Health

Bello Hussein Adoto

Last week, the world marked Antimicrobial Resistance Awareness (AMR) Week. The goal was to raise awareness about  AMR—a phenomenon where antimicrobials no longer kill or prevent the growth of the microbes they used to kill.

Our bodies do an excellent job of containing viral, bacterial, or fungal infections before a doctor chips in with a drug or two to kill the germs and bring us back to good health. These drugs include antibiotics for bacterial infections, antifungals for fungal infections, and antivirals for viral infections.

Unfortunately, some of us don’t go to—or wait for—the doctor to treat actual or presumed infections. We dash to the nearest chemist to buy ampicillin over-the-counter for boils (skin abscesses) and amoxil for typhoid. Patients who can’t tell the difference between dysentery and diarrhoea would buy branded Ciprofloxacin or Amoxiclav to resolve prolonged toilet troubles and stomach pain. Those who are not that buoyant would manage metronidazole.

Our health practitioners also contribute to the problem. A survey of 12 countries shows that Nigeria has the third-highest percentage of antibiotic prescriptions. Three out of every five patients on admission at our hospitals are on antibiotics. This heavy use of antibiotics contributes to Nigeria’s AMR burden.

The consequence of our use, abuse, and misuse of antibiotics is that the viruses, the bacteria, and the fungi have grown tough—they no longer fear us and our drugs. Our pills and creams are no longer as effective. Regular bacterial infections that were once treatable with first-line antibiotics have become stubborn. You may need a second or third line to treat them. Diseases that needed only Ciprotab now call for Ceftriazone and Imepenem. Diseases that were once tolerable have become debilitating, if not deadly.

The WHO recently spotlighted the story of a woman who had reconstructive facial surgery following an accident. The wound got infected and they treated the infection only for it to rebound and eat away at her face. Gradually, her facial muscles turned to cheese. Further tests showed she had MRSA, the dreaded methicillin-resistant Staphylococcus aureus. Luckily, the woman survived. “If I’d known earlier, maybe I wouldn’t have lost huge portions of my face,” she said years later.

Our ignorance about AMR doesn’t make it any less deadly. About five million people died from drug-resistant infections in 2019. More than one million of these deaths were linked directly to AMR.

Aside from being deadly, AMR is expensive. Infections with drug-resistant bacteria, for instance, mean that patients spend more on higher and more effective antibiotics. These antibiotics don’t come cheap. Augmentin, one of the go-to drugs for severe infections, is now 13,000 naira. That’s more than one-third of the minimum wage.

The task before us is to stem the tide this menace. The government is playing its part. It has drawn up a national action plan for AMR. The plan seeks to increase awareness about the problem

, promote surveillance and research, and improve access to genuine antibiotics. Doctors also have concepts like delayed prescription and antimicrobial stewardship to guide their prescriptions. You can join the fight too.

One, don’t use antibiotics without prescriptions. Trust your doctors when they say you don’t need antibiotics. Some viral infections like cold can resolve without drugs.

Secondly, complete your doses when using prescribed antibiotics. It could be tempting to abandon your drugs at the first sign of relief. It could be valid even: some research has shown that extended use of antibiotics after symptomatic relief doesn’t make any significant difference in recovery. Still, don’t discontinue your drugs at a whim. Speak with your doctor.

Thirdly, don’t share antibiotics or prescribe them to others. This should go without saying, but our desire to help friends and loved ones often pushes us to share drugs like antibiotics with them. You can do better by directing your friend or relative see a doctor. Antibiotics are not emergency drugs that can’t wait for a prescription.

Good hygienic practices can help, too. They limit the spread of infections, and the consequent antibiotics (ab)use. Wash your hands regularly. Adopt proper etiquette when you are in a hospital or laboratory environment. Doing otherwise increases your risk of contracting or transmitting new infections to your loved ones.

Five, get vaccinated. Vaccines protect you from contracting potentially resistant infections or spreading them to others. Moreover, viral infections that can be prevented with vaccines, like measles and influenza, are some of the reasons people abuse antibiotics. When you don’t contract influenza or measles, you won’t feel a need to abuse antibiotics.

The AMR Awareness Week has come and gone, but the problem and its consequences remain. They affect us all; everyone can and should contribute to the solution. You can be a part of the fight by not abusing antibiotics or demanding that your doctor prescribe antibiotics for you when you don’t need them. You can join in by not abandoning your treatment or sharing your drugs. You can get vaccinated too. Start now. Start today. Join the fight against AMR.

Hussein can be reached via bellohussein210@gmail.com.

By Dr. Ismail Muhammad Bello

You have likely heard about climate change, a pressing existential threat demanding global collaboration. However, it is not the sole concern. Antibiotic resistance is another rapidly emerging issue that demands urgent attention.

Not too long ago, the pathological basis of diseases was shrouded in mystery, often attributed to superstitions. About four hundred (400) years back, the role of microbes in disease causation was still unknown. It took the discovery of the microscope and the works of Antoni Van Leeuwenhoek to open our eyes to the unseen world – the realm of microbes – surrounding and inhabiting us.

Microbes, omnipresent and adaptable, have evolved significantly to thrive in a constantly changing world. The human connection with microbes is extensive and intriguing. Thanks to their versatility, microorganisms are instrumental in driving human technological advances through their varying applications in agriculture, environmental protection, medicine and industrial production. From drug discovery and development to their role in bioremediation, biotechnology, and the emerging field of genetic engineering, microorganisms have played a monumental role in the survival and progress of life forms on Earth, even shaping civilizations.

Nevertheless, despite their crucial role in the earth’s functions, microbes also contribute to human misery as pathogens. Despite global efforts to combat them, infectious diseases persist as a challenge, particularly in Sub-Saharan Africa where the existing weak health system grapples with a double burden of diseases – an increasing prevalence of non-communicable diseases alongside prevailing communicable diseases.

Apart from the substantial morbidity and mortality resulting from infectious diseases, the burden encompasses economic losses due to healthcare expenses and disabilities, as well as a decline in productivity. In a broader sense, infectious diseases hinder human development by adversely affecting education, income, life expectancy, and other health indicators.

While current morbidity and mortality rates remain notably high, the situation contrasts significantly with the past where certain infections, now easily treatable, were once considered death sentences or challenging to address. The serendipitous discovery of Penicillin by Alexander Fleming stands out as a pivotal moment in medical history. “Antibiotics” not only transformed the curability of many diseases but, coupled with advancements in anaesthesia, also enhanced the safety and feasibility of major surgeries.

While the term “antibiotics” holds a more specific meaning in pharmacology, commonly it refers to a category of drugs utilized in treating “bacterial” infections. Bacteria, while a significant group, represents just one class of microorganisms; others include viruses, fungi, parasites, and even prions. Antibiotics function by disrupting vital processes in microbes leading to a loss of structural integrity or functional capacity, ultimately causing them to die or halt their replication.

Antibiotics encompass a diverse group of drugs, belonging to various classes, each effective against specific types of organisms. They include the well-known Amoxicillin (Amoxil), Ampicillin-Cloxacillin (Ampiclox), Metronidazole (Flagyl), Ciprofloxacin, Amoxicillin-Clavulanate (Augmentin) and numerous others easily accessible over-the-counter in our setting. Antibiotics have played crucial roles in combatting menacing diseases like Tuberculosis, Leprosy, Gonorrhoea, Syphilis, bacterial pneumonia, acute bacterial meningitis, and many others.

The introduction of these drugs came as a huge blow to the pathogenic microbes that previously had a field day. However, in line with natural selection, they didn’t succumb passively and perceived the development as a declaration of war. Over the years, these microbes evolved, becoming insensitive to many of these drugs—a phenomenon known as antibiotic resistance.

In response, scientists discovered new drugs, tweaked some of the existing drugs or synthesized novel ones. This led to a vicious cycle, whereas new drugs are developed, these organisms adapt and become resistant. This trend persists to our present day, leading to the emergence of highly resistant strains of microorganisms that are not susceptible to most of the antibiotics used in treating the kind of infections they cause – the so-called Superbugs. 

Unfortunately, this cycle is not sustainable for mankind. The rate at which microbes adapt to our drugs is faster than the turnout of our drugs. It takes about 10-15 years to develop a new antibiotic. Not only that, studies have shown that the estimated global cost of developing a new, targeted antibiotic will cost over a billion USD ($1 Billion), making it a highly expensive and risky venture for pharmaceutical companies.

The combination of these factors has impeded innovation in the field of antibiotics. Notably, the latest discovery of a new “class of antibiotics” that has reached the market was back in 1987. Since then we have been in a “discovery void” era, and currently, there are few novel antibiotic classes in the drug development pipeline. 

In 2022, the World Health Organization (WHO) identified twenty-eight (28) antibiotics in clinical development that address the WHO list of priority pathogens, of which only six (6) were classified as innovative. The repercussions are felt globally as an increasing number of bacterial infections are becoming hard to treat, once again posing a threat to global health and development.

Undoubtedly, resistance is a natural phenomenon and will eventually develop against some antibiotics. However, the accelerated rate at which it is occurring is aided by our irrational use of these drugs. Therefore, prudent use will surely slow down the process. 

Key determinants of antibiotic resistance include antibiotic abuse in veterinary and medical practice, inadequate provision of Water, Sanitation and hygiene (WASH) infrastructure, and the effectiveness of policy development and enforcement.

Dr. Ismail is a Medical Officer at Khalifa Sheikh Isyaka Rabiu Paediatric Hospital, Zoo Road, Tarauni, Kano State.

By Bilyaminu Abdulmumin

Guns are the enigmatic force that charm practitioners, all over the world, have been trying to crack since time immemorial. There was no length these charm practitioners didn’t go to contain this mysterious “oyibo” invention. In 2017, Daily Trust reported an awful story about a member of a Vigilante Group in Katsina and his quest for bullet charm. This lad was said to test the charm while in the middle of the vigilante gathering, so in a show of bravery and gallantry, he wrapped himself up in the charms, did incantations, picked a dane gun, and fired on himself. He died instantly!

Coincidentally six years later two similar stories shook the internet. One was in Bauchi State. According to an interview by the Bauchi police in the viral video of the purported spiritual helper, luck ran out of them. As he was testing the charm on his client the bullet pierced the helper’s stomach. The second incident, all the way in Ghana, but this time around it was gang members who claimed to have gotten the charm against the bullet, so this too, when testing the charm against one of them he immediately kicked the old bucket. Why is the constant desperation going unorthodox ways for bulletproof when it could be easily achieved when tuned to science’s endless ways?

Bulletproof materials are simply materials fabricated using layers of strong fibers. The fibers that are strong enough can “catch” and deform a bullet, mushrooming it into a dish shape and spreading its force over a larger portion of the fiber materials. In other words, fiber materials like vests could absorb the energy from the deforming bullet, bringing it to a stop before it can completely penetrate the textile matrix. There are fibers everywhere including heaps of waste along the roadsides in our cities, this could be harnessed for such purposes. Some time ago, I heard in an interview from one Nigerian student who was working to harness the fibers in chicken feathers to develop a bullet vest. This student further elaborated the idea behind the bulletproof in another way, he said strong fibers arranged in a particular way act like black hole phenomena, the concept that was revolutionized by the greatest 21st theoretical physicist, Sir Steven Hawking.

A black hole consumes any force that comes close to it without a trace. So a carefully prepared fiber material has this awesome feature. I wish I could learn further where the idea of this student has gone. Perhaps for the show of bravery and gallantry the charms practitioners want it natural, without the use of any vest. Then they should cry no more because there is equally a research in this direction. This involved directly engineering human skin to deflect the bullet. In the Netherlands, another student researched this by bioengineering a small sample of human skin to include spider silk between its layers. The Netherlands Forensics Institute has test-fired low-speed rifle bullets at it, and shown that it halts them.

So, it’s up to researchers to pick up from here by bioengineering human skin with spider silk for higher rifle endurance. The sons of slain victims of bullet charm would have very good motivation to continue with this research. Whenever it comes to bullet charm, Bokero’s legacy stands out. Bokero claims to be possessed by snakes, as a result, he became known for assisting with every spiritual help. So when the East African countries, Tanzanians and co, grew impatient with German colonial rule, back early in the 1900s, they turned to Bokero for help. He provided them the war medicine, according to Bokero the concoction would not only protect them from the German bullets but would turn the bullet into water, motivated by this new charm, these zealots would confront German firearms. May the souls of about 300,000 rest in peace.

By Sabiu Abdullahi 

The Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH) in Bauchi, Nigeria, has announced the successful launch of an innovative laser surgery programme for urological conditions.

The new programme is expected to provide advanced care for patients suffering from a variety of urological ailments, including kidney stones, prostate issues, and other related illnesses. 

The program was launched with the inaugural surgery, which was led by Dr. Evaristus Uzuma Azodoh, a renowned consultant urologist who arrived from the Chiva Specialist Hospital in Abuja.

The procedure, which lasted approximately one hour, was a resounding success, despite being the first of its kind in Bauchi. 

“This is a significant milestone for ATBUTH,” said Professor Yusuf Jibrin, the Chief Medical Director of the hospital.

“We are committed to providing our patients with the best possible care, and this new laser surgery program is a major step forward in our efforts to do so.” 

The new programme is expected to significantly reduce the need for patients to seek treatment elsewhere.

“In the past, patients in Bauchi who needed urological surgery had to travel to other cities or even abroad,” said Dr. Azodoh. “This new program will make it possible for them to receive the care they need right here in Bauchi.” 

By Uzair Adam Imam

The future of some graduates of the Basic School of Midwifery in Dambatta hangs in the balance, as they were left without licences to practice their profession years after graduation.

The graduates recount their ordeal at the hands of the school management, saying that they have been left stranded for years.

The graduates accused the school management of “intentionally dragging them into a dilemma and academic standstill.”

A former student of the institution said that the licence “is the only thin veil that serves as a blockade to his future.”

Many of the former students of the institution decried alleged widespread corruption by the school officials, whom they accused of giving licences to only the well-connected.

The Daily Reality gathered that the licence that is issued to students upon successful completion of their studies is the only barrier between students and multiple job opportunities or university admissions waiting at their doorstep.

Our prayers for intervention were in vain.

The students said that all their efforts to seek intervention from the state government and relevant authorities were in vain, a development that exacerbates their condition.

Mukhtar Ali (not real name) said that some of the students had paid the amount prescribed by the institution to secure the licence, but they have neither received the licence nor a refund of their money.

However, it was gathered that among the students struggling to secure their licences were the first set of students at the institution who had completed their studies eleven years ago.

Members of the batch of graduates said that they had sought intervention from the immediate past administration in the state and the school management, but also agencies like the Human Rights Agency and Anticorruption, but the outcome was not fruitful.

A female student who preferred anonymity said that it was unfortunate that her future was being unjustly destroyed despite the huge investment her parents made in her studies.

She said, “Despite paying for the licence over the years, I have yet to secure it. However, some of my friends who have connections have already secured theirs.

“My fear is that some selfish individuals have gone with our money because the school management denied knowledge of our payment for the licence, even though we have paid. We went back to the place we made the payment, but the whole thing is confusing,” she added.

Another student told our reporter that the school management put pressure on them to pay for the licence as soon as they graduated.

“A very high pressure was mounted on us to pay this money by the school management. We paid N38,000 each. However, three years later, we are yet to secure the license.

“We are confused as to where the problem is. We are urging the Kano State Government to please come to our aid so that we can get our licence and move on.”

Sadiya Ibrahim, not her real name, said that she is totally disappointed by the development, saying her future is being robbed.

Sadiya Ibrahim said, “My fear is that the school management may require us to pay another N38,000, despite the receipt we showed them to prove that we had made our payment.

“The whole thing is so disturbing that the government should please intervene and talk to the relevant authorities about the development,” she stated.

Students with connections not involved

The students disclosed that other students who have connections with some politicians have already secured their licences, as many of them have started practicing or got admissions into the university.

They also stated that daughters of influential businessmen or traditional rulers grab their licences immediately after they graduate from school.

We are working to address the issue— Management

When contacted, Hajiya Asiya Sani, the principal of the School of Midwifery Dambatta, said that the school management has been working tirelessly to address the issue, saying their efforts have started to see the light of day.

She said some of these licences are now ready and will soon be distributed to the owners.She explained that the problem is a vital one that the school management has devoted its time to addressing.

She said, “I am aware of the problem. However, as I am speaking with you now, the Ministry of Health is involved in addressing the problem.

As it is known to everyone, including the students, we don’t give this license. Instead, we also applied for it.”                                               

By Lawal Dahiru Mamman 

Malnutrition, generally, is when humans or any other living organisms get little or insufficient food nutrients, resulting in health problems. Nigeria is one of the 12 world countries recently declared as the epicentre of the global nutrition crisis. 

The other 11, mostly African countries, include Burkina Faso, Chad, Ethiopia, Kenya, Mali, Niger, Somalia, South Sudan, Sudan, Afghanistan, and Yemen.

COVID-19, war in Ukraine and conflicts in some of these countries are factors that have exacerbated the situation. Barely seven years ago, the number of under-nourished people in sub-Saharan Africa rose from 181 million in 2010 to almost 222 million in 2016. This figure increased to 264.2 million according to a study titled, “Malnutrition: An underlying health condition faced in sub-Saharan Africa: Challenges and recommendations,” published in a medical journal, Annals of Medicine and Surgery, in October 2022.

Recently, Anne Patterson, the Director, United States Agency for International Development (USAID) Mission, at the Trade Fair for Ready-to-Use Therapeutic Foods and Other Life-Saving Nutrition Commodities in Abuja, disclosed that Nigeria is ranked as the country with the second-highest malnutrition rate in the world.

This is according to the recent Food Consumption and Micronutrients Survey, she said.

In reality, Africa, with its abundant water body, aquatic life and favourable climate (which supports the growth of various food crops, including fruits and vegetables), has all that is necessary to produce the macro and micronutrients required to nourish the body for optimal growth and health.

For Nigeria, in particular, which has agriculture written all over its national symbol (as the green on our National Flag signifies agriculture, and the black shield on the coat of arms symbolises fertile soil), the country should not be mal- or undernourished, even ranking second globally.

There are also about 200 species of fish, thanks to the large water body nature has blessed our country with. This, along with other aquatic lives, can be harnessed for healthy foods. There are livestock of various types, giving quality nutrients, too.

A lot is invested by the government in building more resilient health systems medical technologies, training of medical practitioners, and treating illnesses. It is time the same energy and resources are invested in nutrition.

For example, during this year’s World Malaria Day, Nigeria still routinely spent an estimated sum of N2.04 trillion on malaria annually.

Breaking this figure further, the Chairman of the Pharmaceutical Society of Nigeria (PSN) said, “The estimated cost for an individual to treat uncomplicated malaria in Nigeria ranges from approximately N700 to N3000, depending on the type of treatment, and the healthcare facility visited.

“While treating complicated malaria could be significantly higher, ranging from N20,000 to N60,000, or more”. 

On the cost to the Nigerian government, the consultant pharmacist said: “This cost includes expenditures on healthcare facilities, medication, and personnel.”

Tackling the menace of investing heavily in treating illnesses and sicknesses affecting citizens would be to invest in its prevention. And that entails boosting the masses’ nutritional health by ensuring the availability of good and nutritious meals. 

This will help in fortifying the immune system of Nigerians and combating all forms of malnutrition troubling citizens, especially Nigerian children from less privileged backgrounds. 

Being a nation that also engages in massive agricultural cultivation of food and tearing of assorted livestock, the last thing citizens should have as a companion is hunger. Therefore, the federal government and other concerned authorities should worry about the global survey that ranked us as one of the world nations battling with the malnutrition crisis. It is a sad commentary.

Lawal Dahiru Mamman writes from Abuja and can be reached via dahirulawal90@gmail.com.

By Uzair Adam Imam

The Kano State Cancer Center has disclosed plan to establish Cancer Care Trust Fund to help the vulnerable indegene patients in the state with the cost of their health treatments.

The co-odinator of the Center, Dr. Aminu Magashi, stated this on Monday in a Facebook post sighted by The Daily Reality.

Magashi said the effort was in collaboration with some international development partners, NGOs and business community among others.

He added that it was also part of their plans to set up a Cancer Registry/Directory in collaboration with the Kano State Bureau of Statistics.

He further stated that also distinguished health committee members tasked them to establish the governing board and open the centre soon as well as be updating.

In the post, Magashi said, “In my humble capacity as the Coordinator of the Kano State Cancer Care Center, today, Tuesday 3rd October, I received in my office a powerful delegation of the Kano State House of Assembly Health Committee led by Hon. Zakariyya Alhassan Ishaq, Chairman Health Committee, Hon. Usman Abubakar Tasiu, Deputy Chair and other esteemed members of the committee and Clarks.

“It was a familiarisation visit. With me is our Legal Adviser/Secretary, Barrister Maryam Jibrin, from the Ministry of Justice.

“We updated them on our plans to commence work at the Cancer Centre with our ‘PPP’ partner H360 as well as our intention to establish the Cancer Care Trust Fund in collaboration with our international development partners, NGOs and business community to cater for indigent patients/vulnerable people’s cost of treatment, set up of Cancer Registry/Directory in collaboration with Kano State Bureau of Statistics.

“Distinguished health committee members tasked us to establish the governing board and open the centre soon as well as be updating,” he added.

As observed by The Daily Reality, many people who commented under the post have expressed their gratitude and prayed for the centre to succeed.

By Uzair Adam Imam

There have been moves for collective efforts between the Kano State Bureau of Statistics, Kano Cancer Center and AMG Foundation to establish a comprehensive cancer registry and directory in Kano State.

A statement by the Technical Assistant to the Statistician, General Kano State Bureau of Statistics, Muhammad Tasiu Abbas, disclosed this on Monday.

Abbas said that Dr. Aliyu Isa Aliyu, the Statistician General of Kano State Bureau of Statistics, met with Dr. Amin Magashi about the development.

He added that their meeting revolved around discussing the possibilities of collaboration in establishing a comprehensive cancer registry and directory in the state.

The statement read in part, “The meeting aimed to enhance efforts in collecting and analyzing cancer-related data, ensuring improved planning, prevention, and treatment strategies in the fight against cancer.

“The proposed partnership between the Bureau of Statistics, Cancer Center and AMG Foundation is expected to strengthen the state’s capacity to combat this disease and address the various challenges it poses to public health,” the statement added.

By Sabiu Abdullahi 

The Nigerian healthcare system faces a severe blow as the National Association of Nigeria Nurses and Midwives (NANNM) will officially commence their indefinite nationwide strike today, in solidarity with the Nigerian Labour Congress (NLC) and Trade Union Congress (TUC). 

The strike, initiated to protest the removal of fuel subsidies and the government’s anti-labour policies, has left the nation’s hospitals in a state of uncertainty. 

NANNM President Nnachi Michael Ekuma emphasised the necessity of the strike, citing the government’s failure to address issues crucial to healthcare workers, such as stagnant salaries, staff shortages, and subpar working conditions.

Ekuma’s letter to association members outlined the dire situation created by the removal of the fuel subsidy, leading to increased living costs for Nigerians without corresponding wage hikes for workers. 

Despite the government’s attempt to mitigate the situation by deploying military personnel to hospitals and clinics, the adequacy of these measures remains uncertain.

Patients are advised to proactively liaise with their healthcare providers to determine the status of their appointments and procedures.

Where possible, rescheduling appointments after the strike concludes is recommended to minimise disruptions to their healthcare services.

The unity of the Nigerian labour movement underscores the depth of dissatisfaction with the government’s economic policies, creating a challenging environment for negotiations and resolution.

By Ahmad Deedat Zakari 

The Jigawa State Government has confirmed the deaths of ten people due to an outbreak of diphtheria in the state, as there are currently about 100 suspected cases of the disease.  

The Jigawa State Ministry of Health disclosed on Saturday that ten people have died following an outbreak of diphtheria across the 14 local government areas of the state.  

The Permanent Secretary of the Jigawa State Ministry of Health, Dr Salisu Mu’azu, disclosed this while fielding questions from reporters in Dutse.

He said that two cases have been confirmed in Kazaure and Jahun local government areas, while some samples have been taken to Abuja for confirmation. 

He said the outbreak occurred in areas with zero-dose routine immunisation against the epidemic. 

Dr Ma’azu also said the ministry had already investigated, collected necessary information and data in the affected areas, and updated the National Primary Health Care Development Agency (NPHDA) and the National Centre for Disease Control (NCDC) for further action. 

He said the state government is making arrangements to administer vaccines once available. 

Dr. Muazu attributed the outbreak to healthcare service disruptions some years ago during the COVID-19 pandemic, when everything was suspended; hence, routine immunisation has become a major challenge in the state.