Seven-year-old Priscilla Adebayo died at the Gbagada General Hospital on 19 February 2020, that is two Wednesdays ago, of symptoms which resembled those of heat exhaustion or heat stroke, as doctors and other medical staff rushed hither and thither to save her life. Priscilla’s death was a sad reminder that we are again in the season of heat exhaustion in Nigeria, and many of us are not creatively responding to it apart from drinking lots of water to quench thirst. It was, also, a sad reminder that child rights hardly exist in Nigeria or are unpopular or not well enforced where they ever exist. Incidentally in the week that Priscilla died, there were heated debates in the media over whether Nigeria had child rights, when an international ranking of nations with the worst child abuses placed Nigeria at 174th position among 178 investigated nations.
Priscilla, an only child of her mother aged 31, had breakfast as she did on any other school day while her mother prepared her for school on February 18. Her mother, Glory Peter, packed two meals in her lunch bag. One was for lunch at school.The other she was to eat at school-lesson which she attended in the school after regular school hours. After lesson, she was to return home with other children in their compound, on Ademola Taiwo street, Ketu, Lagos. Priscilla ate lunch. But, soon after, her temperature began to rise. It got so bad that the school telephoned her mother at work. She requested that her daughter be taken home. Everyone in her own apartment was out, but there was a neighbour who received Priscilla and took care of her until her mother arrived, and gave her some medicines. In the evening, Priscilla’s grandmother warmed the meal Priscilla was to have eaten at the school lesson. She ate some of it and pushed the plate aside, and her grandmother ate the rest. No one suspected that anything was wrong with Priscilla. She even got up from the bed on which she had lain after dinner to tease her uncle who had a minor electric shock as he opened a fridge door. “Good for uuu, good for uuu”,Priscilla teased as most children do at play time. That night, her temperature erupted again. She asked her mother to strap her to her back. Glory did, in between mops with cold water. In the morning, Priscilla was unusually weak and did not get out of bed.
When Priscilla’s grandmother lifted her out of bed and checked her body, the skin was found dotted all over with black spots. Priscilla was immediately taken to a doctor who ran a stethoscope over her body and suggested that her mother urgently take her to Gbagada General Hospital. The journey to Gbagada was strewn with traffic and took almost four hours. From home and on the way, Priscilla was convulsing. She also convulsed at the emergency department of Gbagada General Hospital. The medical team ran some tests and placed her on oxygen support. But before the results of the tests were known, Priscilla died.
Since Priscilla’s death last Thursday, I have wondered like many people who knew her or have heard her story if she may not be alive today if Nigeria pays attention to the rights and well being of children. I remember that when my wife chose a pre-school day care center for our children in the 1980s, she ensured that those “baby schools”, as we called them, were linked to standard private hospitals. If the teachers noticed anything amiss about the children in their care, they took those children to the hospital immediately before they telephoned their parents. It cost something extra, no doubt. But can money buy back the life of a departed child? It is possible that Priscilla would be alive today if her teacher sent her to hospital from school and asked her mother to pick her up from there. Afterall, we say healthcare is the right of a child, and all adults have the responsibility to ensure that this right is respected. The government, the parent and the school have a role to play in this matter. The government already has informed us all about the National Health Insurance Scheme and the Lagos Health Insurance Scheme. Under this health plan, a subscriber pays a fixed sum a year for free health care for either himself alone or for his family. Whenever anyone under this cover goes to hospital, the treatment is free. I do not know if Priscilla’s mother and father were aware of this. Many parents are, but think that about N40,000 is too much to pay for the security of their family in one year. But N40,000 boils down to only about N3,500 a month. How many times in one month do we not throw away N3,500 on unproductive lifestyles. If the citizens are lukewarm to this noble plan which is working in other countries, why can the government not mount a more vigorous campaign to nail it home?. This time, it should not be a question of press conferences or billboards or newspaper advertisments. It should be pro-active in churches, town meetings, teacher/parents association meeting, landlord/tenants association meetings. Would we not achieve more success if private and public schools are compelled by law to hook up? Wasn’t that what made vehicle insurance successful? Is the motor vehicle more important than human life? No parent should be so poor that he or she should not find N500 in a school term for the health insurance of a child if every school is compelled to hook up to this law and admit to school only the child who is signed up. If we had this system at the school level, Priscilla would not have been kept at home all night as her health was getting worse. She would not have been taken to the church in the morning. From the church, she would not have been taken to the local pharmacy from where she was taken on a four hour ride to the general hospital. A well equipped private hospital at the door-step may have saved her life.
There are children bigger and older than Priscilla who enjoy no serious child rights in Nigeria. Let me cite the case of school girls at Girls Junior High School, at Agege, Lagos. There are eight arms in J.S.S II. In one particular arm, there are about 120 girls. They sit in a row in a desk meant for four. Girls who sit on the outside of the pew sit with only one buttock. A poor teacher has to teach 120 students. What would be the quality of the instruction and attention? About half of the class may not hear the teacher. The class is stuffy, smelly, hot. Would the teacher not be praying to be done with the job, however it is done, and get out? Yet we say quality and compulsory education is the right of the child. One day a girl even beat up a teacher who flogged her for misdemeanor, saying the teacher was envious that she had breasts bigger than hers. Once in a while, I test the quality of education these girls are receiving with simple algebra questions I learned to answer in primary V in 1961 at St John’s primary school, Agodi, N5 Ibadan. If they are still alive, my bright class mates who included Adenike Omage, Victoria Eyitayo and Muftau Beyioku may bear me witness. I ask today’s JSS II girl the product of a x a +a +2a and she begins to look skywards. Has this girl not been deprived the right to good education even if she has a fine face and can recite all the lyrics of the songs of naira Marley? Such is the society in which we live which is the 174th nation out of 178 countries in terms of the human rights we accord children.
I cannot forget the school girl who was shot a few days ago at Iyana Ipaja, Lagos, during a police crackdown on motor cycle and tricycle taxis on restricted routes. She was a student of Girls Junior High School, Agege who was going to school. She was walking beside her teacher when a stray bullet hit her. Her death has been announced in school! This is another fallen child. Unsung, she, has gone away. Neither her school, nor her friends, teachers, child right groups etc remembers her well enough to demand Justice in her case.
Heat exhaustion, heat stroke
We must quickly hurry from these events to Nigeria’s present hot weather which may exhaust or damage organs of the body, if not kill in the end. Over many years, I have come to recognise how dangerous this season may be and to be involved in advocacy that the personal responses of many people in the form of copious consumption of water is no more than kid gloves. One of my acquaintances at illupeju model market in Lagos collapsed at the bus stop one day on his way to work. Last year, there was anxiety in my sister’s family when one of the children was rushed home from school. Heat exhaustion, I advised. And it was. The doctors, at a reputable hospital, were meticulous in testing every major organ for viability. Happily, the dark clouds soon cleared. There have been many reported causes of exhaustion and deaths from heat strokes this year. You only have to watch the man or woman who is standing or sitting next to you to know that something is happening to him or her which he or she may not be able to explain beyond the fact that the weather is hot and he or she is sweating, thirsty for something to cool off…and possibly dehydrated.
Some symptoms
Heat strokes have been killing many people for many years, but the deaths are not well documented. In 2002, however, 60 were confirmed in Maiduguri by the University of Maiduguri Teaching Hospital which announced that there could be many more because such deaths were hardly reported. In August of the following year, Europe reported 70,000 killed by sunstroke. In my view, the best way to follow this condition is to imagine the radiator of a motor car with an overflogged engine. If the radiator does not have enough water in it to cool the hot engine which is running, the engine may knock and the radiator may burn or blow up. Sometimes, we are warned of what is going on by a heat censor on the dashboard or by smoke erupting from the bonnet.
Such is life, they say. About 60 percent of the adult human body is water. The brain is believed to be made up of 73 percent water, the lungs about 83 percent, the skin 64 percent. Hard as the bones may appear, water accounts for about 31percent of their make up. Adult men may require about three liters of water every day while adult females need about 2.2liters from food and drinking sources.
The functions of water in the body are too many to mention here. Two-thirds of the water in the body is inside the cells which number about 100trillion in the average adult, and one-third outside the cells. In www.nestlewaters.com, we learn;
“The body of a 70kg man contains about 42 litres of water…28 litres intracellular and 14 litres extracellular of which three litres is blood plasma, one litre is the transcellular fluid(cerobrospinal fluid, occular, pleural, peritoneal and synoval…)”
The list continues. When the weather is hot, as it is now, we lose a lot of water through sweating, a means by which the body tries to reduce the amount of heat the weather has loaded into it. Normal body temperature is 37 degrees centigrade. At about 40 degrees, heat exhaustion may have begun. The organs may have lost so much water that their functions may have begun to fall apart, even damaged by excessive heat. Mayo Clinic reminds us that we also lose sodium and chloride a lot through sweat. That is why sweat and tears taste salty. Potassium, magnesium, calcium are also lost, though in smaller amounts. Mayo Clinic says serious losses of sodium and chloride may lead to problems from “muscle cramps and headaches to seizures and comas…and even death”.
When sodium and chloride levels drop seriously, a health crisis may occur as the right amounts in the body are critical to efficient nervous system function and governance of the body by the brain. Some of the warning signals may be throbbing headaches, behavioural changes such as mental confusion, muscle weakness and cramping, inability to sweat when the nervous system is impaired, attention deficit, dry skin and skin rash, rapid heart beat, nausea and vomitting(strong and weak), rapid and shallow breathing, seizures or convulsions or dizziness and lightheadedness, fainting or even coma and death.
Little Priscilla exhibited many of these symptoms. She lost appetite. She complained to her mother that her abdomen and her legs were hurting. She was irritable. Black spots erupted all over her skin. Her mother said Priscilla was stretching her body. This may translate to seizures. Then, she passed out…and died. The definition of death was that her body was cold and her limbs stiff. It could not be confirmed that the hospital confirmed her death as the absence of brain waves or just as the stoppage of heartbeat, since, in many cases, patience presumed dead through checks on the heart had merely been in coma and returned to life hours or days later.
How to beat heat stroke
Loading up on plain water is not the best approach. The kidneys will merely run out the water.Sodium and chloride losses are causing problems. So are losses of other electrolytes. In this season, as in any other, I add sea salt to my corn pap and water for sodium, chloride and about 42 other useful chemical substances which have been removed from white or table salt, the removal of which makes this type of salt dangerous and poisonous.
Coconut water is rich in electrolytes. Onion juice may be applied behind the ears on the chest and under the foot as Indians do in this situation to reduce temperature. We may even consume plenty of onion or onion juice. Every season has gifts of nature for health at that time. Tamarind is in season now. It is refrigerant, rich in vitamins, minerals and electrolytes. When made into a juice to which a pinch of sea salt is added, tamarind juice may be a wonderful relaxant. As a mild laxative, it improves bowel motion which, at this time especially, take some heat out of the body. Aloe vera is a rugged adaptogenic and grows lushfully in the desert where water is a luxury. The gel is a bundle of water saved up which should be refrigerant at this time. To water or juices, apple cider vinegar may be added for its mineral, vitamins and electrolytes. It beautifully changes the taste of water and is better than soft drinks and caffeine drinks which do not quench the thirst of dehydration but compound its problems. Where sandalwood powder is not available to form into a paste which may be applied to the forehead and chest to bring down high temperature, the oil may be used as massage. When fainting occurs, it is often suggested in traditional medicine that a feather be burned right in front of the nose of the patient. In addition, the tip of the big toe may be gently massaged with the thumb for several minutes. In Reflex Zone Therapy, the big toe represents the head while the heel represents the buttocks. Massaging the big toe opens blocked meridians to supply etheric energy and promote circulation to, and in the head. This is a time to load up on hydrating fruits and vegetables such as tomato, water melon, fennel seeds and celery, which is rich in sodium. Dr H.C.A Vogel advises us in his THE NATURE DOCTOR to not be under the scorching sun if we are hypertensive or have heart challenges. He reminds us that animals prefer shaded and cool places, and that rapid cooling is detrimental to health. Incidentally, I learned that 52 years ago in high school PHYSIOLOGY AND HYGIENE. From him I learned that hot tea in hot weather may be better than ice cold drinks. I learned also, from his example of the bedoins of the desert, that roomy robes are better in hot weather than light clothing. Above all, I advise a reading in www.olufemikusa.com of the article titled PROTECT YOUR VISION WITH POWER ( ENERGY) EYE GLASSES. Scorching sun may cause vision challenges or blindness later in life. Many people are ignorantly or stupidly not protecting their vision in this uncompromising weather. Priscilla must have missed many of these opportunities to free herself of sunstroke. But she left us all many useful lessons. May her soul continue to sprout, flower and fruit wherever she is. Amen.
