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Corruption in the Nigerian health sector has many faces. How to fix it

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Dr Chinyere Mbachu

Countries plagued by corruption can attest to the fact that, once it becomes entrenched, it can be found in all sectors of an economy. But in low and middle income countries the health sector is particularly vulnerable, according to Transparency International. This is because competence and integrity are undermined by poor working conditions and weak systems.
This rings true for Nigeria. The challenge is that there’s no clarity on what constitutes corruption in the country’s health sector or the different ways in which it manifests.
In many instances, practices that should be considered corrupt – like offering bribes and diverting patients to their private practises – are accepted as normal. And it’s difficult for researchers and policymakers to agree on what corruption is – and how to tackle it – given that measures designed to stop it from happening don’t distinguish between illicit practices, corruption and poor governance.
This scenario is commonplace in low and middle income countries like Nigeria. The impact is clearly visible in critical development indices such as life expectancy and education.
We were part of an anti-corruption consortium led by the School of Oriental and African Studies that looked at corruption in the health sector in Nigeria. As part of our study we set out to find the five corrupt practices that most affected the delivery of health care services. We identified them as: absenteeism, procurement-related corruption, under-the-counter payments, health financing-related corruption and employment-related corruption.
The list of corrupt practices all affect the standard of care that patients received.
Based on these findings, we believe that it’s perfectly feasible for government to put policies in place to tackle all five practices. All it requires is the political will to put the necessary policy and regulatory frameworks in place.

How we did it

There were three parts to our study. First we did a systematic review to identify a list of types of corruption that had been identified previously in the health sector.
We then compared this list with one from frontline health workers in the public sector who had a wealth of experience between them. These included doctors, nurses, pharmacists, medical laboratory scientists, radiographers and midwives based at tertiary, secondary and primary health facilities in Abuja and Enugu states. Most were frequently exposed to corruption and were very aware of how it had become embedded in the health system.
After identifying the most prevalent practices we asked this cohort of people to identify the practices that would be most feasible to address given Nigeria’s current political context as well as its regulatory frameworks.
In the third part of the study we engaged senior health care managers and policy makers to ask them to discuss the list of corrupt practices we’d identified. They also provided very useful suggestions on how each one could be tackled.

Our findings

The front line workers, senior managers and policymakers were able to identify what was driving the corrupt practices. They also offered ideas on how to address them.
Some of the practices were more difficult to tackle than others. For instance, procurement-related corruption was found more complicated to address because it usually involves a number of actors including sale representatives, doctors, auditors and pharmacists.
Employment related corruption, such as employing unqualified people, was also considered difficult to manage as the government directly employs workers at public facilities.
Absenteeism topped the list as the most prevalent type of corruption as well as one that was the most feasible to address. It was mostly driven by health care workers’ wanting to make more money by running their own practises and there being no rules around it.
The problem could be addressed by getting managers to monitor clocking-in and out processes, applying rewards and sanctions, salary increases and allowances as well as providing health workers with accessible transportation services. Allowing more flexibility in workers’ contracts would also reduce the practise.
Patients were more prone to make under-the-table-payments in secondary and primary healthcare centres to get served quicker and to get unauthorised medicines. Patients were clearly uninformed about the dangers of using unauthorised medicines. The practices appeared to be driven by inadequate staffing and workers’ need for money.
The practise could be reduced by informing patients and health workers about the dangers of using unauthorised medicine. In addition, regular audits, and decentralised distribution, would have also have a dramatic impact.
We found a range of corrupt practices when it came to payments. These included patients being over billed, unnecessary and unprofessional check-ups being carried out, irregular payments to the National Health Insurance Scheme as well as health providers and health workers issuing fake receipts.
These practises could be curtailed by making the price of health services public, instituting electronic payment mechanisms and introducing suggestion boxes.

What’s next

In many countries, health systems unknowingly create incentives for health workers to engage in corrupt practices. This leads to inappropriate and ineffective care for patients and translates into high costs and poor outcomes for those in need of care.
The proposed solutions could help address these practices. But they can’t be implemented through a top-down approach because health workers are likely to resist them. Instead, health workers, managers and the facilities needed to agree on what action needs to be taken that there’s buy in.
The interventions will still need to be fine-tuned. But ultimately they could all be implemented in the Nigerian health sector to eliminate corruption among frontline health workers.

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Volunteering at ECWA Hospital Egbe

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Peter Gregor, MD, serves as a cardiologist in Kentucky. Possessing more than four decades of experience, he is familiar with a wide range of cardiology treatments in outpatient and inpatient settings. An active philanthropist, Peter Gregor, MD, supports multiple organizations, including ECWA Hospital Egbe in Nigeria.
A 75-bed complex, ECWA Hospital Egbe provides a wide range of care at its 33-acre campus. Church groups, individuals, and families are encouraged to volunteer with the organization on a short-term basis through the hospital’s many non-medical opportunities.
Through these volunteer positions, dedicated individuals and groups can provide hands-on support to the hospital’s revitalization project, community development efforts, and hospital development efforts. The hospital seeks volunteers of all skills, including carpenters, general maintenance personnel, mechanics, plumbers, and roofers. Volunteers with organizational skills are also welcome.
People with medical experience can volunteer at ECWA Hospital Egbe through either a short-term or post-residency program offered by World Medical Mission. Short-term volunteer opportunities are designed to give Protestant dentists, physicians, and other medical professionals the chance to volunteer for at least two weeks. Meanwhile, the post-residency program is designed to give post-resident physicians a chance to work alongside a team of Nigerian physicians and mentors for at least two years.


Peter Gregor MD
Dr. Peter Gregor practices in Owensboro, Kentucky, consulting in inpatient and outpatient settings, & performs stress tests, echocardiograms, and stress echoes.

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NDLEA: Abuse of Tramadol, cough syrup still high among Nigerian youths

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By Prudence Arobani/New York

The National Drug Law Enforcement Agency (NDLEA) has decried the continuous high-level of abuse of Tramadol and codeine based cough syrup among Nigerian youth and women.
NDLEA Chairman, retired Col. Muhammad Mustapha Abdallah, said this while delivering Nigeria’s statement on ‘Crime Prevention, Criminal Justice and World Drug Problem’ at the UN General Assembly at the UN headquarters, New York.
Abdallah said: “Nigeria is witnessing a high level of abuse of tramadol and cough syrups containing codeine, especially by vulnerable youths and women.
“This is a phenomenon common to many countries in the West-African sub-region which has ushered in a new level of transnational organised crimes.
“As a result, a lot of national and sub-regional initiatives, including capacity development, have been put in place to address the situation”.
Abdallah reiterated Nigeria’s commitment to fulfilling its obligations under relevant international instruments in the area of crime prevention, strengthening criminal justice and addressing world drug problem.
Given the linkage between drug abuse and crime perpetration, he said, Nigeria had stepped up the implementation of measures to combat the incidence of drug proliferation, trafficking and abuse.
”This is based on our conviction that strong national commitment and effective international collaboration and partnership are very critical to eliminating the menace of illicit drug flows, ”he stressed.
According to him, the agency is implementing a robust National Drug Control Master Plan (NDCMP 2015-2019) to address illicit drug supply and demand.
The NDLEA boss added that the agency was also countering money laundering and access to controlled narcotic drugs for medical and scientific purposes.
He said the ‘UNPLUGGED’ evidence-based school preventive programme that targeted ages 10 to 14 years instituted in 2016 had witnessed the enrolment of 65 schools in its pilot project.
UNPLUGGED is an evidence-based programme designed to equip young people with specific skills and resources that they need to resist social influences and to support knowledge about drugs and their adverse health consequences.
Abdallah noted the availability, access and control of narcotic drugs, psychotropic substances and precursor chemicals for medical and scientific purposes.
He said the Nigerian Government had produced guidelines, in tandem with international standards, on realistic estimation and quantification needs assessment for required Narcotic drugs, psychotropic substances and precursors for medical and scientific purposes.

 

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Cross River Begins Free Eye Tests, Surgeries For 250,000 School Children

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No fewer than two hundred and fifty thousand school children across different communities of cross river state will benefit from the free comprehensive child eye project in the state.

The project which is with the support of the Central Bank of Nigeria has Cross River as one of the eleven states as beneficiaries in Nigeria.
Speaking during the commissioning of the edifice that will house the eye care project in Ikom local government area, director general of cross river state primary healthcare development agency, Betta Edu said the project will provide free quality eye care services for children between ages one to fourteen.

Edu who said cross river has invested heavily in providing quality healthcare delivery to the rural communities as one of the priority of Ayade- led government urged the people in the hard to- reach- areas to key into the programmes.
On their part, the representatives of the health workers and beneficiaries of the free eye programme commended Governor Ayade for providing health services to the rural communities.
They said thousands of pupils and students with various eye problems will benefit from the project.
The eye care project which will end by December 2019, will provide free eye services, including surgeries, free eye glasses and medications as well as low vision devices, health education and promotion among others.

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WHO vows tighter, broader actions against tobacco industry

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GENEVA– The World Health Organization (WHO) unveiled a global strategy on Saturday to scale up the tobacco control agenda over the next few years and to prevent further interference by tobacco industry in public health policies.
The strategy, titled the Medium-Term Strategic Framework (MTSF), aims to strengthen implementation of the WHO Framework Convention for Tobacco Control (FCTC), with a roadmap to guide the work of the convention parties, the secretariat and other stakeholders with regards to tobacco control from 2019 to 2025.
“The adoption of this strategy marks a key milestone in strengthening the FCTC,” said Dr. Vera Luiza da Costa e Silva, head of the WHO FCTC Secretariat.
“This strategy provides a very clear path forward, with priorities and objectives to reinforce government policies and accelerate global action for more effective implementation of the tobacco control treaty.”
The strategy was concluded during the eighth session (COP8) of the FCTC, which brought together over 1,200 participants, including delegations from 148 parties to the global tobacco control treaty and representatives of UN agencies, other intergovernmental organizations and civil society.
They also agreed to maximize transparency to protect FCTC related sessions and proceedings from the intrusion of tobacco industry representatives and interests.
“More than ever, we need to stay the course and strengthen our commitment to ensure that FCTC efforts to protect and promote public health and sustainable development are not hijacked by the tobacco industry,” Dr. Costa e Silva said. “We must yield no ground to the tobacco industry.”
To prevent further interference by tobacco industry in public health policies, the strategy requires parties to the treaty to protect national public health policies “from commercial and other vested interests of the tobacco industry.”
In addition to tighter control actions, the parties also addressed the need for tobacco control efforts to integrate strategies to combat the destructive impacts of tobacco on the environment and sustainable development.
Since it came into force in 2005, the FCTC has resulted in national strategies and legislation that have introduced health warning on packages of tobacco and comprehensive bans on tobacco advertising, promotion and sponsorship.
As the only existing global intergovernmental meeting exclusively devoted to tobacco control, the FCTC COP has served as a platform for policy formulation and the adoption of implementation mechanisms by the parties to the convention.


Xinhua

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Health

EU Donates Cold Store To Anambra

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By DANIEL EZEIGWE –

The European Union (EU) has donated a fully completed cold store block to the Anambra State Government through the State’s Primary Health Care Development Agency (ASPHCDA).
The cold store, built at Anaku, Ayamelum Council Headquarters, is one of the intervention projects by the European Union in the state to ease storage difficulties and give easy access to immunization vaccines, especially at the grassroots.
The donor calls for adequate safeguard and maintenance of the project by the benefiting community.
Restating the significance of the project to the healthcare demands of the community, the Executive Secretary, Anambra State Health Care Development Agency, Doctor Chioma Ezenyimulu, who represented the Wife of the Governor, Chief Mrs Ebelechukwu Obiano, said that the ultra
modern facility will improve immunization coverage and serve the not-easy-to-access areas of Ayamelum and beyond.
The EU-SIGN Team Leader, Doctor Ibrahim Yissa, who said the handover was only provisional and would become permanent after one year of satisfactory comprehensive maintenance and supervision, called for retention of the structural aesthetics of the building and said the EU-SIGN’s partnership with Anambra State remained exceptional giventhe state’s unbeatable achievements in the areas of immunization coverage and childcare support.
The Commissioner for Health, Doctor Joe Akabuike, represented by the Acting Permanent Secretary of the Ministry, Doctor John Ndube, said that Routine Immunization remains one of the
cardinal and cost-effective health intervention strategies, and said the project is distinct having been sited where it will have the most significant impact.
Earlier in his opening address, the Transition Committee Chairman of Ayamelum Council Area, Mr Kenneth Okolo, said the recognition of the area with the unique project, will serves the desired goal and applauded the EU for the intervention.
The contractor of the project, Chief Joel Udoka, attributed the successful completion of the structure to harmonious supports, assuring of its durability.
Also at the handover were the representative of the Minister for Budget and National Planning, the Supervisory Unit of the EU-SIGN projects in Nigeria, Mrs. Joy Ofokansi, traditional rulers, the Permanent Secretary of the Ministry of Information and Public Enlightenment, Mrs Obiageliaku Umeadi and other stakeholders amongst others.
The keys to the building were later handed over to the Executive Secretary of ASPHCDA, Doctor Ezenyimulu, by the EU-SIGN Team Leader, after which they were shown round the structure by the construction team.

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STATEMENT DELIVERED BY MR. PRESIDENT AT THE HIGH LEVEL MEETING ON “UNITED AGAINST TUBERCULOSIS: GLOBAL ACTION AGAINST GLOBAL THREAT”

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STATEMENT DELIVERED BY MR. PRESIDENT
AT THE HIGH LEVEL MEETING ON “UNITED AGAINST TUBERCULOSIS: GLOBAL ACTION AGAINST GLOBAL THREAT”
26 SEPTEMBER 2018
UNITED NATIONS HEADQUARTERS, NEW YORK
Chairman,
Excellencies,
Distinguished Delegates,
Ladies and Gentlemen.
Let me start by welcoming everyone to this High Level meeting, especially the adoption of the all-important Political Declaration on: “United to End Tuberculosis: An Urgent Global Response to a Global Epidemic”. This is the very first global forum with dedicated focus on worldwide tuberculosis pandemic. Nigeria is delighted that this landmark event is taking place at a period when the pain of the disease, and its dire consequences on the health and socio-economic development of many developing countries is on the rise.
Madam President,
2. TB has become a global challenge that requires consistent and an all-inclusive global strategy based on research and discovery of new drugs. Such efforts must also include mobilization of funds and global partnership of relevant stakeholders working together to address the scourge.
3. The task before us therefore is to initiate a global response towards eradicating the disease globally. In developing countries, counter-measures are sometimes beyond the capacity of such nations. In addition, there is the need to develop new strategies that connect national responses with international finance and technical partnerships to stop the ravaging disease.
4. Nigeria welcomes the adoption of this Political Declaration, especially its relevant provisions which commit to provide diagnosis and treatment to 40 million people, including 3.5 million children between 2018 and 2022. The Declaration should also serve as a template for preventing TB for those most-at-risk, through rapid scale up of access to testing the infection, especially for the high- burdened countries. I am confident that other commitments made under this important document, including those on development of new vaccines, drugs and community-based health services, will further guarantee success in our collective fight against the disease.
Madam President,
5. Our national TB eradication strategy has long been structured to provide tailored quality services in terms of diagnosis, treatment and prevention. Since assuming office in May 2015, we consistently increased budget appropriation for the health sector. This is with a view to ensuring that we promote the well-being of our people through access to qualitative health care services. In this regard, we are investing in research and development in our various public and specialized institutions.
6. Our national Action Plan on TB Eradication 2015-2020 is being pursued with renewed vigour, structured on five (5) overarching priorities.
These are:
Detection of TB in adults and children,
Improving treatment in specific geographic areas that are under-performing,
Integrating TB and HIV services,
Building capacity for diagnosing and treating drug resistant TB; and
Creating strong and sustainable systems to support these achievements. Private sector engagement for TB is being vigorously pursued as a robust Public-Private Mix (PPM).
7. In this connection, our strategic plan is geared towards meeting the overall aims of providing Nigerians with universal access to high quality, patient-centered prevention, as well as diagnosis and treatment services for Tuberculosis, TB/HIV and drug-resistance TB by 2020.
8. Furthermore, we are exploring the possibility of establishing a financial institution dedicated to providing financial support for free, comprehensive and qualitative medical treatments. The aim is to mitigate financial burden on victims and to also ensure that we continue to save lives and create favourable conditions for economic and social development.
Madam President,
9. Finally, let me pledge Nigeria’s continued commitment to the eradication of TB in Nigeria. We remain resolute in efforts to address institutional and societal challenges, through the enhancement of strong multi-sectoral mechanisms. Let me therefore seize this opportunity to call on the global community to demonstrate renewed commitment to today’s declaration.
I thank you.

 

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Screening for cancer: Understanding the basics

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When it comes to cancer, people have many questions but unfortunately, the answers aren’t always clear. However, learning the basics can help in detecting the deadly ailment in its early stages and dealing with it accordingly.
Cancer screening is an important tool in the prevention of cancers in general because when abnormally proliferated tissue or cancer is found early, it becomes much easier and less costly to treat.
Dr Emmanuel Rudakemwa, an associate professor of radiology and imaging sciences at Oshen King Faisal Hospital, says that screening is an available tool used to make sure that the population at risk is checked with the purpose to detect cancers early as this helps people live longer and relatively stable.
With no particular cause of cancer yet certain, some cancers have increased likelihood risks of occurrence, this makes screenings very important.
Cancer screening has all the benefits related to individuals, family, social and nationwide importance, Prof Rudakemwa, says.
Screenings allow medics to see anomalies in the body that can be then tested for cancer. They also help detect early stage cancers, which makes it easier to treat.
“Prevention is better than cure and when it comes to non-communicable diseases and cancers in general, you encourage people to take care of their bodies,” he adds.
With the ever increasing cancer concern, cancer screenings are of great importance, however, not all cancers can be screened.
So which cancers can be screened and when?
BREAST CANCER
Rudakemwa notes that with breast cancer, screening is done by mammography.
“There is something we call a triple test which includes: clinical breast exam, breast ultrasound and then mammography, this increases the sensitivity and specificity to detect the cancer,” he explains.
Breast cancer screenings are usually done for women aged 35 years and above.
COLON CANCER
This is cancer of the colon or rectum, located at the digestive tract’s lower end. It affects both men and women though there is more relative dominance to men than women.
Rudakemwa says that this kind of cancer can be screened from the rectum (the final section of the large intestine) to the cecum (the beginning of the large intestine) and it is done for people aged 40 years and above, unless there are other medically indicated risk factors.
“We do colonoscopies, a procedure in which a flexible fibre-optic instrument is inserted through the anus in order to examine the colon. We can also do virtual CT colonoscopy and fortunately, we have that technology available here at Oshen King Faisal and a few other hospitals in Rwanda. Through the screening, we check your entire large bowel for any lesions,” he explains.
LUNG CANCER
Screening for this cancer is particularly done for the people that have high risks, that is, those who smoke.
“We are lucky most of the insurances are now accepting screening, people need to know this.
“For lung cancer screening, it is done for people aged 40 years and above and it can be done in so many ways, for example, chest X-ray and CT scan, where we are able to see the lungs and notice if there are any nodules. We also have computer aided techniques that enable us to see very small nodules, and if you detect them early, you are able to deal with them early enough, the professor says.
CERVICAL CANCER
The Pap smear is one of the most reliable and effective cancer screening tests for cervical cancers.
“In our set up, cervical cancers contribute to the highest burden of disease and the major cause of morbidity and mortality. But we are very lucky that we are able to fight this cancer through targeted screening and through extensive vaccination programme available in our country.”
It is advisable to go for check-ups between the ages of 35 and 65, and these should be done at least once in two years.
PROSTATE CANCER
It is one of the major causes of morbidity and mortality in African men.
It also has a genetic predisposition, for example, if a father had prostate cancer then a son should beware of the risks, always be vigilant and get checked, Rudakemwa notes.
It is also screened from age 40 and above. Screening is done through prostate specific antigen (an antigen detected in blood).
“There is a certain threshold at which we say that this is highly suspicious, we also combine this with a digital rectal examination, where you feel the prostate, and as you are touching or feeling the prostate, you know that it is not in a good state,” he says.
Rudakemwa also says that they can do a transrectal ultra sound and an MRI, which are both techniques and technologies available in Rwanda.
“All these procedures can act as screening measures but they can as well guide in the diagnosis,” he says.
HOW OFTEN SHOULD ONE GO FOR SCREENING?
With our current national non communicable disease control plan, we advise an annual breast mammography and cervical cancer screening, bi-annual colorectal, lung and prostate check.
“There is, however, no compulsory number of times like it is in the developed world.
“Screening for all these cancers is possible and done at Oshen King Faisal because we are well-equipped to provide the services.”
RISKS ASSOCIATED WITH SCREENING
The risks are there but when one considers the benefits, it is important to opt for screening.
“Let’s say, for instance, with breast cancer, a mammography is risky because we use x-rays to generate images and radiation which can affect tissues.
“I can tell you that as a person who deals with people with cancer, it is best to opt for early screening because it’s only then that the cancer will be detected and doctors could be able to administer appropriate treatment and improve the outcome,” he says.

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70-year-old Nigerian fit with a pacemaker in Dubai

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An AV block is a serious heart condition where the heart beats irregularly and much slower than usual.

If you meet 70-year-old Maria, a Nigerian national, you’d never know she has a dual chamber pacemaker to keep her heart beating well. Full of life and vigour, Maria came to the UAE to treat her atrioventricular (AV) block.
An AV block is a serious heart condition where the heart beats irregularly and much slower than usual. It can cause loss of consciousness or complete collapse. Patients with this condition need to have a pacemaker – a small device that rests inside your upper chest and connects to your heart with special wires where it operates steadily and silently.
As such, when doctors in her home country advised Maria for an implant, she knew that this procedure required the services of an expert. Without wasting any time, she decided to travel to the UAE and approached Emirates Hospital Jumeirah for this surgery.

“When Maria visited us for the first time, her reports indicated that her heart was struggling to send electrical signals between the upper and lower chambers of her heart. This could lead to sudden collapse of the patient and could cause significant detrimental effects due to major injuries and sometimes death if a pacemaker wasn’t implanted immediately,” said Dr Allam Alkowatli, consultant interventional cardiologist and chief of cardiology at Emirates Hospital Jumeirah, who recently implanted the first device at the facility.
“As such, we implanted the most advanced dual chamber pacemaker, which is MRI compatible. This feature allows patients to perform scans and MRIs in the future without a cause to worry.”
Dr Allam and his team implanted the pacemaker, almost the size of a wrist watch, connecting to Maria’s heart within an hour. She was kept under observation for 24 hours and discharged the very next day. On the morning of her surgery, she was offered medication to make her feel sleepy and comfortable.
“An implant is a day-surgery procedure but requires the services of an expert. Having this surgery by inexperienced cardiologists or surgeons can be harmful and may lead to major complications including lung puncture, significant bleeding, blood clots, wound infection, fluids around the heart and rarely death,” he said.

“While pacemakers are opted by several people to improve their living conditions, scepticism surrounding this device is yet very high. However, recent developments and advancements in technology have made the device so small and seamless that there’s no bump in the chest and the patients can barely tell they have a pacemaker at all,” concluded Dr Allam.
Known to be a device of the old, around 10 per cent of people over the age of 70 have a pacemaker implanted in their chest. Approximately one million pacemakers are implanted annually, providing electrical stimulation to regulate a patient’s heartbeat. Conventional pacemakers are surgically placed under the skin of a patient’s chest, with wires, or leads, stretching from the shoulder vein and attaching to the heart. The cost of a pacemaker is higher than the average, but is covered under insurance and can last for 8-12 years.
“While physicians in countries all over the world perform similar procedures and implant pacemakers, the UAE is now known for its great reputation in having such high expertise available, drawing several patients from all over the world to the country,” continued Dr Allam.
According to research report Global Medical Tourism Market, it was noted that the global medical tourism market is projected to display a robust growth represented by a CAGR of 1.65 per cent during 2018-2023. In the past few years, the UAE has become a central destination for world-class medical tourism, with Dubai ranking first in the Middle East due to its advanced treatment and facilities.

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FEC Approves $150M For Polio Eradication

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The Federal Executive Council has approved one hundred and fifty million dollars from the World Bank for polio eradication.

Also approved on Wednesday are twelve ecological projects to address erosion and flood incidences in the six geo-political zones at a contract sum of twelve billion, one hundred and four million and eight hundred and eighty two thousand naira.

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Editorial

Cholera Outbreak Spreads in Nigeria

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Abuja : The cholera outbreak in Nigeria spread to new areas in Adamawa, northeast Nigeria, indicated today the state”s Ministry of Health information official, Mohammed Abubakar.

Abubakar said in addition to North Mubi and South Mubi counties, the pandemic is now hitting Maiha and Hong, and up to Sunday the total number of registered patients in the region amounted to 985, with 16 deaths.

In the case of Maiha and Hong, two patients each were reported and no deaths have been reported yet while in North Mubi 10 of the 427 affected have died, and in South Mubi six of the 554 reported.

The Ministry estimated the death rate from the outbreak at 1.6 percent, a dramatic reduction from the initial 17 percent when the epidemic began in May.

After releasing the figures, the official urged people to do more about personal and environmental hygiene to prevent a resurgence of the deadly disease.

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Can’t get on ANSSID?
If you have been having challenges getting your Anambra State Social Service number, here is what to do:
• send an email and ANSSID login details to: info@airs.an.gov.ng for immediate assistance.
• Visit the ANSSID HELPDESK or call HELPLINES: 07066727750 or 07033822851

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