A month in Ibadan
Elective rotation in Community Child and Adolescent Psychiatry at Centre of Excellence for Child and Adolescent Mental Health, University Of Ibadan, Nigeria.
This visit to the Centre of Excellence provided an opportunity for me to seek mentorship while working towards a strategic and well-informed approach to establishing CAMH services in Pakistan. This experience helped me observe the well-established initiative of CCAMH by having conversations with leaders who developed this robust plan.
My supervisor: Professor Olayinka Olusola (Banjo) Omigbodun (Aka Ma and Prof).
Credentials: MBBS (Ibadan), MPH (Leeds), FMCPsych, FWACP, FAS, Professor of Psychiatry and Provost, College of Medicine, University of Ibadan. Director, Centre for Child & Adolescent Mental Health (C-CAMH) at University College Hospital, Ibadan, Nigeria
Reflective narrative:
I reached Abuja on 11th June 2019. I stayed there overnight (blessing alert: luckily, my Program Director has a family in Abuja) and flew to Ibadan the next day via Overland Airways. I was expected to reach my destination at 16:00 pm. I later found out that some VIP traveled on that same flight, and apparently, he was late to catch his plane. Long story short (LSS), I reached Ibadan at around 630 pm. Upon arrival, I was greeted by Adorable Adeola, who was anxiously waiting for me. And the first thing she does after seeing me is to call Ma. Adeola works as an Associate Programme Officer at C-CAMH and is a very dedicated and hard-working member of the C-CAMH family. I was informed, Ma has invited me over for dinner. I liked the sound of it: Ma. Monosyllable. Simple. No mental effort.
I was so thrilled and excited to meet Prof Omigbodun that night. After a warm welcome and exchange of greetings with her, I was led to the kitchen (intimate, I know) and was offered various delicacies of Nigerian cuisine. I will spare the details, but I am not the type who gets thrilled to try new food. My palate refuses to unfasten. LSS, I end up eating the most familiar taste, i.e., boiled rice, bean stew, and fried plantain. Anyhow, I was too excited for my rotation starting the next day, and I did not allow anything to affect my spirits. And who knew, my upcoming 30 days would be immense experiential learning exceeding my expectations.
My goal was to seize every opportunity to spend time with Prof Omigbodun, get her mentorship, and gather her leadership pearls. It is worth mentioning that Prof Omigbodun has been a mentor to my mentor: Dr. Ayesha I Mian. Both of these superwomen share a persona of courageous and determined CAP leaders from LAMICS, and both are just unstoppable. They both went abroad for their CAP training and returned to their parent countries to establish CAMH services and both started first ever CAMH training programs in Nigeria and Pakistan, respectively. I embarked on my CAMH journey having been mentored by these two exemplary role models.
I started my electives with academically loaded sessions from 08:30 to 06:00 pm. I was fortunate to join at the time when I could attend didactic sessions led by Dr. Cornelius Ani. Dr. Ani is a practicing Child and Adolescent Psychiatrist at Hammersmith Hospital Campus, Imperial College London. Every twice a year, he flies to Nigeria of his own accord and shares his experiential knowledge with students of the Master of Science program in Child and Adolescent Mental Health (MSc. CAMH). These were the concentrated learning weeks, and Dr. Ani made every second worth it. Being away from my workplace with different sets of expectations as an elective trainee, I was able to refresh my clinical knowledge and explore its implications in newer ways. Some of the essential reminders through his learning include:
For a CAP fellow, it is vital to know the local statistics of common pediatric disorders – this invariably helps while liaising with one’s Paediatrics community. It prepares you to anticipate what common presentations and their psychiatric manifestation you are expected to deal with.
A reminder to be mindful of the science behind everything you say in your clinical practice, i.e., I revisited the neurophysiological and molecular explanation of Sleep Hygiene rules that I use right, left, and center in my clinical encounters. I consciously extended this principle to other frequently used techniques such as psychoeducation, placebo, and nocebo effects, which often become a matter-of-fact phenomenon.
Know your history. One can’t imbibe the true essence of the specialty with minimal knowledge of its historical roots.
During my one-month elective rotation, I had been involved in approximately 35 hours per week that included 3 courses of C-CAMH Master’s program, observed patient care at five different practice locations. I regularly attended ward rounds. I observed clinics at Jaja Clinic - University Health Services, Intellectual Disability clinics, and Paediatric Neurology clinics. I visited the Centre for Early Development, Learning and Care (CEDLAC), initiated by a former graduate of C-CAMH. I was also assessed for the courses taken, and I scored well. There was considerable research-based exposure in C-CAMH. I learned a great deal in Thesis Defence sessions.
During this time, I was fortunate for an opportunity to deliver presentations on 2 occasions. The most memorable moment was when I gave a presentation on Day of the African Child, titled: Child & Adolescent Mental Health – Pakistan meets Nigeria. Later, I presented my experience of being a College Psychiatrist and discussed the psychosocial characteristics of Pakistani college students, which are unique in a Pakistani way but also universal, given the developmental stage and needs in a college-going youth. This was followed by a thought-provoking discussion around cross-cultural similarities, struggles, and emerging opportunities.
I spent a day with the research team of iCARE Nigeria: Intensive Combination Approach to Rollback the Epidemic (iCARE) in Nigerian Adolescents. I learned a great deal about mapping resources and grounded peer navigation for those who are at risk of retracting HIV. It is a U.S-Nigeria HIV-cantered academic partnership supported by the NIH/Fogarty HIV Research Training and Capacity Building Program.
At a co-academic level (as in co-curricular), I made some wonderful relationships — Aunty Easter, who fried Bhindi (okra) for me in a Pakistani way almost every other day. Her adorable kids Gidi (Gideon) and Favour, welcomed me with a warm hug every day after returning from CCAMH. Blessing, her eldest daughter, who chaperoned me every day. She has a beautiful voice and many dreams that she is on her way to achieving. I made a gorgeous, relentless friend Ruth who was determined to get desi masala for my palate, and together we went on a masala hunt in a local food market. She later explained to me why people were yelling eebo at me. They meant Oyinbo which in Nigerian means a white person. I spent the rest of my days arguing that I am not Oyinbo. I even showed her a picture of Nick Jonas and Priyanka Chopra to demonstrate what actual Oyinbo looks like when compared to a South Asian.
I found a few similarities between both countries — the Bollywood craze to name one, both were colonized, both abiding by the customs of sharing gifts and presenting souvenirs. Aunty Ester sewed dresses for me made from local Nigerian fabric. And in a remarkably sentimental way, like Pakistani mothers, she carefully handed me over bucha hua kapra (leftover cloth piece that a mother never leaves at a tailor shop).
As a parting gift, Prof presented a personalized souvenir with my name carving and a gorgeous sculpture of a Nigerian mother surrounded by her children. Beautiful and powerful symbolic representation of an integral facet in one’s childhood - Motherhood. (I would like to believe that the father was busy making this sculpture, and next time, perhaps It would-be the mother’s turn to cast.) And yes, I returned with an addition to my mandatory fridge magnet souvenir collection.
From the academic sessions to the cultural influences and diversity in inpatient management, there were learning opportunities in everything. The faculty was warm, welcoming, and loyal to teaching and learning doctrine, making the learning experience inspirational. With students of MSc, I was not only able to learn but have fun. The entire class was incredibly supportive and warm. It was an honor being able to be a part of this community. I was amazed at how my time was well planned and organized even before my arrival at Ibadan. I was welcomed and treated as a part of their team. Although there was a language barrier, it did not get in my way of understanding things.
One of the most heart-touching realizations that came to my conscious mind during this time was that people who disrupt our society in various ways are the children we once neglected. We, as CAMH leaders, share a more significant responsibility. If you are an aspiring researcher in the field of Child and Adolescent Mental Health from LAMIC, C-CAMH is a fantastic choice for an observership in G-CAMH training and Leadership.
