Preventing Global Pandemics: Dr. Dimie Ogoina

In this episode, I interviewed Dr. Dimie Ogoina. Dr. Ogoina is a Nigerian Infectious Disease Physician-Scientist and Professor of Medicine at the Niger Delta University. He is also the chief medical director at its teaching hospital and the President of the Nigerian Infectious Diseases Society. He was named one of the 100 most influential people of 2023 by TIME magazine and was named Nature’s Top 10 in 2022. He sounded the alarm on a new presentation of Mpox (formerly known as monkeypox) and his research became critically important to developing better strategies to prevent and control outbreaks.

Transcription

Transcribed by Mika O’Shea (she/her)

JP Flores: What’s up y’all, it’s your host JP Flores and welcome to From where does it STEM? In this episode, I interviewed Dr. Dimie Ogoina. Dr. Ogoina is a Nigerian Infectious Disease Physician-Scientist and Professor of Medicine at the Niger Delta University. He is also the chief medical director at its teaching hospital and the President of the Nigerian Infectious Diseases Society. He was named one of the most influential people of 2023 by TIME magazine and was named Nature’s Top 10 in 2022. He sounded the alarm on a new presentation of Mpox (formerly known as monkeypox) and his research became critically important to developing better strategies to prevent and control outbreaks.

Dimie Ogoina: Okay, thank you very much. My name is Dimie Ogoina. I’m an infectious disease physician, I’m a professor of medicine and infectious disease. I work for the Niger Delta University and the Niger Delta University Teaching Hospital, both in Bayelsa, in the south south part of Nigeria.

Dimie Ogoina: So I was born in Port Harcourt River State, which is in the south south part of Nigeria, and did my primary or elementary school in the south part of Nigeria, specifically in Cross River State, Nigeria, completed my primary education, and did my secondary education in Lagos State, which which was then the capital of Nigeria, completed my secondary education, then I went to the university, college, Ahmadu Bello University in Zaria, where I did my medical degree. Then I completed my medical degree, and then went to the residency training program to specialize to become an infectious disease physician, also at the Ahmadu Bello University Teaching Hospital. So I qualified as an infectious disease physician, worked in a few hospitals, and finally came back to the Niger Delta University and the Niger Delta University Teaching Hospital, where I was employed as an infectious disease physician and a lecturer, and I grew through the ranks and became a professor of medicine. Currently I serve as the Chief Medical Director of the Niger Delta University Teaching Hospital in Bayelsa State, Nigeria and I’m the current president of the Nigerian Infectious Disease Society.

JP Flores: Awesome, thank you. Yeah, it seems like you’ve had a very decorated career, and we’ll get into more of the details of that later in the interview, but would you mind painting a picture of who you are, right? How were you raised? What was your upbringing like, you know, things like that?

Dimie Ogoina: Yeah, so I’m the first son in a family of 11 children. I have 3 older sisters. I was raised by a father who was in the military, so he was a disciplinarian, and what that means is that we faced a lot of discipline, structure, a structured life, and that desire to do the right thing was instilled in us from childhood. So well, I may be a little bit reserved, but I have a very curious and analytical mind, right from when I was a child. But generally I’m very very reserved. So in terms of social life, I would say I’m reserved. But in terms of academics I’m very interested in technical stuff. And if you look at when I was in school, my secondary education, my high school, I was very good in science, and also very good in mathematics, and […] mathematics, and that’s one of the reasons I wanted to do medicine. And my second choice was actually […] science. So that’s the general, my general outlook in terms of how I grew up, so I grew up mainly in […] but we moved around Nigeria because my Dad was in the military and in the military setting you move from one part of the country to the other part of the country, so had the opportunity of living in various parts of the country. I was initially in the south part of Nigeria, then when my dad was transferred to the north part of Nigeria I also lived in the north part of Nigeria. We grew up in a more regimented setting, because the barrack setting where military men stay, and so very regimented way, rules and regulations and the instructions, and they had the situation where, because of the discipline of my dad, you had to take permission to do almost everything. And that was the life we lived when we were very young. But my dad was also very strict about academics. He wanted a situation where all his children, and he did, all his children went to school and all graduates. He wanted all these children to do very well in school. And he was very thorough about checking up with us. Regarding everything that relates to our life, and that part has significantly contributed to who I am today.

JP Flores: Awesome. Yeah, thank you so much. Have you ever ventured out of Nigeria, or what other countries have you got the chance to visit?

Dimie Ogoina: So, not too many countries. I’ve been to most West African countries, and was invited to Switzerland for a conference a few years back. So other than that I have not had the opportunity of visiting many other countries. So Ghana, Liberia, Sierra Leone, Gambia, then Switzerland are the major countries I’ve gone in terms of outside Nigeria.

JP Flores: Gotcha. Yeah. So just out of curiosity. It feels like, you know, when I’m moving around in the United States, there’s a culture that’s different from state to state. Is there, is it different when you go from you know Nigeria to another Western African country like Ghana? Are there different cultural things to be aware of, or?

Dimie Ogoina: Yeah, so even within Nigeria, yeah, there are differences in culture and behavior. The way people see things and the way people relate to things. Let me talk about Nigeria before I go out to West Africa. For instance in the northern part of Nigeria they are more conservative about the way they approach things. Perhaps I will say they are, they are more trustworthy. I have to say that they are more trustworthy than in the South end, they are more liberal, more liberal minded, and you may see people make decisions based on religious reasons. But religion plays a little role in the southern part of Nigeria.

Dimie Ogoina: When you go outside Nigeria, I think Nigerians generally are very intellectual, and they are very open minded, and they are very industrious, and they get to do a lot of things. And they have a wide, very wide perspective, and that’s why they do well everywhere they go. Outside Nigeria you will say that for a few places. For example when I went to Ghana the place I went to the lifestyle was more structured compared to what we had in Nigeria. More structured in terms of the discipline, too, the discipline was even much more than what what we had in parts of Nigeria, of course, as I said earlier I was raised from one part of Nigeria to to the other, and then, of course, the other thing I observed is that I was amazed that when I went to Sierra Leone and Liberia I noticed that they were speaking what we call broken English. Pidgin English because it’s an adulterated English language. I I thought Nigerians was the only one that speak Pidgin English, but I was presently shocked that they they also speak a broken English, with that asset attached to it, which was very, very exciting, but essentially, I think they are very friendly, very receptive, although reception to people like us, because we Academicians, both of those countries, I attended I attended as a professional. I was already a medical doctor when I attended conferences in those country, and they were very receptive and very very friendly. For instance, in Gambia when we went to Gambia it was a very exciting experience, and they wanted to learn more about Nigeria, because Nigeria is a very diverse country. Several tribes, several religions. And so it’s very diverse. And we we we have had that opportunity to manage, although we challenges to manage our diversity.

JP Flores: Yeah, very cool. Thank you so much. And I’m assuming you’ve talked to people from all over the world, right from- people, from the U.S., let’s say Australia, maybe even. Do you feel any like differences in the way that these people from around the world talk as well? Is it difficult to to talk to them? Is there like a certain like lingo, barrier, or anything like that?

Dimie Ogoina: Yes, also, I I think I had the opportunity to speak to people from different parts of the world on account of monkeypox. I was on account of monkeypox. Many interviews and conferences that we attend, and also collaborations and the partnership we’ve had with colleagues from across the globe. Just on account of monkeypox. And my my perception is that they they they’re very friendly what I’ve seen so far. Again, I’ve not gone to the personal level, so it becomes difficult to know what happens at the personal level. That’s mostly been professional. It’s mostly been professional so they are very patient, willing to listen, and also very friendly, and also willing to learn from your experience. So so I will speak on a professional side. I can’t be to show on a personal level, because I’ve not necessarily had a personal relationship from anybody outside Nigeria, put it that way. Yeah.

JP Flores: Cool. Yeah. So you know, in terms of of of communicating about monkeypox and and all of that. What do you think are the biggest things to be aware of? Because, you know, we just got out of the COVID-19 pandemic. Actually, we’re still in the pandemic. But, what is the most frustrating thing that you have to deal with as a as a you know physician scientist coming out of Nigeria, who has had experience with monkeypox right? Like what are the biggest things that need to be addressed in order to stop outbreaks and and future pandemics?

Dimie Ogoina: Yeah. So so I think what we see in monkeypox relates to what we’ve seen in many other diseases and we have situations where- when an outbreak is first recognized, there is this media attention public attention towards the outbreak. There is a lot of uncertainty, there’s fear, there’s panic, and that results in people wanting to know what are the consequences of this disease? If I get infected, what are the symptoms? Am I likely to recover if I get treatments for this disease? Is it possible that it’s caused by some- you know. So one major challenge we notice, is that when we go through an outbreak that people bring non-scientific approach to this outbreak, and that leads to panic or fear. So, for instance, in Nigeria, very religious, and we also have cultural aspects. So you see, people bring in myths and misconceptions into a outbreak, and it happened repeatedly in monkeypox, where, for instance, I had a patient that felt that the monkeypox he had, it’s not because of a virus, and it was because of a spiritual attack, and there was no need to come to the hospital setting. And then, so we had to go to his church, a spiritualist to get some sort of cleansing before he will get well. So that’s one of the challenge. Then we also have the challenge of poor health-seeking behavior. And that’s a challenge in our health system. So people prefer to go to non-orthodox setting. I’ve just given an example of spiritualist what they prepare to go to a local medicine vendor, a chemist. A small shop where they sell drugs to get treatment before they come to a formal orthodox setting in it in a hospital setting. So we have situations where people come very late to the hospital so late presentation to the hospital is a great challenge. And what that means is that we have a lot of cases that are not being detected, and then we have poor general public awareness related to most outbreaks and infectious disease, and it takes the effort of public health authorities, both at the federal and state level to increase the level of awareness during outbreaks for people to be fully aware about the the clinical condition. The other challenge we have in our country is our health systems are especially weak. And so most of our diseases are only estimated. So I always say that in monkeypox we have been working largely blindly because there are many cases out there they don’t come to the hospital and even when they come to the hospital we lack the capacity to make a diagnosis. Currently monkeypox is diagnosed mainly in 2 or 3 centers in Nigeria. So what it means is that out of the 36 states and the federal capital territory, if you have a suspected case you have to take the sample then send it to the center, and it may take 2 to 5 days for the results to be available. And so that process of collecting a sample and sending it to the very rigorous and tedious proof process. That’s very difficult in major settings. So those are some of the challenges we face with regarding infectious disease and also monkeypox.

Dimie Ogoina: I know the one of the major challenges I faced in 2017, when we had a resurgence of the outbreak in Nigeria was convincing colleagues that there’s a potential it could be transmitted via sexual contact because when cases came to my hospital, because the first case was diagnosed in my hospital and we thought that it would be the routine monkeypox that we had always known, because before then monkeypox was a condition known to affect mainly children or teenagers. And so, when we had the first case, an 11 year old boy with monkeypox, I expected that the other cases that will come will be young children, or perhaps teenagers. But what I saw in our center was that people coming with symptoms of monkeypox and getting admitted were young adults within the age of 20 to 40 years. Most of them were sexually active, single, and remarkably, most of them had genital ulcers and when we evaluated for that in our center we found that a few of them had the concurrent HIV infection and even STI such as syphilis. So when I made that observation, I told some colleagues that there has to be something here. It’s very unusual that there’s localization of monkeypox lesions around the genital area. People are having genital ulcers, they are young men, and they are sexually active. I remember then writing a short concept note and giving it to an organization to sponsor the research work on sexual transmission of monkeypox, and it was dismissed. And it was because they felt the knowledge, the background knowledge, historical knowledge of monkeypox, there was no relationship between monkeypox and sexual contact. So it was very unusual for me to suggest that there was a relationship, some of my colleagues, because then I also suggested that, can we take semen sample? Let’s even take other body fluids and see where the virus was, in semen, but of course nobody was willing to listen to that. I remember when we ever wrote the first article and submitted in a journal, the response was that we are reckless in suggesting that it is possible for monkeypox to be transmitted via sexual contact. I was happy, ultimately, because a number of journals after rejected the work before it was finally accepted in PLOS One. And that’s the story we’re telling today.

JP Flores: Okay, awesome. Yeah. I would imagine that this is extremely frustrating, right? So you have this whole team of researchers that are helping you with this. Have you thought about the next generation of let’s say monkeypox researchers? Have you thought about that at all? Like I’m sure there’s a lot of young young people in Nigeria trying to aspire to get to where you are right? Do you think that it’s important to take them in and teach them, you know how to be a good researcher, teach them about good science communication. What are your thoughts on that, because in order to, you know, improve public health, anyway really it’s to make sure you can train the next generation.

Dimie Ogoina: Yeah. So I’ll say that- I always say, I’m always learning, I’m still a learner, and I always look for mentors, and no matter where I appear to be now, I look for mentors because I know I have- still have a lot to learn. And I’m also very present in mentorship. So I also look for younger colleagues to mentor, because I have a story that regarding the mentorship which essentially started in medical school, if you want I can give you that story?

JP Flores: Yeah, that’d be awesome.

Dimie Ogoina: All right. That’s great. Okay. So I remember in my 4th year of medical school we had a professor of medical microbiology and medicine, Professor […], is now late. He had the habit of coming to the classroom and before he gives his lecture, his formal lecture in medical microbiology, he will take us through what is happening regarding infectious disease and microorganisms in the globe. What are the current outbreaks? What are the new diagnostic test going on, and what is the controversial thing related to medical microbiology? And I found it very intriguing and very exciting, and that was what brought my interest in the field of infectious disease, initial interest I had. So one of such sessions, he challenged the class. We’re a class about close to 100 students or so, all residents. He challenged us to say that microbial gene regulation is an evolving aspect of medical microbiology, and he wanted a situation where we would have a presentation like a public presentation, public seminar. This was my 4th year in medical school, and microbial gene regulation, that was not part of the curriculum of the medical program at that time. And so he truly challenged the class, and the people were very reluctant, because at that point nobody was willing to even read or learn what would not be on your final exams. But I just felt it was a challenge, and I took that challenge and I went to meet him. I went to meet him and I told him I want to make that presentation. I want to give a public seminar. He said great. So he gave me some literature to read, I had to even go and get some additional literature. And I made a presentation on microbial gene regulation. It was very technical, complex, but he also exposed me to genomes, genetic engineering, and the like. So I made a presentation, he was very excited. He just became my friend, and during subsequent lectures he had a tendency of mentioning me, and when he has any question instead of asking the class he’ll ask me first. And because he had the impression that I was going to read it or situations where I’ll do well, other situations I tell him I don’t know. But it was a sort of challenge to me.

Dimie Ogoina: Then fast forward to my clinical part of medical school. I think that was my fourth year, too, when I started the first introductory medicine in clinical medicine. I just observed that I loved bedside medicine. I loved seeing patients clacking patients treating patients getting to listen to patients how they feel. Their symptoms, their signs. And I love the analytical part of internal medicine, where a patient will tell you that story, and your responsibility is to interpret that story and link it to the clinical signs and make a diagnosis. And then instate a plan on how to manage, make- confirm the diagnosis, and treat the patients. So I fairly love internal medicine. So I told myself right from that level that I was going to do internal medicine, as a sub- as a specialization. But I wanted also to do something related to infectious disease. But in my 5th year of medical school I got exposed to Professor […], who is a professor of medicine and immunology. And I became excited about immunology because there were so many things about immunology that was very intriguing. It was also a technical part of medicine, and I love technicality and so immunology it made me to understand how diseases evolve, and how the immune system attempts to contain a disease, and how some diseases are not really necessarily due to the microorganisms themselves, but because of the immune responses to that microorganism. So it was a very exciting field. So if you look at my story, that first presentation I had led to my first publication. My first publication was in the 4th year of medical school which was medicine, genetics, and the future. Because it exposed me to various aspects of genetics, and how it relates to disease causation and the like. So I wrote my first publication, first paper on medicine, genetics, and the future. Then my 6th year- well, before my 6th year of medical school, because of my interest in infectious disease, my colleagues there selected me to give a public presentation on the cause of HIV AIDS. Then in Nigeria, there was a lot of talk about HIV and AIDS, and that made me to also read a lot about HIV to the point that they started my lectures by calling me an expert in HIV AIDS. So I give that talk on HIV AIDS. and also wrote a narrative paper, like a suspense, literature based paper on HIV AIDS. We talked about the need for to be cautious and to take action, you know that to avoid that. That was also my first narrative paper I had written on HIV, and the next one was my final year of medical school, where I was appointed as the editor-in-chief of our medical student journal and we were an institution where we have very interesting, exciting, informative papers scientific papers in that journal, contributions from both students and lecturers. So it was my responsibility to go out and meet a professor of medicine and immunology, Professor Onyemelukwe, to discuss with him, to say that, sir we want, because a few weeks back he gave his inaugural lecture. His inaugural lecture was tied to Games Played by Nigerians and Infections: Immune Systems as Godfathers. And so once I approached him, I approached him myself and said sir I want a way you can summarize your inaugural lecture as a paper in a journal. So what he did, he thought about it. He looked at me straight in the face, and said oh, go ahead. Go and do it. I said, what’s that? He said go and do it. I think you can do it. So kept quiet, but I like also like accepting a challenge. I left, I thought about it. That’s it. Summarize inaugural lecture of the professor, around 50 pages of inaugural lecture, as a paper, 3 page, 3 page article paper. How am I going to do this? But I said, no this is a challenge. So I went back to my hotel and started reading. In fact, that single event exposed me to immunology and even various aspect of infection. So I read a lot about, because I wanted to understand fundamental knowledge about immunology, related to his inaugural lecture, and what he gave. So I read through his papers, all his publications and he opened my eyes even into publications. I read through it and I wrote a first draft. When I brought the first draft, he said excellent, excellent. So we reviewed, checked this, look at this, look at this, then that was my more or less my third paper that I published in the Journal, and we called it RE: Games played by Nigerians and Infections: Immune System as Godfathers. So that was that was a form of mentorship that came through a challenge, I would say, to an opportunity. And so I finished my medical education with, because I was fortunate to get prizes, we recognize in the field of community medicine, because I got the best graduating doctor in community medicine, and I won that prize in continuous assessments.

So the next challenge, where I got another set of mentorship was during my residency training, because when I completed my medical school I did my mandatory internship and I did my national service another one year, then I started my residency training. So I, from the 400 level, I knew I wanted to be internal medicine and infectious disease, so I had no doubt when I did my exam, what we call the primary exam, examination to enter a residential program. I am- passed first sitting. And then I was looking for a space for me to be accepted into a residency program. There was no space. So then I went back to my state to work as a medical officer. And then suddenly I was called to say that they were doing an interview where I trained, for- to take in new residents. So I immediately called because when I was in medical school I just had, a number of lecturers were my friends, and they felt I was also very hard working , my friends, so I immediately called some of them, I said I’m interested in this field. They said come, come, come, come, immediately. We’ll see how we can put you in in the list of people to be interviewed. That’s how I came. I traveled from the South to the North. My name was included in the list of people to be interviewed, and I was interviewed, and I was accepted. So I was accepted into the Internal Medicine department to start a residency program. So I started the residency program, went through the first phase, and passed the exams. As a matter of fact, I passed the exam. I was the best in West Africa, in that internal medicine, the West African College of Physicians Exam. I was the best. So when I passed my exam what- your second half of the exam is a period where you now specialize. You know the field you want to specialize. I remember going to this same professor Onyemelukwe, because he was in that department to tell him that I want to do infectious disease and immunology as a sub-specialization, and he asked me, are you sure you can survive? Are you sure? It will be very tedious. I say that I can because I had already made up my mind. So I did not see any obstacle in the way because the passion and interest was a driving force. So he then said that you’re going to do a lot of work, because at that time in Nigeria there was no structured program for specialization for infectious disease, because that sub-specialty had not grown to that level. So we’re one of the few that started this structured, not necessarily structured, because when I started, it was a […] , I decided, and say, you must do this. You must learn about the community, the bench, and the bedside. So we have to go to different places to learn. So it was during that time I had laboratory posting. I had to go to Eastern part of Nigeria to learn about parasites and insects of medical importance. The, a lot of things. I spent 6 months there lending out to cut insects of medical importance, how to look at the microorganisms in the microscope. Then we did the bacteriology and immunology. I went to the immunology posting to the point I was, as a resident doctor, I was drafted to teach medical students. That’s where my teaching started. I started teaching medical students immunology and infectious disease. And then I went to the southwest part of Nigeria to the WHO poliomyelitis laboratory, to learn about viral cultures, polymerase chain reaction, hybridization, and the likes. It was an exposure, ELISA and different things I learned there, then I also learned infection prevention and control. But also, what was also remarkable in my residency training is that because of my passion for research, because I’ve always had passion for research and the academics. In my medical school, I already knew that I wanted to be a professor of medicine. I already knew that I wanted to be a professor of medicine, and I knew that I will do nothing else than that. So when I was in medical school and see exciting cases I thought I should publish this as a case report, publish this as an observational study. And so fortunately I had a mentor that gave me assignments. People call it, then people say this man is giving you too much work. I tell them now that the work he gave me was what built me to what I am now. Because he will say, Ogoina, go and write this paper. Ogoina, there’s something like this, go and write. Go and write. Go and write. That’s what he was just telling me, go and write. And when I write, it may be difficult. I write, I come back to him. He will look at it, and, inside, because he was a very thorough person, very, very thorough, I learned the principle of multi-tasking even from him. So there was even a situation where we had an outbreak of cholera also, and the country was calling a meeting of experts on epidemic-prone infectious disease. This was in my residency training when I was, I just qualified as a senior register. I think that was 2006 0r something like that, 2006 or something, so I just qualified as a senior register during my residency training. So the country was organizing a symposium, a workshop on the epidemic-prone infectious disease, and they wanted to- and they invited authorities from across Nigeria. And my main topic, so Onyemelukwe was an authority on, of course he had worked on several infectious diseases including cerebrospinal meningitis. And so they brought experts on each of the fields. So he was invited to give a talk on cerebrospinal meningitis. So I was surprised when he called me to his office and said, Ogoina, I’ve been invited by the Ministry of Health. But you’re going to give that talk on my behalf. I said, what? Can I do this? He said come to my house. We can do a preliminary slide on cerebrospinal meningitis in Nigeria. So I went to read and I went to his house, I made a slide. We sat in his house for close to 10 hours, to meet in his house. Correcting each slide. This one, move this one. Put this, remove this. Put this, put this. Don’t go there and embarrass me. You must do well. Go, you will, you can do it. You can do it. So I said no problem. So I learned a lot, even from that incident. So then I went. When I went to, then it was Abuja, I went to Abuja. And they, of course, as a young man, all the other people making presentation were very old professors. So when they saw me, and they said Professor Onyemelukwe and called my name everyone was surprised. Who was this man coming to make presentation amongst the gurus of infectious disease in Nigeria? So he said, don’t just be able to see a small boy. Put your head up and give your presentation. So when it was time for me to present, I just went there, and decided not to look at anybody’s face. And thankfully I had prepared enough, and the opportunity I’ve had to give presentation, even as a medical student also had prepared me to also have that confidence in making presentation. So I give that presentation, not withstanding the caliber of people there, and ultimately I was told that it was a very good presentation, because they called him later to say your student that you sent, he did very well. He did very well. So he went through several efforts where he said go and write this, write this, write that, and then learned a lot. And that’s why, before I even became an infectious disease physician, I’d done close to 20 research works and given guest lectures and many other things that don’t, I didn’t even have time to write all my publications before I was appointed a lecturer, because I had already published about 8 of those papers. About 12 of them had not been published.

So one other thing that happened that also influenced me was during my residency I had not had the opportunity of failing an exam track. My professional career, I’ve been very fortunate that I’ve passed most of my exams. Then the final step where, that will make me be an infectious disease physician, my project work, my thesis, or, if you like my dissertation, was on- because I did two dissertations. On toxoplasmosis, toxoplasmosis in HIV and human herpesvirus 8 and Kaposi’s sarcoma, also in HIV. Because I did 2 fellowships, one in West African College of Physicians, and the second one in National Post Graduate Medical College, and that was not also easy, because most of my colleagues could not take 2 fellowships. But because of grace, and the fact that the person I worked with, saw I was also hard working. He was also willing to support me. And then I would say also, I worked for him but learned in the process. So for the West African College of Physicians, when I went for my defense of my dissertation, I was told that I did not use the appropriate statistical analysis to analyze my results. And because of that, the findings are arguable, debatable, and they might not be correct. So I need to go back because there are different types of ways they look at the exam. When you do an exam, they say you are referred. It means that you have corrections to make. You have to come back. Do the corrections and come back and defend. So I was referred, not outright failure I was referred, so I felt very, very discouraged, not necessarily discouraged. I felt bad. And I said, I have not failed any exam. When I tell my colleagues, they say it’s not failed. Go and make a correction and bring it back. But I considered that a failure because I’ve always been passing the exams, but it was also a lesson, and that even led me to read the book- what was his name? I can’t remember his name. Failing Forward, where every failure, you take every failure as an opportunity to learn and to create a success. So that singular event made me to learn medical statistics. So I went back home. I got books on medical statistics, learned a lot about logistic regression, Cox regression analysis, different types of things I learned just to be sure that there were no loopholes in my work. And of course I did that, and I cleared the exams. And that singular event made me to be who I am because you can’t write a good paper if you don’t have good knowledge on statistics, medical statistics. And the challenge I noticed that most of the other colleagues have is that if you want to write a paper, then you have to look for a statistician to start analyzing your work. That’s also a delay. But if you have some knowledge of statistics, it becomes easier for you, except maybe deep statistics. It’s always good, or if you’re working on a big project, it’s good to have a statistician on board. But there are some work you want to do, that you can do yourself. And it’s even faster if you are able to do it yourself, so that’s improved, so I would say, even in medical statistics, I have above average knowledge on medical statistics, and that’s been one of the influence on what I’m doing now. So I have taken that perspective, and even when, by the grace of God, I became a professor after, 5 years after I qualified as an infectious disease physician.

I’ve been still very interested in research and academics. And I always look for opportunities to see, because I’m very curious minded, and analytical. So I look for opportunities to see is there something here, there’s something to learn here. Is there information to share? I tell my younger doctors now, because every opportunity to have I say that is an interesting case, you can share it in a conference, you can publish it as a case report, you can publish it as an observational study. Go and write. So I think we all have the responsibility, I say that I’m still a learner, so I’m not in the state where I’ll call myself an authority, a big authority. I’ve still looking for opportunities to learn. But I always try to carry along my younger colleagues, and I give them a challenge. It’s not easy, because not everyone is willing to accept that challenge. People look at it as work. They look at it, some people look at it as trouble. But they don’t see opportunities in it, because every success comes as work. That’s the truth. Every breakthrough first presents itself as work. And nobody will give you a breakthrough on a platter of gold, it comes as work. You need to work through it before you see your breakthrough. Unfortunately, some younger colleagues are not willing to take advantage of that work to get to their breakthrough. And that’s a challenge, I see, even with the mentorship I have now. Because I have some younger colleagues that are not willing, actually not willing to do the work. And some are looking for quick finishes, which is not necessarily appropriate. So because of my love for mentorship to- when I said it, when we, because I work in the HIV AIDS clinic, I established a team we call the craft team. Which is creating ideas for, to answer questions. Creating ideas to answer questions, research questions. We created a forum and the idea was to bring people together, younger colleagues together, where we ask them to go and draft topics, go and build hypotheses, grant proposals, research proposals, concept notes. Then we sit as a group, we analyze these concept notes and then they go to the field, conduct the research, we come collectively together, look at it, analyze it, make presentations. Then I always tell people that I was exposed to publications very early. That it’s one thing to write a paper. It’s another thing to publish it. It takes a lot to publish it. You need to be very patient as a researcher. A number of people are fortunate to have love for it. So because I noticed that some colleagues publish, not because the love for research, but because it is required for promotion. So if you are an academic, for you to move from one level to the other, you need to publish papers. So people do it, not because they love research, but because they want to be- they want to be promoted, and they have a tendency where people don’t want to work, but they want their names to appear in the research as part of co-authors. And that’s what I don’t like, and I had one situation where I actively worked- there are situations where people invite me to join the work. When I don’t see my contribution, I don’t want to join. Because I want to be actively involved in whatever work I am doing. So we have had that opportunity to go through that learning process with colleagues. And do that.

And the other area where I’ve also been involved in mentorship, and I’ve also been mentored is the Nigerian Infectious Disease Society. As the president of the society, and because of my love for research, I’m also the chair of the research committee of the Nigerian Infectious Disease Society. So we have had opportunities of doing collaborative research, because it is also a learning experience from collaborative research. People from different walks of life, different professional groups, different experience, different exposure. You get to learn a lot. So I’ve worked on several grants, and with colleagues from different places in Nigeria, and even outside Nigeria, and in such situations I’ve got to listen to very senior colleagues and their deep perspective. I always say that learning itself, and what you know, goes through 3 phases, and you become an authority when you get to that last phase. The first thing you have is you have knowledge. Knowledge is not good if you don’t have understanding. Understanding is not sufficient if you don’t have revelation, and revelation is the depth of it. We would have the revelation of issues, they have the depth of knowledge that you can think of, and when you have a revelation about any issue, you have good understanding, good knowledge, and you are able to apply it in whatever you are doing. And I observe that when we have such meetings with very senior colleagues. They have vast experience and knowledge. They are words, what they see. It tells you that it’s not everything, because I learned a lot, even from writing, from my pro- when I was younger, I was such a writer. I want to say everything, everything I see, everything I know. I want to say it in that paper. They say, no, this is not necessary for this. Look at the focus, focus of the work. Few words, focus, science based, evidence based. But as a young researcher I want to write, write this, write everything. They say no, there has to be focus in this work. Don’t write rubbish here. Focus, focus. And then I also want to quote every reference. Put references, and I’ll put 10 references together. I said, do you put in references this way? No, this is not necessary. Most important reference. So it is what I’ve been exposed to, and I always say this to my younger colleagues: nobody would give you knowledge on a platter of gold. Nobody does that. You get knowledge from your work, your willingness to sacrifice. To put yourself in your position to work. Because knowledge doesn’t come on a platter of gold, nobody does that. That’s the truth. Nobody does that. Your mentor will not, even if somebody is your mentor. They may do a little for you, but they want to gauge what your interest, level of interest. Unfortunately, mentors don’t just come, because that’s not how they learned. They don’t just come and say, this is how to write a paper, this is how to publish, this how to- they don’t do that. You learn it through a process. So you have to take the challenge of coming and suggesting a topic to them. They refine the topic. Go in to write the first draft. They refine it. Trying to submit for publication. I give a story of when we submitted our first paper. I wrote the paper, and it was submitted and reviewers came back, and they […]. And there’s something you’ll learn from reviewers, a lot of things you’ll learn, and it does expose my, even me to a lot of things too. They broaden your perspective and knowledge about what you have written. Because we allow our blind spots, there are certain things we don’t see. And when a reviewer looks at your work he’s able to understand it better, and take better action. So let me stop here for now I think I’ve been talking for too long.

JP Flores: No, no, no, that was beautiful. Everything you said was beautifully said. I mean, I just have a couple of more questions, one of which is, you talked about mentorship, right? How resilience and perseverance has led you to where you are in your career. How much, how important it is to do science for a good reason, right? Not just for the resume, or for an award, and the publication. Things like that. Can you just list a couple of main qualities that you know you think a mentor should have, or a good scientist should have?

Dimie Ogoina: Yeah. So the qualities of a good scientist may be different from the qualities of a good mentor. They may be similar but may be different. But I think a good scientist should be curious, and they should be open minded, you know that’s the experience I had even with monkeypox. And I say now, what I said is that when I was in medical school my prof encouraged me to challenge assumptions. But when I became an infectious disease physician and researcher, I tell myself and I tell my colleagues you can even challenge established norms. There are norms out there that people feel can not be changed. But it’s your responsibility to bring the evidence to even challenge established norms, and that’s the mindset of a scientist. And I teach my medical students now, I call it the concept of why. And even I go to the classroom because I said it’s good, every medical doctor, every clinician, every medical doctor is a scientist. The world would be better. But unfortunately, most medical doctors are not scientists. They are focused on individual and curing disease, but not looking at what caused it? Why did it happen? And I tell my students that the concept of why, that’s- whatever happens, if you are treating the patient, ask the question why? And I gave them my analogy that I was once called to review a case as an internal medicine physician. And this patient had hypertension. And was a young man, about 32 years old. He had hypertension, and he had had 2 strokes, 2 episodes of strokes, hypertensive strokes in the past. So when I came to review the patient, the first question I asked him is why should this man have hypertension? He was confused. Hypertension is common in our country, so people are entitled to that. I said no, why should this man have hypertension? Next question I asked him is that why should he even have a stroke? And why, on 2 occasions, why this man? Why should he have a stroke on 2 occasions? Then I also asked him- he had a skin lesion on the chest, so I asked, why should he have a skin lesion? And he was perplexed, and I told them that what we do as clinicians most often is that when we see a case, we go through the norm and say people are entitled to have hypertension. My responsibility is to treat them and get well and go home. But we don’t ask why, today, is it possible that something else is causing his hypertension apart from primary hypertension, because it turned out to be a secondary hypertension. This case I’m talking about turned out to be secondary hypertension. That’s treatable. It’s a treatable hypertension, and if you didn’t ask the why, you have a situation where you will give an anti-hypertensive, the person will be coming, you give an anti-hypertensive, you are just treating the symptoms. Not the source of the problem. So because of a why it’s very important. It was also applicable in the monkeypox. Because I asked the question during the monkeypox. Why should young men come up- all of them sexually active young men, come up with genital ulcers? And they, some of them had multiple sexual- there’s something there. We need to look at it further. So a scientist, you have a curious mind and should be open minded, should be prepared to get feedback. And I tell my students now, when I want to do lectures, I tell my students I don’t have all the knowledge, so as long as you are not disrespectful, you can challenge whatever I’m saying. You are free to challenge me, and that’s what a scientist is. So I think that’s very important, and you should have a depth of knowledge, and you should understand what is happening in environment. Scientists understand what is currently in vogue? What are the contemporary issues? What are the prior knowledge? Historical background? Because that’s where creativity comes. Creativity comes from reflection, from the knowledge you have within you, and the ability to think outside the box, not even within the box, outside the box. So I said throw away the box. You don’t need any box. Just think. Just think, very broadly. So I think those qualities are very important for a good scientist.

A good mentor has to have the depth of knowledge and experience. That’s very important. You have to have gone through the ropes of that profession that you are offering mentorship, because to all intents and purposes you can’t offer good mentorship if you have not gone through the ropes. Mentorship requires that. And I think that’s very critical. I always tell students don’t look for a mentor that doesn’t have the depth of knowledge regarding what you want to, the knowledge you aim to achieve. That’s very important. So a good mentor has to be somebody with good competence and skills. Knowledge in that chosen area. A good mentor should be patient. There’s a lot of patience that is required. Sometimes I will struggle with it. I notice that some of my students, some are faster than the others. Some are very slow. And sometimes, we don’t, mentors don’t look at what they went through to achieve the knowledge they have now. So when their mentees are doing work and it appears too mediocre. It appears too cheap. And you tend to interpret that work based on your experience, not knowing that, what you know now was drawn from your years of experience and knowledge. And so the way we interpret the work of our students, we need to be more patient with most of our mentees, and understand that they are also learning, and we take them through the ropes from one point to the other. A good mentor should be receptive. When I say receptive, mentees have problems assessing their mentors. So you have a situation where you have a challenge, and you cannot assess your, you can’t speak freely to your mentor. A good mentor is somebody that is approachable. So the mentees have the opportunities to approach them, to ask questions, and also to challenge them. A good mentor should be humble enough to be challenged by his mentee. And this is why I also tell my students, I’m very open minded, and you can challenge me just don’t be disrespectful about it. If you have a different opinion, say sir, I have a different opinion. This is what I think. Then we can debate. The worst that can happen is that we disagree. But we can debate and I know you have your perspective. And so a good mentor should not be vindictive. If you have a situation where you cannot work with your mentee, it’s better to close that relationship. And make it very clear to your mentee that because of these reasons I don’t think I can work with you, rather than being vindictive about- because we have situations where mentors are very vindictive, and especially when it’s in a in a formal academic setting, so mentors become vindictive. And mentor-mentee relationships should- it varies, depends on what you work. I believe that, ultimately your mentees, depends on how you’re impacting their lives, may reflect your personal life. But that’s not my- a good mentor should not expect the mentee to always reflect in the personal life. And what I mean by that, because sometimes mentors want to use mentees as houseboys. Housegirls. So they wash their cars. They clean their offices. They do all menial jobs. That’s not the responsibility of the mentee, but the mentee may want to do some of those things because you have also impacted their lives. So it should not be mandatory. So these are a few things that I think a mentor should have.

JP Flores: Definitely. Yeah, you’ve- I have a lot of mentees as well, because I’m a peer mentor, and it’s made me rethink a lot of the relationships I’ve had with them, too. So how do you stay motivated? Because it seems like you are, you are obviously a very high accomplishing individual. You have a good idea of how to mentor, you have mentees, you collaborate with people all over the world, you inform everybody about, for example the monkeypox virus, how do you stay motivated in all of it? How do you prevent burnout?

Dimie Ogoina: Yeah. So I stay motivated by aligning what I do to my interest and passion. And I say I always tell my colleagues, younger colleagues, and even colleagues, that if you have an ambition, for instance, you want to specialize. You want to do an area of what you want to do in life, it is good to focus on what you are passionate about. Not, and I give typical example of my doctors who all need to specialize, and I tell them there are different fields of medicine, and people have the perception that there are some fields where you have more money and more prestige. So people want to specialize in some fields, not because they like it or they’re interested, but because they feel they’ll have more money and more prestige. And I always tell them focus on what you are passionate about and what you have interest, and importantly, what- where you have the skill set. And if you focus on that you’ll excel, and you’ll be known for it. You’ll certainly be known for it. And I say, ask yourself, what can you do for free. If I ask you to do something, what can you do for free? Because you love it so much that you can do for free. That’s where your life ambition is, that’s where your pathway is. So over time, I’ve gone through- my interest in life has evolved over time in terms of my professional career itself, because I started up in medical school, was very interested in academics and research. Then, when I qualified as a consultant I became a lecturer, also interested in academics and research, and I became an administrator because I became head of department, currently I’m the Chief Medical Director. So I felt I needed to be more efficient, because the way I perceive life is that whatever assignment I’m given, I must do it very well, and I do it very excellently well. And you can’t do something well, if you don’t know it, that knowledge, and in fact, I always want to also get to the point of revelation for every field and every assignment I’m doing, because I become an expert. And so because I wanted to be more efficient in my administrative skills, I’ve learned a lot of our leadership. How to address people, teamwork, and a lot of things. And I also noticed that I needed to be more efficient in the way I manage people and resources. I also noticed that when I was teaching medical students I wanted to make my presentations more exciting, more informative, more engaging. I’m saying this because it led me to another thing again. I studied learning medical animations, because I wanted my medical students, I wanted to paint a picture of the disease, using animations, illustrations, and the likes, and I felt that was a good way of communicating information to my students. So I think I did it without any formal training, because I learned from Youtube, I learned from Youtube.

JP Flores: Do you use Adobe Illustrator? What do you use to make the animations?

Dimie Ogoina: I downloaded Adobe Illustrator, I downloaded Adobe Animate, I even had to use my salary to pay for some of those things. I learned a lot of software design, 2D animation. I even went to 3D animations, it was very tedious because I have blender in my system. I even had to download Mac and which other design software because I, even when we had, was it COVID or something, I wanted healthcare workers to be more familiar with the isolation facilities. So I had the idea of developing a software where a healthcare worker can enter the isolation facility without entering it, the virtual reality, and learn how to manage cases in the isolation facility. I started working on it, but was distracted on some other things. But I’ve done so many animations, for instance, malaria life cycle, I’ve done animation. I do medical games. I also went to software design. So, for instance, I did the software for my hospital. The customer management app for my hospital. Then I’ve done games, I do medical games, and because- when I say doing medical games, when I give it to some colleagues, they say they don’t want to be playing medical games. Can I do other games that are not medical? So I’ve also done non-medical games. And I’ve also done electronic software for my hospital because I’m data driven, I’m a data driven person. I like to take decisions it is always important to use data, and I observe that in a setting, because of limited resources, you call the experts and they charge you exorbitant fee. It became very difficult, and it was as if they were restricting my progress and decision making. And that was what even forced me to go and learn software development. Two reasons I learned software development and animation: for medical education, and to make administrative work very, very easy. So my spare time now, although I rarely have spare time now, because if not the administrative work taking my time, the fact that I’m the president of the NIDS, then my clinical work is also taking my time. Sometimes I teach medical students. But when I have spare time I’ve actually done close to 5 games, not yet published because I’m trying to perfect them, and publish them in the various, both app store, play store and then the normal desktop app. So I’m working on that. I’ve even learned app- because when I started learning app development, for instance, in the Pharmacy Department, I wanted a situation where I will have firsthand information of what is happening in that department. So I developed an app, I started using Excel. Then I went to a software where I developed what- the problem I had was the network. So it was not live. And you have situations where the network will drop and you lose all your information. So I said, is there a way where I can store the information when there is network automatically it will upload. So wherever you are, if you enter any information into your system, if there is no network, it will be saved. As soon as the network is available it will transfer to the back end. And that’s what led me to go and learn progressive web app. So I’ve mentioned progressive web app now, but app development. And it’s an area, too- I’m very excited about technology, applying technology and learning and doing so many things. I’m not yet perfect. But, I don’t think I will even be perfect, but that’s the area that I’m also motivated about, and I do a lot. And of course, when I have spare time I watched a lot of wrestling. I don’t know, I’ve liked wrestling since I was a child. And also I watch lawn tennis. My favorite player is, of course, Rafel Nadal. I don’t miss the event when he’s playing. So I do that. So that’s what I do, essentially, and of course read, get exciting information about what is happening. Then I always look for opportunity to conduct research, and I also, I enjoy making presentations, medical presentations and giving lectures, and I’ve done a lot because it brings out my creativity. It brings out my creativity, and even my passion. Yeah.

JP Flores: Well, thank you so much for doing this. Thank you for sharing that about yourself. Yeah. And again, thank you for taking the time to come on and talk to me and share all of your stories. I really really really appreciate it. It gives- I love doing these because it reminds me about, you know, why I’m in science, right? So I appreciate you taking the time to share all of that and sharing your perspective, even being like halfway across the world, too. Right? So.

Dimie Ogoina: Yeah, thank you very much. That’s a good opportunity and a privilege to talk to you.

JP Flores: Yeah. I hope you had some fun, too.

Dimie Ogoina: Yes I had good fun. Good fun, yeah.