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Archive for the ‘Health promotion’ Category

A news website wholly dedicated to reporting the Nigerian health sector has been launched in Lagos.

The Nigerian Health Journal according Kingsley Obom-Egbulem , its Managing Editor, intends to satisfy the need for useful ,well researched stories on the Nigerian health sector written in an engaging prose.

“To achieve this, we are leveraging on the power of social media to access and share life saving news and information that can reverse the growing cases of preventable deaths due largely to lack of useful news and applicable health information. That is what Nigerian Health Journal is all about; news for the sake of your health”, says, Obom-Egbulem.

The website (www.nigerianhealthjournal.com )which began two years ago as a blog offering well written features, special reports, exclusive interviews and analysis of major health stories recently expanded its scope on popular demand to serve as the hub for news, information and debates on critical health issues in Nigeria. “

We are creating a one-stop market place of ideas for Nigerians to engage with those they trust with their lives and we believe this is long overdue”, says Obom-Egbulem.

Health news in most Nigerian dailies hardly ever lead the papers either as major front page or back page stories unless there is an epidemic or a major health event is happening or a personality is in town. In these circumstances, health is reported as events not necessarily as an issue with far-reaching economic ,social and even security implication.

Obom-Egbulem says “this is an anomaly that reflects weak understanding of the right to health, poor priority given to the place of health systems reforms ,universal access to quality and affordable health care and preventive medicine especially through health education within the media.”

“It is also an indictment on reporters who expect health news to just happen. When it comes to health, the news doesn’t just happen or break, you happen to the news; you literally break it. For instance, how many professors of medicine are still teaching in our colleges of medicine and how many are required to produce the quality of doctors Nigeria needs. Such news can never break, you have to break it.”

The Nigerian Health Journal according to Obom-Egbulem has taken part of the responsibility of not only holding government accountable for actions and inactions on health but would also provide a “virtual people’s court “ where anyone can be put on trial for mismanaging the health of Nigerians.

“We must start to engage so as to proliferate health information. Let’s keep talking and doing something about our health care system because if we remain silent and allow politicians to keep politicking with our health, by the time they are out of office, we would definitely have need for more morgues, hospices and graveyards.”

Health news competes with football, entertainment, celebrity gossips and the horse-trading within our political clime. And Obom-Egbulem says “because health is a matter of life and death health news must compete well and that means being innovative. It also means that health news should be sexy, sassy and smashing without losing its capacity to activate positive change”.

For more information contact:editor@nigerianhealthjournal.com

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With diabetes now one of the burdens of  affluence among most Nigerians, its presence in a patient portends even greater danger as TB may just be lurking in the corner writes Kingsley Obom-Egbulem

Some diseases may not have come close to the dwelling places of most Nigerians but for a change in their  life style occasioned primarily by an increase in income and status. Diabetes is one of such diseases and its  affecting and claiming the lives of millions of Nigerians  albeit silently.

Diabetes is a disease that causes high level of glucose in the blood. People with diabetes lack insulin which is needed for the control  blood sugar.And due to inadequate insulin production they need to be on insulin injection for life.

There are two types of diabetes; Type 1 usually develops in childhood and requires lifelong injection of insulin, while Type 2  develops in middle age( causing kidney, eye, and nerve damage.) It may not  have symptoms and usually can be controlled by diet and drugs if detected early.

For those "who have arrived",it might just be wise to add a lifestyle of regular check ups to the "chop ups"

“Diabetes is both a disease of poverty and affluence especially in Africa and I can say without any fear of contradiction that some people wouldn’t have had diabetes if not  for the fact that the food they eat and how they live changed with an increase in their income”, says Dr. Anthonia Ogbera ,Head ,Endocrine Department at the Lagos State University Teaching Hospital(LASUTH),Ojo.

Consultant Endocrinologist at the Lagos University Teaching (LUTH)Dr. Olufemi Fasanmade seem to agree with her.

“Overseas ,obesity is a disease of the poor. The rich are slim while the obese are apparently poor but here one of the signs that you have arrived is your size and when you are slim it’s a sign that you are not eating well and that’s is why we have people who are really sick but would not admit it until it is too late just because of the picture our society have painted about a healthy person”, say Fasanmade.

Most Nigerians are now living in urban centres with its attendant change in lifestyle and diets. African foods ,vegetables and fruits which are readily accessible and affordable in the rural areas become a thing of the past the moment families migrate to rural areas. With that comes also a change in diet as well as lack of time to exercise and work out due to the busy nature of urban life. This perhaps explains why half a million Lagosians are believed to be living with diabetes according to information from the Sonny Kuku Foundation(KSF).

An aversion for check up

The matter is worsened by poor  health seeking behaviour as a result of high cost of accessing quality medical care and checkups. “And after several years of  not checking your  blood pressure(BP) or monitoring your blood sugar level the next thing  is that the person begins to present with signs of diabetes and  when you tell them they have diabetes they wonder and ask you ‘how come’, they hardly believe it, but that’s the fact,” says Ogbera.

According to a study carried out in LASUTH in 2006 on the burden of diabetes in Lagos alone, about 140 to 160 patients already diagnosed with diabetes are catered for on weekly basis and 25% percent of people with diabetes already have diabetes related complications by the time they are diagnosed of the disease.

It is believed that diabetes accounted for 1 in 6 hospital admissions in Nigeria and 1 in 6 persons admitted for the disease eventually die of diabetes related complications.Over half a million Lagosians are said to be living with diabetes

Unlike infectious diseases,diabetes  does not ‘jump’  on  anyone as it takes time to develop in a perosn. The tendency for it to develop can be checked or prevented. Early onset of diabetes can also be detected and complications prevented through regular checkups. However, some doctors believe that the poor health seeking bahaviour of Nigerians is responsible for this.

Dr. Femi Olaleye of Optimum Healthcare Services is of the view that the average Nigerian would ordinarily  not seek  for medical attention and when he is ill, he would not bother much so long as his appetite, sex life and bowel movement are not affected by the illness.

“This attitude is commonly seen in regions where there is poverty and lack of access to free healthcare services. The decision-making capabilities of the poor man are eroded to a point where he lives in hope that his medical condition will ameliorate miraculously as long as the condition does not affect what he considers as his primary functions which are; eating, excreting and enjoying sex. But we know that the definition of good health is not the absence of disease but the maintenance of physical and mental well-being of the body and the prevention of diseases. But it costs money to maintain health and prevent diseases”, says Olaleye.

It also pays to eat with discretion and be sure to check your waistline and body mass:Pic:CDC

Staying healthy in the face of competing demands according to Olaleye is a major challenge for most Nigerians. “We have gradually over-priced healthcare services out of the reach of the average Nigerian, and as result, the demand for our kind of healthcare services are plummeting. Our patients are now seeking ’cheaper’ alternatives, which sadly in some cases, are very fatal and continues to lead to loss of lives.”

Even for those who can pay for a checkup, there is still an attitude that is anti-checkup and this has a role to play in case detection rate of diabetes and similar disease of lifestyle.

The Link with Tuberculosis(TB)

One of the challenges of living with diabetes is the risk of being infected with TB. In 2008,a survey of TB patients receiving treatment at the LASUTH showed that the prevalence of under-diagnosed diabetes was 6%. And for most endocrinologists, this trend is a worrisome reality that needs to be given some measure of attention. Hence the SKF made it a subject of focus at its recent public seminar in Lagos.

Titled; “the Emergence of Diabetes Mellitus in Tuberculosis”, the seminar was to raise awareness on the relationship between diabetes and TB such that screening for diabetes in TB patients will be mandatory.

But Dr. Dan Onwujekwe, Senior Research Fellow and TB clinician at the Nigerian Institute of Medical Research(NIMR),Lagos said the reverse should be the case. “Most doctors would agree with me that diabetes lowers the immune system  and affects the body’s ability to cope with diseases  and so you become prone to infections; and not just that, the TB bacterial thrives in sugar environment hence, we will rather advice that those currently treating diabetes  should screen regularly for TB because they are highly susceptible”.

While it may sound like a case of which comes first;between the egg and chicken, whichever way it is tagegd, emergence of diabetes in TB patients or emergence of TB in diabetes patients are frightening combination the Nigerian healthcare system should be bothered about and starts responding to.

Sadly, most TB treatment  programmes in Nigeria are donor driven initiatives most of which do not incorporate diabetes detection and treatment, hence Onwujekwe’s counsel  for those currently treating diabetes to go for TB screening regularly since the treatment is free.

But the implication of treating TB in a person with diabetes is enormous. “TB patients with diabetes can actually have their blood sugar increased when they commence TB treatment due to the effects of Isoniazid one of the drugs used in TB treatment”, says Fasanmade.

One way to address this burden according to Fasanmade is through a co-location of treatment centers for diabetes, TB,HIV and AIDS . “That way ,we can ensure that diabetes patients  can also have the opportunity to access TB diagnoses and care within the same facility”.

Perhaps, this might just be one way out of the woods. But the greater responsibility rests on our health system as it is currently configured with no template for  such co-intervention. The potentials are there however, especially with the successes recorded in  TB/HIV co-response.

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Please find below a list of information on latest job openings  within the health sector in Nigeria.

Job Title – Medical Officer, needed in an expanding hospital in Warri
Closing Date – November 5,2010
Organisation –Not Stated
Offer     – Attractive Salaries and Fringe benefits
Qualifications: Minimum of 5years Post NYSC Working experience
Apply to: warrihospital@yahoo.co.uk or call 07043358538

Job Title – Medical Director needed for a hospital chain in Port Harcourt
Closing Date – November 5  2010
Organisation –Not stated
Offer  – Attractive Salaries and Fringe benefits
Qualifications: Minimum of 5years Post NYSC Working experience
Apply to: emo_mem@yahoo.com

Other Positions:
•    Medical Doctors, with 5years post MBBS experience
•    Radiographers(Degree qualified and registered with professional bodies regulating radiography practice in Nigeria
•    Laboratory Scientists(Degree qualified)

Closing Date – November 5  2010
Organisation –Not stated
Offer – Attractive Salaries and Fringe benefits
Qualifications: Minimum of 5years Post NYSC Working experience
Apply to: emo_mem@yahoo.com

Job Title – Medical Representatives
Closing Date – November 5,2010
Organisation –Cipla Evans Nigeria Ltd-as subsidiary of Evans Medical Plc.
Qualifications: Minimum of B.Pharm Post NYSC Working experience.
Candidates with less than 6 months to complete their NYSC will be considered for interview. Candidates above 30 years need not apply.

Apply to: career@evansmedicalplc.com  with a copy of your CV.

Job Title – National Programme Analyst, Reproductive Health Commodity Security,needed in an expanding hospital in Warri
Closing Date – November 5,2010
Organisation –UNFPA
Offer     – Not Stated
To apply: visit http://www.nigeria.unfpa.org/vacancy.htm

1)Job Title – Medical Representatives, needed in a fast growing Pharmaceutical company
Closing Date – November 5,2010
Organisation –Not Stated
Location: Abuja, Kano, Benin and Middle Belt
Qualifications: B. Pharm. Interested candidates must not be more than 27years

2)Job Title – Community Pharmacists
Closing Date – November 5,2010
Organisation –Not Stated
Qualifications: B.Pharm. Previous experience in community pharmacy practice will be an added advantage
Apply to: paratieko@gmail.com with resume for positions 1 and 2

1)Job Title – Medical Representatives, needed in a young dynamic multinational  Pharmaceuticals
Closing Date – November 5,2010
Organisation –Not Stated
Location: Not specified
Qualifications: Bsc/HND in Bio-Chemistry, Microbiology, Pharmacy or any related course.

2)Job Title – Product Manager
Closing Date – November 5,2010
Organisation –Not Stated
Qualifications: B.Pharm preferred.
Candidate should have sound product knowledge with at least 5 years experience in similar capacity or as manager in field.

Apply to: mnpil2011@gmail.com or call 08036922870 for both positions. All candidates must valid driving license

Please Note:It is always advisable to apply for jobs immediately the openings are announced!

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By Kingsley Obom-Egbulem

Imagine this scenario: You are the governor of a state and there is an outbreak of cholera epidemic which has killed over 100 people in your state. The epidemic has not only exposed how clueless you are in dealing with minor health problems but have also exposed your lack of leadership in mobilising resources to address an emergency as a governor.

Sensing the precarious situation in which the people you claim to govern have found themselves in the face of this epidemic, several organisations have come to your rescue.

Unfortunately,(or so it seems)one of those who seem to be trying to help is one of your political opponents; in fact the man who has declared interest in your seat. The man decides to take advantage of the ugly health situation the cholera outbreak has created in the state you are governing to” assist” by donating drugs worth millions of naira to treat patients affected by cholera.
What do you?

Disgusting irony:Cholera patients in one of the world's largest old producing nation?

Rather than accept the donations,celebrate the donor and probably make him look like a good man that he is not(and then go back and work on your leadership capacity),you turn down the “gesture”  at the detriment of hundreds of lives hanging in the balance.

The governor of Yobe state definitely needs some schooling on where to draw the line when it comes to playing the game of politics. With over 188 lives lost and more not sure whether they will live or leave, this is not the time to score cheap political points.

I read the story and for me it is a frightening reflection of how a man’s short sightedness is costing his people their lives.

Any governor worth his mandate should be concerned that cholera (a disease that has been banished in poorer climes) could be linked with his state in the first place and with casualty figures as high as 100. It is simply a symptom of visionless leadership and not to accept help from a political opponent is even more infantile and petty.

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As we conclude our discussion on the role infertility is playing in swelling cases of violence against women and the attendant health implication especially the spread of sexually transmitted infection, perhaps it won’t be out of place to ponder on the words of Dr. Oliver Ezechi.

In a recent interview with NIGERIAN HEALTH JOURNAL, Ezechi who is consultant Obstetrician & Gynaecologist and Chief Research Fellow and in the Sexual and Reproductive Health Research Unit of the Nigerian Institute of Medical Research, Lagos said:

“The pressure from society forces men infertile relationships to engage in extramarital affairs to prove their manhood. Now, because of the intense pressure, some women will also go out searching for pregnancy especially if they suspect the fault is from the man. This is so that the woman can be at peace, save her head and shut the mouth of everyone because sometimes the torments from family members can push people to unimaginable length.”

This is puzzling, to say the least. To think that there is a married woman somewhere, currently having affairs with other men(with the approval of her husband; by the way) so she can get pregnant and protect him from society’s ridicule is  one of the weirdest thing to imagine let alone do.

It doesn’t make sense to any observer who is not too conversant with the African society and how it is dealing with

African women:when will your jubilee come?

issues of infertility. But these stories are real and like some public health physicians and epidemiologists may have realized, have added to the list of harmful cultural practices believed to be driving the HIV/AIDS epidemic in most African societies.

Part of what this reality suggests is that  perhaps, marriage is becoming particular risky and dangerous for an average African woman as it appears that she is even more exposed to HIV in marriage than as a single woman.

Doesn’t this provide the basis for interrogating some of the cases of HIV sero-discordance we’ve had to deal with in Africa?

Dr. Ebun Adejuyigbe, consultant pediatrician and associate professor, Obafemi Awolowo University, (OAU) Ile Ife, Osun State would rather say an emphatic yes to that poser and she has a strong case to support her stand.

Just  in case you are wondering “HIV discordance refers to a pair of Sexual partners in which one is HIV positive and the other is HIV negative.”

After studying several cases of pediatric HIV infection she and her colleagues have had to deal with over a period of time  and the fact that only the mothers of the children were the ones with HIV, Adejuyigbe soon discovered that sterility or sexual impotency and infertility were all at the root of the whole problem.

“We discovered that these women  with HIV positive babies apparently were encouraged by their husbands to go out and be impregnated by another man. The choice of man the woman decides to opt for would be determined by the possession of certain physical features that could clear any possible doubts about the child’s paternity. No one would ever imagine that a man irrespective of his medical condition would allow his wife to go out and get pregnant by another man and pose as the father when the child is born”, said Adejuyigbe.

That is the norm in some parts of Nigeria and the women in a bid to shield their husbands from social stigma that comes with sterility or impotence would actually go and have sex with another man and come back pregnant for her husband. But these days, the women are not only coming back pregnant. They are also coming back infected with HIV. And their husbands may  never get infected especially for those whose husbands are sexually impotent.

“I never knew this was happening until we started noticing an unusual trend at the pediatric ward in OAU. We were seeing several sick children, infected with HIV and expectedly ,you will have to talk to the parents of such kids and after encouraging the mothers to go for HIV counseling and testing; the result is usually positive”.

That is often the beginning of several revelations according to Adejuyigbe, especially if the clinician insists that the father of the child should also be tested for HIV.

“The women involved would wonder at our display of naivety if we conclude that the man probably would also be infected with HIV. But they will tell us emphatically that their husbands cannot be HIV positive. Of course, you want to ask is he not infected and the women would tell you their husbands can never get infected because “he doesn’t, and can’t have sex with them. If you probe further they will tell you because he is impotent”.

This development was confirmed following further survey and interview of several women visiting the pediatric ward with children infected with HIV. The women are counseled to go for HIV test and if the result turns out positive, they are usually not in doubt as to the source of the infection.

It all started as a problem of infertility and the need to shield themselves from the social stigma that  infertility attracts. One partner decides to cover the shame of infertility they both will have to live with and it turns out that she is actually laying down her life.

Again, the question many would want to ask is ‘how can men protect their wives from society’s ridicule if indeed she is medically confirmed to be the one with the problem that has caused the couples infertility?’

Marrying a second wife or even divorcing the woman has been the norm for most men. If a woman could decide to get pregnant by another man just to protect her husband from the shame of sterility(and eventually get infected with HIV)then men should start thinking of a better sacrifice to make when the table is against their partners.

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Ibrahim Umoru

At the early years of the HIV and AIDS epidemic when treatment was a mirage, a woman testing positive to HIV gives up hope of bearing a child for the fear of having HIV+ children.

With the advent of robust treatment, care and support; our women folks taking advantage of Prevention of Mother to Child Transmission(PMTCT) services smile with relief for the ability to have babies who are HIV+. What a wonderful world!

However, as a father, a husband and somebody living positively and constructively with HIV, I sure do have a role, in fact a bold and big one at that, in my wife’s effort at accessing PMTCT. I play strong roles in supporting my wife on treatment to attain a robust CD4 count and undetectable level of HIV in her blood. It is my responsibility to make her have a good nutrition and maintain a good health as well as encouraging safer sex to the time of peak ovulation. This is to reduce re-infection.

One of the ways to prevent mother-to-child transmission of HIV involves a long course of antiretroviral drugs and

Make sure she sees a midwife:Living up to his responsibility beyond just getting her pregnant:source:africanfathers.org

avoidance of breastfeeding, which reduces the risk to below 2%. In developed countries ,the number of infant infections has plummeted since this option became available in the mid-1990s.

Since 1999, it has been known that much simpler, inexpensive courses of drugs can also cut mother-to-child transmission rates by at least a half. The most basic of these comprises just two doses of a drug called nevirapine – one given to the mother during labour and the other given to her baby soon after birth. These short-course treatments, combined with safer infant feeding, have the potential to save many tens of thousands of children from HIV infection each year.

However, for the whole robust course of a full ARV regime, opting for elective CS, alternative infant feeding; men’s roles are obviously essential and we MUST be there for our female partners.

It is important to note that as husbands we have a role to play to make the period of pregnancy less stressful for wives and always be there for them and for the union too. In encouraging my wife to consent to elective caesarian section, I continued with such support and was in the theatre by her side when she had her baby.

This is my opinion about men being part of the solution rather than the problem. We played a role in the pregnancy and since we cannot carry it (the pregnancy) we should be responsible enough to support and  encourage the woman till she enters the labour room.

If we all agree with this summation, then we can collectively agree that the term PMTCT which is Prevention of Mother To Child Transmission of HIV  should  be broadened to  read PREVENTION OF PARENT TO CHILD TRANSMISSION OF HIV (PPTCT). We all should work for that success as I and  my darling wife continues to celebrate the birth of our latest baby born HIV free baby.

Have a pleasant day!

Ibrahim Umoru

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Ibrahim Umoru

When HIV is in the family, divorce comes knocking, love flies out of the window. This seems the story of most homes affected by HIV. And Im really hoping we can stop this trend..and that is why I appreciate the opportunity offered by Nigerian Health Journal to educate subscribers to this blog on HIV sero-discordance and how we can protect ourselves and our families against HIV infection. And just in case we are already infected or affected by the virus, how to live a happily and fulfilled life.

Like the Moderator hinted earlier I will be sharing mostly my experience on this blog how I have been able to live with HIV for the past 10 years and counting as well as experiencing gained form helping families affected by HIV stay together and strong

It won’t be out of place to set this discourse rolling by providing some background information to help us understand what sero-discordance is all about.

HIV discordance refers to a pair of Sexual partners in which one is HIV positive and the other is  HIV negative. This condition has caused several painful, dreadful experiences in once beautiful marriage. When HIV infection enters the family, it heads straight to the root of the relationship and starts breeding discords, suspicion and worst still dissolution of the relationship. All thanks to the high rate of stigma and discrimination encapsulated in the robust level of ignorance in the society.

Whenever a married man or woman gets infected with HIV something else very precious to that individual also gets infected. Suffice to say that the first target of attack as soon as HIV infects a married person is his/her marriage. It is no longer news that many marriages are daily lost to HIV infection in Nigeria. The once loving husband or wife suddenly becomes a foe the moment their spouse comes home with a HIV positive test result.

Divorce seems the next destination and before you know it both partners are heading their separate ways. This would have been less worrisome if they remain lonely. But they are soon involved in fresh relationships thus increasing their chances of either getting infected, re-infected or infecting someone else. But a simple, yet fundamental support by way of education and counseling could help address these anomalies.

No doubt a wide gap exists as far as AIDS response in Nigeria is concerned. This gap includes the need to strategically reduce the number of AIDS related divorces. Marriages must be preserved. Homes need not break or disintegrate with HIV infection. There can be much love after HIV infection. This is why I would rather invest so much in building

Can your marriage withstand it when the HIV test says "positive"? source:blackchristiannews.com

HOMES than just building Houses!

Two types of HIV discordance have been identified in the course of our work.

Soft Discordance or Discordance Simplex: This is a condition where the woman is HIV positive and the man is negative. This classification is done based on the need for child bearing. In Nigeria and indeed Africa, childbirth is the icing on the relationship of any couple. In this condition the woman needs to have a relatively high CD4 cells, very low viral load or preferably undetectable and with the support of the medical team and the counselor, the woman  can collect the sperm of the male partner during her ovulation period in a sterile syringe without the needle and introduce it to her vagina. She can get pregnant with this simple method and continue with other Prevention of Mother to Child Transmission (PMTCT) practices as may be prescribed by the medical team. In our environment, the financial cost implication of this practice is very minimal hence I ascribe the terms   ‘Soft’ or ‘simplex’.

Hard Discordance or Discordance Complex: This is a condition where the male is HIV positive and the female is negative. Getting the female pregnant with minimal chance of infection can be very complex. This happens to be so as the sperm of the male which though is HIV free is in the medium of the semen that carries HIV, hence would have to be separated from the HIV carrying semen before introducing it into the woman. The financial cost implication of this procedure, sperm washing and artificial insemination is outrageously high. Most fertility facilities in Nigeria shy away from this practice and rather would refer couple in this condition to facilities in South Africa and Europe. This is most regrettable and frustrating to the couples and even the supporting counselors too.

With robust counseling support over time, it has been prove couples could live happily. Hence, our national response to HIV need to bridge the gap that exist in the peculiar need of this group by increasing the services of the tertiary HIV care centers  to include sperm washing facilities and expertise while enhancing couple communication and disclosure.

Ibrahim Umoru

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