…as stakeholders advocate the passage of Nigeria Tobacco Control Bill
African nations seem poised to undergo the highest increase in the rate of tobacco use among developing countries. This is as about 90 percent of people on the continent perhaps remain without meaningful protection from second-hand smoke.
Earlier this year, it was estimated that smoking will claim the lives of six million people globally in 2010, 72 per cent of whom reside in low and middle-income countries, Nigeria inclusive. However, it is believed that if current trends continue, tobacco may kill seven million people annually by 2020 and more than 8 million people annually by 2030.
Following health risks associated with tobacco consumption which according to health experts is the second leading cause of death (after hypertension) and currently responsible for the death of one in 10 adults globally, experts are of the view that enacting effective policies towards reducing tobacco consumption in Nigeria will go a long way at saving the lives of people.
In an interview with BusinessDay, Akinbode Oluwafemi, Programme Manager, Environmental Rights in Nigeria/ Friends of the Earth, said that tobacco that cigarette contains about 4000 toxic and cancer-causing chemicals which is responsible for most cases of lung cancer.
While acknowledging the fact that smoking causes various forms of cancer, Akinbode noted that measures aimed at reducing smoking in Europe and America has driven the tobacco industry to developing countries like Nigeria, where the industry continues to flout regulations, marketing to young and impressionable youths, and hooking them on smoking.
According to him “Several African countries are fighting against the tobacco industry‘s aggressive campaigns to stop public health interventions by putting smoke-free laws into place, probably protecting more than 100 million more people since 2007. Smoke-free public places are one example of a low-cost and extremely effective intervention that must be implemented now to protect health.”
For Tosin Orogun, Programme Manager, Africa Tobacco Control Regional Initiative, Nigeria, “the World Health Organisation insists that strong worldwide enforcement and implementation of the Framework Convention on Tobacco Control (FCTC) could save 200 million lives by the year 2050.” Orogun stated that though Nigeria signed the FCTC, which had been ratified by over 168 countries since 2005, there has recording of deaths relating to tobacco, especially cancer.
As Parties to the global tobacco treaty begin their biennial meeting in Uruguay, the African Tobacco Control Consortium (ATCC), a coalition of global and African public health organizations focused on preventing the tobacco epidemic in Africa, there is the need to ensure that adoption of effective guidelines on Article 9 & 10 of WHO’s FCTC which seeks to promote smoke free environment which tobacco multinationals’ are alleging to scuttle.
At the moment, only Osun, Cross River states and the Federal Capital Territory being the only states to have passed the law prohibiting people from smoking tobacco in the public in Nigeria. Giving this reality, there is the need for Nigeria to key into WHO”s FCTC which seeks to protect people from the consequences of tobacco consumption by reducing the demand for and supply of tobacco, call for stronger tax and price measures, regulation of tobacco advertisements and the introduction of strong health messages on tobacco packages, adopting protective measures against exposure to tobacco smoke, the lives of Nigerians would greatly be protected.
It is noteworthy to state that in about less than two years, Kenya and Niger Republic enacted national smoke-free policies, and South Africa, which has been smoke-free since 2007, demonstrated that smoke-free laws could work in Africa. In what seemed as a first for the region, Mauritius recently passed a law that is close to meeting the Framework Convention on Tobacco Control standards, ranking among the most robust anti-smoking measures in the world.
The National Tobacco Control Bill (NTCB), which seeks to prohibit tobacco smoking in places and is now before the National Assembly, saw over 45 Non-Governmental Organisations (NGOs), including local and international organisations, making presentations in support of the bill.
Since the Public Hearing in July 2009, Nigerians and others stakeholders in public health including Babatunde Osotimehin, former health minister; Umar Modibbo, former FCT minister, Nigerians are hoping for Senator Iyabo-Obasanjo Bello, Chairman, Committee on Health at the national assembly to return the bill to plenary for adoption. But for how long will the hope of 150 million people be eventually realized?
Stakeholders are of the view that the bill is passed and enforced, two outcomes are possible: The level of national savings will increase and other forms of consumption expenditure will be substituted for tobacco expenditure.
Studies in several countries have examined the potential economic impact of the complete elimination of tobacco use and production. The evidence shows that elimination of tobacco will not affect the economy. This is because tobacco use has many externalised costs (costs not paid for by smokers or tobacco manufacturers). This involves healthcare costs incurred by governments to take care of smoking -related diseases.
When people no longer spend their money on tobacco, they will spend their money on other things. This alternative spending will stimulate other sectors of the economy. If the money is saved rather than spent, the increased savings are likely to have stimulatory macroeconomic effects.
by Alexander Chiejina
Thursday, November 18, 2010
Wednesday, November 10, 2010
African Baby Exhibition to promote infant and maternal survival
Unlike babies in developed countries, many babies in Africa are confronted with the challenge of undernourishment, malnutrition, insufficiencies, inadequate attention and insecurity right from birth. This nauseating condition in Africa has triggered a new kind of attention that is synergistic, connective, communicative and all-embracing.
In recognition of these problems, N-HANSA, a non-governmental organisation is now giving these babies a new lease of life through the African International Baby Exhibition which has been designed as an intervention plan to get the best for infants in a bid to reduce maternal mortality in Africa.
In an interview with BusinessDay, Consultant of Enhancer Exhibition Services, Oscar Odiboh during the unveiling of the project in Lagos recently said the exhibition, which is first of its kind, is a strategic regional partnership with the University Teaching Hospitals in Port Harcourt, Abuja and Lagos.
Giving insight into the programme billed to hold March 2011, Odiboh bemoaned the plight of care babies in Africa are faced with when compared to developed countries.
According to the consultant,” some societal practices does not adhere to guidelines on newborn care. Some of these babies born suffer from hypothermia (extreme cold), because they are bathed immediately after birth. This is very risky as these babies may die, develop pneumonia, feeds less and the amount of glucose or sugar in the blood decreases. This affects the baby's brain and increases risk of infection.
We know that the best place for a child is with a family. Even the best institution, with well-trained housemothers, will fall short of the love and nurturing a child finds with a caring parent. All hands should be on deck to ensure that care is given to babies at their infancy stage so as to reduce the rising rates of maternal and child deaths.”
The 2011 African Baby Exhibition tagged ‘AFRIBABY’ is expected to bring together the private bodies, organisations, professionals that focus on care of infants. The exhibition is to provide a platform for generating and disseminating the latest information through interactive discourses on the survival of new births, maternal joy, protection of lives and provision for the growth of babies in Africa.
For Olayinka Odiboh, Executive Director, N-HANSA, “the exhibition is geared towards raising awareness on adoption and misconception of the motherless babies homes and other issues such as stealing, selling, swapping and trafficking of babies in hospitals as recorded by the security agencies and media. This no doubt has become a subject of concern for years now as enormous pressure is on government agencies to curb the menace.”
It is believed that the programme would create a sustainable way to help motherless babies’ homes get sponsorship by creating massive awareness for them. The fair will also features symposium on the challenges of baby care, training of nannies by nutritionists, as well as free pregnancy and eye tests.
In recognition of these problems, N-HANSA, a non-governmental organisation is now giving these babies a new lease of life through the African International Baby Exhibition which has been designed as an intervention plan to get the best for infants in a bid to reduce maternal mortality in Africa.
In an interview with BusinessDay, Consultant of Enhancer Exhibition Services, Oscar Odiboh during the unveiling of the project in Lagos recently said the exhibition, which is first of its kind, is a strategic regional partnership with the University Teaching Hospitals in Port Harcourt, Abuja and Lagos.
Giving insight into the programme billed to hold March 2011, Odiboh bemoaned the plight of care babies in Africa are faced with when compared to developed countries.
According to the consultant,” some societal practices does not adhere to guidelines on newborn care. Some of these babies born suffer from hypothermia (extreme cold), because they are bathed immediately after birth. This is very risky as these babies may die, develop pneumonia, feeds less and the amount of glucose or sugar in the blood decreases. This affects the baby's brain and increases risk of infection.
We know that the best place for a child is with a family. Even the best institution, with well-trained housemothers, will fall short of the love and nurturing a child finds with a caring parent. All hands should be on deck to ensure that care is given to babies at their infancy stage so as to reduce the rising rates of maternal and child deaths.”
The 2011 African Baby Exhibition tagged ‘AFRIBABY’ is expected to bring together the private bodies, organisations, professionals that focus on care of infants. The exhibition is to provide a platform for generating and disseminating the latest information through interactive discourses on the survival of new births, maternal joy, protection of lives and provision for the growth of babies in Africa.
For Olayinka Odiboh, Executive Director, N-HANSA, “the exhibition is geared towards raising awareness on adoption and misconception of the motherless babies homes and other issues such as stealing, selling, swapping and trafficking of babies in hospitals as recorded by the security agencies and media. This no doubt has become a subject of concern for years now as enormous pressure is on government agencies to curb the menace.”
It is believed that the programme would create a sustainable way to help motherless babies’ homes get sponsorship by creating massive awareness for them. The fair will also features symposium on the challenges of baby care, training of nannies by nutritionists, as well as free pregnancy and eye tests.
Challenges of cancer management in Nigeria
by Alexander Chiejina
In recent times, cancer has emerged as a major public health problem in many developing countries, matching its effect in industrialised nations. Africa is no exception and with Africa's biggest population, Nigeria has a big share of the problems
Recent reports from the World Health Organisation (WHO) reveal that there are 100,000 new cancer cases in Nigeria annually although observers believe the figure could become higher than the stipulated figure.
With lung, stomach, liver, colon and breast cancer causing most cancer deaths annually and tobacco use been the single most important risk factor for cancer, medical experts have called for a co-ordinated approach towards preventing and treating cancer in Nigeria.
In an interview with Edamisan Temiye, Chairman, Nigerian Medical Association, Lagos State Branch, Temiye said that cancer accounted for 7.4 million deaths or around 13 percent of all deaths globally in 2004 and deaths from cancer are projected to continue rising globally with an estimated 12 million deaths in 2030.
Temiye stated that tobacco use, alcohol use, chronic infections from hepatitis B (HBV), hepatitis C virus (HCV) and some types of Human Papilloma Virus (HPV) are leading risk factors for cancer in low- and middle-income countries, with about one-third of the cancer burden likely to be decreased if cases were detected and treated early.
“In Nigeria, there seem not to have a co-ordinated approach to the prevention and treatment of cancer. The individuals who are stricken with cancer are left to fend for themselves with high cost of treatment, poverty, superstition, lack of appropriate facility for care and other factors which has made cancer an extremely deadly disease in Nigeria,” Temiye revealed.
Lending his view, Samuel Eyesan, consultant orthopaedic oncologist, National Orthopaedic Hospital, Igbobi, Lagos, said that problems of impeded access to health care, ignorance, and poverty have resulted in delayed diagnosis. The consultant orthopaedic oncologist noted that lack of coordination of issues of health education has gone a long way in complicating the management of cancer.
He hinted that the economic cost associated with the management of patients with cancer are expensive, with imaging facilities such as computerized tomography (CT) and Magnetic Resonance Imaging (MRI), used for imaging patients not readily available in every health institution. He added that when such facilities are available, the cost of such studies are prohibitive – putting them out of reach of the average citizen.
“The same argument of high cost applies to chemotherapy. While pathology services are generally available, the scope of services is limited. Molecular diagnostic methods are not widely available and surgery is often performed by surgeons whose primary clinical practice is not oncology, and there is a very limited scope for multidisciplinary cancer care. There is also the challenge of public enlightenment strategy, which is poor, institutional factors (such as infrastructural decay, inadequate trained personnel) etc, which we are a nation are confronted with in the management of cancer,” Eyesan disclosed.
Taking a cursory look at the entire scenario of cancer management, the absence of proper cancer data is a major factor militating against cancer management in the country. This is evident in cancer registration which officially began in 1960 but it was not until 1990 that a National Headquarters of Cancer Registries was established in Ibadan. How functional this registry is still in doubt.
With early detection of cancer based on the observation that treatment is more effective when cancer is detected earlier, educating people through electronic and print media on the need to recognize early signs of cancer and seek prompt medical attention for symptoms, which might include lumps, sores, persistent indigestion, persistent coughing, and bleeding from the body's orifices is of utmost importance.
At the meantime, calls have been made to the federal government to establish a functional cancer registry centre for proper statistical data and analysis of the disease. The centre, when established, would help in the control and management of cancer in the country even as doctors and nurses at the primary health care level should be trained to diagnose cancer to help in early detection.
For Temiye “we need to encourage the government at all levels to assist the populace by way of providing care to those who are affected. Non-governmental organisations specializing in the provision of education materials and support for the prevention and treatment of cancer should be encouraged and supported by all concerned. For successful management of cancer, team work is needed by all concerned in the treatment.”
In the estimation of Lewis Nwoku, Professor of Oral, maxillofacial plastic surgery at the Lagos University Teaching Hospital (LUTH), Idi-Araba, “there is the need to increase political commitment for cancer prevention and control; Develop standards and tools to guide the planning and implementation of interventions for prevention, early detection, treatment and care; Facilitate broad networks of cancer control partners at regional and national levels; as well as strengthen health systems at national and local levels.”
In recent times, cancer has emerged as a major public health problem in many developing countries, matching its effect in industrialised nations. Africa is no exception and with Africa's biggest population, Nigeria has a big share of the problems
Recent reports from the World Health Organisation (WHO) reveal that there are 100,000 new cancer cases in Nigeria annually although observers believe the figure could become higher than the stipulated figure.
With lung, stomach, liver, colon and breast cancer causing most cancer deaths annually and tobacco use been the single most important risk factor for cancer, medical experts have called for a co-ordinated approach towards preventing and treating cancer in Nigeria.
In an interview with Edamisan Temiye, Chairman, Nigerian Medical Association, Lagos State Branch, Temiye said that cancer accounted for 7.4 million deaths or around 13 percent of all deaths globally in 2004 and deaths from cancer are projected to continue rising globally with an estimated 12 million deaths in 2030.
Temiye stated that tobacco use, alcohol use, chronic infections from hepatitis B (HBV), hepatitis C virus (HCV) and some types of Human Papilloma Virus (HPV) are leading risk factors for cancer in low- and middle-income countries, with about one-third of the cancer burden likely to be decreased if cases were detected and treated early.
“In Nigeria, there seem not to have a co-ordinated approach to the prevention and treatment of cancer. The individuals who are stricken with cancer are left to fend for themselves with high cost of treatment, poverty, superstition, lack of appropriate facility for care and other factors which has made cancer an extremely deadly disease in Nigeria,” Temiye revealed.
Lending his view, Samuel Eyesan, consultant orthopaedic oncologist, National Orthopaedic Hospital, Igbobi, Lagos, said that problems of impeded access to health care, ignorance, and poverty have resulted in delayed diagnosis. The consultant orthopaedic oncologist noted that lack of coordination of issues of health education has gone a long way in complicating the management of cancer.
He hinted that the economic cost associated with the management of patients with cancer are expensive, with imaging facilities such as computerized tomography (CT) and Magnetic Resonance Imaging (MRI), used for imaging patients not readily available in every health institution. He added that when such facilities are available, the cost of such studies are prohibitive – putting them out of reach of the average citizen.
“The same argument of high cost applies to chemotherapy. While pathology services are generally available, the scope of services is limited. Molecular diagnostic methods are not widely available and surgery is often performed by surgeons whose primary clinical practice is not oncology, and there is a very limited scope for multidisciplinary cancer care. There is also the challenge of public enlightenment strategy, which is poor, institutional factors (such as infrastructural decay, inadequate trained personnel) etc, which we are a nation are confronted with in the management of cancer,” Eyesan disclosed.
Taking a cursory look at the entire scenario of cancer management, the absence of proper cancer data is a major factor militating against cancer management in the country. This is evident in cancer registration which officially began in 1960 but it was not until 1990 that a National Headquarters of Cancer Registries was established in Ibadan. How functional this registry is still in doubt.
With early detection of cancer based on the observation that treatment is more effective when cancer is detected earlier, educating people through electronic and print media on the need to recognize early signs of cancer and seek prompt medical attention for symptoms, which might include lumps, sores, persistent indigestion, persistent coughing, and bleeding from the body's orifices is of utmost importance.
At the meantime, calls have been made to the federal government to establish a functional cancer registry centre for proper statistical data and analysis of the disease. The centre, when established, would help in the control and management of cancer in the country even as doctors and nurses at the primary health care level should be trained to diagnose cancer to help in early detection.
For Temiye “we need to encourage the government at all levels to assist the populace by way of providing care to those who are affected. Non-governmental organisations specializing in the provision of education materials and support for the prevention and treatment of cancer should be encouraged and supported by all concerned. For successful management of cancer, team work is needed by all concerned in the treatment.”
In the estimation of Lewis Nwoku, Professor of Oral, maxillofacial plastic surgery at the Lagos University Teaching Hospital (LUTH), Idi-Araba, “there is the need to increase political commitment for cancer prevention and control; Develop standards and tools to guide the planning and implementation of interventions for prevention, early detection, treatment and care; Facilitate broad networks of cancer control partners at regional and national levels; as well as strengthen health systems at national and local levels.”
Polio eradication in Nigeria and the challenges ahead
by Alexander Chiejina
Over the years, the nation’s healthcare has been saddled with the challenge of eradicating the incidence of wild poliovirus (WPV). Sadly, this disease has placed Nigeria among countries like India, Afghanistan and Pakistan (PAIN) known to be endemic with the polio virus. This no doubt spurred authorities in the country’s health sector to seek lasting solutions towards addressing this anomaly and reversing the trend.
Hence, governors of the 36 states in February 2009, collectively signed the “Abuja commitments to Polio Eradication', by providing the necessary leadership to eradicate polio. Also, with the relentless efforts of community health workers, traditional and religious leaders who pledged to provide active leadership via allocating adequate human and financial resources to the polio immunization activities, including mop-up plans and feedback, marked improvements in several previously high-risk states were noted. Currently, the nation has recorded just 8 polio cases in 2010, compared to 382 this time last year and 798 in 2008 – an unprecedented drop.
As Nigeria and the international community continue to applaud the success recorded in Nigeria in fighting against the dreaded poliomyelitis scourge which experts describe as the single largest drop in polio cases ever recorded, there are fears that possible resurgence of the WPV might scuttle plans to totally eradicate polio in Nigeria. This fear is coming as the Experts Review Committee (ERC) on Polio Eradication Initiative (PEI) has envisioned that within the next six months, polio should have been eradicated within the six geopolitical zones of the country.
Speaking to newsmen in Lagos recently, Oyewale Tomori, Experts Review Committee Chairman on PEI, said that so far, Nigeria has recorded 98 percent reduction in polio cases within 12 months which is a remarkable achievement within a short period of time. Tomori stated that attaining this percentage reduction is not enough in eradicating a disease like polio as efforts must be made to attain 100 percent success.
Tomori, who is a professor of virology and Vice Chancellor Redeemer’s University noted that Nigeria should double its efforts to eradicate the disease, as any attempt to relent in plans to achieve positive result could be disastrous for, not only the country, but the entire world.
In his words “In order to achieve the desired success within the proposed time-frame, the National Primary Healthcare Development Agency (NPHCDA) and development partners in the fight against polio should engage in aggressive mop up strategies in areas where new cases have been recorded. Also, government at all levels should continue with their support, as development partners were still willing to fund the project.”
Lending his view at the recent World Polio Day, Muhammad Pate, Executive Director, NPHCDA, revealed that Nigeria is one of the last frontiers in the global campaign to eradicate polio. Pate stated that as long as there’s polio anywhere, the threat of polio exists everywhere.
The Executive Director disclosed that since polio threatens children in Nigeria and other neighbouring countries, the Honourable Minister of Health Onyebuchi Chukwu was leading a special effort to ensure cross-border coordination of immunization and disease control with our neighbours, including Cameroun, Chad and Niger.
According to Pate; “Leadership at all levels will make the difference between success/failure. We have seen unprecedented leadership from our Executive Governors and Local Government Chairmen who have provided oversight and resources, particularly in the Northern states where the risks of polio are greater. We benefit from essential support for the polio fight from our traditional leaders who are helping to plan campaigns, mobilize communities and ensure families understand the threat of polio and the benefits of the oral polio vaccine.
Stopping polio means that our families will never again lose another child to this crippling and disfiguring disease. Over time, eradication will save billions of naira, and we can invest the funds in other health priorities. The infrastructure we have built and the lessons learnt from polio eradication are a spearhead to tackle other health challenges. If we can eradicate polio, we can save our children from other killer childhood diseases, protect our mothers in childbirth and deliver better health services to all Nigerians.
In Nigeria, we have the vaccine technology and the knowledge to contribute to the worldwide mission to eliminate polio. Now, we need continued leadership to ensure our children are immunized. Polio eradication is a priority worthy of our investment.”
With the ERC report, which covers October 2009 to October 2010, warned that despite the success recorded, some gaps still existed that threaten the achievement of 100 percent polio eradication in the country among which was that not all high risk areas have significantly improved, it is important the country adopt an aggressive and intensive mop-up strategy to respond effectively to the menace.
For Shilaj Chakravorty, Consultant Pathologist, BT Health and Diagnostic Centre, Lagos State University Teaching Hospital (LASUTH), the National Immunization Days should be intensified together with mop-up operations to see that the initiatives of eradicating polio succeed. Also, all tiers of government should work in concert to see that polio is wiped out of Nigeria. He pointed out the fact that since this is a global initiative, no country should pull the rest of the world back. In other words, every country must ensure that the initiative succeeds.
Furthermore, Government should mount vigorous media campaigns in English, Pidgin and local languages to sensitize the public on the programme. In addition, all health-related Non-Governmental Organizations (NGOs) should regard themselves as relevant partners in the effort to achieve this laudable goal.
Till date, four countries – Afghanistan, India, Nigeria and Pakistan – are still harbouring the disease, which attacks the nervous system and can cause irreversible paralysis and the global health body-WHO- should pay special attention to these four countries that still have reservoir of the virus.
Over the years, the nation’s healthcare has been saddled with the challenge of eradicating the incidence of wild poliovirus (WPV). Sadly, this disease has placed Nigeria among countries like India, Afghanistan and Pakistan (PAIN) known to be endemic with the polio virus. This no doubt spurred authorities in the country’s health sector to seek lasting solutions towards addressing this anomaly and reversing the trend.
Hence, governors of the 36 states in February 2009, collectively signed the “Abuja commitments to Polio Eradication', by providing the necessary leadership to eradicate polio. Also, with the relentless efforts of community health workers, traditional and religious leaders who pledged to provide active leadership via allocating adequate human and financial resources to the polio immunization activities, including mop-up plans and feedback, marked improvements in several previously high-risk states were noted. Currently, the nation has recorded just 8 polio cases in 2010, compared to 382 this time last year and 798 in 2008 – an unprecedented drop.
As Nigeria and the international community continue to applaud the success recorded in Nigeria in fighting against the dreaded poliomyelitis scourge which experts describe as the single largest drop in polio cases ever recorded, there are fears that possible resurgence of the WPV might scuttle plans to totally eradicate polio in Nigeria. This fear is coming as the Experts Review Committee (ERC) on Polio Eradication Initiative (PEI) has envisioned that within the next six months, polio should have been eradicated within the six geopolitical zones of the country.
Speaking to newsmen in Lagos recently, Oyewale Tomori, Experts Review Committee Chairman on PEI, said that so far, Nigeria has recorded 98 percent reduction in polio cases within 12 months which is a remarkable achievement within a short period of time. Tomori stated that attaining this percentage reduction is not enough in eradicating a disease like polio as efforts must be made to attain 100 percent success.
Tomori, who is a professor of virology and Vice Chancellor Redeemer’s University noted that Nigeria should double its efforts to eradicate the disease, as any attempt to relent in plans to achieve positive result could be disastrous for, not only the country, but the entire world.
In his words “In order to achieve the desired success within the proposed time-frame, the National Primary Healthcare Development Agency (NPHCDA) and development partners in the fight against polio should engage in aggressive mop up strategies in areas where new cases have been recorded. Also, government at all levels should continue with their support, as development partners were still willing to fund the project.”
Lending his view at the recent World Polio Day, Muhammad Pate, Executive Director, NPHCDA, revealed that Nigeria is one of the last frontiers in the global campaign to eradicate polio. Pate stated that as long as there’s polio anywhere, the threat of polio exists everywhere.
The Executive Director disclosed that since polio threatens children in Nigeria and other neighbouring countries, the Honourable Minister of Health Onyebuchi Chukwu was leading a special effort to ensure cross-border coordination of immunization and disease control with our neighbours, including Cameroun, Chad and Niger.
According to Pate; “Leadership at all levels will make the difference between success/failure. We have seen unprecedented leadership from our Executive Governors and Local Government Chairmen who have provided oversight and resources, particularly in the Northern states where the risks of polio are greater. We benefit from essential support for the polio fight from our traditional leaders who are helping to plan campaigns, mobilize communities and ensure families understand the threat of polio and the benefits of the oral polio vaccine.
Stopping polio means that our families will never again lose another child to this crippling and disfiguring disease. Over time, eradication will save billions of naira, and we can invest the funds in other health priorities. The infrastructure we have built and the lessons learnt from polio eradication are a spearhead to tackle other health challenges. If we can eradicate polio, we can save our children from other killer childhood diseases, protect our mothers in childbirth and deliver better health services to all Nigerians.
In Nigeria, we have the vaccine technology and the knowledge to contribute to the worldwide mission to eliminate polio. Now, we need continued leadership to ensure our children are immunized. Polio eradication is a priority worthy of our investment.”
With the ERC report, which covers October 2009 to October 2010, warned that despite the success recorded, some gaps still existed that threaten the achievement of 100 percent polio eradication in the country among which was that not all high risk areas have significantly improved, it is important the country adopt an aggressive and intensive mop-up strategy to respond effectively to the menace.
For Shilaj Chakravorty, Consultant Pathologist, BT Health and Diagnostic Centre, Lagos State University Teaching Hospital (LASUTH), the National Immunization Days should be intensified together with mop-up operations to see that the initiatives of eradicating polio succeed. Also, all tiers of government should work in concert to see that polio is wiped out of Nigeria. He pointed out the fact that since this is a global initiative, no country should pull the rest of the world back. In other words, every country must ensure that the initiative succeeds.
Furthermore, Government should mount vigorous media campaigns in English, Pidgin and local languages to sensitize the public on the programme. In addition, all health-related Non-Governmental Organizations (NGOs) should regard themselves as relevant partners in the effort to achieve this laudable goal.
Till date, four countries – Afghanistan, India, Nigeria and Pakistan – are still harbouring the disease, which attacks the nervous system and can cause irreversible paralysis and the global health body-WHO- should pay special attention to these four countries that still have reservoir of the virus.
Friday, November 5, 2010
Federal Government urged to focus on Pneumonia eradication
…As Pfizer launches Prevenar 13 pneumococcal vaccine
Alexander Chiejina
There is no gain saying that Nigeria is the economic powerhouse of West Africa. However, despite been one of the wealthiest countries on the African continent, its health indices is a course of major concern to health experts in the country giving the fact that about a million children under the age of 5 die every year from preventable childhood illnesses.
Only recently, the World Health Organisation (WHO) revealed that pneumonia is the single largest cause of death in children globally with an estimated that 1.8 million children under the age of five years dying from the disease and another 155 million cases of childhood pneumonia reported annually.
Driving this matter home, the burden of pneumococcal diseases in the world has placed Nigeria first in Africa and second in the world after India on the list of 15 countries, with an estimated 700, 000 infants affected by the disease thus recording three-quarters of childhood pneumonia cases in the world. Also, Nigeria lies in the Pneumococcal Meningitis belt of Africa where mortality in children and adults has remained high since the seventies despite availability of antibiotics for treatment.
Giving this worrisome indices, experts at a program organised by Pfizer Inc. to launch its pneumococcal polysaccharide conjugate vaccine Prevanar 13 in Lagos have tasked the Federal Government to increase vaccination of children with a view of nipping this disease in the bud.
Explaining the aetiology, Christy Okoromah, Consultant Cardiology/Infection Disease Unit, Department of Paediatrics, Lagos University Teaching Hospital (LUTH), Idi Araba, said that Pneumonia is a form of acute respiratory infection which affects the lungs.
Okoromah disclosed that the most common cause of this life threatening childhood pneumonia is caused by the bacterium Streptococcus pneumoniae; Haemophilus influenzae type b (Hib) – the second most common cause of bacterial pneumonia; and in infants infected with HIV, Pneumocystis jiroveci which is responsible for at least one quarter of all pneumonia deaths in HIV-infected infants.
According to her; “the normal inhabitant of S. pneumonia is in the nasopharnyx of humans. It can be spread via air-borne droplets from a cough or sneeze. In addition, pneumonia may spread through blood, especially during and shortly after birth. The symptoms of pneumonia include rapid or difficult breathing, cough, fever, chills and wheezing (more common in viral infections).
When pneumonia becomes severe, children may experience lower chest wall indrawing, where their chests move in or retract during inhalation (in a healthy person, the chest expands during inhalation). Infants may be unable to feed or drink and may also experience unconsciousness, hypothermia and convulsions.”
For Adegoke Falade, Consultant Paediatrician, University College Hospital, UCH, Ibadan, while most healthy children can fight the infection with their natural defences, children whose immune systems are compromised are at higher risk of developing pneumonia. Falade stated that pre-existing illnesses, such as symptomatic HIV infections and measles, also increase a child's risk of contracting pneumonia.
In his words “the bacterium S. Pneumonia is invasive, invisible and has got many deadly serotypes in the country that are resistant to antibiotics. However, drivers that predisposes to antibiotic resistance include the prescription of most antibiotics for the treatment of pneumonia which is not necessary. Another major concern is the low dose and long duration of illness when antibiotic is used for treatment. It is noteworthy to state that indoor air pollution caused by cooking and heating with biomass fuels (such as wood or dung), overcrowding can increase a child's susceptibility to pneumonia.”
Even as Nigeria continues in its quest to attain the Millellium Development Goals (MDGs) by2015, there is the need to prevent pneumonia in children which is an essential component of a strategy to reduce child mortality. Hence, immunization against Hib, pneumococcus, measles and whooping cough (pertussis) is the most effective way to prevent pneumonia.
For Enrico Liggeri, country Manager, Pfizer Nigeria and the African region, since pneumococcal disease is the number 1 vaccine preventable cause in children under the age of 5 years globally, the launch of the New Prevenar 13 vaccine which is already in use in over 50 countries will go a long way in preventing babies dying in their thousands from preventable infection when immunized by the vaccine.
“Prevenar 13, which is a pneumococcal conjugate vaccine, helps to protect against the disease caused by 13 of the most prevalent pneumococcal serotypes globally (1,3,4,5,6A, 6B,7F, 9V, 14, 18C, 19A,19F and 23F which causes invasive pneumococcal disease including sepsis, meningitis, bacteria in blood, bacteria)etc. Hence, as many pathogens other than pneumococcal serotypes represented in the vaccine may contribute to pneumonia burden in children, protection against all clinical pneumonia is expected to be lower than for invasive pneumococcal disease (IPD)”, Amgad Gamil, Regional Medical Director, Vaccines, Pfizer Dubai revealed.
In addition, adequate nutrition is key to improving children's natural defences starting with exclusive breastfeeding for the first six months of life. This is also effective in preventing pneumonia and reducing the length of the illness. Also, addressing environmental factors such as indoor air pollution (by providing affordable clean indoor stoves) and encouraging good hygiene in crowded homes also reduces the number of children who fall ill with pneumonia.
There is the need for the Ministry of Health to collaborate with the National Primary Health Care Development Agency (NPHCDA) to ensure that pneumonia vaccines are included in 2011 strategy plans in the country’s routine immunisation process.
More importantly, the Federal, State and Local Governments should ensure through appropriate intervention, that the mortality and morbidity of this ‘forgotten killer’ (Streptococcus pneumonia) be curtailed at all levels, bearing in mind the resolution of the World Health Assembly in May 2010. However, the inauguration of a National Advisory Committee on Vaccination and Immunisation as found in developed countries such as the United States of America and Germany is recommended.
With this in place, understudying and understanding the pattern of infectious diseases in Nigeria whether periodic or seasonal and use evidence - based research epidemiology and surveillance will guide the nation.
Alexander Chiejina
There is no gain saying that Nigeria is the economic powerhouse of West Africa. However, despite been one of the wealthiest countries on the African continent, its health indices is a course of major concern to health experts in the country giving the fact that about a million children under the age of 5 die every year from preventable childhood illnesses.
Only recently, the World Health Organisation (WHO) revealed that pneumonia is the single largest cause of death in children globally with an estimated that 1.8 million children under the age of five years dying from the disease and another 155 million cases of childhood pneumonia reported annually.
Driving this matter home, the burden of pneumococcal diseases in the world has placed Nigeria first in Africa and second in the world after India on the list of 15 countries, with an estimated 700, 000 infants affected by the disease thus recording three-quarters of childhood pneumonia cases in the world. Also, Nigeria lies in the Pneumococcal Meningitis belt of Africa where mortality in children and adults has remained high since the seventies despite availability of antibiotics for treatment.
Giving this worrisome indices, experts at a program organised by Pfizer Inc. to launch its pneumococcal polysaccharide conjugate vaccine Prevanar 13 in Lagos have tasked the Federal Government to increase vaccination of children with a view of nipping this disease in the bud.
Explaining the aetiology, Christy Okoromah, Consultant Cardiology/Infection Disease Unit, Department of Paediatrics, Lagos University Teaching Hospital (LUTH), Idi Araba, said that Pneumonia is a form of acute respiratory infection which affects the lungs.
Okoromah disclosed that the most common cause of this life threatening childhood pneumonia is caused by the bacterium Streptococcus pneumoniae; Haemophilus influenzae type b (Hib) – the second most common cause of bacterial pneumonia; and in infants infected with HIV, Pneumocystis jiroveci which is responsible for at least one quarter of all pneumonia deaths in HIV-infected infants.
According to her; “the normal inhabitant of S. pneumonia is in the nasopharnyx of humans. It can be spread via air-borne droplets from a cough or sneeze. In addition, pneumonia may spread through blood, especially during and shortly after birth. The symptoms of pneumonia include rapid or difficult breathing, cough, fever, chills and wheezing (more common in viral infections).
When pneumonia becomes severe, children may experience lower chest wall indrawing, where their chests move in or retract during inhalation (in a healthy person, the chest expands during inhalation). Infants may be unable to feed or drink and may also experience unconsciousness, hypothermia and convulsions.”
For Adegoke Falade, Consultant Paediatrician, University College Hospital, UCH, Ibadan, while most healthy children can fight the infection with their natural defences, children whose immune systems are compromised are at higher risk of developing pneumonia. Falade stated that pre-existing illnesses, such as symptomatic HIV infections and measles, also increase a child's risk of contracting pneumonia.
In his words “the bacterium S. Pneumonia is invasive, invisible and has got many deadly serotypes in the country that are resistant to antibiotics. However, drivers that predisposes to antibiotic resistance include the prescription of most antibiotics for the treatment of pneumonia which is not necessary. Another major concern is the low dose and long duration of illness when antibiotic is used for treatment. It is noteworthy to state that indoor air pollution caused by cooking and heating with biomass fuels (such as wood or dung), overcrowding can increase a child's susceptibility to pneumonia.”
Even as Nigeria continues in its quest to attain the Millellium Development Goals (MDGs) by2015, there is the need to prevent pneumonia in children which is an essential component of a strategy to reduce child mortality. Hence, immunization against Hib, pneumococcus, measles and whooping cough (pertussis) is the most effective way to prevent pneumonia.
For Enrico Liggeri, country Manager, Pfizer Nigeria and the African region, since pneumococcal disease is the number 1 vaccine preventable cause in children under the age of 5 years globally, the launch of the New Prevenar 13 vaccine which is already in use in over 50 countries will go a long way in preventing babies dying in their thousands from preventable infection when immunized by the vaccine.
“Prevenar 13, which is a pneumococcal conjugate vaccine, helps to protect against the disease caused by 13 of the most prevalent pneumococcal serotypes globally (1,3,4,5,6A, 6B,7F, 9V, 14, 18C, 19A,19F and 23F which causes invasive pneumococcal disease including sepsis, meningitis, bacteria in blood, bacteria)etc. Hence, as many pathogens other than pneumococcal serotypes represented in the vaccine may contribute to pneumonia burden in children, protection against all clinical pneumonia is expected to be lower than for invasive pneumococcal disease (IPD)”, Amgad Gamil, Regional Medical Director, Vaccines, Pfizer Dubai revealed.
In addition, adequate nutrition is key to improving children's natural defences starting with exclusive breastfeeding for the first six months of life. This is also effective in preventing pneumonia and reducing the length of the illness. Also, addressing environmental factors such as indoor air pollution (by providing affordable clean indoor stoves) and encouraging good hygiene in crowded homes also reduces the number of children who fall ill with pneumonia.
There is the need for the Ministry of Health to collaborate with the National Primary Health Care Development Agency (NPHCDA) to ensure that pneumonia vaccines are included in 2011 strategy plans in the country’s routine immunisation process.
More importantly, the Federal, State and Local Governments should ensure through appropriate intervention, that the mortality and morbidity of this ‘forgotten killer’ (Streptococcus pneumonia) be curtailed at all levels, bearing in mind the resolution of the World Health Assembly in May 2010. However, the inauguration of a National Advisory Committee on Vaccination and Immunisation as found in developed countries such as the United States of America and Germany is recommended.
With this in place, understudying and understanding the pattern of infectious diseases in Nigeria whether periodic or seasonal and use evidence - based research epidemiology and surveillance will guide the nation.
Urbanization in Nigeria; a challenge to public health
By Alexander Chiejina
Nigeria as a nation has over the years been experiencing an accelerated shift of her populations from rural to urban areas. This rapid rate of urbanization has no doubt engendered several challenges and problems similar to situations in other parts of the world.
Sadly, most problems confronting cities, towns and their inhabitants as identified in Agenda 21 in Nigeria include inadequate financial resources, lack of employment opportunities, spreading homelessness and expansion of squatter settlements, increased poverty, growing insecurity and rising crime rates, inadequate and deteriorating building stock, services and infrastructure.
Other problems include substandard and inadequate housing, slums, transportation problems, low productivity, crime and juvenile delinquency, lack of health and educational facilities, improper land use, insecure land tenure, rising traffic congestion, increasing pollution, lack of green spaces, inadequate water supply and sanitation, uncoordinated urban development and an increasing vulnerability to disaster.
Giving this daunting reality which stares everyone in the face, health experts in the country have called for actions which should be directed towards reorganising the chaotic development that is rife in the cities and return the people to healthy development and living conditions.
Speaking to BusinessDay recently at the 2010 Physician Week organised by the Lagos State Branch of the Nigerian Medical Association (NMA), Edamisan Temiye, Lagos State Chairman of NMA, said that the growing urbanisation has become one of the biggest health challenges of the 21st century to Nigeria and the African continent.
Temiye disclosed that health is a major urban policy issue in Nigeria because poverty and slum conditions pose a serious public health threat to the country's rapidly expanding urban population. He stated that in vast areas of Nigerian and other African cities, inadequate sanitation and waste management and poor state of public health infrastructure have led to the spread of a wide variety of water-borne and other communicable disease.
In his words “those of us who are living in the megacity of Lagos are very much aware of the constraints for space and the rapidly disappearing neighbouring meeting places for relaxation. We are well aware of the slums often located in the vicinity of comfortable living and well constructed neighbourhood. Our actions as individuals, community, corporate organisations and government should be focused towards taking actions to mitigate the challenges of urbanization.”
For Akin Osibogun, Chief Medical Director, Lagos University Teaching Hospital (LUTH), Idi-Araba, though urbanization has its positive effect, one of the health problems urbanization is confronted with is the issue of mental health as evident in the number of people with stress, depression and anxiety.
Osibogun noted that urban cities have the increased risk factors for non communicable diseases and their risk factors such as tobacco use, unhealthy diets, physical inactivity, harmful use of alcohol as well as risks associated with disease outbreaks.
“River pollution is particularly found to be worse where rivers pass through cities and the most widespread is contamination from human excreta, sewage and oxygen loss. In many cities in the country, there is limited access to clean drinking water. The quality of several watercourses is poor, with pollutant levels higher than the WHO’s standards.
Sadly, pesticide contamination from urban agriculture, residues from sawmills and manufacturing industries, wastewater from urban drains and municipal dumping of waste especially human excreta pollute drinking water sources that affect the health of the urban and peri-urban populations. In the long- term, treatment of sewage would be required for safer vegetable production and to reduce water pollution,” Osibogun stated.
It is noteworthy to state that ill equipped settlements characterised by inefficient and uncoordinated urban governance, poor economic and resource base of cities, lack of community participation in urban development, poor urban land management and unsustainable development have endangered the lives of people living in urban areas.
Giving these realities, there is the need for all levels of government to take responsibilities to address these challenges by showing serious commitment to overcoming them through various planned strategies as evident in Lagos state with the megacity development.
For Muiz Banire, Commissioner for Environment, Lagos State, “when people become aware of the effects of their unwise use of the environment and well- equipped with the techniques of environmental management, the goals of the national Policy on environment will be easy to achieve. There is also the need for environmental awareness (Education) to institutions (primary and post primary) curricula.
The challenge of inadequate professional and supporting technical staff as well as inadequacy of current digitized data and information on urban conditions should be scaled up. This is because effective urban management strategies depend on comprehensive and up to-date information base.”
More importantly, governments at all levels including relevant stakeholders should be engaged in promoting urban planning for healthy behaviours and safety, improve urban living conditions, ensure participatory governance, build inclusive cities that are accessible and age-friendly and make cities resilient to disasters and emergencies.
Nigeria as a nation has over the years been experiencing an accelerated shift of her populations from rural to urban areas. This rapid rate of urbanization has no doubt engendered several challenges and problems similar to situations in other parts of the world.
Sadly, most problems confronting cities, towns and their inhabitants as identified in Agenda 21 in Nigeria include inadequate financial resources, lack of employment opportunities, spreading homelessness and expansion of squatter settlements, increased poverty, growing insecurity and rising crime rates, inadequate and deteriorating building stock, services and infrastructure.
Other problems include substandard and inadequate housing, slums, transportation problems, low productivity, crime and juvenile delinquency, lack of health and educational facilities, improper land use, insecure land tenure, rising traffic congestion, increasing pollution, lack of green spaces, inadequate water supply and sanitation, uncoordinated urban development and an increasing vulnerability to disaster.
Giving this daunting reality which stares everyone in the face, health experts in the country have called for actions which should be directed towards reorganising the chaotic development that is rife in the cities and return the people to healthy development and living conditions.
Speaking to BusinessDay recently at the 2010 Physician Week organised by the Lagos State Branch of the Nigerian Medical Association (NMA), Edamisan Temiye, Lagos State Chairman of NMA, said that the growing urbanisation has become one of the biggest health challenges of the 21st century to Nigeria and the African continent.
Temiye disclosed that health is a major urban policy issue in Nigeria because poverty and slum conditions pose a serious public health threat to the country's rapidly expanding urban population. He stated that in vast areas of Nigerian and other African cities, inadequate sanitation and waste management and poor state of public health infrastructure have led to the spread of a wide variety of water-borne and other communicable disease.
In his words “those of us who are living in the megacity of Lagos are very much aware of the constraints for space and the rapidly disappearing neighbouring meeting places for relaxation. We are well aware of the slums often located in the vicinity of comfortable living and well constructed neighbourhood. Our actions as individuals, community, corporate organisations and government should be focused towards taking actions to mitigate the challenges of urbanization.”
For Akin Osibogun, Chief Medical Director, Lagos University Teaching Hospital (LUTH), Idi-Araba, though urbanization has its positive effect, one of the health problems urbanization is confronted with is the issue of mental health as evident in the number of people with stress, depression and anxiety.
Osibogun noted that urban cities have the increased risk factors for non communicable diseases and their risk factors such as tobacco use, unhealthy diets, physical inactivity, harmful use of alcohol as well as risks associated with disease outbreaks.
“River pollution is particularly found to be worse where rivers pass through cities and the most widespread is contamination from human excreta, sewage and oxygen loss. In many cities in the country, there is limited access to clean drinking water. The quality of several watercourses is poor, with pollutant levels higher than the WHO’s standards.
Sadly, pesticide contamination from urban agriculture, residues from sawmills and manufacturing industries, wastewater from urban drains and municipal dumping of waste especially human excreta pollute drinking water sources that affect the health of the urban and peri-urban populations. In the long- term, treatment of sewage would be required for safer vegetable production and to reduce water pollution,” Osibogun stated.
It is noteworthy to state that ill equipped settlements characterised by inefficient and uncoordinated urban governance, poor economic and resource base of cities, lack of community participation in urban development, poor urban land management and unsustainable development have endangered the lives of people living in urban areas.
Giving these realities, there is the need for all levels of government to take responsibilities to address these challenges by showing serious commitment to overcoming them through various planned strategies as evident in Lagos state with the megacity development.
For Muiz Banire, Commissioner for Environment, Lagos State, “when people become aware of the effects of their unwise use of the environment and well- equipped with the techniques of environmental management, the goals of the national Policy on environment will be easy to achieve. There is also the need for environmental awareness (Education) to institutions (primary and post primary) curricula.
The challenge of inadequate professional and supporting technical staff as well as inadequacy of current digitized data and information on urban conditions should be scaled up. This is because effective urban management strategies depend on comprehensive and up to-date information base.”
More importantly, governments at all levels including relevant stakeholders should be engaged in promoting urban planning for healthy behaviours and safety, improve urban living conditions, ensure participatory governance, build inclusive cities that are accessible and age-friendly and make cities resilient to disasters and emergencies.
Monday, November 1, 2010
Nigerian donates cornea for transplant
… As experts call for local harvest of cornea in the country
The first successful cornea transplant operation on two patients by a local donor recently has received commendation by members of the medical community, friends and family of the donors and recipients of the cornea in Lagos.
The two patients- names withheld, had a successful cornea transplant in August 2010 following the death of Kola Shodipo, a 47 year old man who prior to his death on the 18th of the same month, pledged to donate the cornea in his eyes which were removed some hours after his death. The corneas were later used to restore sight to two individuals who had cornea blindness in one eye each.
Speaking to journalists at a recent press conference at Lagos State University Teaching Hospital (LASUTH),Ikeja, Lagos, Mosun Faderin, Medical Director of Eye Bank for Restoring Sight, Nigeria, said that cornea blindness encompasses a range of eye conditions that ultimately affect the transparency of the cornea, leading to blindness.
Faderin stated that though cornea blindness is reversible giving the fact that it is only the front part of the eye that is damaged, the aftereffects of bacterial, fungal, or viral infections, eye trauma, traditional medicine or home remedies, which often harm the eye rather than relieve pain or improve eyesight have been implicated in the cause of blindness.
In her words “Attacking the root causes of corneal blindness is the best path to blindness prevention. When that part is damaged, the person cannot see but with a successful surgery which involves the replacement of the damaged cornea with another got from another human, sight can be restored. For the cornea to be useful for a transplant, it must be removed within 12 hours after death with the consent of either the deceased, given before death, or the family members.”
Olaseinde Akinsete, Chairman of the Board of Eye Bank, recalled that although corneal transplant is lawful in Nigeria under Decree No.23, titled Cornea Grafting Decree 1973, not many corneal grafting operations have been carried out in the country.
“Under the decree, any person can either by writing or orally in the presence of two or more witnesses authorizes the excision of his or her eyes after death. The law stipulates that the person lawfully in custody of the body after death may unless he has reason to believe that the request was subsequently withdrawn, authorize removal of eyes. Notwithstanding the promulgation of the above mentioned decree, not many corneal grafting operations were carried out in Nigeria.”
While giving an insight to the number of people with cornea blindness in Nigeria, Akinsete added: “Nigeria has about 1,170,000 blind people, based on a blindness rate of 0.78 percent. Cornea blindness is about 7.9percent that is 92,430. It is the latter that may benefit from corneal grafting.”
Taking a cursory look at cornea transplant in Nigeria, late Shodipo is the first Nigerian to donate his eyes for a cornea transplant. Until now, all cornea transplants in Nigeria have been done with corneas got from other countries, mostly from India.
However, since the Eye bank became a reality when the Nigeria Society for the Blind and the Ophthalmological Society of Nigeria (OSN) got together to give birth to the Eye Bank from the money donated for cornea grafting in 2004, not a single cornea has been harvested locally until very recently. Sadly, the biggest challenge the country is faced with is that the public first of all don’t believe they should donate any part of their body after death. This is as pertinent as it is not possible to restore sight to a ‘blind’ person. In order to convince the public that someone who has cornea blindness (and this group accounts for about 33 percent of those with reversible or curable blindness worldwide), that the Board of the Eye Bank decided to source for corneas from abroad.
There is no gain saying that late Shodipo made his intention of donating his eyes in 2008 because of his love for people and applauded his humanitarian work. The first locally harvested corneas from a Nigerian donor who had pledged/donated his eyes after he saw and heard the experiences of two cornea graft recipients prior to his passing on have to be commended.
For Femi Olugbile, Chief Medical Director of LASUTH, the transplant is a landmark achievement even as he commended the family for ensuring that they obeyed Shodipo’s wish. Olugbile however called for the creation of proper legislation that would make it possible for unclaimed dead bodies and bodies of destitute be used for the extraction of useful body parts that can help sustain lives of those who have serious medical condition which would need transplant.
“The challenge of harvesting corneas and other body tissues for use on live patients in our country is a major one. Unfortunately, these bodies cannot be touched for cornea transplant and that is a major waste. There has to be a way in which that can be tidied up. A practical law creation exercise needs to be embarked upon to get access to these corneas,” Olugbile stated.
It is noteworthy to state that in 1994, the Government of India passed the Transplantation of Human Organs Act that legalised the concept of brain death and, for the first time, facilitated organ procurement from heart beating, brain dead donors this was borne out the fact that thousands of lives were lost in India annually from heart and liver failure since transplantation of unpaired organs like heart, liver and pancreas were either difficult or impossible from living donors.
Hence, organ and tissue donation is a way to help others- by allowing organs or tissues to be taken from a death individual and transplanted in someone else’s body. It may save another person’s life. Organ and tissue donation is a way of “giving something back” to society. It costs nothing, it does not change your own life, and it can mean a huge improvement to others’ lives.
Organ failure can strike anybody at any time as a result of illness or infection. For most people who experience organ failure, a transplant is their only realistic treatment option. If one dies, the organs could help several people through organ transplants and many others through tissue grafts. For instance a person who is attached to a dialysis machine could return to full-time work after receiving one kidney. Every effort is made to save one’s life before donation is considered as donation doesn’t disfigure the body.
The first successful cornea transplant operation on two patients by a local donor recently has received commendation by members of the medical community, friends and family of the donors and recipients of the cornea in Lagos.
The two patients- names withheld, had a successful cornea transplant in August 2010 following the death of Kola Shodipo, a 47 year old man who prior to his death on the 18th of the same month, pledged to donate the cornea in his eyes which were removed some hours after his death. The corneas were later used to restore sight to two individuals who had cornea blindness in one eye each.
Speaking to journalists at a recent press conference at Lagos State University Teaching Hospital (LASUTH),Ikeja, Lagos, Mosun Faderin, Medical Director of Eye Bank for Restoring Sight, Nigeria, said that cornea blindness encompasses a range of eye conditions that ultimately affect the transparency of the cornea, leading to blindness.
Faderin stated that though cornea blindness is reversible giving the fact that it is only the front part of the eye that is damaged, the aftereffects of bacterial, fungal, or viral infections, eye trauma, traditional medicine or home remedies, which often harm the eye rather than relieve pain or improve eyesight have been implicated in the cause of blindness.
In her words “Attacking the root causes of corneal blindness is the best path to blindness prevention. When that part is damaged, the person cannot see but with a successful surgery which involves the replacement of the damaged cornea with another got from another human, sight can be restored. For the cornea to be useful for a transplant, it must be removed within 12 hours after death with the consent of either the deceased, given before death, or the family members.”
Olaseinde Akinsete, Chairman of the Board of Eye Bank, recalled that although corneal transplant is lawful in Nigeria under Decree No.23, titled Cornea Grafting Decree 1973, not many corneal grafting operations have been carried out in the country.
“Under the decree, any person can either by writing or orally in the presence of two or more witnesses authorizes the excision of his or her eyes after death. The law stipulates that the person lawfully in custody of the body after death may unless he has reason to believe that the request was subsequently withdrawn, authorize removal of eyes. Notwithstanding the promulgation of the above mentioned decree, not many corneal grafting operations were carried out in Nigeria.”
While giving an insight to the number of people with cornea blindness in Nigeria, Akinsete added: “Nigeria has about 1,170,000 blind people, based on a blindness rate of 0.78 percent. Cornea blindness is about 7.9percent that is 92,430. It is the latter that may benefit from corneal grafting.”
Taking a cursory look at cornea transplant in Nigeria, late Shodipo is the first Nigerian to donate his eyes for a cornea transplant. Until now, all cornea transplants in Nigeria have been done with corneas got from other countries, mostly from India.
However, since the Eye bank became a reality when the Nigeria Society for the Blind and the Ophthalmological Society of Nigeria (OSN) got together to give birth to the Eye Bank from the money donated for cornea grafting in 2004, not a single cornea has been harvested locally until very recently. Sadly, the biggest challenge the country is faced with is that the public first of all don’t believe they should donate any part of their body after death. This is as pertinent as it is not possible to restore sight to a ‘blind’ person. In order to convince the public that someone who has cornea blindness (and this group accounts for about 33 percent of those with reversible or curable blindness worldwide), that the Board of the Eye Bank decided to source for corneas from abroad.
There is no gain saying that late Shodipo made his intention of donating his eyes in 2008 because of his love for people and applauded his humanitarian work. The first locally harvested corneas from a Nigerian donor who had pledged/donated his eyes after he saw and heard the experiences of two cornea graft recipients prior to his passing on have to be commended.
For Femi Olugbile, Chief Medical Director of LASUTH, the transplant is a landmark achievement even as he commended the family for ensuring that they obeyed Shodipo’s wish. Olugbile however called for the creation of proper legislation that would make it possible for unclaimed dead bodies and bodies of destitute be used for the extraction of useful body parts that can help sustain lives of those who have serious medical condition which would need transplant.
“The challenge of harvesting corneas and other body tissues for use on live patients in our country is a major one. Unfortunately, these bodies cannot be touched for cornea transplant and that is a major waste. There has to be a way in which that can be tidied up. A practical law creation exercise needs to be embarked upon to get access to these corneas,” Olugbile stated.
It is noteworthy to state that in 1994, the Government of India passed the Transplantation of Human Organs Act that legalised the concept of brain death and, for the first time, facilitated organ procurement from heart beating, brain dead donors this was borne out the fact that thousands of lives were lost in India annually from heart and liver failure since transplantation of unpaired organs like heart, liver and pancreas were either difficult or impossible from living donors.
Hence, organ and tissue donation is a way to help others- by allowing organs or tissues to be taken from a death individual and transplanted in someone else’s body. It may save another person’s life. Organ and tissue donation is a way of “giving something back” to society. It costs nothing, it does not change your own life, and it can mean a huge improvement to others’ lives.
Organ failure can strike anybody at any time as a result of illness or infection. For most people who experience organ failure, a transplant is their only realistic treatment option. If one dies, the organs could help several people through organ transplants and many others through tissue grafts. For instance a person who is attached to a dialysis machine could return to full-time work after receiving one kidney. Every effort is made to save one’s life before donation is considered as donation doesn’t disfigure the body.
Delivering excellence through customer care
As the globe celebrates customer service week which is a period set aside to reinforce the significance of providing a quality experience for the consumer, Alexander Chiejina writes on how First City Monument Bank (FCMB) hinges on customer care to drive its business to new heights
Good customer service no doubt has over the years been the lifeblood of any business. As it is the case with most organisations in Nigeria and the world at large, they may offer promotions and slash prices to bring in as many new customers as they want but unless one can get some of those customers to come back, such a business won’t be profitable for long.
However for Ebele Enuani, a staff with CAP plc, good customer service is all about bringing customers back. And about sending them away happy – happy enough to pass positive feedback about one’s business along to others, who may then try the product or service you offer for themselves and in turn become repeat customers.
“If you are a good salesperson, you can sell anything to anyone once. But it will be your approach to customer service that determines whether or not you will ever be able to sell that person anything else. The essence of good customer service is forming a relationship with customers – a relationship that that individual customer feels that he would like to pursue. How do you go about forming such a relationship? By remembering the one true secret of good customer service and acting accordingly- “You will be judged by what you do, not what you say,” Enuani disclosed.
Hence, as service-oriented organizations across the globe mark this year’s Customer Service Week, a period set aside in the month of October when customers are celebrated and appreciated by organizations, First City Monument Bank Plc (FCMB) has announced it is using the customer week which begins from Monday October 25th to 29th to appreciate the patronage and relationship it has shared with its esteemed customers over the years.
Making this known to newsmen in Lagos, Ladi Balogun, FCMB Group Managing Director revealed that the week is meant to celebrate and appreciate the esteemed customers including entrepreneurs for their loyalty and focus on their feedback which has gone a long way in improving its level of service and customer intimacy.
With the theme for this year Customer Service Week - ‘Customer First’, Balogun stated that “its focus in hinged on three main points: “re-emphasizing our Customer First strategy, re-affirming our commitment to building a long lasting relationship which supports their businesses and provide true memorable customer experiences”
According to the Group Managing Director, “During the week, the bank would be appreciating its customers nationwide, organizing Customer Forum to connect via providing clients with business ideas and opportunities and more importantly, obtain feedback on how they can be better served. It will also be an opportunity to renew its commitment to continually deliver on its Customer First strategy which forms the basis of the partnership. The bank had in 2008 launched the second phase of its advertising campaign, My Bank and I to refresh its promise to customers and other key stakeholders.”
Balogun disclosed that “the campaign titled “Commitment” was an extension of the success of the “My Bank and I” phase one which was launched the previous year.
“FCMB the previous year unveiled the first phase of the corporate campaign, which set a new standard in bank-customer relationship. It was designed to build a stronger relationship with the bank’s customers, cutting away the differentiator and making it a kind of partnership relationship where customers have as much stake as the bank in the daily business operations. The objective of the new campaign underscores the secret of the bank’s successes over the years and its unique selling proposition going forward.
In My Bank & I Phase 2, what we are saying to our customers and the larger stakeholders is that our service offerings have gone beyond the basic relationship and partnership. We are now talking about commitment, which is the bedrock of any good partnership. We do this by anticipating our customers’ needs in order to provide solutions to those needs,” Balogun concluded.
No doubt, Customer Service Week , which is been celebrated across countries like the United States of America, the United Kingdom, etc, it provides a unique opportunity for service and support professionals to join in a celebration of the important role that customer service plays in every organization.
It is noteworthy to state that core goals of the week celebration include boosting morale, motivation and teamwork, reward frontline reps for the important work they do all year long, raise companywide awareness of the importance of customer service, let clients know about the organization’s commitment to customer satisfaction.
There is no gain saying that customers have more options than ever before-and feel less loyalty. They want products and services fast, cheap, quick from whoever will provide them. That means that the competitive advantage is now in the firm’s ability to keep customers and build repeat business. This business firms in Nigeria should emulate as in this way, one continually delivers on Customer First strategy which forms the basis of partnership.
Good customer service no doubt has over the years been the lifeblood of any business. As it is the case with most organisations in Nigeria and the world at large, they may offer promotions and slash prices to bring in as many new customers as they want but unless one can get some of those customers to come back, such a business won’t be profitable for long.
However for Ebele Enuani, a staff with CAP plc, good customer service is all about bringing customers back. And about sending them away happy – happy enough to pass positive feedback about one’s business along to others, who may then try the product or service you offer for themselves and in turn become repeat customers.
“If you are a good salesperson, you can sell anything to anyone once. But it will be your approach to customer service that determines whether or not you will ever be able to sell that person anything else. The essence of good customer service is forming a relationship with customers – a relationship that that individual customer feels that he would like to pursue. How do you go about forming such a relationship? By remembering the one true secret of good customer service and acting accordingly- “You will be judged by what you do, not what you say,” Enuani disclosed.
Hence, as service-oriented organizations across the globe mark this year’s Customer Service Week, a period set aside in the month of October when customers are celebrated and appreciated by organizations, First City Monument Bank Plc (FCMB) has announced it is using the customer week which begins from Monday October 25th to 29th to appreciate the patronage and relationship it has shared with its esteemed customers over the years.
Making this known to newsmen in Lagos, Ladi Balogun, FCMB Group Managing Director revealed that the week is meant to celebrate and appreciate the esteemed customers including entrepreneurs for their loyalty and focus on their feedback which has gone a long way in improving its level of service and customer intimacy.
With the theme for this year Customer Service Week - ‘Customer First’, Balogun stated that “its focus in hinged on three main points: “re-emphasizing our Customer First strategy, re-affirming our commitment to building a long lasting relationship which supports their businesses and provide true memorable customer experiences”
According to the Group Managing Director, “During the week, the bank would be appreciating its customers nationwide, organizing Customer Forum to connect via providing clients with business ideas and opportunities and more importantly, obtain feedback on how they can be better served. It will also be an opportunity to renew its commitment to continually deliver on its Customer First strategy which forms the basis of the partnership. The bank had in 2008 launched the second phase of its advertising campaign, My Bank and I to refresh its promise to customers and other key stakeholders.”
Balogun disclosed that “the campaign titled “Commitment” was an extension of the success of the “My Bank and I” phase one which was launched the previous year.
“FCMB the previous year unveiled the first phase of the corporate campaign, which set a new standard in bank-customer relationship. It was designed to build a stronger relationship with the bank’s customers, cutting away the differentiator and making it a kind of partnership relationship where customers have as much stake as the bank in the daily business operations. The objective of the new campaign underscores the secret of the bank’s successes over the years and its unique selling proposition going forward.
In My Bank & I Phase 2, what we are saying to our customers and the larger stakeholders is that our service offerings have gone beyond the basic relationship and partnership. We are now talking about commitment, which is the bedrock of any good partnership. We do this by anticipating our customers’ needs in order to provide solutions to those needs,” Balogun concluded.
No doubt, Customer Service Week , which is been celebrated across countries like the United States of America, the United Kingdom, etc, it provides a unique opportunity for service and support professionals to join in a celebration of the important role that customer service plays in every organization.
It is noteworthy to state that core goals of the week celebration include boosting morale, motivation and teamwork, reward frontline reps for the important work they do all year long, raise companywide awareness of the importance of customer service, let clients know about the organization’s commitment to customer satisfaction.
There is no gain saying that customers have more options than ever before-and feel less loyalty. They want products and services fast, cheap, quick from whoever will provide them. That means that the competitive advantage is now in the firm’s ability to keep customers and build repeat business. This business firms in Nigeria should emulate as in this way, one continually delivers on Customer First strategy which forms the basis of partnership.
Need for quality health services re-echoes at WAH 2010
The need for quality in healthcare services in the country was last week re-echoed at the just concluded fifth West African Health Exhibition (WAH) as over 500 experts who brain-stormed identified poor hospital services and management as a major factor that has plagued the development of the health sector in Nigeria.
In a chat, the Chairman National Consultative Committee on Cancer Control in Nigeria, Prof. Francis Abayomi Durosinmi – Etti who was also the chairman of the occasion said “Although the necessity of introducing quality and health care risk management procedures in health care institutions is no longer contested, it must be recognised that total quality control is coming to hospitals very slowly”
Speaking during the opening ceremony of 2010 WAH in Lagos, Durosinmi – Etii who applauded the theme “Delivering Quality Healthcare Services in West Africa” noted quality of healthcare services determines the desired health outcomes and are consistent with current professional knowledge.
His words, “Indeed, quality management is a profound change in the hospital that leads to transformation of its organisation. This transformation concerns every actor within the organisation; implying a change in culture, habits and behaviour and disrupting the sociological hierarchy and power systems”
While noting that hospitals across the country are searching for ways to improve quality of care and promote effective quality improvement strategies, he pointed out that in more developed countries, essential elements of a successful strategy must include developing the right culture, attracting and retaining the right people, devising and updating the right in – house processes and giving staff the right tools to do the job.
He further added that external influences, such as local market competition and public or private health quality initiatives and standards also have an impact in quality health care service delivery. To ensure quality, the Chairman told the participants that first, is the need for healthcare institutions to attract and retain the right people.
“High- quality physicians, nurses, administrators, and ancillary staff are critical to producing high – quality outcomes and effective quality improvement. Successful recruitment and retention of nursing staff is tied to an absolute respect for and empowerment of nurses who must be treated as full partners in patient care and given opportunities for advancement. All are expected to be good team players, able to participate in multi- disciplinary teams for both quality improvement and patient care management.”
He further stressed the need for health care institutions to equip and give their staff the right tools to do the job. “ Our hospitals must give their physicians, nurses and other staff the tools and support they need to practice high – quality medicine on a daily basis and to identify and investigate quality problems when they do surface. This, he said, must include; investments in information technology as well as quality improvement/performance improvement departments with qualified staff who abstract medical records, analyse data, and facilitate the quality improvement process.”
Durosinmi – Etii however, regretted that hospital environment in Nigeria is not a favourable terrain for such changes as they are institutional organisations charactered by a high level of involvement on the part of health care professionals, particularly doctors in the decision making process.
He noted that professional bureaucracy has limited power, contrary to the mechanical bureaucracies found in the industry. The Chairman enjoined stakeholders that in setting up quality management, they should take into account these obstacles adding that no matter what quality management model retained, great importance must be placed on implementation strategies necessary to achieve the goals of quality management.
In his welcome address, the Executive Director, Global Resources, Dr. Wale Alabi said the theme of the conference was chosen to highlight one of the biggest issues still hampering the ability to deliver 21st century medicine and quality healthcare in the country’s healthcare service delivery, processes and systems.
Alabi stressed that before we can experience any meaningful development in the health sector, the country must adequately put in place protocols and processes that would support quality assurance and raise the standard of care in healthcare institutions across the country.
A comprehensive approach, supported by strong national leadership, governance and information systems, is needed to ensure skilled, motivated and supported health workers in the right place at the right time. For example, national authorities may focus on rapidly increasing the outputs of education and training programmes, along with measures to improve recruitment, performance and retention of workers - especially in rural and underserved areas - and actions to address imbalances in the mix and use of skills within a primary health care framework.
In a chat, the Chairman National Consultative Committee on Cancer Control in Nigeria, Prof. Francis Abayomi Durosinmi – Etti who was also the chairman of the occasion said “Although the necessity of introducing quality and health care risk management procedures in health care institutions is no longer contested, it must be recognised that total quality control is coming to hospitals very slowly”
Speaking during the opening ceremony of 2010 WAH in Lagos, Durosinmi – Etii who applauded the theme “Delivering Quality Healthcare Services in West Africa” noted quality of healthcare services determines the desired health outcomes and are consistent with current professional knowledge.
His words, “Indeed, quality management is a profound change in the hospital that leads to transformation of its organisation. This transformation concerns every actor within the organisation; implying a change in culture, habits and behaviour and disrupting the sociological hierarchy and power systems”
While noting that hospitals across the country are searching for ways to improve quality of care and promote effective quality improvement strategies, he pointed out that in more developed countries, essential elements of a successful strategy must include developing the right culture, attracting and retaining the right people, devising and updating the right in – house processes and giving staff the right tools to do the job.
He further added that external influences, such as local market competition and public or private health quality initiatives and standards also have an impact in quality health care service delivery. To ensure quality, the Chairman told the participants that first, is the need for healthcare institutions to attract and retain the right people.
“High- quality physicians, nurses, administrators, and ancillary staff are critical to producing high – quality outcomes and effective quality improvement. Successful recruitment and retention of nursing staff is tied to an absolute respect for and empowerment of nurses who must be treated as full partners in patient care and given opportunities for advancement. All are expected to be good team players, able to participate in multi- disciplinary teams for both quality improvement and patient care management.”
He further stressed the need for health care institutions to equip and give their staff the right tools to do the job. “ Our hospitals must give their physicians, nurses and other staff the tools and support they need to practice high – quality medicine on a daily basis and to identify and investigate quality problems when they do surface. This, he said, must include; investments in information technology as well as quality improvement/performance improvement departments with qualified staff who abstract medical records, analyse data, and facilitate the quality improvement process.”
Durosinmi – Etii however, regretted that hospital environment in Nigeria is not a favourable terrain for such changes as they are institutional organisations charactered by a high level of involvement on the part of health care professionals, particularly doctors in the decision making process.
He noted that professional bureaucracy has limited power, contrary to the mechanical bureaucracies found in the industry. The Chairman enjoined stakeholders that in setting up quality management, they should take into account these obstacles adding that no matter what quality management model retained, great importance must be placed on implementation strategies necessary to achieve the goals of quality management.
In his welcome address, the Executive Director, Global Resources, Dr. Wale Alabi said the theme of the conference was chosen to highlight one of the biggest issues still hampering the ability to deliver 21st century medicine and quality healthcare in the country’s healthcare service delivery, processes and systems.
Alabi stressed that before we can experience any meaningful development in the health sector, the country must adequately put in place protocols and processes that would support quality assurance and raise the standard of care in healthcare institutions across the country.
A comprehensive approach, supported by strong national leadership, governance and information systems, is needed to ensure skilled, motivated and supported health workers in the right place at the right time. For example, national authorities may focus on rapidly increasing the outputs of education and training programmes, along with measures to improve recruitment, performance and retention of workers - especially in rural and underserved areas - and actions to address imbalances in the mix and use of skills within a primary health care framework.
Lagos Floods: Residents, businesses count their losses
With many of the victims of the recent flood disaster in Lagos relocated to a relief camp and some still fighting marooned The victims of the recent ALEX CHIEJINA write that it would take some time before business activities would be restored in the affected areas
Cletus Attah had always been the envy of his contemporaries. His shop in Ikorodu area of Lagos had a rich display of all kinds of foodstuffs which he stocked in sacks. And with a large customer base frequently thronging his shop, Attah became a happy- go- lucky trader who regularly smiled to the bank.
But that was before the floods came and swept away his shop and his residence that was just behind the shop. Today he is an emotional wreck; helpless, homeless and denied of a place in the relief camp set up by Lagos State government to temporary cater for the victims of the flood disaster.
For Attah, and many others living in Ajegunle in Ikorodu area of Lagos as well as in such communities as Mile 12, Ikosi Ketu Owode Elede, Thomas Laniyan Estate, Owode Onirin, Agboyi Ketu, Owode Orile, Odo Ogun, Itowoloa and Agiliti, both in Lagos and Ogun State, this is definitely not the best of times.
They are still reliving their experience with the recent floods that had submerged residential, commercial buildings with massive loss of household items, and schools. Children and adults had to swim through flooded roads to get out of their houses. Those who could not swim had to hire canoes.
Some community folks who spoke to journalists assessing the impact of the flood said that though flooding in the communities had been a regular occurrence since 2007, the current flooding which started early October 2010 has remained their worst experience. The situation was occasioned by the release of excess water from Oyan Dam by Ogun State River Basin Authority and enhanced precipitation. On the other hand, the River Basin Authority said the release of the water was targeted at stopping the dam from bursting following incessant rains which had made the facility take in more water than required.
Not only has the recent flooding left scores of residents in these communities homeless, business activities in the flood-ravaged areas may take a long time to come alive again as workers and business people gradually come to terms with the situation.
Already, businesses worth millions of naira have done down with the flood. The inability of many to run their daily businesses, among other hardship, has turned the affected residents into refugees in their own land. When Business Day visited the affected communities last week lock-up shops, private schools, several companies, and houses were still under lock and key as the owners have been forced to relocate temporarily.
At Owode Elede, a popular livestock market near Ojodu-Berger, it was discovered that the surge has almost completely overran the market and forced livestock owners to move their cows and goats to safer areas. The market which used to be a bee-hive of activity is now like a ghost of itself.
At Odogun Oniyanrin in Ajegunle, known for its huge number of upholstery makers, it was learnt that most of the traders were taken unawares by the flood. This is due to the fact that only a few were seen trying to salvage some of their chairs and tables that were not ruined by the flood. They lamented their fate as they moved their drenched cushioned seats out of the lock-up shops for sun-drying.
At Ojodu-Berger, virtually all the state-owned and private schools on either side of the Lagos/Ibadan Expressway close to the Lagos Toll Gate are shut following the pool of water which has made it impossible for both pupils and teachers alike to gain access to the schools.
Speaking to BusinessDay, Ikedioha James, an Upholstery maker at Owode-Elede near Ojodu-Berger said "I have never seen flooding like this in all my life. It was a surprise to me that the lockup shop that I left the day before the flooding was totally covered by water when I returned a day after and all the cushioned chairs and wood for my work were totally soaked in water. Since the incident I have depended on goodwill of the public to feed. Government should come to our rescue"
In the meantime, activities at the usually bustling markets like the Mile 12, Agiliti, as well as supermarkets, shops and restaurants have either been halted or scaled down considerably. Yemisi Oyeleke, a trader said she had never seen Mile 12 dry like this ever since the flood began.
"Trading is not moving as usual ever since the flood enveloped some of the neighbouring communities. It is as though people are in a mourning period. No doubt, business has not been flourishing. I am contemplating whether to suspend coming to the market until things improve," Oyeleke revealed.
The same goes for Joy Omame, a trader at Odogun Oniyanrin Community area of Mile 12 who disclosed that the flood had affected her trading in foodstuff as people, many of them having host their possession, are no longer in a position to maintain their patronage. According to her, "my greatest dilemma is the plan of the Lagos State government to demolish our buildings. I was born and brought up here and my grandparents lived here; so how can we leave here because of the dam which was not here when we started living here. Breaking our houses is not the solution. The solution is the upgrading and reconstruction of the Odogun Road which leads to Mile 12. "
Apparently disenchanted, Babatunde Owolabi, a livestock seller in Odogun Oniyanrin community told Business Day that it would be almost impossible for him to recover from the misfortune: "My wife and three children are at the Agbowa relief camp and it pains me to see what they feed them there. Most of my property got missing in the confusion that followed the flood so I am already at a loss but we have no option because my business is already ruined. Water is supposed to be a blessing but this one is the action of man and it has brought destruction".
It will be recalled that about a fortnight ago, President Goodluck Jonathan approved the sum of N2.1 billion to victims of the recent flood disasters in Lagos, Ogun and Jigawa states in a view to mitigate the effects of the disaster. Each state was to receive the sum of 700 million Naira.
While sympathising with the victims in Isheri Olofin community in Ogun state and Ajegunle community in Lagos state, President Jonathan assured them that apart from the cash assistance, the federal government was assembling a team of experts to undertake a comprehensive study of the recurring floods with a view to finding a permanent solution to the recurring problem of floods.
No doubt, some of the destruction could have been avoided or its effects mitigated if proper environmental rules had been observed and the authorities had not been lax in enforcing building codes. In some parts of the country, flooding has become something of a seasonal occurrence during the rainy season. As such, communities often prepare for the impacts of such floods, and take precautionary measures.
As is the case with some parts of Lagos, areas prone to flooding have blocked drainages and waterways, and absence of proper drainage system. Sadly, either by design or default, permits are given to developers to erect structures that interfere with waterways.
Given the discomfort being suffered by the residents whose communities were ravaged by the flood, many people have called on Lagos and Ogun State governments as well as concerned federal institutions to adequately provide for them in their time of need.
James wants the Ogun/Osun River Basin Authority to "some extent take responsibility for the disaster and compensate the impacted people and imbibe international best practices in its operations to forestall recurrence of the flood incident."
However, Tony Akanbe, a Ketu resident who was not really affected by the flood believes that members of the communities also have a role to play in guarding against similar damage in the future.
"Community leaders have a role to play in guiding the people to imbibe good environmental habits. They could do this by assisting municipal authorities propagate information about the need to keep drainages provided in the community free of dumps that might clog the waterways and cause flooding during the rains. More importantly, municipal authorities should ensure they construct culverts, drainage channels and storm drains in the cities, and provide an efficient refuse disposal system that would lessen the tendency among residents to dump domestic waste in water passages, thereby blocking them."
Cletus Attah had always been the envy of his contemporaries. His shop in Ikorodu area of Lagos had a rich display of all kinds of foodstuffs which he stocked in sacks. And with a large customer base frequently thronging his shop, Attah became a happy- go- lucky trader who regularly smiled to the bank.
But that was before the floods came and swept away his shop and his residence that was just behind the shop. Today he is an emotional wreck; helpless, homeless and denied of a place in the relief camp set up by Lagos State government to temporary cater for the victims of the flood disaster.
For Attah, and many others living in Ajegunle in Ikorodu area of Lagos as well as in such communities as Mile 12, Ikosi Ketu Owode Elede, Thomas Laniyan Estate, Owode Onirin, Agboyi Ketu, Owode Orile, Odo Ogun, Itowoloa and Agiliti, both in Lagos and Ogun State, this is definitely not the best of times.
They are still reliving their experience with the recent floods that had submerged residential, commercial buildings with massive loss of household items, and schools. Children and adults had to swim through flooded roads to get out of their houses. Those who could not swim had to hire canoes.
Some community folks who spoke to journalists assessing the impact of the flood said that though flooding in the communities had been a regular occurrence since 2007, the current flooding which started early October 2010 has remained their worst experience. The situation was occasioned by the release of excess water from Oyan Dam by Ogun State River Basin Authority and enhanced precipitation. On the other hand, the River Basin Authority said the release of the water was targeted at stopping the dam from bursting following incessant rains which had made the facility take in more water than required.
Not only has the recent flooding left scores of residents in these communities homeless, business activities in the flood-ravaged areas may take a long time to come alive again as workers and business people gradually come to terms with the situation.
Already, businesses worth millions of naira have done down with the flood. The inability of many to run their daily businesses, among other hardship, has turned the affected residents into refugees in their own land. When Business Day visited the affected communities last week lock-up shops, private schools, several companies, and houses were still under lock and key as the owners have been forced to relocate temporarily.
At Owode Elede, a popular livestock market near Ojodu-Berger, it was discovered that the surge has almost completely overran the market and forced livestock owners to move their cows and goats to safer areas. The market which used to be a bee-hive of activity is now like a ghost of itself.
At Odogun Oniyanrin in Ajegunle, known for its huge number of upholstery makers, it was learnt that most of the traders were taken unawares by the flood. This is due to the fact that only a few were seen trying to salvage some of their chairs and tables that were not ruined by the flood. They lamented their fate as they moved their drenched cushioned seats out of the lock-up shops for sun-drying.
At Ojodu-Berger, virtually all the state-owned and private schools on either side of the Lagos/Ibadan Expressway close to the Lagos Toll Gate are shut following the pool of water which has made it impossible for both pupils and teachers alike to gain access to the schools.
Speaking to BusinessDay, Ikedioha James, an Upholstery maker at Owode-Elede near Ojodu-Berger said "I have never seen flooding like this in all my life. It was a surprise to me that the lockup shop that I left the day before the flooding was totally covered by water when I returned a day after and all the cushioned chairs and wood for my work were totally soaked in water. Since the incident I have depended on goodwill of the public to feed. Government should come to our rescue"
In the meantime, activities at the usually bustling markets like the Mile 12, Agiliti, as well as supermarkets, shops and restaurants have either been halted or scaled down considerably. Yemisi Oyeleke, a trader said she had never seen Mile 12 dry like this ever since the flood began.
"Trading is not moving as usual ever since the flood enveloped some of the neighbouring communities. It is as though people are in a mourning period. No doubt, business has not been flourishing. I am contemplating whether to suspend coming to the market until things improve," Oyeleke revealed.
The same goes for Joy Omame, a trader at Odogun Oniyanrin Community area of Mile 12 who disclosed that the flood had affected her trading in foodstuff as people, many of them having host their possession, are no longer in a position to maintain their patronage. According to her, "my greatest dilemma is the plan of the Lagos State government to demolish our buildings. I was born and brought up here and my grandparents lived here; so how can we leave here because of the dam which was not here when we started living here. Breaking our houses is not the solution. The solution is the upgrading and reconstruction of the Odogun Road which leads to Mile 12. "
Apparently disenchanted, Babatunde Owolabi, a livestock seller in Odogun Oniyanrin community told Business Day that it would be almost impossible for him to recover from the misfortune: "My wife and three children are at the Agbowa relief camp and it pains me to see what they feed them there. Most of my property got missing in the confusion that followed the flood so I am already at a loss but we have no option because my business is already ruined. Water is supposed to be a blessing but this one is the action of man and it has brought destruction".
It will be recalled that about a fortnight ago, President Goodluck Jonathan approved the sum of N2.1 billion to victims of the recent flood disasters in Lagos, Ogun and Jigawa states in a view to mitigate the effects of the disaster. Each state was to receive the sum of 700 million Naira.
While sympathising with the victims in Isheri Olofin community in Ogun state and Ajegunle community in Lagos state, President Jonathan assured them that apart from the cash assistance, the federal government was assembling a team of experts to undertake a comprehensive study of the recurring floods with a view to finding a permanent solution to the recurring problem of floods.
No doubt, some of the destruction could have been avoided or its effects mitigated if proper environmental rules had been observed and the authorities had not been lax in enforcing building codes. In some parts of the country, flooding has become something of a seasonal occurrence during the rainy season. As such, communities often prepare for the impacts of such floods, and take precautionary measures.
As is the case with some parts of Lagos, areas prone to flooding have blocked drainages and waterways, and absence of proper drainage system. Sadly, either by design or default, permits are given to developers to erect structures that interfere with waterways.
Given the discomfort being suffered by the residents whose communities were ravaged by the flood, many people have called on Lagos and Ogun State governments as well as concerned federal institutions to adequately provide for them in their time of need.
James wants the Ogun/Osun River Basin Authority to "some extent take responsibility for the disaster and compensate the impacted people and imbibe international best practices in its operations to forestall recurrence of the flood incident."
However, Tony Akanbe, a Ketu resident who was not really affected by the flood believes that members of the communities also have a role to play in guarding against similar damage in the future.
"Community leaders have a role to play in guiding the people to imbibe good environmental habits. They could do this by assisting municipal authorities propagate information about the need to keep drainages provided in the community free of dumps that might clog the waterways and cause flooding during the rains. More importantly, municipal authorities should ensure they construct culverts, drainage channels and storm drains in the cities, and provide an efficient refuse disposal system that would lessen the tendency among residents to dump domestic waste in water passages, thereby blocking them."
Wednesday, October 20, 2010
EU, UNICEF signs agreement for rural water and sanitation in six states.
Recently, the European Union (EU) signed an agreement with UNICEF that will bring sustainable and integrated water supply and sanitation as well as hygiene promotion to 200,000 people in rural communities in selected states and local governments.
The EU’s investment of 9 million Euros (1.9 billion naira), which will be funded under the Support to Reforming Institutions Programme, is to stimulate accountability and transparency in State and Local Government Area (LGAs) budgeting processes in six states: Anambra, Osun, Cross River, Kano, Jigawa and Yobe. UNICEF will implement the programme over the next two (2) years.
Speaking at the occasion, David MacRae, Ambassador/Head of the EU Delegation to Nigeria said “We at the EU believe that the provision of water and sanitation and the promotion of hygiene are essential public services. They protect populations from diseases that particularly affect children, including cholera and diarrhoea, and they help contain malaria. We will be pleased to support the state and local governments that are leaders in this area.”
The first phase of the agreement is for a public expenditure management and financial accountability review in the six states to assess their public finance management; the extent of their investment in water, sanitation and hygiene so far; and the activities required to bring water and sanitation to rural areas.
Only states and local governments that the review shows to have committed to and made progress on reform, particularly in public finance management, will win EU investments in the second phase. The second phase will comprise a series of activities in the selected local governments and states, including mobilizing schools, communities and local governments to develop community action plans for promoting sanitation and hygiene; building the capacity of communities and local governments for delivering sustainable water and sanitation services; establishing community-based water, sanitation and hygiene models in rural communities, including increasing access to improved source of water for about 200,000 rural people; raising awareness and visibility of accountability and transparency practices that contribute to good governance in the water and sanitation sector; strengthening monitoring and evaluation systems at community, local government and state levels.
For Suomi Sakai, Representative of UNICEF in Nigeria, “We are proud to partner with the EU on this innovative programme. Communities and governments that provide sanitation and safe water can promote good hygiene as well - save lives, particularly of children.”
The EU’s investment of 9 million Euros (1.9 billion naira), which will be funded under the Support to Reforming Institutions Programme, is to stimulate accountability and transparency in State and Local Government Area (LGAs) budgeting processes in six states: Anambra, Osun, Cross River, Kano, Jigawa and Yobe. UNICEF will implement the programme over the next two (2) years.
Speaking at the occasion, David MacRae, Ambassador/Head of the EU Delegation to Nigeria said “We at the EU believe that the provision of water and sanitation and the promotion of hygiene are essential public services. They protect populations from diseases that particularly affect children, including cholera and diarrhoea, and they help contain malaria. We will be pleased to support the state and local governments that are leaders in this area.”
The first phase of the agreement is for a public expenditure management and financial accountability review in the six states to assess their public finance management; the extent of their investment in water, sanitation and hygiene so far; and the activities required to bring water and sanitation to rural areas.
Only states and local governments that the review shows to have committed to and made progress on reform, particularly in public finance management, will win EU investments in the second phase. The second phase will comprise a series of activities in the selected local governments and states, including mobilizing schools, communities and local governments to develop community action plans for promoting sanitation and hygiene; building the capacity of communities and local governments for delivering sustainable water and sanitation services; establishing community-based water, sanitation and hygiene models in rural communities, including increasing access to improved source of water for about 200,000 rural people; raising awareness and visibility of accountability and transparency practices that contribute to good governance in the water and sanitation sector; strengthening monitoring and evaluation systems at community, local government and state levels.
For Suomi Sakai, Representative of UNICEF in Nigeria, “We are proud to partner with the EU on this innovative programme. Communities and governments that provide sanitation and safe water can promote good hygiene as well - save lives, particularly of children.”
Lagosians groan as hospital remains shut for over two months
…as Nigerians call for dialogue to resolve the impasse
Lagosians who think they will soon access medical care from any Lagos state owned hospital may have to wait longer as the payment of the Consolidated Medical Salary and Professional Allowance (CONMESS) by the Federal Government to doctors working in federal health institutions have caused ripples in the health sector as doctors under the employ of the state government have vowed to continue its 9 weeks old industrial strike over the non- payment of the CONMESS.
To any individual following the development, the industrial strike which began from August 12 2010 till date has no doubt brought untold hardship and misery to Lagosians thus leaving the clinics and wards of the state owned hospitals open with no doctor attending to any patient. Interestingly, most private hospitals, of which one may not be able to guarantee its operational ability, have now become the last resort of most people who believe are reaping the gains of the current strike action by charging exorbitant fees for medical care.
A visit to Lagos University Teaching Hospital (LUTH), the only functional health institution, within the last 2 weeks has witnessed large number of patients awaiting medical attention. Most wards like the Accident and Emergency session, Radiography, Olikoye Ransome Children Emergency Centre, to name but a few are filled to the bream with little or no space to admit more patients. Already, the hospital management expressed fears that the large number of people waiting for treatment might lead to the outbreak of an epidemic. However, this situation has also increased the hours patients have to wait before been attended to by a physician.
Lamenting his ordeal to BusinessDay, Ebele Enuani, a patient at LUTH said he had to wait for over an hour before doing his x-ray examination due to the large number of people waiting to be examined. He stated that this is has placed much pressure on facilities at the hospital as patients wait endlessly to be attended to.
“I can’t be able to afford the huge bills which private hospitals are currently charging. They are already making some fortune from the strike. Currently, I have to bear with the situation; it’s just that I have to wait for long hours and this is frustrating.”
For Amaka Okoye, she had to spend over three hours before she could do two medical tests and collect her drugs at LUTH. The same cannot be said of Taiwo Okundayo who lost the father due to late referral from a private hospital where he was receiving treatment.
In his words: “I took my father to one of the private hospitals at Apapa, Lagos where we were told a compulsory consultancy fee of five thousand Naira. We did as we were told. When his health worsened, the doctor never said referred us to LUTH till he was in a critical shape. En route LUTH, he died. While I was at LUTH to deposit his body at the morgue on Saturday last week, about eight bodies were deposited within a space of five hours with people wailing the loss of their loved ones.” And the list goes on and on.
In a bid to know current efforts made to resolve the strike action which has made patients pass through trying times, Ayobode Williams, Chairman, Medical Guild, which is the umbrella body for all doctors in the service of Lagos State with affiliates drawn from the Medical and Dental Consultants Association in General Hospitals along with the Association of Resident Doctors of LASUTH, said the Guild made only one demand to the Lagos State Government-the payment of the CONMESS with effect from August 2010 and their arrears withheld as from January to July this year.
Speaking to BusinessDay, he revealed that In September 2009, the Federal Government approved the payment of CONMESS package for medical and dental practitioners with effect from January 2010. According to him, in November 2009, the Medical and Dental Council of Nigeria (MDCAN) General Hospital wrote a letter to the Executive Governor of Lagos State Babatunde Fashola concerning the payment of the new salary.
“Currently, doctors in the service of Lagos State earn less than half of the monthly income of their colleagues in the Federal service despite the fact that they work more than their counterpart in the other states. We are ready for negotiation but the letter from the State Government stated that the government will pay us whatever it thinks fit and I am not sure we have asked for ‘whatever.’ Other requests include the reinstatement of our immediate past chairman, Ibrahim Olaifa, who was unlawfully dismissed, our union dues, and over taxation which we demand be corrected,” Williams disclosed.
With scores of people dying on a daily basis due to the inability of doctors to attend to them, calls have been made from several quarters towards seeking a lasting solution through effective dialogue between the Government and the doctors.
Executive Chairman, Yaba Local Council Development Area (LCDA), Jide Jimoh appealed to the striking doctors in Lagos to resume work as a matter of urgency in order to save the lives of patients who are dying in the hospitals. He stated this recently while donating an ambulance to the Harvey Health Centre in Yaba, Lagos.
According to Jimoh “It is unfortunate that doctors are on strike and patients in the hospitals are dying. This is the time for the state government and the resident doctors to dialogue and find a lasting solution to the incessant strikes. Though strike actions are bound to happen, the state government and the striking doctors should be considerate because they were playing with the lives of people.”
For Babatunde Fashola, Governor of Lagos state, while at the commissioning ceremony of the haemodialysis centre donated by MTN Foundation to Alimosho General Hospital within the week said appealed to doctors to come back to work as no amount of money paid to them can bring back those who have died during the strike action even as the government is open to dialogue with the doctors.
While Lagosians await the end of the strike which has crippled hospital activities, efforts should be made to resolve the various differences as more people are bound to lose their lives if nothing urgently is done.
Alexander Chiejina
Lagosians who think they will soon access medical care from any Lagos state owned hospital may have to wait longer as the payment of the Consolidated Medical Salary and Professional Allowance (CONMESS) by the Federal Government to doctors working in federal health institutions have caused ripples in the health sector as doctors under the employ of the state government have vowed to continue its 9 weeks old industrial strike over the non- payment of the CONMESS.
To any individual following the development, the industrial strike which began from August 12 2010 till date has no doubt brought untold hardship and misery to Lagosians thus leaving the clinics and wards of the state owned hospitals open with no doctor attending to any patient. Interestingly, most private hospitals, of which one may not be able to guarantee its operational ability, have now become the last resort of most people who believe are reaping the gains of the current strike action by charging exorbitant fees for medical care.
A visit to Lagos University Teaching Hospital (LUTH), the only functional health institution, within the last 2 weeks has witnessed large number of patients awaiting medical attention. Most wards like the Accident and Emergency session, Radiography, Olikoye Ransome Children Emergency Centre, to name but a few are filled to the bream with little or no space to admit more patients. Already, the hospital management expressed fears that the large number of people waiting for treatment might lead to the outbreak of an epidemic. However, this situation has also increased the hours patients have to wait before been attended to by a physician.
Lamenting his ordeal to BusinessDay, Ebele Enuani, a patient at LUTH said he had to wait for over an hour before doing his x-ray examination due to the large number of people waiting to be examined. He stated that this is has placed much pressure on facilities at the hospital as patients wait endlessly to be attended to.
“I can’t be able to afford the huge bills which private hospitals are currently charging. They are already making some fortune from the strike. Currently, I have to bear with the situation; it’s just that I have to wait for long hours and this is frustrating.”
For Amaka Okoye, she had to spend over three hours before she could do two medical tests and collect her drugs at LUTH. The same cannot be said of Taiwo Okundayo who lost the father due to late referral from a private hospital where he was receiving treatment.
In his words: “I took my father to one of the private hospitals at Apapa, Lagos where we were told a compulsory consultancy fee of five thousand Naira. We did as we were told. When his health worsened, the doctor never said referred us to LUTH till he was in a critical shape. En route LUTH, he died. While I was at LUTH to deposit his body at the morgue on Saturday last week, about eight bodies were deposited within a space of five hours with people wailing the loss of their loved ones.” And the list goes on and on.
In a bid to know current efforts made to resolve the strike action which has made patients pass through trying times, Ayobode Williams, Chairman, Medical Guild, which is the umbrella body for all doctors in the service of Lagos State with affiliates drawn from the Medical and Dental Consultants Association in General Hospitals along with the Association of Resident Doctors of LASUTH, said the Guild made only one demand to the Lagos State Government-the payment of the CONMESS with effect from August 2010 and their arrears withheld as from January to July this year.
Speaking to BusinessDay, he revealed that In September 2009, the Federal Government approved the payment of CONMESS package for medical and dental practitioners with effect from January 2010. According to him, in November 2009, the Medical and Dental Council of Nigeria (MDCAN) General Hospital wrote a letter to the Executive Governor of Lagos State Babatunde Fashola concerning the payment of the new salary.
“Currently, doctors in the service of Lagos State earn less than half of the monthly income of their colleagues in the Federal service despite the fact that they work more than their counterpart in the other states. We are ready for negotiation but the letter from the State Government stated that the government will pay us whatever it thinks fit and I am not sure we have asked for ‘whatever.’ Other requests include the reinstatement of our immediate past chairman, Ibrahim Olaifa, who was unlawfully dismissed, our union dues, and over taxation which we demand be corrected,” Williams disclosed.
With scores of people dying on a daily basis due to the inability of doctors to attend to them, calls have been made from several quarters towards seeking a lasting solution through effective dialogue between the Government and the doctors.
Executive Chairman, Yaba Local Council Development Area (LCDA), Jide Jimoh appealed to the striking doctors in Lagos to resume work as a matter of urgency in order to save the lives of patients who are dying in the hospitals. He stated this recently while donating an ambulance to the Harvey Health Centre in Yaba, Lagos.
According to Jimoh “It is unfortunate that doctors are on strike and patients in the hospitals are dying. This is the time for the state government and the resident doctors to dialogue and find a lasting solution to the incessant strikes. Though strike actions are bound to happen, the state government and the striking doctors should be considerate because they were playing with the lives of people.”
For Babatunde Fashola, Governor of Lagos state, while at the commissioning ceremony of the haemodialysis centre donated by MTN Foundation to Alimosho General Hospital within the week said appealed to doctors to come back to work as no amount of money paid to them can bring back those who have died during the strike action even as the government is open to dialogue with the doctors.
While Lagosians await the end of the strike which has crippled hospital activities, efforts should be made to resolve the various differences as more people are bound to lose their lives if nothing urgently is done.
Alexander Chiejina
Scaling up HIV/AIDS interventions in Nigeria through universal access and ART adherence
When antiretroviral drugs (ARVs) were introduced in Nigeria in the early 1990s, they were only available to those who paid for them. With calls towards achieving universal access to HIV/AIDS beyond 2010, Alexander Chiejina calls for renewed political and funding commitments in the wake of ART usage.
Over the years, Human immuno Virus (HIV) epidemic has continued to remain a major global public health challenge with a total of 33.4 million people living with HIV globally. In 2008 alone, 2.7 million people were newly infected with HIV globally.
Coming home, the 2007 National HIV/ AIDS and Reproductive Health Survey (NARHS Plus) in Nigeria showed that the national HIV prevalence of people living with HIV and AIDS is 3.6 percent (females 4.0 percent; males 3.2 percent with increasing cases in the rural areas in some parts of the country.
Although HIV prevalence is much lower in Nigeria than in other African countries such as South Africa and Zambia, the size of Nigeria’s population (around 150 million) meant that by the end of 2010, over 4.5 million people will be living with the virus. With AIDS claiming so many lives, Nigeria’s life expectancy has declined significantly with latest figures suggesting that the figures had fallen to 48 for women and 46 for men.
Inspite of this shortfalls, since 2006 when United Nations Member States committed to scaling up services and interventions towards the goal of universal access to HIV prevention, treatment, care and support by 2010, the World Health Organisation (WHO), United Nations Children Emergency Fund (UNICEF) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) sought to monitor key components of the health sector response to the HIV epidemic worldwide.
The year 2009 saw continuing progress in expanding access to HIV testing, prevention, treatment and care in low- and middle-income countries. The report assessed HIV/AIDS progress in 144 low- and middle-income countries in 2009 stated the following: 15 countries, including Botswana, Guyana and South Africa, were able to provide more than 80 percent of HIV-positive pregnant women in need, the services and medicines to prevent mother-to-child HIV transmission; 14 countries, including Brazil, Namibia and Ukraine, provided HIV treatment to more than 80 percent of the HIV-positive children in need; and eight countries, including Cambodia, Cuba and Rwanda, have achieved universal access to antiretroviral treatment (ART) for adults.
Though the development of potent anti retroviral therapy (ART) has dramatically improved treatment of HIV, medical experts and stakeholders in the country have stressed the need delivering universal access must be scaled up even as strict adherence to ART medication is required.
Speaking at a recent program organised by Journalist against AIDS (JAAIDS) at Ikeja, Lagos, Deborah Igbokwe, a medical expert at APIN clinic, Nigerian Institute of Medical Research, NIMR, Yaba, Lagos said that adherence is a major issue in HIV treatment given the fact that it affects how well anti-HIV medications decrease the patient’s viral load as well as help prevent drug resistance.
Igbokwe stated that HIV treatment regimens can be complicated as most regimens involve taking multiple pills each day; some anti-HIV medications requires one to take medication on an empty stomach, while others must be taken with meals, and before or after doses of other medications.
In her words “This can be difficult for many people, especially for those who are sick or are experiencing HIV symptoms or negative side effects caused by their medications. Other factors that can make it difficult to adhere to an HIV treatment regimen include experiencing unpleasant side effects after taking one’s medications, travelling away from home, being too busy, forgetting to take medications just to name but a few.”
For Ogechi Onuoha, a member of JAAIDS, findings from an earlier project implemented in 2009 by JAAIDS with funding support from SIDACTION France revealed that people living with HIV/AIDS (PLWHA) faced challenges of long waiting time at clinics, inadequate doctor/client interaction, limited capacity of counselors and infrequent adherence counseling, as well as low knowledge level of the treatment received and how it works.
According to her “the project study which was carried out in Lagos and Oyo states in February 2010 revealed that only a few sites truly offer comprehensive ART services – all expense paid, some PLWH were sometimes unable to afford meals and transport to the clinic, some PLWH were deceived into abandoning their treatment to seek for “miracle cures” and positive mothers who are forced due to cultural influence to breast feed their infants and risk transmitting the virus to their babies and this seriously affected the treatment regimen spelt out by the physician.”
It is noteworthy to state that obstacles to scaling up HIV treatment include funding shortages, limited human resources, and weak procurement and supply management systems for HIV drugs and diagnostics and other health systems bottlenecks which persists in most countries. It is believed that one third of countries reported at least one or more cases when supply of HIV medicines had been interrupted in 2009.
In Nigeria, resources needed to provide sufficient treatment and care for those living with HIV in Nigeria are seriously lacking. A study of health care providers found many had not received sufficient training on HIV prevention and treatment and many of the health facilities had a shortage of medications, equipment and materials. The government's National HIV/AIDS Strategic Framework for 2005 to 2009 set out to provide ARVs to 80 percent of adults and children with advanced HIV infection and to 80 percent of HIV-positive pregnant women in 2010.
Currently, about 34 percent of people with advanced HIV infection are said to be receiving ARVs in the country this year. In the revised framework (from 2010 to 2015), the treatment goals were set back to 2015. Going further, availability and safety of blood and blood products continue to be a concern for HIV prevention. While 99 percent and 85 percent of blood donations in high- and middle-income countries respectively were screened in a quality-assured manner in 2009, in low-income countries the comparable figure was 48 percent. And the list is endless.
No doubt, steps towards achieving universal access beyond 2010 calls for a clear set of actions to be taken by Nigeria and the international community includes renewing political and funding commitments to achieve universal access to HIV/AIDS prevention, treatment and care; improving integration and linkages between HIV/AIDS and related services such as tuberculosis, maternal and child health, sexual health and harm reduction for drug users.
More importantly, special approaches remain necessary to address the particular circumstances and needs of those populations at greater risk for HIV infection. Programmes must be designed and delivered in ways that ensure equity in access, including for children and women. There is no gain saying that only such a combined commitment to programme planning and delivery, built upon a solid primary healthcare framework can fully capture synergies between interventions, ensure programmatic sustainability and maximize coverage and impact.
Over the years, Human immuno Virus (HIV) epidemic has continued to remain a major global public health challenge with a total of 33.4 million people living with HIV globally. In 2008 alone, 2.7 million people were newly infected with HIV globally.
Coming home, the 2007 National HIV/ AIDS and Reproductive Health Survey (NARHS Plus) in Nigeria showed that the national HIV prevalence of people living with HIV and AIDS is 3.6 percent (females 4.0 percent; males 3.2 percent with increasing cases in the rural areas in some parts of the country.
Although HIV prevalence is much lower in Nigeria than in other African countries such as South Africa and Zambia, the size of Nigeria’s population (around 150 million) meant that by the end of 2010, over 4.5 million people will be living with the virus. With AIDS claiming so many lives, Nigeria’s life expectancy has declined significantly with latest figures suggesting that the figures had fallen to 48 for women and 46 for men.
Inspite of this shortfalls, since 2006 when United Nations Member States committed to scaling up services and interventions towards the goal of universal access to HIV prevention, treatment, care and support by 2010, the World Health Organisation (WHO), United Nations Children Emergency Fund (UNICEF) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) sought to monitor key components of the health sector response to the HIV epidemic worldwide.
The year 2009 saw continuing progress in expanding access to HIV testing, prevention, treatment and care in low- and middle-income countries. The report assessed HIV/AIDS progress in 144 low- and middle-income countries in 2009 stated the following: 15 countries, including Botswana, Guyana and South Africa, were able to provide more than 80 percent of HIV-positive pregnant women in need, the services and medicines to prevent mother-to-child HIV transmission; 14 countries, including Brazil, Namibia and Ukraine, provided HIV treatment to more than 80 percent of the HIV-positive children in need; and eight countries, including Cambodia, Cuba and Rwanda, have achieved universal access to antiretroviral treatment (ART) for adults.
Though the development of potent anti retroviral therapy (ART) has dramatically improved treatment of HIV, medical experts and stakeholders in the country have stressed the need delivering universal access must be scaled up even as strict adherence to ART medication is required.
Speaking at a recent program organised by Journalist against AIDS (JAAIDS) at Ikeja, Lagos, Deborah Igbokwe, a medical expert at APIN clinic, Nigerian Institute of Medical Research, NIMR, Yaba, Lagos said that adherence is a major issue in HIV treatment given the fact that it affects how well anti-HIV medications decrease the patient’s viral load as well as help prevent drug resistance.
Igbokwe stated that HIV treatment regimens can be complicated as most regimens involve taking multiple pills each day; some anti-HIV medications requires one to take medication on an empty stomach, while others must be taken with meals, and before or after doses of other medications.
In her words “This can be difficult for many people, especially for those who are sick or are experiencing HIV symptoms or negative side effects caused by their medications. Other factors that can make it difficult to adhere to an HIV treatment regimen include experiencing unpleasant side effects after taking one’s medications, travelling away from home, being too busy, forgetting to take medications just to name but a few.”
For Ogechi Onuoha, a member of JAAIDS, findings from an earlier project implemented in 2009 by JAAIDS with funding support from SIDACTION France revealed that people living with HIV/AIDS (PLWHA) faced challenges of long waiting time at clinics, inadequate doctor/client interaction, limited capacity of counselors and infrequent adherence counseling, as well as low knowledge level of the treatment received and how it works.
According to her “the project study which was carried out in Lagos and Oyo states in February 2010 revealed that only a few sites truly offer comprehensive ART services – all expense paid, some PLWH were sometimes unable to afford meals and transport to the clinic, some PLWH were deceived into abandoning their treatment to seek for “miracle cures” and positive mothers who are forced due to cultural influence to breast feed their infants and risk transmitting the virus to their babies and this seriously affected the treatment regimen spelt out by the physician.”
It is noteworthy to state that obstacles to scaling up HIV treatment include funding shortages, limited human resources, and weak procurement and supply management systems for HIV drugs and diagnostics and other health systems bottlenecks which persists in most countries. It is believed that one third of countries reported at least one or more cases when supply of HIV medicines had been interrupted in 2009.
In Nigeria, resources needed to provide sufficient treatment and care for those living with HIV in Nigeria are seriously lacking. A study of health care providers found many had not received sufficient training on HIV prevention and treatment and many of the health facilities had a shortage of medications, equipment and materials. The government's National HIV/AIDS Strategic Framework for 2005 to 2009 set out to provide ARVs to 80 percent of adults and children with advanced HIV infection and to 80 percent of HIV-positive pregnant women in 2010.
Currently, about 34 percent of people with advanced HIV infection are said to be receiving ARVs in the country this year. In the revised framework (from 2010 to 2015), the treatment goals were set back to 2015. Going further, availability and safety of blood and blood products continue to be a concern for HIV prevention. While 99 percent and 85 percent of blood donations in high- and middle-income countries respectively were screened in a quality-assured manner in 2009, in low-income countries the comparable figure was 48 percent. And the list is endless.
No doubt, steps towards achieving universal access beyond 2010 calls for a clear set of actions to be taken by Nigeria and the international community includes renewing political and funding commitments to achieve universal access to HIV/AIDS prevention, treatment and care; improving integration and linkages between HIV/AIDS and related services such as tuberculosis, maternal and child health, sexual health and harm reduction for drug users.
More importantly, special approaches remain necessary to address the particular circumstances and needs of those populations at greater risk for HIV infection. Programmes must be designed and delivered in ways that ensure equity in access, including for children and women. There is no gain saying that only such a combined commitment to programme planning and delivery, built upon a solid primary healthcare framework can fully capture synergies between interventions, ensure programmatic sustainability and maximize coverage and impact.
Wednesday, October 13, 2010
Over 2.5 million Nigerians aged 40 blinded by glaucoma in Nigeria---Stastitics
...as the world celebrate 'Sight Day'
The eyes no doubt are one of the numerous organs in the human body, whose function is very vital given its role of providing sight. Sadly, many people pay little attention to eye health, let alone eye exam. Hence, protecting it from developing any impairment is one issue "Vision 2020: The Right to Sight", is a global advocacy effort to prevent blindness which was created by the World Health Organisation (WHO) and the International Agency for the Prevention of Blindness (IAPB) is built on. This call is coming at a time as Nigeria joins the rest of the world to mark World Sight Day (held on second Thursday in October).
In the light of this, medical experts in the country have called on Nigerians to visit their physician frequently to avoid developing one form of visual impairment or the other as global attention on blindness, visual impairment and rehabilitation of the visually impaired is brought to the fore.
In an interview with BusinessDay, Adeola Onakoya, Consultant Ophthalmologist, college of medicine, Lagos University Teaching Hospital (LUTH), said that the global target was to ultimately reduce blindness prevalence to less than 0.5 percent in all countries in keeping with the Vision 2020; The Right to Sight.
Onakoya disclosed that the new data based on the world population of 2002 showed a reduction in the number of people who are blind or visually impaired, in particular, those who are blind because of infectious causes. However, there is an increase in the number of people who are blind or visually impaired due to increasing longevity and the increase of non-communicable chronic diseases.
According to the Consultant Ophthalmologist, “the main causes of visual impairment include cataract, glaucoma, refractive errors and low vision, childhood blindness, diabetic retinopathy, age related macular degeneration, genetic eye diseases as well as trachoma (which is caused by Chlamydia trachomatis and is spread by direct contact with eye, nose, and throat secretions from affected individuals, or contact with inanimate objects such as towels and/or washcloths) and Onchocerciasis (river blindness).”
She revealed that the increase of diabetes among many population groups has caused diabetic retinopathy to be added to the priority list while glaucoma, an eye disease of the nerves known for centuries, remains on the public health agenda due to difficulties in its early diagnosis and frequent necessity of lifelong treatment as well as uncorrected refractive errors which is now an emerging important cause of visual impairment.
For Kunle Hassan, National President, Ophthalmological Society of Nigeria (OSN), much advocacy is made on glaucoma because it causes progressive damage of the optic nerve at the point where it leaves the eyes which carries visual information to the brain affected. Hassan stated that glaucoma is the second cause of irreversible blindness globally and the main cause of blindness in Nigeria progresses without warning or obvious symptoms to the patient.
In his words: “Certain factors such as high intraocular pressure (IOP), family history, ethnic background (mostly blacks), age or optic nerve appearance, have been implicated in people who develop glaucoma. However, most Nigerians who visit eye centres for screening more often than not present the later stage.”
According to a survey conducted in Nigeria in 2007, over 16.7 percent (over 2.5 million) of Nigerians aged 40 years were suffering from glaucoma and more Nigerians at present are predisposed to the disease giving lack of awareness of the disease. Already, an estimated 80 million people is anticipated to suffer from glaucoma globally by the year 2020 if awareness and continuous eye screening is not done. In addition, approximately 314 million people worldwide live with low vision and blindness. Of this number, 45 million people are blind and 269 million have low vision.
Giving these alarming figures, there is no gain saying that periodic eye and vision examinations are an important part of preventive health care. Many eye and vision problems have no obvious signs or symptoms. As a result, individuals are often unaware that problems exist.
Forging a way forward for Nigerians, Onakoya stated that for Nigerians who have no family history of eye defect/ disease, they should visit an optometrist /ophthalmologist at least once a year so as to detect any eye disease which may further lead to visual impairment if not detected in time.
In her words “Some problems might not be easily found until they come to late stage. But they can be easily detected through certain eye checks. In other words, most of these eye problems can be well prevented or slowed down if detected at early stage. On the whole, regular eye exam can do people a lot of benefits. But what should the frequency be. People who are younger than forty should get one eye exam at least annually as annual check is needed as they age.”
BY Alexander Chiejina
The eyes no doubt are one of the numerous organs in the human body, whose function is very vital given its role of providing sight. Sadly, many people pay little attention to eye health, let alone eye exam. Hence, protecting it from developing any impairment is one issue "Vision 2020: The Right to Sight", is a global advocacy effort to prevent blindness which was created by the World Health Organisation (WHO) and the International Agency for the Prevention of Blindness (IAPB) is built on. This call is coming at a time as Nigeria joins the rest of the world to mark World Sight Day (held on second Thursday in October).
In the light of this, medical experts in the country have called on Nigerians to visit their physician frequently to avoid developing one form of visual impairment or the other as global attention on blindness, visual impairment and rehabilitation of the visually impaired is brought to the fore.
In an interview with BusinessDay, Adeola Onakoya, Consultant Ophthalmologist, college of medicine, Lagos University Teaching Hospital (LUTH), said that the global target was to ultimately reduce blindness prevalence to less than 0.5 percent in all countries in keeping with the Vision 2020; The Right to Sight.
Onakoya disclosed that the new data based on the world population of 2002 showed a reduction in the number of people who are blind or visually impaired, in particular, those who are blind because of infectious causes. However, there is an increase in the number of people who are blind or visually impaired due to increasing longevity and the increase of non-communicable chronic diseases.
According to the Consultant Ophthalmologist, “the main causes of visual impairment include cataract, glaucoma, refractive errors and low vision, childhood blindness, diabetic retinopathy, age related macular degeneration, genetic eye diseases as well as trachoma (which is caused by Chlamydia trachomatis and is spread by direct contact with eye, nose, and throat secretions from affected individuals, or contact with inanimate objects such as towels and/or washcloths) and Onchocerciasis (river blindness).”
She revealed that the increase of diabetes among many population groups has caused diabetic retinopathy to be added to the priority list while glaucoma, an eye disease of the nerves known for centuries, remains on the public health agenda due to difficulties in its early diagnosis and frequent necessity of lifelong treatment as well as uncorrected refractive errors which is now an emerging important cause of visual impairment.
For Kunle Hassan, National President, Ophthalmological Society of Nigeria (OSN), much advocacy is made on glaucoma because it causes progressive damage of the optic nerve at the point where it leaves the eyes which carries visual information to the brain affected. Hassan stated that glaucoma is the second cause of irreversible blindness globally and the main cause of blindness in Nigeria progresses without warning or obvious symptoms to the patient.
In his words: “Certain factors such as high intraocular pressure (IOP), family history, ethnic background (mostly blacks), age or optic nerve appearance, have been implicated in people who develop glaucoma. However, most Nigerians who visit eye centres for screening more often than not present the later stage.”
According to a survey conducted in Nigeria in 2007, over 16.7 percent (over 2.5 million) of Nigerians aged 40 years were suffering from glaucoma and more Nigerians at present are predisposed to the disease giving lack of awareness of the disease. Already, an estimated 80 million people is anticipated to suffer from glaucoma globally by the year 2020 if awareness and continuous eye screening is not done. In addition, approximately 314 million people worldwide live with low vision and blindness. Of this number, 45 million people are blind and 269 million have low vision.
Giving these alarming figures, there is no gain saying that periodic eye and vision examinations are an important part of preventive health care. Many eye and vision problems have no obvious signs or symptoms. As a result, individuals are often unaware that problems exist.
Forging a way forward for Nigerians, Onakoya stated that for Nigerians who have no family history of eye defect/ disease, they should visit an optometrist /ophthalmologist at least once a year so as to detect any eye disease which may further lead to visual impairment if not detected in time.
In her words “Some problems might not be easily found until they come to late stage. But they can be easily detected through certain eye checks. In other words, most of these eye problems can be well prevented or slowed down if detected at early stage. On the whole, regular eye exam can do people a lot of benefits. But what should the frequency be. People who are younger than forty should get one eye exam at least annually as annual check is needed as they age.”
BY Alexander Chiejina
Placing health research in Nigeria’s healthcare sector
Taking a cursory look at healthcare delivery across the globe, there is no gain saying that health research plays a pivotal role in the development of any nation. This is in view of its contribution to the provision of solutions to health problems, providing evidence for addressing communicable and non-communicable diseases, reducing health disparities, strengthening national health systems as well as deliver healthcare services. Little wonder the World Health Organisation (WHO) revealed that improvement in healthcare delivery has closely been associated with advances in medical research.
Sadly, with Nigeria not in the driving seat of health research in sub Saharan Africa let alone the entire globe, medical experts have called for the Government to provide the necessary leadership in the development and sustainability of health research, create enabling policies, guidelines, ethics and legal framework in lieu of current health challenges in- country and at global levels.
Speaking recently at a program organised by the Nigeria Institute of Medical Research, (NIMR), Yaba, Lagos on the theme “Nigeria at 50; Health Research for National Development” Lecky Mohammed, Director, Health, Planning, Research and Statistics in the Federal Ministry of Health, Abuja said that till date, medical research has provided the strongest support for preventive and curative medicine.
Lecky revealed that medical research began to develop in Nigeria in 1920 when the Rockfeller Foundation established the Yellow Fever Commission and seminar initiatives like the International Conference on Health Research priorities for Nigeria in the 1990s, National seminar on Essential National Health Research (ENHR) etc. to name but a few were held but regretted that certain policy directives to champion health research in the country is still yet to be implemented thus stalling the advancement of medical research in Nigeria.
According to Lecky “The National Health Research Policy and the National Health Research Priorities, which were drafted in 2001 and revised in 2006, is still awaiting implementation into the mainstream of the nation’s health system. Although the National Ethical Research Committee is on place, there is poor adherence to ethical guidelines in medical research resulting probably from absence of ethical review boards in most states and higher institutions. Also, monitoring, and evaluation of research is limited and researchers are not adequately motivated.”
He added that factors responsible for the inadequacies in health research in nigeria includes lack of co-ordination, lack of regular forum to discuss health research, poor linkage between research and policy, dearth of research infrastructures, sub-optimal capacity building strategies, ineffectual documentation.
For Okey Nwanyanwu, Country Director, Centre for Diseases and Country, (CDC) Nigeria, irregular and insufficient funding of health institutes (such as Nigerian Institute of Medical Research and National Institute for Pharmaceutical Research Development NIPRD), human resources challenges, shortage of specialised expertise, inadequate prioritization by development partners and other funding bodies have negatively contributed in the relegation of medical research in the country
Nwanyanwu noted that currently, health research is not a priority of governments and most funding agencies, weak linkages with the academia, governance and industry even as health research is considered not attractive due to time constraints, bearing in mind the high technical expertise and a diversion of intervention resources.
He added that “there is the need to promote public-private partnerships, advocate improved funding for public health research, encourage philanthropy to invest in health research like Ford Foundation, Bill & Melinda Gates Foundation, partner to include research into all interventions and encourage the use of research findings in services”
It is worthy to state that the increased longevity of humans over the past century can be significantly attributed to advances resulting from medical research. Among the major benefits have been vaccines development for measles and polio, insulin treatment for diabetes, classes of antibiotics for treating a host of maladies, medication for high blood pressure, improved treatments for AIDS, statins and increasingly successful treatments for cancer and other emerging diseases.
Furthermore, research funding in many countries emanates from research bodies which distribute money for equipment and salaries. For instance, in the United Kingdom, funding bodies such as the Medical Research Council derive their assets from UK tax payers, and distribute this to institutions in a competitive manner.
In 2003, The National Institutes of Health and pharmaceutical companies in the United States collectively contributed 26.4 billion dollars and 27.0 billion dollars, respectively which constitute 28 percent and 29 percent of the total as at 2003 to medical research.
Other significant contributors included biotechnology companies, medical device companies, other federal, state and local governments as well as foundations and charities, led by the Bill and Melinda Gates Foundation.
With developed nations setting the pace globally, Nigeria can’t afford to lag behind bearing in mind its vision of becoming one of the twenty leading economies in the year 2020 as well as meeting with the Millennium Development Goals deadline of improved healthcare by 2015.
For Innocent Ujah, Director General, NIMR, “Key requirements for health research success include strategic research planning, sustainable funding of research, strengthening identifiable health research institutions at all levels such as NIMR, NIPRD, teaching hospitals, Federal Medical Centres, linking research to global and national initiatives and objectives, develop transparent approach for using research findings to aid evidence based policy at all levels and undertake research at critical areas already identified in different forums.”
More importantly, at the institutional level, there is the need to generate innovative development plan based on the National Strategic Health Development Plan (NSHDP- which is a heath component of Vision 20;2020) which is to serve as a tool for resource mobilization, develop plans that are aligned to NSHDP. In addition, at the national level, it is eminent to progressively increase investment in health research, pursue the passage of the Health bill and approve Health Research Policy and priorities, and establish a robust database of health research for better co-ordination.
ALEXANDER CHIEJINA
Sadly, with Nigeria not in the driving seat of health research in sub Saharan Africa let alone the entire globe, medical experts have called for the Government to provide the necessary leadership in the development and sustainability of health research, create enabling policies, guidelines, ethics and legal framework in lieu of current health challenges in- country and at global levels.
Speaking recently at a program organised by the Nigeria Institute of Medical Research, (NIMR), Yaba, Lagos on the theme “Nigeria at 50; Health Research for National Development” Lecky Mohammed, Director, Health, Planning, Research and Statistics in the Federal Ministry of Health, Abuja said that till date, medical research has provided the strongest support for preventive and curative medicine.
Lecky revealed that medical research began to develop in Nigeria in 1920 when the Rockfeller Foundation established the Yellow Fever Commission and seminar initiatives like the International Conference on Health Research priorities for Nigeria in the 1990s, National seminar on Essential National Health Research (ENHR) etc. to name but a few were held but regretted that certain policy directives to champion health research in the country is still yet to be implemented thus stalling the advancement of medical research in Nigeria.
According to Lecky “The National Health Research Policy and the National Health Research Priorities, which were drafted in 2001 and revised in 2006, is still awaiting implementation into the mainstream of the nation’s health system. Although the National Ethical Research Committee is on place, there is poor adherence to ethical guidelines in medical research resulting probably from absence of ethical review boards in most states and higher institutions. Also, monitoring, and evaluation of research is limited and researchers are not adequately motivated.”
He added that factors responsible for the inadequacies in health research in nigeria includes lack of co-ordination, lack of regular forum to discuss health research, poor linkage between research and policy, dearth of research infrastructures, sub-optimal capacity building strategies, ineffectual documentation.
For Okey Nwanyanwu, Country Director, Centre for Diseases and Country, (CDC) Nigeria, irregular and insufficient funding of health institutes (such as Nigerian Institute of Medical Research and National Institute for Pharmaceutical Research Development NIPRD), human resources challenges, shortage of specialised expertise, inadequate prioritization by development partners and other funding bodies have negatively contributed in the relegation of medical research in the country
Nwanyanwu noted that currently, health research is not a priority of governments and most funding agencies, weak linkages with the academia, governance and industry even as health research is considered not attractive due to time constraints, bearing in mind the high technical expertise and a diversion of intervention resources.
He added that “there is the need to promote public-private partnerships, advocate improved funding for public health research, encourage philanthropy to invest in health research like Ford Foundation, Bill & Melinda Gates Foundation, partner to include research into all interventions and encourage the use of research findings in services”
It is worthy to state that the increased longevity of humans over the past century can be significantly attributed to advances resulting from medical research. Among the major benefits have been vaccines development for measles and polio, insulin treatment for diabetes, classes of antibiotics for treating a host of maladies, medication for high blood pressure, improved treatments for AIDS, statins and increasingly successful treatments for cancer and other emerging diseases.
Furthermore, research funding in many countries emanates from research bodies which distribute money for equipment and salaries. For instance, in the United Kingdom, funding bodies such as the Medical Research Council derive their assets from UK tax payers, and distribute this to institutions in a competitive manner.
In 2003, The National Institutes of Health and pharmaceutical companies in the United States collectively contributed 26.4 billion dollars and 27.0 billion dollars, respectively which constitute 28 percent and 29 percent of the total as at 2003 to medical research.
Other significant contributors included biotechnology companies, medical device companies, other federal, state and local governments as well as foundations and charities, led by the Bill and Melinda Gates Foundation.
With developed nations setting the pace globally, Nigeria can’t afford to lag behind bearing in mind its vision of becoming one of the twenty leading economies in the year 2020 as well as meeting with the Millennium Development Goals deadline of improved healthcare by 2015.
For Innocent Ujah, Director General, NIMR, “Key requirements for health research success include strategic research planning, sustainable funding of research, strengthening identifiable health research institutions at all levels such as NIMR, NIPRD, teaching hospitals, Federal Medical Centres, linking research to global and national initiatives and objectives, develop transparent approach for using research findings to aid evidence based policy at all levels and undertake research at critical areas already identified in different forums.”
More importantly, at the institutional level, there is the need to generate innovative development plan based on the National Strategic Health Development Plan (NSHDP- which is a heath component of Vision 20;2020) which is to serve as a tool for resource mobilization, develop plans that are aligned to NSHDP. In addition, at the national level, it is eminent to progressively increase investment in health research, pursue the passage of the Health bill and approve Health Research Policy and priorities, and establish a robust database of health research for better co-ordination.
ALEXANDER CHIEJINA
Wednesday, October 6, 2010
Kidney failure on the rise in Nigeria
...As calls have been made for regular medical check up
The human kidney is one essential organ responsible for the removal of waste products and excess fluids from the body. Aside this, the kidney helps in reabsorbing useful substances like glucose, protein and electrolysis into the body in precise levels needed for proper body functioning as well as produce hormones which help various organs carry out their specific functions.
Despite the critical role this organ plays, medical experts are worried on the increasing cases of kidney failure or end stage renal disease which is becoming a major issue in Nigeria giving the increasing incidence of the medical ailment.
Recent statistics indicate that kidney failure is increasing worldwide by approximately 7 to 8 percent annually even as incidence in Nigeria could be as high as 10 per million population. In addition, about 12 to 14 cases of patients aged between 20 and 50 years come for kidney dialysis in Lagos University Teaching Hospital (LUTH), idi-araba, Lagos on a weekly basis.
With a significant number of Nigerians who fall within the working population likely to be affected, medical experts have called for Nigerians to maintain healthy lifestyles, go for medical checkups giving the fact that the threat to the future of Nigeria’s economy is at stake.
Speaking at a Kidney Rejoice Program in Lagos recently, Toyin Amira, Consultant Nephrologist, Lagos University Teaching Hospital (LUTH), Idi-araba, Lagos, said that kidney failure results from damages to one or both kidneys giving rise to accumulation of waste and fluids in the body.
Amira stated that the damage to the kidneys can be sudden (as in acute failure) with adequate co-progressive and irreversible insult to the kidney, often referred to as End Stage Kidney Failure.
According to Amira: “Healthy kidneys work 24 hours a day to remove waste products from the blood that build up mainly from the food that we eat. These waste products include urea, creatinine, potassium, sodium, phosphorus and fluids. However, kidney failure may show no symptoms until it reaches an advanced stage. However, some identified causes include hypertension, diabetes, glomerulonephrities, HIV/AIDS, analgesic nephropathy, certain diseases like polycystic kidney diseases, to name but a few. “
She hinted that a failure of the kidneys could lead to so many negative complications and gradually affect the other organs of the body which may eventually make the patient succumb to death except treated by dialysis or transplantation.
For Hadunni Ogunjumelo, co-coordinator, Kidney Rejoice, a non-governmental organsation targeted at creating awareness of Kidney issues in Nigeria said that “Because hypertension-often referred to as a “silent killer”-cause no symptoms and medications are expensive and may cause unwanted side effects, many find compliance with required treatment difficult and this further compound the problem of hypertension related kidney disease.
In her words “Poverty has been identified as a major problem in the bid to reduce this casualty. In advanced countries, they have extensive prevention programmes on kidney while for us in Nigeria we need to depend even more on prevention modes. Unfortunately, quite a high number of patients in Nigeria end up with no treatment option. In other words, they just wait to die due to unawareness, inability to afford treatments and inaccessibility to good treatment modes. Don’t forget that a typical renal patient has a 3 to 5 hour dialysis treatment; three times per week. For instance, in Nigeria, each session of dialysis treatment will cost an average of N25, 000. 00 (twenty-five thousand naira) or over seventy–five thousand naira per week, a cost much more than the average Nigerian worker cannot bear.”
With the World Health Organization (WHO) statistics of 2002 which put death rate from intrinsic kidney and urinary tract disease at one million and the prevalence of impaired kidney function estimated to range between 10 percent and 20 percent of adult population in most countries worldwide, it is evident that urgent attention needs to be paid to the risk factors for chronic kidney disease and to instituting interventions to slow the progression of renal disease.
For Joe Okei-Odumakin, President, Women Arise for Change initiative, whose brother was diagnosed of kidney failure three months before he died, stated that since the kidney is a sensitive organ in the body, Nigerians should endeavour to consult their health care provider for prescription of drugs as unregulated across the shelf consumption of drugs could affect the kidney without the person knowing about that.
“Make efforts to check your blood pressure since chronic high blood pressure have been identified as one of the most common causes of acute kidney failure in adult men and women; quitting cigarette smoke lowers the blood pressure, which is important for preventing kidney failure; and maintaining healthy lifestyle by checking what you eat/ drink is also important. You can reduce the strain on your kidneys by cutting all alcoholic drinks out of your lifestyle. These drinks require that your kidneys work very hard and not drinking them can help prevent kidney problems,” Okei-Odumakin added.
alexander Chiejina
The human kidney is one essential organ responsible for the removal of waste products and excess fluids from the body. Aside this, the kidney helps in reabsorbing useful substances like glucose, protein and electrolysis into the body in precise levels needed for proper body functioning as well as produce hormones which help various organs carry out their specific functions.
Despite the critical role this organ plays, medical experts are worried on the increasing cases of kidney failure or end stage renal disease which is becoming a major issue in Nigeria giving the increasing incidence of the medical ailment.
Recent statistics indicate that kidney failure is increasing worldwide by approximately 7 to 8 percent annually even as incidence in Nigeria could be as high as 10 per million population. In addition, about 12 to 14 cases of patients aged between 20 and 50 years come for kidney dialysis in Lagos University Teaching Hospital (LUTH), idi-araba, Lagos on a weekly basis.
With a significant number of Nigerians who fall within the working population likely to be affected, medical experts have called for Nigerians to maintain healthy lifestyles, go for medical checkups giving the fact that the threat to the future of Nigeria’s economy is at stake.
Speaking at a Kidney Rejoice Program in Lagos recently, Toyin Amira, Consultant Nephrologist, Lagos University Teaching Hospital (LUTH), Idi-araba, Lagos, said that kidney failure results from damages to one or both kidneys giving rise to accumulation of waste and fluids in the body.
Amira stated that the damage to the kidneys can be sudden (as in acute failure) with adequate co-progressive and irreversible insult to the kidney, often referred to as End Stage Kidney Failure.
According to Amira: “Healthy kidneys work 24 hours a day to remove waste products from the blood that build up mainly from the food that we eat. These waste products include urea, creatinine, potassium, sodium, phosphorus and fluids. However, kidney failure may show no symptoms until it reaches an advanced stage. However, some identified causes include hypertension, diabetes, glomerulonephrities, HIV/AIDS, analgesic nephropathy, certain diseases like polycystic kidney diseases, to name but a few. “
She hinted that a failure of the kidneys could lead to so many negative complications and gradually affect the other organs of the body which may eventually make the patient succumb to death except treated by dialysis or transplantation.
For Hadunni Ogunjumelo, co-coordinator, Kidney Rejoice, a non-governmental organsation targeted at creating awareness of Kidney issues in Nigeria said that “Because hypertension-often referred to as a “silent killer”-cause no symptoms and medications are expensive and may cause unwanted side effects, many find compliance with required treatment difficult and this further compound the problem of hypertension related kidney disease.
In her words “Poverty has been identified as a major problem in the bid to reduce this casualty. In advanced countries, they have extensive prevention programmes on kidney while for us in Nigeria we need to depend even more on prevention modes. Unfortunately, quite a high number of patients in Nigeria end up with no treatment option. In other words, they just wait to die due to unawareness, inability to afford treatments and inaccessibility to good treatment modes. Don’t forget that a typical renal patient has a 3 to 5 hour dialysis treatment; three times per week. For instance, in Nigeria, each session of dialysis treatment will cost an average of N25, 000. 00 (twenty-five thousand naira) or over seventy–five thousand naira per week, a cost much more than the average Nigerian worker cannot bear.”
With the World Health Organization (WHO) statistics of 2002 which put death rate from intrinsic kidney and urinary tract disease at one million and the prevalence of impaired kidney function estimated to range between 10 percent and 20 percent of adult population in most countries worldwide, it is evident that urgent attention needs to be paid to the risk factors for chronic kidney disease and to instituting interventions to slow the progression of renal disease.
For Joe Okei-Odumakin, President, Women Arise for Change initiative, whose brother was diagnosed of kidney failure three months before he died, stated that since the kidney is a sensitive organ in the body, Nigerians should endeavour to consult their health care provider for prescription of drugs as unregulated across the shelf consumption of drugs could affect the kidney without the person knowing about that.
“Make efforts to check your blood pressure since chronic high blood pressure have been identified as one of the most common causes of acute kidney failure in adult men and women; quitting cigarette smoke lowers the blood pressure, which is important for preventing kidney failure; and maintaining healthy lifestyle by checking what you eat/ drink is also important. You can reduce the strain on your kidneys by cutting all alcoholic drinks out of your lifestyle. These drinks require that your kidneys work very hard and not drinking them can help prevent kidney problems,” Okei-Odumakin added.
alexander Chiejina
Experts seek means to improve mental healthcare in Nigeria
…as the world celebrates World Health Day
To medical experts, physical and mental health is intertwined hence, mental health is seen as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.
Taking a cursory look at the Nigerian society, people with mental and psychosocial disabilities are among the most marginalized group. Even though development actors have pledged to focus their work on the most vulnerable in a community, many programmes continue to ignore and exclude this vulnerable group. Sadly, the treatment gap for mental, neurological and substance use disorders is alarming especially in poor resource countries with Nigeria not left out of this frame.
As Nigeria joins the rest of the world to celebrate World Mental Health Day every October 10- a day set aside to raise public awareness about mental health issues, promote more open discussion of mental disorders, and investments in prevention and treatment services, medical experts in the country have tasked the government on the need for availability and access to mental care to Nigerians.
Speaking recently to newsmen in Lagos, Olufemi Olugbile, Chief Medical Director, Lagos State University Teaching Hospital (LASUTH) said that it has been estimated that at least, about 90 percent of people with clear-cut mental health syndromes do not even get any treatment at all in Nigeria which is an atrocious figure and everybody knows the issue.
Olugbile, who is also a consultant psychiatrist stated that the specialists, such as psychiatrist nurses, social welfare officers, occupational therapists and all those who form members of the mental health team, are very few in numbers, grossly inadequate even as the number of hospital units available for the treatment of mental disorders is also very low.
According to him “Mental healthcare is supposed to be one of the elements of primary healthcare in Nigeria but that is only seen on papers. Most of the people at the level of the primary health care don’t know much about mental health, don’t have interest in it and don’t have facilities, including simple drugs for treating mental illness. We believe that if we reverse all these three things, giving them knowledge, facilities and supervision, mental healthcare would reach its optimal goal. Right now, there are more people outside the net than inside the net.
The problem is not all about non-availability of specialists but the way, services are organized currently do not make for appropriate coverage. Of course, when people do not have access to the so-called mental healthcare services, what are they supposed to do? They patronize people closer to them the traditional healers. What Lagos State has done is that, it has set up a body to coordinate the traditional healthcare and also to help standardize it so that they would be doing some kind of certification, inspecting what people are doing, checking both their environments and the details of their practice.”
He added that “In the United Kingdom and other nations of the world, mentally-ill people are actually not treated by mental health specialists but by General health Practitioners. Most illnesses are of such an order that they can actually be substantially treated and relieved by lower level of care, non specialized care, such as what is available in primary health care centres and in general practices.”
For Oye Gureje, President, Association of Psychiatrists in Nigeria (APN), mental health conditions are responsible for a great deal of mortality and disability, accounting for 8.8 percent and 16.6 percent of the total burden of disease due to health conditions in low and middle-income countries, respectively according to latest reports from the World Health Organsation (WHO).
Guruje disclosed that “this report calls for development actors to address the needs of people with mental and psychosocial disabilities in development work by: recognizing the vulnerability of this group and including them in all development initiatives, scaling up services for mental health in primary care; involving people themselves in the design of development programmes and projects; and improving social services for people with mental and psychosocial disabilities as the nation may not be able to achieve the lofty dreams of Millennium Development Goals (MDGs) if proper attention is not paid to the burning issue of mental welfare of the nation.”
It is eminent to state that In Africa, less than 50 percent of countries have a mental health policy. In Nigeria, the progressive 1991 primary health care policy states that mental health should be integrated at the primary care level but this is still yet to be implemented.
However, the most severe mental illnesses require long-term treatment. Although this treatment when given in the community is not expensive, the system of paying out-of-pocket means that many families find it hard to afford the care their loved ones need month after month. It is unclear whether the National Health Insurance Scheme will adequately cover mental ill health.
Some schools of thought believe that monies expended by the Federal government for mental health is what is being used to run the eight psychiatric hospitals that the Federal government has. If this is what it really is, it means there may be insufficient funds for programmes such as initiative and public education, as well as the scourge of debilitating mental disorder in our nation.
No doubt, to revamp mental healthcare in Nigeria, there must be equal attention, even more attention, paid to advocacy and programmes meant to change the pattern and reverse the statistics which suggest that about 90 percent of people lack access to mental care. This is a paradigm shift which the government has to make.
Alexander Chiejina
To medical experts, physical and mental health is intertwined hence, mental health is seen as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.
Taking a cursory look at the Nigerian society, people with mental and psychosocial disabilities are among the most marginalized group. Even though development actors have pledged to focus their work on the most vulnerable in a community, many programmes continue to ignore and exclude this vulnerable group. Sadly, the treatment gap for mental, neurological and substance use disorders is alarming especially in poor resource countries with Nigeria not left out of this frame.
As Nigeria joins the rest of the world to celebrate World Mental Health Day every October 10- a day set aside to raise public awareness about mental health issues, promote more open discussion of mental disorders, and investments in prevention and treatment services, medical experts in the country have tasked the government on the need for availability and access to mental care to Nigerians.
Speaking recently to newsmen in Lagos, Olufemi Olugbile, Chief Medical Director, Lagos State University Teaching Hospital (LASUTH) said that it has been estimated that at least, about 90 percent of people with clear-cut mental health syndromes do not even get any treatment at all in Nigeria which is an atrocious figure and everybody knows the issue.
Olugbile, who is also a consultant psychiatrist stated that the specialists, such as psychiatrist nurses, social welfare officers, occupational therapists and all those who form members of the mental health team, are very few in numbers, grossly inadequate even as the number of hospital units available for the treatment of mental disorders is also very low.
According to him “Mental healthcare is supposed to be one of the elements of primary healthcare in Nigeria but that is only seen on papers. Most of the people at the level of the primary health care don’t know much about mental health, don’t have interest in it and don’t have facilities, including simple drugs for treating mental illness. We believe that if we reverse all these three things, giving them knowledge, facilities and supervision, mental healthcare would reach its optimal goal. Right now, there are more people outside the net than inside the net.
The problem is not all about non-availability of specialists but the way, services are organized currently do not make for appropriate coverage. Of course, when people do not have access to the so-called mental healthcare services, what are they supposed to do? They patronize people closer to them the traditional healers. What Lagos State has done is that, it has set up a body to coordinate the traditional healthcare and also to help standardize it so that they would be doing some kind of certification, inspecting what people are doing, checking both their environments and the details of their practice.”
He added that “In the United Kingdom and other nations of the world, mentally-ill people are actually not treated by mental health specialists but by General health Practitioners. Most illnesses are of such an order that they can actually be substantially treated and relieved by lower level of care, non specialized care, such as what is available in primary health care centres and in general practices.”
For Oye Gureje, President, Association of Psychiatrists in Nigeria (APN), mental health conditions are responsible for a great deal of mortality and disability, accounting for 8.8 percent and 16.6 percent of the total burden of disease due to health conditions in low and middle-income countries, respectively according to latest reports from the World Health Organsation (WHO).
Guruje disclosed that “this report calls for development actors to address the needs of people with mental and psychosocial disabilities in development work by: recognizing the vulnerability of this group and including them in all development initiatives, scaling up services for mental health in primary care; involving people themselves in the design of development programmes and projects; and improving social services for people with mental and psychosocial disabilities as the nation may not be able to achieve the lofty dreams of Millennium Development Goals (MDGs) if proper attention is not paid to the burning issue of mental welfare of the nation.”
It is eminent to state that In Africa, less than 50 percent of countries have a mental health policy. In Nigeria, the progressive 1991 primary health care policy states that mental health should be integrated at the primary care level but this is still yet to be implemented.
However, the most severe mental illnesses require long-term treatment. Although this treatment when given in the community is not expensive, the system of paying out-of-pocket means that many families find it hard to afford the care their loved ones need month after month. It is unclear whether the National Health Insurance Scheme will adequately cover mental ill health.
Some schools of thought believe that monies expended by the Federal government for mental health is what is being used to run the eight psychiatric hospitals that the Federal government has. If this is what it really is, it means there may be insufficient funds for programmes such as initiative and public education, as well as the scourge of debilitating mental disorder in our nation.
No doubt, to revamp mental healthcare in Nigeria, there must be equal attention, even more attention, paid to advocacy and programmes meant to change the pattern and reverse the statistics which suggest that about 90 percent of people lack access to mental care. This is a paradigm shift which the government has to make.
Alexander Chiejina
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