The Nation Newspaper

Tag: dying

  • Living and dying with tuberculosis

    • Patients share heartrending encounter with drug-resistant tuberculosis
    • The buzz about Bedaquiline

    Tanimola begged her father to teach her to whistle. But much as he tried to teach her, she couldn’t. Her infant lips were too tender to hoot.

    “She kept blowing air and bathing me with spittle,” said Folajimi David, her father.

    Then, one Sunday evening, the five-year-old said, “Daddy, I can whistle with my chest.” To this, David responded with a smile, enthusing about how talented his little girl was.

    He knew she couldn’t whistle with her chest. But “kids will always be kids,” thought the widower, craning his ear against her chest to hear it ‘whistle.’

    All he could hear was the deep-seated wheezing that broke with her cough.

    He blamed it on her inability to pass out the phlegm that was stuck in her chest. It’s one of the things she inherited from him, he thought; “I have never been able to cough out phlegm no matter how hard I tried,” he said.

    Thinking she got that from him too, along with her looks, he gave her cough syrup, and then, a tincture of honey, bitter kola and mint.

    But neither the cough syrup nor the potion provided relief to the five-year-old. She couldn’t sleep and she coughed through the night. By dawn, David noticed a spatter of blood on the bed sheet, at the spot she rested her head.

    “Her symptoms got worse and she wheezed for breath like an asthmatic. But she had never been diagnosed of asthma. In the morning, she complained of fatigue, and collapsed on the way to the bathroom. That day, she didn’t go to school. I took her to a neighbourhood clinic from where she was referred to the Lagos teaching hospital,” he said.

    Early diagnosis indicated that Tanimola had pneumonia and typhoid fever, for which she was treated. But her symptoms persisted.

    “I became very scared when her teacher called, urging me to come for her; she said her cough had aggravated, and droplets of blood stained her teeth at every expiration,” said David.

    Thus precisely eight days after she was treated at the teaching hospital, Tanimola was rushed to a private hospital, where lab tests and analysis revealed that she was infected by the Multi Drug Resistant strain of tuberculosis , widely known as MDR-TB.

    David was diagnosed with the same disease, and father and daughter were advised to commence treatment at the state’s MDR-TB centre.

    “We received the result late in the day, around 6.25 pm. There was no way we could report for treatment at that hour. I intended to take her to the clinic the following morning, which was a Tuesday,” said David.

    But Tanimola would not make the trip with him. Seventeen minutes past midnight, she died in his arms.

    David should have paid good mind to his daughter. Contrary to his belief, that, the five-year-old suffered a mild cough, she was in the advanced stages of MDR-TB. It wasn’t until she died, that, he understood the reason for her protracted cough and tiredness.

    Today, David is “almost rid” of the disease. But he would never be rid of guilt.

    The bereaved widower and his late daughter, however, represent a fraction of the country’s missing MDR-TB cases.

     

    •An MDR-TB patient using his medication on the watch of a health officer at a DOT centre.

    An awful way to die

    Each year, nearly one and a half million people die from tuberculosis, that, for many years, has been treatable and curable. More than 30 million people have died since the World Health Organisation (WHO) declared TB as a global emergency in 1993.

    The devastation wreaked by the disease is best captured in the anonymous quote: “When TB wakes up and gets into the lungs, it eats them from the inside out, slowly diminishing their capacity, causing the chest to fill up with blood and the liquid remains of the lungs.

    “A wet, hacking cough is evocative of TB. The lungs, now in liquid form, are sloshing around in the chest. Cough that up, even in microscopic, impossible-to-see droplets, near other people, and they have a very good chance of getting TB too.

    “Eventually, liquid replaces the lungs; the suffering patients cannot get enough oxygen, and respiratory failure occurs. They can no longer breathe and they drown. It’s painful. It’s drawn out. It’s an awful way to die. But before any of this happens, the disease weakens you. It diminishes your capacity for work, and puts your family and friends, and anyone else you come into contact with at risk. Individual death is only part of the problem.”

    The bereaved family often inherits death from the deceased too. Or vice versa. In the case of the Davids, for instance, the father infected his daughter with the disease “because her immune system was very low, compared to his own,” said one of the doctors that attended to the deceased.

    The typical pathway of the infection according to health experts is as follows:

    When somebody coughs, it spreads through the sputum and then a susceptible host inhales it. If the person’s immune system is intact, the TB stays dormant in the lungs, without causing any harm to the body. But if the body’s immune system is compromised, the bacteria mutates aggressively in the body, corrupting and totally overwhelming the host’s immune system as a full blown infection. From a single host, TB can spread to infect between 10 and 12 people.

    The progression is worse where the hosts dwell in a slum. It spreads rapidly, and assumes the state of a pandemic.

    According to the 2017 Global TB Report, Nigeria is among the 14 high burden countries for TB, TB/HIV and MDR-TB. The country is also among the 10 countries that account for 64 percent of the global gap in TB case finding. India, Indonesia and Nigeria account for almost half of the total gap.

    Nigeria is also ranked 7th among the 30 high drug-resistant tuberculosis (DR-TB) burden countries and second in Africa, with an estimated 4, 700 patients with multi drug-resistant-TB (MDR-TB) in 2015.

     

    •A shanty kid picks her way through a river of filth in Makoko. The Lagos slum is widely known as a cesspit of diseases like tuberculosis.

    Why TB persists…

    Tuberculosis, widely adjudged to be a disease of the poor, is endemic in urban slums and communities, where the poverty level and population density is high.

    “Most hospitals in the communities are, however, not equipped with TB care and that is where you have most of the cases. Also, most of the affected areas are hard to reach,” said Dr. Babawale Victor, a Senior Health Officer with the The National Tuberculosis and Leprosy Control Program (NTLCP), in a chat with The Nation.

    Further findings revealed, that, while TB care services are supposed to be available at the Primary Health Centres (PHCs) across the country’s 774 local government areas (LGAs), they are absent in most of the target coverage areas.

    Where PHCs are present, they are ill-equipped and understaffed to contain and treat TB patients, let alone MDR-TB sufferers.

    Victor argued that prohibitive cost of treatment also delays and prevent individuals from initiating TB treatment after diagnosis. The dearth of paediatric TB specialists in areas most affected by the disease also poses an impediment to containment efforts, he said, stressing that, delay in reporting cases for treatment and lack of point-of-care laboratory capacity also hinder treatment and containment efforts, especially for multi drug-resistant TB.

    A nurse at a Lagos based directly observed treatment (DOT) centre revealed, that, in order to encourage patients to complete the full course of treatment, they are provided some token for transport fare and meals. After the intensive phase, patients are allowed to return home for the continuation phase of treatment.

     

    Why paediatric TB goes neglected

    Until very recently childhood TB has not been a priority in public health and has remained essentially a hidden pandemic. All too often, paediatric TB goes undiagnosed in children.

    While high-income countries now use sophisticated molecular tests to detect the disease, most developing countries, Nigerian inclusive, still use the method developed 130 years ago: the patient must cough up a sample of sputum, which is then checked under the microscope for the bacteria that causes TB.

    Young children, generally, are unable to produce a sample. Even if a child with active TB succeeds in providing a sample, it often contains no detectable bacteria.

    Compounding difficulties with diagnosis is the fact that children with TB have families that are poor, lack knowledge about the disease and live in communities with limited access to health care.

     

    •TB bacteria inside the human body.

    The burden of stigmatisation

    Isa Mahmud, 35, was forbidden from using the same cutlery with his parents and siblings, soon after he was diagnosed with TB.

    “Even after I started treatment, they kept their distance from me. My brothers stopped sleeping in the same room with me and my mother turned her face away from me whenever she had to talk to me, even after using a nose mask. I have been treated like a leper. They don’t even tell me sorry anymore, when I cough. Instead they frown and hiss. Sometimes, I feel like killing myself,” he said.

    Experiences like Mahmud’s have often led to non-disclosure of illness by TB patients. Even while the chronic cough persists, some simply explain it away as “chest problem.”

    Patients also dread being quarantined in the hospital, often likening it to a jail cell.

    “They will make you feel like a condemned prisoner. The nurses are particularly careless in thought and speech. They shout at you and treat you like a hardened criminal. They make you feel like you are doomed for death,” said Gladys Onuh, who quit treatment at a Lagos Direct Observation Treatment (DOT) facility to patronise a herbal doctor.

     

    The ugliness of hospital based care

    A typical ward in Nigeria would contain 24 patients with MDR-TB, who should be cared for by 10 specially trained nurses running shifts, where they provide 100 per cent of their time for this service. Additionally, doctors attend to patients for about 15 minutes weekly. This depicts an ideal situation.

    In reality, patients complain of stigmatisation by doctors, nurses and other health officers. Princewill Okeh, an outpatient in a treatment facility in the southern part of the country, complained that many TB sufferers are reluctant to come forward due to the hostility they might experience from public health officers.

    “It’s one thing to be maltreated by your family but when government doctors and nurses also treat you badly, you lose hope in the system. This disease (MDR-TB) will make nurses and doctors avoid you. My girlfriend also has TB, but she would rather treat it from home. She has witnessed my experience with family and doctors and nurses. They all treat me like a demon. This is why she will never come to DOT for treatment. She is using home remedy and antibiotics,” he said.

    Further findings revealed that some public health workers avoid the wards of MDR-TB patients thus leading to a fragmented bedside interaction and hindered service delivery.

    In a recent Focused Group Discussion (FGD) conducted by health researchers, some participants recalled that healthcare providers in other facilities, which they visited for specialised services such as audiometry and chest X-ray avoided contact with MDR-TB patients and were more resentful than the healthcare providers at the

    treatment centre.

    They also stressed that it was disparaging and unfair for patients to use an inferior quality face mask while healthcare providers used a superior type.

    “It is an inferior face mask. It is not a good type. It is the type they are selling in the market that they brought to us. They were using the better type. You see Nigerians! I argued with them seriously. They said, I argue too much because I am educated,” said a 54-year-old male patient.

     

    The cost factor

    Management of identified MDR-TB cases is based on a standardised WHO approved treatment regimen of 20 months, consisting of an eight-month intensive phase and a 12-month continuation phase.

    Patients are placed on Pyrazinamide and four second-line anti-TB drugs namely Levofloxacin, Kanamycin (replaced by Capreomycin when indicated), Prothionamide

    and Cycloserine. The five drugs are used for the eight-month intensive phase, at the end of which Kanamycin (or Capreomycin) is discontinued for the remaining 12-month continuation phase.

    A recent study revealed that three models of MDR-TB care were utilised in Nigeria between June 2013 and December 2014, and differed only in their eight-month intensive phase.

    Patients treated under Model A, were hospitalized for the complete duration of the intensive phase; patients in Model B were hospitalised for a duration of five months in the intensive phase while patients treated under Model C received the complete

    intensive phase treatment as ambulatory care in the community.

    The estimated total cost of providing diagnostic and treatment care as outlined in the Nigerian MDR-TB guidelines, was $18, 528 (N2,927,464) per patient for Model A, $15, 159 (N2,395,070) per patient for Model B and $9, 425 (N1,489,080) per patient for Model C – all 2014 figures.

    Although financing for care and prevention has increased over the last decade, there remains a funding gap – $2.3bn (£1.74bn) in 2017. The biggest donor, the Global Fund to fight Aids, TB and Malaria, allocates just 18 per cent of its resources to fight the disease.

    Babawale Victor

    Is Bedaquiline the next-best elixir?

    There is no gainsaying the emergence of multi-drug resistant tuberculosis (MDR-TB) has threatened the progress made in TB control globally; MDR-TB is the resistance to Rifampicin and Isoniazid, the most effective first line anti-TB drugs, by the disease.

    Els Torreele, executive director of Médecins Sans Frontières’ access campaign, said there has been a dearth of research and development (R&D) over many years for adequate tools for diagnosis and treatment.

    In the last few years, however, Bedaquiline (a bacterial drug belonging to a new class of antibiotics) has been released to treat patients with drug-resistant TB.

    “Before Bedaquiline, the last drug we developed was before we put a man on the moon,” said Aaron Oxley, executive director of Results UK. “Unfortunately in TB – or fortunately now – things are about to get more expensive because we’re getting tools that actually work.”

    Bedaquiline (BDQ) has a novel mechanism of action. It binds to mycobacterium tuberculosis ATP synthase, an enzyme that is essential for the generation of energy in the pathogen. Inhibiting ATP synthesis results in bactericidal activity. The atpE gene product (subunit c, a proton pump) is the target of Bedaquiline in mycobacteria.

    The distinct target and mode of action of Bedaquiline minimises the potential for cross-resistance with existing anti-TB drugs thus the buzz about its efficacy and potency as an anti-MDR-TB nullifier.

     

    Tackling the MDR-TB conundrum

    A major issue with TB in Nigeria is the low TB case finding for both adults and children. In 2017 only 104, 904 TB cases were detected out of an estimated 407, 000 of all TB cases.

    This indicates a treatment coverage of just 25.8 per cent thus leaving a gap of 302,096 cases, which were either undetected or detected but the cases were not notified especially in non DOT sites.

    A total of just 1,783 MDR-TB cases were notified out of an estimated 5, 200, according to the health minister, Prof. Isaac Adewole.

    Nigeria currently has 6,753 Direct Observation Treatment (DOT) centres compared to 3,931 in 2010. The total number of microscopy centres has risen from 1,148 in 2010 to 2,650 in 2017. GeneXpert machines installed in the country have increased from 32 in 2012 to 390 in 2017.

    Treatment centres for patients with MDR-TB expanded from 10 in 2013, to 27 in 2017, while the number of TB reference laboratories also increased from nine in 2013 to 10 in 2018. Over 90 per cent of the TB patients notified in 2016 have documented HIV test results compared to 79 per cent in 2010, according to Adewole.

    The health minister disclosed, that, in addition to this, a shorter drug regimen for the treatment of MDR-TB was introduced in the country in 2017 to reduce the treatment duration for patients with MDR-TB and ensure better treatment outcomes.

    •An x-ray of a lung damaged by TB

    “To further strengthen TB notification in some challenged states, TB Surveillance officers have been recruited in 12 states (Rivers, Delta, Imo, Anambra, Lagos, Oyo, Benue, Niger, Kaduna, Kano, Bauchi and Taraba) to work with non-NTP facilities (private Health facilities, atent medicine vendors, community pharmacists), disease surveillance and notification officers, state epidemiologists and TB programme officers, to improve TB case notification, he explained.

    In a bid to bolster Nigeria’s anti-TB campaign, the Federal Ministry of Health has also initiated an active case-finding campaign in key affected populations spanning people living with HIV, children, urban slum dwellers, prisoners, migrants, internally displaced people and facility based health care workers.

    The result has been encouraging so far, with the detection of over 11,500 TB cases through active house to house case searching in 2017.

    However, the number of TB cases detected represent a small fraction of the over 300,000 missing cases of TB in the country; that is, those that go undetected.

    Recently, Nigeria signed a $71 million agreement to support efforts to control TB in the country over the next two years (2019-2020) thus signalling the government’s intention to prioritise TB efforts.

    In the wake of the development, national TB program officials and health care practitioners converged in Lagos, as part of a training focused on building health systems’ capacity to tackle TB and multi drug-resistant TB (MDR-TB) at the national and sub-national levels.

    Prof. Isaac Adewole

    These, among other efforts, are certainly meant for the long haul. On the short-run, the government and partnering agencies would do right to increase sensitisation efforts. It’s the only way prevent an experience like the Davids.

    Sometimes, when he shut his eyes, David, 36, remembers his deceased daughter’s smile, and the pitter-patter of her feet.

    In those moments, the world peels away and the bereaved father and TB patient, experiences fresh torment; heartbroken, he relives the screaming gleam in his daughter’s eyes just before the glimmer turned clay-like, the colour of burnt mud.

    “I know she is in a better place. But I should have been more observant. My carelessness led to her death,” said David, in the tenor of a man for whom time and memory allows the gift of reflection. Until reality afflicts him with the plague of truth: Tanimola, his bubbly five-year-old daughter, lays dormant beneath cracked earth.

     

    PHOTOS: William Daniels, Olatunji Ololade, Library

  • I’m dying please help, says man diagnosed with kidney failure

    A 38-year-old man, Kayode Benjamin Onabanjo, who hails from Ijebu-Ode in Ogun State, says he is dying of kidney failure.

    The father of one was in April diagnosed with stage 5 chronic kidney disease, secondary chronic glomerulonephritis and had begun maintenance haemodialysis.

    According to him, his medical report stated that he needed a kidney transplant.

    Onabanjo will need N150,000 per week to undergo maintenance haemodialysis.

    He said: “I was an employee of Ero Oil and Gas Nigeria Ltd in Mowe, Ogun State until my health condition worsened and I could no longer cope with the job.

    “I sold my house, car and land to take care of my health, but it is still deteriorating. I ‘m dying, please help me.

    “My family, relations and friends have tried to keep me alive, but the money I need is too much. I implore Nigerians at home and abroad, government, non-government organisations, philanthropists and corporate bodies to help me.”

    Read also: Boy with kidney failure needs N13m for transplant

    Onabanjo, who read Town and Regional Planning at the Federal Polytechnic, Ilaro, Ogun State, could not hold his tears, as the pains of the disease were severe.

    He has been given quit notice at his 3, Tayo Kehinde Street, Egbeda, Lagos, home because of indebtedness.

    His wife, Odunayo, said she had sold everything she had, including the little container shop she used to store her goods.

    “I don’t have anything again. Our seven- year-old daughter, Treasure, will soon be sent out of school if we don’t pay the next fee,” she said.

    Onabanjo’s next appointment at the Alimosho General Hospital, Igando, Lagos and at a private hospital in Ikeja will not hold this week if he cannot pay the bills. His condition needs urgent medical attention.

    Readers can donate to save him through his UBA account: Onabanjo Benjamin Kayode, 2044946052 (savings); or through his wife’s Access Bank account: Onabanjo Odunayo Olanike 0689746448 (savings).

     

  • Are your heart and blood vessels dying? (2)

    Going by responses to the first part of this series, POMEGRANATE should become one of the nutritional supplements many people challenged with heart ailments will look out for in 2018. Dr. Syed Zair Hussain, of Pakistan, aroused interest in Nigeria, with his experiments which showed how pomegranate helped many people in Pakistan to clear up heart diseases, some of which would have resulted in by-pass surgery. So confident has Dr. Hussain become about Pomegranate therapy that he has launched a campaign against by-pass surgery, claiming cardiologists were merely exploiting their patients by booking them for by-pass surgery to correct coronary heart blockage(s) and circulation dysfunction in the heart. In coronary heart by-pass surgery, an artery from another part of the body is sewn into a heart artery to by-pass the blockage and damaged artery, in order to bring oxygenated blood to dying heart tissue.

    In the United States, a heart by-pass surgery may cost a patient who is not covered by health insurance anything from 70,000  dollars to 200,000 dollars or more.

    This series was spurred by the celebration on September 29 of THE WORLD CARDIOVASCULAR DAY. It is a date every year when world health authorities encourage everyone to save a thought for his or her heart and blood vessels. Concern for the heart and its blood vessel system arose from the fact that more people worldwide are dying from diseases which torment them than are dying from cancer, HIV/AIDS and malaria put together. The internal environment of every human being is, indeed, an interesting one. Unfortunately, many people do not know much about it or take care of this WONDERFUL WORLD WITHIN, as Dr. Roger John Williams titled one of his books. Dr. Williams was an American biochemist who spent his academic career at the University of Texas at Austin where he isolated and named folic acid and helped to discover Pantothenic acid (Vitamin B5), Vitamin B6, Lipoic acid and Avidin. These are some of the chemical food substances which keep our organ healthy and active and prevent us from bowing to disease and dying needlessly. Many of us ignore or are ignorant of that “wonderful world within” and expend vast resources instead on cosmetics, jewelry, power dressing and such other external paraphernalia which add little or nothing to the health of that “wonderful world within” which requires our help to stay young, and disease-free.

    The heart and its blood vessels belong to that “wonderful world within”. The website https://skeptics.stackexchange.com gives us a hint of its magnitude when it says:

    “An adult human has been estimated to have some 60,000 miles (96, 560km) of capillaries with a total surface area of some 800 to 1000m2 (an area greater than three tennis courts).”

    These are only the blood capillaries, tiny branches from the major blood vessels. At interestingthings.info, we learn that, if the heart were to pump blood outside the blood vessels, each pumping can make the blood squirt up to nine meters high. “The length of your blood vessels is about 100,000 kilometers”, says the website. “To understand this distance – the circumference of earth is about 40,000 kilometers. The distance between the earth, the moon, is about 300,000 kilometers. So, if we take the blood vessels of three people, and connect them edge to edge – we could easily step where Neil Armstrong did.”

    This is a great picture many of us do nothing about until we suffer damage to it in one form or another. What we have just learned is that if the blood vessels of three people are stretched out and joined together, they would be long enough to reach the moon from the earth. Heart diseases were explored in the first part of this series. This section will explore the problems we may encounter in the blood vessels. As stated, Arteries take blood from the heart to all parts of the body. Capillaries take the blood from the arteries to nooks and crannies of the organs to give them oxygen and nutrients, and to remove carbon dioxide and other wastes which they pass on to the veins. The veins are smaller than arteries and take used blood back to the heart, from where this is pumped to the lungs to be re-oxygenated and ridden of the poisonous carbon dioxide waste through the breadth.

     

    Diseases of blood vessels

     

    Disturbances in blood vessels are often called pheripheral blood diseases or artery disease. The blood vessels become narrowed either in the arms, abdomen, legs or any other region of the body. The narrowing is caused by a buildup of plaque or fatty deposits. The narrowing means less blood will flow through them and, consequently, reduced blood flow will mean less oxygen delivery to the cells, tissue and organs. With poor oxygen deliveries over time, the cells begin to weaken, wilt, age and even die. Blood vessel disease presents some signs which may include muscle pain, cramps, aches here and there, pale skin, cold hands and feet, discoloration of the nails, long-term injuries such as diabetic ulcers. When some old wounds are scratched, and a blackened under surface is exposed, or the hairs on the legs, feet and toes begin to fall off, or if the pulse in the legs or feet becomes pale or dull or when exercise brings pain which subsides during a rest, it may be time to suspect that enough oxygen is not being delivered to these sites by blood vessels. This is a cause of the amputation of some limbs.

    Dr. Ann Wigmore experienced this when she suffered from gangrene in one limb. The limb was to be amputated on the advice of her doctors. But she was strong-willed and objected, preferring to die instead. Providentially one day, she asked to be wheeled in her wheel chair to her garden. There, she observed that sick cats were coming to eat a particular grass. She observed them for days and weeks and when she found they were getting healed. She, too, began to eat this healing grass. The healing grass turned out to be wheatgrass, the juice of which her grandfather used to heal the gunshot injuries of World War II soldiers in her country. Soon, blood began to flow better in the occluded limb of Ann Wigmore and the limb began to heal till the amputation once prescribed was no longer necessary. This shot up the reputation of wheatgrass as a healer.

     

    Retinal vascular occlusion

    The retina is the light-sensitive layer of the eye. It is populated with rod and cone-shaped structures which convert light signals to nerve messages. These are passed through the Optic nerve to the brain, where they are converted to vision. It is possible for blood vessels in the retina to become blocked by cholesterol plaque or blood clot. This will reduce oxygen flow to the retina and the eye and cause fluid buildup. The retina may be prevented from picking light efficiently. This may impair vision. Retinal vascular occlusion or blockage are of two types, and each type depends on which blood vessel is disabled. The blockage may be in the artery or in the vein. The blockage may be in the main eye artery or vein or in their branches. Occlusion in the main vessels are often more serious conditions than those in their branched vessels. Hardening of the vessels (arteriosclerosis) and blood clots are thought to be the culprits. A blockage or narrowing of the neck’s carotid arteries is also a risk factor. Other risk factors may be irregular heart beats, like diabetes and high blood pressure, high cholesterol, obesity, free radicals, macular edema (fluid buildup), thickening of the central part of the retina and inflammation disorders. Whatever it is, vision may become blurry, temporary or permanent, and urgent medical attention may be required. Some complications may develop. This, as said, may include Macular edema in which blood builds up in the central part of the retina, or neo-vascularisation, in which a lack of adequate blood flow and oxygen supply a compensated by an abnormal blood vessels growth. In an article on age-related macular degeneration, Maureen A. Duffy edited a contribution by Lylas G. Mogk in visionaware.org which says:

    “In wet age-related macular degeneration, abnormal blood vessels under the retina begin to grow toward the macula. Because these new blood vessels are abnormal, they tend to break, bleed, and leak fluid, damaging the macula and causing it to lift up and pull away from its base. This can result in a rapid and severe loss of central vision.”

    Neo-vascular glaucoma may occur in which a fluid-buildup in the eye chambers may threaten vision. Seldom does retinal detachment occur.

     

    Cerebral blood small vessel disease (SVD)

    This refers to small blood vessels in the brain. These vessels, too, are affected by arteriosclerosis (hardening of the arteries) and atherosclerosis (blockages) and micro bleeding. They, too, can be subject to inflammation. Normally, an MRI examination sees brain matter as white. When you read in a radiologists report that the MRI suggests “brain matter changes”, that may indicate a SVD…small vessel disease. It is possible a small vessel has been leaking or has leaked on some areas of the brain tissue. The symptoms may be mild, moderate or severe. Sometimes the SVD is “silent”, presenting no symptoms. SVD may affect cognition, walking gait, depression, dementia, stroke et.c. Many doctors say there are far too many possible causes of SVD that they do not wish to boil them down. But some mention risk factors in stroke, including hypertension, diabetes, high blood cholesterol, cerebral amyloid, angiopathy, aging, free radicals. Many doctors prevent or treat SVD by treating hypertension and other risk factors, with mixed results. In Alternative medicine, SVD treatment goes hand-in-hand not only with cardiovascular system health therapies but, also, with therapies specially adapted to the brain. As was stated in the first part of this series, addition of Magnesium supplement to the diet offsets the possibility of extra Calcium load causing arteriosclerosis. Dietary supplements such as Cayenne, Lecithin, Essential Fatty Acids (EFAs), Ginkgo biloba, Bilbery, Chromium, Grape Seed Extract, Pomegranate e.t.c keep the blood vessels free of atheroma and atherosclerosis. Grape Seed Extract is a unique food supplement in that it is one of those few food or medicinal factors which easily crosses the Brain-Blood-Barrier (BBB) not only to thin the blood and prevent an infringement of the Law of Motion (unhindered blood flow) but to also protect all brain contents against the damaging effects of free radicals. Alpha Lipoic Acid (ALA) will be found useful here, too, because it is one of those few antioxidants which are simultaneously active in fat and fluid media. Bleeding can be stopped with a number of supplements such as Pawpaw (papaya) leaf juice, Shepherd’s purse, Mimosa Pudica (especially in excessive menstrual bleeding and in leg or foot swellings), Yarrow et.c. If blood vessels break and leak because they are fragile, we must look at the fragility of connective tissue and deploy either Horsetail or Edible Earth (Diatomaceus or Diatom) or the appropriate cell or tissue salts. Horsetail is useful because it is rich in Silica. Diatom is about 96 percent Silica, a bonding agent. The cell salt silica (No 12 in the series) is about 100 percent Silica. Rutin, a member of the bioflavonoids family, tightens leakage areas to prevent blood leakages. Aluminium cookware should be avoided, as should aluminium tea pots and plates as they leach aluminium into food and this may be an ingredient in amyloid plague which damages blood vessels. The sing-song should be antioxidants, antioxidants and antioxidants.

     

    Small vessels disease of the hand

     

    On a radio programme last week, a listener called a presenter, a medical doctor, to know why three of his fingers in one hand appeared to be lifeless. The doctor replied that the condition may have to do with nerves, and that he may seek help from his doctor. Nerves may, indeed, be the cause of the numbness. But so may, also, be a condition in the wrist know as carpal tunnel syndrome, which response to Vitamin B6 therapy. If you turn your wrist up, you would notice what appears to be a “gutter” at the base. It is a condit or tunnel through which tendons and Median nerve go into the hand to the fingers. If the nerve is under pressure and inflamed, this may affect nerve energy flow to the thumb and the next three fingers which are controlled by this nerve.

    As for small vessel problems in the arm and fingers, there may be as many as five possible scenarios. Trauma is one of them. The vessels become compressed, that is…flattened. We are by now more familiar with blockage.  Growths or tumours may throw spanners in the works. Spasms (something akin to muscle pulls) may cause narrowing. Some of the signs may include pain, colour changes in the finger tips, sensitivity or hypersensitivity to cold and/or cold hands and arms, wounds that do not heal easily, numbness of the finger tips, swellings. Other presentations may be decreased or absence of pulse in the armpit, elbow, wrist or finger tips, wounds or gangrene. Sometimes, the arteries or veins may be tangled at birth or later in life, not to mention varicose veins which present like a spider web. Some people suffer from vasculitis or angiitis, other names for inflammation of vessels, which may cause those vessels to narrow and reduce blood flow to organs, thereby damaging them. When veins are inflamed, the condition is venulitis. Only the experts can advise us about the various forms of vasculitis and venulitis and their deep-seated causes. But it has been observed that they sometimes follow the patterns of some types of diseases such as immune dysfunction, infections, including Hepatitis B, cancers, exposure to some chemicals and some medications, rheumatoid arthritis and Systemic Lupus Erythematosus (SLE). The mention of SLE seriously disturbs the peace of mind of one of my female acquaintances, a lawyer. It affects her scalp, not as SLE perse, but as Discoid Erythematosus (DE), which is not life threatening, although it breaks blood vessels here and there and is causing her alopecia. Vasculitis can be a terrible disease in the brain, it may cause headaches, seizure, stroke, paralysis, lightheadedness et.c. In the lungs, cough and shortness of breadth are common symptoms. Kidney failure may occur in the kidneys. Muscle pains are not left out. So are skin discoloration and ulcers if it presents in the skin. Congestive heart failure may arise in the heart. Weakness, fatigue and weight loss are members of this family as well.

    Treatment of many of these conditions are as already mentioned for coronary heart disease and other presentations. A few years ago, a nutritional network marketing company in Nigeria sold a product named CARDIOTONIC PILL. To demonstrate its capacity to create thoroughfare for blood circulation in blood vessels, the company carried out an experiment in which human hands were placed in a freezer to freeze circulation and induce chilblains. Then, Cardiotonic Pill was orally given to the guinea pigs. The conditions of the hands were examined with MRI before and after the therapy. The images showed a frozen hand and then a normal hand within about five minutes after Cardiotonic Pill was taken. The magic wand was said to be the presence at one percent of Camphor in the composition of Cardiotonic Pill. As for Vasculitis, we have many Alternative Medicine recipes today which work better than Ibuprofen the treatment of choice in conventional medicine. One of them is CUCURMIN 2000X. This is Cucurmin combined with Cayenne in such ratio as is said to make Curcumin 2000 times more active than in its natural state. Orange peel is anti-inflammatory. So are greens such as Barley grass, Wheatgrass, Kale and Spirulina, to mention a few. Their high Chlorophyll content cleans up the dross that may be causing irritation and inducing inflammation, their oxygen molecules burn out disease and they stimulate the immune system to normalise the system, among their many benefits.

    Small vessel disease occurs in other part of the body such as enlarged veins in the scrotum.

  • Living and dying in denial

    There is a certain defensiveness that could pass for denialism. Before our very eyes, President Muhammadu Buhari appears to be facing a life-threatening health challenge. It is a season of creative euphemisms employed by the president’s defenders to downplay the evidence of reality.

    A picture of things as they are was presented by Olalekan Adetayo and Bayo Akinloye in an April 23 Punch report: “Fresh anxiety is mounting over the state of health of President Muhammadu Buhari, who returned to the country on March 10 after a 49-day medical sojourn in London, United Kingdom. The 74-year-old Nigerian leader was only seen in public once throughout last week, when he joined other Muslim faithful for a Juma’at service on Friday at a mosque located near his office inside the Presidential Villa, Abuja.  The service lasted less than one hour after which Buhari returned to his residence. Before Friday’s brief appearance, the last time he was seen in public was penultimate Friday when he attended the same service at the same venue. Presidency sources attributed the president’s continuous non-appearance at public events to his ailing health and the need to take further rest.”

    The report continued: “One of our correspondents reported that, although some government officials were reported to have met with Buhari in his office during the week to update him on developments in their ministries, no photographs or video recordings of such encounters were made available by the Presidency, which was contrary to the usual practice. Although the government officials spoke with reporters after their separate meetings with the president, the absence of such photographs and video recordings raised doubts as to whether, indeed, the government officials met with the president.”

    This representation of reality landed the newspaper’s Presidential Villa watcher Adetayo in the soup as he was robotically expelled from Aso Rock   by Buhari’s Chief Security Officer (CSO), Bashir Abubakar. The revolting reaction has been reversed, but it is thought-provoking that Buhari’s Special Adviser on Media and Publicity, Femi Adesina, tweeted:  “We weren’t consulted in the media office by the CSO before he expelled the Punch reporter. President Buhari is committed to press freedom.” If this is true, then it would suggest that the president and his CSO are not necessarily on the same page when it comes to non-negotiable respect for press freedom. If that is the case, it is curious that this CSO is still the CSO.

    The defensive game took a less physical dimension with a response by Buhari’s   Senior Special Assistant on Media and Publicity, Garba Shehu, to rising public criticism of the president’s serial absence from the regular meetings of the Federal Executive Council (FEC) which he is supposed to chair.  After another non-appearance by Buhari on April 26, Shehu said in a statement: “As eager as he is to be up and about, the president’s doctors have advised on his taking things slowly, as he fully recovers from the long period of treatment in the United Kingdom some weeks ago. President Buhari himself, on his return to the country, made Nigerians aware of the state of his health while he was in London. Full recovery is sometimes a slow process, requiring periods of rest and relaxation, as the Minister for Information, Lai Mohammed, intimated in his press briefing after the FEC meeting on Wednesday.”

    Shehu added: “Despite his lack of visibility, Nigerians should rest assured that President Buhari has not abdicated his role as Commander-in-Chief of the Nigeria Armed Forces. He receives daily briefings on the activities of government, and confers regularly with his Vice President, Professor Yemi Osinbajo. His private residence, where he has been spending the majority of his time recently, has a fully equipped office.” A question may be asked: If the president can work from home, does he really need another office outside his home?

    There are those who argue that Buhari’s poor health is bad enough to necessitate his resignation. Apparently, Buhari himself does not think so. Also, his loyalists do not think so.  But the truth cannot be denied. To go by appearances, President Buhari is in bad shape.  This perhaps explains the observation that the Presidency seems reluctant to share photos and videos of his alleged recent meetings with government functionaries “contrary to the usual practice.”

    If pictures are more graphic than words, it is easy to understand why the Presidency is sticking to words in conveying Buhari’s health condition. Pictures would tell it all; and Buhari’s defenders don’t want telling images.

    How long can the game last? Sooner or later, it will be so glaring that Buhari’s bad health cannot allow him to perform. What will happen when the country comes to the point that is beyond denial?

    It is interesting to observe the thinking of the opposition on this issue. The chairman of the Caretaker Committee of the Peoples Democratic Party (PDP), Ahmed Makarfi, was quoted as saying: “My take is that if the president is not fully fit to stay in office, it is better that he tell Nigerians, so that the vice president will continue to be Acting President, exercising the powers of acting president. For a number of reasons, the PDP wishes the president well, for stability of this country, political stability, and the fact that we want to defeat a sitting president. We don’t want any confusion politically in this country. “

    This is agenda-setting thinking. Why must Buhari remain in office if his health does not permit it? To suggest that there will be “confusion politically” if Buhari is not well enough to continue in office is to insist that he must remain in office even if his health condition does not allow it.

    Living in denial happens; so does dying in denial.  A denial is a denial, and a denialist is a denialist. It remains to be seen whether denialism can resolve Buhari’s undeniable health condition and its undeniable implications.

    It is a critical juncture in the country’s progression, and the country’s progress may suffer retrogression just because of the president’s ill health and the denialism of the president and his defenders. .

  • Stella Monye’s only son is dying!

    Stella Monye’s only son is dying!

    •Veteran singer cries for help

    For 17 years, music artiste, Stella Monye has carried the cross of her only son, Ibrahim, who has been in and out of hospital.

    With little or no headway, Stella is afraid that if his condition lingers, it will be double-tragedy. “When I grow old and infirm,” she told Ripples, “how can Ibrahim take care of me, when he has lived most of his life, moving from one hospital to another?”

    Time indeed is running out for Ibrahim who would need US $50, 000 for a life-saving surgery, according to the Urology Centre, in Indiana USA, where Dr. Ayo Gomih is medical director.

    Ibrahim had an accident when he was 11. His mother was said to be out serving her country, as part of a musical group producing the Nigeria ’99 theme song, en route to hosting the FIFA U-21 World Cup.

    Recalling the ordeal, the singer disclosed how the phone call about her son’s accident came when she and her colleagues were presenting the Nigeria ’99 theme song to Head of State, Gen. Abdulsalami Abubakar. She said she went on tour to promote that theme song, thinking the accident was minor.

    Ibrahim’s butt had landed pat on spikes, as he fell from a raised water tank, piercing vital organs, and tragically altering his young life into a relay of heart-rending medical emergencies.

    His condition has gone from bad to worse, especially as the surgeries have failed over the years, particularly the 2014 one in India, for which Stella, with other artistes like K1, Daddy Showkey, Orits Wiliki, Onyeka Onwenu, Lagbaja and Pasuma staged a roadshow to appeal for funds. The failed surgeries, she said, had further damaged more of Ibrahim’s internal organs such as the left kidney, the bladder and the uretha.

    Crying for help, Stella who seeks urgent remedy for her son’s condition can be contacted on +2348037305052. Her account details are: Stella Monye, First Bank account number 2021451638.

  • He is just two … but dying

    He is just two … but dying

    Kehinde Oluwapemisayo Akinbo, the second of a set of twins, is two years, but he looks as if he were a year younger than his brother, Taiwo. The twins were born on August 11, 2014. They were growing up together but when it got to a time to walk, it was only Taiwo that could walk but Kehinde could not walk and struggled to grow in size.

    When Kehinde ’s mother, Mrs Damilola Akinbo,  noticed that his legs are weak and not straight, she took him to an orthopaedic hospital at Igbobi, Yaba in Lagos believing that the boy had dislocation.

    All the effort by the doctors in the hospital proved abortive and was from there referred to Lagos State University Teaching Hospital, Ikeja (LASUTH).

    Mrs Akinbo said Kehinde also has challenges with his strength as he cannot play well and gets tired easily.

    According to her, despite huge expenses on the boy’s health, no positive result has been achieved; instead, it became worse.

    It was when he was referred to a heart treatment section at LASUTH that it was discovered that he has a heart problem. And the only means he can get over it is through a surgery at Max Smart Super Specialty Hospital, Saket, New Delhi in India.

    It was learnt that the needed surgery would cost N3,714 000 to cater for his surgery and travelling to India. But his parents have been trying all means to gather money since last year to no avail.

    The disturbed mother has pleaded with generous Nigerians and Governor  Akinwunmi Ambode to come to her son’s aid as they have spent all they have on his health and cannot withstand the financial burden of the needed surgery.

    A bank account which has been open to that effect is as follow: Account Name: John Oluwapemisayo Akinbo. Guarantee Trust Bank, Account number: 0229742485

     

  • ‘How to keep babies from dying’

    ‘How to keep babies from dying’

    With a health survey report that 854,000 of over 7million babies born yearly before the age of five, a group, The Partnership for Advocacy in Child and Family Health (PACFaH) is mounting a campaign to reverse this grim trend. ABDULGAFAR ALABELEWE reports 

    The news is not cheery. There are 7.028 million live births in the country yearly, according to the Nigeria Demographic Health Survey (NDHS), but 854,000 of the babies born do not live to celebrate their fifth birthday.

    The good thing is that something is being done about it. The Partnership for Advocacy in Child and Family Health (PACFaH) has launched a campaign to reverse the trend. The group has a four-point plan: sensitise people on good nutrition for mother and child, family planning, routine immunisation, and comprehensive management of child killer-diseases. PACFaH said if you take care of these areas, you will keep more children from dying before their fifth birthday.

    Speaking at an event in Kaduna to mark this year’s anniversary of the Day of the African Child, Senior Programme Manager from Pharmaceutical Society of Nigeria (PSN), David E. O Akpotor said pneumonia and diarrhoea account for 14% and 9% of the under-five mortality rate among Nigerian children. This means that no fewer than 400,000 children die annually from pneumonia and diarrhoea.

    Akpotor said, “The major reason for these preventable deaths is poor access to healthcare, particularly in rural areas. This problem can be effectively addressed by ensuring availability of recommended essential drugs up to the community level.

    “There is also need for improved healthcare seeking behaviour amongst parents and caregivers and appropriate referral to healthcare facilities.”

    Speaking on family planning, Programme Manager, Health Reform Foundation of Nigeria (HERFON), Dr. Hassana Adamu re-sounded the alarm note, saying Nigeria has one of the highest maternal mortality rates in the world

    He added, saying that one woman out of every 29 Nigerians faces a lifetime risk of death during childbirth.

    “Family planning has, however, been universally recognised as one of the key pillars and approaches towards achieving safe motherhood and survival of the child directly and indirectly. It is only a healthy mother that can provide and protect the child.

    “Due to its direct positive impacts on the health of the family and consequently the economy of a nation as a whole, meeting the unmet need for family planning can help Nigeria significantly reduce maternal and child mortality.

    “Providing family planning or child spacing will avert at least 31,000 maternal deaths, with over 700,000 mothers prevented from injuries or long-term complications due to childbirth.

    Similarly, Malam Isah Gidado, a Programme Officer from Community Health Research Initiative (CHR), said child killer diseases such as Tuberculosis, Tetanus, Diphtheria, Meningitis, Pneumonia, Measles and Polio constitute a huge burden on Nigeria, but can be tamed with routine immunisation.

    He pointed out that routine immunisation is confronted by several challenges such as imminent shortage of funding for vaccines, inadequate budget as well as delay and piecemeal release of funds

    Backing his claims, Malam Gidado said, “We appreciate the Federal Government for the allocation of N12.6 Billion for immunisation covering Polio campaign and immunisation in the 2016 appropriated act, but the amount is too minimal to carry out the project.”

    He said, not less than N40billion is required to carry out the assignment.

    In the area of nutrition, as presented by Mr. Sunday Okonkwo who represented Civil Society Scaling up Nutrition in Nigeria, with about 11 million stunted children, Nigeria accounts for the highest burden of malnutrition globally.

    In his words, “Nigeria Demographic and Health Survey (NDHS) Results of 2013, reported at the National level shows; prevalence of Stunting 37% underweight 29% and wasting 18% in Children under five years old.

    “In Kaduna State, Stunting is at 56.6%, underweight 57.6% and wasting 42% in children under five years old. This means Kaduna State with 56.6% stunting has the third highest number of stunted children under-5 years of age in Nigeria after Kebbi 61% and Katsina and Jigawa with 59% respectively.” He said.

    He however said, with budget line in place for nutrition in the Kaduna State 2016 budget and the school feeding programme, the status of Kaduna will soon be reversed.

    Recommending solutions to the challenges leading to death of almost a million Nigerian child annually, Programme Manager of Civil Society Legislative Advocacy Centre (CISLAC) Chioma Kanu stressed the need for budget lines and release of funds for Nutrition, Immunisation, Management of Child Killer Diseases and Family Planning.

    According to Kanu who spoke to reporters on the way out, the Federal Government, through the Ministry of Health, has developed the Health Sector Component on National Food and Nutrition Policy, the document, if adopted and fully implemented, at the state and local government area levels, will by 2019 reduce stunting by 20%, reduce childhood wasting by 15% and increase exclusive breast feeding in the first six months by 50%.

    “We urge governments at the national and state levels to adopt the National Strategic Plan of Action (NSPAN) with specific focus on Maternal and Child Nutrition component of the plan, create specific budget line on nutrition across relevant institutions, encourage exclusive breast-feeding, adopt an effective implementation of the costed NSPAN at all levels to combat endemic malnutrition in the country,” she said.

    They equally urged governments at all levels on provision of appreciable access to family planning services through adequate budget provision, fulfilled government’s commitment at London summit to family planning related issues, as well as massive awareness creation on the appropriate compliance to the required medical procedures in administering family planning services to secure individuals’ confidence and acceptance.

    “Government must also prompt adoption and implementation of the National Blue Print on Family Planning (Scale-up Plan 2014–2018) and the Costed Implementation Plans to reflect the local context to promote effective implementation across the Country.”

    “As we mark the Day of the African Child today we urge the Government of Nigeria and relevant Stakeholders to place high premium on the adequate management of the aforementioned preventable and treatable childhood killer diseases.

    “Our specific advocacy requests are: The adoption and listing of Amoxicillin DT as the First Line Drug for the Management of Childhood Pneumonia in the National Standard Treatment Guidelines and the National Essential Medicines List;

    “States’ Ministry of Health to invest in and scale up the implementation of the National Guideline on Integrated Community Case Management (iCCM) of Childhood illness for the reduction of under-5 mortality, as directed by the 58th National Council of Health Meeting held in Sokoto in March 2016, as well as increase public awareness and acceptance of the use of Zinc-LO-ORS Co-pack as the First Line Drug in the Management of Childhood Diarrhoea.

    The creation of a  specific budget line for the procurement of these Essential Drugs (Amoxicillin DT and Zn-LO-ORS) that have been shown to reduce Pneumonia and Diarrhoea Deaths Globally and Nationally. And timely release and judicious use of funds allocated for the procurement of these Essential Medicines as captured in the budget.

     

  • Help! my daughter is dying

    Help! my daughter is dying

    •Girl needs N3m for heart surgery

    Eight months after her case went public, three-year-old Teniola Bashorun is yet to get the N3million required for her heart surgery in India.

    The girl is diagnosed with a hole in her heart.

    Her father, Kehinde Bashorun, said they have been nursing the ailment for three years and that help is yet to come.

    He also said the sickness has deprived his daughter from schooling and has also stopped her from mingling with her peers in the neighbourhood.

    “We have been taking her for medical check up for the past three years with the little money we got from people. But, the situation became worse two weeks ago when she began to excrete blood. I rushed her to Lagos State University Teaching Hospital (LASUTH) because I thought I was going to lose her and since then, she has been feeding on drip,” he said.

    The primary school teacher also said he is now a debtor because he has been borrowing money to manage her sickness.

    He said: “So many times, she becomes unconscious. She urinates and excretes uncontrollable on her body. I have been with her since she has been admitted because my wife is nursing a set of twins.

    “I was told that if we don’t act fast, her heart may fail to pump blood,” he said.

    To save Teniola, an account has been opened at Ecobank with number: 2961198124 under the name: Bashorun Felix Kehinde. The Bashoruns can be reached on 08188275717 and 08028561402.

  • I’m dying, kidney patient cries out

    I’m dying, kidney patient cries out

    When Adesoji Adebola, an estate surveyor, first experienced renal pains in February last year, his family didn’t realise that it had a serious problem at hand.

    His face and legs were swelling up, followed by severe bouts of malaria. At the Lagos University Teaching Hospital (LUTH), Idi-Araba, he was initially diagnosed of infection and he was treated for it.

    He thought it was all over, but in April, he was diagnosed of kidney failure. All efforts to save him began.

    But there was a snag – the dialysis machine at LUTH did not work, leading to his transfer to a specialist hospital.

    “He was just talking incessantly for over 24 hours. We had to rush him back to LUTH where they said he would have to undergo dialysis immediately. Unfortunately, the machine wasn’t working and we had to move him to a private clinic,” his sister, Adebukola Adesoji, said.

    At the Dialyser Specialist Medical Centre in Oshodi, Lagos, where Adebola was admitted, he was told that his kidneys had packed up. To live, he has only one option: He must undergo an urgent kidney transplant in India. He was also told that on his kidneys have been destroyed by infection. Also his Packed Cell Volume (PVC) was less than 20, hence he would need blood transfusion every time he goes for dialysis.

    When The Nation contacted the hospital, its Medical Director, Jacob Awobusuyi, said: “He has kidney disease and it is a permanent one.  The infection which caused the problem is glomerulonephritis, an inflammation which the body produces and it has destroyed his kidney.”

    Awobusuyi said Adebola would need an urgent kidney transplant which would cost at least N7 million, adding that the patient also needs a kidney donor urgently.

    For now, Adebola undergoes dialysis twice weekly at about N45,000 per session; the family is groaning under the financial stress.

    Adebola is appealing to kind-hearted Nigerians to help him raise the fund. “I’m dying; Nigerians should please help me.”

    Donations, the family pleaded, can be made into his Guaranty Trust Bank (GTB) Account number: 0011516188 under the name, Adesoji Adebola.

  • A dying art

    What would you do if opportunity beckons for you to come back home to Nigeria after spending years in the United States of America (USA)? From what you can gather, the level of intellectual discourse you were used to before you left is a far cry from what is presently obtained. Should you remain in the US with its state-of-the art education facilities or return to contribute your quota toward the development of Nigeria? This is the dilemma a former colleague faces as he determines to take a decision that could make or mar his future.

    I saw in him an individual who truly loves Nigeria. After spending close to an hour on phone discussing about intellectuals and social critics in both countries, he was baffled that things are worse now than when he left. “All the news I seem to hear from Nigeria is practically about one bomb blast or the other; what is really happening on ground”? How did we derail and get to this ridiculous level? He queried.

    He told me that there is not a university in the US or Canada where you will not find, at a minimum, one Nigerian professor or professional. There is not a single hospital where you will not find Nigerian medical doctors and or nurses and other professionals. There is not a single private or public institution anywhere in the US that you will not find Nigerian students. He said the same may be true of the UK. These intellectuals and professionals dispersed because successive Nigerian governments, military and civilian, did not give rooms for intellectuals and professionals.

    Those of us who grew up listening to – and reading – the likes of the late Gani Fawehinmi; Beko Ransome-Kuti; Bala Usman, J. F. Ade-Ajayi; Eskor Toyo; Biodun Jeyifo; Claude Ake; Olatunji Dare; Kole Omotosho; Tam-David-West; Tai Solarin; Grace Alele Williams; Niyi Osundare and a host of others would’ve been appalled that intellectual pursuit and social criticism is a dying art in Nigeria. These and other individuals I cannot all mention because of space would never remain silent in the midst of injustice. Beko and Gani, for instance, spent time in detention because they refused to remain quiet.

    One thing is certain; there is a price to be paid for silence and cowardice in the face of oppression and injustice. What we see today is the majority joining the government bandwagon because of expected crumbs. Nigeria is now paying the price for abandoning intellectual pursuits. We already see the decay in the system. We see this in our national priority. We see it in how and what our country is becoming. And we see it in the pervasiveness of hopelessness and in the moral and political corruption that have come to characterise our country. Is this our Nigeria?

    Why do I love intellectuals? I do because they are men and women who have committed their lives and times to the pursuit and or dissemination of rigorous ideas and serious knowledge. They can be found in all areas of life – including music, arts and culture, medicine, mathematics, economics, politics, law, philosophy, and literary criticism.

    Beside the university or institution-based intellectuals, there are the public intellectuals who, for the most part, are engaged in very public discourses within the public sphere. However, it should be pointed out that there are times when it is difficult to differentiate between public intellectualism and political activism — or between political activists and social critics. The lines are sometimes blurred; however, all exist to make society better.

    I still recollect the days of military rule when many of these men and women were labelled “radicals” or “leftists.” Retired Colonel Lawan Gwadabe was once quoted as saying the government abhors “undue radicalism.” But those who knew better knew that these were the salt of our nation. They were the nation’s conscience.

    Many – during the military era- were prosecuted, persecuted, harassed, jailed, or sent into exile. Civilian administrations also contributed to the malaise. In the end, some of our best and brightest who could not stand mediocrity left in search of stability and greener pastures elsewhere.

    That was how our decent toward infamy began. Gradually, the distasteful and impermissible became permissible and sacred. It became the norm to not only steal, but to loot. It became acceptable to be a professional “intellectual” sycophant. They revere men and women with inferior IQ and dubious character, all because of crumbs from the master’s table.

    Those who study how societies develop and progress know too well that we need a bourgeoning class of intellectuals to highlight alternative paths to development. Without them, our society may stagnate, regress or even disintegrate. Even as brutal and repressive and unpredictable as some military regimes were, the Nigerian intellectual class, along with a budding class of social critics, helped to keep the government in check. But today, things have changed. Nigeria is different.

    We have lost fair grounds already, but we can still make amends for future generations by repositioning our universities to take their rightful place in the knowledge economy. We can incorporate the Japanese example where graduate teachers are the best paid public servants. There was a time in Nigeria when the salaries of professors were in tandem with that of a federal permanent secretary.  Today however – and despite the increased workload of professors – a distinct pay differential has emerged between apex positions in the civil service and those of senior academics.  Ironically, it is this sense of unfair disparity that has turned our academics into perpetual agitators with destructive consequences for the academic calendar.

    I am yet to hear from my former colleague if he has decided to leave the safety nest of the US for the unpredictable waters of Nigeria.

     

    Farewell Jude Isiguzo

    Last Saturday morning, the Group Sports Editor, Ade Ojeikere sent me a short but despairing BB message: “Jude Isiguzo is dead.” The news hit me like a thunderbolt. I replied immediately; what, how, when? “This morning,” was his short reply. I was confused.

    I first met Jude when he joined us in the now rested The Comet as a reporter, we bonded immediately. The bond got tighter when I later knew he was the brother of Mr. Ikeddy Isiguzo, a mentor and friend who is also the chairman of the editorial board of Vanguard newspaper. He used to send messages to his brother through me – we didn’t have mobile phones then.

    When I lost Ngozi (my late wife) in 2012, Jude was among the delegation that paid me a condolence visit; he was amiable and always unruffled. He takes life the way it comes. Just like the late Edo Ugbagwu, he was friend to almost everyone. This is why we all felt this untimely loss. I remembered the story Ngozi told me of how his wife threw a surprised birthday party for him by feeding the entire newsroom.

    For the short time I interacted with him before I left full time journalism, I noticed he had a good sense of humour; no matter how serious an issue is, Jude will inject humour into it and lighten the burden and mood. Even when he visited, he still had a smile on his face while encouraging me to take heart and be confident that Ngozi is in a better place. He would not hurt a fly as he always wears what became his trademark smile.

    I must also add that he was a very free-minded fellow; I can’t remember ever seeing him getting angry or quarrelling with anybody.

    My condolence goes to his lovely young wife, Gwendaline and his family. Jude was simply a good man. May his soul find rest with our Lord.