Dr. Grace Chinelo Okengwu has learned to make the most of her situation. As a young doctor in the Abia state of Nigeria, she was often faced with difficult decisions, fighting a lack of resources and a shortage of staff.

Early on, Okengwu learned to improvise and “activate Plan B.” When her unit did not have the funding to continue operations, Okengwu and her colleagues would fundraise money themselves to keep it up and running. When they didn’t have enough drugs to treat their patients, or when the electricity or water would run out, they would find a way. Their creative fundraising efforts eventually helped build their hospital’s first neonatal ICU.

“No matter what is happening around me, I always make sure I am doing whatever I can to provide quality care to my patients,” Okengwu said.

An Ethical Dilemma

Okengwu wasn’t just fighting against a shortage of staff or resources, though. At times, she found herself at odds with her own hospital’s rules. One night, a woman came to Okengwu’s hospital after giving birth to a set of twins. She was experiencing postpartum hemorrhaging, and she and her preterm babies needed immediate intervention. However, it was against the hospital’s rules to treat babies who were not born at the hospital. 

Okengwu had a choice to make — turn the mother and babies away or treat them knowing she could face consequences for her actions. Her colleagues had refused to assist her, believing it was too risky to be involved. 

“There was nowhere else this mother could go,” Okengwu recalled. “I knew I was breaking the rules but I had to treat them.”

Okengwu spent the next 3 days tending to the mother and her babies nonstop. After their successful recovery, she was able to refer them to a different facility where they could be managed now that they were more stable.

Six weeks later, the mother returned to the hospital, but this time only to offer her gratitude to Okengwu for saving her and her babies’ lives, even at the risk of Okengwu’s own job.

“I believe in doing what I can to save lives as long as I have the means,” Okengwu said. “If I can do something, no matter how little, I will do my best to help someone, even if it means going against the rules.”

Where Does Work End and Motherhood Begin?

Okengwu’s belief in helping no matter the cost has guided her throughout her career, and drove her to find ways to treat her patients regardless of the resources available. Her tenacity and resourcefulness were developed early in Okengwu’s career, when she became a mother.

Okengwu had just finished her compulsory year of service when she had her first child, a daughter named Chimdi. Having just spent a year in the national service corps, Okengwu could not afford to wait any longer to begin working. When her daughter was four months old, Okengwu began working at the Ministry hospital in Abia state. However, she could not find anyone to take care of her daughter while she was at work.

“I had to take her to the hospital with me every day,” Okengwu remembered. “I had a friend at the hospital who would watch her, and I would take breaks to feed and change her, and then it was back to work.” 

Once, Okengwu had worked from 8 am to 4 pm, and was scheduled to work the night shift until 8 am the following morning. On a normal day, she would have a two-hour break where she would be able to breastfeed her daughter. On this particular day, she was told she had no time for a break and was forced to wait a full 24 hours before she could breastfeed again.

“I felt like I was being tortured,” Okengwu remembered of her time away from her daughter, “but I had patients in critical condition, so what could I do?”

Eventually, Okengwu was able to get through this challenging period, which she feels ultimately made her stronger. Okengwu would continue to bring her daughter, Chimdi, to the hospital with her when she wasn’t in school. However, there were still often times where Okengwu would need to work night shifts and spend long amounts of time away from home, and Chimdi would voice her disapproval.

Continuing the Medical Legacy

“I had to speak to her like a grownup at an early age,” Okengwu said. “I had to make her understand the life of a doctor and why I needed to be away from her sometimes.”

Okengwu began explaining to her daughter, in the simplest terms possible, what being a doctor meant and why it was important. To Okengwu’s surprise, Chimdi quickly understood, and the more she understood the more she believed in what her mother was doing. So much so, that at the tender age of four years old Chimdi told her mother that she had decided she wanted to become a doctor herself. 

“Because of our conversations she understands the challenges we face as doctors in Nigeria, but she still has not changed her mind,” Okengwu said of Chimdi, who will turn eight later this year. “She knows it is not an easy life and it requires a lot of hard work, but I see traits in her that would make her successful in this field.”

Okengwu says she will not push her daughter into following in her footsteps, but admits that Chimdi’s medical ambitions have made it easier for Okengwu to balance life and work.

“Now that she knows how important my work is, it is not as difficult when I need to work long hours,” Okengwu said. “I explain to her that I need to help people and she understands, and I just have to make it up to her when I come home by spending time with her.”

A New Chapter on Campus

Her daughter’s understanding also made things easier when Okengwu had to decide whether or not she was joining UGHE’s MGHD program, which would mean spending a full year away from home. The program had been recommended to Okengwu by her mentor, who felt the program could be a stepping stone to great things for her.

“Given the challenges I had faced in my work, I knew that the wealth of knowledge and skills that i will acquire at UGHE one thing that would help me be able to contribute to the revitalization of our health system,” Okengwu said.

When it came time to decide, Okengwu sat her daughter down and — just as she had many times before — explained to her the situation. As usual, Chimdi understood. After discussing more with her family, Okengwu decided to enroll at UGHE in the fall of 2019.

“We knew it was going to be difficult,” Okengwu recalled. “But knowing I had the support of my family, especially my daughter, made me confident in my decision.”

That support became even more important when the COVID-19 pandemic forced Okengwu to make another decision, whether to stay at UGHE or go home to be with her family. Okengwu is the kind of person who finishes what she has started, but the uncertainty of the situation could not be ignored.

“I talked for hours with my family every day,” Okengwu said. “My daughter knows what is happening with the coronavirus. When I explained to her why I had wanted to stay, she understood. Thankfully, my whole family agreed.”

With her family’s support, Okengwu decided to stay in Rwanda to complete her courses. At UGHE she had found a community of people who understood the problems she had experienced in her career and shared her vision of finding solutions. The program was addressing the challenges in her previous work and helping her build the skills she needed to go back to Nigeria prepared to confront them.

A Hope for the Future

Throughout her career, Okengwu has been motivated by her belief in equity for all her patients. But now, she has another motivation guiding her as she seeks to improve Nigeria’s health system — knowing her daughter may one day be a part of it. Thinking back to the obstacles Okengwu faced, both as a doctor and as a mother, she hopes that if her daughter grows up to be a doctor, she won’t face the same hardships — and neither will her patients.

“If Chimdi becomes a doctor, I hope the skills and knowledge I gain at UGHE will help me reshape the system she would be a part of,” Okengwu said. “Knowing she may follow my path makes everything I am learning here mean that much more.”