Why No Nigerian Woman Should Die From Unsafe Abortion

CHIOMA UMEHA

Lagos

Unsafe abortion has been proved to be one of the leading causes of avoidable deaths of women in many countries where it is prevalent. Unfortunately, almost half of all abortions worldwide are unsafe, and nearly all unsafe abortions occur in developing countries. This is just as evidence has shown that unsafe abortion is widespread in places where abortion is illegal.

Women who have unsafe abortions are at risk of serious medical problems, including incomplete abortion, infection, uterine perforation (when the uterus is pierced by a sharp object) and hemorrhage (heavy bleeding).

Also, unsafe abortion causes damage to the genital tract and internal organs (when dangerous objects such as sticks, knitting needles, or broken glass are inserted into the vagina or anus). 

 Describing the incidence as alarming, Professor Adetokunbo Fabamwo, a Consultant Obstetrician and Gynaecologist, Lagos State University Teaching Hospital (LASUTH) noted that unsafe abortion is an everyday preventable occurrence worldwide.

 He said; “Globally, 55,000 unsafe abortions happen every day with 19 million of the unhealthy and deadly practice occurring in developing countries every year.”

Stating this recently at a two-day Population Reference Bureau (PRB) Safe Engage Training Workshop in Lagos, Professor Fabamwo, who is also the Chief Medical Director, (CMD) LASUTH, added that in Africa, nearly half of all abortions happen in the least safe circumstances.

The Professor also said the risk of dying from an unsafe abortion is the highest in Africa, where most are carried out by non-physicians.

Giving the breakdown of the situation in the country, he said; “Unsafe abortion contributes 13 per cent to all pregnancy-related deaths. About 610,000 unsafe abortions occur in Nigeria every year and half of the women that will die from it are young people or adolescents.”

He further stated; “Unsafe abortion continues to contribute needlessly to maternal mortality and morbidity in Nigeria, largely due to the consequences of a highly restrictive abortion law. Repeated attempts at liberalising the Nigeria Abortion Laws had failed despite a compelling case for it.

“There should be continued and relentless advocacy towards changing the law. Other safety measures, like medical abortion should continue to be explored.”

However, the LASUTH CMD said that currently, medical abortion is legal under the Lagos State Criminal Code if having the child will put the mother’s life and her physical health in danger.

He explained, under the code, “A medical doctor is not criminally responsible for performing in good faith, with reasonable care and skill a surgical operation on any person for his benefit, or on an unborn child for the preservation of the mother’s life and physical health, if the performance of the operation is reasonable, given the circumstances of the case.”

The CMD further noted that elective abortions were not usually done until the Ministry of Health’s circular of April 2019, adding; “Now, for legally indicated cases, options of medical and surgical abortions are now available.”

According to him, medical abortion is a procedure that uses medication to end a pregnancy. It does not require surgery or anaesthesia and can be started in a medical office or at home. It is most effective in the first trimester of pregnancy.

Giving more details, Fabamwo said that medical abortion is done to complete an early miscarriage or to end an unwanted pregnancy if there is a medical condition that makes continuing a pregnancy life-threatening. The pregnancy, of course, must be less than nine weeks.

However, he said, medical abortion is not applicable under certain medical conditions like in women on blood thinners or steroids, bleeding disorders, heart disease, liver, kidney and lung disease

The 2018 review of Performance Monitoring and Accountability 2020 (PMA 2020) survey show that the most recent family planning data for Nigeria and Lagos revealed startling statistics of abortions among Nigerian women aged between 15 and 49 years.

Specifically, he said abortions among Nigerian women aged between 15 and 49 years has risen to between 1.8 and 2.7 million annually, according to PMA 2020 survey.

The survey results also unveiled the characteristics of women who have abortions and reasons for the practice within or outside the healthcare system in three countries, Nigeria inclusive.

Dr Funmi OlaOlorun, the co-principal investigator of the PMA 2020 survey provided further analysis. Dr OlaOlorun said, likely abortions are higher among women who are in their 20s, with at least secondary education and live in urban areas based on PMA 2020 survey.

The survey, she said which indicated that unsafe abortion is an equity issue, found more than six out of 10 abortions which were considered least safe, and 11 per cent of women experienced complications for which they sought post-abortion care at a health facility.

Dr OlaOlorun said the overall survey shows that 37 per cent of women underwent surgery to ultimately terminate their pregnancy while seven per cent used Mifepristone/ Misoprostol. The remaining 56 per cent, she said used other or unspecified medications or traditional methods.

Also, most public tertiary facilities provided post abortion care (92 per cent) and safe abortion services to save a woman’s life (83 per cent); lower level public facilities and private facilities were much less likely to do so.

In Nigeria, abortion is a debatable issue. Yet the practice continues to go on secretly and mostly carried out by non-physicians because of many reasons. These include ignorance, poor access to family planning services, rape, incest, lack of resources to raise and support a /another child, rape and incest.

Professor Ayodele Atsenuwa of Department of law at University of Lagos giving a summary of the legal framework affecting abortion said that Nigeria’s abortion law is not as restrictive as many people presume since it still makes provisions for therapeutic abortion.

She noted; “There are criminal provisions against abortion, but abortion is lawful when the legal indication within the provisions of the law is satisfied.

“It is important that our response to abortion should be based on the law. It is not that there are no instances when a woman can have a lawful abortion, the law is very clear.”

Professor Atsenuwa who faulted the country’s abortion law said; “That has always been in the law, even in the 1904 criminal code. There is a definition of what is the crime and anything that does not fit that definition is not the crime.”

“Defence is available, especially under the provisions of sections 297 of the criminal code and something similar is in section 201 of the criminal law of Lagos State.

Atsenuwa said; “It is important that we disseminate information about when the law recognises that it is necessary to allow women to have access to safe abortion. It recognises that there are circumstances when it is in the best interest of the society to allow women have access to abortion that is safe and affordable.”

On her part, Ms Sybil Nmezi, founder and coordinator of Generation Initiative for Women and Youth Network (GIWYN), alleged that Nigeria’s collapsing social, health and other support systems expose women to sexual violence, unwanted pregnancy, unsafe abortion and death.

Nmezi explained, though women’s sexual and reproductive health is related to multiple human rights, including the right to life, health, privacy, education, the prohibition of discrimination, make an informed decision and be free from torture, stating that, “Nigeria does not implement or enforce most of them.”

She stressed, messages such as, “Only bad women have abortions and contraceptive” or “A pregnancy is more valuable than the woman carrying it,” must also be changed in the media.

Nmezi lamented that many people lack understanding of provisions under the law when women can assess abortion and this had contributed to the misconception on the illegality of abortion in Nigeria

Family Planning: Health Experts Task FG On Funding To Check Population Explosion

CHIOMA UMEHA

Lagos

Studies have shown that family planning protects the health of women and children as well as reduces ugly risky overpopulation burdens by helping a family to plan and responsibly fulfill its parental roles.

The media is replete with many reports which X-rays the roles of family planning in population control, more so in view of the newest Nigeria’s population figures which is put at 201 million.

It was therefore not surprising that critical stakeholders in the health sector have urged the Federal Government to invest in family planning programmes to check population explosion.

There call came at the background of the just concluded 2019 World Population Day celebration.

Stakeholders, who spoke with DAILY INDEPENDENT, said Nigeria’s rising population remained a threat to the country’s economic and social development.

They maintained that the little resources meant for certain number of people, were being stretched for more people due to the large population, thereby stagnating the country’s future development and advancement.

The Country Director, Pathfinder International, Dr. Jega Farouk, said the focus of this year’s World Population Day should be on how to address the country’s impending demographic explosion.  With our population estimated to be the fourth highest in the world by 2030, Farouk said Nigeria should focus on how to ensure a more sustainable population growth, by increasing access to voluntary and quality family planning services.

 “Unfortunately, the 2019 budget as signed by the President shows a reduction, rather than an increase in the budget allocation for contraceptive commodities in the country,” he added.

He said the impact of unchecked population growth, especially one that does not align with GDP growth, needs to be understood and addressed.

“We will be heading for a demographic disaster with the current growth rate in population, especially given that the majority of the populace is made up of young people who should be productive.

“Unfortunately, they are mostly untrained, uneducated, unskilled and unemployed.

The result is the increased spates of insecurity we are currently faced with.

This therefore calls for government intervention to address this unsustainable growth rate,” says the Country Director.

He said; “Fortunately, we have an opportunity to turn this demographic scenario into an opportunity to achieve the so-called demographic dividend.

This window of opportunity will not last forever, and will not happen automatically.

“We have to invest in the education, health (include access to family planning) and jobs for these army of young people, turn them into a productive workforce that will contribute to our GDP growth.

“The media can support information and public awareness efforts in communities.

There are many misconceptions around family planning that can be addressed with the right information.”

Farouk however urged the media to consistently provide correct and easily understood information on the advantages of family planning dispel misconceptions around side effects and hold government accountable to fulfill its FP2020 and other commitments made in support of family planning.

On his part, Programme Director, Development Communications (DevComs) Network, Akin Jimoh said 25 years after the historic International Conference on Population and Development (ICPD), there is need to support the National Population Commission (NPoPC) to reflect on the best ways to solve the issue of population explosion in Nigeria.

The government needs to place population management at the front burner of their policy making and allocation of resources, especially investment in programmes like family planning services, says Jimoh in a statement to mark the international day.

He added that prioritising and investing in family planning will help the government save money that can be invested in other development programmes like education, health and job creation.

Contributing, the Chairman, Association for the Advancement of Family Planning (AAFP), Dr. Ejike Oji decried the challenges of Nigeria’s bourgeoning population and the Federal Government’s approach in tackling the menace.

Dr. Oji told DAILY INDEPENDENT that there was a disconnection between what the nation was currently doing and what it was supposed to do in terms of policies and the actions being taken.

For example, he noted that the country currently has a demographic crisis: 64 per cent of the nation’s population is under the age of 25 years and  45 per cent of the population is under the age of 15 years, making them a largely dependent and largely unemployable.

According to him, the only place that these categories of persons can be employed is in the agrarian industry, adding that although, the Federal Government was doing a lot to improve that sector, it was not paying off, considering that people could not return to the farms based on increasing insecurity in that sector.

Similarly, Oji cited the examples of Nigerian professionals migrating to overseas, where they were seeking greener pastures. Over 40,000 Nigerians are practicing medicine abroad. 

“This is just a tip of the iceberg,” Oji said, adding that there were many in Europe, Canada and elsewhere.

Similarly, Oji noted that the one that was mind boggling was what was happening with the nation’s unskilled migrant population, given the risk to their lives while crossing the Mediterranean Sea into Europe.  He cited the example of nine Nigerians that were killed recently at migrant camp in Libya.

The latest examples, he said was evident in what is happening in the country where nationals were killing nationals: militancy in the south west, kidnappings in the Niger-Delta, ethno-religious crisis in the Plateau, Boko Haram in the north east, banditry in the North West and farmer-herders crisis taking place all over the federation.        

Placing these background  in perspective, the chairman of AAFP said these are the kind of activities that could happen when a nation’s youthful populations were largely unemployed, saying they would be easily recruited by mischief makers, religious bigots, kidnappers, robbers, among others because they got nothing doing.

Highlighting other factors hindering Nigeria from curbing its population at an appreciable rate, he said in the 2019 appropriation, family planning budget was slashed by over 80 per cent.

Instead of $4 million dollars, what the federal government released was about $980,000 dollars as counterpart funding, meanwhile the country needs about $26 million dollars to purchase family planning commodities. “That is why I said there was a disconnection between what we are doing and what we are supposed to be doing”.

Oji further blamed a lot of state governments for inaction. While the Federal Government purchases family planning commodities, he lamented that most of the state governments that were supposed to buy the consumables with which to administer the family planning commodities do not have budget lines.

“This is why the prevalence of family planning uptake in the country remains low at 12 per cent, going the 2019 NDHS.”

While family planning prevalence in the country for about 10 years was 10 per cent of women in their reproductive age 15 to 45 years, Oji was worried that unmet need is about 19 per cent of people in their reproductive age. 

“This is very low and calls for worry,” he said. Unmet need is the number of women of reproductive age who want to use family planning, but are not getting the services due to one reason or another.

Oji said, “There is no way the populace can get democratic dividends until we reduce our fertility rate.”

On the solution, Oji called for extra-budgetary allocation to make up for family planning budget that was under-funded. 

He also urged state governments to come together and put money into the common basket that the federal government uses, which could be given to the UNFPA to increase the commodities that are purchased for the country.

According to Oji, the real disaster would happen next year because the country does forward-buying. “The UNFPA pays for the family planning commodities one year in advance.

“Sadly, this year, we have a shortfall of about $8 million dollars. If that shortfall is not met, it means that next year, we will not have commodities.

“There will be a great shortage of family planning commodities next year. That is a disaster waiting to happen.”

He lamented that the country already has an unmet need of 19 per cent. Nineteen per cent of women in the reproductive age 15 to 49 years are saying: we need this family planning, but we are not getting it.”

The gyneacologist said if the country invests in health, appropriate education, provides an environment of justice, peace and tranquility and creates at the atmosphere that would create jobs, “Nigeria will transform to be a very rich country. But, if we do not, it is anarchy.”

Gambari Tasks Stakeholders On Empowerment Of Women, Youth For National Growth

Some members of the Board of Fellows of the Pharmaceuticals Society of Nigeria (BOF-PSN) during dinner\ awardnight held by BOF-PSN in Lagos recently.

•As BOF For Pharmacists Holds First Public Lecture

CHIOMA UMEHA

Professor Ibrahim Agboola Gambari, former Ambassador and Nigeria’s Permanent Representatives to the United Nations (UN), has said that there is need for Nigeria to empower its huge population of women and youth if the nation’s quest for growth would be meaningful.

Gambari, who spoke at the first public lecture of the Board of Fellows of the Pharmaceutical Society of Nigeria (BOF- PSN), in Lagos recently, urged stakeholders to invest immensely towards the growth of women and youth to enable them contribute to national development.

The Eminent scholar and Diplomat reasoned that if Nigeria empowers her vast youth population and women they will be able to make invaluable contribution that will help save the nation.

Professor Gambari who spoke on the topic; ‘Rebirth of Nigeria: Harnessing the Great Potentials’ however enjoined women and youth to accept the responsibility to compete and take over leadership positions, observing that nobody willingly gives out power.

Speaking further, Prof. Gambari explained that the most important factor in any political organisation is governance which depends largely on the personalities elected into political offices. 

According to him, there can be no rebirth for the country without good governance and taking personal and collective responsibility for making Nigeria a better country for all.

He said, every Nigerian must rise to the challenge of the times and citizens must not relent in demanding only the best from those at the helm of governance.

To this end, he called for the appointment of competent leaders with vision from all parts of the country who will work in unity to take Nigeria out of the woods. Besides, he stressed that the importance of collective leadership in carrying out effective governance that will move the country forward.

To this end, he called for the appointment of competent leaders with vision from all parts of the country who will work in unity to take Nigeria out of the woods. Besides, he stressed that the importance of collective leadership in carrying out effective governance that will move the country forward.

He decried the standards and processes for recruitment and the performance of our leaders over the years, noting that this has left much to be desired across all the three levels of government.

Prof. Gambari also said that the civil society, NGOs, youths, traditional leaders have a critical role in taking the country back from the grip of visionless leadership anchored in faulty leadership selection process.

While calling for the institution of good governance, Gambari lamented that Nigerians have been following a dangerous narrative of going from one election to another, for instance, going from 2015 to 2019, etc. 

The Diplomat noted that the nation has paid the price in divided societies, persistent poverty, growing inequality, massive corruption, flagrant and pre-mediated abuse of power and office, wastage of public institutions, high level of urban violence, a disaffected youth and marginalised women.

On the issue of economic recession, he said; “Another problem is poverty; if we don’t address these problems of Nigeria, people will link the country with Somalia, Yugoslavia and similar countries in such categories.”

The former Ambassador further condemned the deployment of military to the highways as part of strategies to watch flash points on the roads, noting that it was not part of the work of the military as defined by the constitution.

Gambari therefore, advised the federal government to seek help from the international community in finding lasting solutions to the numerous challenges currently facing the country including the Boko Haram and other forms of terrorism, banditry, kidnapping, among others.  

The Vice President Yemi Osinbajo has said the federal government would engage the military to watch flashpoints on Nigeria roads, when he visited Pa Reuben Fasoranti, the leader of Afenifere group, to condole with him over the killing of his daughter, Mrs. Olufunke Olakunrin along Benin-Ore Highway at about 2pm on last Friday.

However, Gambari said; “We should not be afraid to ask for help in tackling terrorism, the BokoHaram menace, banditary, kidnapping, among other vices plaguing the nation.”

According to Gambari, there will not be Sierra Leone, and South Africa today, without the assistance Nigeria and other nations provided those countries during their trial period.

Arising from this premise, he advised; “We should be free to ask for help. We should not pigeon-hole ourselves in fighting the numerous challenges facing currently facing us.”

According to Gambari who is Founder, Chairman of the Board of Directors, Savannah Centre for Diplomacy, Democracy and Developnment, “Nation building is a continuous process.”

Going back to the contributions of the founding fathers of the country, Gambari said they strengthened the regions which resulted in harnessing the competitive spirit of the various regions.

Sadly, he noted that the central government has currently become over-strengthened, while the regional governments have become weak.

On the political structure that the nation should adopt in addressing the problem, Gambari called for continuous national conversations to enable the nation agree on the way forward.

According to him, Nigeria should not be afraid to amend its constitution, citing the example of the United States (US), which has amended its constitution 27 times.

He also said, the country must tackle the several enemies of the nation including poverty, ethnic and religious divisions, corruption, lack of delivery of social services, which are part of the factors making the health, transportation systems and others unworkable.

He further tasked stakeholders to ensure that the Federal structure in the country is adjusted to ensure good governance at all levels.

“We should be focused on good governance. While giving our leaders the free hands, nation-building must be based on solid foundation and there must be a continuum.”

The Chairman of the occasion, Osaretin Afusat Demuren who is Chairman of Guaranty Trust Bank Plc, lamented the challenge that drug abuse among youths have imposed on the country and called of measures to ensure the non-prescriptive medicines should not be got from over the counter without doctor’s prescription.

In her welcome remarks, Prof. Mbang Femi-Oyewo, chairman, PSN-BOF said that the decision to have the first public lecture of the group was in fulfillment of its mandate to monitor government policies as they affect the practice of the profession and to address contemporary issues of importance within and outside the Pharmacy profession.

Prof. Femi-Oyewo noted that the theme of the lecture is quite apt and timely as Nigeria really needs a rebirth at all levels and all sectors, noting that the Pharmacy profession also needs a rebirth.

She said the Mid-Year Meeting, an annual event was aimed to monitor government policies as they affect the practice of the pharmacy profession and pharmacists

Other eminent personalities at the event were Prince Julius Adelusi-Adeluyi, president, Nigeria Academy of Pharmacy; Pharm. (Sir) Nnamdi Obi, chairman, Planning Committee and Pharm. N.A.E. Mohammmed, registrar, Pharmacists Council of Nigeria (PCN)

Nigeria Needs Innovative Approach To Fight Drug Abuse – Yakasai

Pharm. Ahmed Yakasai, Immediate Past President of the Pharmaceutical Society of Nigeria (PSN, was the keynote Speaker during the 38th Annual National Scientific Conference of the Association of Community Pharmacists in Nigeria tagged ACPN Kano 2019. He spoke with CHIOMA UMEHA at the sideline of the conference on the Menace of Drug Abuse in the country. Experts:

How do you feel speaking at the Association of Community Pharmacists in Nigeria (ACPN) Kano 2019 Conference?

 I was told to speak on the theme, “Tackling Menace of Drug Abuse in Nigeria: A Disruptive Innovative Approach.”  Indeed, this topic is apt and it is a topic that is dear to my heart for the last 36 years as a Pharmacist.  As I speak to you right now, a family somewhere in Nigeria may be experiencing financial hardship because one of their daughters is a drug addict. Perhaps, also somewhere a mother’s   heart is filled with sadness because her son whom she has invested all her resources to train is now a source of pain due to the influence of substance abuse. Many Nigerians have lost their lives because the criminals who attacked them are under the influence of drugs. My point is, drug abuse is now a menace in Nigeria and its consequences are all around us.

From your perspective, describe challenge of drug abuse in the country?

In 2018, the United Nations Office on Drugs and Crime (UNODC) conducted a national survey in the country stating that in 2017, 10.6 million people abuse cannabis, 4.6 million Nigerians abuse opioids, 2.4 million abuse cough syrup containing codeine, 2.4 million people abuse sedatives ad tranquilizers, 481,000 people abuse ecstasy, 340,000 people abuse solvents and inhalants, 300,00 people abuse prescription inhalants and amphetamines and 92,000 people abuse cocaine. 

In other words, we currently have 21,213,000 people who abuse various substances. This confirms the fact that drug abuse is a cankerworm eating really deep into the fabric of the Nigerian society. This also calls for innovative approach towards tackling the menace of drug abuse in Nigeria.

What are the factors responsible for the spate of drug abuse in Nigeria?

Many factors have been identified as responsible for its insurgence. They include dysfunctional family systems in which parents who use drugs do not pay attention to the activities of their children and failure to reprimand them during the initial phase of drug use. There is also the high level of unemployment among the youth population predisposing them to idleness and consequently, crime and drug use to feel good and forget their worries.

Others are ignorance of the deleterious effects of substance abuse particularly in boosting physical activity, sexual gratification and recreational use; peer pressure and the desire to feel among; poverty and the desire to use drugs to achieve a sense of pleasure; poor awareness of the menace and dangers of drug abuse.

There are also poor drug distribution system which allows the sale and peddling of controlled psychoactive drugs by unqualified persons; social media influence which exposes youths to newer trends of substance abuse, promotion of drug abuse thus inspiring curiosity to try using drugs; traditional beliefs about substance use especially alcohol and cigarette which promote early use of psychoactive substances hence breeding more difficult cases of addiction; lack of sufficient rehabilitation facilities to help treat victims of substance use disorders who can serve as counselors with first hand experiences to influence young people to stay away from substances of abuse, among others.

What are the social impacts of drug abuse in our society?

Health problems impair family life and productiveness of employees, diminish the quality of life and may threaten survival. Deaths as a result of drug abuse are a major source of concern. Recent informal estimates are that perhaps 200,000 drug-injecting-related deaths may occur per annum based on the estimated size of the current world population of injecting drug abusers of approximately 5.3 million (United Nations). The highest negative impact of drug abuse is felt in the health and wellbeing of the abuser.

The negative impact of drug abuse is highly felt by the family members and the immediate community of the abuser. Many young people who abuse drugs find it difficult to concentrate on their studies because of the negative impact of drug abuse. However, education is the principal means of preventing drug abuse. In addition to formal education in schools, other settings are important for the contributions they make to informal learning and socialisation.

What are your recommendations for curbing drug abuse in the country?

The menace of drug abuse among Nigerian youths had been shown to be a multifaceted one both in the area of causes and effects. Truly, no one or institution is spared of the consequences of this ugly and fast spreading and evolving trend. It is no doubt cancerous in nature and all hands must be on deck to arrest it by addressing the very fueling factors of this menace. Curbing Drug abuse particularly among Nigerian youths requires the efforts of the youths, their families, government, religious and traditional institutions, and regulatory agencies, non-governmental and other corporate organisations.

The youths should avoid taking drugs for recreational purposes and/or without the prescription of a trained healthcare provider and taking drugs from friends or exposing themselves to places or conditions where they can be drugged such as accepting opened drinks from casual friends and strange persons.

They should appreciate the value of hard work and practice as prerequisites for perfection and success rather than using drugs to achieve euphoria and inspiration. Most musical arts today live on drugs to put up dramatic stage performances and only a matter of time they eclipse from public scenes battling drug addiction or being incarcerated for crimes committed under the influence of drugs.

Youths should avoid resorting to drug abuse in order to feel good in times of emotional distress as drugs do not solve any problems but only temporarily makes them forget their pain causing damages in the body which linger even after the problem has been solved. Hence it is more profitable to speak to a trusted superior or a professional counselor at times of emotional difficulty.

They should discover their innate potentials, talents and special skills, develop desirable skills; acquire education or some other training so as to always stay busy, productive and useful to self, family and friends. By towing this line, there will be less time to indulge in drugs and associate with unproductive people.

 Parents and family members also have a role to play. They must seek to know the behavioural changes, symptoms associated with and consequences of substance abuse and be vigilant to these so as to detect early when their wards, children and/or family members are abusing drugs and provide help promptly.

Family members should avoid stigmatizing other members of the family who have problems with drug use or some form of challenge or the other. Many times this can cause the affected persons to feel less of them and resort to the abuse of drugs in order to derive pleasure for themselves. It is also very pertinent that drug use is detected and help sought promptly other than covering up the menace in order to save face. The practice of giving alcohol to little children to ‘make them strong and tough’ only predisposes them to severe cases of addiction in the future.

Families must be a harbour of love and understanding. Parents have a duty to show love to their children and wards, correcting them fairly with love, avoiding curses and violence. Parents must ensure open communication for thoughts and feelings with their children so as to know the difficulties of growing up which their children encounter and proffer solutions on time. Parents have a duty to be good examples to their children.

What role should government play in this?

Government should address unemployment and poverty! It has been established that unemployment of the youths which is at an alarming level is a frustrating experience which inspires indulgence into drug use. Government can help reduce the menace of substance abuse by putting in place measures and ensuring favourable business climes for the teeming population of youths to be engaged in meaningful work and have less time and motivation for drug use.

Government can do a lot to discourage drug use by punishing peddlers and unlicensed dispensers of controlled substances; avoid dispensing free cash to persons who have nothing doing.  It should develop and enforce laws and policies to frustrate the activities of drug traffickers, availability and cultivation of illicit drugs in the states and all over the country. This can also be done by placing huge taxes on alcohol beverages, tobacco and bans on sales or use of illicit substances.

Government must ensure that law enforcement agents like National Drug Law Enforcement Agency (NDLEA), Pharmacists Council of Nigeria (PCN), National Agency for Food and Drug Administration and Control (NAFDAC), Police, and Judiciary are provided with adequate tools to work and rewarded for the good work they do. Punitive measures on drug users should be de-emphasised while appropriate laws to combat illicit access and use be promulgated and implemented.

D-8 Consultation Re-Energises Member Countries’ Commitment To Health Development

•Says Political Will Apparent For Achievement Of SDGs

Deputy Ministers of Health and experts from Nigeria and other member states of the D-8 Organisation for Economic Cooperation (D-8) have resolved to strengthen their commitment towards the implementation of the organisation’s Health and Social Protection Programme (HSP ). 

This was part of their resolutions in a communiqué issued after the inaugural consultative meeting of the programme organised by the D-8 Secretariat and the federal government in Abuja.

The D-8 Organisation for Economic Cooperation (D-8), is an organisation for development co-operation among eight developing countries in the Muslim world. 

They are: Bangladesh, Egypt, Nigeria, Indonesia, Iran, Malaysia, Pakistan, and Turkey.  It was established in 1997 and aimed at sustainable economic development, and uplifting the standards of living of member states.

The inaugural consultation was organised to enable solidarity and cooperation for health and social protection as well as amplify linkages between investment in health and overall social and economic development of the D-8 countries

“The gathering outlined the urgent need to accelerate improvement in health outcomes, and broker collective economic development through improved wellbeing, which will help the countries achieve health SDG and its Universal Health Coverage (UHC) target” said Dr Ado Muhammad, Special Adviser, Head Health and Social Protection Secretariat.

Inadequate and sustainable financing constrain achievement of health SDGs, and the UHC target, as well as constrain overall social and economic development within and across member countries of the D-8 were identified by participants as key challenge for member countries.

The consultation also highlighted building new narratives in innovative and sustainable financing for health, unprecedented cooperation towards trust and solidarity for collective action among its members.

A cursory look at the diversity of health burdens, access to services and health systems architecture helped countries to understand areas of alignment and potential collaboration across the 8 countries, as well as opportunities of shared learning.

“The D-8 group of countries has been successful in energy, transportation, industrial cooperation, and agriculture and food security since the last two decades but the health sector lagging behind, we organized the consultation to enable us  develop a robust Health and Social Protection Programme” Ado said.

Lancet series of 2018 on progress and key determinants of Reproductive, Maternal. Newborn, Child and Adolescent Health in Muslim Majority Countries (MMC) suggests that despite notable reductions between 1990 and 2015, MMCs compared with a global estimate of all countries including MMCs had higher mortality rates, and MMCs relative to non-MMCs within Countdown countries also performed worse.

“Coverage of essential interventions across the continuum of care was on average lower among MMCs, especially for indicators of reproductive health, prenatal care, delivery, and labour, and childhood vaccines. Outcomes within MMCs for mortality and many reproductive, maternal, newborn, child, and adolescent health indicators varied considerably.” the report said.

The lancet findings also suggests, “ Structural and contextual factors, especially state governance, conflict, and women and girl’s empowerment indicators, were significantly worse in MMCs compared with non-MMCs within the high-burden Countdown countries, and were shown to be strongly associated with child and newborn mortality within low-income and middle-income MMCs.”

As its support to member countries, the consultation concluded that it would mobilize resources and assets to improve health. It will also build country programmes in health and social protection along the 7 pillars of the D-8 HSP Programmes, harnessing the achievements and strategies within existing global health initiatives and programmes.

Wives Of Governors Partner Roche On War Against Cancer

Some wives of Nigerian Governors, under the aegis of Wives of Governors Against Cancer (WOGAC), has formed strong alliance with Roche Nigeria as part of their efforts to win the war against cancer in Nigeria.

Roche, an international organisation with headquarters in Basel, Switzerland, is a leader in research-focused healthcare with combined strength in pharmaceutical and diagnostics, and is also the world’s largest biotech company with truly differentiated medicines in oncology, virology, inflammation, metabolism and CNS.

Roche’s personalised healthcare strategy aims at providing medicines and diagnostic tools that enable tangible improvements in the health quality of life and survival of patients.

WOGAC’s partnership arrangement with Roche which took place during a round table meeting held at Belanova Apartments and Suites, Maitama, Abuja, with the theme; TOGETHER FOR HER, promises to yield results that will change the  narrative on cancer control and care in Nigeria.

Ondo first lady, Chief Mrs. Betty Anyanwu-Akeredolu, founder, Breast Cancer Association of Nigeria, BRECAN, and first ladies of Niger, Cross River, Enugu state, Her Excellencies,  Dr Amina Abubakar Bello, founder Raise Foundation, Dr Linda Ayade, founder, Mediatrix Development Foundation, Mrs Monica Ugwuanyi, founder, Ugo’s Touch of Life Foundation (U-TOLF), respectively were present at the meeting.

Others who were represented at the meeting include wives former governors of Kwara and Oyo state, Mrs. Omolewa Ahmed, founder LEAH Foundation, and Mrs. Florence Ajimobi, founder, ABC Foundation, respectively.

Speaking to journalists after the meeting, Mrs. Akeredolu, who is also a breast cancer survivor, stated that early detection, which is driven by awareness, increases the chances of the patient to survive and reduces the cost of treatment, but noted that some patients cannot even afford the little amount at that stage and therefore called on Nigerians to be their brother’s keepers by supporting Cancer-based NGOs in raising funds.

The event also featured lectures on  BCPJ Study delivered by Dr Razaq Oyesegun, an Oncologist from National Hospital and “Catastrophic Health Fund; the role of WOGAC” by Dr Olumide Okunola of World Bank.

Lagos Govt Committed To Ending Maternal Deaths From Unsafe Abortions – LASUTH CMD

CHIOMA UMEHA

P

rof. Adetokunbo Fabamwo, the Chief Medical Director (CMD), Lagos State University Teaching Hospital (LASUTH), has disclosed that Lagos State government was committed to saving women’s lives from unsafe abortion that has killed millions annually and at a great cost.

Speaking at a training programme of the Population Reference Bureau (PRB) and SAFE ENGAGE in collaboration with the Network of Reproductive Health Journalists (NRHJN) in Lagos recently, Prof. Fabamwo said the state government was working assiduously to improve access to safe abortion within the extant laws of the land.

He said that statistics shows that unsafe abortions account for roughly 5,000 maternal deaths every year in Nigeria, or on average, 14 maternal deaths each day, while unsafe abortions are also costly to women and the health care system.

He added that 50% of deaths due to unsafe abortion are adolescents while 60% of abortions are done by quacks.

The LASUTH CMD noted that restrictive abortion laws, prohibitive costs, poor access to safe health services, and intense social stigma were barriers that prevent women from accessing safe and legal abortion.

He said the Lagos Ministry of Health was planning to give effect to the 2011 Criminal Code that allows for legal abortion to protect the physical health and life of a woman and requires that safe abortion services be provided within the full extant the law.

Prof. Fabamwo advocated safe abortion done by qualified personnel while the drugs should be strictly prescription drugs in order to avoid abuse.

Calling on other states of the federation to emulate Lagos State, he said there were opportunities to adopt the nationally approved clinical guidelines on safe abortion for legal indications and the 2015 Violence Against Persons Prohibition (VAPP) Act.

The VAPP Act, he explained, protects girls, women, and marginalised communities from abuse, and ensures comprehensive medical services for victims of rape and incest.  

Dr. Funmi Ola Olorun, Co-Principal Investigator, PMA2020, in his own presentation said that abortion occurs among women of all ages and socioeconomic status.

Stakeholders were of the opinion that there was need to step up public awareness on causes and consequences of unsafe abortions and the dangers of not having access to legal and safe abortion.

Save The Children Donates Relief Materials To Collapsed Ita Faji Building Survivors

LUCY SAMUEL

Some of the Survivors of Collapsed Ita Faji Building Survivors at the event. Inset: Some donated Items by Save The children International

Worried over the fate of accident victims and families at the Ita Faji building collapse in Lagos earlier in the year, health experts have called for support to ensure that adequate healthcare and rehabilitation is provided for them.

Among those who made the call penultimate Tuesday in Lagos was the Area Operations Manager for Save The Children International, Kayode Ajumobi, when the organisation made a donation of some relief materials to the victims.  

Ajumobi further urged public-spirited individuals, and government at all levels to come to the aid of the victims of the collapsed building, reasoning that many of them are still in pitiable conditions and yet to recuperate.

For instance, Nine-year-old Joy Ikwueze has been at Gbagada General Hospital, Lagos, for over three months, where she is receiving medical attention to enable her walk again.

Lamenting, Joy’s mother, Ifenyinwa Ikwueze, said, “My daughter is among those that got hurt on the March 13, 2019 due to the collapsed building in Ohen Nursery and Primary school Ifaji, Lagos Island.

“After the incident, I took my daughter to Gbagada, where we spent two months and three weeks. During that process, my daughter went through dialysis and surgery. We are still battling over health, but for now she cannot walk, I believe God that soon she will start walking though she is still receiving treatment.”

Joy is one of the many children that sustained serious injuries at the Ita Faji building collapse in the state.

The plight of joy and other children has attracted the attention of government officials and international communities for support.

Worried about accident victims and families, Ajumobi urged society, policy makers and government at all levels to see the safety of children as paramount.

The expert also called for adequate healthcare to be provided for them as well as their reintegration into the society.

Reasoning that every member of the society has a role to play in child protection, the Area Operations Manager said, “Everyone has a role to play in protecting children, it is not left to government alone, and it is left to everyone within the society and community. Similarly, everyone overseeing building construction should abide by proper regulations, oversight, monitoring and evaluation. With these in place and everyone playing their part, I believe we would make a great difference.”

Still on the Ita Faji building collapse, he said, “If parents had seen noticed abnormalities in the structure prior to the its collapse and had taken it up to the appropriate authorities and the later had also taken it up with the owner of the building, it is very likely that there would have been fewer victims when the incident happened.

“So every Nigerian has to play a role to make sure that incidents like this never happen again in the country to avoid the tragedy. We call for social safety to be put in place by government at all levels.”

Speaking with Comrade Kamal Salau-Bashua, Chairman, Lagos Island, Local Government Area (LGA) in an interview told DAILY INDEPENDENT that the occasion was significant to them in Lagos Island, and especially to the survivors of the ugly incident.

Salau-Bashua while appreciating Save The Child gesture, stressed that prevention is cheaper than cure.

 He said that the incident has forced the state government and partners to boost safety measures to prevent similar tragedies in future.

‘The advocacy is on-going and we can see many illegal houses and buildings that have being demolished all over the state. This has resulted to developers and property owners moving ahead of government to destroy their building by themselves for proper rehabilitation. This is because they know that government is on the trail of such buildings,” he added.

He further appealed to citizens to abide by the laws and rules for the safety of Lagos state.

He also urged corporate bodies to partner with Save The Children so that government’s burden will become lighter, saying that it is a collective responsibility to support the victims of  the collapsed Ita Faji building.

Ita Faaji building collapse led to the lost of many lives and displacement of many families on March 13, 2019.

JOHESU Urges Ministry To Address Unresolved Labour Issues

• Pledges Improved Health Sector

CHIOMA UMEHA

Com. Biobelemoye Joy Josiah, Chairman, Joint Health Sector Unions (JOHESU), has urged the Federal Ministry of Health (FMoH) to comply with all judgments of the National Industrial Court of Nigeria (NICN) issued on March 28, 2019 pertaining to the payment of outstanding 2018 salaries to members and actualising the adjustment of CONHESS Scale pending for many years.

Josiah made the appeal when he led a delegation of JOHESU/ Assembly of Healthcare Professional Associations (AHPA) national leadership on a courtesy visit to Abdullahi Abdulkadir, the Permanent Secretary, FMoH last Thursday, in Abuja.

He told the Perm Sec that contrary to the pervading impression that JOHESU does not believe in dialogue, members had always excelled in the finest tenets of rules of engagement to ensure the stability and growth of the health sector.

He then intimated him of some of the lingering welfare challenges of JOHESU members which include implementation of Alternative Dispute Resolution (ADR) consent judgment; payment of withheld April and May, 2018 salaries of members; adjustment of CONHESS salary structure and implementation of the ADR reached between JOHESU and the Federal Government.

He said, “We wish to bring you tremendous goodwill from the National Secretariat of the Joint Health Sector Unions (JOHESU) and Assembly of Healthcare Professional Associations (AHPA), which constitute over 95 percent of workforce in the health sector.

“JOHESU further draws your attention to the very important subject matter which is germane to the career, progress and wellbeing of all health workers under the umbrella of JOHESU.  An undiluted implementation will go a long way to return the lost harmony which in turn would enable effective, efficient and affordable healthcare delivery to the masses of Nigeria.  You will observe that the Federal Ministry of Health has been mandated through specific intervention plans with timelines to ameliorate the restiveness of our members.

“This development is a product of many years of rigmarole taking us through negotiations with the Federal Ministry of Health, Federal Ministry of Labour and Employment (FML&E) and a complete complement of other relevant Ministries, Departments and Agencies (MDAs).  Our members have noted the relative inactivity that ensued after the consent judgment of the NICN and therefore humbly request that the FMoH immediately put necessary machinery in motion to actualise the various ADR resolutions which have now become a judgment of the National Industrial Court of Nigeria (NICN).  The reality as it stands now is that the Federal Ministry of Health has violated the judgment of the NICN because many of the timelines have expired.”

Josiah told the Permanent Secretary that JOHESU specifically demands that the FMoH  immediately sets up the reflected structures in line with the NICN judgment, Central Internship Placement Committee for all eligible health professionals (timeline 4 weeks from execution of ADR) March  28, 2019; the FMoH liaises with CMDs/CEOs PICA & IPPIS to effect payment of promotion/skipping arrears;  Staff Audit Committee including members of JOHESU to critically examine concerns of understaffing and irregular employment affecting members of JOHESU (Execution of the exercise to be within 2 to 4 weeks from date of execution of this term (March 28, 2019); and implementation of the five-man committee report on Specialist Allowance for Health Professionals.

Others are that the FMoH presents a fresh memo to the National Council on Establishment (NCE) on the review of the retirement age of health workers.  It demands that in writing such a memo, the FMoH should take cognizance of the resolution at ADR which counseled that the FMoH should make it clear in its new originating memo that the beneficiaries are healthcare workers in the Federal Health Institutions.

It also includes that FMoH in line with agreements to ensure appointments shall be in line with enabling statutes ensures that representatives of Non-Academic Staff Union (NASU) and PSN are appointed to fill vacant membership slots at the Specialist Hospitals (National Eye Centre and National Ear Centre) and that the FMoH should as a matter of urgency begin the processes to implement the 30th September, 2017 Agreement on Adjustment of CONHESS Salary Structure.

On withheld salaries of JOHESU members in April and May, 2018, JOHESU chairman said, “We find it extremely necessary to draw your attention to the challenge of withheld salaries of our members in April and May, 2018.  This was hinged on a selective ‘No Work No Pay’ resolution of the Federal Executive Council.  It is on record that the controversial ‘No work No Pay’ policy of the Federal Government has never been applied in any sector of the economy. 

He said, “In one instance ASUU was on strike for at least three months, yet their salaries were never withheld.  Even when medical practitioners (medical doctors) were on strike, no such obnoxious policy was used against them (Resident Doctors in LUTH for six weeks in 2018).

“Once again we refer the FMoH under your watch to the 2017 Terms of Settlement we had with the Federal Government on September 30, 2017 which forbade victimisation of those who participated in the April and May 2018 strike which was a direct consequence of the failure of the Federal Government to implement the Terms of Settlement within five weeks of signing same.  Sir, our teeming members expect that after this visit, your kind intervention will make way for a breakthrough.”

On adjustment of CONHESS Scale as was done to CONMESS Scale, Josiah said that in 2009 the Federal Government committed itself to a MoU on relativity in the two salary scales that were introduced via CONHESS for all health workers except doctors and CONMESS for doctors.  The express implication of the MoU was that any adjustment on any of the scales would transcend to the automatic tinkering of the other scale by a commensurate percentage.

“Since 2014 when the Federal Government adjusted the CONMESS Scale holistically, it has further adjusted selectively in 2017.  During negotiations on this matter with a team of Federal Government officials led by the erstwhile Minister of Labour and Productivity, Dr. Chris Ngige, and the Minister for Health, Prof. Isaac Adewole, who incidentally are Medical Doctors.

“At the peak of negotiations with this Federal Government team, it offered N6.5 billion which we rejected because it was grossly below the N22.6 billion prepared by NISWC as agreed in the 2017 Terms of Settlement.  An intervention was also brokered by the erstwhile President of the Senate, Dr. Bukola Saraki, who promised to accommodate Federal Government approvals for CONHESS through supplementary budget. 

“An unofficial source had also hinted during the Senate President intervention that the Federal Government was willing to increase the appropriation for CONHESS to N8.25 billion, and that the balance should be provided for in the 2018 supplementary budget.

“These moves were never sealed before events took us to the Alternative Dispute Resolution (ADR) centre of the NICN, where to the chagrin of the JOHESU leaders, the FMoH claimed it could only offer N2B billion at a time N6.5 billion had been earlier rejected.  At this stage, it was obvious the FMoH team to the mediation which stretched proceedings to over three months on flimsy excuse of seeking the Health Minister’s approval for a realistic vote was playing games to wear us out which was why the matter of CONHESS adjustment suffered a deadlock at the ADR Centre,” the JOHESU chairman explained.

Josiah also spoke about the Anti-corruption Policy at FMC Owerri. He said JOHESU fully subscribes to the anti-corruption policy of the Federal Government which motivated it to enlist members to ensure whistle blowing at FMC Owerri to expose the monumental corruption of the erstwhile management of the facility led by Dr. Angela Uwakwem.

“Surprisingly, this has turned out to be an albatross to our members who provided information in this direction as they have been denied their salaries for four months in 2017, promotion opportunities in 2018, in addition to losing benefit packages tied to whistle blowing.  This is most discouraging and we strongly urge the Permanent Secretary to device remedies in this regard.

“We therefore, call on you to stand to be counted by dispensing justice to members of JOHESU and actualising the adjustment of CONHESS,” he said.

Josiah called on the Federal Ministry of Health FMoH to set up the Sub-Committee on the critical labour matters and the Central Standing Committee to address the various pending issues assigned to them via the consent judgment of the NICN, adding that the Sub-Committee should have JOHESU leaders as members.

Replying, Abdullahi Abdulkadir, the Permanent Secretary, FMoH, thanked Josiah and his team for the courtesy visit and assured them of maximum cooperation.

Abdulkadir promised to set up a committee of relevant stakeholders from FMoH and JOHESU to tackle the matters arising.

Why Role Of Parents In Managing Autistic Children Is Crucial – Ndolo

Chioma Umeha

Autism is a simple behavioral disorder and disability that can be managed so that the affected person can connect with the society and reach their highest potential in life, according to Mrs. Dicta Ndolo, a United States-based Behaviour Analyst who has dismissed beliefs that the condition is a disease. She also advised parents of children living with Autism to break the silence by seeking the answers to their wards disability, instead of shying away, noting that would not be of help. Mrs. Dicta Ndolo who also is creating massive Autism Awareness campaign in Enugu state, told DAILY INDEPENDENT in an interview that symptoms of Autism can be identified in children through their communication, social behaviour and speech challenge, just as she admonished parents to be on the lookout for these signs. ‘Autism is a developmental, neurological disability that affects one in 87 children and for every five kids affected, four of them are boys and one is a girl’ Giving further details on health condition, she said, “Autism is a complex neurobehavioral condition that includes impairments in social interaction and developmental language and communication skills combined with rigid, repetitive behaviors. Because of the range of symptoms, this condition is now called autism spectrum disorder (ASD). It covers a large spectrum of symptoms, skills, and levels

of impairment. ASD ranges in severity from a handicap that somewhat limits an otherwise normal life to a devastating disability that may require institutional care. “Children with autism have trouble communicating. They have trouble understanding what other people think and feel. This makes it very hard for them to express themselves either with words or through gestures, facial expressions, and touch.” “A child with ASD who is very sensitive may be greatly troubled – sometimes even pained – by sounds, touches, smells, or sights that seem normal to others. “Children who are autistic may have repetitive, stereotyped body movements such as rocking, pacing, or hand flapping. They may have unusual responses to people, attachments to objects, resistance to change in their routines, or aggressive

or self-injurious behavior. At times they may seem not to notice people, objects, or activities in their surroundings. Some children with autism may also develop seizures. And in some cases, those seizures may not occur until adolescence.” She also explained, “Some people with autism are cognitively impaired to a degree. In contrast to more typical cognitive impairment, which is characterized by relatively even delays in all areas of development, people with autism show uneven skill development. They may have problems in certain areas, especially the ability to communicate and relate to others. But they may have unusually developed skills in other areas, such as drawing, creating music, solving math problems, or memorising facts. For this reason, they may test higher – perhaps even in the average or above-average range – on nonverbal intelligence tests.” She further advised parents to be on the lookout for a behaviour expert for their children who will provide help to such disabilities, reasoning that Mr. Bill Gates, the Microsoft CEO had Autism, yet he still made it to the peak of his career. “Symptoms of autism typically appear during the first three years of life. Some children show signs from birth. Others seem to develop normally at first, only to slip suddenly into symptoms when they are 18 to 36 months old. However, it is now recognised that some individuals may not show symptoms of a communication disorder

until the demands of the environment exceed their capabilities. Autism is four times more common in boys than in girls. Being an adult with Autism is not a terrible thing except the person involved was severely affected during childhood,” she said. “Autism has three main characteristics and minor ones. The main ones are difficulty in communication, difficulty with social skills and difficulty with the sensory response,” she added. She explained that difficulty in communication signifies that some of them may likely not speak or if they speak, one might not understand their pronunciations. Some may not understand spoken languages which will mean those using gestures and sign language. While some talk, but might have problem with volume, others scream, and the rest may whisper. Concerning social skills, she said that though children with Autism don’t play properly with toys, it is nothing to be ashamed of. During the awareness which was held at Bush House Arena Nza Street, Enugu on Saturday, July 6, Mrs. Dicta lamented that children get affected with Autism when they are born and don’t get help which makes them grow into an adult with autism. She went further to pleaded with parents to stop hiding their children living with Autism because some of them starve to death after being abandoned and ostracised. Many of them are classified as mentally challenged persons as a result. “Every child is a gift from God,” she stressed