Wednesday, 1 March 2017

Health Dangers Of Stopping Exercise

Body weight and fat gains

If you go from being a gym rat or a doing a strict marathon training program to a completely sedentary lifestyle, you’ll quickly notice increases in body fat. One study found that highly-trained athletes who quit working out suddenly had increases in body fat after five weeks.

To avoid weight gain, you’ll need to alter your diet to take into consideration your lack of physical activity. That means saying goodbye to dessert, the bread basket, and those extra high-calorie toppings. By controlling or reducing your calorie intake, you can prevent weight gain with or without the gym.

Your blood sugar jumps

After just five days of trading the treadmill for your couch, your blood sugar will rise. Typically your blood glucose rises after you eat and then drops down as your muscles and other tissue absorb the sugar they need for energy. If you’ve been skipping the gym, your post-meal blood sugar levels will remain elevated. Continuously increasing blood sugar readings can actually raise your risk of heart disease and diabetes, but after just a week of regular exercise your post-meal blood sugar will drop dramatically.

Your mood will shift

Every fitness addict knows the elated feeling post-workout. You feel light, healthy, clean, and strong. Exercise has the ability to improve your mood and actually suppresses chemicals in the brain that cause depression by releasing other chemicals that lessen depression. Not only will you miss that post-workout high, but you are more likely to feel grumpy and self-conscious about your physical appearance as you lose strength and the pounds start adding up.

Lagos Begins 100 Days Statewide Free Healthcare Services

Following the growing cost of medical care with out-of-pocket payments, the Lagos State Government has today commenced free medical mission to provide free healthcare services to residents of Lagos across the 20 Local Governments and 37 Local Council Development Areas, LCDAs.

The State Commissioner for Health, Dr Jide Idris, who said this on Monday at a news conference in Alausa, Lagos, Southwest Nigeria said that the free healthcare, under the Lagos State Medical Mission, would commence on March 1 and end on June 8, 2017.

Idris said the programme over the years had helped to complement health service delivery in the state, aside helping government to take healthcare to the grassroots and undeserved areas of Lagos State, by addressing pressing health issues of the rural communities in the state.

The State Health boss said: “These medical missions are significant because it will enable this administration to provide healthcare services to all who come irrespective of their age, gender, socio-economic status and affiliations.”

The commissioner added that the medical teams providing these services are competent professionals committed to ensuring that the mandate of the state government was fully realized.

Idris stated that the vision of sustainable healthcare and universal coverage demanded that the state adopted an approach that was not only efficient, but also effective in addressing the growing health demand of Lagos megacity.

He said: “With a teeming population of over 22 million residents, the healthcare demands of this urban population are growing at an exponential rate, and as the cost of care with out-of-pocket payments are also increasing, the economic burden on our citizens are becoming more unbearable by the day. This cannot be allowed to continue.

“With the current economic downturn, the free health policy of the state has become inefficient to addressing these issues. Lagos residents will require a safety net to be in place to improve the health outcome of all residents, especially the most vulnerable in the society, as well as significantly reduce out-of-pocket payment that persists in Nigeria.

“Hence, it has become imperative that we provide adequate financial protection for our citizens through the Lagos State Health Insurance Scheme. This health insurance scheme will take off this year and will be made mandatory for all residents of the state.”

Idris said the state government was working tirelessly to ensure that all citizens had healthcare coverage and that this was one of the current strategies designed to address this.”

Meaning Of Embryo, How It Is Created

Embryo freezing is a procedure that allows embryos to be preserved for later use. The first successful pregnancy resulting from freezing a woman’s healthy embryos was in the 1980s. Since then, many embryos have been frozen for later use.

The embryos may be stored to enable a future pregnancy, to donate to others, for medical research or for training purposes.

The process begins by using hormones and other medications to stimulate the production of potentially fertile eggs. The eggs are then extracted from the woman’s ovaries to either be fertilized in a lab or frozen for later use.

Successful fertilization may lead to at least one healthy embryo, which can then be transferred to the woman’s womb or uterus. Hopefully, the embryo will develop and the woman can carry the developing infant through pregnancy to a live birth.

Since fertilization often results in more than one embryo, the remaining embryos can be preserved through freezing.

According to the Oxford Living Dictionaries, an embryo is “a human offspring during the period from approximately the second to the eighth week after fertilization.”

Before freezing can take place, suitable embryos have to be created. To create an embryo in the laboratory, the eggs must first be harvested and fertilized.

First, the woman will be given hormones to make sure she ovulates correctly. She is then given fertility medications to increase the number of eggs she produces.

In the hospital, a doctor will extract the eggs, using an ultrasound machine to ensure accuracy. The eggs may be frozen or used at once.

If the woman wishes to become pregnant at once, in vitro fertilization (IVF) or intra-cytoplasmic sperm injection (ICSI) may be used to fertilize the egg.

During the process of IVF, the eggs are exposed to sperm and the mixture is cultured in a laboratory. Fertilization may take 16 to 20 hours. The fertilized eggs are called embryos.

An embryologist will monitor the development of the embryos over the next 6 days, after which a suitable embryo may be chosen for implantation.

In ICSI, once the eggs have been extracted, a single sperm is injected directly into an egg. This may be done if there is a problem with the sperm or if past attempts at IVF have been unsuccessful.

While one embryo can be used for pregnancy, others may be frozen.

How is an embryo frozen?

The main goal of embryo freezing is to preserve the embryo for later use. The biggest problem is the water within the cells. When water freezes, crystals can form. This expansion can burst the cell, causing it to die.

To prevent this happening, the water in the embryo’s cells is replaced with a protective substance called a cryoprotectant. The embryos are left to incubate in increasing levels of cryoprotectant before they are frozen.

Once most of the water has been removed, the embryo is cooled to its preservation state through one of two methods of embryo freezing:

Controversy Trails Increasing Deaths At Traditional Birth Homes

* Practitioners Trade Blames

It was great excitement for Bisola Ogidi, 22, and her husband, Lanre, 28, when for the first time after

four years of childlessness she became pregnant. For them, it was a dream come through. But little did they know that Bisola will not be alive to carry her baby as she died while giving birth in a traditional birth attendant (TBA) home.

She was never asked to undergo any kind of test or scan throughout her visit to the TBA home. The woman in charge of the home, being an unskilled TBA, believed that all was well with Bisola and the unborn baby. Eventually Bisola struggled to deliver her baby. Exhausted, she died with the baby, which suffered fetal distress in her womb.

Isioma Alaka, 24, was pregnant for her second baby. Once she discovered this, Isioma registered with a TBA home, where the male attendant placed her on herbal medication.

She was not asked to go for any test or scan even when she complained of some bleeding.

At the ninth month, she visited the TBA home, where she was detained for two weeks without any sign of labour. But no sooner had the husband decided to take her to a health care than she died with the baby.

The sad narratives of Bisola and Isioma are typical examples out of a thousand other cases of preventable maternal deaths that occur in the country owing to growing patronage of TBA homes.

There is a dearth of statistics on maternal death rates following the use of TBAs. However, one of the available statistics on maternal deaths came after the rollout of the Abiye Programme in 2009, which led to the setting up of the Committee for Confidential Enquiry on Maternal Death in Ondo State (CEMDOS), according to Mamaye reports.

The CEMDOS research states: “Despite only contributing to two per cent of world population, Nigeria actually accounts for about 14 per cent of maternal deaths.”

The 2010 CEMDOS research on causes of death of pregnant women in the State showed that 90 per cent of the occurrence was due to delay from Traditional Birth Attendants (TBAs) and the Mission Home Birth Attendants (MHBAs) in seeking medical care for their clients.

Also, data that came from the two documentaries that told the story of horror of childbirth due to delays from TBAs and MHBAs, and the interventions that have been put in place by the government of Ondo State, for example, showed that 114 maternal deaths out of 4, 500 were traced to the TBAs/MHBAs.

However, Independent investigation showed that 90 per cent of the deaths from TBAs were blamed on the health facilities. Independent also learnt that the TBAs often quickly offloaded a dying woman to the health facility after delaying referral.

However, Prince Olusesi Tajudeen, a traditional midwife registered with the Lagos State Board of Traditional Medicine, and President of Association of Traditional Midwifery of Nigeria, has dismissed the criticism trailing the activities of the TBA homes.

Olusesi, attributed the development to the rivalry between them and orthodox medicine practitioners.

He noted that the number of TBAs registered with the Lagos State Government Hospital Board is over 2,000, and “they are working very well with primary health care facilities”.

He argued: “WHO recognises us as traditional midwives, but due to the rivalry between us and orthodox practitioners, they call us traditional birth attendants. We are traditional midwives because we are close and dear to our community. At times when you ask some people to go to the hospital to give birth, they say ‘no, we want to visit our traditional birth attendants because it solves mysteries; first spiritually, second due to our culture, and three, the beliefs of our people’. They believe that there are some things we can do that the orthodox cannot do.”

And what are those things? He said: “Number one, in Africa, they can tie pregnancy spiritually, and the person will not be able to be delivered of the baby. Even if they carryout CS on the person, she will die. But through deliverance, the person would be saved,” he said.

“Number two, let’s say that the pregnant woman has complications, the orthodox practitioners would go for Caesarean Section. They will operate on the woman, but here, we have soups, we have powders that work in a miraculous way that the women will take. It is what we have used for years now. There are medical doctors that have challenged this, and they have now come to believe in it. It is genuine.

“God has blessed herbs and roots. That is why I have always said we should go back to nature because God has given us nature. Some years back, officials from the Akwa Ibom State Ministry of Health came to Lagos to learn how we were doing it. My office was one of the places they visited; my office was one of the case studies. They stayed here with their officials, and we showed them some herbs and how we do it”.

He concludes that “traditional medical practice is not a religion; it is a profession”.

On the perception by some people that herbs do have adverse effects, he said; “There is nothing that God created that will have adverse effects if taken with due care. If you take too much water, it will have adverse effects; if you take too much food, it becomes poison.

When you pass through the training, you will know the kinds of herbs that you will administer on a pregnant woman at different levels of the pregnancy. ”

Prince Olusesi who owns a traditional birth home known as Sesiking Herbal Clinic averred that the real sources of problems are the auxiliary nurses trained by some unregistered and unskilled private, traditional and unorthodox hospitals. Indeed, according to him, a trained TBA, knows his/her limit.

Prince Olusesi would want the state government to assist the State Board of Traditional Medicine in monitoring quackery.

Fatai Ogunlade, Chairman, Agege Local Government Traditional Medicine Practitioners, and Director, Yewa Traditional Clinic and Maternity Home, decried the activities of quacks in the industry. For him “training makes people understand their limits, one of which is recognition of when to refer a client to an orthodox health facility”.

But most orthodox medicine practitioners see TBAs as unqualified to provide maternity services because they are “untrained.” Many maternal deaths in secondary and tertiary maternity facilities are actually blamed on TBAs who, it is said, after having messed up the women, hurriedly arrange their transfer to orthodox facilities. There, some are saved, while many others die because the damage to them had become too far gone to be remediable. A good number are actually brought in dead by relations who hope against all hope.

Prince Olusesi again denies this claim, a blaming ‘quack TBAs’ for unwholesome practices that lead to maternal deaths. In addition to training in traditional medicine and maternity practices, he said many of the registered TBAs also have western education and training.

For instance, Mrs. Opeyemi Sesi, a traditional midwife, who assists her husband at Sesiking Herbal Clinic, attended the Lagos State Polytechnic before she trained in general hospital under the auspices of the traditional medicine board, in addition to attending many seminars and workshops.

Mrs. Mary Elufiede, traditional midwife and traditional medical practitioner, as well as Chief Matron, Temitope Clinic and Maternity Home said: “I proceeded to traditional medicine board to register as a midwife, and also trained as a full traditional medicine practitioner in 1997. Later, I was posted to Orile-Agege General Hospital to do my industrial training (IT), after which I got my Lagos State certificate.

Ogunjimi Gbolagade, General Secretary of Lagos State Branch of the Association of Traditional Midwifery of Nigeria, and Director of Temitayo TR Clinic & Maternity Home in Alimosho said: “I registered in 1991 with the Board of Traditional Medicine. I went for IT at Isolo General Hospital.”

Registration and Menace of Quacks

Recently, 40 unregistered TBAs responded to the call of the paramount ruler of Ikorodu, the Ayangburen, Oba Kabiru Adewale Shotobi, at a town hall meeting in Ikorodu, Lagos and were offered free registration with the Primary Health Care Board (PHCB), which could have cost them the sum of N6, 000 each.

When Independent asked if the registered TBAs were conforming to regulations guiding their practice, the Lagos Health Commissioner, Dr Jide Idris said: “Any practising TBA must now conform; that’s why they need to register, and if they don’t register we can capture them.

“We train them in how to take delivery in a safer way, but under the insurance scheme, there is no room for them. But, you cannot say, ‘I am stopping the TBAs’ when there is a gap. It is a disservice to our people.”

The Special Adviser to the Governor on Public Health, Dr. Olufemi Onanuga, also aligned his thought to earlier ones when he said: “In Ikorodu, we were able to catch many of them who were not registered. We have the registered TBAs who work in collaboration with the public health facilities and a board for them – Board of Traditional Medicine, where they are supposed to register.

“But, some of them – the illiterate and nonchalant are not registered. Through an enlightenment campaign, we are making sure that we educate them on the need to register.


“We have made up our mind to sanction any TBA who is not registered; the law is there and the law has to work. After all with our enlightenment campaign and everything, any TBA that is not registered, we make sure we sanction them,” Dr Onanuga explained.

On his part, the Chairman, Lagos State House of Assembly (LSHA) Committee on Health, Hon. Segun Olulade, has read the riot act, vowing that the state would crackdown on any unregistered TBA. He charged community leaders in Lagos State to fish out unregistered TBAs and ensure their registration as soon as possible; otherwise they will face the full wrath of the law.

Olulade, told Independent that some of the TBAs, including the unregistered ones, were exceeding the limits of their capabilities.

He blamed unregistered TBAs for contributing to the high maternal and infant mortality rates by failing to refer pregnant and nursing women with complications to public health facilities in time.

He explained that the acceptance of TBAs was due to the cultural beliefs of the people with the understanding that registered TBAs will work within acceptable limits. “Thus, they are not expected to use any orthodox medications, injections or instruments, because they are not technically trained to apply them”.

NAFDAC Raids Companies Producing Counterfeit Alcoholic Beverage, Milk

National Agency for Food and Drug Administration and Control (NAFDAC) on Tuesday in Lagos , said, it carried out surveillance which led to a successful raid of Ezedams Enterprises Nig. Ltd on Badagry Expressway, Ojo which is into illegal production of counterfeit alcoholic beverages.

The Acting Director General of NAFDAC, Mrs. Yetunde Oni, said that a thorough search of the facility led to the discovery of several drums of Ethyl Alcohol; Rayner’s Flavouring Agents ; unidentified chemicals in several jerry-cans and packaging materials.

Addressing journalists on Tuesday in NAFDAC Oshodi office, in Lagos, was the Head of NAFDAC’s Investigation and Enforcement, Mr. Kingsley Ejiofor,   who spoke on behalf of the agency’s DG added that the facility has been sealed with investigation on-going.

In addition,   he said that following intelligence received on a transport vehicle containing suspected counterfeit Peak Milk products bound for Lagos from the East, the Agency set up surveillance from about 4am on the February 17, 2017 which led to successful interception of the vehicle and its contents as it was arriving Lagos.

He recalled that on February 24, 2017, Mr. Daniel Ezekwelu was arrested by the Federal Task Force on Fake and Counterfeit Products for production of fake water for injection within two compounds at Ojoto village near Nnewi, Anambra state.

Continuing he said : “During the raid, two underaged girls were found filling and sealing the fake water for injection under the cover of Mr. Daniel Ezekwelu. The production takes place between 8:00am and 3:00pm every day, while the finished products are transported to the market at night.

Items recovered include: plastic containers, gas cylinders and packs of the fake water for injection labelled “Sterilised water for injection BP” with manufacturing date 2015 and expiry date 2020 and said to be produced by Hossanna Laboratories Limited, Surrey. The product is packed as 100 x 10ml vials. The suspect made useful statement to the Police. Investigation is ongoing.”

According to him, the agency also paraded suspected fraudsters for forgery of the agency’s documents and impersonation.

He said that the agency received three different complaints from three countries about alleged impersonation and scam by some Nigerians that posed as NAFDAC staff to process registration documents for intending importers of regulated products.

According to Ejiofor, one of the complaints which came from the High Commission of Nigeria in New Delhi, India was reported on behalf of a company called, Bharti Phosphates.

The second complain was from Dr Yaser Dezhkam, the Chief Executive Officer of Dr Haps company, a German company and manufacturer of pet food supplement.

The third was from one Mr. Akrem from Tunisia who wanted to confirm whether he should pay money to a company in Nigeria called Samjoe Ventures for the registration and shipment of 5,000 metric tons of calcium carbonate, the Head of NAFDAC’s Investigation and Enforcement added.

Explaining further he said: “All the cases were diligently investigated and it was discovered that the three cases were hatched and executed by the same syndicate. This professional criminal group is an international gang headed by Mr. Eze Okoronkwo, a Nigerian who is resident in Aba, Abia state.

“The other Nigerian collaborators are: Mr. Ndukwe Darlington Ukonu, Mr. Nwabugo Okoro, Miss Ohanaokwu Chinonyen, and one Mr. Smart who resides in India. Their Indian collaborators are Miss Kokula Hongva, Hoi Ching Suamtak, Tongso M. Anal and Aneng Mate.

“The other countries whose nationals allegedly collaborated and acted as brokers to the syndicate are the Philipines, Tunisia, El-Salvador, the US, Canada, Mauritania, Denmark, Mexico, Greece, Switzerland, Indonesia, and Republic of South Korea.

“The syndicate had collected the sum of $13, 640. 00, while there were plans to collect further sum of $57, 720. 00. We believe this is a tip of the iceberg.”

The acting DG further revealed that the mode of operation of the group involves the sourcing of brokers with Dollar or Euro account; with a promise that a broker will be entitled to 30 percent – 40 per cent of the proceeds of the venture .

Explaining further, the acting DG said: “They contact the companies thereafter through known websites – company or group websites, example, European Union-Distributors website. The victim is then gradually fleeced, while being presented with fake documents.”

Enumerating some of the fake NAFDAC documents produced by the syndicate, he said they include: Certificate of Registration, some bearing the forged signature of the acting Director General of NAFDAC, Mrs. Yetunde O. Oni; Notification of products approval; Confirmation of file number for immediate issuance of NAFDAC certificates among others.

Maintaining that NAFDAC is doing everything to ensure that only safe medicine and wholesome food of the right quality are sold to Nigerians, the Acting DG solicited for the support of health practitioners, community leaders, religious leaders, the Media and all stakeholders to continue to educate their wards and family members to desist from patronizing quacks and hawkers of medicines on the street.

However, he advised consumers of NAFDAC regulated products to be watchful of drug, food and other regulated products they purchase and obtain receipt of payment for same adding, “The general public should not hesitate to report any suspicious activities within their environment to the nearest NAFDAC office”.

Tuesday, 28 February 2017

How Ignorance, Poverty Lead Women To Traditional Birth Homes.

The Lagos-based Bamideles hail from Yoruba land in Nigeria, where pregnancy is viewed as a time of great peril for a woman. Many sayings and actions attest to this, but the most widespread is the greeting after child birth: e ku ewu omo (congratulations on delivery from the peril of childbirth). It is therefore common practice for young pregnant women to be under the tutelage of older ones believed to be experienced in pregnancy matters for guidance during this period of peril.

Iyabo’s non-literate sister-in-law immediately enrolled her in a near by traditional maternity home, admonishing her to abide by all the instructions that would be given there. “My sister in-law told me she had had all her children at the maternity home, run by a traditional birth attendant (TBA), stressing that it was the way to go,” Iyabo told Independent.

Although she had earlier registered at a private hospital, she followed her sister-in-law’s advice and religiously visited the TBA home, where she dutifully bathed with and drank agbo, a herbal concoction. At 28 weeks, she was given a substance called aseje, which she ate, and a powdery mixture made from some crushed dried leaves, which she added to pap.

And at 30 weeks, she was given a black soap for bathing. All of this was for safe pregnancy and easy delivery.

Iyabo also regularly visited County Hospital, Ogba, the private hospital where she had registered for antenatal care.“I would have loved to deliver in the hospital, but I could not, due to family pressure, which saddled me with the burden of being under the supervision of my sister in-law, and she insisted that my delivery must be in the TBA home.

“Out of ignorance and pressure from family members who would say ‘this is the way to do it’, and you would be afraid that if you defied them and something happened to the baby or to you…So as soon as I noticed signs of labour, I summoned courage and went to the TBA home,” Iyabo further told Independent.

At the TBA’s,an attendant inserted a finger into her and said that the baby was due. “That was around 6p.m. He gave me two injections, and I thought l would die. The man is neither a doctor nor a nurse, and he administered injections to me. Then, labour started strongly.”

The TBA prepared all sorts of concoctions, which she was made to drink, and a soap with which she bathed, but Iyabo says she didn’t even understand what she was going through.“However, to God be the glory, I had the baby around 3.30 am, but unfortunately, l sustained a serious tear. The next morning my husband took me to County Hospital because the TBA could not repair the tear.”

At County Hospital, the doctor could not hide his anger, and wondered how Iyabo had survived the trauma and blood loss. He explained that the baby ought to have been delivered by Caesarean Section (CS) as he was too big to pass through the birth canal easily, hence the tear. The doctor stitched her up, while the baby received attention.

Iyabo survived to tell the story, which represents the ordeal of thousands of pregnant Nigerian women who visit TBA homes where there are no gynaecologists or nurses, and no proper antenatal or post-natal care.

Unlike, Iyabo, however, many others do not survive the ordeal; they die in the process of giving birth at TBA homes. At other times, when things get out of hand, TBAs encourage family members to rush dying women to orthodox health facilities, where they may be brought in dead, or die shortly after arrival. This annoys many orthodox maternal health providers, who decry the cunning of TBAs in pushing to them deaths that should not occur in the first place.

Eighteen year-old Hannatu did not receive proper antenatal care because she did not register with any hospital. She visited a TBA home until she was due for delivery, but the TBA did not know that she had a small pelvis and would not be able to deliver her baby normally. On the day that labour started, although the TBA discovered that she had weak contractions, he did not know what to do to help Hannatu deliver, and failed to refer her to a hospital. Hannatu laboured for two days and eventually died with the baby in her womb.

Yoruba people seem to be right about pregnancy and childbirth being a time of peril. A woman dies while giving birth in Nigeria every 15 minutes of the day.

According to the National Demographic and Health Survey (NDHS) 2013, the maternal mortality ratio is 576 deaths out of every 100,000 live births, the second highest maternal mortality ratio in the world. The figure is as high as 1,100 deaths per 100,000 live births in northern Nigeria and in rural communities where women have little or no education, and access to essential health services is low, the NDHS 2013 survey said.

With about seven million annual births, the number of women who die is about 58,000 each year.

The World Health Organisation(WHO) blames the deaths on simple mistakes, wrong diagnosis, carelessness, incompetence, and lack of access to prompt and affordable healthcare. Many other African nations, record fewer maternal deaths, which irks many health care providers in Nigeria. The argument is that with the huge amount of resources at Nigeria’s disposal, having the second worst number of maternal deaths in the world is a shame. In some advanced nations, maternal deaths are as low as three per 100,000.

Why Women Prefer TBAs

Investigations revealed that most pregnant Nigerian women, particularly from the Southern parts of the country, prefer using traditional medical facilities because they see it as part of their culture.

Theresa Pius, who had her first baby at Yewa Traditional Clinic and Maternity Home, Agege in Lagos, five years ago, said she has been using the TBA home ever since.“It was a friend who introduced me to the home when I was pregnant with my first child. I had developed a problem during the fifth month, and she introduced me to Yewa Traditional Maternity Home where I later delivered my baby,” she explained.

Another patient, Oyin Agida said that it was the problem of infertility that made her mother introduce her to a TBA.“I actually started coming here because I was looking for the fruit of the womb. Before then, I had visited some other TBAs to no avail.”

On her part, Muyibat Adisa started visiting Yewa in 2013 because she had been unable to conceive for four years, after which her mother in-law introduced her to the home. After a while, she became pregnant and gave birth to a baby girl who is now three years old now.”

 “When my mother was having babies, she also used TBAs. I am Yoruba and I know that we have the leaves and herbs; in fact everything, and I believe that they would work perfectly. This is what my mother told me, and I have learnt from it,” said another TBA client, Adesina Adenike.

Shortage of Medical Personnel

For many people, a visit to public hospitals in Lagos and other parts of the country on a weekday is an eye-opener. The situation at any of the primary, secondary or tertiary health centres is usually depressing, and many people ask: where are the nurses, doctors, and other health workers? This is because there are always too many patients,and not enough health care personnel around to cater to their needs. During the 2014 Ebola virus disease outbreak, for instance, health worker shortage was a big threat to the containment effort.

On the average, a doctor, who should not see more than 30 patients is compelled to attend to between 100 and 150 daily. Sometimes, one doctor is on call for two to four days at a stretch. And not only is there a shortage in numbers, there is shortage in specialisation.

WHO defines health workers as “all people engaged in actions with the primary intent of enhancing health,” including those paid as “health service providers” and “health management and support workers.”

Going by WHO standards, Nigeria is not on track to meet the very low benchmark of 2.5 doctors per 1,000 people.

WHO also recommends a ratio of one nurse to 700 people. But, according to the Open Journal of Nursing 2014, Nigeria has fewer than 150,000 registered nurses for an estimated 160 million population, giving an average nurse-population ratio of 1:1,066 people.

For pharmacists, the Registrar of the Pharmacists Council of Nigeria (PCN), Mohammed Elijah said, “Although WHO recommends one pharmacist per 2,000, in Nigeria we have approximately one pharmacist per 12,000 population.”

The health worker shortage therefore underlines the need for TBAs capacity building, and Lagos State Governor, Mr Akinwunmi Ambode, said this is a challenge that requires new strategic thinking.

Intervention to Make TBAs Safe

Recognising the role of TBAs as the preferred service providers for child delivery in rural communities even though they are usually self-taught or informally trained, the Lagos State Government initiated the General Hospitals Immersion Programme. Under the programme, TBAs undergo training to build their capacity for improved antenatal care and delivery.

Speaking, while presenting certificates to some TBA graduates last year, Governor Ambode said: “One of our policies in the health sector is to empower our traditional medicine practitioners and make them an integral part of our healthcare delivery system. Lagos State has a functional traditional medicine board that has strategic programmes targeted towards regulating, monitoring, promoting and integrating traditional medicine into modern health care based on the 1978 Alma Alta Declaration of WHO.

The objective is to streamline traditional medicine and change public perception of traditional medicine as a religious and spirit-magical practice by virtue of their proximity and accessibility to the rural dwellers, the governor explained.

The state decided to train TBAs to provide the following services: protecting the health of mother and baby; care of women during pregnancy and child birth; and referring women and newborn to higher care when conditions arise beyond their scope of practice and capabilities.

 “We are committed to taking traditional medicine practice to a higher level through innovative research and development. We will continue to strengthen our efforts in the areas of regulation, training, coordination, monitoring, and supervision of practice of traditional medicine towards effective integration with orthodox medicine,”the Governor said.

 “We know a lot of our people go to TBA homes for cultural reasons. Why do they go there? This is because there is a gap in service provision; it is that gap that we are trying to fill. Our facilities are not enough, and we are renovating more. The attitude of some of our staff is very bad; TBAs are compounding the problem, said Lagos State Commissioner for Health, Dr Jide Idris.

“If our people have places to go, they wouldn’t need to visit TBAs. But, you cannot stop TBAs when you have not provided the people where they will go. So let’s deal with the problems rather than the symptoms,” he added.

Orthodox Practitioners’ Attitude

On preference of TBAs by rural dwellers, the Minister of Health, Prof. Isaac Adewole, once said that traditional healers were competitors of orthodox medicine practitioners, and that the only way to really create a change in their view of orthodox medicine is to offer better services, show more care, and more compassion. “Let us be honest, traditional healers communicate better with our people,” he said.

“The average Nigerian who patronises them does not see them as arrogant, but people complain about the negative attitude of our nurses. So, we (orthodox medicine practitioners) need to change that perception.”

He added that orthodox medicine providers also need to make health care services affordable. “Some years back, baby delivery in my Church was N300.

At that time, in the University College Hospital, Ibadan, in Oyo State, ante-natal care was N18, 000. So, people would line up in the Church. We need to make health care services affordable; we need to show compassion; we need to show care and really recognise that we have competitors. If we don’t, patients wouldn’t come to us even though we are doing something greater and better.”

Mrs. Adeyemo Muinat, TBA nurse at Yewa Traditional Clinic and Maternity Home, Agege, concurs. She said: “One of the things that scare women from delivering in public health facilities is lack of money for treatment, drugs and blood.”

This story was published in Independent Newspapers
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