Tuesday, 28 April 2009

Prof Grange's new job

....we are quick to forget.

Professor Adenike Grange Former Minister of Health, who lost her job from the Umaru Yar'Adua administration over the controversial unspent budget, was recently appointed as Chief Executive Officer (CEO) and Provost, Otunba Tunwase National Pediatric Centre, Ijeb-Ode, Ogun State.

While the case against her lingers on through the bureacratic hurdles of our judiciary, in the court of public opinion. At the beginning of this administration, when there seemed to be a clear determination to fight corruption, we mulled over the the issue on if Professor Grange will be seen as a victim or villian by the Nigerian people.

Since then a lot has happened in Nigeria. Politicians that raped the Nigerian people have turned kingmakers and elderstatesmen. Those that led the anti corruption crusade have been hounded out of the country. We are now in comical era of "rule of law" where emphasis is placed on branding, or re-branding.

The vision of the Otunba Tunwase National Pediatric Centre, it is an international centre of excellence, for teaching, research and health care for children with a total commitment to the very best in all activities related to the survival of infants and children.

According to its website, the Otunba Tunwase National Paediatric Centre has established a Non Profit Organization (NGO) known as the ‘‘Association of Friends of Otunba Tunwase National Paediatric Centre’’ a registered philanthropic NGO whose objectives is to raise funds both Nationally and Inter nationally for equipping, maintaining and generally financing the Paediatric centre and providing for all spheres of its activities in perpetuity.

We wish her well.

Saturday, 25 April 2009

Malaria...too common?

I remember growing up in Nigeria, through primary and secondary school...the several bouts of malaria, the painful chloroquine shots and a few days on incapacity. A small inconvenience at most. It was one of my most enlightening moments in medical school when I realised that malaria was the single largest cause of death in children in Nigeria. My initial surprise turned into shock during my first job as a house officer in paediatrics as a I watched children die in my hands. The link to poverty and ignorance became clear to me as women brought their children into hospital after they had been treated with paracetamol for days with a fever, often paper white with pallor...

Memories of those deaths linger....I remember them always....but especially today...

The World Malaria Day 2009

This is the impact on the health of Nigerians...

  • Malaria accounts for about 60% of outpatient cases in health facilities
  • For approximately 300,000 annual deaths.
  • It is also responsible for 25% of all infant related mortality.
  • 30% of child related mortality.
  • 11% of maternal mortality.
Insignificant...it is not!

Today, for the first time in 50 years, the international community is poised to win the fight against malaria worldwide. Effective, low-cost tools exist to prevent and treat the disease and new and improved tools are currently being developed and tested. A consensus global action plan has been put forth to guide a coordinated international effort to control, eliminate and eventually eradicate malaria. A robust Partnership, uniting all key actors and stakeholders in malaria control, is in place to respond to challenges that no organization or government can face alone.

But ...will our country do its bit? Or will we be "the last country standing" like it has been for Polio, Guinea worm etc....Do we have the public health infrastructure to deliver bed nets to the people that need it most.

It will be even more embarrassing ...as the name of our capital will always be associated with the renewal of efforts ...the "ABUJA DECLARATION" at the African Summit on Roll Back Malaria at Abuja, Nigeria, 25 April 2000. They committed themselves to, among others,
  • “halve malaria mortality of Africa’s people by 2010”, and
  • resolved to “initiate appropriate and sustainable action to strengthen the health systems so that by 2005, 60% of populations at risk (especially pregnant women and children) have access to preventive measures, while 60% of those suffering from Malaria have access to prompt treatment”.
How far have we gone with this....well....you know the answer. The truth is that there is NO concerted action against malaria in Nigeria. None.....

That is our reality...

Find a list of statements relating to the World Malaria Day HERE

Find an excellent blog on malaria matters by a colleague passionate about Nigeria: Malaria Matters

To find out why things are stagnating despite the huge cost to your children, brothers, sisters...write:

Dr T.O. Sofola, National Malaria Control Programme Manager - email

Ask him....

Friday, 24 April 2009

2 Health Meetings in Nigeria

The second Nigeria National Health Conference (NHC2009), will hold on 8-10 June 2009, at the Le Meridien Ibom Hotel and Resort, Uyo, Akwa Ibom State, Nigeria THEME: ‘Primary Health Care in Nigeria - 30 Years after Alma Ata’ DATE: June 2009.

Nigerian National Health Conference (NHC 2009) 8-10 June 2009

The Pan African Society of Cardiology (PASCAR) in association with The Nigerian Cardiac Society (NCS) invite all to the 9th PASCAR Congress and the 2ND All Africa Conference on Heart Disease, Stroke and Diabetes in Abuja 2009

Pascar Conference 2009 26 - 30 September 2009

Wednesday, 22 April 2009

Some Lives are more valuable than others…

by ndubuisi edeoga

Eric Arthur Blair, some of you would know him as “George Orwell” said it years ago in his famous book Animal Farm, "all animals are equal, but some animals are more equal than others". This is even more pertinent to our Nigeria of today.

The headline in dailies “Ex-Gov Turaki to be flown to Germany” Thisdayonline. The paper goes on to say that the patient was in a stable condition at the national Hospital Abuja Intensive Care Unit.

The ex-governor even had the choice of going to Singapore but the president in his infinite wisdom “primus inter pares” stepped in to help! “our president was said to have preferred Germany because of the country’s expertise in treating accident injuries”. We must ask ourselves why our President was so concerned. This Honourable Senator of the Federal Republic spent eight disastrous years as the governor of Jigawa. Under his watch, the state remained steeped in underdevelopment while he set records as a gallivanting and visionless governor travelling the globe seeking "foriegn investors". He became famous when EFCC finally caught up with him and he was reduced to a crybaby as the preferred charges were read out loud. But this is not really the essence of this piece.

On the same day there was a story goes on to tell us about 37 people “lesser animals” that were involved in another series of accidents with 24 people dying at the site and 10 people on the danger list in hospitals in Jebba.

I did not see any mention of the president sending a message of condolence to these “lesser families” or recommending treatment for them at the country of his choice.

Fast forward to the United States, the recent shooting of 13 people in New York, got a presidential mention, even when the president was out of the country....that is what leadership feels like....

In related stories in the Vanguard newspaper, a 60-year-old got her knee replaced in a Nigeria hospital, the surgery was led by a Belgian Dr. Jean-Luc Burrette. While speaking at the occasion Commissioner for Health, Dr. Samson Parker said “the state used to fly such cases abroad at a cost of about N10 million, but said a lot would be saved by carrying out the operation locally, since it cost between N500, 000 and N700, 000”

What would be the cost of medical treatment for ex-governor Turaki in Germany? Your guess is as good as mine. Who is footing the bill, your guess is as good as mine? What’s the criterion for choosing who goes to Germany for medical care, your guess is as good as mine?

The current Bill sponsored by Mr. Bassey Etim representing Uyo Federal Constituency in the House of Representatives calling for an amendment to the Federal Road Safety Commission (FRSC) Act and adding free medical treatment for accident victims on Nigerian roads.
According to Mr. Etim “the bill seeks to amend the FRSC Act to include the free treatment of accident victims because most survivors of road crashes often die due to lack of proper medical care. He said it was not enough for FRSC officials to evacuate accident victims and dump them in hospitals, adding that with the planned law, the Federal Government would foot such bills to enable the victims get proper attention. The lawmaker decried the current situation where accident victims are dumped in hospitals and left to die”. Just like the 10 people on the danger list in Jebba.

We representing the “lesser people “ of Nigeria should make another amendment to Mr. Etim’s bill, let’s amend the bill to read free treatment for all accident victims in Germany since they have the best trauma centers in the world according to our president “primus inter pares”...

In Germany we trust! Long live Senator Turaki!

Tuesday, 14 April 2009

Pfizer settles...but what of their collaborators at home?

While we celebrate "justice" for Pfizer, as we did for Siemens and Halliburton...in their dealings with Nigeria...the real devil is among us, in the Nigerians among us that collaborated with these firms. As long as those Nigerians are free, we are all captive, captive to an ongoing systematic rape of a people by its "leaders"...

You would have read from the links on our last post that Nigeria's Kano State and the US drugs firm Pfizer have agreed to settle a multi-million dollar lawsuit out of court. Pfizer has been accused of killing 11 children and injuring 181 others when an antibiotic was tested on them during a meningitis epidemic in 1996. Pfizer has always maintained that the tests were carried out with the approval of the Nigerian government and that the children's parents were fully informed.

Now it is time for those Nigerians involved to declare their roles in this episode.
Non of what happened could have been remotely possible without the active and deliberate connivance of Nigerians in high places. That is the truth we have to face.

  • Pls read our previous blog on this issue referring to to a book written by Dr Idris Mohamed - “Academics, Epidemics and Politics”….and eventful career in public health. He was the Chairman of the Taskforce of the Federal Republic of Nigeria sent to manage the outbreak.
  • Read a copy of the report of an investigative committee set up by the Nigerian Ministry of Health to investigate the incident here
While it is convenient to blame Pfizer and make them pay...we must ask ourselves the hard questions. Our society will never improve if we let our "leaders" get away with killing, robbing and disenfranchising their own people.

Who has taken responsibility in the Federal Ministry of Health? In the Kano State Ministry of Health...those are the questions that Nigerians need answers to.

Now that NEXT has published details of our leaders involved in the "Halliburton" scandal... Nigerians...that accepted at least N27 billion in bribes from the oil services companies in exchange for billions of dollars in contracts to build our liquefied natural gas plant, as revealed by US investigators...

And the names of those invloved in the Siemens scandal are also in the public domain...Nigerians who were alleged to have received about 10 million euros as bribes from the German telecommunications company Siemens...

As long as all these
Nigerians are free, together with our colleagues that worked with Pfizer, and many still actively participating in "governance"....the message for the Nigerian people is that is okay to steal...as long as you are Nigerian, stealing from Nigerians...and for the foreign companies....justice will come to them through their own systems.


Wednesday, 8 April 2009

Pfizer settles Nigeria Trovan law suit

The pharmaceutical company, Pfizer has reached an out of court settlement in the suit over the use of Trovan in a meningitis outbreak in Kano State

For more information, read here and here

Tuesday, 7 April 2009

What is the "cost" of a life in Nigeria

by ndubisi edeoga

There they go again. I read in the papers that 4 teaching hospitals were slated for renovation....again. The last renovation was done sometime back by the famed VAMED Engineering GmbH and Co kG of Vienna for US$291million....

A friend of mine who is a cardiologist in one of the teaching hospitals that was renovated in preceding round of renovations called me a couple of weeks back and needed information and assistance in buying parts for a HP sonos 2000 ECHO machine. Extremely surprised....I asked..."I thought you guys got brand new ECHO machine some months back from VAMED". He responded that the new machines are there but they are useless, so useless that he would rather spend his money and time to fix the more than 10year old Sonos machine, that he has used for many years, and has been satisfied with the performance.

What does this say about government funded renovations in Nigerian teaching hospitals?

Similar scenario; 2 years ago I was in New York in a general hospital that serves the Harlem Community. The hospital planned to replace their aging CT Scan machine for newer ones. What did they do. The hospital bigwigs narrowed the options down to two, based on cost, functionality and other factors, then they got all the radiologists and radiology technicians and made them go to two sites that had the different machines and work with the machines on two different days and get a feel of each and they were given the leeway to decide on which machine they felt would better for them to use.

In Nigeria the decision on what to buy is made hundreds of miles away, with little or no input from the end users; doctors and technicians.

In one instance they supplied equipment that was too big for the existing room at the teaching hospital and since then the equipment has been in the store room waiting for another round of renovation like this for them to build a bigger room for the supplied equipment.

I have read so many articles and posts about "physician assisted deaths" or "outright murders" in Nigeria, and I still ask...

What is the "cost of a life in Nigeria"?

One month ago I got a call from Alex; young, up coming banker, ambitious, with dreams aplenty. We talked about the stimulus package in the US and the need for stimulus 2.0 in Nigeria.

Two days after our conversation, I got a call from Nigeria at 3.00am (you better start praying, who is dead now, who got kidnapped,what bad news).

And I was right like always; Alex is dead.....what dead.....what...he went for a surgery.....what surgery.......TONSILLECTOMY...TonsiWHAT.....by now I was screaming (apologies to my neighbours).

The story was that this young man that I spoke with 2 days before he died, (he sounded good to me over the phone), went for an elective "TONSILLECTOMY" in a private clinic in Garki Abuja, on a Sunday morning.

Well the good doctor who did not think that he would need oxygen, or any other form of resuscitation equipment, called in a fellow doctor and they both "MURDERED" this young man. He did not make it to surgery...they anaesthetised him and he died on the table while they were "waiting" for the anesthesia to knock him out.

So....what really is the cost of this life in Nigeria?

Where are the lawyers when we need them? When you watch our beloved NTA news at 9 pm you see hundreds of them, with their wigs et al defending our gubernatorial aspirants as they fight for the spoils of public funds. Here in the US, I pay a substantial part of my income in insurance (and yes I moan about this every month).

The fear of malpractice suits is the beginning of wisdom...

It is time that a few examples are set by the courts on the consequences of medical malpractice. Lets not leave judgement to God. Lets start right here on earth. Right here in Nigeria.

Maybe, just maybe...we might start finding out what the cost of life in Nigeria really is.

To Alex's young widow and 2 children I say take heart, and to my dear friend Alex I say Adieu!!

Sunday, 5 April 2009

Mental Health Care in Nigeria; the forgotten issue

A few good things are happening in Nigeria. One of this is the emergence of a news medium called 234NEXT....which led this weekend (04/04/09) with a topic even health professionals in Nigeria prefer to ignore - Mental Health. The title above is not mine but theirs, but I could not have put it any better. Pls click on it and read before continuing...

Mental Health Care in Nigeria; the forgotten issue...

Its great to see a Nigerian daily take on a challenging social issue as this lead story. Kudos to next!

The journal has a couple of extras to their article, my only criticism of which is that no attempt is made in stating the sources of their information.

Facts on mental health in Nigeria

One of these "facts" is that there are around 130 working psychiatrists in the whole of Nigeria. Almost all of these psychiatrists are based in one of the country's large specialist hospitals in major cities.

A few months ago ....when the Punch reported that The Medical Director of the Federal Psychiatric Hospital, Yaba, Lagos, Dr. Taiwo Ladapo, as saying there were only 100 psychiatric doctors in the country!...I made a mental note to blog on this.

To understand what that means....lets take one of the more severe mental illnesses - schizophrenia. Schizophrenia is characterized by delusions, hallucinations, incoherence and physical agitation...There are effective interventions (pharmacological and psychosocial) available and the cost of treatment of a person suffering from chronic schizophrenia is about US$2 per month; the earlier the treatment is initiated, the more effective it will be. However, the majority of the persons with chronic schizophrenia do not receive treatment, which contributes to the chronicity....and more so in Nigeria.

It is generally agreed that rates of schizophrenia are generally similar from country to country—about .5% to 1 percent of the population....so lets do the math....we are in trouble here.

But...where are the positives. We have a rich history in teaching and learning psychiatry. Many will know the Neuropsychiatric Hospital, Aro, established in 1954 administered by the first indigenous Psychiatrist in Nigeria, the late Professor Thomas Adeoye Lambo, the former Deputy Secretary General of World Health Organization. He was among the first clinicians to observe the 'comparatively quick recovery, lack of chronicity, and better therapeutic response generally of schizophrenic patients’, which he attributed to the ‘favourable social and environmental factors inherent in the community to which the mentally ill are exposed in Africa’.

Lambo’s most innovative development was the Aro village system. Psychiatric patients were boarded out to 4 villages around Aro, accommodating between 200 and 300 patients from a wide geographical area. Lambo believed that those who were boarded out more quickly adapted themselves to their situation than those taken into hospital. He also thought that this was the result of their contact with a settled, tolerant, and healthy environment.

So back to the problem of today. If our health sector is in a mess, mental health services are in the extreme end of that mess. Our society does not make it any better either. Several papers have shown our society has still not come to terms with mental illness and still believe that supernatural factors are responsible for developing these conditions.

There have been several stories in the past that shocked those not in the know about how people ith mental illness are treated in several towns in Nigeria...as this on Shackled day and night. in Nigeria...

Mental health is one issue that will take a while to solve. But there is no better time to start than now...