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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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Health

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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Health

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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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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Health

More People Benefit From Mrs Obiano’s Prosthetic Limbs Support Initiative

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BY EMMANUEL OKONKWO

The wife of the state Governor, Chief Mrs Ebelechukwu Obiano, says her good works and selfless service to humanity through her nongovernmental Organization,the Caring Family Enhancement Initiative, CAFE, has no political undertone.
The wife of the Governor, stated this at the Professor Dora Akunyili Women Development Centre Awka, during the second day of the distribution exercise of artificial limbs to the beneficiaries of the fourth edition of the intervention involving those who were measured on the Month of July 2017.


The beneficiaries who are both indigenes and non-indigenes of the state were drawn from the twenty-one local government areas of the state.
Addressing the beneficiaries, Chief Mrs Ebelechukwu Obiano, while commending the amputees for honouring the invitation, said her kindness to the less privileged is an expression of passion she has for them from the onset, making it clear that her selfless services to humanity through her pet project, the Caring Family Enhancement Initiative, CAFE, has no political undertone as she started the intervention since 1991 in Lagos state, promising not to relent as according to her, it is a divine mandate to her and her husband.

On his part, the State Commissioner for Health, Doctor Joe Akabuike, while commending the Governor’s wife for impacting in the lives of the less privileged in the society through her CAFE initiative, reminded the people on the need to reelect Governor Willie come November eighteenth, noting that his administration has brought a commendable transformation in the Health sector which he said has increased the health status of the citizenry.
Contributing, the Senior Special Assistant to the Governor on Political Matters, Dr. Mrs Ifeoma Mmadukasi, who is in charge of the exercise, advised the beneficiaries to exercise little patience with the artificial limbs as according to her, they will be temporary uncomfortable with it.

Earlier in a remark, the Special Assistant to the Governor on Disability Matters, Honourable Chuks Ezewuzie, noted that physically challenged persons have never had it so good in the state since creation, and promised that they would reciprocate the kind gesture by voting massively for the All Progressives Grand Alliance during the election as they have already prepared their voters card.
In their separate speeches, some of the beneficiaries including Chief Patrick Anyaoha, Mrs Benedicta Kanu, and Miss Peace Okeobasi, eulogized the Governor’s wife for his love and care for the disabled persons in the state, and for saving them the pain experienced using one leg, and promised to rally round APGA during the election to ensure the Governor’s triumph.
Highpoints of the event was songs of solidarity to the Governor’s wife by the beneficiaries, and distribution of the artificial limbs.

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Book Review : The Morning Sunset By Joy Chinwe Aguguo Duru

 

By Joy Chinwe Aguguo Duru
The Morning Sunset is a book written to sensitize our people over the issue of engaging in a perilous journey to Europe via Libya. It is a story written for everyone: the youths; kids; fathers and mothers. The continuing migration of people into Europe across the Mediterranean is unnecessary. People are not born to waste their future that way.
The Morning Sunset is simply passing a message to people in Africa. Those that have not been opportuned to visit western world think that it is a bed of roses. In fact a paradise . Where as it is not like that. Many chose to come in search of greener pastures. They believe that Europe is the only place they will have the opportunity to get a better life for themselves and that of their families.

My messages to Nigerians and Africans are that our people should not abandon any tangible thing they have or their education just to embark on this long and dangerous journey through road and desert because the life in Europe does not worth such risk . Also let some parents and relatives be aware especially those that are anxiously waiting for the day their beloved children will come back from Europe but they never knew that the bones of their children have been rotten in Sahara deserts and in the seas of foreign land.

 


Joy Chinwe Aguguo Duru is originally from Nigeria but lived in Italy for several years before moving to Leicester , UK.

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