Breaking!! #OnofiokLuke Becomes First Sitting Speaker to Present #Bill. 

-As Primary Healthcare Development Agency To Be Established In Akwa Ibom State. 

By Henshaw NYONG, Uyo.

The Speaker, Akwa Ibom State House Of Assembly-Rt. Hon. (Barr.) Onofiok Luke- has recorded yet another great milestone with the presentation of a bill to establish Primary Healthcare Development Agency (PHCDA) in the State.

Luke is the first Speaker in modern history of the state to present a bill on the floor of the House as Speaker.

Speaking as member representing Nsit Ubium State Constituency, Barr. Onofiok Luke said it was pertinent for the state to have a primary healthcare development agency in order to actualize the globally adopted universal health coverage principle in the state.

He urged the house to consider the rapid passage of the bill to cater for the needs of the people of the state who need the harnessing of the health resources in the state to meet the needs of people, especially low income earners and rural residents. Debate on the bill is currently ongoing. 

It will be recalled that he presented the highest number of private member bills in the Sam Ikon-led 5th Assembly.

Recently, a bill he presented in that Assembly which was not signed into law, the bill for the protection of physically challenged persons in the state, was re-presented and was passed by the House.

Speaking at his constituency briefing two weeks ago, Barr. Luke said he was positive that Governor Udom was going to sign the bill into law.

Suffice it to say that Onofiok’s bill have always been forged to cater for the needs of minority groups, the low income earners, and the common man in general.

Apart from the physically challenged persons protection bill, the first major bill which is now a law of the land was the bill for the law to establish the Akwa Ibom State HIV/AIDS control agency, functions of the Agency and other connected matters.

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(MUST READ!!) 6 Reasons Pregnant Women Die From TBAs. 

​DEATHS FROM TBA: WHY NO END INSIGHT? By Dr. Abia, Ubong. 

Traditional Birth Attendants (TBAs) are Mid-wives who provide medical care to women during pregnancy, labour and post-partum. Most of them are informally trained while some claim to have inherited the art from fore bearers. Their operations date back to antiquity in Africa as orthodox medicine was not in existence or did not have wide coverage. They are different from Skilled Birth Attendants (SBAs) who are health care professionals with prerequisite license to practice. SBAs generally include a Medical Doctor, Nurse or Midwife.

In Akwa Ibom, TBAs are fully in operation both in rural and urban centres even with the near complete coverage of Primary Health Centres. Their function – to a medical personnel − seems to be in the interim pending when government will provide formally trained mid-wives and Nurses to man all our Primary and Secondary Health Facilities.  But this is an illusion because as long as we have TBAs, pregnant women will patronize them at their own peril. 

TBAs’ practice is not limited to pregnancy as they now treat body rashes, febrile convulsion, infertility and fibroid. During labour, they even administer Intravenous fluid, oxytocin and Ergometrine as most patients who left their shores when the deeds have been done present in hospital with IV cannula insitu. These medications are given irrespective of a woman’s stage in labour and as soon as the ripple effect of this malpractice sets in, they attribute it to evil spirit having followed the pregnant woman or pregnant woman having committed infidelity. 

In 2015, WHO report stated that Nigeria’s neonatal mortality rate per 1000 live births and maternal mortality ratio per 100,000 live births were 34.3 and 814, respectively. Also, according to Safe Motherhood: ‘Every minute of every day, somewhere in the world and most often in a developing country, a woman dies from complications related to pregnancy or childbirth. That is 515,000 women, at a minimum, dying every year. Nearly all maternal deaths (99 percent) occur in the developing world’ – largely due to home delivery. This grave situation has given me cause for great concern as there seems to be no end in sight. 

The chart below shows number of pregnant women who presented in Imaobong Missionary Outreach Medical Centre (IMOMC), Mbak Ekpe from TBAs with Intra-uterine foetal deaths in 2015 and 2016.

From the chart above, about 28 and 31 pregnant women lost their babies in 2015 and 2016 respectively. What distraught me most is when these women present with an absolute indication for caesarean section or life threatening condition requiring series of blood transfusion and all that. Why our women still patronize TBAs despite a better alternative (orthodox medicine) isn’t an enigma, but something that needs to be nip in the bud.

Firstly, there is an ingrained general feeling that pregnancy is sacred and divine, hence doesn’t need to be handle in hospital. The highest thing pregnant women who share this belief do is to register in hospital just to get tetanus toxoid immunization. After that, they continue their antenatal care with TBAs. TBAs also share, propagate and promote this belief by conducting prayer/fasting sessions for their clients in order to cleanse them of evil spirits that may want to obstruct their birth passage during labour. There is no drug offered in orthodox medicine that can be more appealing than this. What could be more satisfying than hearing that your birth passage has been cleared of evil spirits; that your sins of infidelity −even when you didn’t commit – have been forgiven; that your fore bearers’ bad obstetric history shall not be your portion? TBAs are wise as they capitalize on this misconception to get more clients and make more profit from their business. Disbanding this misconception will be an uphill task as even some formally trained Mid-wives share in this belief.

Secondly, TBAs are easily accessible without the bureaucracy of formal institutions. They visit their clients’ homes making them trustworthy, compassionate, loved and desired. What could be so good than having your Doctor or Nurse examine you under your roof; having your care provider give you enema in your home? 

Thirdly, most women are not empowered. The poverty level among women is alarming and this plays an important role in their decision making, though there are women who are empowered but still succumb to husband or family’s pressure of delivering at TBAs, perhaps due to reduce self-esteem, fear of being seen as ‘insulting’ the husband or due to ignorance of best place to deliver.  This inability to make decision is rifest in teenage pregnancies.  ‘Doctor, my mother took me to TBAs’ place’ or ‘Doctor, I didn’t have money to come on my own, hence my mother took me to TBA’, these are what one hears every now and then as referred cases from TBAs land in hospitals.

In some instances, poor road network especially those linking rural to urban centres where health facilities are mostly located also indirectly and adversely increase perinatal and maternal mortality as most women whose labour start or have obstetrics complications at midnight and need urgent referral will have to wait until morning when the roads will be motor-able. These delays at times are costly as a foetus in distress waits for no day-break.

In other cases, some pregnant women who attend Ante-natal Care in Health Facilities and have been informed that they will have caesarean section at term due to one reason or the other, visit TBAs with the hope of having a vaginal delivery; regarding the outcome of their visit, your guess is as good as mine. Caesarean Section is seen as a reward for personal or past generational evil deeds, no thanks to socio-cultural and religious beliefs as children born through this route are thought not to perform exceedingly well in academics and other endeavours.

Lastly, shortage of man power in our institutions is another factor why pregnant women deliver at TBAs’ place. Most primary health centres only function during the day as paucity of staffs hinders running of shift. A woman who booked in such centres will have to find alternatives if labour starts at night. In addition, few pregnant women loath being examined by male medical personnel, they view hospitals as male dominated world and as such seek treatment and care from TBA as shortage of female Doctors continues to be a challenge.  

Whatever may be the reasons – whether external or internal – for delivering at a TBAs’ place, the chart above is a grim reminder of the danger therein. The ugly picture isn’t limited to Imaobong Missionary Outreach Medical Centre, Mbak Ekpe but cut across other health facilities in the State and Country. 

Personally, the current effort by government isn’t yielding the desired result. Training and re-training of TBAs has shown not to be the panacea to safe delivery as it has been Government’s fig leaf for the continuing malpractice of the former; TBAs still go back to practise based on culture, tradition and religion. A carrot and stick approach should be use, but first, government should make sure that all health care facilities are being manned by at least an NYSC Doctor and formally trained Mid-wife, after that, all forms of home delivery should be banned as was done or being done in Lebanon, Sudan, Malawi and Turkey; TBAs who default should be fined heavily while pregnant women who deliver in hospital should be rewarded. Also, caesarean section should be free or attract same fee akin to Vaginal delivery; ambulance should be made available in all hospitals; roads and hospital infrastructures should be upgraded; staff especially Mid-wives should be motivated and trained to be patient, compassionate and empathic towards a woman in labour. 

In Malawi, maternal mortality stood at 807 women per 100,000 live births in 2007, however, following the restriction imposed on TBAs that same year, the figure was reduced to 510 women per 100,000 live births in 2010 according to U.N Millennium Development Goal Review in September, 2010. Though, the ban was lifted largely due to overstretched Medical personnel and facilities, Nigeria could borrow a leaf from that and make the policy sustainable. We have the man power; we have the resources; what is stopping us from nipping these preventable deaths in the bud?
Dr Abia, Ubong Utioh (MBBS) is a

Medical Officer at IMOMC, Mbak Ekpe.

He has a special interest in Public Health.

Nigerian Doctors React to the Death of Corp Members in Oreintation Camps. 

The recent death of six Corp Members in Oreintation Camps across the country this year has got people talking. Some have blamed it on the Scheme; others on the Federal Government; still others on corp doctors. The following status and comments were seen on my Facebook news feed yesterday. I just had to share it. It important to spread this message for change they say, begins with you and me. 

“​My heart is heavy. I feel pain, gotta pour it out. We barely appreciate people in this country. Just read a news feed on NYSC Facebook page on the demise of corp members in orientation camps across the country and the comments that followed got me tearing.

When everything gets down well they just jump outta bed, mutter a few words of appreciation and zoom off; if the contrary happens they call for your head not minding the prevailing circumstances. It wasn’t surprising for me to see a couple of people castigate the corp doctors of negligence and gross ineptitude. Some made comments like “corp doctors are bunch of proud foolish medical students who come to form Medical Dr in camp”

I was once a corp Dr and I knw how it feels to work in camp clinic without adequate basic equipments or essential drugs.

Some camps only make provisions for analgesics and multivitamins but expect you to perform miracles when serious medical emergency comes. Some don’t even have a functional ambulance, the one in front of the clinic may just be an artefact though not in the museum.

No right thinking human should even think of attacking another human doing a charity job. To put it straight, corp doctors and other corp medical personnel are not paid for the services they offer in camp. For instance my batch had just 9 medical doctors, out of which 2 left two days after resumption of camp, leaving 7 of us to attend to over 2500 corp members. We had to run Marathon shifts. Most nights we didn’t sleep for even 10mins because of emergencies. At times at very odd hours we had to move the patients we couldn’t manage to a tertiary facility not minding the security condition of the country.

Occasionally we go without any security personnel. What sacrifice can be more than this?

I’m grateful to God for the privilege he gave us to save lives. Imagine what would be the fate of these corpers if there were no corp doctors. I agree there could be a few cases of mismanagement but that’s where the services of more experienced doctors should come in. Nysc/Govt should make provision for more experienced doctors to supervise the work of camp doctors, however this never happens in most camps.

If the govt isn’t ready to provide for the health needs/welfare of corp members then I suggest the scheme be scrapped or made optional. No one should castigate corp doctors anymore, they didn’t come as #BenCarson, they came like every other prospective corp member, however found themselves in the battlefield with no ammunition.

Dr . Ofonmbuk Ituen

2014 Batch C

Anambra State.”

“Leave the ignorant…I was a Dr in camp…I know d shit I saw…I had to solely carry a patient from d parade ground to the clinic who collapsed after an asthma attack and was crowded by other corpers who were fanning her…Had to attend to a patient who was pale white and we told the camp clinic coordinator who wasnt a dr that dis girl was to be taken out for better management and transfusion and we were told the had to get permit from the camp coordinator who wasnt around. Had to take aggression before she was taken out. Well the world we leave in…People who barely cant do anything blame people who try to do something for every wrong so its accepted…This same people bow to u when the need help but condemn u when tins dont go right and feel to thank you when things go right.” Ej Achalu. 

“My chief you have said it all. Majority of these camp clinics are grossly lacking in essential medications. In my camp for instance, we barely have drugs to treat malaria and the camp officials have instructed we shouldn’t dispense drugs beyond 24hrs for any patient. This is a country where we are trying to fight drug resistance.” Akwa Ekperikpe. 

“I am compelled to commend ur bold initiative as enshrined in ur well scripted piece!! When things go wrong, the blame comes to Doctors while the appreciation goes to pastors when all is ok! If only a BOI is set up to investigate d immediate n remote causes of d deaths of these Corp members and possibly implementing the probable recommendations of d said BOI, we will b better for it!! I am restrained to say more on this issue bt I think this write up shud get as many likes and shares as necessary until appropriate authority rises to d occasion n redouble their efforts towards efficient healthcare delivery both at NYSC camps n beyond. #excorpdoctor #tropicalmedicine” Nonye Ndahbroz. 

“Tnx for this enlightenment Dr Ituen. Was saddened by the deaths but even more by the horrible things people say about Drs. Have been attending to corp members in the last 9 days. They come with all type of cases and can’t even buy drugs, and the hospital is treating them free per se. The federal government budgeted only forty naira as medical bills for each corp member for 21 /7!!!! Those critical of Drs can’t even use their free data to call the FG/NYSC to order. Criticisms like this tend to harden me because it reminds me that those I am having sleepless night for don’t appreciate my services.” Emin Emin. 

“Respect to all Nigerian Doctors who solve complex health problems just with the provision of Paracetamol.” Daniel Inyang. 

“Beautifully scripted doc…You have said it all. I don’t blame most of them cos ignorance is bliss, however may the souls of the faithful departed rest in peace.” Emeka Mekzy Cyril. 

WALKING AFTER EATING MAY LOWER DIABETES AND HEART DISEASE RATE–STUDY



For people withtype 2 diabetes, a short walk after eating may help lower blood sugar levels more than exercising at other times of the day, a new study shows.

A measurement of blood sugar called postprandial glycemia, which has been linked with heart disease risk, averaged 12 percent lower when study participants took a walk after eating, compared with those who exercised at other times. The largest drop in postprandial glycemia, 22 percent, was achieved by walking after dinner, the study authors found.

“If you have type 2 diabetes, there is a guideline to be active for at least 150 minutes a week,” said study author Andrew Reynolds, a researcher at the University of Otago, in New Zealand.

But, he added, “the benefits we observed due to physical activity after meals suggest that current guidelines should be amended to specify after-meal activity, particularly when meals contain a substantial amount of carbohydrates,” he said.

“Consider walking after you eat as part of your daily routine,” he added.

However, one U.S. diabetes specialist offered a caveat on that advice.

Exercise is indeed part of good management and care for those with type 2 diabetes, said Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City.

But, he urged caution about the benefits of exercising right after meals.

Because heart disease is common among those with type 2 diabetes, “we need to be careful in encouraging exercise after a meal, as the demands on the heart increase with meals,” he explained. “This is especially important in people with heart disease, as diversion of blood from the coronary or carotid arteries to the gut is not always best for these patients.”

The study findings were published Oct. 17 in the journal Diabetologia.

In the study, Reynolds and colleagues had 41 people with type 2 diabetes walk a total of 150 minutes a week. In the first phase of the study, participants walked for 30 minutes daily whenever they wanted. In the second phase, 30 days after the first phase, participants were told to take a 10-minute walk no later than five minutes after each meal. During both phases, blood sugar was monitored. Walking after meals lowered blood sugar levels more effectively among the participants, the study found.

Improvements in controlling blood sugar with exercise have been shown by many trials, Zonszein noted, but exercise and good lifestyle are often not enough.

“In type 2 diabetes, a combination of good lifestyles and proper medications is important for successful outcomes,” he said.

In a second study in the same issue of the journal, British researchers analyzed the findings of 23 studies on the relationship between physical activity and incidence of type 2 diabetes. In all, these studies included more than 1.2 million people. Among these participants, more than 82,000 developed type 2 diabetes, the researchers reported.

The researchers found that those who exercised at least 150 minutes a week had a 26 percent lower risk of developing type 2 diabetes. The results also suggested that exercising more than the recommended 150 minutes had even greater benefits in reducing the risk of diabetes, cutting it by more than half.

The British team was led by Andrea Smith, who’s with the Health Behavior Research Center at University College London.

Source: http://www.drug.com

Why You Should Not Eat Beyond 8pm! A Must Read! 

​The time you eat could be just as important as what you eat. So you could be fuelling your risk of heart attack by eating your dinner after 8pm.
New research reveals a link between eating late and a lethal form of high blood pressure which can trigger heart attacks.

The correlation between the types of foods eaten and the timing of evening meals shows eating dinner late has the biggest single impact on overnight blood pressure.

The research is the world’s first into the links between late night eating and “non-dipper hypertension”.

The new study suggests eating late at night had a far greater impact than missing the first meal of the day.

It is normal for blood pressure to reduce overnight, even in people with hypertension, more commonly known as high blood pressure.

Skipping breakfast also makes you more likely to fail to see an overnight dip in pressure.

It has been discovered that having dinner less than two hours before bed time does more damage than the long-established risk of having a high salt diet. In fact, going to bed could be a warning sign of serious heart problems.

A healthy diet meant eating a good breakfast and lunch, but limiting the last meal of the day to a light meal, ideally no later than 8pm, researchers said. Hypertension is one of the key risks for heart disease.

In 40 percent of cases, blood pressure fails to drop properly overnight, sharply increasing the chance of heart attacks.

The study found that those who eat dinner late are much more likely to suffer from this “non-dipper hypertension”—the lethal form of high blood pressure where pressure fails to drop properly overnight.

In total 24 percent of those who ate dinner within two hours of going to bed suffered from blood pressure which did not drop sufficiently overnight, compared with 14 percent of those who ate their evening meal earlier.

Experts said that eating late leaves your body on “high alert”, encouraging the production of stress hormones, such as adrenaline, while it might also disrupt the circadian rhythms.

But this had less impact than late night eating. This might be explained by the fact those who ate late night were more likely to skip breakfast, researchers said.

Experts say modern life is encouraging people into “erratic” eating habits which could prove deadly. Normally at night, your body is getting ready for sleep but not if you are eating late.

If we eat late at night, the body essentially remains on high alert as during the day, rather than relaxing for sleep and stress hormones are secreted causing blood pressure not to decrease during sleep which should normally happen. We must define the ideal frequency and timing of meals because how we eat may be as important as what we eat.

Eating breakfast is important, we should have a strong breakfast, we shouldn’t skip lunch. We must have a small dinner and it mustn’t be later than 8pm in the evening.

Blood pressure is supposed to drop by at least 10 per cent at night, to allow the body to rest and recover from the day. If it remains raised, it significantly boosts your risk of heart disease and heart attacks.

Studies have linked late night eating to a higher risk of obesity, and to insulin resistance, which can fuel Type 2 diabetes.

Foods to avoid before going to bed

Eating right before bed is a recipe for gaining weight and sleeping poorly, but it can also seriously damage the tissue in your throat and esophagus. The single greatest risk factor is, by far, the time that people eat dinner. Have supper no later than three hours before bed. But even if you manage to do that, be aware that late-night snacking can have the same ruinous effect.

If you are going to hit the fridge before you hit the sack, here are seven items you should never, ever grab.

1. Alcohol

It relaxes the valves that connect the stomach and esophagus. When this happens, your body is unable to keep food where it belongs.

2. Soft drinks

Soft drinks are acidic and actually more acidic than anything found in nature. The acid damages those same valves. Plus, carbonation increases stomach pressure.

3. Chocolate

Certain flavours are high in fat—which comforts and relaxes the valves, too

4. Cheese

It’s another fatty food, but if you must indulge, hard varieties such as Parmesan and Swiss have less of a reflux effect than softer types such as feta and mozzarella. (Yes, that means no pizza.)

5. Nuts

When it comes to reflux, fat is fat, whether saturated or unsaturated. So despite the fact that nuts generally contain a healthy dose of the latter, they should be avoided before bed.

6. Citrus

It’s also highly acidic. A glass of orange juice or a green Apple are your worst choices, but some people can eat red apples without problems—it depends on the person.

7. Coffee

Not only is it inherently acidic, but the caffeine it contains also generates additional stomach acid. If you must sip, decaf generally has lower acid levels than regular.

Anything that’s low in acid, such as bananas, a bowl of low-sugar cereal with low-fat milk or chamomile tea are soothing fill you up and settle the stomach.
Source: http://www.nigeriatoday.ng

WHY DIETS DON’T WORK

​As written by Dan DeFigio, Nashville personal trainer and nutrition counselor. 

Diets don’t work because they are temporary changes to a recurring problem.

Take this typical scenario:

Your “normal” eating patterns have gotten you too fat over time, so you “go on a diet” to try to lose some weight. “Diets” by nature are temporary, overly-strict eating regimens that are usually not sustainable for any length of time. After you drop a few pounds on the latest Hollywood-banana-peel-and-cactus-juice diet, you return to your former habits and you start gaining weight again.

Sound familiar?

The reason you “just can’t keep the weight off” is that you haven’t changed anything!

In order to have permanent weight loss, you have to change how you usually eat — you much improve your eating to a new “normal”.

Keep in mind that gaining or losing weight is a series of small, ongoing decisions. You didn’t get fat in a week, so you won’t get back to your ideal weight quickly and stay there. Consistent smart decisions over time yield permanent changes. If you start taking baby steps like eating more vegetables than starches, cutting your sugar intake in half, or eating breakfast if you haven’t been, you’ll start to improve your “normal” and begin to show permanent improvements.

NMA AKS Chairman Visits the Akwa Ibom State House of Reps. 

On 31st August 2016, the State Officers Committee (SOC) and State Executive Council (SEC) members of the NMA AKS, paid a courtesy call to the Speaker Akwa Ibom State House of Assembly Rt. Hon. Onofiok Luke @ the VIP lounge of the House of Assembly Complex.

In attendance were Rt. Hon Aniekan Uko representing Ibesikpo state constituency and Hon. Bar. Dennis Akpan representing Etinan State Constituency….

Making the NMA AKS Delegation were

Dr. Aniekeme Uwah – Chairman

Dr. Nsikak Nyoyoko – Secretary

Dr. Ikanke Mathias- Assistant Secretary

Dr. Abraham Anlak – Treasurer

Dr. Aniekpeno Eyo – Public Relation Officer

Dr. Eyo Ekpe – Editor-in-Chief

Dr. Augustine Umoh – Immediate Past Chairman

Dr. John Udobang – Past Chairman

Dr. Etiobong Etukumana -Past Chairman

Dr. Udeme Inim – NMA Eket Zonal Chairman

Dr. Adeneye Adetayo Chhristian -ARD President

Dr. Aniekan Utuk -ARD Secretary

Dr. Ned Ndafia -ARD Financial Secretary

Dr. Ekemini Bassey -ARD PRO

Dr. Ekerete Ekot – Immediate Past ARD President

Dr. Imoh Ibiok – Chairman,Committee on Prostate Disease Awareness.

Dr. Usenebong Akpan – Chairman, Communique drafting Committee.

Dr. Ekemini Hogan – member, Physician week planning Committee.

Dr. Rhoda Peter – Secretary, ICT Committee

It was a very interesting moment to engage a highly cerebral People’s Speaker in an all inclusive discussion as it relates to the welfare of Doctors in the State,as well as ways of improving Health Care Delivery to the people of our dear state.

It was indeed a great time, made possible by God.

NMA AKS is Working the Work!!!!

From the Desk of

Dr. Aniekpeno Eyo

NMA AKS PRO.