Cancer. It is a dreaded word that strikes fear into the heart of
people. The World Health Organization (WHO) reported about 14 million
new cases and 8.2 million deaths in 2012 related to cancer. It is the second most common cause of death in developed countries and among the three leading causes of death in developing countries. In Nigeria,
it is estimated that over 71,000 people die each year from cancer
related causes, with about 102,000 new cases diagnosed each year. A neglected arena of public health in Nigeria
Faced with the second highest burden of HIV in the world, an
increasing incidence of tuberculosis, a health care system that is
unable to provide primary care, cancer has not been high on the list of
priorities in Nigeria. Very little is being done on prevention and even
less on establishing excellent treatment centers that can cater to the
growing number of cancer cases in the country. There are a few treatment
centers for cancer and cancer related illnesses but they are always in
the news for the wrong reasons – a failure of their radiotherapy
infrastructure.
National Hospital Abuja currently has the only functioning radiotherapy machine in Nigeria. Photo source: olisa.tv
In a country of over 170 million people there are only nine radiotherapy facilities, and (as at October 2015) the only functioning machine
is at National Hospital, Abuja. The effect of such poor cancer services
is expensive medical “tourism” for those who can afford to get care
outside the country, or turning to private hospitals, traditional
healers and religious leaders, for the many Nigerians who cannot afford
to travel. By and large, cancer treatment and care in Nigeria is sorely
inadequate.
Cancer treatment is expensive. With the fragmented nature of private
medical care, we are mainly reliant mainly on provision of care services
by government facilities. These currently lack the funding, support and
management capacity needed to bring consistent, high quality care to
the average Nigerian cancer patient. Changing the cancer treatment story in Nigeria
When government fails, as is so often the case in Nigeria, the
private sector steps in. There are a few examples of groups that finding
innovative approaches to the provision of care. We have highlighted a
few in the past such as “Kidney Solutions” providing renal care and D&TEC
providing endoscopy services, both in Lagos. One new organization that
is passionate about changing the situation with cancer in Nigeria is the
Lakeshore Cancer Center in Lagos. It is taking a series of steps to become the most comprehensive cancer care and treatment center in Nigeria.
Dr. Chumy Nwogu is the CEO of Lakeshore Cancer Center, Lagos. Photo Credit: Nigeria Health Watch
The center began in July 2014, and is the dream-child of Dr. Chumy
Nwogu, a U.S. trained Thoracic Surgical Oncologist. Nwogu began his
journey at the University of Nigeria Nsukka (UNN), and still works
part-time at the Roswell Park Cancer Institute in Buffalo, New York, when he is not in Nigeria.
Nigeria Health Watch recently visited Lakeshore Cancer Center, to
talk to some of its pioneering staff. We met with Dr. Oge Ilegbune, the
Center’s in-house general practitioner, to discuss the ways in which the
Center is working to improve the access to quality cancer care services
in Nigeria. Ilegbune, who herself returned to Nigeria in September
2014, said Nwogu wanted a “comprehensive cancer center in Nigeria
because he found that cancer care was being done in patches. It was a
case of trying to get cancer care under one roof, a bit like what
Roswell Park does.”
The need for such a comprehensive center is obvious, Ilegbune
asserts. “In Nigeria, you have a lot of private hospitals that do
sporadic chemotherapy and some even invite oncologists to come in to
manage the odd patient. Some teaching hospitals have their oncology
departments, but it is one of several services,” she said. “Until
now, there hasn’t been this sort of coordinated care, where you are
doing not only cancer treatment and chemotherapy, but also cancer
education and awareness and prevention all under one roof.”
A private chemotherapy treatment room at Lakeshore Cancer Center, Lagos. Photo Credit: Nigeria Health Watch
Lakeshore services include cancer consultations, chemotherapy, as
well as palliative care for cancer related illnesses. “If a patient goes
to India for treatment and returns to Nigeria, and needs to continue
their regimen, we care for that patient,” Ilegbune said, adding that
“It’s expensive and emotionally draining for someone to leave their
country and go to another country to stay for an extended time while
getting treatment. There are financial and emotional implications, many
patients cannot afford to be away for too long, so when they return,
they need a place to go. In the long term, we hope that there will be no
need for them to go at all, as we hope to be able to provide for all
their care”. And this is what Lakeshore offers. A place for those
dealing with the complex and difficult care and treatment of cancer to
go to, here in Nigeria, and receive world class care from concerned and
expert staff.
Since June of this year, Roswell Park is officially affiliated to the
Lakeshore Cancer Center. Roswell Park Cancer Institute is one of the
most renowned cancer research and treatment centres in the world. “Dr.
Nwogu is here in Lagos every six to eight weeks, and when he is here he
carries out surgeries and provides specialist care,” Ilegbune said,
adding that, “We have an affiliation with other specialties at Roswell
Park, who are available when patients request a second opinion from a
known cancer institute.”
The Center recently hosted a team from Roswell Park, who spent a week
doing in-house training for staff as well as training nurses at LUTH
and UCH Ibadan. The Center has also held a Continuous Medical Education
(CME) course with LUTH and Pathcare. Ilegbune says continuous
development is part and parcel of Lakeshore’s vision. “We do not just
want to achieve excellence in our centre, but to support those working
in other centres, especially the public sector.”
A pharmacist at the Lakeshore Cancer Center Lagos. Photo Credit: Nigeria Health WatchBeyond cancer treatment alone
Besides treatment, Lakeshore offers prevention services such as
cervical cancer screening. Early detection is an important part of
reducing cancer prevalence in Nigeria. Ilegbune said her team is
advocating for cancer screening to be covered under the insurance
packages of Health Maintenance Organisations in Nigeria. “We are in the
process of getting advocacy groups to recognise that lots of HMOs in
this country do not have cancer screening on offer, which leads to a
situation where patients end up paying a lot more in the long term for
care. She said a “nationally recognized screening program” for certain
cancers will help bring down the incidence of cancer in Nigeria. “In the
UK or US, women get a letter when they turn 40 to come in for their
mammograms, and it’s the same thing with a pap smear, when at 25, and
subsequently every three years to come in for cervical screening. It’s
already built into the system,” she said.
She adds that Lakeshore hopes to “set up a directory that anyone who
passes through us for any type of screening can be reminded at the
appropriate time to come for subsequent screening appointments.”
She notes that government support is key, as well as private
investment, if Nigeria is going to one day be known for excellent cancer
treatment centers. “At the end of the day, it’s going to have to be a
collaborative effort,” she says, adding, “It can’t be the public sector
alone, it can’t be the private sector, there’s got to be some sort of
merge, some sort of relationship between the two, to get it going.”
from: Nigerian Health watch November 3, 2015
Oncologist advocates free cancer treatment in Nigeria
Posted By: Rosemary Nwisi, Port Harcourton: in THE NATION: news update
The
head of Oncology Department of the University of Port Harcourt, Dr.
Rawlings Jamabo, has appealed to the Federal and state governments to
provide free cancer treatment for patients in Nigeria, as a measure to
reduce the high rate of cancer related deaths in the country.
Jamabo, made the appeal while addressing newsmen in Port Harcourt on the forth-coming World Cancer Day, February 4.
He said the call/appeal has become necessary following the increasing
cases of the ailment in the country, followed by its high cost of
treatment, which according to him is beyond the financial capacity of
Nigerians.
The coordinator of Cancer Therapy in the University however blamed
the rising cases and death toll of victims of the disease in the country
on the ability of patients to report early in hospitals apparently for
lack of money.
He noted that patients of the disease would report early for
treatment, should they realise that the treatment is free as is done in
developed countries of the World.
— Feb 15, 2016 10:16 am
The Nigerian Medical Association (NMA), Niger State branch
has defended its members against criticisms that doctors who are
permanent scretaries earn more in the state civil service.
The Association in a statement signed by its chairman, Dr Usman
Abubakar, yesterday in Minna noted that they were in support of the
screening exercise embarked upon by the state government but frowned at
the allegations leveled against their senior members
.”We frown at the malicious allegations against any of our members,
especially senior colleagues that have distinguished themselves in
service to the state over the years” the statement read in part.
The statement explained that there are circulars defending the earnings of the said permanent secretaries.
“ Doctors in Nigeria, Niger State inclusive, are on Consolidated
Medical Salary Scale (CONMESS), which clearly states what allowances are
due all doctors based on levels, qualifications and appointments”.
According the NMA: ‘‘That a doctor is appointed a permanent secretary
does not change his status as a medical doctor nor stops his or her
clinical practice, considering the fact that most of them are
specialists, whose services are still very much needed in our hospitals
and hence the need to earn professional allowances”.
The doctors argued that the said doctors still discharged their
duties as medical doctors in government hospitals in the state despite
their administrative position hence they were entitled to some of the
allowances.
They demanded that NMA be represented in the screening body and also
part of investigations in some of the allegations made against their
members.
A good nurse is the best a human
being can be.’ How true? To be able to reduce misery and save lives is
the most incredible feat good nurses achieve on a daily basis. Nurses
have the enormous privilege of touching and changing lives. I know Jesus
died a long time ago, but good nurses perform miracles every second of
the day. It requires an awesome level of conscientiousness.
So, what makes a good nurse?
A
cousin of mine rushed his father to the emergency room with acute
retention of urine. The man could not pass urine due to obstruction
caused by an enlarged prostate gland. A nurse came out, took one look at
the old man and called the son aside. “Your father is dying,” he said.
“You should go and buy a big cow to celebrate his long life.”
I
asked him to remove his father to another hospital immediately. At the
new hospital, the nurses asked the right questions, examined the patient
and passed a urinary catheter. The patient felt immediate relief. His
blood pressure settled and he stopped sweating profusely while he
suddenly found his voice. He lived for much longer and the family did
not buy a cow!
There are many qualities that make a good nurse but humanity, curiosity and professionalism are the key values.
Humanity
A
good nurse is a human being who can relate to others as if they are
members of a family. Once you see your patients as an extension of your
own humanity, you will go that extra mile to do the best you can for
them. The question that really great nurses often ask is: ‘What if this
was my family?’Once you answer that question correctly, you would move
mountains.
Studies
show that having a warm and accessible nurse not only makes you a more
satisfied patient, it also has another important benefit. Experts say
when patients trust their nurse, they are more likely to adhere to
treatment plans and follow advice. They add that if you’re looking for a
good nurse, start by looking for a human being who cares about people. A
good nurse must be able to treat all patients equally, regardless of
their ethnicity, lifestyle choices or conduct. The job is to treat your
patients, not to judge them.
A
good nurse is not looking for a community that can support his/her
needs. Rather, he or she is looking for a community that desperately
need his or her attention. It is an altered mindset looking for who you
can help with compassion and your expertise. This is different from many
who work in our hospitals or areas where they hunger to get the most
pay for the least amount of work. Such nurses often have little respect
for people and are largely unsupportive when they are truly needed.
Curiosity
A
good nurse has fine manners and excellent communication skills. It is
not enough to know your job and do it well; you are in a wrong
profession if you have terrible bedside manners and lack empathy. A
nurse’s ability to explain, listen and empathise has a profound impact
on a patient’s care. A good bedside manners is simply good medicine.
The
best nurses always ask courteous questions, let people talk, and listen
to them carefully. They give unbiased advice, let people participate
actively in all decisions related to their health and health care,
assess each situation carefully, and help whatever the situation is.
Many
patients tell us what is wrong with them and exactly where the problem
is, in many situations. Usually, you might find that you have a rough
idea of what is wrong with your patient within the first minute of their
visit, but until you’ve dug deeper and got a real understanding of
their situation, you will not be able to treat them to the best of your
ability. Listening and hearing exactly right is therefore fundamental to
making the right diagnosis. If you are distracted, you could miss vital
clues.
Professionalism
This
is of utmost importance, along with your skills. It is critical that
you behave well and maintain a professional distance from your patients.
They need to feel safe in your company to disclose information at their
discretion, and they need to be sure that anything they say will not be
broadcast. Nurse/patient confidentiality is extremely important and it
has been a fundamental strand of nursing ethics.
If
a patient feels they are being cared for by the right nurse who has
taken an interest in their well-being, their body will suppress their
awareness of pain and they will experience faster recovery. And,
conversely, the stress of having a bad nurse who doesn’t show an
interest can actually prolong the patient’s suffering.
Finally,
the nurse should be a human being, happy, healthy, caring and
competent. They should have a balanced life and care for themselves and
their families too.
NB:
There is a real need to train and test nurses in interpersonal and
communication skills in Nigeria. Therefore, we have started improving
nursing standards courses in Abuja. The workshops and lectures on all
aspects of nursing take place every Saturday. Run by two great nurses,
Joy Ugochukwu and Cecilia Nwankwo, they hope to elevate nursing care to
lofty heights. See Facebook for more details.
Find below NMA's open letter to the Inspector General of Police on the disruption of the peaceful protest embarked upon by members in Imo State:
OPEN LETTER TO INSPECTOR GENERAL OF POLICE
REF: NMA/PRE/SG/02/01038
9th February, 2016.
Inspector General of Police
Nigerian Police Headquarters
Louise Edet House,
Abuja
Dear Sir,
A CALL FOR A PROBE AND RESTITUTION ON THE VIOLENT DISRUPTION OF A PEACEFUL PROTEST EMBARKED UPON BY MEMBERS OF NIGERIAN MEDICAL ASSOCIATION IMO STATE ON THURSDAY 4TH FEBRUARY 2016 BY MEMBERS OF THE NIGERIAN POLICE FORCE IN OWERRI IMO STATE.
The attention of The Nigerian Medical Association has been drawn to the incidents leading to lethal violence meted out to medical doctors and resulting from the botched attempts of members in Imo state chapter to bring to the notice of the state governor Owelle Rochas Okorocha and the entire citizens of the state the negative developments unfolding in the public healthcare delivery sector in Imo state on Thursday 4th February 2016.
The national secretariat of the noble association is aware as we gathered that the officers of the Association in the state sought and got the cooperation of the state command of Nigerian Police Force to enable them embark on the peaceful demonstration without violence or rowdiness should infiltrators from members of the public join the group.
NMA is therefore in shock that an orderly procession of unequivocally identifiable members of the medical profession who have previously sought and gotten the assurance of protection from the police could be so assaulted with tear gases and other forms of brutality leading to the infliction of a deadly injury to the head of one of them.
The Nigerian Medical Association wishes to state that the action of the police in contradiction to the provisions of the 1999 constitution as amended in chapters 39 & 40, and various judgements of the competent courts of jurisdiction in Nigeria including the Court of Appeal as it concerns the inalienability of the citizens? right to Peaceful Assembly and Association; freedom of Movement and those of Thought and Conscience, is unfortunate and shocking. Our Association also recognises that whereas democracy guarantees the expression of dissenting opinions through protests, rallies and demonstrations as long as the people do not constitute themselves into an unholy assembly or riotous crowd, the brutal dispersion of doctors? peaceful march is unbecoming of an organisation that is statutorily entrusted with the protection of lives.
In the light of the foregoing therefore, NMA as a law abiding professional association wishes to state unambiguously that the draconian, vindictive and violent action meted out to our members who were simply bemoaning their fate in the face of the mistreatment they are subjected to by Imo state government stands condemnable before all men and women of good conscience.
The Association therefore demands as follows;
i. The police officer and his/her commander who fired/ ordered the firing of the near fatal missile that injured our member Dr.Bede Azudialo be identified and subjected to appropriate action according to the law; and the hospital bills incurred in the course of his treatment be borne by the so-identified officer/s.
ii. All expressed as well as conceived threats against the executive and other members of NMA in Imo state be withdrawn immediately and their safety guaranteed as law abiding citizens of Nigeria are entitled to.
iii. The erring officer and/or the Imo state Command of the Nigerian Police Force should offer an unreserved apology to Dr. Azudialo, Imo state chapter of the NMA and Nigerian doctors in general.
iv. That on no account should members of the Association again in the future be harassed and threatened with death in the hands of the members of the Nigerian Police Force in Owerri, Imo state or any other parts of Nigeria; while admonishing the state police command not to take sides unnecessarily with the state government on issues of labour unrest as our members and other citizens of Nigeria have a guaranteed right under the constitution to say no to oppressive, repressive and draconian policies of the government.
We wish to restate that Nigerian Medical Association acknowledges the precarious nature of various stresses the nation is facing today and would always work as partners with government and her agencies towards rebuilding our nation from its foundations. It therefore behoves on us as the custodians of the peoples? health to say no whenever certain policies that are inimical to the availability, affordability and efficiency of healthcare are formulated and implemented in any part of the country.
Please be assured of the regards of our highest esteem as we join hands to build a better, safer and progressive nation.
Yours faithfully,
Signed:
Dr. Kayode OBEMBE Dr. Adewunmi ALAYAKI
President Secretary General
Nigerian Medical Association Nigerian Medical Association
Cc:
Honourable Minister of Health
Honourable Minister of State for Health
Governor of Imo State
Commissioner of Health, Imo State
Director of State Security Service
Chairman, NMA Imo State.
Electrical shocks always need emergency medical attention -- even if the person seems to be fine afterwards.
Call an emergency line, most countries have dedicated line for emergencies e.g 911, for country who do not have call for nearby help (medical or not) if available.
Your safety is the most important: use the first 30 second to 1 minutes to observe, think then act.
Check the environment :
Type of current (high or low voltage)
the source and the switches,
look for wetness,
nearby metal (conductors) ,
non conductors,
the victim(s) position in relation to the environment,
the condition of the victims (breathlessness, convulsion etc)
1. Separate the Person From Cur rent's Source
To turn off power:
Unplug an appliance if plug is undamaged or shut off power via circuit breaker, fuse box, or outside switch.
If you can't turn off power:
Stand on something dry and non-conductive, such as dry newspapers, telephone book, or wooden board.
Try to separate the person from current using non-conductive
object such as wooden or plastic broom handle, chair, or rubber doormat.
If high voltage lines are involved:
The local power company must shut them off.
Do not try to separate the person from current if you feel a
tingling sensation in your legs and lower body. Hop on one foot to a
safe place where you can wait for lines to be disconnected.
If a power line falls on a car, instruct the passengers to stay inside unless explosion or fire threatens.
2. Do CPR, if Necessary
When you can safely touch the person, do CPR if the person is not breathing or does not have a pulse.
Begin CPR if the person shows no signs of circulation, such as breathing, coughing or movement.
3. Check for Other Injuries
If the person is bleeding, apply pressure and elevate the wound if it's in an arm or leg.
There may be a fracture if the shock caused the person to fall.
Try to prevent the injured person from becoming chilled.
Apply a bandage. Cover any burned areas with a sterile gauze
bandage, if available, or a clean cloth. Don't use a blanket or towel,
because loose fibres can stick to the burns.
4. Transport the victims to hospital.
an ambulance is preferable, use other safe means if not available
5. Follow Up
A doctor will check the person for burns, fractures, dislocations, and other injuries.
An ECG, blood tests, urine test, CT scan, or MRI may be necessary.
The person may be admitted to the hospital or a burn centre.
The danger from an electrical shock depends on the type of current,
how high the voltage is, how the current travelled through the body, the
person's overall health and how quickly the person is treated.
An electrical shock may cause burns, or it may leave no visible mark
on the skin. In either case, an electrical current passing through the
body can cause internal damage, cardiac arrest or other injury. Under
certain circumstances, even a small amount of electricity can be fatal.
A person who has been injured by contact with electricity should be seen by a doctor.
Caution
Don't touch the injured person if he or she is still in contact with the electrical current.
Call your local emergency number if the source of the
burn is a high-voltage wire or lightning. Don't get near high-voltage
wires until the power is turned off. Overhead power lines usually aren't
insulated. Stay at least 20 feet (about 6 meters) away — farther if
wires are jumping and sparking.
Don't move a person with an electrical injury unless he or she is in immediate danger.
When to seek emergency care
Call 911 or your local emergency number if the injured person experiences:
Severe burns
Confusion
Difficulty breathing
Heart rhythm problems (arrhythmia)
Cardiac arrest
Muscle pain and contractions
Seizures
Loss of consciousness
Take these actions immediately while waiting for medical help:
Turn off the source of electricity, if possible. If not, move
the source away from you and the person, using a dry, nonconducting
object made of cardboard, plastic or wood.
I
asked him to remove his father to another hospital immediately. At the
new hospital, the nurses asked the right questions, examined the patient
and passed a urinary catheter. The patient felt immediate relief. His
blood pressure settled and he stopped sweating profusely while he
suddenly found his voice. He lived for much longer and the family did
not buy a cow!