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HEALTH INTERACTIVE WITH DR AMINU MAGASHI Health and Development: As Shekarau Marks One Year May, 29th is being observed in Nigeria as a Democracy Day and it is a day where by politicians at various tiers of government look back to assess their performance. This year's May 29th is not an exception, it came with various forms of assessment and celebration ranging from press conference, phone-in-programme, advertorials, congratulatory messages, assessment review and even in some quarters discussion, interacting and hearing from the electorates who are the most qualify to pass a judgement whether a sitting chairman, governor or president has perform in the last one year of the second part of Fourth Republic. By this article, I have also join the band wagon of commenting and assessing the first one year of stewardship, not of course the entire nation but Kano State, even that only looking at health and related matters, issues that I am a keen follower and observer. My reader may remember on this page an article published on 13th/May/03 entitled "Letter To Mallam Ibrahim Shakarua. Although then Mal Shakarua was only a governor elect of Kano State, but not with standing, I still drew his attention on certain specific health issues in the State, which I hoped would form part of his programme and government policies and promises. I believe one year is enough for me to comment on those issue raised with the sole aim of attempting to evaluate and assess achievement and/or short coming to enable programming for better tomorrow. As a matter of principle, I am going to stick to the issues I raised on that article without wild goose chasing on the entire health programme in the State. To put it boldly is to say that my assessment and judgement on his Excellency performance will only be restricted to those issues because right from onset, I set my objectives to look upon at the end of one year. To begin with , let me summarize those items in my write up, first on the list to address is Eclampsia, HIV/AIDS Prevention And Control, Exodus Of Doctors And Other Health Workers To Greener Pasture, Immunisable Preventable Childhood Killer Diseases And Lastly Relationship Between State And NGOs/Civil Societies And International Donor Agencies. In brief, these are among the numerous issues in the State that I prioritize then. Eclampsia ( Pregnancy Induced Hypertension ) a condition that is being experienced mostly by women during first pregnancy who during second part of pregnancy present with high blood pressure, body swelling which if not control will end up with fits and convulsion either before, within or after labour. From hospital based data in 2002, Eclampsia alone accounted for 51 % of all maternal death related to pregnancy and its complication at Murtala Mohd Specialist Hospital, (MMSH), the biggest secondary center not only in the State but in northern Nigeria. That 51 % was only a hospital event, at the community due to delay in taking decision about health problem and delay in transportation, women in eclamptic fit, I can make an authoritative guess that, not fewer than 3 potential mothers are perishing on daily basis in the State courtesy of Eclampsia alone , the disease is a monster and canker worm and the single most important maternal problem in the State, then, now and beyond unless if a specific intervention is fashioned out to curtail the menace. Looking at the State health policies, it is worth mentioning to say that the free antenatal care policy and its implementation is highly commendable, at least at hospital level, mortality attributed to Eclampsia may have reduce over the last one year due to timely response to arrest the situation by resuscitative measures and either induction of labour or caesarean section depending on situation on ground. The only short coming to that policy is the fact that, it is not going to achieve reduction in the incidence, and prevalence of the disease, it will neither appreciably reduce the mortality rate nor the influx of eclamptic patients to hospital which as a result of that beds are inadequate to admit all of them. As I always preach that specific problems need specific interventions, Eclampsia is not an exception, to reduce the occurrence, incidence and prevalence and death due to the disease is to ensure community intervention to complement the free antenatal services. I call on his Excellency and his health team to create a State Action Committee On Eclampsia or a task force on that as a survival tool, the committee to be a multi sectoral by involving bureaucrats , civil societies, media and private sector whom will be tasked with drafting an action plan for the State on eclampsia, notably among its function will be, to come up with a training manual for providing effective training and capacity building and skills on basic management of eclampsia and other related illnesses to managers and staff of health posts at various local governments, provision of basic facilities for detection of signs and symptoms of the disease and to ensure massive awareness raising campaigns in the available electronic media in the State Funding may be an impediment to implement such tasks, but I believe the State government enjoys a lot of good will to enter into agreement with the 44 LGAs in the State to be committing on monthly basis 1 % of their monthly allocation towards this mission. Overhauling the problem of eclampsia by adopting this approach will reduce the cases of prolong/ obstructed labour, bleeding during pregnancy and other infections which will be detected at the right time to ensure safe motherhood. The advertorial entitled Governor Shekarau First Anniversary : Kano State Ministry Of Health Achievements Between May, 2003 To May, 2004 published by TIE of May this year, a private owned monthly magazine published and circulated in Kano made an interesting reading, the said achievements which covered 13 pages elaborated on diverse areas of health, the AIDS CONTROL PROGRAM progress report caught my attention especially the area of voluntary counseling and testing ( VCT ), prevention of mother to child HIV/AIDS transmission ( PMTCH ). In the said report, it mentioned that in collaboration with Family Health International , an international NGO having an office in the State will establish and commission 2 centers , one at MMSH and one at Wudil to provide PMTCH and provision of anti retroviral drugs ( ARV ), on this development, I expect the State to tread carefully as to who will be responsible for the purchase of the drugs, funding as well, how many people will be on the list, issue of sustainability beyond the partnership with FHI which is time bound, these fears are raised to avoid issues to do with developing resistant and dangerous side effects of the drugs. One area that is highly innovative is the creation of an Advisory Office on NGOs to His Excellency, The Executive Governor Of Kano, the State stand to benefit a lot from a genuine and sincere relationship with NGOs, civil societies and IDAs in terms of attracting foreign and local aid and grants and investment in the State, which the advisory office is expected to facilitate such moves and tasks, the irony of the beautiful innovation is the fact that the two people handling such office know next to nothing about NGOs/civil societies and IDAs intricacies and understanding their scope and operation to warrant providing effective advise to the State to benefit from such relationship. How ever, no matter the shortcomings, it has provided a flat form for improvements for better tomorrow. On the exodus of doctors and other health workers, already the State had earlier on inaugurated a Welfare And Remuneration Committee and had already submitted its report , what the entire State awaits is the implementation of the report which for now is experiencing dilly dally and bottle neck administration. Finally, I will conclude by saying that as the administration enters its second year, it deserves to be commended but however, there are a lot of areas to improve on and the challenge ahead is enormous. Dr Magashi Is The Executive Director Of Community Health And Research Initiative ( CHR ) , Kano, Nigeria. |