Tag: LUTH

WALE ADEPOJU writes that indigent patients at the Lagos University Teaching Hospital (LUTH), Idi Araba, desire a typical family life.

He wakes up in the morning from his bed at the corner of the room in the Paediatric Ward of the hospital and rushes to the in-patient bathroom to have his bath.

Thereafter, he rushes to the Staff School, Lagos University Teaching Hospital (LUIH), IdiAraba, where he is a primary five pupil, to pursue his life-long dream of becoming an accountant.

After school hours, he returns to his corner; takes his lunch, attends to his academic assignments and retires for the day.

This is the life of 15-year-old Chinonye Ogbonna, an abandoned patient at the Paediatric Ward of the Lagos University Teaching Hospital (LUTH).

He strikes some sort of chord in some in-patients. But, oftentimes, the bondings are short-lived. A nurse explained the reason. “Most children in the unit are cancer patients who have limited lifespan. Some die in the ward while others recover and return to their homes,” she stated.

Ogbonna was brought to the Accident and Emergency (A and E) Ward unconscious and in a coma about four years ago.

At LUTH, he was revived but he could not recollect where he came from. The only person he remembered was an uncle he identified as Mr Austin Okoro, an indigene of Imo State.

He said: “I could not remember my home address because I was sick. But I know I am from Imo State. I also remember Jakande Bus Stop.

Ogbonna is frustrated; he has witnessed no fewer than 30 deaths of some patients, who were once ‘his friends’ in the hospital. Their deaths were terrifying for him. He longs to belong to a family and wants good Nigerians to help him realise that.

He said: “I feel good here because of the way they received and relate with me but here is a hospital, not a home”.

Master Ogbonna has been performing well in his studies. Last term, he came First in his class. He said he intends to maintain it and move to secondary school as the best student.

The Medical Social Services (MSS) of LUTH have tried without success to locate his relatives.

Efforts made by the hospital staff to locate his address were abortive.

At the moment they are trying to find him a home but all homes in Lagos State seemed to have been filled up.

The Medical Social Services (MSS) department has written to the Lagos State Ministry of Youth and Social Development to help him find a home but no response has been received.

Another patient, 63-year- old Taiwo Adekunle, a retired staff of the hospital, is still unmarried and has no home of his own. He too has taken refuge at Ward A2 of LUTH. His predicament started when he retired from the hospital, fell sick and was admitted. It was his neighbours who brought him to the hospital when he fell sick. When he recovered he could not go back to his rented apartment because his lease had burnt out. He was stranded at the hospital.

The Medical Social Services (MSS) department of the hospital got him an accommodation. But, he was soon back to the hospital ward when he could not sustain the payment of the apartment. He has since been having social problems, including solitude and almost recluse. It is impossible for the MSS to make any contact with any of his relatives.

Attempts by the hospital staff to locate his family members in Abeokuta, Ogun State, Southwest of Nigeria, were unsuccessful.

But, luckily after many attempts to locate his relatives; the hospital stumbled on his brother who said as a family, they thought he had died as they have not seen him in 20 years. His brother said their parents had died thinking he was dead.

Unfortunately, the brother was too poor to house him. After that nobody could trace his brother again.

He had been treated and recovered. But nowhere to go.

His mobility had been affected due to a troubled leg.

He could not get his gratuity because of problems with his documents. He has no next of kin. When he was asked to submit some documents, it was the MSS department that served as his next of kin.

Mrs Victoria Agaete, 63, is an Ishan woman from Edo State. She has been admitted at the Accident and Emergency (A and E) ward of LUTH July last year.

She was brought to the hospital by a Good Samaritan who found her lying down with an open wound she sustained. She was discharged in August of the same year but  had nowhere to go. She was allowed to stay since LUTH is a Federal Government-owned hospital. Patients were not usually sent packing from the hospital.

She claimed she is a widow without any biological child of her own. She came to Lagos after the death of her husband. Mrs Agaete and begs for alms to feed. She only speaks Ishan dialect and a bit of Yoruba.

The MSS department contacted the Edo State Liason Office on September 4, last year to assist with her repatriation to her town. But the liason office is yet to communicate to the hospital.

In November, the hospital again wrote the liason office. This time, it asked for more time. Last March, the MSS wrote another letter on her behalf, which was forwarded to the Ministry of Women Affairs and Social Development, Edo State.

An officer from the liason office came to the hospital in April to see the woman. He said the liason office would let the hospital know when she would be repatriated. But, the hospital has not heard from the liason office since then. The office said it has difficulties placing her in a home.

Madam Agaete is still on her bed at the A and E ward of LUTH. Nobody has come for her. The staff of the hospital said they have been responsible for her feeding and upkeep.

Deputy Director/ Head of Department, Medical Social Services, LUTH, Mrs Funmi Doherty said there are many contributory factors why patients are abandoned in hospital wards.

“But the major ones are due to social, economic and medical reasons”, she said.

She said relatives may abandon a patient if they do not understand the ailment or if there is a taboo attached to it. “They will say rather than this person bringing shame to us, let us leave him in the hospital. This is a reason often given by some,” she said.

Mrs Doherty said that is why the medical social workers go out of their way to ensure family members understand what the medical situations of the hospitalised relatives are. “We usually tell them the dos and don’ts so that they can be supportive,” she said.

She said there are cultural and social factors attached to it, such that it causes stigma to the patient.

“Some even say this may bring stigma to the family or bring the family’s name to ridicule,” she said.

The economic factor, she said, is the main reason why patients are abandoned in the hospital. She explained: “When people don’t have money to pay they just abandon their relative in the hospital. Some think it is a government hospital, why should they pay so much. But majority of abandoned cases are due to inability of family members to pay the cost of treatment.”

Other reasons, she said, may be due to housing problem, saying if a patient does not have a place to go after the completion of his treatment, such patient may take refuge in an hospital which is quite secure.

“Some of the patients are still in the hospital despite being healed because there are no homes to go to,” she said.

She urged the Federal Government to do more in the provision of social facilities. “Many of the patients we treated free do not have a place to go. I think we should have a place such as a home to put them while trying to link them up with their family members,” she said.

Mrs Doherty said many sick patients are being denied beds in the hospital, stressing that unless abandoned patients leave the wards it may be difficult for them to be admitted.

“As they occupy the beds another patient is being denied admission, treatment,” she said.

She said most children abandoned cannot leave as the orphanages are full. “Some do not have amenities. We need to have facilities and services, and homes to take them to”, she said.

Mrs Doherty said medical social workers do counselling and link patients with their relatives.

“We have been acting as a broker and link to agencies to support the patients. We also identify agencies that are into charitable works,” she said.

She called for more fund for indigent patients because “It is not everybody that will be able to afford the hospital bills”.

She added: “This morning a woman was begging for alms to be able to treat her sick child. Unknown to her, she too was asthmatic. When she got to our office she fell into crisis. And we had to look for over N1,000 to buy inhaler for her. This is just one of many examples of people who cannot afford the cost of treatment”.

The Blood Bank of the Lagos University Teaching Hospital (LUTH), Idi Araba has been increased by 120 pints.

This is courtesy of Novartis Pharma Services Scientific during the marking of its Community Partnership Day (CPD) to commemorate the merger that created Novartis in 1996.

According to the Country Group Head, Novartis Pharma Services Scientific Office, Mrs. Vera Nwanze, the voluntary donation by staff of the company has presented a unique opportunity for all associates to make a difference in their local community and make their personal contribution to Corporate Citizenship.

“This worldwide initiative is aimed at supporting local communities, social institutions and non-profit organisations with projects compatible with the Novartis commitment to social responsibility. Each year, projects are planned in close collaboration with the institutions they are intended to benefit,” she stated.

Nwanze added, “By motivating potential donors to donate blood voluntarily on a regular basis, we will at least be achieving a safe blood donation culture and on our part, it is our hope that this gesture of ours could serve as a motivation for other corporate organisations to emulate us as we aspire to make a difference in our community.”

 

The Head of Department, Haematology and Blood Transfusion Medicine, LUTH, Dr Sulaiman Akanmu appreciated the 120 voluntary blood donours and said, “The World Health Organization’s (WHO) goal is for all countries to obtain all blood supplies from voluntary unpaid donors by 2020 in accordance with World Health Assembly resolution 28.72, which was adopted in 1975.

 

In this sequel to the investigative series on the dangers of excessive consumption of herbal gin products, The Nation reveals results of laboratory tests showing presence of poisonous metals in the blood of selected herbal gin lovers By Olatunji OLOLADE, Assistant Editor and Kunle AKINRINADE

The truth dawned on Sola Awoyale like twilight of eternal damnation but he bared his teeth in a scornful smile. It was his measured, careless response to frightening news. Striking a casual pose, he yelled: “Kosi were! Baba no go die unless to ba darugbo…Laye laye! Laye laye!” (roughly translated thus: No worries! I will never die until I grow old…never!).

The 28-year old hollered defiantly, like a badly scarred soldier feigning defiant pose in the face of death. But Awoyale is no soldier; rather he is a roving electrician and breadwinner of a family of six – comprising his wife, daughter, sister and aged parents. And if he does not curtail his addiction to herbal gin very soon, he will have serious health issues to contend with.

Laboratory test and analysis conducted on his blood plasma samples revealed the presence of the heavy metal, lead (pb), at toxic level. Lead contained in his blood towers at 56ug/dL (56 microgram/deciliter), which is precisely 46 micrograms higher than the acceptable lead limit of 10ug/dL.

The study which was conducted in furtherance of The Nation investigation of the dangers of excessive consumption of local herbal alcoholic beverages was conducted at Pathcare Nigeria’s medical laboratory at the Lagos University Teaching Hospital (LUTH), following a three-month observation of the test subjects including Awoyale and four other consumers of herbal gin products. Blood and urine samples of the five subjects were collected and analysed simultaneously at the medical centre’s Nigeria and South African laboratories over one month.

In the course of the research, conscious efforts were made to isolate the research subjects from other potential sources of heavy metals including cigarette, leaded petrol, mining and uptake of plants from contaminated soil.

Worrisome test results

While Awoyale’s test results showed that his blood lead level was dangerous at 56ug/dL (56 microgram/deciliter), the other test subjects, who pleaded anonymity, also recorded worrisome results from the test. For instance two of the test subjects had cadmium concentration in their blood at high levels beyond World Health Organisation (W.H.O)’s permissible limit while the heavy metal abounds in the fourth subject’s blood towered at borderline level. The fifth subject however, suffers a deficiency of iron in his blood, according to interpretations given by the medical centre’s resident pathologist Dr. Segun Isioye.

Awoyale, like the other test subjects, presented a forlorn sight at press time; he perspired –particularly when agitated – like a sickly child caught in a wooly blanket. His freckled face tapered off into a weary smirk every time he smiled and his blackened lips twisted into a pout at news of his test result; behind that smirk resonates a silent wail for help perhaps?

Death by installment

The case of Awoyale is particularly worrisome because lead poisoning can have rapid, acute effects or chronic, long-term effects in an average human, according to medical experts. Acute and sub-acute effects are typically caused by relatively large doses of lead over a short period— often days to months. These effects can be dramatic and include sudden death, severe abdominal cramps, anemia, ataxia, strange headaches, and behavioral changes, such as irritability and appetite loss.

A high level of lead in the blood is dangerous to health argued Dr.Chukwuemeka Isanbor, a Physical and Organic Chemistry don in the Department of Chemistry, Faculty of Science of the University of Lagos, Akoka, Lagos. According to him, a blood lead level of 70-100ug/dL can cause death. “Acute exposures often manifest as central nervous system (CNS) and gastrointestinal symptoms. Central nervous system symptoms include encephalopathy, convulsion, and stupor. Colic, a gastrointestinal symptom, is a consistent symptom of lead poisoning characterised by abdominal pain, cramps, and nausea.

“Adults have exhibited lead-induced colic at BLL as low as 40 µg/dL. Chronic exposure differs from acute exposure in that chronic symptoms manifest as general malaise, anorexia, constipation, wrist drop, hematuria, and anemia. Although not specific to lead poisoning, basophilic stippling may be seen in erythrocytes due to changes in ribosomes. Additionally, lead targets the proximal tubules of the kidneys and is capable of inducing nephrotoxicity in the form of proximal tubular nephropathy, glomerular sclerosis, and interstitial fibrosis. A decreased glomerular filtration rate and the direct inhibition of the biosynthesis of erythropoietin (EPO) production by lead may contribute to “lead-induced anemia.” Long term accumulation of lead could lead to illness and lower cognitive functions,” he explained.

In the face of arguments that lead ingested at lower levels poses no serious consequences on human health, recent research findings reveal that chronic effects are most often the result of smaller amounts of lead being taken in over longer times – months to years. These effects can be quite subtle and nonspecific, but include all body systems. A brief list of effects documented in people includes such effects as lowered sex drive, decreased fertility (in males and females), miscarriages and premature births, learning problems, hypertension, cardiovascular disease, and increased aggression and kidney problems.

The body handles lead in much the same way as calcium. Calcium is a crucial element for living things, being used in a wide variety of metabolic activities, signaling pathways and structural compounds. Most lead is absorbed through the digestive and respiratory systems. Under some circumstances, primarily occupational exposures, certain forms of lead can also be absorbed through the skin. The key is that however it enters the body, the most important step is the absorption of lead into the bloodstream. Nearly all lead vapors getting into the lungs cross into the blood quickly and easily.

Lead entering the digestive system is acted upon by stomach acids and made into soluble salts that can be absorbed by the intestine. In adult male people about 10 to 15 per cent of ingested lead is usually absorbed, the rest leaves the body in feces. But in young children, up to 50 per cent of ingested lead is absorbed. Lead can upset this ordered contraction leading to a great deal of stomach and abdominal pain, long referred to as “lead colic” in people. In the blood stream, lead interferes with the functions of hemoglobin, limiting the amount of oxygen that is carried to organs. Lead also interrupts the formation of new red blood cells in the bone marrow, leading to anemia. Effects in the skeletal and reproductive systems can cause problems such as stunted growth and infertility (in both genders). In situations where the body needs to use bone calcium stores, like growth, fracture healing, dietary imbalances, pregnancy and lactation (in mammals), and or bone loss due to aging or osteoporosis, lead is released from bones and can cause chronic, low level poisoning.

Like lead, cadmium is also very dangerous to health. Once absorbed, cadmium is efficiently retained in the human body, in which it accumulates throughout life. It is primarily toxic to the kidney, especially to the proximal tubular cells, the main site of accumulation. Cadmium can also cause bone demineralization, either through direct bone damage or indirectly as a result of renal dysfunction. Excessive industrial exposure to airborne cadmium may impair lung function and increase the risk of lung cancer, according to Bosun Akintunde, a United Kingdom (UK) based Chemical Pathologist.

Cadmium is hazardous both by inhalation and ingestion and can cause acute and chronic intoxications. When ingested as part of alcoholic beverage, it ultimately accumulates in the body of the drinker; by far, the most salient toxicological property of cadmium is its exceptionally long half-life in the human body. Once absorbed, it irreversibly accumulates in the human body, in particularly in kidneys and other vital organs such the lungs or the liver. In addition to its extraordinary cumulative properties, cadmium is also a highly toxic metal that can disrupt a number of biological systems, usually at doses that are much lower than most toxic metals, noted Akintunde.

Changing patterns in alcoholic beverage consumption

At the backdrop of this phenomena, Emeka Dumbili PhD, of the Department of Sociology and Communications, Brunel University, London, United Kingdom (UK), argued that in more recent years, there have been some striking changes in the patterns of consumption, brought about by the development of the socio-political and economic structures of the country.

“Consumption is no longer solely regulated by custom and tradition of the people and it is no longer reserved for social gathering or entertainment of a guest alone. The patterns of use, the users and reason(s) for consumption are changing rapidly, especially among young drinkers. A sharp contrast from what hitherto existed is the alcohol contest among youths in bars, restaurants, drinking joints, hotels and nightclubs that are strategically located near various schools in Nigeria. This competition is always among boys and the winner is judged based on two standards – the ability to drink large a quantity without showing signs of intoxication and the ability to drink faster than the opponent.”

Dumbili’s argument is substantiated by prevalent contests and rampant drinking binge indulged in by herbal gin lovers across the nation’s local pubs.

The new trend of alcohol consumption no doubt contributes to Nigeria’s ranking among thirty countries with highest per capita consumption of alcohol according to W.H.O rankings. Such ranking however, fail to account for the unrecorded production and consumption of alcohol, particularly local brews like the ubiquitous herbal gin. Recent reports do not indicate a decline in consumption but rather revealed that Nigeria consumed about 10.57 litres per head of the population. This corroborates earlier findings that heavy episodic and daily drinking, rather than moderate drinking is common among users of alcohol in Nigeria and that alcohol is the most commonly used drug among Nigerians.

Consequences of splurging on herbal gin

The consequences of excessive consumption of herbal gin can hardly be denied. They cut across social, health, economic, psychological and many other consequences. The consequences attributable to excessive consumption account for large costs to families and the society and they are not limited to health-care costs, but also costs related to social harm.

Locally brewed herbal gin like ogogoro, beer and other alcoholic beverages have been linked to increase in violence in local communities and this is almost a daily occurrence in most Nigerian homes and higher institutions. Often times, there is a strong relation between economic wealth and alcohol consumption: the higher the gross domestic product, the higher the overall volume of consumption and the lower the proportions of abstainers. Though moderate alcohol consumption may enhance the control of coronary heart disease, misuse has been linked to heart disease, especially as the user grows older. It also causes liver disease for which there is no effective treatment in Nigeria. There is the option of transplantation, but only a few can afford the cost in Nigeria.

There is also a serious problem of how to determine moderate consumption in a country where there is no definition of a standard drink, no inclusion of alcohol by volume on most labels and where alcoholic beverages are served in different sizes of bottles, cans, glasses and calabashes.

Harmful alcohol use by pregnant women affects the unborn child leading to foetal alcohol syndrome. It leads to malformation of the brain in the unborn resulting in birth defects. The fact that women are beginning to drink even more than men now in Nigeria means that the country may continue to witness birth defects.

Another major consequence of the changing patterns of alcohol consumption is road traffic accidents due to drunk-driving. This has continued to claim lives yearly in Nigeria and may continue because drivers are advised to drink responsibly by the brewers rather than abstain. Nigeria presently ranks third out of the 10 countries with the highest number of deaths related to road accidents and the problem may continue due to lack of policy to check alcohol availability, use and misuse. The sale of herbal gin like ogogoro is not regulated and the brewers are increasingly embarking on aggressive marketing of their products, advertising mostly in local soft-sell magazines. This hinders the anticipated benefits from the campaign for moderate consumption among drivers for instance, while the alcoholic beverages flood the neighbourhood and commercial motor parks.

Stitch in time…

The situation no doubt demands government’s radical intervention to stem the tide of excessive consumption of herbal gin by adults, young adults and even high school teenagers.

Conscious efforts must be made by the mass media, medical doctors and other health care agencies to enlighten the public more on the toxicogenic, carcinogenic and socioeconomic implications of the excessive consumption of herbal gin, according to Idris Age, a doctor and ‘rural healthcare giver.’

Dr. Isanbor, on another note, suggested that: “There should be stricter regulation of these products. They shouldn’t be allowed for sale if their claims can’t be substantiated. The public should be wary of consuming these products excessively as there are no set limits for their consumption.”

Until then, herbal gin lovers like Jude Afunso will continue to bask in the bittersweet intoxication of his favourite beverages. For Afunso, alcohol is a very necessary article, it invigorates him for the hard physical tasks of his daily job; it also enables him to do things at midnight that no rational person would do at 11 in the morning. For instance, while returning from a drinking binge on a Friday night, about two buildings away from his Agege, Lagos apartment, Afunso saw an empty cab with the key in the ignition. Promptly, he jumped behind the wheels of the cab and drove off. The driver of the cab who was peeing in a gutter behind the cab immediately gave chase and with the assistance of a police patrol team, he was able to reclaim his cab from Afunso. The latter had to be accompanied by the police to his house the following morning to confirm his identity with neighbours as well as his claim that he committed the joy ride under the influence of alcohol. Afunso’s act could have resulted in a ghastly accident claiming multiple lives as he was heavily drunk and according to the cab owner, very much disoriented behind the wheels at the time of his arrest. Two empty bottles of a particular herbal gin and an unopened bottle of another were found in his pockets at the time of his arrest. Afunso reeked of alcoholic beverages and seemed visibly disoriented but he claimed that he was perfectly okay. The same can hardly be said for Awoyale and a host of die-hard herbal gin lovers.

 

THE Ogun State College of Health Technology, Ilese-Ijebu, is to hold its maiden convocation on Thursday, March 13.

A statement by the Chairman, Academic Ceremonies Committee, Dr. Olusegun Ogunyanwo, said activities marking the three-day ceremony will begin on March 11 with a novelty football match.

The convocation lecture is to be delivered by Professor Akin Osibogun, Chief Medical Director of the Lagos University Teaching Hospital (LUTH), Idi-Araba in Lagos at the college auditorium on March 12.

The highpoint of the ceremony is the grand finale on March 13 at the college convocation ground, which will feature the graduation of students of the institution from 2007 when the college was upgraded to a polytechnic status.

The state governor, Senator Ibikunle Amosun who is also the visitor to the college, is expected to chair the occasion.