A Moment With Doc...

This was a post originally put on Facebook by my very delectable, hardworking pal, Dr Oma Abii.


In clinic today, I saw a 14 year old girl, SS1 student. Very pretty, chubby, reminded me of my kid sister. She has sickle cell disease.
Very bright child I tell you! She wanted to know her (orthopedic) diagnosis, when I told her, she turned to her mom and said "I told you it was likely to be **** not. *****. I didn't have fever and the other things! "
I was curious, I asked her she said she had been googling her symptoms and the answers kept pointing to her diagnosis. She asked what we would do for her and all, it didn't feel like I was talking with a child... I was impressed!
Then without prompting, she asked me:
Her: Dr, do I have to be a doctor first before becoming a hematologist?
Me: As far as I know, yes
Her: I want to be a hematologist
Me: cool, why?
Her: I want to help and find a cure to this sickle cell disease. I hate it, I hate the pain, I hate that other people are passing through it too. It's not fair!
Me: *stunned*

It's been a while I had that kind of sober moment, I actually had goose bumps. She said she would read up on her diagnosis and come for her next appointment with plenty questions,lol. She's a jewel, that one, with a big heart. I pray her dreams come true!
PS: parents and intending parents, please for the sake of God, know your genotype before making children. These kids suffer too much; physically, emotionally and otherwise.

- Oma Abii 

CERVARIX

Remember that gist I told you about yesterday I had with a friend that birthed two posts? Well, this is the second post.

We were talking about Cervical Cancer and prevention and I told her about Cervarix. In case you have not heard, Cervarix is a vaccine against certain types of cancer-causing human papillomavirus (HPV). Cervarix is designed to prevent infection from HPV types 16 and 18, that cause about 70% of cervical cancer cases. These types also cause most HPV-induced genital and head and neck cancers.(Wikipedia)

Well, I took my son to get his vaccination when I learned from the nurse that the vaccine was available at UNTH Old Site ( for those who live in Enugu) but you must have screened and found to be negative before you go for the vaccine. So, armed with this info, I went to spread the good news to all who cared to listen to me. 

Imagine my surprise when my friend told me she went to get the vaccine and was told by the doctor that she couldn't get as she was too old!!! Well, I went back to some doctor friends of mine to find out why this was so and I was informed that it was because the vaccine gets less effective with age and may not be useful if you have been sexually exposed.

That notwithstanding, the vaccine is available for females from the ages of 9-25 years. It is given in 0,1 and 6 months.That means that you get the vaccine now, then a month later, you collect the second dose. 6 months later, you get the last dose. You pay for each dose though, so go prepared. 

Whether you get the vaccine or not, you still need a pap smear or Liquid based cytology (a better option, if you ask me) test done every other year to screen for HPV and for cervical cancers. Remember, a stitch in time, saves nine. There are some centres that offer the test at a very subsidized rate but a few places where they are available charge a fee for it. 

Till next post,

Your Friendly Health Worker...

HEALTH INTERVENTION SCHEME IN NIGERIA 1

My e-friend, Aishatu ( I hope to meet her in person this year, insha Allah), does some awesome work with an NGO and she gets to travel to cool places to monitor compliance to treatment and how Global funds are used to fight the scourge of TB. She shares some detail about her work which is quite interesting. This was originally featured on her Facebook page and will come as a series. Read and be informed...

So Community Health :
Let me start at the beginning :
A household survey was conducted among the poorest of the poor, and the major causes of death among the poorest of the poor via hospital records were discovered to be Malaria, complications from HIV infections and Tuberculosis. Childhood diseases that are mostly preventable through vaccination were leading causes of infant mortality in children, malnutrition among the most vulnerable population .
To this end Global Fund, Clinton Foundation, Bill and Melinda Gates Foundation, the United States Presidential Intervention Fund, and lately Dangote and TY Danjuma Foundation ( TY Danjuma Foundation also concentrates on Eradication of River Blindness as it is quite common in Taraba the state the Founder of the Foundation is from) decided to focus resources to fight these disease areas.
Funding and communication with Global Fund and other donors is coordinated through the country coordinating mechanism CCM, it is made up of members of Civil societies, government agencies and labor organization. It is headed by a Chairman and Secretary. There is a secretariat that sees to the day to day running. CCM meets regularly to ratify decisions like engagement of Principle Recipients and Sub Recipients. They also monitor and supervise activities by PRs and SRs
First step was to renovate and revive the Primary Health Care System because these are the centers closest to the people in the community. This was done in partnership with the world Bank, Federal Government of Nigeria at that time through the Millinuenm Development Goals Project Headed by the New Un Deputy Secretary Amina Mohammed, at that time she was the special Assistant to President Obasanjo on MDGs. We were lucky to have her as she ensured that these Primary Health Care Centres were indeed built or renovated as contracted no Magu Magu.
The terms of the partnership was Government provides 30 percent, renovating and building the centres, deploying staff to the hospital and paying Staff Salaries while the NGOs listed above do 70 percent ; Pay for the drugs, pay for the services which will be received free by the clients, pay for project vehicles, pay salaries of the NGO workers who will ensure compliance, pay for community mobilization and information dissemination to ensure behaviorial change among the population, pay for the feeding intervention to ensure the Orphaned and Vulnerable Children get the most support in intervention states, pay for support group meetings of infected clients, pay for after school club meetings for vulnerable kids, kids orphaned by HIV so they can meet play, support each other and learn skills.
At the beginning of the intervention there were many challenges which would be discussed later.
It initially kicked off in all 36 states including FCT making 37 but due to dwindling funds, failure of some state Governments to pay their own part of the counterpart funding intensive intervention has been reduced to 20 priority states including FCT. Services and drugs are provided in the remaining states but there is no community mobilization or behavioral communication change.
The Global Fund works through Principal, Sub Recipients and Sub Sub Recipients ; Meaning NGOs can apply to be Principal Recipients receive funding directly from Global Fund and Manage Sub Recipients, the Sub Recipients work with Community Based Organizations in the Grassroots to directly implement. This has created employment to thousands of people including me.
Kaduna and Lagos are the First states to become Principal Recipients, meaning they receive funds directly from Global Fund to Implement in their states. This is a pilot scheme
In summary these are some of the services received free at Primary Health Care Centers due to this intervention :
1. HIV TESTING AND SERVICES
2. MALARIA TESTING AND SERVICES
3. TB TESTING AND SERVICES ( IN DOTS SITES)
4. FAMILY PLANNING SERVICES
5. FREE VACCINATION AGAINST CHILDHOOD DISEASES
6. PRIORITY IS PREVENTION OF MOTHER TO CHILD TRANSMISSION BY TESTING PREGNANT WOMEN AND COMMENCING IMMEDIATE ENROLLMENT TREATMENT OF PREGNANT WOMEN WHO ARE POSITIVE TO PREVENT TRANSMISSION TO FOETUS.

By Aishatu Ene Ella-John

To be continued...