity and performance. A doctor that is assigned to an area will make better diagnosis of his patients using Hospital In A Box.  Depending on the number of Hospital In A Box in his assigned area, his productivity will be multiplied by the number of the machine. His patients will have better care because his diagnosis will be more accurate.

It is life saving. Apatient panting when examined with Hospital In A Box can be diagnosed to have either a cardiac or pulmonary or endocrine disease. Making the right diagnosis on time can be life-saving. A tachycardic patient found out just by doing a pulse oximetry because the patient is tending towards shock, and prescribing giving liquids only can be life-saving. A patient found to be obstructed as in asthma, nebulizing him immediately can be a very huge life-saving function of Hospital In A Box. The life saving aspects of this awesome machine are numerous.

Its battery life – is about 12 – more than 24 hours depending on the usage.
Based on these advantages, I can categorically say that Hospital In A Box makes healthcare cheaper and easier to get. It is powered by rechargeable batteries. These batteries can be charged using electricity, a functioning cigarette lighter in a motor vehicle and solar energy.

Hospital In A Box which weighs approximately 26 pounds can perform the following examinations: Blood pressure to diagnose hypertension which is a silent killer. Pulse oximetry- measures the oxygen level in the blood Spirometry. This is a lung function test the result of which can be normal, restrictive or obstructed. In those patients that are obstructed as in asthmatics, Hospital In A Box has a nebulizer to relieve the obstruction. I have a story associated with the nebulizer.

My late uncle-in-law, Alhaji Garuba Abdullahi, formerly of Federal Housing Authority (FHA) died of an asthmatic attack in his village after the dusty road he travelled on triggered it. He took out his inhaler which unknown to him was empty. He eventually died. This was the motivation for the addition of the nebulizer which I believe will save so many lives.

Scomet performs four different functions. It can take pictures for electronic medical records. It can take temperature by the non-touch technique because of the recent Ebola scare. It can also be used to examine the ear and eyes and take their picture for before and after comparison. Electrocardiogram – examination of the heart.

What inspired you into inventing the machine and how far have you improved on it?

After my fellowship in Pediatric Emergency Medicine in 1998, I was employed by New York Hospital, Queens as a Pediatric Emergency Physician. On one winter night, I went to work. My shift used to be 7pm to 7am. On this day, there were about 40 kids waiting to be seen. In this ER at that time, only one nurse and a physician will cover the department. I thought to myself only if I had a machine that I can use to examine patients even in the hallway. I sat down for about 30 minutes thinking out how the machine will look like and what the contents will be. I put all these ideas down in writing and the next day I approached a patent lawyer who filed for the patent. After I had the patent, I called some of the reputable computer manufacturers like IBM, Compaq and a company in China. They all told me it was not possible. I then went to the Internet and asked ‘Professor Google’ for Prototype developers. I called as many companies as I could.

Two days later, a gentleman drove down from Connecticut to my office in Manhattan, New York. He could not come down because there was no parking space in the neighborhood where my office is located. He had to stay in his car in front of a Seventh Day Adventist church. We had the meeting in his car. He told me: “Before I can start anything, I need a $10,000.00 cheque from you”. I said to myself, even though I don’t know this man, I will give him the cheque because we are standing before God in that church. I went into my office, wrote out the cheque and gave it to him. We then signed a Non- Disclosure Agreement. I still remember the look on my wife’s face when I told her what I did earlier in the day.

Since the initial prototype in 2005, we have spent a lot of money in research and development. Those people who are familiar with Hospital In A Box or those who have been to our website will find the older version which weighs about 50 pounds. Some of our customers did complain about the weight, especially since women were the ones working mostly with them. We have reduced the weight to about 26 pounds.  We will continue to improve and add more functions to it. Our research is still ongoing.

 

What is the place of the machine in the US health sector?

Hospital In A Box’s place in the health sector is going to be huge. We have just started to make our presence known in the US. We started this late because we just started the FDA certification process. Hospital In A Box has been selected to be showcased in Defense Innovative Summit 2015 taking place in Austin, Texas from December 1 to 3, 2015. This is being organized by the US Department of Defense.  I sincerely think this is a very big deal.

Walk-in clinics. A lot of people don’t have time to spend waiting for their appointments. In order to save time, people will be able to walk in and get checked.

Doctors’ offices – A lot of doctors can actually start a practice by renting smaller places. All that will be required will be a waiting room and a private room where people can be examined. Doctors can actually have multiple offices where healthcare providers that have been trained to use Hospital In A Box man those locations. The doctor can be anywhere and provided he has access to the internet, will be able to take care of those patients being seen by each of those providers.

Home Visits – In the past, doctors did do house calls. With the development, the equipment needed became too big to carry around. Hospital In A Box now weighs about 26 pounds. Doctors will now be able to do house calls and nurses do home visits with little or no problems.
Schools – School nurses will now able to do more for the students instead of just sending them to the Emergency Rooms.

Pharmacists will now be able to better take of sick and well patients by having Hospital In A Box in the pharmacies. People will now be able to go to their pharmacists for their checkups and their data being reviewed by their doctors.

Sick patients who don’t want to go to spend some 3-6 hours in the hospital can also go to these pharmacies where Hospital In A Box can be used to examine them and their data sent to their doctors for treatment.
Ambulances – When equipped with Hospital In A Box will give the control and command centres better data to work with by sending the data to them.

Hotels and resorts – People will be able to have checkups and sick visits while checked in a hotel. It is usually difficult for visitors to have access to doctors when they are sick away from home. With Hospital In A Box in every hotel and resort, this problem will be solved.

Airlines and Airports – People get sick anytime without any warnings. In the airport or inside the plane, people should be able to receive good treatment through coordination from a physician.

Disasters – such as earthquakes, Tsunamis, hurricanes etc usually damage most infrastructures.  Hospital In A Box can be deployed to such locations and be used to take care of people until those infrastructures are repaired. We also have a communications components in our company that can be added for easier communication with the rest of the world in such situations.

Battlefields and military installations – Hospital In A Box can actually be carried on backpacks by soldiers trained on the machine to take care of wounded colleagues. This can also be in the military installations where checkups can be performed and also take care of sick patients. The US military sent soldiers to help in Liberia during the Ebola Epidemic. Hospital In A Box is ideal for such situations.

Sporting events – As an emergency room physician, I have taken care of patients from baseball, basketball and American football arenas.  I have also taken care of near drowning victim from the beaches. Hospital In A Box will be very useful in such arenas.

Offshore rigs – like mining sites Offshore rigs will now be able to deliver the basic comprehensive healthcare to its occupants by using Hospital In A Box.

Ships – Sea travels are usually slower than air travels. With Hospital In A Box in a ship or boat the data of examined patients can now be sent to their physicians.

Mining or Drilling sites – Occupational Physicians will be able to take care of their workers at their sites by using Hospital In A Box while at the same time take care of those patients who go to their company clinics.

Recently you were part of the US professional delegation to Africa to discuss business opportunities? How did it go?

The United States Commerce Department selected us as part of the largest Trade mission to Africa. I am sincerely grateful to the US government for giving me this opportunity and the coming opportunities that I have been offered. The trade mission was very well organized and we were well taken care of. If I may, I want to say thank you to the US Commerce Department and the US government under President Barack Obama.

I chose to go to Angola, South Africa and Nigeria as part of my company’s Trade mission.  The mission went very well and I am very satisfied with the outcome. Hospital In A Box was wanted by everyone that had the opportunity to see it. Our problem right now is choosing from the interested pack of reputable companies that want to represent us in their countries.

Are you making effort to bring the product to Nigeria?

I have been making efforts to bring Hospital In A Box to Nigeria since 2007. Sometime in 2005, a friend of mine wanted to introduce me to some company in South Africa. It was about this time that General Benedict Obasa (rtd) came to my office for his annual checkup.

I told him about my plan of taking the technology to South Africa. General Obasa implored me to give him a chance. He promised to talk to the late General Azazi. He did and we established a relationship and eventually I was invited to come to Abuja to give a demo to the Nigerian Army in 2007. During this visit, my friend, Arch. Sonny Echono, currently the Permanent Secretary of Ministry of Agriculture, saw the machine and immediately saw the potential and need for it in Nigeria.

I had told him earlier about it without showing it to him. He was very impressed when he got to see it. He tried his best to present it to President Olusegun Obasanjo but to no avail. However, he succeeded in securing an appointment with the Secretary to the Government, Mr. Stephen Oronsaye who referred us to the Chief Medical Officer at the Aso Rock Clinic. I gave a demo to him, the Chief Ophthalmologist and Chief Dental Officer. Dr. Femi Bella (I think that is his name) was really excited. He was particularly happy because the ECG machine in Hospital In A Box prints on regular paper.

He said they had an ECG machine that was locked up for many months because they never had the special paper that the machine prints on. This was a few weeks to the end of President Obasanjo’s regime. Dr Bella promised to write a report and recommendations to President Obasanjo and the President was supposed to have handed it over to President Yar’Adua. Nothing happened for the next few years.

In 2010, I decided to travel to Abuja and asked my friend Arch. Sonny Echono to help schedule a meeting with the Minister of Health, Professor Christian Onyebuchi Chukwu and Minister of Niger Delta, Mr. Godson Orubebe. I gave a demo to the Minister of Health in the company of the Permanent Secretary, Mr. Linus Awute, Dr. Bola Olowu in charge of Diaspora, to mention but a few.

The Minister was so excited, and he said: “You mean a Nigerian invented this machine?”  He asked me to submit a proposal and that I will be contacted. I submitted a proposal and was never contacted.

I also gave a demo at the Ministry of Niger Delta during this trip. The conference room was full. There were some reporters in the room. After the presentation, Mr. Orubebe, with his Minister of State beside him, said: “My people do not know how to use computers. I do not think they can operate this machine”.

During one of those my trips to Nigeria, my younger brother called me at Murtala Muhammed Airport, Lagos as we were waiting to board Arik Airline to New York. He said his friend, Mr. Mike Igini, was also at the airport waiting to board the same plane. I made contact with him. He eventually came to Trinity Medical Group, my practice in New York, to have physical examination done for him. Hospital In A Box was used on him. Because he liked what he saw, he promised to introduce me to one of his friends.

I was later invited by NDDC to come give a demo. I gave a presentation and demonstration of Hospital In A Box to a group that included Mr. Chibuzor Ugwoha, Dr. George Uzonwanne, Mr. Osmond C Adiele, Mr. Victor Ossia and Dr Sylvanus Ojum, an external expert.

The criticism I got from the engineer in the group at that meeting led to the better organization of the current units of Hospital In A Box. On reflecting on that meeting, I think Nigeria’s rate of development would have been faster if professionals who always think of ways of improving on the status quo, are put in decision-making positions instead of those who take delight in denying development opportunities for their communities solely because they think they have the power to do so.

In 2013, during the luncheon organized for President Goodluck Jonathan and the Business community in the Diaspora, I was lucky to be given the opportunity to ask the President a question. He had about four questions. When he asked who the inventor was, I stood up and actually lifted the about 50 pounds machine amidst a thunderous shout of Go! Go! Go! Mr. President said: “Minister of Health talk to him”. We had a meeting about two days later and I was asked to re-submit a proposal.

I made several trips to Abuja and was finally referred to National Primary Care Development Agency where I met with the Executive Director, Dr. Ado Muhammad. He later set up a committee headed by Dr. Emmanuel Odu, who asked me to submit a proposal for a partnership with the agency. I submitted the proposal and I have not officially received any response from the Agency.

As you can see, I have made tremendous efforts in bringing Hospital In A Box to Nigeria. This is because I believe charity should begin at home.

What has been the acceptance of the product in the Nigerian health sector?

Nigerian doctors, like any of my colleagues in every country that I have been to, including the United States, who saw Hospital In A Box have been very impressed. One of the functions that thrilled my epidemiologist colleagues was the fact that it will simplify their job with the ease at which data can be collected for analysis.

Many health centres just have tables and chairs. Some have manual sphygmomanometer and thermometer. A colleague was very hopeful that if Hospital In A Box distributed to all health centres, it will help improve healthcare delivery in Nigeria.

Some of them are happy that people can be trained to use the device. An entrepreneur colleague of mine sees this as a very good job creator. We all know most people commit crimes because they have no jobs and still have to take care of their families.The doctors and the business executives are particularly happy with the battery life and mode of charging it because we put the erratic power situation in most African countries into consideration in the design of Hospital In A Box.
What is your plan for professionals who can adequately operate the product?

Hospital In A Box can be operated by anybody that can read, write and follow simple instructions. My main objective is to make comprehensive healthcare cheaper and easier to get.

What about its maintenance and repairs?

Hospital In A Box has undergone many phases of development to its simplest form currently. We will have people trained to repair. We are going to have a close relationship with our customers since we need to upgrade their soft wares as time goes on. In other words, nobody will be left stranded. Technical support will be made available.

*Source Guardian Nigeria

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