AS part of efforts to build on the gains achieved, especially in the eradication of Wild Polio Virus (WPV) in Nigeria and to increase immunisation coverage, the Federal Government has provided logistical support – motorcycles and laptops, to frontline routine immunisation officers in low performing states.
Supported by the World Bank and the World Health Organisation (WHO), the 456 motorcycles and 456 laptops will help the frontline workers penetrate inner cities and villages where immunisation has been low, to gather quality data about their status, which will inform critical decision making, planning and management.
The Executive Secretary of the National Primary Health Care Development Agency (NPHCDA), Dr. Faisal Shuaib, made this known on Friday in Abuja, during the commissioning of motorcycles and laptops for routine immunisation officers in poor performing states.
He said, “We experienced a situation where the lockdown prevented people from being able to access primary healthcare centres. So, there was a decline in practically all primary health care services.
“As at the last time we checked our data, we have now started to see that primary health care (PHC) services, especially routine immunization, is going back to the levels that they used to be before the COVID-19 pandemic. We are pretty confident that with better understanding of COVID-19 pandemic, people are more confident and will access primary health care services, and indeed all healthcare services.
“Never before in the history of Nigeria have we seen more than a doubling of routine immunisation coverage within such a short period. Today, as we try to improve and get even beyond where we are today, we are donating these motorcycles and laptops to frontline workers.
“Only three years ago when we declared a state of emergency on the low routine immunisation coverage, we also recognised that it was going to take more than rhetoric to make sure that we achieve our ambition of ensuring that no child in Nigeria is left behind when it comes to getting all the vaccines that they need to grow into healthy and productive adults in our society.
“This is why working with the World Bank and our partners; we decided to ask ourselves why routine immunisation has been so poor. We realised that there was a need for us to provide frontline workers with the tools that they need.
“The tools that they need is part of what we are giving out today in terms of making sure that they have the logistics to get to the last mile, making sure that they have the equipment to be able to manage data.”
He added, “In the last two years, because of all our efforts in this space, we have been able to reduce the difference between administrative data and survey data to less than 20 percent. This is very huge.
“The provision of these laptops will provide the routine immunisation officers at the local government areas direct access to data and will be able to interrogate the quality of data.”
The Minister of Health, Dr. Osagie Ehanire, while commissioning the motorcycles and laptops, said, “Routine immunisation is a major pillar of the primary health care system. Our goal of universal health coverage is not complete unless we have a full and well established routine immunisation programme.
“It gives me much joy to see the National Primary Health Care Development Agency pursuing its mandate to implement a system-wide plan to enhance the routine immunisation programme and to ramp up coverage, especially in the poor performing states, towards accelerating universal health coverage objectives.”
ONE of the most touching responses to the first part of this series came from a 25 year-old man and his friend. The man, Fasasi Sadullah, telephoned me last Saturday (August 15, 2020) to say: “I had colostomy twice, meaning I stool with the left side of my abdomen’’.
That meant a hole was surgically made on that side of his abdomen to let out stool through a hose into a bag which he had to wear on his waist.
His voice was bright, betraying no evidence that he would be gone next day (August 16), and his earthly remains buried in Lagos Monday (August 17). One of Fasasi’s friends and a regular reader of this column, Sharif Odunaye, introduced Fasasi to me on the telephone about a week before the departure of Fasasi.
He wanted to know if alternative medicine could help his condition. I sent him some suggestions via WhatsApp.
I advised him to immediately undertake organic coffee (not edible) enemas to clean up his liver and other vital organs before other natural therapies would follow.
This was because he had under-gone chemotherapy and invasive surgery. Chemotherapy is, arguably, one of the most dangerous poisons which cancer doctors give their patients in order to kill cancer. But few patients survive chemotherapy because it poisons and kills cancer and healthy cells alike. Surgery makes cancer more aggressive and likely to spread.
The day before Fasasi’s death, Sharif sent me this WhatsApp message:
” We have been making effort to raise money for Fasasi but the result was discouraging. As a matter of fact, I called his dad yesterday night and today, and he told me his effort had not been fruitful. He has spent over N2 million over the past months. Now, I guess people are tired of helping. We are still making effort to raise money…”
The following day, that is last Sunday, I read on Sharif’s WhatsApp status: “We have lost him, Fasasi Sadullah”.
Another reader of this column wrote: “I have read your publication in The Nation newspaper of Thursday, August 13, 2020. Some of the problems enumerated in Diagram C (engorged colon) are what I am encountering. I always strain to pass stool. I have hernia and prostate (gland) issues which I need to operate”.
From Aba came this one: “I am 52. I recently developed delayed stooling. I have high blood sugar, which I am managing. I have weak erection. I just went to the lab yesterday, and they told me that my prostate gland had enlarged silently as a result of suppressed infections. There are also traits of hepatitis in my liver”.
There were more enquires than cannot be accommodated here. As I explained in every case, the bottomline is that we are what we eat and the waste from what we eat which we fail to get out of our bodies. Let us begin to look at the picture from when we put food in the mouth. We have teeth with which we are expected to grind food to paste, so that we can create a large surface area of it for saliva to mix with. Saliva is not in the mouth for the fun of it. It contains some substances called enzymes, which break down the complex food eaten. Immunoglobins are present, too. Immunoglobin kills germs in the food and performs other immune functions. When we swallow food and do not let saliva mix with it for some time, we allow some dangerous and unwanted guests in the food get into the stomach.The swallowing of food without grinding it to paste comes partly from table etiquette. Our neighbour is not expected to hear the sound made in our mouths when we munch food. Mr. S.O Kolade, my fourth form “O” level Health Science teacher, knocked this out of us in the 1967 set of Olivet Baptist High School, Oyo.
He made sense to me when he reminded the class that Africans eat a lot of complex carbohydrate such as yam which are called POLYSACHARIDES. An enzyme in the saliva called PTYALIN breaks polysaccharides down into DISACHARIDES a simpler carbohydrate. The simplest way I can describe these terms for now is that a polysaccharides is a huge crowd of carbonhydrate molecule groups while a Disacharides is a group of two molecules and monosacharides is a single carbonhydrate molecule. Ptyalin is an enzyme, which suggests the roles enzymes in other parts of the digestive system would need to play in order not to only to make complex foods available to the body in simpler or micro forms but to keep that system healthy as well. Thus, taught Mr. Kolade, all foods put in the mouth must be well masticated (ground) to paste prior to swallowing. This change in taste is the evidence that a complex sugar, MALTASE, has been broken down or converted into simpler sugar, maltase, and that the single molecule could then be swallowed without it causing harm in the stomach and in the rest of the body.
The culture of “swallow” foods in Nigeria does not permit this natural process. So, the stomach receives a large volume of polysaccharides, which it is not comfortable with. This may not make much sense to many people. They could, in defiance, say in Pidgin: Na today we begin swallow eba, fufu, semo, etc. We never die. Leave us jare! But it should be remembered that “little drops of water makes a mighty ocean”. Put another way, we may say “every day for the thief, one day for the owner.” The mill of Mother Nature grinds slowly but surely and finely. No one disregards her laws without paying for them. As my friend, Mr. Dotun Akitoye, always says, EVERY MISTAKE WILL AVENGE ITSELF SEVERELY.
Every day, we commit other table sins which cause trouble in the intestine. Over-eating is one of them. One day, I watched a man who sat opposite me at a canteen eat double portion of eba. He was sweating and uncomfortable. He loosened his belt and called for a big-size bottle of stout. The stomach was over filled or overloaded. Muscles of the stomach have to squeeze up and down and sideways to properly mix the content with digestive enzymes. Where this is not well done on account of overeating, many molecules may pass, undigested. Some may even be pushed on to the lower esophagus to start an acid reflux and perhaps cancer of the throat. We should not lose sight of the polysaccharides from the mouth. The immune system rushes an army after them, suspecting them to be foreign and inimical, since there are no allowances for them in the stomach. Even Disaccharides cannot be digested in the stomach. Their digestion takes place in the small and large intestines. Where they become MONOSACHARIDES. They are the simplest forms of sugar which can cross the intestinal wall in to the blood stream without harming the surface tissue. Larger molecules such as polysaccharides would break the sieves when they force their way through.
Meanwhile, the stomach is suffering from “overloading.” It produces a weak form (0.05 percent) concentration of HYROCHLORIC ACID. This is the environment in which PEPSIN, an enzyme which digests proteins, is produced. Fat is also cuddled in the stomach into droplets by bile salts from the liver. Where overloading has occurred, these enzymes may not be enough to do the job well. So, the food is literally “imprisoned” for longer than its natural exit time. An uncomfortable stomach then tries to expel it through the esophagus, causing acid reflux (heart burn) or downwards into the duodenum.
If the sphincter muscle, which keeps the gate with the duodenum, refuses to let go, as it is sensitive only to alkaline substance from the pancreas, the organ releases pancreatic juice into the duodenum only when the stomach has finished its job. When the juice is not released and the duodenal gate is locked against the stomach, the stomach is left to suffer with its burden. Food over staying its time in the stomach begins to decay or spoil, forming acid and foul gas which we experience when we belch. The cells of the stomach are gradually cooked in an acid bath. The tissue changes from raw meat to “cooked meat”. This is evidenced in GASTRITIS or inflammation of the tissues. This may lead to PEPTIC ULCERS and to perforation of the stomach which may cause leaks into the abdominal cavity. This in turn leads to sepsis and other dangerous health implications. Pylori bacteria are known to flourish in such an environment, compounding the acid situation when the immune system unleashes an acid attack on them. But where the stomach successfully expels some of its acid content into the duodenum, a duodenal ulcer may be fomented.
Anchlorhydria
We speak so much about too much acid in peptic and other ulcers. But there are also conditions in which low acid levels delay digestion or cause protein sludge (undigested protein) which causes troubles in other parts of the body, in particular tissue damage and food sensitivity. One of these conditions is Achlorhydria, which is related to genetic inability to produce stomach acid or enough of it. In the case of supposed high level of stomach acid, when the doctors suggest dilution by drinking water or consumption of calcium or milk to their patients to suppress acidosis, or when the doctor prescribes antacids to suppress the so-called stomach acid pumps, an already compromised low acid environment is further depleted. There are about 500 bacteria families in the stomach. A high acid content (0.05 percent hydrochloric acid) is required to deactivate or destroy them.
I am not a Muslim. But I agree with Prophet Mohammed in the QUARAN that when we eat, we fill only one third of the stomach with food, another third with fluid (digestive juices)and the last third with air. This is a formula against overloading of the stomach. Watch the animals. That is how they eat.
Nigerian Medical Association (NMA) in Anambra State has allayed fears over stigmatization and dramatization of COVID-19 pandemic in the state.
Chairman of the body, Dr. Jide Onyekwelu disclosed this on Wednesday at the ongoing 2-day training on COVID-19 Infection Prevention and Control (IPC), urging patients to report to hospitals anytime they felt any symptoms of the virus for quick medical attention.
He admitted the initial dramatization of the pandemic which resulted to stigmatized of suspected patients, assuring that such situations were no longer obtainable.
He said, “Many sick persons are afraid of going to hospital because of fear of being neglected and would be branded COVID-19 patients simply because they have fever.
“This is not true. I must confess that initially, there was much dramatization of the pandemic which led to some stigmatization of patients. But those have all been removed.
“No doubt, COVID-19 is very infectious, but not very deadly. Out of 100 people with the infections, probably one or two will die, but the remaining 97 will survive, with or without medicine.
“Initially, there were precautions from the Federal Ministry of Health that only designated hospitals will treat COVID-19. But because of the constraints in making appropriate diagnoses early enough, it’s been liberalised.
“Every health facility can handle suspected COVID-19 case. You no longer need to wait for confirmatory results to come out. Sometimes, before the results come out, the patient has recovered.
“People should not be afraid of reporting to hospital when they notice any of the Covid-19 symptoms. Don’t stay at home. Even if they brand it COVID-19, there’s treatment.
“If you don’t go, you may have complications. But if you go, the chances are minimized. There’s no stigmatization and no drama about it.”
Earlier, Commissioner for Health in the state, Dr. Vincent Okpala applauded the NMA leadership for the Initiative, expressing optimism that the training would boost the confidence of the doctors and decrease adverse outcome.
“The healthcare workers are going to learn more about how to stop the infection spread from patient to health workers, and vice versa. Having an informed health care provider, creates a confident one,” he added.
Executive Director of the Niger state Primary Healthcare Development Agency (NSPHCDA), Dr Ibrahim Ahmed Dangana and the Niger State Nutrition Officer, Hajiya Asmau Mohammed have warned against the increasing use of supplements by individuals.
According to the medical experts, supplements currently flooding the market do not contain most of the ingredients they claim to contain.
The duo stated this while fielding questions from participants regarding the impact of supplement drugs in the body at a review meeting on allocation, releases and utilization of nutrition budget with key stakeholders from the Legislature and nutrition line ministries in Niger state.
According to the Executive Director of the Niger state Primary Healthcare Development Agency, the majority of the supplements being marketed are nutrients that are found in the food we eat.
“It is alarming that we see all sort of supplement in the market but with the availability of food, we do not need those supplements. Whatever is being marketed are things that naturally occur in our food.
“And some supplements are so expensive that you wonder what really is special about them. I agree that there are some ingredients that they source it from very difficult sources like oysters which is deep in the sea, they bring in what seems like very rare goods and make people think that because they are rare, they must be special or they give the body a special kind of energy or powers but they do not.”
“That is NDA always put a caveat on the supplements that these products are not intended to diagnose, treat or prevent any disease. That is the truth.
“The truth is that once we eat our balanced diet, we do not need that kind of supplements, only when someone is malnourished, the person may want to supplement because people are taking it carelessly. There are others that are important like zinc that boosts our immunity but for the rest, the markets are just out to make money. ”
In her remarks, the Niger state Nutrition Officer, Hajiya Asmau Mohammed explained that supplements should not be made the first line of choice especially with the abundance of food available in the country.
“It is sad to see so many nutritional supplements circulating around from different brand or company name.
“From the name supplement, we are not saying they do not have a role to play but they should not be made the first line of choice especially with the abundance of food we have and looking at the fact that the world is turning to organic foods.”
She cautioned that there is no need for anyone to go into supplement except when the need arises adding that majority of those who consume the supplements have no knowledge of what these supplements really do in the body.
“Those of us who consume the supplements might not have the knowledge of how to manage supplements in the sense that the marketers may want to sell, however, we have what we call blood toxicity because every supplement has a recommended intake, what your body needs to be taken.
“Before going into supplements, it is necessary to ask these questions which include does it meet up with the recommended intake? Is it going above their recommended intake? These are issues that have to do with supplements and you will never get the right answers from the marketers who the only emphasis on what you will only get instead of telling you the nitty-gritty of that.”
Mohammed then advised people to get their choice of nutrient from their natural food stating that when it becomes clear that they have to take these supplements, they need to seek the advice of professionals to know when to stop.
To keep the malaria fight alive and front of mind during the COVID-19 pandemic, a new team of global influencers are joining with youth champions behind the Zero Malaria Starts with Me campaign to inspire awareness and action this World Mosquito Day (August 20).
Against the backdrop of the global pandemic, leading athletes from Africa and beyond, including Kenyan world-record-holding marathon runner Eliud Kipchoge, World Cup-winning South African rugby captain Siya Kolisi, top female South African explorer Saray Khumalo, veteran international footballer Luis Figo, and founder of the first-ever Nigerian bobsled team Seun Adigun, are urging people to ‘see the bigger picture’ by tackling COVID-19 and malaria together to save more lives.
Siya Kolisi
Malaria is one of the world’s oldest and deadliest diseases, transmitted by mosquitoes, which still kills an average of over 400,000 people annually – over 90 percent of them in Africa. An estimated 228 million long-lasting insecticidal nets (LLINs) were due to be delivered across Sub-Saharan Africa this year – more than ever before – but severe disruptions to life-saving net campaigns and limited access to antimalarial medicines as a result of COVID-19 could potentially result in a doubling of the number of malaria deaths in the region compared to 2018, according to recent modelling analyses by the World Health Organization (WHO) and Imperial College, London.
Eliud Kipchoge
Dr. Abdourahmane Diallo, CEO of the RBM Partnership to End Malaria, says: “Malaria does not stop devastating lives during health emergencies and still kills a child every two minutes; indeed, experiences from the Ebola outbreak in West Africa show it can resurge in times of crisis with immediate and deadly consequences. COVID-19 has exposed weaknesses in health systems around the world and, with lives at risk and resources increasingly stretched, long-term malaria investment alongside short-term COVID-19 response is essential, smart, and cost-effective.”
Saray Khumalo
Emergency Response Campaign – The Bigger Picture
To shine a spotlight on the vital importance of sustaining malaria efforts during the COVID-19 pandemic, the Bigger Picture campaign, launching today, features Eliud Kipchoge, Siya Kolisi, Saray Khumalo, Luis Figo, and Seun Adigun.
The stars film themselves wearing a face mask whilst talking about the vital importance of tackling malaria and saving more lives during the pandemic, creating a striking image of both COVID-19 and malaria together – a visual representation of seeing the Bigger Picture.
Kenyan athlete and Olympic champion Eliud Kipchoge, the world’s fastest marathon runner, says: “As a marathon runner, there’s nothing more important than keeping focus. As a father, there is nothing more important than protecting my children. With the fight against COVID-19, the world has been united, as one. Let us stay focused not just to fight COVID-19, but to fight Malaria as well. Let’s continue the fight for Zero Malaria – because no human is limited.”
South Africa’s World Cup-winning Rugby Captain Siya Kolisi says: “It was so important to me that I lent my voice to the Zero Malaria campaign. Malaria is a huge problem on the continent, but it can be combated in my lifetime. It is for this reason that I am using my platform, in these times of uncertainty, to support the fight against this deadly disease, transforming the lives of Africa’s next generation.”
South African explorer Saray Khumalo, the first black African woman to reach the South Pole and summit Mount Everest, says: “I grew up experiencing malaria in DRC and Zambia, so I know how devastating this disease is. Ending malaria is a challenge, even more with COVID, but it is a surmountable challenge that we can rise to together. Let’s set our sights on reaching zero malaria!”
Veteran footballer Luis Figo, a champion of the Zero Malaria Starts with Me campaign, says: “Both COVID-19 and malaria are formidable opponents, and we must come together to tackle them at the same time and save more lives. As we fight COVID-19, we must not let our guard down against malaria, which strikes the poorest and the most vulnerable hardest. Zero malaria means no child should die unnecessarily from a preventable and treatable disease.”
World Mosquito Day
Also launching the week of World Mosquito Day, Zero Malaria’s #MosquitoClapChallenge will comprise a series of short videos featuring influencers as well as malaria youth champions from across Africa to illustrate the importance of continuing to fight the world’s oldest and deadliest disease despite the challenges of COVID-19.
When mosquitos get in people’s faces, it is usually accompanied by a swat or a clap to shoo them away or to catch them. Zero Malaria has teamed up with international Afropop dancer and choreographer Ezinne Asinugo to turn this clap into an easy 5-step routine for anyone anywhere to share across social media platforms, including Instagram and TikTok.
The resulting film of collated entries from around the world will be released in lead up to the 75th session of the United Nations General Assembly, running from 15-30 September 2020, to encourage world leaders and key players to sustain their efforts during the COVID-19 pandemic in the fight to end malaria.
About Zero Malaria Starts with Me:
Zero Malaria Starts with Me campaign was launched by African Union leaders in 2018 in support of the continent’s goal to end malaria by 2030. The campaign sparks grassroots movement by engaging political leaders at all levels, mobilising resources and funding, and empowering communities to take ownership of malaria efforts and hold leaders accountable in the fight against malaria. For more information about Zero Malaria Starts with Me, please visit zero malaria.africa and follow @ZeroMalaria on social media.
About the RBM Partnership to End Malaria:
The RBM Partnership to End Malaria is the largest global platform for coordinated action against malaria. Originally established as Roll Back Malaria (RBM) Partnership in 1998, it mobilises for action and resources and forges consensus among partners. The Partnership is comprised of more than 500 partners, including UN agencies, malaria-endemic countries, their bilateral and multilateral development partners, the private sector, non-governmental and community-based organisations, foundations, and research and academic institutions. The RBM Partnership Secretariat is hosted by the United Nations Office for Project Services (UNOPS) in Geneva, Switzerland. endmalaria.org
About Malaria No More UK:
Malaria No More is a UK charity determined to end malaria by inspiring the UK public, businesses, and government to fight for a malaria-free world. www.malarianomore.org.uk / @malarianomoreuk
Key Malaria Facts
• Malaria is one of the world’s oldest and deadliest diseases.
• A child still dies from malaria every two minutes. That is an average of over 700 children every day.
• Nigeria and DRC are the world’s worst-affected countries – over third of all deaths take place in these two countries alone.
• In 2018, about 11 million pregnancies in moderate and high transmission sub-Saharan African countries would have been exposed to malaria infection, seriously impacting their health.
• Malaria is a major contributor to a cycle of poverty in Africa. In Malawi, estimates indicate that the direct and indirect costs of each malaria episode consume more than a week’s worth of income for most families.
• In 2018 there were 228 million cases of malaria worldwide and 405,000 deaths.
• Approximately 1.5 billion school days would be gained among children in agricultural households from 2018 through 2040 by achieving malaria elimination in 2040.
• More than one-third of young children in Africa are still not sleeping under a mosquito net.
• The large-scale distributions and uptake by communities of insecticide-treated nets are responsible for 68 percent of the malaria cases prevented in Africa between 2000 and 2015.
• Over the last decade, 10 countries have been certified by the WHO Director-General as malaria-free.
• The whole population of Kenya is at risk of malaria – there were over 3.5million cases, and over 12,000 deaths in 2018 (latest WHO Malaria Report data).
Since February 27 when Nigeria recorded its first COVID-19 case, there has been an overwhelming amount of information on social media, websites and mainstream media about the virus. The increased access to information has led to a proliferation in sources of information, with the consequence that it has enabled the spread of misinformation and fake news. Through a project supported by Meedan and launched in June 2020, Nigeria Health Watch counters misinformation and fake news about COVID-19 in Nigeria. Nigeria Health Watch leverages on Meedan’s team of public health experts who fact-check health rumours, responding and debunking them. Meedan is a technology not-for-profit that builds software and designs human-powered initiatives for newsrooms, NGOs and academic institutions for improving the quality and equity of online health information.
The evolving nature of information about the virus has created a vacuum that is being filled with many unknowns, as a result leaving people vulnerable to misinformation and disinformation. Nigeria Health Watch uses social and traditional media to disseminate the debunked misinformation in an engaging and informative approach. This is done by producing multimedia messages to reach different target audiences and especially communities at the grassroots. The platform that Nigeria Health Watch provides is important because it provides feedback for the rumours that are circulating around COVID-19.
Meedan’s experts have debunked several common rumours and pieces of misinformation on COVID-19, including the myth that malaria and COVID-19 are the same. This is particularly important as malaria cases peak at this period in Nigeria and both diseases have similar symptoms but have different modes of transmission and a misdiagnosis could have serious repercussions, harming people’s lives. Other rumours that have been debunked include the potential for COVID-19 reinfection, drinking of alcohol to prevent COVID-19 and wearing of gloves to protect against COVID-19. “Through Meedan’s public health experts, Nigeria Health Watch is filling the misinformation gap in Nigeria by debunking COVID-19 rumours in a timely manner. For Nigerians to stay safe and protect themselves from COVID-19, they need to be accurately informed,” said Vivianne Ihekweazu, Managing Director at Nigeria Health Watch.
Medical experts have given insights into how people with diabetes and hypertension can cope with their ailments during coronavirus pandemic, reports Associate Editor ADEKUNLE YUSUF
As COVID-19 cases surge, with over 20 million confirmed infection cases and more than 700,000 deaths in over 200 countries and territories, focus is tilting towards how to manage the severe cases. While the virus is not a respecter of persons or status, people with pre-existing medical ailments – hypertension, diabetes, kidney diseases, HIV/AIDS, cancer, tuberculosis, etc. – happen to be more vulnerable, medical experts have continued to warn.
At least, 70 per cent of those who have died as a result of COVID-19 complications were those with preexisting chronic diseases, as doctors insist that the viral infection presents a double challenge for such people with comorbidities. In the United States, for example, a government study claimed that “nearly 40 per cent of people who have died with COVID-19 had diabetes.” Pictures in other countries are not better either. Other chronic ailments have also been fingered as great contributors to huge COVID-19 fatalities.
How coronavirus affects people with diabetes
To change the sad narrative and educate the public on what can be done during the coronavirus pandemic, Eko Hospital held a webinar recently on “COVID-19 and Chronic Diseases: Focus on Diabetes and Hypertension.” According to doctors, people who have diabetes – regardless of what type – are no more likely to catch coronavirus than anyone else. Although the majority of people who do get coronavirus – whether they have diabetes or not – will have mild symptoms and may not need to go into hospital, diabetics are more vulnerable. Anyone with diabetes, including those with type 1 or type 2 (gestational and other types), is vulnerable to developing a severe illness if such people do get coronavirus – though the ways coronavirus affect people vary from person to person.
When people fall ill, the body tries to fight the illness by releasing stored glucose (sugar) into the blood stream to give energy. But because the body can’t produce enough or any insulin to cope with the illness, blood sugar rises. For diabetics, the body is made to work overtime to fight the illness, making it harder to manage the diabetes. This often leaves diabetics more at risk of having serious blood sugar highs and lows.
Out of people who have died from COVID-19 in Nigeria, Dr. Sunny Kuku said between 22 and25 per cent are diabetic. This means that at least one in five people that have lost their lives to coronavirus complications is diabetic. The emeritus endocrinologist, who is one of the triumvirate that founded the famous Eko Hospital, warned that the situation becomes worse when hypertension, cardiovascular diseases and respiratory illnesses and other non-communication diseases. “This is so because diabetes is one of the conditions that lower the (body) immunity and infections are more common where immunity is lowered. There is also a vicious cycle because infections are also linked to diabetes; diabetes has two-pronged attack. It lowers the immunity and then the infections worsen in diabetics.
Diabetics who have COVID-19 disease tend to have obesity, especially the abdominal obesity. Abdominal obesity is what we call insular resistance. We also know that diabetics with insular resistance due to abdominal obesity do produce more small molecules or active agents that are destroying the system. That is one of the major problems of COVID-19 disease and diabetics with obesity tend to get it more than others,” he explained. The foremost endocrinologist added that it is also known that diabetics who have complications such as kidney and heart diseases have worse outcomes with COVID-19 than people who don’t have the virus.
How to manage diabetes and hypertension during COVID-19
In asymptomatic diabetics who have tested positive, Dr. Kuku admitted that “we don’t do much with them,” adding that all that doctors need to do is to advise them to be tighter in their control and watch their diet. “We advise them to be tighter in their control, test their glucose (level) more often, watch their diet, exercise as we advise everybody to do and more importantly, to obey the rules: wash your hands, social distancing and avoid crowd, and if possible, stay at home or self-isolate if you see symptoms,” he said.
Dr. Kuku said it is different for the COVID-19-positive people battling with the type 2 diabetes. According to him, type 2 diabetes constitutes nothing less than 90 per cent of diabetes in Nigeria. He said remedy open to the physician managing such a condition includes titrating the blood sugar and ensuring that the diabetes is controlled. For type 1 diabetes, it is mandatory that patients remain on insulin, adding that diabetics should know a lot about diabetes so that they can be their own doctor and their nurse and even know more than their doctor. “Cough is common in COVID-19 disease and we use a lot of cough mixtures. I want to remind our diabetics that cough syrups have a lot of sugar in them and they can worsen their diabetes. So, they should be very careful when taking cough syrups. There are other drugs that can lower blood sugar; so they need to be very careful,” Kuku said.
While speaking, Dr. Oyatokun Olugbenga, a consultant cardiologist, said high blood pressure increases COVID-19 death risk. According to him, patients with raised blood pressure have a two-fold increased risk of dying from COVID-19 compared to patient without high blood pressure. This is a scenario that plays out in virtually all the countries, he said, though he cautioned that hypertension has always been a leading cause of death even before COVID-19. “Most common risk factors associated with increased morbidity and mortality are hypertension, obesity, advanced age and diabetes mellitus. Studies have shown that 13 to 30 per cent of severe cases have hypertension and diabetes.
In Nigeria, Olugbenga said studies rated prevalence of hypertension at 30 to 45 per cent, with prevalence rising with age. Sadly, only a third of patients are aware of their hypertension status; only a third of which takes medications regularly and have good blood pressure control, he said. The cardiologist recommended that hypertensive patients should always continue to take their medications, ensure adequate home measurement of their blood pressure to ensure good control, adhere to lifestyle and dietary recommendations, and restrict hospital visits as much as possible. For patients with stable hypertension, the medical doctor urged them to embrace e-clinic while the elderly patients with multiple comorbidities are advised to always contact their doctors first if symptomatic to evaluate need for hospital visit – considering the risk of getting exposed to the virus in the hospital.
Prof Ogbera Anthonia, consultant endocrinologist, said individuals with diabetes are at the increased risk for bacterial, parasitic and viral infection. “Usually, people with higher glucose levels are likely to be at greater risk for infection than those with more normal glucose levels. This is because high glucose levels can inhibit white cell function. However, current data suggest that people with diabetes are usually not at increased risk for catching the coronavirus, but once they become infected, they may do less well, particularly if they are severely ill enough to warrant hospitalisation in an intensive care unit setting. Even though COVID-19 disease is unpredictable, younger people as a whole do better than older people.
The more complications are present, such as cardiovascular disease and chronic kidney disease, the higher the risk for mortality and doing poorly. Clinical research suggests that diabetes and obesity are firmly associated with increased risk of COVID-19 complications or sever symptoms. Diabetic patients with uncontrolled blood sugar levels are more susceptible to developing severe symptoms resulting in prolonged hospitalisation and increased risk of death. In addition, risks of developing critical illness caused by COVID-19 in patients with diabetes or obesity rise proportionally in the presence of other pre-existing medical conditions such as hypertension, heart disease and kidney disease,” she said. I
While maintaining that people with diabetes are more likely to experience severe symptoms and complications when infected with a virus, the consultant endocrinologist submitted that the risk of getting sick from COVID-19 is likely to be lower if people manage their diabetes properly. “When people with diabetes do not manage their diabetes well and experience fluctuating blood sugars, they are generally at risk for a number of diabetes-related complications. Having heart disease or other complications in addition to diabetes could worsen the chance of getting seriously ill from COVID-19, like other viral infections, because the body’s ability to fight off an infection is compromised,” she added.
Speaker after speaker emphasised that living with diabetes during the virus era involves people to look after themselves, knowing that changes in lifestyle, stress and illness can impact glucose levels in all sorts of ways. Like other speakers at the webinar, Prof Anthonia advised Nigerians that the future of healthcare is tele-medicine because COVID-19 is not going anywhere soon. “So we have to adopt telemedicine as the way to go,” she said.
HOW healthy is your intestine today? I ask this question for the umpteenth time because the number of intestinal cases in Nigeria appears to be growing. Many people strain to pass faeces. Many people have abdominal pain. Where is that man or woman whose abdomen is not swollen? Among the common complaints is the passing of hard or compacted stool which falls into the water closet in pellets or in round, tiny forms like a goat’s. Some challenged persons help themselves out by using the handle of a small spoon or their left index or middle finger to chip out the hard stock in bits until the soft layer comes falling out with little or no push. I wish, therefore, to revisit earlier reports of medical advice that “Death begins slowly but surely in the intestine”.
The diagrams below are enough food for thought. In the first, we see the image of a normal colon, well-rounded and robustly healthy. It is the healthy colon. The person blessed with it does not have a bulging abdomen or a “pseudo pregnancy”, as we jokingly describe it in Nigeria. The second diagram images the spastic colon. In the third, we can imagine the Engorged Colon. That means it is troubled by a pile up of faeces. Sometimes, we are deluded by the fact that we empty the bowel once or twice a day when what we are evacuating had been on the queue for weeks, whereas the journey of a meal from the mouth to the anus should take no longer than 18 hours on the average, according to The Charcoal Test. The Sagging Colon has lost muscle tone and cannot maintain itself in its allotted space. It may, therefore, fall upon some other organ(s) and, irritate them, while sparking off inflammation and pain.
These diagrams and the warnings that “death begins silently in the intestine” ring serious bells in my ears any time I am told someone has a bowel health challenge. Such a challenge may range from trouble such as seemingly easy to deal with matters as indigestion, constipation, gas and bloating, ulcers of all types, occult blood, inflammation, appendicitis, hernia, irritable bowel syndrome ( IBS), irritable bowel disease(IBD), colitis and ulcerative colitis, diverticula and diverticulosis to the most problematic of them all, Cancer. Outside the intestine, intestinal problem can cause anemia, Prostate gland questions, headache, mal- nutriention, immune defficiency and health challenges in other parts of the body including cancer.
In my middle forties in the 1990s, I began to sight clean, rich red blood on the tissue paper after a poop. I saw one of our company doctors in Surulere, Lagos.He suggested a Barium Meal check. I declined it and prepared myself for the worst case scenario, for the blood could have been coming from a cancer. It could also have been that hard stool was impacting weak anal veins and they were breaking and bleeding. Vitamin C and bioflavonoids could have been scarce in my system, which could also do better with more Zinc, Silica and Calcium. The condition could simply also have been internal hemorrhoids …from pile up of pressure, polyps or breaking diverticula. Diverticula is the plural of diverticulum. Diverticula are diversions of cells in the colon to form pouches toward the outer wall. When these are inflamed and break, bleeding may occur. Sepsis or poisoning, a very serious condition, may also arise. The possibilities were endless. This condition led to my discovery of Calamus Root which helps such conditions, and to Detoxification of the Colon.Calamus root has to be used with caution to prevent its residue from accumulating in the liver. For this reason, it is often prescribed along with hepaprotectives (liver protecting herbs) such as Milk Thistle, or, once in a while, with a herb which cleans and flushes the liver such as Carqueja. I obtained my first colon detoxifying herbs for enema from Amelia Organics, Lagos in the 1990s. In those days, the organic enema coffee (inedible) was not easily available in Nigeria.
My first colon enema detoxification ended in disaster. It roused the colon so fast and I rushed to the toilet so late that I messed up my bedroom. I cleaned it up and sanitised it thoroughly. Then, I waited for my Madam to return from work. I was, and still am, a playful husband. I liked to hide behind the door and create a scare. In this case, I reasoned that what was good for the goose should be liked by the gander. After all, husband and wife are meant to be five and six or six and half a dozen. I tricked my wife, Dayo, into experimenting with a colonic, and made sure I overloaded her kit. And when it all came down in her neatly kept room and I had a wonderful exercise of my lungs, which provoked anger and bitterness, I helped with the cleaning. Soon, I almost forgot to check for poop blood. The appearance diminished from about once a week to once in several months until it disappeared altogether.
I was lucky. Many people are not so lucky. I have seen some persons whose rectal end of the intestine closed up or they were about to do so, and the doctor had to bore a hole on one side of their abdomens for them to let out stool into a bag which smelled all around them, day and night! I have met with people whose cases grew into cancer against which the doctor prescribed Chemotherapy to no avail. One of them was a courageous doctor’s wife, who declined chemo and surgery and opted for prayer and herbs. Months after, she surprised her husband when her defecation, though still not perfect, improved and the bleeding became occasional.
I also followed with joy the story of a caterer in her late forties who was down with esophageal cancer and had to feed through a tube inserted into her stomach. She had to juice or liquidify all her meals and then pour it into a funnel that emptied into a tube. If there was no electricity, her feeding was delayed. She could not eat all she would have liked to eat. Her esophagus was blocked and even a drop of water could not pass through without provoking terrible cough as the cancer fought in self protection from drugs. But, surprisingly, saliva could sail through. She weighed 38kg when her brother mentioned her case to me. I told her she had to accept the new feeding protocol advised by her doctor while she tried to fight cancer. She agreed and made 65Kg before she died after spells of Chemotherapy and radiotherapy while waiting to make75kg when surgeons would remove the esophagus and replace it with a section of her intestine.
Next month, it will be about one year since Ngozi left us. Everyone in my household in Lagos broke down when the news came to us from Port Harcourt that she bowed out after the first dosage of Chemo at the University of Benin Teaching Hospital (UBTC). Mr Oye-Igbemo, who is over 80, gave us joy when he defeated Occult blood with herbs. Two Colonoscopy exams had warned him of scary bleeding discomfeitures in the upper section of his colon.
In the series which follows, I invite attention to why the intestine may be getting sicker nowadays. It is hoped that many of us would become more aware that this pit toilet inside all of us, as I often described the intestine, is the cause of disease and installmental death if we do not take proper care of it.
Meanwhile, it is hoped that all challenged persons in search of respite would find this series useful.
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The University of Uyo Health Center has been shut down indefinitely following a reported case of COVID-19 in the facility on Monday.
Our correspondent gathered that activities at the health centre came to a halt when one of its patients tested positive to the virus.
A medical staff, who pleaded anonymity, said the centre was closed down to enable the management carry out a decontamination exercise, having unknowingly admitted a COVID-19 patient.
“We were still running skeletal services to help people, especially the pregnant women and women on labour. But the recent experience has made the place unsafe for everyone, so we had to close down for proper decontamination.
“While on operation, we tried to ensure that no other person except the patients were allowed into the wards. And new mothers without complications were discharged few hours after delivery. But now we can no longer help people,” he said.
Our correspondent reports that a pregnant woman on labour who arrived the health centre was turned back. A situation which got the woman and her husband to rush to a private home to have their baby.
An elderly woman, who also arrived at 9am but was turned back lamented “I don’t know how to cope with other healthcare facilities. They understand my situation better, that is why I had to come alone, without any of my children. I just hope Covid-19 would not deny us access to basic healthcare”.
The Director of Information, University of Uyo, Mrs. Blossom Okorie when contacted said the shutdown was to allow for fumigation.
She defended that the closure had nothing to do with COVID-19 as the management was simply carrying out a Federal government directive.
The Medical and Dental Council of Nigeria (MDCN) has begun the payment of insurance claims to families of some doctors who died in service.
The Council, however, said there is an urgent need for Directors of Medical Services in the states and the Nigerian Medical Association (NMA) to furnish it with a detailed compilation of doctors who died to stop overreliance on newspaper publications to be aware of such cases.
The Registrar and Chief Executive of MDCN, Dr. Tajudeen Sanusi, made this known this in Abuja, during the presentation of cheques to the families of dead doctors.
In attendance were NMA President, Prof. Innocent Ujah and Executive Vice Chairman of Dykes Insurance Brokers Limited, Dau Kenny Tekenah.
The deceased doctors were Patience Selumun Tsavande of Benue State University Teaching Hospital, Makurdi; Oluwamayowa Nofisat Alaka of the Lagos State University Teaching Hospital (LASUTH), Ikeja, and Stephen Urueye of Lagos University Teaching Hospital (LUTH), Idi-Araba.
“The insurance for doctors has been there in our subsidiary legislation, that is, the code of medical ethics. The latest is 2007 and stipulates that every registered practitioner must have what we call constitutional indemnity. We have not been able to enforce it because of the absence of the enabling law. The enabling law was signed into law in 2014. The execution started in 2016. We have been dragged severally before the ICPC (Independent Corrupt Practices and Other-Related Offences Commission). People were accusing us of selective implementation. We said well, when you have a law like this, you start with the younger colleagues. As at the time they were coming in, we enforce it. That was what happened.
“For most of these cases, we were not informed directly. We just read in the papers and we felt we owed them that responsibility, since they have that insurance. The cheques had been ready before Covid-19 came up. But because of the exigencies of duties, we have not been able. And because of that, the cheques got stalled and we had to return them to the broker for revalidation. For doctors that have their properties registered with the National Health Insurance Scheme, this is part of the requirements to be fulfilled before they can be accredited by the NHIS. After knowing about the cases from newspapers, we try to link up with the institutions where these doctors practice, and check the records.’’
