A Reply to Kelechi Show!

Optom

Kelechi ShowMar 4, 2012 01:46 PM

Wow, I am very moved by your statement. I am a Nigerian but trained in the US as an optometrist. I will be going back to Nigeria to practice but unaware of the eyecare climate back home.I wanted your advice on what the most pressing issue is so that I'm prepared.

Kelechi Show

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Hey colleague! Am really very pleased that my blog is receiving attention from people like you in the North Americas. I saw your comment in my blog titled "Training Optometrists receive in Nigerian Universities".
First Optometry in Nigeria is still @ its teething stage but I must tell you that much water has crossed the bridge...
To start with, Nigerian Optometry has not fully been assimilated into the Ministry of Health & our regulatory Board (see my blog on "Legal codes for practicing Optometry in Nigeria?") is flexing its flabby muscles in a desperate bit that only takes us further down the path of 'isolation' from the public health care hierarchy in this country! It means that there is 90% chance of ending up in the private Optometry practice which often comes with little or no benefits (am not saying that private practice in Optometry is not lucrative but over sight duties of the Board in form of its disciplinary committee [See Part V section 22 of Decree 34 of December 1989 which in recent times is known as the popular Cap 09, Laws of the Federation of Nigeria 2004] is very much lacking for instance!) while the very few openings in the Federal health sector is lobbied with gusto!
The average Optometrist working in a private clinic in this country earns between N35, 000.00- N150, 000.00 ($ 250 dollars- $ 1, 000.00 dollars) per month! Most of the private clinics are under-equipped and sharp practices have become the order of the day partly because the Board is too lazy to effectively carry out her oversight duties... It's a more or less money collecting Board than professionally poised group. Partly its as a result of high costs of eye care equipments, the willingness of people accessing eye care for cost purposes, for ignorance purposes, lack of know how in the field and for myriads of other reason!
Though the Board in recent times is trying to show some courage! Under his watch, Dr Ntem, the current Registrar of the Board, continuing education (CE) as obtained in North America, Canada, Australia etc has come to stay! Every practicing Optometrist must obtain 15 units of their general yearly units from continuing education (C.E.) while the yearly organised General Conference fetches the remaining points.
I must tell you this, a semblance of professional audacity is claiming the entire ODORBN structure! Like for instance inter-school conferences of the Board student Board members known by its acronym NOSA aka Nigerian Optometrists students Association is taking a particular professional turn that encourages me on the future of this noble profession! In their third annual conference, NOSA Conference in IMSU (Imo state University Owerri) at the school of Optometry in the faculty of Medical and Health Education, I was there on humanitarian grounds and was pleased by the prevailing professional aura that presided the conference! Again, I will personally commend the professionalism being entrenched in Optometry in Nigeria since the CE became part of our requirements. Still its not yet time to start celebrating!
To this end, I will be very pleased if you decide to come practice here in Nigeria but, do not be fooled, its going be very challenging! There exists only minimal relationship between the Nigerian Optometrists and their counterpart eye care colleague, the Ophthalmologists, in terms of blindness prevention, inter-referral or co-managements. The later finds it very easier to work with ophthalmic nurses in their quest to achieve vision 2020 goals than to co-manage patients with us, except we work for them! This has resulted in many cases of unnecessary blindness in the Nigerian populace.
I do not all that blame the divisiveness between Ophthalmologists, General physicians etc with the Optometrists on the former as I blame it on the professional foundation in our schools! Most of our newly inductees often find it very challenging to perform acceptably without much baby-sitting by a senior colleague. More than 65% cannot perform a Retinoscope examination with 80% accuracy while 50% cannot view the optic nerve with 90% accuracy.
Our schools are understaffed with mostly dissatisfied Optometrists who might not be fully prepared to pass on knowledge to young Optometrists for the purpose of developing the profession. There is often no good remuneration and no means to go for oversea trainings as often required by law. Other lecturers might have other businesses that keeps distracting them from their professional calling or some others might be sit-at-home-do-nothing lecturers who are not practicing and yet others that can't even keep clinics afloat talk less of effectively training the leaders of tomorrow!
I was on hand in IMSU during the Conference's free eye treatment session and there was no supervising lecturer(s)! I was horrified at the whole lackadaisical posturing of some of our lecturers!Again, the Board's oversight on schools are condemnable! There was no day a single official from the Board visited my school and the school clinic for inspection (from 2000-2006), except during our induction in 2007 when a representative from ODORBN visited- not to inspect rather to preside in the induction. That's why some of our colleagues cannot boldly tell the minimum Blood pressure (BP) that defines hypertension! This CE introduced by the Dr Ntem's ODORBN is highly commendable or else I do not know what would have become of us.
Our ODORBN code of conduct states in Part 1 section 8, "Foreign-trained practitioners are expected to undego a professional Board assessment (i.e. proficiency test) of their qualification(s) before they can be registered with the Board..."
 Again, in the Act of Parliament that established ODORBN (Optometrists and Dispensing Optician Registration board of Nigeria) in 1989, now famously known as Cap 09 of the laws of the Federation 2004, puts it thus:
"Where a person satisfies the Board- ...(b) that he holds or has passed examinations necessary for obtaining some qualification granted outside Nigeria which is for the time being accepted by the Board for the purposes of this section as respects the capacity in which, if employed, he is to serve; and
(c) he pays any fee prescribed for registration,
The Board may, if it thinks fit, give a direction that he shall be temporarily registered."
These are the necessary things required of you to come home and practice Optometry!
In Nigeria, the qualification(s) for registration as a member of Optometrists and Dispensing opticians Registration board of Nigeria [ODORBN] is outlined in Cap 09, Laws of the Federation 2004 in Schedule three [Section 10(1) and (4)]:
Accepted minimum qualification for the purpose of registration on the register established under this Act
  For Optometry -
 1) Diploma in Optometry obtained before 1976.
 2) B.Sc. in Optometry.
 3) O.D. (Doctor of Optometry).
 4) Any equivalent qualification from a recognised institution.

 For Dispensing Optics-
1) Certificate of the National Institute,
2) Diploma in Dispensing Optics,
3) Any equivalent qualification from a recognised institution.

I hope this article will be of help Dr Kelechi Show!
Thanks,
Dr Ezebuiroh Victor Okwudiri.
N/B: This blog attracts no financial assistance anywhere & the opinions here are technically mine!