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Adopting a Culture of Preventive Medicine amongst Nigerians; A wake up call By Taiwo O Fasoranti MD
A couple of years ago as a young graduate, a friend of mine owned a vehicle that he drove wherever it could take him. His daily routine was to wake up in the morning and just get into the vehicle and start the engine; the vehicle was a beauty and never complained to him; all he did was buy gas. For so long this was my friend’s routine. After so much abuse and neglect (No oil change or visit to the local mechanic for a tune up), the vehicle started giving some warning signs; Red lights started flashing on his dash board, this he later realized were the brake light, engine oil light, and the radiator light; a sign of overheating. He chose to ignore these warnings. One faithful Saturday morning, he was on a trip to his country home, about two hours into travel, he heard a loud noise coming from the front end of the vehicle and the vehicle rolled into a complete stop. The diagnosis: “KNOCKED ENGINE AND BURNT RADIATOR” A result of long term neglect!
THE TRUTH:
This, my fellow country men/women is what we do to our bodies and our health; we neglect our health, we work so hard to make money, we eat “all the good foods” and above all we ignore the warning signs from: dizziness, headaches, and frequent tiredness as a result of little strenuous activities. Our bodies actually tells us a lot of things, but because we are too busy, or due to ignorance and apathy, we fail to listen. Majority of the killer diseases we see in our community today are all treatable if caught early. We have heard numerous stories of Nigerians who have died suddenly especially prematurely. This is a pattern that I have noticed and it is very common in our society regardless of where we live and whatever our socioeconomic status is.
THE PICTURE OF HEALTHCARE IN NIGERIA;
It is important to have an idea of the number of facilities providing care to our population of about 130 million people.
According to available records, there are: · 36 Teaching Hospitals &Federal Medical Centers · 6 Specialist Hospitals · Most cities have General Hospitals · Numerous Primary Health Centers in small communities · Numerous private doctors’ offices; some operated by individuals not authorized to practice medicine. (Quacks) · Thousands of Alternative Medicine and Spiritual Healers.
These hospitals are not functioning to their fullest capacities as a result of inadequate manpower and inability of our government to adequately fund these institutions. Is it any surprise that Nigerians at home have lost hope in the healthcare system making the business of Alternative and Faith healers a lucrative one? Nigeria invested heavily in Primary Care and Preventive Medicine when the late Professor Olikoye Kuti was the Federal Minister of Health. The results were amazing: Maternal Mortality Rate decreased remarkably, people had access to affordable health care, and Physician morale was high during his time. There was no need to run after money doing a lot of locum because salaries and call duty allowances were paid timely. I strongly suggest that we return to this style of healthcare administration in Nigeria because this method was effective, results oriented and accountability by all stakeholders was a priority.
BURDEN OF CANCER IN OUR SOCIETY:
According to Globocan Nigeria: Cancer mortality from (Breast, Cervix, Prostate, Liver, lymphomas, Colon Ovaries and Stomach), account for about 70% of cancer deaths in Nigeria. The remaining mortality can be attributable to other chronic diseases that are obviously preventable. Looking at these Cancers, it is important to note that they are all treatable in the early stages if diagnosed; but unfortunately the reverse is the case. People wait too long before showing up at the physician’s office by which time the disease is widespread. Treating cancer in Nigeria is very difficult, most patients show up in the late stages of the disease. We can prevent this from happening by educating the community on the advantages of screening, early diagnosis, simple and effective treatment.
QUESTION:
If you answer “Yes” to any of the following questions, you need to develop a relationship with a Physician wherever you live and follow up on my suggestions as soon as possible..
Suggestions:
Majority of cancers if diagnosed at routine screening, allows for early treatment and cure in most cases.
SUDDEN DEATH AMONGST NIGERIANS:
According to recent findings by a group of pathologists in a recent publication in the West Africa journal of medicine: Rotimi, Fatusi and Odesanmi of the Obafemi Awolowo University School of Medicine Ile-Ife, Nigeria:
“Hypertensive heart disease is the most common cause of sudden cardiac death in Nigerians, and many of hypertensive cases were previously undiagnosed. Cases of coronary heart disease and myocardial infarction played significant roles as causes of sudden cardiac death, indicating that their incidence may not be as rare among Nigerians as previously thought.” Recently we read in the news media about the dramatic increase in sudden deaths amongst the highly educated both in Nigeria and in the Western World (Especially amongst Nigerians). I am sure readers have seen the same cases amongst friends, colleagues, neighbors etc. Many people walk around without knowing their Blood Pressure or Blood Sugar reading. Sudden death is preventable if certain precautions are taken.
Suggestions:
Yet again, develop an ongoing relationship with a physician where your Blood Pressure and Blood Sugar can be monitored regularly if you are Hypertensive. Many Nigerians are Hypertensive and Diabetic and are not aware of the fact that they have the diseases. For those who might not necessarily have access to a Physician; the Federal Government can conduct a massive mobile blood pressure and blood sugar measuring campaigns all over the nation.
OVERVIEW OF CHRONIC DISEASES: HYPERTENSION & DIABETES IN NIGERIA:
HYPERTENSION:
For the purpose of this write up, I will concentrate on findings from a recent Cohort studies on Hypertension in Nigeria and Zimbabwe. Epidemiological information show that between 10 and 20 million people in sub-Saharan Africa may have Hypertension and that treatment could prevent around 250 000 deaths each year. This is indeed reality. We need to act now to prevent this ongoing catastrophe.
DIABETES:
There are no reliable statistics to explain the prevalence of Diabetes amongst Nigerians, but according to figures in literature, the crude prevalence rate is about 8% in the general population. The long term effects of untreated Diabetes and Hypertension are serious ranging from KidneyFailure,Blindness,Coma, Neurological Deficits from Stroke, Heart Attacks and eventually Death if treatment is not commenced. In a study carried out by Nyenwe et al in 2003 on the prevalence of T2 Diabetes in Port Harcourt Nigeria, they discovered that 40% of the population they studied had Diabetes but were undiagnosed, and more than 80% were asymptomatic, which is very peculiar to the disease. The conclusion was to encourage routine screening amongst the population. This picture I strongly believe is representative of what we see in Nigerian communities both locally and internationally.
WAY FORWARD!
There are a number of issues contributing to the failure of our healthcare delivery system in Nigeria. Until our leaders recognize the importance of having a vibrant and adequate healthcare system, millions of Nigerians will continue to die from these otherwise preventable but fatal diseases, Our healthcare delivery system is one area that can surely use some funds and I am sure if we prioritize this, the impact will be felt immediately. It is also important to realize that many Nigerians who can afford to travel overseas for their healthcare issues might not need to do so if they adopt a habit of early prevention and screening by visiting a local doctor in Nigeria regularly. I have seen situations where the damage has already been done and then they decide to travel abroad only to return home in a casket. It is also important to note that keeping a healthy population contributes to a vibrant economy.
FINALLY:
Adopting the P.E.E .option is a step in the right direction.
P: Physician E: Exercise E: Eating Right
In closing:
“Our Public Health Interventions should be deliberate, purposeful, & goal oriented. Government owes it to the population regardless of where they reside in Nigeria. We should take our messages into the community. Once we do this, people will respond and show up at the various screening sites set up by the government. Health is Wealth.” TOAF
Taiwo O Fasoranti MD
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