{HEALTH MATTERS} Caesarian Section: Physician Counsels Against Attaching Spiritual Attacks

 

By FRANCIS EZEDIUNO

Women who are fearful of undergoing Caesarian Section [CS] to give birth to their babies have been advised to as much as possible do away with any fears associated with the procedure, as it is perfectly normal and due to advances in medical and surgical sciences the risks associated with the procedure have been minimally cut.

Dr. Sunday Ojenuwah, a Consultant Obstetrician and Gynaecologist at the LifeLine Specialist Hospital, Ibadan stated this during a telephone interview with this medium recently.

The physician, described CS as a medical procedure through which pregnant women who cannot give birth through the natural process of the baby passing through the birth canal are assisted to deliver through surgical procedure of opening the womb, bringing out the baby and closing up the womb again.

He noted that what professionals encounter in the field has been that when expectant mothers start attending antenatal sessions in the hospital, some issues may arise which propelled that the parents are notified that there was need for a planned birth because the mother may not be able to give birth naturally.

“Many reasons may lead a physician to counsel expectant mothers on the necessity for a CS procedure.

“It may be due to the fact that, the pelvic is too narrow, the baby is too big, the baby is a ‘precious baby’, the mother is too sickly, the mother is anaemic, obesity, as a result of unplanned emergencies, ignorance on the part of the expectant mother and so on.

“The problem here is that we attach too much spirituality to this issue. CS is such a simple procedure now that from conception to birth, the parents of the new baby can plan for the procedure and under one week after the procedure, both mother and child are out of the medical facility for good.

“Parents in our society attach evil attacks and bad luck to this procedure which is supposed to in many ways be an elective procedure, that is parents even willingly plan for it”.

Ojenuwah also revealed that in times past, a woman was counseled to stop all pregnancies after the third CS but advances in the procedure has made it possible to carry out four CS without any complications.

He called on expectant mothers to cast away the fear and ignorance associated with CS and urged them to approach the procedure with optimism as it was one of the advances with which medical science had been able to reduce and defeat maternal and child mortality.

And as per the pain associated with surgery referred to as post operative pains, he advised that once the affected mother take all the pain medication the doctor recommends on schedule, take adequate rest and exercise appropriately, things would be in good shape.

According to him, the exercise should involve walking as soon as possible after the CS as this can prevent blood clot, speed bowel recovery and boost comfort levels.

{MAGAZINE} Moving Towards Restoring Healthy Living

 

Since his assumption of office in November 2010, the Rauf Aregbesola-led administration in Osun has been seen to be proactive in the public health sector to ensure that citizens and residents of the state get access to quality health services. However, the enrolment of the state in the Health Insurance Scheme (OHIS) is another effort of the government to enroll the entire populace into some financial and risk-pooling health scheme. KINSGLEY OMOYENI writes.

A responsible government must create and maintain the conditions under which members of the community can be healthy, though the maintenance of healthy living and public health is a responsibility of every member of the society.

Society’s efforts have been carried out through a combination of personal health care and public health system. Through the activities of both private and governmental health care providers, organisations, and institutions, the personal health care system provides primarily curative services, such as treating illnesses and injuries, to individuals with relatively little attention to prevention.

These agencies build partnerships and often provide or coordinate direct services to ensure that there is access to adequate healthcare in a community. Public health agencies have particularly played this role in efforts to reduce the spread of diseases, illness, injuries, environmental and other risks. They have also directly taken on the challenges of addressing the health care service needs of the most vulnerable.

Public health agencies meet obligations to their communities in many different ways: by fostering a wide range of policy-guided community initiatives to promote health, improve health conditions through the collection, monitoring, and dissemination of information about health status and disease occurrence; through the direct provision of service in the community and in the home; and through community education.

Another role public health agencies play is to regulate sources of risk and promote health and safety practices, such as licensing restaurants and health facilities, and regulating water and air quality.

Public health tasks are carried out primarily by governmental health and environmental protection agencies at local, state, and national levels.

Frequently, the government agency provides either financial or technical assistance. This is because government functions as a representative of the people and needs to be responsive to them, the ultimate responsibility for public health activities must lie with government agencies.

Non-Governmental Organisations carry out many useful activities. However, only government agencies that derive authority from the community, locality and nation are therefore accountable to members of the public. Public health agencies, even while being cost conscious, are in principle not constrained by profit motives, nor by agenda other than that of the public’s health.

Public health interventions focus on the health needs of the entire population or population groups. Personal healthcare providers have little incentive to consider population-based services, although they may provide individual clinical preventive care. Even with increased attention to the provision of clinical preventive services by healthcare organisations and others, the clinical preventive services provided will often be those with short-range, immediate payoffs.

Moreover, population most at risk for increased morbidity and mortality may be least likely to receive these clinical preventive services because of financial and non-financial barriers. Public health addresses these issues through outreach, health education, transportation and translation services, and culturally sensitive provision of services. These are provided by the public health system.

Since assumption of office in November, 2010, the Rauf Aregbesola-led administration has done everything possible in the public health sector to ensure that citizens and residents of the state have access to quality health services in all the nooks and crannies of the state. No wonder the life expectancy at birth in Osun has increased from 45 to 75 years, according to reports.

The Osun Ambulance scheme, an idea of the present administration has saved countless souls from untimely death, as the state governor procured ambulance vehicles worth millions of naira and equipped them with facilities and personnels and stationed in strategic locations around the state to arrest emergency health challenges.

Health facilities and hospitals across the state are never left unattended to, as they are constantly being upgraded; just recently the state government through the ministry of health took delivery of health equipment for government hospitals across the state, training of medical personnels, while provision of drugs are also being attended to.

The Aregbesola administration has strengthened the state’s health system by carrying out comprehensive changes in policies and regulations, develop strong financing mechanism, changing organisational structures and relationship across the health system and ensure effective use of resources to improve multiple health services.

Supporting the health system can also include any activity that improves services, from upgrading facilities and equipment to distributing mosquito nets. All these are the efforts of the present administration in Osun.

For a government that has put the health of its citizens on the front burner since assumption of office, it was no surprise to learn that the administration is going another step further at ensuring that the people have more access to affordable health services.

Since a single stay in hospital can wipe out your savings and more, not many people can afford to go without some kind of health insurance – even if they’re healthy. Not only will health insurance protect the rich from bankruptcy in the event of a major medical event, it will also give the vulnerable or poor of the poorest in the society peace of mind knowing that they can have access to quality health delivery when the need arises.

The National Health Insurance Scheme (NHIS) has been there for many years, but the truth is that many people at the state and local governments’ level do not understand how to enjoy the service nor have access to it; hence the NHIS has only been in existence for existing sake.

Many people still view the national health insurance as a contract between you and an insurance scheme company that says that the insurance company will pay a portion of your medical expenses if you get sick or hurt and have to visit a doctor or hospital. They believe that such contracts also specify that the insurance company will pay a portion of your medical expenses such as paying for annual physicals or immunisations all at a burden which you will still have to bear one way or the other.

It was therefore a huge step in the right direction when the government of Osun under Rauf Aregbesola did everything possible to be part of the first sixteen states that will serve as pilots for the state health insurance schemes. At an awareness programme to sensitise the people of the state on their roles and responsibilities under the Osun Health Insurance Scheme (OHIS), it was made clear that it is to enable the people, rich or poor to have access to universal health scheme.

The Osun Health Insurance Scheme (OHIS), is an insurance plan seeking to enroll the entire population into some financial and risk-pooling insurance mechanism or set of mechanism with the aim of removing the financial barriers of attaining Universal Health Coverage (UHC) so that needless deaths caused by lack of immediate funds will be avoided.

For a government that has done so much in the state’s health sector, it is worth eulogising such government for going another step further to ensure that the people are completely covered when it comes to issues relating to their health as OHIS will ensure that even the poorest of the poor will have access to quality health services because through the scheme such expenses would have been taken care of through tax and donors from the rich.

With the Osun Health Insurance Scheme, everybody is covered as avoidable deaths will be avoided. With adequate awareness and taking up of responsibilities by all stakeholders, the Aregbesola administration has set a new standard in the discharge of health services to all in Osun, which means, days when simple illnesses claim the lives of the poor as a result of lack of money to visit the hospital or doctor are gone for good.

It should be noted that the provision of quality healthcare delivery is a right of the people and through the scheme, the burden of catastrophic health expenditure will be eliminated and the people of the state are encouraged to take the opportunity and enjoy access to quality healthcare at the appropriate time.

The appointment of a former Chairman of the Nigeria Medical Association, (NMA), Dr Niyi Ogini as the Executive Secretary to pilot the Osun Health Insurance Scheme (O’HIS) has again reaffirmed the commitment of the government to the scheme.

Dr Ogini while speaking at an awareness programme stressed that public health services should be considered part of the social safety net which is the responsibility of government to provide for the people.

“Governor Rauf Aregbesola wants free health for his people but at the same time he realises that it cannot be totally free, he knows that it cannot be hundred per cent possible, hence the creation of the Osun Health Insurance Scheme.

“It is the desire of the Governor to deliver quality health services to the people of the state on the basis of equity. I want to assure the people of the state that through the O’HIS, the death of children under five will be greatly reduced in Osun.

“The scheme would be operated on equity where those who do not have money can have access to quality health services and we want it to succeed so that Osun will be an example to emulate”, Ogini stressed.

It is hoped that citizens and residents alike in Osun will embrace this good gesture of a government that is determined to restore healthy living as contained in its six points integral action plan.

 

HEALTH MATTERS: Care Of The Aged

FRANCIS EZEDIUNO

We will get old one day and it is the prayer of everybody to grow old in good health and vitality.

Medical science that specialises in the medical care and treatment of old people is called Geriatrics while that of infants and children is referred to as Paediatrics.

Elderly care or care of the aged is the fulfillment of the special needs and requirements that are unique to senior citizens. This broad term encompasses such services such as; assisted living, adult day care, long term care, nursing homes, hospice care [for terminally ill patients], and home care.

Elderly care emphasizes the social and personal requirements of senior citizens who need some assistance with daily activities and health care, also for the aged, at is important to note that the design of housing, services, activities, employee training and health care delivery should be truly customer centered.

However, it has been observed that the elderly in the globe consume the most health expenditures out of any other age group as comprehensive observations has shown.

Traditionally, elderly care has been the responsibility of family members and are provided within the extended family home. Increasingly in modern societies, elderly care is now being provided by state or charitable institutions which include private and religious institutions.

The reasons for this change include decreasing family size, the greater life expectancy of elderly people, the geographical dispersion of families, and the tendency for women to be educated and work outside the home.

Organisations or individuals that provide room and board, personal and health care also provide rehabilitation services in a family environment for at least two and no more than six persons.

It is important for caregivers and health workers to ensure that measures are put into place to preserve and promote function rather than contribute to a decline in status in an older adult that has physical limitations.

Caregivers need to be conscious of actions and behaviours that can cause aged adults to become dependent on them and need to allow older patients to maintain as much independence as possible. Providing information to the older patient on why it is important to perform self-care may allow them to see the benefit in performing self-care independently.

If the older adults are able to complete self-care activities on their own, or even if they need supervision, encourage them in their efforts as maintaining independence can provide them with a sense of accomplishment and the ability to maintain independence longer.

One of the problems that may confront people as they grow old is the issue of mobility. For years, these senior citizens have been used to going out in the morning and coming back late in the evening. Now, in their twilight, they have to seat around doing nothing and if they are lucky they have their grandchildren around them to give them some comfort.

Impaired mobility is another major health concern for older adults, affecting 50% of people over 85 and at least a quarter of those over 75. As adults lose the ability to walk, to climb stairs, and to rise from a chair, they become completely disabled. The problem cannot be ignored because it has the tendency to bring on suicidal thoughts.

Therapy designed to improve mobility in elderly patients is usually built around diagnosing and treating specific impairments, such as reduced strength or poor balance. It is appropriate to compare older adults seeking to improve their mobility to athletes seeking to improve their split times.

People in both groups perform best when they measure their progress and work towards specific goals related to strength, aerobic capacity, and other physical qualities. Someone attempting to improve an older adult’s mobility must decide what impairments to focus on, and in many cases, there is little scientific evidence to justify any of the options. Today, many caregivers choose to focus on leg strength and balance.

We cannot however overrule the fact that some seniors are blessed with eternal strength and abundant energy coupled with youthful figure that even in their advanced years, they are still going strong.

The family is one of the most important providers for the elderly. In fact, the majority of caregivers for the elderly are often members of their own family, most often a daughter or a granddaughter. Family and friends can provide a home (i.e. have elderly relatives live with them), help with money and meet social needs by visiting, taking them out on trips and so on.

Many an aged person has died due to neglect on the part of family members and relatives. Apart from providing for them, there is need to show them TLC, Tender! Loving! Care!

Have you ever stopped to wonder why in your youthful days, when you fall, you get up and keep going but as you age, falling now becomes a burden and you take care to avoid a fall.

That is what happens to elders and falling is one phase often associated with aging. One of the major causes of elderly falls is hyponatremia, an electrolyte disturbance when the level of sodium in a person’s serum drops below 135 mEq/L. Hyponatremia is the most common electrolyte disorder encountered in the elderly patient population.

Studies have shown that older patients are more prone to hyponatremia as a result of multiple factors including physiologic changes associated with aging such as decreases in glomerular filtration rate, a tendency for defective sodium conservation, and increased vasopressin activity. Mild hyponatremia ups the risk of fracture in elderly patients because hyponatremia has been shown to cause subtle neurologic impairment that affects gait and attention, similar to that of moderate alcohol intake.

Aisha Buhari Wants Private Medical Facilities In Nigeria To Reduce Charges

Private medical institutions operating in Nigeria have been urged to review their high services charges so that most Nigerians can afford them.

The appeal was made by the wife of the President, Aisha Buhari during a courtesy visit paid her by officials of the Association of General and Private Medical Practitioners of Nigeria at the State House on Wednesday, a press statement from the state house said.

The statement, signed by Suleiman Haruna, Director of Information to Wife of the President was made available to newsmen on Thursday.

Mrs Buhari observed that many Nigerians who do not have access to public health services resort to private hospitals which are very expensive and this has implications on not just the patients but the nation’s health indices.

“Private health care is expensive, your association needs to revisit the issue of charges, make treatments affordable so that more people can access your services and health outcomes can improve,” she said.

Mrs Buhari also lamented the brain drain in the health sector, saying ironically, people travel abroad mostly to be treated by Nigerian practitioners.

She solicited for better working conditions for the practitioners so that they are encouraged to remain in Nigeria.

She also urged the association to check cases of medical malpractices by private hospitals, “which are becoming more rampant.”

She recommended a Public-Private Partnership, whereby private sector firms can invest in the health sector and reduce the burden on the government.

“That is why I am convening a stakeholders event soon, to draw their attention to the possibilities and opportunities in the sector,” she said.

President of the Association, Frank Odofen, commended Mrs Buhari and her commitment to the health of women and children through the Future Assured Programme, which dovetailed into her recent appointment as UNAIDS ambassador.

Also, President of World Organisation of Family Doctors, Amanda Howe, who was on a two-day visit to Nigeria, observed that the pronouncements and programmes of Mrs Buhari are worthy of emulation as the challenges in the health sector require strong commitment.

She also noted that medical personnel embedded in communities in Nigeria are doing “wonderful jobs by providing support and preventing diseases through education of families, patients and health workers.”

Jigawa Uses Sweets in Polio Immunization

A Local Government in Jigawa, called Miga Local Government Area says it has purchased 25 cartons of sweets to woo children to participate in the ongoing polio immunisation.

The Information Officer of the council, Alhaji Abdullahi Yakubu, made this knwon on Sunday.

Yakubu said that the sweets would help the council to achieve its target of immunizing no fewer than 65,429 children against polio in the ongoing round of the immunization in the area.

He said that the council had received 72,000 doses of Oral Polio Vaccines (OPVs) to cover the targeted number of children.

Yakubu explained that the children would be immunised against the disease during the five-day exercise which commenced on April 7, Saturday.

He said that the council’s Head of Health Education, Alhaji Sule Shehu, had earlier visited District Heads of Miga and Zareku communities to sensitise them on the need to participate in the immunisation.

The Information Officer added the council also sought the support and cooperation of other stakeholders in the council for the successful conduct of the exercise.

Beneficiaries Share Ordeal with Fistula

The life of Mrs. Patience Stephen, an indigene of Akwa Ibom State, took a downward plunge 18 years ago, when she developed vesico vagina fistula (VVF). Not only did her husband abandon her, other family members also deserted her because of her worsening health condition.

Fortunately, Mother Luck smiled on her, as she was successfully repaired and treated.“It started after I had my first child,” she narrated. “During this period, I was stigmatised because of the offensive odour my body was emitting, as a result of steady leakage of urine.

“But today, I thank God for the opportunity and the sponsorship that got me healed. I am better and stronger now. I would want to advise other women with the same condition to visit hospital for repair, since it is free.”

Another fistula client, 27-year-old Mrs. Lucas Oluwaseyi from Osun State said she went into prolonged labour. But rather than go to a hospital, she went to her church, where her problem became more complicated. So, she was taken to Mother and Child Hospital in Ondo State, where she was operated on. Sadly, the baby did not survive and she also developed fistula.

She explained that it was her brother, who encouraged her to go for fistula repair, which was successful. She said: “During my predicament, all my friends abandoned me, and even my husband-to-be, who impregnated me ran away. I was helpless until this opportunity came.

“From my experience, I would advise pregnant women to register at the hospital for proper antenatal care. They should avoid going to wrong places for medical attention, such as the church. Those who have fistula should come here because the repair and treatments are free.”

These two testimonies were obtained during Media Roundtable Discussion on Fistula Intervention/Fistula Repair Programme at Obafemi Awolowo University Teaching Hospital Complex (OAUTHC) Ilesa, Osun State, organised by Fistula Care Plus Project, implemented by Engender Health and funded by the United States Agency for International Development (USAID), held in Ilesa Osun State.

Country Project Manager, Fistula Care Plus, Chief Iyeme Efem, said his organisation is supporting 12 states and have 13 facilities in the states, which include OAUTHC Osun State, Adeoyo Maternal Hospital in Ibadan, Oyo State, Sobi Specialist Hospital Ilorin Kwara State, VVF Centre in Kebbi State, Maryam Abacha Women and Children Hospital Sokoto, Women and Children Hospital Gusau Zamfara, National Obstetric Fistula Centre Katsina, Laure Fistula Care Hospital Kano, VVF Centre Kaduna, VVF Centre Zaria, VVF Centre Bauchi, National Obstetric Fistula Centre Abakiliki Ebonyi, Ogoja General Hospital Cross Rivers State and the newly opened VVF Centre Damaturu, Yobe State.

Efem said: “USAID research in 2012 showed that 200,000 women live with fistula, while 12,000 new cases occur every year. USAID does 200,000 repairs yearly. This means we have 400, 000 to 500, 000 cases every year and it does not catch up with 12, 000 new cases. The research shows additional 700,000 cases entering into backlogs. Looking at it from that perspective, it shows we have not done enough and we have a long way to go.

“The only way we can say we have prevented fistula is if we prevent the occurrences and reduce the incidents to zero, but we do not have the structure in place. Which is why one of the strategies we are introducing is having teaching hospitals undertake fistula repairs. This will help to reduce occurrences to zero. But you know teaching hospitals charge fees. So, we were able to negotiate with the minister of health, who liaised with the teaching hospitals, by sending memo to them to stop fees. Some of the hospitals have begun to comply, but some are not.

“The strategy is that, every teaching hospital should do at least 15 repairs in a month. If we have 44 teaching hospitals undertaking 15 repairs, this means we have 660 repairs from each of them in a month. Multiply this by 10 months, and you have 6,600 repairs. So, in a year, we will have about 700,990 repairs by teaching hospitals alone.

“If we add this to what Fistula Care Plus is doing, which is 200, 000 repairs yearly, we have 9,990 repairs plus 3,000 by other programmes, making 12,000 repairs in all. With this, we will completely zero the incidents of fistula cases in Nigeria.”

Head of Obstetric and Gynaecology, OAUTHC, Prof. Ernest Orji, said treatment and repair of fistula had been in existence in the hospital, though it was under missionary control. But the challenge then was that many of the women who developed the condition were indigent, and they found it difficult to afford treatment.

“This was the trend, until Engender Health came in. And ever since, there has been a lot of improvement in terms of health workers’ training and provision of consumables,” he said. “They have been very helpful. Now, we have dedicated surgeons among us, unlike before when all our consultants are surgeons. OAUTHC Ilesa has been dedicated for fistula repair among others branches of the hospital in the Southwest.”

He explained that in the whole of Southwest, awareness creation about fistula repair and treatments in the hospital have been ongoing. So, new clients are being admitted on a daily basis.

Orji said: “The awareness has been on radio and television jingles, social media and WhatsApp, among others. More women are coming for repair, especially now that it is free. We partner with market women, community leaders and traditional rulers to ensure that the information reach people at the grassroots. We also work with social workers in Osun State to ensure more awareness and improvement.”

In terms of manpower, he said the hospital is ready to serve clients even better, as they recruit gynaecologists regularly, as well as train their health workers.

“We also organise skill acquisition for women after the repair, as many of them are poor and unable to feed and care for themselves. I would want government to employ more doctors and nurses for the hospital,” he said.

He explained that private organisations, families and individuals have been donating to the hospital, which has helped in the development and maintenance of the facility, adding that there is a fistula centre under construction in the hospital.

He said: “By time we complete the centre, we will employ more doctors, nurses and other health workers to ensure adequate improvement in the hospital setting. We also advise philanthropists to donate more resources to enable us take care of our clients.

“We advise pregnant women to book early for antenatal, as well as deliver in hospitals with qualified personnel. They should come for delivery early and not when labour has become complicated. What we do is to save the women’s lives and we advise them to stay away from sex for at least three months after a successful repair and wait for two years before getting pregnant.”

Source: Guardian

HEALTH MATTERS: Achieving A Sound Healthy Living

 

By Francis Ezediuno

I wonder why some car owners spend thousands to keep their cars in optimum shape. Some of us spend handsomely to look good, fit and trim, while some people spend a fortune to get the latest smart phone and also lavishly spend to get data and airtime on same devices.

They live in big and pretty houses and also empty their bank savings to refurbish such and yet default when it comes to taking care of the most precious asset they have, which is their health?

From experience, human body is built like a car engine and every engine needs servicing once in a while. Little wonder people just fall ill, and die and the cause of death is deemed a supernatural attack from somebody in the village. However, a close look scientifically would reveal something else, probably death from exhaustion or from an underlying hitherto unnoticed malady.

From the research, the ailment that one refuses to treat at an early age would come back to hunt one in the old age and the primary cause of death may be attributed to it. There is always a primary and secondary cause of death.

A popular physician once said that all deaths can be attributed to something when subjected to scientific post-mortem examinations.

So, what are we doing about our health? Are we just leading our lives as if we do not care or we are leading it with caution?

Hypertension or a state of high blood pressure has no symptoms. It can lie low for several decades, undetected but when it rears up its ugly head, the negative actions maybe swift. High blood pressure could lead to stroke, heart attacks, heart, kidneys, liver, pancreas and eventually death.

Just mentioning high blood pressure does not mean that this is the only ailment that can attack a careless individual, there are dozens of it.

The advice is to seek medical help immediately you detect that the engine has one complaint or the other but before that, a regular visit to the physician once in 6 months is not a bad idea. That does not mean the individual does not believe in God or in divine healing, but rather only heeding the call not to perish through lack of knowledge.

So what do we do? How do we save ourselves the stress of needless pain as we advance in age?

There are steps we can take to achieve this. These are:

Health Insurance Plan: This would save you money and you would be able to access health care even if you are broke. We always have a problem with this in Nigeria because of the term INSURANCE attached to it. Most individuals see it as a waste of money and shockingly, this exists among the elite and educated class.

The thinking is in terms of the money that will be spent on the insurance and they may not get to use in the event that they would not fall sick. What skips their ignorant understanding is that when sickness calls, it will dig deeper into their pockets and they would be forced to spend more than what they would have spent to get a health insurance plan. This is the wisest thing to do because access to health care is very expensive.

Enrolment of family members: There are different health insurance packages for this. You can enrol your wife, children, parents and in-laws depending on your pocket but wisdom dictates you enrol them after you have done yours.

Do not just register and go off to bed: Ensure it is judiciously used to the fullest and when it is due for renewal, renew your enrollment.

Be aware that not all medical examinations and conditions are covered: You must be aware that not all medical examinations and conditions are covered by the insurance scheme and some medical facilities would not accept to dispense treatment and drugs under the scheme.

This is due to no fault of theirs, as medical facilities which fall under this category are the government owned tertiary health facilities which do not get paid directly into their purse but through the Treasury Single Account [TSA] of the federal government.

Go for medical examination: Go for medical examinations every now and then. At least, twice a year. That is every 6 months.

Take every medication and counsel: Like a religious zealot, take every medication and counsel given to you by the physician and do not wait till your next appointment date before you report any emergency.

Liaise with your Health Management Organisation: In case of a long distance journey, ensure you liaise with your Health Management Organisation to direct you to any health facility in the town you are visiting in case you may need to access it.

Constantly service your body:      As you age, some funny things tend to happen to us physiologically, somebody nuts and bolts may be loosen due to aging and there is need to constantly have them serviced so as to prevent a total engine knock.

Keep in mind that as we age, the disease that may eventually kill us would be lurking around the corner and if waved aside, it will hit without warning and suddenly like a thief in the night.

Self medication should be discouraged: Over The Counter [OTC] drugs intake should be reduced to the barest minimum as often advised on drug packages, the advice of a physician should be sought if symptoms persist after three days.

Drug cocktail should be reduced: What is the meaning of cocktail, it means the combination of different types of drugs. This practice is often observed amongst labourers and workers found working in construction sites who abuse drugs and analgesics such as Tramadol.

For good and sound health, persons should make regular calls at the nearest health facility a compulsory part of living and once a person is late in his or her late 30’s and early 40’s, blood pressure checks should form part of the weekly schedule.

The health of the children in the family too should not be taken for granted. Immunity levels of children can be affected by environment and biological factors. This is the more reason why parents should always monitor their children and wards for any irregular change in behaviour.

At the slightest notice of any abnormal display of behaviour, the counsel of a qualified paediatrician should be sought because their vulnerability puts their health at risk.

 

HEALTH MATTERS: Psychiatrist Attributes Stress To Lifestyle And Behaviour

 

By FRANCIS EZEDIUNO

A psychiatrist has opined that there are many factors in the life of an average human being that can cause stress, adding that it is a natural reaction as the body tries to deal with any negative pressure placed on or around it.

The psychiatrist, Dr. Ore Olagunju stated this during a health sensitisation workshop organised for ministers, workers and members of the Redeemed Christian Church of God, House of Glory Zone, Oshogbo recently.

While delivering a paper titled: “I FEEL STRESSED, Signs, Causes and How to deal with stress”, the physician noted that factors like work deadlines, financial troubles, congested traffic, and at times arguments could cause stress.

According to him, “stress can become a problem when these pressures become overwhelming, and in some cases, can be a precursor to anxiety disorders and depression.

“Thankfully, stress is very manageable, and a little stress can even help a person to perform better. This is often seen in students when studying for examinations or in athletes as they prepare for any sporting competition.

“There are many ways to deal with stress, and simple techniques practiced frequently can really help”.

While explaining what stress was, Olagunju hinted that it can be defined as a response of the body to any demand placed on it which can be influenced by both external and internal factors.

Examples of external factors include: work, relationships and finances. Internal factors such as health, hunger and amount of sleep can affect how people deal with situations in which they might otherwise have dealt with competently.

“In other words, stress is a normal human experience and can be useful when dealing with demanding situations”.

He explained that the body deals with acute stress by releasing chemicals that tell the body that it is in danger, and therefore activates the flight or fight response.

This response according to him “is a survival mechanism that prepares the body to face danger and changes seen during this response include increased heart rate, rapid breathing, dry mouth and sweating. This response does not have any long-term effects on the body, and often can help in dealing with stressors. Stress, in many instances, can be useful, and help the person deal with the demands placed on them, by making them more alert, energised, and attuned to external cues.

“However, long term exposure to stress, and the exposure of the body to high levels of hormones, such as cortisol and adrenaline, can lead to increased vulnerability to illnesses, such as depression, obesity, heart disease”.

He maintained that the symptoms of stress can vary between different individuals, saying, the most common symptoms includes sleep disturbances, muscle tension, irritability, anxiety, depression, tiredness, lack of motivation, difficulty concentrating, change in eating habits, increased use of alcohol or other drugs, unhealthy eating and decreased level of exercise, adding that the symptoms in turn, affect how people deal with the events that cause stress, thereby worsening the stress.

While discussing on the causes of stress, Dr. Olagunju related that certain life situations were more likely to predispose a person to experience stress.

He revealed that surveys have found out that mothers who worked full time had the highest stress levels in the populations surveyed and other situations that could lead to stress were financial pressures, unemployment, work stress, lower education, social isolation, conflict, personal/family illness, and relationship problems.

“The loss of a job may be viewed as a disaster that affects feelings and behaviour. Alternatively, it may be viewed as an opportunity to move on to something better. The manner in which this event is viewed explains the different responses that people have to the same event. Other factors such as personality and previous experience also influence how the event is perceived. Another factor that leads to stress is a mismatch between the experience and the resources available to cope with it. Losing a job, for example, might be a difficult event, but if a person is having difficulties with a relationship in addition to this, then they might not have the support to get through a difficult period, emotionally and financially”.

“Dealing with stress by using various techniques, such as monitoring and challenging the way you think about events and solving your problems in a structured manner. In addition to this exercising, cutting down on drug and alcohol use, and doing things you enjoy can help in coping with stress”.

He however warned that in cases where severe stress leads to depression or anxiety, medications such as anti-depressants might have a role to play.

It would be best to consult your local doctor in such cases, as they will be able to advise you on the suitability of medication, or to direct you to an appropriate professional, Olagunju advised.

Highlight of the programme was the screening for HIV, blood pressure measurement and Hepatitis B screening for members.

One of the technicians who was part of the team emphasized the importance of the screening and noted that it was important to know ones status.

She noted that the HIV screening did not mean that they were living a life of immorality and the negative results that many got did not mean that they should also go ahead and lead a careless life but it was done as a type of precautionary and awareness campaign.

She also explained, knowing ones status in terms of HIV and Hepatitis B will go a long way in determining the health condition as HIV and Hepatitis B were both viral conditions which when left untreated could result in the death of the patients but if treated the patient could lead a normal healthy life.

“High blood pressure is a silent killer which does not respect age, gender or social status. It could be hereditary of environmentally linked, so it is advisable to have blood pressure check every now and then preferably at 2 weeks interval.

“Many people have dropped dead suddenly and we attribute it to spiritual factors but a cursory will later revealed the cause of the death as a result of complications due to high blood pressure. There are no specific symptoms for it but it always result in stroke, heart failure, arterial blockage, paralysis and lastly death if not properly diagnosed and treated”.

General Hospitals’ Doctors, Their Sharp Practices Against Pregnant Women

Chief Consultant Reacts

By Ismaeel Uthman

Allegations of sharp practices against doctors and matrons in General Hospital, Asubiaro, Osogbo, State of Osun and some other government hospitals in the state are becoming a reccurring decimal, making people to lose confidence in the personnels there and the medical services rendered.

Commonly, the doctors are being accused of lackadaisical attitude to patients in the hospital, as they were alleged that instead of giving them (patients) due medical attention, the doctors refer patients to their own various private hospitals for treatment.

OSUN DEFENDER gathered that the referral of patients by the doctors at Asubiaro to their private hospitals for treatment has become a ‘norm’ to enrich themselves at the expense of the medical and financial conditions of the patients.

Some of the medical personnels at the hospital, according to reports, were allegedly working to sabotage the efforts of the government at providing quality healthcare delivery and other services to the people of the state.

Recent findings by the medium have revealed that this unprofessional conduct of the doctors at the hospital is more prominent at the antenatal section of the hospital.

It was gathered that pregnant women do spend three to five hours before being attended to by the doctors and matrons at the hospital.

The medium learnt that some of the doctors and matrons are in the habit of subjecting the pregnant women to inhuman treatment, a situation that frustrate some of them to leave the hospital without medical attention.

Some pregnant women, who spoke with OSUN DEFENDER on condition of anonymity, accused the doctors of negligence and nonchalant attitude for their health status, alleging sabotage, swindling and unethical conducts.

According to the pregnant women, some of the doctors attending to pregnant women usually give them drugs they claim to be anti-malaria, whereas, the drugs tighten pelvic muscles so that such woman in labour would not be able to deliver on her own.

The pregnant women alleged further that the doctors would thereafter inject the pregnant woman to make her weak so as to scare her and her relatives.

As a result, many of the pregnant women who took the drug and are unable to deliver on their own would be referred to the private hospitals of the doctors for caesarean section with a uniform amount of N150, 000.

One of them said: “We are antenatal patients at the general hospital, Asubiaro in Osogbo. Doctors attending to pregnant women in the hospital usually give us drugs claiming it is anti-malaria drugs. These drugs work for the tightening of the vagina so that the woman would not be able to deliver the baby on her own. This is done in conjunction with some matrons at the hospital.

“When the woman in labour is unable to deliver as a result of the non-opening of the vagina, they will tell the patient that they want to help her by referring her to a doctor. They will warn her not to tell the gatemen where she is going to if asked.

“To the surprise of the patient, the doctor would turn out to be the same doctor attending to them at Asubiaro hospital and then tell her that she needs Caesarian Section (CS) which will cost her N150, 000 naira.”

The pregnant woman added that, some of the doctors involved in these ugly practices boast of their ‘connection with security agents and as such they could not be arrested.

According to the pregnant women, some of the private hospitals which the affected doctors allegedly refer their victims to include, Atoke Hospital, Igbona area, Oasis of Grace Hospital beside Ota-Efun Garage and Osogbo Special Hospital, Oke Baale, all in Osogbo.

They challenged anyone to visit the private hospitals listed and interview each of the antenatal patients there on the circumstances that led them to the hospitals.

They stated that as Aregbesola government is working to protect lives of women in the state, the doctors and matrons at Asubiaro hospital are sabotaging his efforts.

“If any woman delivered at Asubiaro hospital, it must have been that the head of the baby was already out before she got to the hospital”, one of them stated.

Our reporter recalled a case of a pregnant woman who was referred to Atoke Hospital located at Baba Omigbodun’s house junction, Owode-Igbona Area, Osogbo last year.

The pregnant woman said she was referred to the Atoke Hospital from Asubiaro where she had been having her antennal and she delivered her baby girl through caesarean section and she was billed N150, 000.

When contacted, the state Commissioner for Health, Dr Rafiu Isamotu said the state government would look into the allegations.

Reacting to the allegations, the Acting Chief Consultant of the hospital, Dr Ola Ibigbami, said, “I do not think that is true”, saying, “some people might want to spoil the name of the people that work here”.

Ibigbami said it is illegal for any doctor to refer patient at general hospital to any private hospital, explaining that a patient could only be referred to higher or specialist hospital with referral letter.

He called on any patient that has fallen victim of such illegal practice to come forward and provide the referral letter, the name of the hospital and the name of the doctor or health worker that made the referral.

He said: “We need to educate our people. They should know that we have Primary Health Centre, Secondary Health Centre and Tertiary Health Centre. If there is something the health workers cannot do at the Primary health centre, they will send you to a comprehensive health centre.

“When you get to comprehensive health centre where you find doctors and nurses, they will send you to a higher place like a state hospital, a state hospital can refer to state specialist hospital and a state specialist hospital can refer to either a teaching hospital in Osogbo here or outside Osogbo.

“To refer a patient requires a referral letter. A referral letter is a legal document. referral is not a wrong thing. If a patient is referred from Asubiaro to Wesley Hospital and the ambulance driver goes to somewhere else, there will not be a letter to cover it.

“The allegation has not been substantiated. We have not been able to see someone who says Mr A is responsible for the conduct. The few cases we had in the past were investigated and the people involved were dealt with. The allegation is not something we should continue to discuss if the people involved cannot produce the referral letter or mention the name of the health workers involved.

“You can challenge somebody that he referred a patient, and the response will be where is the referral letter? Let the people making the allegation come up with referral letter and if they cannot, they should be able to point to the doctor that referred them. We have means to deal with that.”

 

NACA To Establish HIV/AIDS Trust Fund

The National Agency for the Control of AIDS (NACA) has initiated the process to establish an HIV/AIDS Trust Fund, the Director-General, NACA, Dr Sani Aliyu has disclosed.

Dr, Aliyu, who was speaking on Monday at the 4th National Council of AIDS meeting with a theme: “Making our money go further: Improving Efficiency of HIV service Delivery,” said the establishment of the HIV/AIDS Trust Fund is in agreement with the resolution of the last council meeting.

The NACA director general said the Trust Fund would be private driven, where private organizations and individuals will contribute to the fund.

While commending the donor agencies and partners, he pointed out that enormous work has been done within the HIV response since the last council meeting.

He stated that individual, organizational and collective efforts have accounted for the successes recorded and the improvement that has been seen.

Specifically, he acknowledged the contributions of the United States Government, the Global Funds and the World Bank; adding that NACA has gone through a restructuring process to reposition the agency to increase her effectiveness in coordinating the HIV response in Nigeria.

According to him, there is a global evidence in support of the interventions adopted and applied in delivery of HIV services.

He said: “However, we need to make our money go further, by exploring ways to increase our efficiency in the delivery of these services. The theme of the 4th NCA is a call to improve the efficiency of our services across the continuum of HIV care from prevention, to treatment and care services.

The United States (US) Government Representative, Shirley Daddy said as donor funding tightens, Nigeria must find ways to be more efficient, “to make our money work harder, and to achieve more with less.”

She pointed out that this has been their theme at the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) over the past several years.

According to her: “From our perspective, there are several reasons why this may be a positive development. First, a more efficient programme will be more sustainable, second, it will be more cost-effective once the Government of Nigeria takes over the programme at all levels and third, we will be able to locate and peace 150,000 more people living with HIV on live-saving treatment in the coming year, which is, of course, our overarching goal.”

She promised that the United State Government will continue to work with stakeholders to find sustainable ways to support HIV testing and counselling.

Just In: Kogi Doctors Suspend 72 Days Strike

The Nigerian Medical Association (NMA) in Kogi State, has suspended its 72-day old strike to enable further negotiations with the state government.

The Chairman of the chapter, Dr Godwin Tijani, said this on Tuesday in a statement after an Emergency Congress of the Association in Lokoja.

He said the suspension was to honour the NMA National President, Prof. Mike Ogirima who appealed to the congress to suspend the strike, to further dialogue with the state government.

Tijani also said that the congress decided to suspend the strike due to the plea from the general public, coupled with the love the doctors had for the patients.

“All doctors working with Kogi Government are hereby directed to resume work as from Thursday, March 22.

“The Congress also expected the state government to pay the arrears of salary owed its doctors within the next one month and address other issues that resulted in the strike, to avoid another round of strike.

“The congress warned against any form of victimisation of any member of the association that participated in the strike as such action will be resisted by NMA,” Tijani said.

‘’The association, however, commended ‘’the medical elders’’, CMD KSSH, CMD HMB, Special Adviser to the Governor on Health Matters, Dr Attah Ahmed.

‘’We also praise the Commissioner for Health, Dr Saka Audu, all for their role to ensure amicable resolution of the crisis.

Newsmen report that the NMA on Jan. 7, directed its members in all the state hospitals to embark on strike due inability of the state government to meet their demands.

The demands include: “Irregularities in salary payment for doctors. 10 doctors owed salary ranging from four to 15 months, gross underpayment of salaries to doctors with some receiving as low as N35, 000 per month.

“Non-promotion and annual step increment for several years, non-implementation of Revised CONMESS, 60 per cent payment of August to December 2017 salary to doctors while implementing 100 per cent tax deduction from the same salary.

“Retirement of senior doctors yet to attain the statutory age or year of retirement, implementation of ‘No-work-No-Pay’ policy in the ongoing strike by not paying doctors January 2018 salary.”

NAN