The Nation Newspaper

Tag: Diseases

  • Ageing diseases

    Ageing diseases

    • Longevity is a function of many factors and not always all about what experts say

    Ageing comes with all the paradoxes and contradictions humans often do not think about as young people. Everybody wants to grow old but many do not often think about the challenges that come with ageing. The body change manifestations like weaker veins, grey hairs, various disease manifestations such as cancer, diabetes, high blood pressure, eye and dental issues, arthritis, etc., all point to the fact that the body must undergo certain undeniable changes.

    How people age or manage the resultant diseases depends on how much they care about healthy lifestyle and concern for their old age.

    This was pretty much the conclusion of Professor Bade Omololu, an Ibadan-based orthopaedic surgeon who said that despite the fact that his father battled two otherwise terminal diseases, diabetes and prostate cancer; he still lived for more than 100 years, having died at 105 years. Prof. Omololu believes that more awareness about healthy and conscious healthy choices can prolong lives and help in managing age-related or non-age related diseases.

    He advises that people must begin planning for their retirement from the first day they start to work. This way, retirement does not automatically translate to a desolate, unhappy and unhealthy retirement and aging.

    Retirement sometimes comes with varied health challenges, including various diseases, depression, slow metabolism, loneliness and many other health challenges. The antidote to most of the challenges is a good plan, healthy diet, exercises and companionships, especially in an age of mass migration (socially referred to as the ’Japa’ syndrome) that often leaves parents with empty nests as children and grandchildren are often scattered across continents, seeking better life.

    While he acknowledges divine grace, good genes as contributory factors to longevity in some cases, he believes that good choices of active physical and mental life can help individuals ward off certain diseases that are often seen as terminal and easy killers. Reading, communal associations, physical bonding with offspring and the extended families are very therapeutic in an internet age where gadgets seem to have displaced human connections, especially at the core family levels.

    Fatalism and religious fanaticism can never replace nature or on their own cure or prevent diseases. This then means that the human must make efforts to stay healthy and prevent or control the impact of diseases not just as young people but in old age too. Regular medical checkups, especially of the vital organs; heart, liver, lungs, kidney , eyes, etc., and adhering to the advice by medical doctors can help people prolong their lives because, as the saying goes, ‘a stitch in time saves nine’. Seeing doctors must be supported by dietary control (as metabolism slows down with age) and regular exercises.

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    The black race is particularly vulnerable to various old age diseases. However, managing old age seemed easier in the past when communities were together and bonding was more effective. A time of phones and social media seems to be very isolating, and with it comes the problems of isolation and depression. Children must also realise that money and materials can never replace human connections.

    We marvel at the miracle of Pa Omololu’s longevity despite having been saddled with two much-feared diseases. Presently in Nigeria, there seems to have been an epidemic of both in the last few decades. Sadly, there have been several victims of both who never lived to be 50 due to a variety of factors.

    More often than not, a diagnosis of either is seen as death sentence and, in most cases, most people mentally give up, caring less about management of the diseases.

    This very amazing story seems to indicate that there is more to life than scientists often make us believe. The key factors however remain that making healthy choices, adhering to doctor’s advice, exercising, and regular medical checkups can help individuals manage their health not just when they are old but choices must be made very early in life because as they say, ‘prevention is better than cure’, and, in the case of Pa Omololu, even if you can’t prevent these diseases, try to moderate your lifestyle following a diagnosis. It all just shows that information is power and we must embrace it.

  • ‘Underage mothers, diseases, delayed healthcare access contributing to maternal mortality in Nigeria’

    ‘Underage mothers, diseases, delayed healthcare access contributing to maternal mortality in Nigeria’

    …Kano Tops Maternal Mortality Chart as Stakeholders Identify Key Causes

    Participants at the ongoing workshop on the implementation design of the Maternal and Neonatal Mortality Reduction Innovation Initiative (MAMII) in Kano have identified the major causes of maternal deaths in Nigeria, highlighting why Kano State leads in the statistics.

    The stakeholders developed a strategic template to address these challenges, which stem from health complications, cultural factors, and socioeconomic conditions.

    The federal government launched the MAMII implementation design on Monday with the Kano workshop, aiming to significantly reduce or eliminate maternal deaths nationwide.

    Among the participants were Dr. Saidu Ahmed Dombulwa, Director in the Office of the Coordinating Minister of Health and National Programme Manager of NEMSAS; Kano State Commissioner for Health, Dr. Abubakar Labaran Yusuf; and representatives from the National ALGON, Northern Governors Forum, and various medical professionals from across the country.

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    Key causes of maternal deaths identified include hypertensive disorders in pregnancy, obstetric hemorrhage, pregnancy-related sepsis, acute cardiac diseases, HIV/AIDS-related complications, and uterine rupture.

    In their social autopsy, the team found out that financial constraints and lack of health insurance significantly delay access to medical care.

    They discovered high prevalence of young or underaged mothers with poor knowledge of healthcare as well as non existence of emergency transport system at health facilities.

    Also, inadequate number of staff at health facilities was identified as a major challenge, as the participants observed that a midwife who is available only three days a week was not seen at the time of visit at the facility where she works.

    “Access challenges, including poor road infrastructure and long distances to health facilities, worsen these delays.

    “Health system inadequacies, such as insufficient staffing, lack of essential resources, and poor communication, further hinder timely and effective care.

    “Community factors, including reliance on traditional medicine and cultural norms influencing healthcare decision-making, were also identified as critical barriers.

    “After identifying the challenges and barriers, the participants reviewed their findings from the field and co-created a template of intervention suite for MAMII,“ the communique by the participants said.

  • Addressing non-communicable diseases in underserved communities

    Addressing non-communicable diseases in underserved communities

    Sir: A recent engagement with communities in Kano and the Federal Capital Territory (FCT) revealed the heavy economic burden faced by individuals living with Non-Communicable Diseases (NCDs) such as hypertension and diabetes. Without proper management, these conditions can escalate into more severe health complications, including heart disease, stroke, and kidney failure. Despite their profound impact on public health and the growing prevalence of NCDs, one cannot help but question why these diseases receive far less attention and resources compared to others like HIV/AIDS. This stark disparity underscores the urgent need for a more focused and proactive approach to addressing the NCD crisis before it spirals further out of control.

    While global efforts focus on high-profile public health emergencies, chronic non-communicable diseases (NCDs) continue to silently ravage rural communities in low- and middle-income countries (LMICs). It’s no surprise that NCDs now account for 71% of global deaths, with 29% of those occurring in Nigeria alone.

    In Nigeria, approximately 30% of adults suffer from hypertension, and 7% live with diabetes, making these two conditions among the most prevalent NCDs in the country. Beyond the statistics, this translates to lives lost, families torn apart, and communities becoming less productive and more vulnerable. Shockingly, the majority of people living with NCDs are unaware of their conditions, largely due to a lack of awareness about risk factors, leading to late diagnoses and inadequate treatment. This underscores the critical need for timely interventions in the detection and management of these diseases.

    Unfortunately, access to quality, affordable care for NCDs remains a significant challenge, particularly in rural areas and primary healthcare settings. This is largely due to a combination of limited resources and socio-economic factors, which have contributed to an environment where NCDs continue to thrive unchecked. Effective management of these diseases requires innovative and unconventional strategies, particularly in community engagement, education, and accessible healthcare.

    Countries like Sri Lanka, Indonesia, Vietnam, and Bangladesh are taking intentional steps to integrate the WHO’s Package of Essential Non-Communicable Diseases (PEN) interventions into their primary health systems. This comprehensive, cost-effective approach aims to improve healthcare delivery, enhance health outcomes, and reduce the burden of NCDs, especially in underserved populations.

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    In Nigeria, eHealth Africa and the EHA REACH Clinic have also piloted the PEN intervention to improve rural access and address hypertension and diabetes in the Federal Capital Territory and Kano State. This approach emphasizes community engagement, cross-sector collaboration, data-driven decision-making, and access to essential medicines. With training on effective hypertension and diabetes management, Community Health Extension Workers (CHEWs) are now supporting over 200 patients in managing their conditions. This model has proven effective in improving health outcomes, especially in rural communities. In fact, CHEWs have become trusted figures who lead health education efforts on NCD prevention, conduct screenings, and help patients access healthcare services while educating them about lifestyle changes that reduce NCD risks.

    While community engagement through CHEWs is essential, innovative digital health tools also play a critical role in improving NCD management. Mobile health tracking apps can motivate individuals to take control of their health and monitor their progress. These apps make educational content more engaging and accessible, helping to foster a more proactive approach to managing chronic diseases.

    Prevention is key in addressing chronic conditions like hypertension and diabetes. Community-based fitness and nutrition programs can support healthier lifestyles. Advocating for policies that improve health infrastructure in rural communities will complement these efforts. This includes better funding for primary healthcare facilities, transportation services for medical visits, and initiatives that promote healthier environments.

    Most importantly, it is high time we prioritize NCDs and provide free medical support for conditions like hypertension and diabetes, just as we have for HIV/AIDS and other vaccine-preventable diseases. As HIV/AIDS has garnered global support for free treatment, we must now recognize the urgent need for equitable, accessible care for hypertension and diabetes. This will ensure that those affected are not left behind in the pursuit of better health outcomes. Given the long-term nature of these conditions, which often require ongoing medication, offering free treatment will significantly reduce the burden on individuals and healthcare systems alike.

    In conclusion, prevention, early detection, and the integration of innovative approaches within primary healthcare systems are essential to tackling NCDs. These strategies will not only improve individual well-being but also strengthen the overall resilience of communities.

    •Moshood Isah,eHealth Africa, Abuja.

  • Minister seeks multi-sectoral approach to forestall diseases’ outbreak

    Minister seeks multi-sectoral approach to forestall diseases’ outbreak

    • Lagos, Cross River, others embark on ways to tackle cholera

    Coordinating Minister of Health and Social Welfare, Prof Muhammad Ali Pate, has called for a multi-sectoral approach to forestall outbreak of infectious diseases like cholera, typhoid fever and tuberculosis.

    He said the approach should not only be biomedical, which is curative, noting that many diseases are socially determined, hence, the right public policies must be put in place to provide social safety nets for vulnerable and poor people.

    “There are many diseases that are socially determined; they are diseases of largely the population that are vulnerable and poor who live in inadequate housing, with low sanitation, who don’t have enough food, who are malnourished or whose occupation exposes them to certain disease conditions,” the minister said on Channels Television’s The Morning Brief show yesterday.

    “So, to address population health, there is the biomedical which are certain diseases that we handle but there are some that go beyond that, and are multi-sectorial in terms of the determinant of why those diseases occur and how to respond to them.

    “At the end of the day, we need to grow our economy, we need to translate that growth into income for households, we need to also build infrastructure; the base for the urbanisation that we are seeing so that people will have good housing, good nutrition, safe spaces, proper mental health, in addition to access to health facilities they can afford to get proper mental services.

    “So, health is one thing that is not just a biomedical issue; there is health in almost all public policies, whether it is on housing, transportation, agriculture, environment, youths, even the gender dimension of it to ensure the women are not left behind, and there are vulnerabilities that will have to be addressed through social protection mechanism to ensure that there are safety nets for those who are left behind.”

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    Meanwhile. the Cross River State Heath Ministry says there are no cases of cholera outbreak in the state as the last case was recorded in January.

    The Health Commissioner, Dr Henry Egbe Ayuk, clarified that the disease outburst was yet to be confirmed.

    Ayuk said: “The last time there was a confirmed case was in January 2024 and that has been addressed. This notwithstanding, the state is fully prepared for any emergency response in the current wave of national outbreak.

    “The public health emergency response centre has been activated while the local government response teams have all been strengthened with adequate capacity, including commodities to handle any emergency.’’

    In Lagos, the Nigerian Red Cross Society, Lagos Branch, has  trained  60 emergency response volunteers to enable them to acquire skills to curb cholera spread in communities.

  • Healthcare and diseases in Nigeria

    Healthcare and diseases in Nigeria

    Sir: Healthcare delivery in Nigeria has experienced progressive deterioration as a result of weakened political will on the part of successive governments to effectively solve several problems that have existed in the sector over the years. Most health workers leave the country for good because of the insensitivity of government towards the health sector and unwillingness to address myriads of problems in the sector. The public healthcare system runs on primary healthcare facilities; general hospitals and teaching hospitals are either underfunded, not supervised or not well managed. Several outbreaks of diseases have shown that the healthcare system lacks medical intelligence, surveillance.

    Statistics show that drug manufacturers and pharmacies in Nigeria hiked drugs by over 150%. Common anti-malaria drugs have gone beyond the reach of many Nigerians. Nigeria is witnessing more morbidity and mortality, as well as recycling of poverty among the majority of the population. A responsible government that has value for human lives will do all it can to subsidize the prices of essential commodities, life-saving drugs and services. The nature of our healthcare services is a reflection of the culture we found ourselves in. Just like we demand new things and change our fashion, sometimes we demand new drugs, miracle cure or the magic bullet. We must not take tablets for every ailment; the practice of relaxation exercise, change in diet or lifestyle modification could be the magic. We must begin to ask our doctors the right questions – must I require another prescription? Must I take these drugs? Every drug has contra-indications, side-effects and interactions.

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    Nigeria has a high burden of communicable and non-communicable diseases. Malaria, TB, HIV/AIDS constitute a big challenge. Malnutrition is also common with astounding rate at 43.6%. Disease burden is the impact of a health problem on a given population, and can be measured using a variety of indicators such as mortality, morbidity or financial costs. Progress in reducing the burden of diseases has been at a standstill endangering lives and perpetuating a vicious cycle of inequity. Some of these diseases like malaria, which is preventable and treatable, still affect many who are vulnerable due to poverty and limited education.

    The World Health Organisation has lamented that the burden of diseases in low-income countries is high. “An apple a day keeps the doctor away” is an agelong proverb that has come to explain the health of citizens in Nigeria. Nigerians are hungry and it impacts their well-being. ‘A healthy nation is a wealthy nation’ – the absence of a decent wage in the country underscores the irresponsibility of governance and care, high cost of living and inability of the masses to access medicare.

    •Obiotika Wilfred Toochukwu Awka

  • Saving Nigerians from Non -Communicable Diseases

    Saving Nigerians from Non -Communicable Diseases

    • Through sugar-sweetened beverages tax

    Health experts have linked excessive consumption of sugar-sweetened beverages (SSBs) to Nigeria’s non-communicable diseases (NCDs) burden. A new study presented by Corporate Accountability and Public Participation Africa (CAPPA) recommends an increment in the current SSB Tax from N10 to N130 per litre to protect Nigerians from health challenges resulting from excessive consumption of SSBs and subsequently shoring up the government’s revenue by N729 billion. CHINYERE OKOROAFOR reports.

    Concerned about the increasing rate of health issues emanating from excessive consumption of sugar-sweetened beverages (SSBs), the Federal Government introduced a sugar-sweetened beverages (SSBs) tax embedded in the Finance Act of 2021. The Act set an N10 levy for every litre of carbonated drinks and non-alcoholic drinks.

    Again, the country’s rising non-communicable diseases (NCDs) burden was a source of concern. Data shows that the country is the fourth highest consumer of SSBs.

    The N10 levy meant, for instance, that for every 50 centilitres of carbonated drinks consumed, the Federal Government gets N5, expected to be utilised to strengthen the healthcare sector to, among others, cater for those who have health challenges arising from SSB consumption.

    Sugar-sweetened beverages are laden with empty calories, fueling a public health crisis of diabetes, obesity and heart disease.

    Health experts say that “the statistics are sobering: one in 10 Nigerians now lives with diabetes, placing a crippling burden on individuals and Nigeria’s healthcare system.”

    Investigations reveal that the health effects of SSBs have increased over the past decade. Substantial evidence linking SSB consumption to several health consequences among adults has also emerged. Some of these health consequences include weight gain, cardiovascular risk factors (e.g., dyslipidemia), insulin resistance Type 2 diabetes and non-alcoholic fatty liver disease.

    However, penultimate Thursday, health experts raised the alarm that the N10 levy is ineffective in curtailing addiction to sweetened drinks. They warned that more Nigerians are coming down with severe SSBs-linked NCDs, including Type 2 diabetes, heart disease, and various types of cancer.

    They spoke in Lagos at Corporate Accountability and Public Participation Africa (CAPPA)’s public presentation of a simulation study titled “Potential Fiscal and Public Health Effects of SSB Tax in Nigeria.”

    SSBs explicated

    SSBs refer to drinks that contain natural or added sweeteners, including various forms of sugars such as brown sugar, corn sweetener, corn syrup, dextrose, fructose, glucose, high fructose corn syrup, honey, lactose, malt syrup, maltose, molasses, raw sugar and sucrose.

    The drinks include soft drinks, juices, sweetened coffee, nectars, energy drinks and flavoured dairy products.

    Concerns

    Expectedly, the SSB industry has kicked against the proposed hike, arguing, among others, that sugar taxes may disproportionately affect low-income individuals and that those with limited resources may continue to consume sugary beverages despite higher prices, resulting in a disproportional economic burden.

    The industry also often argues that it is wrong to assert that SSBs alone are the singular or principal cause of the highlighted public health issues. In several articles, it is often claimed that as with any dietary choice, moderation is key. A balanced nutritional approach, which allows for the occasional indulgence in sugary beverages, can harmonise with a healthy lifestyle and dispel misconceptions about their influence on obesity and related health issues.

    A participant at the Lagos presentation also argued that the N130 per litre tax was anti-poor, in the light of the rising cost of living.

    Nigeria’s NCD burden

    CAPPA’s Executive Director, Akinbode Oluwafemi described Nigeria’s NCDs burden as a public health emergency that requires urgent attention.

    He referenced, among others, data from the World Health Organisation (WHO), whose Country Disease Outlook published in August 2023, says NCDs were responsible for 27 per cent of deaths in Nigeria in 2019.

    According to the WHO, in 2021, the mortality rate across four major NCDs (Cardiovascular Disease, Chronic Respiratory Disease, Cancer and Diabetes), was 565 deaths per 100,000 males and 546 deaths in females.

    An earlier WHO report put the risk of premature death from cardiovascular diseases, cancers, respiratory diseases and diabetes among Nigerians aged 30 to 69 at 22 per cent. As of 2020, there were more than 21 million overweight and 12 million obese people in the Nigerian population aged 15 years or more, accounting for an age-adjusted prevalence of about 20 per cent and 12 per cent respectively.

    Olufemi further argued that tax raises are sometimes necessary on certain products, such as SSBs, considered to have serious health implications.

    He recalled that Nigeria’s introduction of the N10 per litre excise charge on SSBs under the Finance Act in 2021 was celebrated as a victory for public health.

    The CAPPA Executive Director stated that N10 per litre is a fixed tax that is not inflation-adjustable; hence, it may be worth less than four kobo in today’s currency value.

    He further said that a flexible framework for inflation needs to be included in the 2024 Fiscal Act, along with a significant rise in the SSB tax.

    Oluwafemi said: “It is obvious that the increase in NCD cases in Nigeria is alongside the rise in consumption of SSBs, alcohol, tobacco, trans-fat, unhealthy consumption of salt and other diets that are non-nutritive and harmful to the body.“

    According to him, the prevalence of diseases in Nigeria also keeps many people impoverished since they must spend a large portion of their income on deficient diets, which raises healthcare expenses and worsens matters for the populace.

    “It is a cycle that needs to break. In a country with more than 80 per cent of its population paying for healthcare out-of-pocket, we must find a policy pathway that will effectively remove obstacles to good health and national productivity such as modifiable risk factors of consumption-related diseases and other NCDs,” he said.

    Oluwafemi also referenced the SSB industry’s opposition to the increased tax, saying they were concerned with their profits, rather than their customers’ health.

    He added: “The argument of the people who care more about their profit over public health on consumption needs does not outweigh the many benefits inherent in this tax.

    “The damage done to fa milies and loved ones who cater for the sick is enough motivation to see the public rally around the government in doing what is right for the public. The cries and woes of the Armageddon by paid agents and allies of the SSB industry must not drown the voice of reason and the genuine concern for our welfare.”

    CAPPA, SSB industries differ on claims

    Oluwafemi said: “For years, the sugar-sweetened beverages industry has painted a picture of  sugary drinks as innocent pleasures. But behind the vibrant colours and catchy jingles lies a grim reality. SSBs are laden with empty calories, fuelling a public health crisis of diabetes, obesity and heart disease. The statistics are sobering: one in 10 Nigerians now live with diabetes, placing a crippling burden on individuals and Nigeria’s healthcare system.”

    He also noted that the manufacturing industry “actively targets children and youths, bombarding them with sugary advertising and social activities, normalising unhealthy habits at a crucial stage in their development.”

    In his view, this “predatory marketing” exploits the vulnerability of young minds, shaping preferences that echo for years., adding that “the consequences are far-reaching as diabetes and its complications steal years of healthy life, erode productivity, and strain resources; leaving families shattered and futures uncertain.”

     Is the proposed SSB tax pro-health?

    Basing their argument on facts from the study, CAPPA said that the proposed N130 per litre levy is a “pro-health tax.”

    The categories of SSBs covered in the simulation – in line with Section 17 of the Finance Act of 2021 – are soft drinks, energy drinks, and malt. This definition excludes 100 per cent fruit and vegetable juices. The study emphasised the urgency of addressing the health risks of SSB consumption.

    The report states that “an annual decrease of 29 per cent is expected for aggregate consumption of SSBs in Nigeria following a practical implementation of the SSB Tax. The simulation results further indicate a significant reduction in Body Mass Index (BMI).

    “Specifically, the tax is estimated to reduce BMI by four per cent on aggregate over five years, thereby yielding a decline in the mean prevalence of overweight (0.42 per cent for males and 0.37 per cent for females) and obesity (0.46 per cent for males and 0.53 per cent for females) if effective SSB taxation at a rate of N130 is implemented.

    “Such measures hold the potential to not only save lives but also curtail healthcare costs and enhance overall public health.”

    How the SSB Tax would work

    The report advises the Nigerian government to consider setting the SSB tax rate at a minimum of N130 per litre. This tax increase is estimated to trigger a substantial price surge of 39 per cent increase per litre, thereby discouraging consumption effectively by about 29 per cent annually.

    It added that “to ensure persistent health gains from the SSB tax, it is very important to regularly review the tax rate upward while accounting for inflation effect.

    “Also, comprehensive awareness campaigns should be initiated to educate the public on the benefits of the tax and the health risks of excessive SSB consumption. These campaigns should highlight the fact that the increase in SSB price is a protective public health measure and not a ‘price burden,’ and consumers should be encouraged to embrace healthy alternative beverage choices.”

    N729b gain for healthcare

     Beyond public health benefits, CAPPA viewed the proposed SSB tax increase as presenting a unique opportunity to bolster government revenue. The report estimates that implementing an SSB tax in Nigeria could result in a substantial increase in tax revenue.

    “Specifically, revenue from this excise tax is estimated to rise by 972 per cent (amounting to N729 billion). This additional revenue could be strategically allocated through earmarking to strengthen the country’s healthcare system, particularly basic healthcare, which currently grapples with inadequate funding. The potential to enhance healthcare infrastructure and address diet-related diseases through SSB taxation cannot be overstated,” the report added.

    According to the Research Associate at the Centre for the Study of the Economies of Africa (CSEA) which carried out the study, Fidelis Obaniyi, the increased tax could have favourable impacts on public health.

    Obaniyi argued that by carefully distributing this extra money through earmarking, the country’s healthcare system—fundamental healthcare, which is currently beset by a lack of funding—could be reinforced.

    He added that the purpose of the tax is to correct market failure; trigger behavioural change – public awareness of the negative effects of SSB consumption; increase fiscal revenue and reduce health burden.

    He further explained that the tax increase would help to reduce the consumption of sugary beverages, which, in turn, could improve public health by reducing intake and preventing health issues such as obesity and diabetes.

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    “In addition to promoting healthier choices, SSB taxes can generate government revenue.

    “The primary purpose of implementing an SSB tax is to reduce the consumption of these sugary beverages and address public health concerns related to obesity, diabetes and other health issues associated with excessive sugar intake,” Obaniyi added.

    Federal Government’s position

    The Federal Government affirmed its determination to help Nigerians live a healthy life free of excessive SSB consumption.

    The Director of Public Health at the Federal Ministry of Health and Social Welfare, Dr Chukwuma Anyaike, who spoke last Monday in Abuja during the first unveiling of the report, lamented the negative effects of SSBs on the populace.

    Noting that an estimated 38.6 million litres of soft drinks are sold daily in Nigeria, Anyaike said: “This makes Nigeria the 4th highest soft drink consuming country in the world.”

    Anyaike said the drinks are marketed in such a way that customers believe that they get better value when they buy the biggest bottles of soft drinks, leading to over-consumption.

    “Of particular concern is the trend of over-consumption among Nigerian adolescents which can lead to childhood obesity and negative health consequences in adulthood.

    He said the institution of the SSB tax has been identified as the most effective way of reducing the consumption of excess SSBs, which will consequently reduce the incidences and prevalence of NCDs.

    He was, nevertheless, clear that it was not within the Ministry of Health’s power to determine taxes.

  • Concerns over rising incidents of silent killer diseases, sudden death

    Concerns over rising incidents of silent killer diseases, sudden death

    • Health experts explain how to avoid them

    The number of Nigerians dying suddenly without apparent ill health is on the rise. But health experts say the sad development is caused more by ignorance and carelessness on the part of victims than the harsh economic realities that currently confront the nation. GBENGA ADERANTI examines the phenomena and how they can be avoided.

    Some hours before he passed on, 50-year-old Tunde Aderemi was bubbling with life. He showed no sign of weakness or ill health. “He was not sick. We ate supper together. He showed me no sign whatsoever that he would be leaving so soon,” his bewildered mother said repeatedly as tears rolled down her cheeks.

    Mallam Audu, Tunde’s neighbor who operates a provisions kiosk on their street, said he was still in shock over his sudden passing in the early hours of the day.

    “We were together till midnight before he left for their house. Walahi, me I no believe say he don die. He no sick now,” Audu said in a fit of utmost shock.

    Like Tunde, 35-year-old Sayo Anslem passed on barely two hours after conversation with her father who had visited her.  Sayo, who only got married a year earlier, was, according to her husband, hale and hearty moments before her death. He said the only thing he noticed was that she could not eat much that night.

    The distraught husband said: “We chatted for hours before we went into the room. Then at about 11 pm, she just shouted as we were talking. Before I knew it, she slumped and was later pronounced dead at the hospital.”

    Sudden death, a phenomenon that has become rampant in recent times, refers to a natural, unexpected fatal event occurring within one hour from the onset of symptoms in an apparently healthy subject or in one whose disease was not so severe to predict such an abrupt outcome.

    No fewer than five Nigerians were reported to have died ‘suddenly’ during the recent African Cup of Nations (AFCON) match between Nigeria and South Africa in Ivory Coast, last month.

    Among them were a chieftain of the ruling All Progressives Congress (APC), Cairo Ojougboh; Deputy Bursar, Kwara State University, Malete, Ayuba Abdullahi; a national youth corps member serving in Adamawa State, identified simply as Samuel; an Anambra-born businessman based in Cote d’Ivoire, Osondu Nwoye  and a sales rep based in Abeokuta, Ogun State, Mikail Osundiji.

    Ojougboh was said to have slumped when a penalty kick was awarded against Nigeria during the match, which gave the South Africans an equalizer. He was said to have suffered a heart attack and later confirmed dead at the hospital where he was rushed to.

    Abdullahi, on his part, was said to have complained of dizziness while watching the match. Reports said he was not aware that his blood pressure had shot up. On getting home, he collapsed and was rushed to a private hospital where he died before he could be attended to.

    Osundiji, who until his death was working with one of the multinational manufacturing companies in Nigeria, was said to have died as a result of shock after the centre referee cancelled a goal that would have given Nigeria a two-goal cushion against South Africa and, instead, awarded a penalty that drew South Africa levels with the Super Eagles.

    A close relative of the 43-year-old sales rep said he suddenly breathed out heavily after Nigeria’s second goal was cancelled, lowered his head and fell to the ground at the viewing centre.

    But it is not only in Nigeria that the phenomenon of sudden deaths is on the rise. According to a report, the rate at which people are dying in the US is alarming.

     The 2022 report indicated that cardiovascular cases account for up to 73 per cent of the sudden deaths that occur in God’s Own Country.

     Hypertension and diabetes mellitus are regarded as the two leading cause of sudden death worldwide. Hypertension is said to affect more than one billion people worldwide (1 in 4 adults), with more than 28 million cases in Nigeria in the year 2020, rising from 4 million in 1995.

     No fewer than 425 million people live with diabetes mellitus worldwide and about 4 million people in Nigeria, thus a big worry, said Dr. Hally Oluwawemimo, a family physician.

     The United States Centre for Disease Control and Prevention disclosed that more than 356,000 people have an out-of-hospital cardiac arrest in the United States every year, and about 60% to 80% of them die before reaching the hospital.

    According to the centre, cardiac arrest occurs when the heart suddenly and unexpectedly stops beating and blood stops flowing to the rest of the body. People who survive cardiac arrest can have brain injury or injury to internal organs. Psychological distress, like anxiety, Post-Traumatic Stress Disorder (PTSD) and depression, can also be a causative agent for sudden death.

     While cardiovascular disease may account for up to 73% of sudden deaths, other conditions such as asthma, epilepsy, and intra-cerebral hemorrhage could lead to sudden death, another report revealed.

    Conditions such as low or high blood sugar may trigger sudden death, a

    United Kingdom-based Nigerian medical doctor, Temmy Dada, said. While it is not uncommon for many to resort to taking soda and energy drinks to boost sugar levels, she said the solution to long-term low sugar is not energy drinks or soda. She reiterated the need to identify the cause of low sugar.

    Rather than resort to self-medication, sudden death could be prevented if those with chronic illnesses ensure they receive treatment from qualified professionals in standard hospitals and not from quacks. “This will give them access to the right information and treatment.  Through this, they will know how to identify signals which they need to be on the lookout for,” said Dr. Dada

    Excessive consumption of energy drinks has become a way of life for some people. Dada, however, warned that because energy drinks are addictive stimulants, they can affect the heart and lead to sudden death.

     Despite the presence of both public and private hospitals, many who are battling with one ailment or the other prefer to resort to self-medication.

    Dada, while condemning the lackadaisical attitude of some Nigerians towards their health, revealed that many do not fancy going to hospitals.

     She blamed multi-factorial availability of services, accessibility of service, affordability, waiting time in hospitals, lack of human and capital resources in the health system, attitude of health workers and cultural and religious beliefs as part of the reasons why many Nigerians prefer to resort to self-medication.

     The good news, however, is that while stigmas are attached to certain ailments like mental illness, HIV and others, this is not so common with hypertension or diabetes.

    “The main issues with stigmatised ailments are cultural and religious beliefs, and poor understanding and lack of knowledge about them,” she said.

    She also warned that since a sedentary lifestyle is associated with different health issues, it is beneficial to do away with such a lifestyle and build exercise into our daily routine for better health and well-being.

     So what causes sudden death and what are the ways to avoid it?

    To this, Dada said: “Sudden death is sometimes a consequence of an underlying undiagnosed illness, and this happens because many don’t do routine check-ups to know the status of their health.

    “Many people have undiagnosed hypertension because they never just checked their blood pressure. Sudden death is preventable by checking on our health status from time to time without waiting for symptoms to see our doctors.”

    Also speaking on the phenomenon of sudden death, Dr. Oluwawemimo, disclosed that hypertension and diabetes mellitus are the two leading causes of sudden death worldwide.

    She disclosed that the normal fasting blood sugar is usually btw 50- 110mg/dl. “People with low blood sugar usually have less than 50mg/dl on a consistent basis. If this is so, they should seek medical help as there are reasons for this. For example, they may have pancreatic cancer. So drinking soda doesn’t really solve the issue.”

     Both low blood sugar and high blood sugar (diabetes mellitus) can cause sudden death. According to her, the brain and the cells of the body aren’t receiving enough glucose as in the case of low blood sugar, thus causing body weakness.

    In the case of high blood sugar (diabetes mellitus) the hormone that controls glucose into the cells called insulin is either non-available as in Type 1 Diabetes (which occurs usually in childhood) or low as in Type 2 Diabetes (which occurs in adults). Thus the glucose needed for energy and activity in the body isn’t driven into the cells of the body, thus causing weakness and sudden death.

    Complications of diabetes like heart attack, unhealing wounds and kidney failure can also result in death.

    She warned that people with diabetes, hypertension, low sugar and hepatitis should be alarmed the first day they go to the hospital and are tested. They should be counselled on taking their medications regularly “because complications from the diseases are preventable although the disease itself may not be totally curable.

     “No self-medication. Self-medication is dangerous, thus seeking proper medical attention.”

    The Nation gathered that many people die suddenly because they don’t go to the hospital for various reasons, which include, ignorance, lack of funds, belief in quacks, and non-accessibility to health care due to distance from their homes.

    Unfortunately, many people do not seek medical assistance because of the stigma attached to these ailments.

    Hally observed that “Numerous people are afraid when they are diagnosed with these diseases, but really, it’s nothing to be scared about as there are medications to manage them.”

    She warned those with a sedentary lifestyle risk developing hypertension. Therefore, they should be active, exercise regularly and “to the elderly a brisk walk of 10-30minutes daily.

    “People should have regular checks on their health at least twice a year and take to their doctor’s advice. This would prevent sudden death in most cases.”

  • Redeemer’s varsity’s infectious diseases centre attracts $200m grants

    Redeemer’s varsity’s infectious diseases centre attracts $200m grants

    • Institution’s 44 graduands make First Class as best student gets job

    The Redeemer’s University at Ede in Osun State has won over $200 million grants through the African Centre of Excellence for the Genomics of Infectious Disease (ACEGID) to combat infectious diseases and other public health-related issues.

    The university’s vice chancellor, Prof. Anthony Akinlo, announced this during the pre-convocation briefing yesterday at Ede.

    Highlighting the successes the school had recorded, the vice chancellor said the school’s ACEGID Department, which came to limelight in 2020 during COVID-19 era, hosted eight young Africans from six countries for internship in molecular biology and genomics. He said the centre had also trained 10 scientists from five other African countries.

    Akinlo said: “At the centre of ACEGID, we are training our students. The equipment are there for everybody. We are training Master’s and PhD students. It is for the benefit of every students in the Sciences. I can tell you in a very simple way that the centre has attracted grants of not less than $200 million. Many more grants are still coming…

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    “We have many new programmes. Among them is the Centre for Gender and Humanitarian Studies. This centre will be the first in Nigeria. So far, we have graduated 6,995 students from this school from various departments.

    “On infrastructure, the ongoing projects in the school will cost us several billions. The building of the Faculty of Law will cost us N3.27 billion. Also, the Engineering Faculty will cost us N1.8 billion; the Faculty of Basic Medicine will cost us N1.2 billion. The event centre will cost us N400 million; the Health Sciences will cost us N540 million. We have more and more. The dual carriage way will cost us N450 million. It is a whole of money.”

    He added: “For the 15th convocation, we have altogether 750 graduands: 44 of them made First Class honours; 290 are in the Second Class Upper Division; 264 are graduating with Second Class Lower; 74 others fall into the Third Class category, and three with Pass. The Overall Best Student automatically gets a job in this institution.”

  • Achieving wellness for Individuals with Non-Communicable Diseases

    Achieving wellness for Individuals with Non-Communicable Diseases

    Experts have identified Non-Communicable Diseases (NCDs) as the leading cause of death worldwide, saying they present a huge threat to health and development. At the second edition of the Positive/Wellness Summit organised by Sickle Cell Advocacy and Management Initiative (SAMI) to mark its 15th anniversary, the experts maintained that the federal government, financial, health and private sector’s involvement is needed in tackling the burden. Aderinsola Bamidele reports.

    More often than not, according to experts, some Non-Communicable Diseases (NCDs) were caused as a result of individual lifestyles which could have been prevented had they been educated and aware of the consequences of their choices.

    They reel off tobacco use, physical inactivity, indiscriminate alcohol intake and unhealthy dietary patterns as the major behaviours that cause NCDs. Also, living in a toxic environment, air pollution and inhaling of second-hand smoke are also contributory factors for NCDs.

    According to the World Health Organisation (WHO), the main types of NCD are cardiovascular diseases (such as heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma) and diabetes.

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    Others include cancer, sickle cell anaemia, mental illness, neurological and substance use disorders, road traffic injuries, and oral health disorders among others.

    These diseases are, to some extent, preventable and manageable. But it is estimated that by 2030 they will cause 75 percent more deaths than malnutrition and infectious diseases.

    Although there are no official statistics for the burden of NCDs in Nigeria, but 2019 WHO NCD Country Profiles, NCDs accounted for 29% of all deaths in Nigeria with cardiovascular disease, predominantly hypertension, responsible for 11% of all NCD deaths, and premature mortality due to NCDs at 22%. Premature mortality due to NCDs is defined as the probability of dying between ages 30 and 70 years from any of the common NCDs.

    Out of these, diabetes accounted for two percent; cancer, four percent; injuries, eight percent, and cardiovascular diseases, 11 percent.

    With the theme: The Strength of it All: The Future of NCD in Nigeria.” The summit, which is aimed at promoting consciousness, education, and empowerment concerning (NCDs) in Nigeria, took a holistic look at different healthy practices that will help sufferers and individuals who are at risk to thrive instead of surviving.

    To prevent NCDs, experts recommend a balanced diet, regular exercise, and adequate sleep.

    Many NCDs can be prevented by reducing common risk factors such as tobacco use, harmful alcohol use, physical inactivity, and eating unhealthy diets.

    In her opening remark, the Founder of SAMI, Ms Toyin Adesola, said that NCDs greatly impact the country’s health and economy.

    Adesola said: “The economic burden of NCDs is numerous since chronic disease treatment is always very costly. People with NCDs have high healthcare bills, and their families face increased financial risk. Thus, an increase in household expenses on health leads to an unprecedented financial catastrophe and impoverishment. Sickle Cell Disease (SCD) is NCD as well. In our 15 years of dealing with people with SCD, we found out that the awareness of NCD is not much compared to communicable diseases like Human Immunodeficiency Virus (HIV), COVID-19, or Tuberculosis but NCDs are limited to specific persons but NGOs like ours and others try to talk about these issues.”

    On what the government, financial, and health sectors can do to tackle the burden of NCD, Adesola appeals to the FG to finance the treatment of NCD just like they do for communicable diseases.

    She also urged the financial sector to consider giving health insurance to persons living with SCD and other NCDs to help cushion the burden.

    Adesola said: “We need the medical, government, corporate people and those in the financing sector because one of the challenges of NCD is that for health insurance we see it as a pre-existing condition and these are the people who need health insurance the most. They hardly give people with SCD insurance and even when they do, it comes with a high premium, and people can barely afford it and they struggle and some eventually pass on.

    “We are trying to bring these issues together and see how we can strengthen it and support each other by having a proliferation of all these issues. What are we doing for health finance and how can they have access to healthcare now that doctors are leaving the country among others? NCD need more access to a specialist.

    “Government should finance NCD more. There is a lot of financing for communicable diseases. When you talk about SCD and cancer, the rich and upper class may be able to get treatment but people in rural areas will be blaming it on spiritual things which half of the time is poor health management. The medical sector should find ways to manage people’s health by involving the corporate sectors; it is about funding entertainment shows while there are lots of sufferers dying as a result of poverty.”

    Also speaking at the summit, the Art Therapeutic Coach, Olayinka Enahoro defined art therapy as a type of creative therapy that professionally licensed psychotherapists use in counselling to help patients interpret, express and resolve their emotions, thoughts, and deep-seated mental health issues.

    She emphasized that stress, which is one of the issues with NCDs affects the body and mind, adding that it can also be reduced using art therapy.

    Enahoro said: “Stress is one of the issues with NCDs. When we are over-stressed, our brain releases a hormone called cortisol and if you live a highly stressful life, cortisol starts running around in your body in excess and starts giving rise to all sorts of other things. The brain also releases hormones when viewing or creating art and its related expressions, and these hormones can help reduce the amount of cortisol in the body. They help to reduce stress and, by extension, all the opportunistic ailments such as weight gain, depression, female fertility problems, digestive issues, erectile dysfunction/ low sex drive among others.

    “The brain does this by helping to release our daily dose of feel-good hormones such as dopamine, oxytocin, serotonin, and endorphins, contributing to improved health and positive emotions among others. Art is viewing it, doing it, and by art, we don’t necessarily mean painting, drawing but dancing, art involves drama, poetry, and music. There is evidence to show that bedside music of cancer patients can actually be used as a tool in health and healing. There is a book titled “Brain on Art that talks about how the brain when exposed to art and its expressions can release certain things and it can chase away the cortisol.

    “There is something that the brain does when it comes to creating art. There is something called neuroplasticity in which you are rewiring your brain because stress helps to destroy certain things and as you age as well, the neurons in the brain begin to slow down. Art can also help in the early onset of dementia. This year, I found out that Sickle Cell patients who engage in art regularly either creating or listening to music can have less of a crisis because of the way one of the chemicals released has helped the blood cell to expand and can pass easily. It is important to put art into our daily life to help in reducing stress so we can be more focused.”

    Speaking on the impact of nutrition, the former president of the Nigerian Institute of Food Science and Technology (NIFST) and Nutritionist, Mrs Dolapo Coker, said that food is the major ingredient for wellness.

    She said: “The macronutrients, the vitamins, and enzymes in food are actually what give us wellness. You are your own first consultant because it is the way you feel that you will tell the doctor. So, you consult yourself first by checking what you ate or drank and why you are feeling the way that you do. And as such, if you identify that thing, you will avoid it.

    “Water is essential. When you don’t feel comfortable even with a headache and you think of taking water, you will be surprised that you will feel much better. Probably something you ate was not doing well with you but when you dilute your system with the water, it washes it away and you feel better.

    “You must not have a favourite food and as such that is what you eat most of the time. It is good to eat a variety of food because the macronutrients in different foods differ and they will do you a lot of good. Don’t run away from oil and fat because some of the vitamins are in the oil and fats. Why not eat the ones that God created rather than go to the pharmacist to buy drugs? You are your own doctor, study yourself, even for those who don’t sleep well, try to study what you have eaten or drank that day and then you can identify it and therefore you sleep. Daily exercise is also important. You collect vitamin D from the sun.”

    Mental Health Therapist and Chief Executive Officer of Reuel Consulting Limited, Totuse Francis admonished parents, guardians, and people living with Non-Communicable Diseases, NCDs, not to put all their hope in medication when dealing with crises associated with the disorder.

    Francis said that people living with NCDs, especially sickle cell warriors, are trained to deal with pain so they find themselves on several drugs and at some point the body becomes dependent on the medication.

    He said: “The thing about dependency on medication is once the body gets used to it, and then it doesn’t work anymore, they increase the dosage and it goes on and on because the pain they experience is sometimes unexplainable.”

    Francis explained that sometimes the pain can make them feel like ending their own life when all the medications they take seem not to be sufficient to take away the pain.

    Another aspect of this kind of experience that they have is addiction. When it comes to the issue of drug or drug addiction.

    Francis suggested different ways of dealing with sickle cell crisis aside from drugs, “There are different techniques in therapy to help sickle patients different help.

    There is psychotherapy, which is like talk therapy, there’s cognitive behavioural therapy, and there is just stop therapy so that different aspects or different techniques when it comes to therapy. We adapt the one that works well for the person. It is different from medication where only psychiatry is to recommend medication.”

    On the role of Neurology in Sickle Cell Disorder, Prof Mustapha Danesi a Consultant Neurologist said: “Black people are more prone to be SS. Sickle cell disease is quite common in this part of the world.

    “It is very difficult to know the exact prevalence but we do have a large number of people here with sickle cell. I can’t say the exact figure but it is very large. The majority of sicklers in the world are found in Africa.”

    Danesi explained that it is best to start testing immediately once they discover a person has sickle cell. Check the system to find out whether they have very high cerebral blood flow.

    “So the earlier they start testing the better for the patient, because if you start testing early you will be able to discover those who are at risk and then give preventive treatment and preventive measures. So that at the end of the day, they will live a normal life, but if you don’t start early like in this part of the world you may have complications before you start taking treatments. So it is better to prevent than to start treating after they have had these complications,” Danesi said.

    The one-day summit looked at several topics including ‘Understanding the Role of Neurology in Sickle Cell Disorder’ by Prof Mustapha Danesi, ‘The Crisscross Effect: Mental Health and Non-Communicable Disease’ by Mr. Toluse Francis, among others.

    There was a panel discussion on building a resilient healthcare system to empower and improve NCDs in Nigeria.

    The panelists include Prof Gladstone Airewele, Dr. Oge Ilegbune, Yewande Sheu, Sharon Browne-Peter, Halima Jafiya, Timleyin Edwin, Dr. Kehinde Giwa, Dr. Joy, Dr. Emeka Nwunna, Dr. Benita Uzonwanne, Mr. Peter Osikoya and hosted by Adesola.

    The summit was supported by Xcene Research Ltd, among other partners.

  • Toilets, diseases and witches in Nigeria

    Many articles have been written in the local newspapers and other outlets on the subject of toilet facilities and disease outbreaks in Nigeria. More would still be published so long as this issue, despite its centrality to healthy life and living, is yet to be rigorously attended to by governments at the local, state and federal levels. Suffice it to say, that a healthy society is critical to an efficient labour force for local industrialisation and by extension, economic development. Therefore, faecal waste management which is embedded in culture must be handled with great care anchored to public health awareness in diverse ways. Culture is transformational in character, understandably because man’s social and material environmental conditions as well as sensitivities are not a fixity.

    The popular but unhealthy open defecation culture in Nigeria has its long, firm roots in considerable antiquity. Use of the surrounding bush, rivers, streams, and ponds as toilets were/are a socially acceptable practice among most citizens. Our urban settlements appear to be worse in this connection. Human faeces litter roadsides, flyovers and other locations in Nigerian cities.  Even Abuja, despite its federal capital status, is not a complete exception. Numerous houses and business centres have no lavatories and/or urinals. This primordial toilet culture robs Nigeria of its corporate dignity. Therefore, the country must be quickly rescued from the swamp of filthiness into which it has been sinking fast. We cannot afford to spin out of total control. Toilet facilities remain an alien concept to most landlords and land ladies even as they pollute every neighbourhood with shops. Proper hand washing and food hygiene practices are laughable trivialities largely because such things do not occupy a key position in the people’s vocabularies of popular essence.

    Sometimes, traders especially those selling foodstuffs in the market neatly wrap their faeces in polythene bags and dispose of them in front of their shops in the evening before closing for the day. Well-dressed ladies and men buy foodstuffs in these filthy markets with obvious relish. Both the people and governments do not care a hoot about the health implications of this behaviour. According to the report by the United Nations Children Fund (UNICEF) about 59,000 children die annually in Nigeria from water-borne diseases such as cholera, typhoid, hepatitis, ascariasis and schistosomiasis. In addition, at least 120 million Nigerians are at the risk of contracting guinea-worms and infectious hepatitis among others, due to a general lack of access to drinkable water.

    Again, the European Union (EU) and UNICEF claim that two out of three residents of Ekiti State are still engaging in open defecation. It is a pity that about 1.8 million out of 2.7 million people of the state continue to use local streams and the surrounding bush as toilets. The above two bodies promised recently to construct some public toilets for two local government council areas in the state – Gbonyin and Ekiti-West. Such public toilets would be located in motor parks and market places. Nigerians should not completely surrender their destinies to these international bodies that may soon begin to experience donor fatigue. This is a Nigerian problem that must be tackled largely from within.

    Many public tertiary institutions are equally in a mess in this regard. According to Kingsley Jeremiah in The Guardian newspaper edition of April 13, the Kogi State University’s Inikpi hostel was in a sorry state. In this hostel, 26 students were/are using one toilet, thus leading to several cases of infection especially among the females. Please visit other public university toilets in Nigeria before you start castigating the management of the Kogi State University.  In most public universities, ladies use potties as a coping strategy while the male students leisurely engage the bush in the 21st century. What a crying shame!  It is a pan-Nigerian challenge that should worry all of us! Although open defecation still goes on in India and a few other parts of the globe, the Nigerian government should not breathe a sigh of relief because of this. We must emulate the advanced nations and develop a multi-scalar understanding of this critical subject. Nigeria has to draw from the West for fundamental innovations in toilet culture including other elements of material technology on a sustainable scale.

    The Nigerian government has to show the willpower and allocate at least five percent of the country’s GNP to health including provision of public toilets. The World Health Organisation (WHO) recommends that every country should spend at least five percent of its GNP on health. Painfully, Nigeria is spending between 1.5 and four percent only. On the other hand, most advanced nations spend at least 10 percent of their GNP on public health. There is need for networking with relevant ministries and agencies in order to have a success story. In this regard, the ministries of health, water resources, housing, and education must begin to dance together. Self-seeking and corruption should not be given a place to stand in the scheme of things.

    Apart from providing toilets and urinals, there must be a strong piece of legislation on the use and management of these facilities from the perspective of maintenance and sustainability. Anybody who falls foul of this legal arrangement must be sanctioned accordingly. Toilet managers must also have supervisors for optimal efficiency. User charges may have to be paid to ensure good maintenance of these toilets at all times, in line with the best global practices. Modifying or changing a people’s cultural orientation needs a great deal of sophisticated social engineering enshrined in sociology, anthropology and psychology. Consequently, the government has a long, fierce battle to fight against monumental ignorance including primordial fear of bewitchment that afflicts many citizens like a plague.

    Whenever rains carry human faeces from the bush into rivers, streams and ponds from where water is fetched for drinking and washing dresses, then the people are directly introducing all kinds of germs into their bodies. This is a desideratum for diseases-one main index of underdevelopment in Nigeria. Therefore, witches –real or imaginary are not to blame. We should leave witches out of this.  Those defecating in open spaces including water bodies are the witches or wizards that must be tamed at all costs through appropriate health education especially regular public awareness campaigns. This is in addition, to the government that does not show sufficient commitment to the issue of public health as a baseline for improving the human condition.

     

    • Professor Ogundele writes from Dept. of Archaeology and Anthropology, University of Ibadan.