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Cholera: Physicians task schools, parents on personal, environmental hygiene

Cholera

By Lilian U. Okoro
Lagos, June 18, 2024 (NAN) Two Lagos-based Physicians have urged parents and schools’ management to maintain optimal hygiene to avoid the spread of cholera.

They gave the advice in an interview with the News Agency of Nigeria (NAN) on Tuesday in Lagos, following the outbreak of cholera in the state and some states across the country.

According to them, this is  necessary since most schools will  resume from mid-term break and the sallah holiday on Wednesday.

NAN reports that on June 9, 2024, the Lagos State Government declared a cholera outbreak as reported by the Emergency Operation Centre (EOC) on June 12.

According to the EOC, 324 suspected cholera cases have been reported in the state, including 15 people who died.

A General Physician Consultant,  Dr  Gerald Chinasa, said the disease could spread fast in schools if preventive measures were not in place.

Chinasa said that pupils, particularly the younger ones, were at higher risk of contracting cholera, a food and water-borne disease caused by the ingestion of the vibrio cholera bacteria.

He advised that parents should be more conscious of how they prepared and packaged their children’s foods, saying that proper personal and environmental hygiene should always be maintained.

According to him, parents should ensure that the cooking utensils, lunch box and cutleries among others are properly washed and rinsed with clean running water.

He suggested the option of giving bottled water to the pupils instead of sachet water while going to school, saying that cholera could easily be contracted through contaminated foods and water.

For the schools, Chinasa reiterated the need for proper environmental sanitation and personal hygiene particularly after using the restroom, within classrooms and at playing grounds.

He emphasised the need for existence running tap water with standby soap for hand washing at strategic points within the school premises.

“For pupils that are very young, their hygiene starts from homes; parents should underscore the importance of personal hygiene particularly when preparing and packaging their foods.

“Parents should ensure that cooking utensils, lunch box and cutleries are properly washed and rinsed under running water.

“In schools, environment and personal hygiene are also key.

“The rest room should be constantly cleaned and sanitised. Regular hand washing at key moments like after using restroom, before and after eating, should be encouraged,” he told NAN.

Contributing, a Consultant Family & Lifestyle Medicine Physician, Dr Moyosore Makinde, cautioned against consumption of contaminated foods and water to avoid contracting cholera infection.

Makinde, also the President of Society of Lifestyle Medicine of Nigeria (SOLONg), said that consumption of contaminated foods and water remained the major means through an individual could contract cholera.

According to her, highly dedicated personal hygiene, which entails safe drinking water and consumables remain the only means to prevent contraction of cholera.

“Cholera is transmitted through food and water that are contaminated with a bacteria called Vibrio Cholerae.

“The recommendations for prevention include hand hygiene, particularly hand washing at key moments after using the toilet and before eating.

“Boiling of drinking water and use of treated water for cooking are also essential.

“Individuals should avoid eating raw food or undercooked foods like seafood and vegetables. Fruits should be thoroughly washed before consumption.

“Environmental sanitation is a critical factor as well; which entails proper disposal of human waste and cleaning of drainages. And the cholera vaccine can also be administered to prevent infection,” Makinde said. (NAN)(www.nannews.ng)
LUC/DE/VIV

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Edited by Dorcas Jonah/Vivian Ihechu

Appraising Nigeria’s health sector in 25 years

Democracy

By Folasade Akpan

Abuja, June 18, 2024 (NAN) As Nigerians revel in the nation’s 25 years of uninterrupted democracy, a cross section of citizens, including stakeholders in the health sector have expressed different views on how the sector fared.

Mr Chibuzor Akpa, a businessman, said the years of uninterrupted democracy has been good for the health sector as it has seen changes that would otherwise have been absent had the nation continued to tow the line of military rule.

According to Akpa, the re-birth of democracy in 1999 brought about health insurance for Nigerians, which has helped to reduce out-of-pocket expenses on healthcare.

He said “though that has only served civil servants, others in the private sector and who make up the bulk of Nigerians are yet to be captured.

“I am also of the opinion that those who are above 18 years, as well as other Nigerians in the private sector or who work for themselves should be captured too so that everyone can benefit.”

For Mrs Victoria Akande, a retired civil servant, democracy is the best thing that happened to Nigeria.

Dwelling on the health sector, she said that in the past, old people were made to wait long hours in the queue before being attended to in hospitals.

She said senior citizens now have their own section and they are promptly attended to, as medical personnel are friendlier with them now.

“I also noticed that there are more and better medical equipment than there were before and the outlook of the hospitals are better and neater than in the past.

“Also, the health insurance system is better now for retirees, we pay N15,000 to access services for one year, which is better than not having access to healthcare like it was in the past.”

As for Prof. Mike Ogirima, the former President of the Nigerian Medical Association (NMA), the last 25 years was a departure from military style of planning and execution of policies.

According to him, the pre-democratic era witnessed diversed health policies acquired from the missionaries and colonial rule.

“However, with democracy, we witnessed health insurance scheme and authority to reduce out-of-pocket expenses on health.

“There were episodes of upgrade of selected tertiary hospitals though with less emphasis on Primary Health Care (PHC) with poor and total lack of secondary level of healthcare in many states of the federation.

“Overall, there is little improvement in the budgetary provision for health at the federal level (4.67 per cent of 2024 budget).

“Few states are however spending close to 15 per cent of their budgets on health with visible impacts”, he said.

Ogirima added that more than before, the health sector is witnessing massive brain drain.

He, however, commended the efforts of the present administration, adding that it is gradually turning the drains into gains through the attraction of specialists from developed centres to provide services in form of outreach and establishment of specialised care centres.

For him, medical tourism is slowly being discouraged, while epidemics are being effectively restricted although with heavy extra- budgetary spending with variable governance issues.

“The present administration will need to do more to saturate the labour market to stem migration by improving the training facilities and motivating human resource for health,” the former NMA President advised.

On his part, the Managing Director of Society for Family Health (SFH), Dr Omokhudu Idogho, said 25 years of unbroken democracy is a commendable step for Nigerians, judging from the benefits and the gains recorded over the years.

He said that prior to democracy in 1999, the health sector was just struggling, with the country being like a pariah nation.

This, he said, meant that a lot of the foreign donor support were not coming in and the resources that were available to respond to health challenges were mostly domestic.

He, however, said that since 1999, there has been significant growth in terms of inflow of resources to support the health sector in different areas.

“We must be honest with significant achievements in certain spaces. For example, infectious disease as a country, I would say, in the last 25 years, we’ve almost moved to epidemic control for HIV.

“We made very giant strides in tuberculosis control and those are things that are commendable and worth celebrating, while immunisation coverage has also gone up in this timeframe.

“We have also seen some moderate increase both in terms of contraceptive prevalence rate, as well as Safe Motherhood as the number of women who actually have care during delivery increased.”

Idogho said though there have been lots of improvements in the sector, there have also been areas of challenge.

He said that in 25 years, with the resources the country has, it could have done better if some of the resources were better coordinated.

“We could have done better if we have had maybe strong leadership within the health sector, in terms of clarity of direction.

“We also must celebrate the moment that at least some of that is slowly coming together with the leadership of Prof. Ali Pate and his team who are now at the helm of affairs in the ministry.”

On the issue of brain drain popularly referred to as ‘Japa Syndrome’ in the health sector, which seems to have increased unlike pre-1999, he said it is a global issue.

According to him, there is need to recognise that human resource is a global phenomenon.

“If you’re looking at the difference between 25 years ago and today, it is an increasing realisation that when you train your doctors, pharmacies, nurses, they become globally mobile.

“It is one of the outcomes of globalisation that you can ply your trade anywhere in the world, which was less so a couple of years back, but it may have been there.”

He, however, said that it’s a situation that should be converted into an opportunity.

“That is really where we should focus on, we have the population, we have the intellect. So, the idea is how do we build pipelines of healthcare workers that will save us as Nigerians?.

“Generate a surplus that would still serve the wider human resource market with a caveat that we do this in a proactive way, so that we get the value of that approach.”

For the Minister of Health and Social Welfare, Prof. Ali Pate, a lot of the developments recorded in the last 25 years occurred in the context of sustained democratic system that allowed interface between different levels of government and everyone in government priority setting.

According to him, health is the responsibility of the federal, state and local governments.

Going down memory lane, Pate told NAN that in 2004, the first National Health Policy was enacted, assigning the responsibility of PHCs to local governments, the states attend to secondary care and support the local governments, while the Federal Government support the states, local governments and PHCs.

The minister said “that phase tried to rationalise the roles and responsibilities of various actors and kicked off the development of the National Health Bill and ultimately the National Health Act that was passed in 2014, signed by President Goodluck Jonathan.

“That National Health Act created a national health system that has continued to develop and with President Bola Tinubu’s administration, his Health Sector Renewal Investment Initiative and the sectorwide approach that we are implementing in the health sector.

“This is the bulk of the reforms that preceded our time, but are now being executed to improve the health outcomes of Nigerians, using the Basic Health Care Provision Fund, which allocates one per cent of the Consolidated Revenue Fund to PHC Centres to make them functional.

“In addition, with the democratic process that we’ve been implementing, the National Health Insurance Scheme gradually evolved and in 2022, became National Health Insurance Authority (NHIA) that mandated insurance for everyone.”

Pate also said that the NHIA created the vulnerable group fund that is now expanding to ensure that healthcare services are affordable for the majority of Nigerians for the poorest and vulnerable to also be protected.

He added that there is also the expansion of the health infrastructure through federal teaching hospitals, with several of them being expanded, while institutions like the National Centre for Disease Control deals with public health crisis.

He noted that in terms of public health intervention, Nigeria has made tremendous progress in vaccination against critical diseases like polio and eventually eliminated the Wild Polio Virus.

He said that moving away from military rule has seen health policies being developed under a democratic dispensation, while in a non-democratic setting, it’s primarily by fiat and as directed.

He recalled that before 1999, many development partner support to Nigeria had exited the country, but with the re-installation of democracy, the confidence of Nigerians was enhanced.

He said “there is a sense of positivity that wouldn’t have happened if we had a dictatorship.

“This year, we have our president as Africa Union Champion for Health, Human Resources, as well as for community health delivery, chosen by the African Union Heads of States.

“We have the Africa Centre for Disease Control that has established office here in Abuja, and the President was gracious to give them a location.

“We have ourselves here representing the Nigerian Ministry of Health and Social Welfare, elected by the West and Central Africa to serve as representative of the region in the Global Fund Board in Geneva, Switzerland.

“These are all because we have a democratic dispensation.”

Envisioning another 25 years of the health sector in a democracy, Pate said he shares the President’s vision that in 25 years, Nigeria’s youthful population would be healthier.

He also said that the health system would have developed with a strong public sector, as well as a strong private sector and that the nation would be able to manufacture drugs, commodities, devices that it uses.

“We will have robust health infrastructure and equipment that other countries in the region and perhaps even globally can come to Nigeria and seek for healthcare services, and that many of our citizens that are in the diaspora will find it comfortable to come back home.

“Those who are leaving will find no reason to leave, and the country will be on its path to greatness, as envisioned by the President and the work that his administration is doing across sectors, including health and social welfare.” (NAN) (www.nannews.ng)

FOF/HA

Edited by Hadiza Mohammed-Aliyu

Experts suggest early cancer screening for successful treatment

Cancer

By Justina Auta

Abuja, June 18, 2024 (NAN) Medical experts have encouraged Nigerians, especially women and girls, to engage in regular screening for early detection and successful treatment of cervical cancer.

They made the call during a zoom meeting organised by AIDS Healthcare Foundation (AHF) Nigeria and partners, on Tuesday in Abuja.

The zoom meeting had the theme: “Understanding Cervical Cancer and Its Intersection with HIV”.

The partners include John Hopkins Programme for International Education in Gynecology and Obstetrics (JHPIEGO), National Agency for the Control of AIDS (NACA), Institute of Human Virology, Nigeria (IHVN) and GirlsAct.

Dr George Ikaraoha, JHPIEGO Advisor on Pre Exposure Prophylaxis (PREP) and Cervical Cancer Prevention Programme (CECAP), explained that cervical Cancer was a malignant tumor of the lower-most part of the uterus.

He added that cervical cancer could be prevented and treated if detected early.

Ikaraoha identified Human Papillomavirus (HPV) Infection, early sexual activity and multiple sexual partners, smoking and immune system deficiency as factors that contribute to cervical cancer.

Ikaraoha also identified long-term use of oral contraceptives, having many children, poverty, poor access to healthcare services, as well as information amid cultural beliefs as other factors.

He, therefore, encouraged regular screening as crucial for detection and treatment of precancerous conditions before they developed into cervical cancer.

“By understanding the risk factors and adhering to recommended screening schedules, women can significantly reduce their risk of developing cervical cancer and improve their chances of successful treatment, if cancer does occur,” he said.

Ms Omoseke Bamijoko, an Antiretroviral Therapy (ART) Nurse with AHF, also stressed the need for early diagnosis, which she explained would enable experts detect and treat cancer successfully.

She said: “Women living with HIV are more prone to cervical cancer and as such should go for screening every three years while others can be screened every five years.

“Also, the public should desist from stigmatising people to enable them access health care.”

She urged girls and women to seek health professionals, when they observe unusual bleeding, increase in foul-smelling vaginal discharge, persistent pain in the back and leg or pelvic.

Others, she said are weight loss, fatigue and loss of appetite, vaginal discomfort, swelling in the legs among others.

Dr Lois Maji, a Programme Officer with IHVN, advised young girls to take advantage of the Federal Government’s free programme on HPV screening and vaccine to protect themselves against cervical cancer.

She emphasised  that early detection would not only reduce the burden of cervical cancer in Nigeria but would also prevent genital warts and other genital growths in women and girls.

Mrs Menakaya Atenchong, senior nursing officer with AHF, called for more investment and affordable healthcare services, public education, engagement of community leaders and utilising culturally sensitive approaches to enhance cervical cancer screening and treatment services.

Mr Steve Aborisade, AHF Nigeria Advocacy and Marketing Manager, said that cervical cancer and HIV were significant public health issues that disproportionately affect women, particularly in resource-limited settings.

Aborisade said the meeting was organised to acquaint participants with information on the relationship between HIV and cervical cancer.

“This will also enable us discuss preventive measures, and to share the latest research and strategies for effective management and support,”he said.

The News Agency of Nigeria (NAN) reports that over 160 participants from across the country joined the meeting. (NAN)

JAD/OJI/AMM

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Edited by Maureen Ojinaka and Abiemwense Moru