Mediating Doctors' Strikes in Patients' Interest: What Should the Media Do Better? July-October, 2015 AfDB incoming top boss: Africa’s Regional Integration for Shared Prosperity Living with sickle cell disease in Nigeria and the UK: the big difference Learning to breathe in New Delhi: why Nerandra Modi should do more for Indian health by bringing air pollution to safe levels. Akinwumi Adesina Conquering culinary fears, one recipe at a time: how to make coconut rice with fun Sisi Jemimah Funmi Williams Health Politics & Today ...exploring the interface 1st i o c e h c Agrima Raina The politics of health workers’ strike in Nigeria: corruption, insincere government and overbearing unions NMA vs JOHESU in this issue Clinical Blues IX Dami Ajayi Art+Health Notes on Africa UK India Yummy Kitchen www.literamedianetwork.com
1. Mediating Doctors' Strikes in Patients' Interest: What
Should the Media Do Better? July-October, 2015 AfDB incoming top
boss: Africas Regional Integration for Shared Prosperity Living
with sickle cell disease in Nigeria and the UK: the big difference
Learning to breathe in New Delhi: why Nerandra Modi should do more
for Indian health by bringing air pollution to safe levels.
Akinwumi Adesina Conquering culinary fears, one recipe at a time:
how to make coconut rice with fun Sisi JemimahFunmi Williams Health
Politics& Today...exploring the interface 1st io c eh c Agrima
Raina The politics of health workers strike in Nigeria: corruption,
insincere government and overbearing unions NMA vs JOHESU in this
issue Clinical Blues IX Dami Ajayi Art+Health Notes on Africa UK
India Yummy Kitchen
2. Making our health system work for the people uman resource
is the most important factor in any He discusses those issues the
media often fail to adequately institution. It is even more
important in a health deal with when reporting and the way forward.
Would system since it deals directly with human life and Nigerian
medical doctors play the spectator on the globalHhealth. Now that
the highly esteemed Buhari
stagewheremedicalpracticeisadvancingbythesecond? administration has
been sworn in, we ask: What is the future of health workers' strike
in Nigeria? It is imperative that Olusola Orimoloye is bothered by
the fact that doctors in issues affecting human resources for
health in Nigeria must training waste ample time going on strike
and attending once and for all be addressed by the Buhari
administration if union/solidarity meetings when their colleagues
in other any progress must be made in the Nigerian health system
climes continue to roll back the frontiers of medicine. He under
his administration. In this issue, we take on a problem describes
in vivid terms the deleterious effects of strikes on that has
effectively brought the Nigerian public healthcare
residencytrainingofdoctors. system to its knees incessant strikes
embarked upon by variousunionsinthehealthsector. We have introduced
a for you via our partnership with sisijemimah.com. Do you know It
is impossible to quantify losses incurred by the Nigerian
howtomakecoconutfriedriceorhaveyouhaditbefore?Sisi people and
government as a result of lack of effective Jemimah is a fast
growing Nigerian and African recipe
leadershipinNigeria'shealthsector.Frequentlethaldosesof
developer,helpingwomen(andmen)conquerculinaryfears. industrial
strikes are a major factor contributing to She narrates meal making
in simple, clear sentences with unacceptable health outcomes in
Nigeria. It is equally true to colourful and sharp pictures. You'll
find out how to prepare say they are symptoms of poor governance
and failure of coconutfriedricesoon. leadership within the health
system. But what are the underlying causes? Who are the key
players? And where is Our South Asia editor Agrima Raina tells us
how doctors' thebattlefield? strike in India is often fuelled by
assault on doctors by frustrated patients and their relatives. She
suggests a review The key players are the Government (especially
the Federal of medical curriculum to address lack of communication
and State Governments); Nigerian Medical Association
skillsamongIndiandoctors,amongothermeasuresthatmay (NMA), umbrella
body of Nigerian medical doctors; and the be put in place to check
the situation. She also warns that Joint Health Sector Union
(JOHESU) which is an while Delhi is enveloped in a highly polluted
air leading amalgamation of unions of health professionals such as
respiratory diseases for many, the Indian government
physiotherapists, pharmacists, nurses, optometrists, response is
abysmal. She also discusses poor sanitation and medical laboratory
scientists and other cadres of health open defecation in India, a
major public health problem for a workers such as community health
workers, pharmacy country that has excelled in technology,
pharmaceutical and technicians, medical records etc. The public
hospital is their manyotherfields. playingfield. Temitope Ojedokun
says the government and health Opeyemi Akindele presents insightful
analysis and professionals must act now to stop disrespectful
maternal commentary which revolve around the triangle of treatment
during delivery. She points out that hurtful, non- [inadequate]
health funding, government insincerity, and dignifying treatment of
women at child birth poses health workers unions' legitimate and
unreasonable significantbarriertoaccessinghealthcareamongwomen.
demands. He hopes to tackle issues on power tussle and
equalopportunitiesinsubsequenteditions. There are many more
interesting contents for your
consumption.Wehopeyouenjoythisedition. Wole Oladapo takes the media
perspective, showing how the media can better mediate doctors'
strike in patients' interest. He argues that the Nigerian media
should take a holistic perspective when reporting health workers'
strike. Yummy! new and exciting session Submit article, comments,
enquiries, advert to: [email protected] Individual
authors own the copyright of their essays or pictures. Where we
provide health information, it is no substitute for expert medical
advice or consultation although we try hard to ensure we provide
accurate information. The contents and opinions expressed in this
publication belong to the contributors or various news sources we
use, and not the official position of Health and Politics Today or
Litera Media Network Ltd. Editors Note health & politics today,
July/Oct 2015
3. our team health & politics today, July/Oct 2015 3
Temitope Ojedokun (B. Pharm) Managing Editor Wole Oladapo (B.A.,
M.A. Communication & Language Arts) Development Communication
Olusola Orimoloye (MBBS) Contributing Editor Agrima Raina (BDS)
South Asia Editor Opeyemi Akindele (B. Pharm., MPH)
Editor/Publisher contents 5 8 news + updates Ebola updates, WHO,
African Development Bank, Healthcare, Pharmacotherapy Coconut fried
rice recipe, Diabetes and microwave, kidney health food + health
tips 11 15 24 32 29 25 cover story womens health afristory
interview art + health 13 16 Disrespectful maternal treatment
during childbirth Dr Akinwumi Adesina: transforming Africa Olu
Onyimadu Funmi Williams Olaosebikan Notes on Dami Ajayis Clinical
Blues Series: The Redemption of Dr Bode Johnson Design &
concept by Litera Media Network [email protected]
http://www.literamedianetwork.com/got-enquiries-or-business/
https://ng.linkedin.com/in/opeyemiakindele
4. Well put you right in the hands of your customers... Want to
go global? Grow your customer base? Then take this space! health
& politics today, July/Oct 2015 ADVERTISE
5. health & politics today, July/Oct 2015 5 1st oich e c
news + updates nfortunately, contrary to the wish of Professor
Oyewale Tomori, a foremost veterinarian andUvirologist from Africa,
Ebola did not wait till another 10 years before it rears its
ugly,deathlyhead. leave. The African countries will be are enmeshed
in other left not really knowing what has battles misuse of EVD
happened to them. Like someone hit funds and the inability to them
smack in the face, totally fully utilize aid and disoriented. There
will be millions of resources donated by international agencies.
scandals about how money was Therefore, is Africa prepared for the
next misspent and so on. We will focus on epidemic? Has Africa
learnt important lessons At the International Meeting on those and
move on. Ten years from now, from the current EVD outbreak in West
Africa? Emerging Diseases and Surveillance in people will have
forgotten that there was Will Africa still be helpless and totally
dependent November 2014, Tomori was Ebola and we will be back to
where we on international agencies for assistance to interviewed by
Kai, a contributing started. control any future epidemic? Will the
scientists correspondent for Science magazine. The and governments
of the developed world professor was reportedly angry at how
African In May 2015, the former Regional Virologist continue to so
control the processes of a leaders were unable to use their own
resources for the WHO Africa Region published an sustainable global
disease surveillance system, (human and capital) to contain Ebola.
He hoped article in BMC Central, having patiently leaving no
meaningful role for participants from that the WHO African region
would not be in a laboured and waited to see the end of the
thedevelopingcountries? helpless situation when/if Ebola reappears
in worst Ebola outbreak in West Africa. He the future, as enough
lessons should have been titled his article: Will Africa's future
Unfortunately, African leaders and health learnt by African
governments in the last 40 epidemic ride on forgotten lessons from
authorities have not had time to reflect on the
yearsofEbolaoutbreak. the Ebola epidemic? Obviously indignant, last
and most devastating Ebola outbreak and in the conclusion of his
thought-provoking the issues raised by Professor Tomori before a
When asked if he thought the unprecedented piece, he spewed a
barrage of questions all new Ebola case was confirmed in Liberia on
outbreak would change things, here is what the over the continent
and elsewhere at June 29 when routine surveillance detected a
Professorofvirologysaid: whomeveritisthatcares. newconfirmedcase
thefirstsinceMarch20. I wish I could say with confidence that in 10
So, don't let off your guard. Have a high index of
years'timewewillnotbewherewearenowwith Even as agencies,
foundations, governments, suspicion. Wash your hands often hand
Ebola. But the countries have totally lost control and institutions
outside Africa are holding washing remains the most effective way
of of what is going on. If you go to Sierra Leone or meetings to
assess the lessons learnt from the preventing infection generally.
Aviod touching Liberia today, there must be at least 10 EVD
disaster and map out strategies for the dead and direct anyone with
high fever to international groups there. At the end of this better
response and control of future thehospital. epidemic, everybody
will pack their bags and epidemics, EVD devastated African
countries Ebola is back in West African Liberia! Growing health
literate kids 1 2 3 ealth & Politics Today celebrated 2015
Children's Day (May 27) with Nigerian kids. We took
theHopportunitytoencourageparentstohelp their children cultivate
health eating habits by providing them with adequate fruits and
vegetables and teaching them the benefits of eating more fruits.
Fruits contain lots of vitamins and minerals needed by children for
normal growth, strong immune system, strong teeth and bonesetc. r
Akinwumi Adesina has been elected President African Development
Bank (AfDB) on 28th May during the development bank's 50th Annual
General Meeting. He was born on February 6, 1960. Dr Adesina was
Nigeria's MinisterDof Agriculture and Rural Development under
former President Goodluck Jonathans administration. From September
1, 2015 Akinwumi will succeed Dr. Donald Kaberuka, Rwandan and
current AfDB president who was elected in July 2005 and re-elected
to second term in 2010. Dr Adesina, an alumnus of University of Ife
(now Obafemi Awolowo University) holds PhD in Agricultural
Economics, Purdue University, USA (1988) Awarded the Most
Outstanding PhD Thesis. Masters in Agricultural Economics, Purdue
University, USA (1985) Bachelor's degree (1st Class Honors) in
Agricultural Economics, University of Ife, Nigeria (1981). Mr
Akinwumi has made important reforms and achievement in the
agricultural sector as a key player under the outgoing President
Goodluck's administration and Transformation Agenda. Nigeria's
President Muhammadu Buhari, who was sworn-in on Friday 29th May is
key to the emergence of Adesina as AfDB top boss for the next 5
years. Buhari, in the build up to the AfDB election asked Atiku
Abubakar, former vice-president of Nigeria to use his influence and
contacts across Africa to ensure majority support for Dr Adesina
among delegates who were going to vote at the AfDB general meeting.
Dr Akinwumi Adesina emerged the winner among contestants with
impressive pedigree and who are well- qualified as well: Sufian
AHMED: Minister of Finance and Economic Development of Ethiopia
Jaloul Ayed: Former Minister of Finance, Tunisian Republic Kordj
Bedoumra: Minister of Finance and Budget, Republic of Chad Cristina
Duarte: Minister of Finance and Planning, Cape Verde Samura M. W.
Kamara: Minister of Foreign Affairs and International Cooperation,
Sierra Leone Thomas Z. Sakala: Zimbabwean and retired Vice-
President, Country and Regional Programmes, AfDB Birama Boubacar
Sidib: Malian and Vice-President, Islamic Development Bank, Jeddah,
Saudi Arabia. AFDB welcomes new top boss!
6. 7 6 4 news + updates WHO releases new guidelines for
prevention of neural tube defects NTDs health & politics today,
July/Oct 2015 6 1st oich e c HO has issued new guidelines for
folate Good sources of folate concentrations for women of include:
reproductive age. Each year, about AsparagusW300,000 babies
worldwide are born with neural Bell peppers tube defects (NTDs),
but adequate daily Broccoli consumption of folic acid before and
during early Brussels sprouts pregnancy has been shown to
significantly reduce Cauliflower t h e r i s k f o r N T D s .
Chickpeas The new guidelines state that at the population Fortified
breakfast cereals level, red blood cell (RBC) folate concentrations
Liver should be greater than 400 ng/mL (906 nmol/L) Okro in women
of reproductive age to achieve the Peas greatest reduction of NTDs.
Suggesting that 5mg Seeds & nuts o f Fo l i c a c i d p e r d
ay i s s u f f i c i e n t . Spinach Although no serum folate
threshold is recommended for prevention of NTDs in women of
reproductive age at the population level, In addition,
microbiological assay is recommended as the most reliable choice to
obtain comparable results for RBC folate c o n c e n t r a t i o n
a c r o s s c o u n t r i e s . (Source: Morbidity and Mortality
Weekly Report (04/24/15) Vol. 64, No. 15, P. 421 Cordero, Amy M.;
Crider, Krista S.; Rogers, Lisa M.; et al.) RBC folate thresholds
can be used as an indicator of folate insufficiency in women of
reproductive age. t Health & Politics Today, our commitment is
to put healthcare
issuesandpolicyonthepoliticalagendaandmakethemamatterof public
debate. A bane of poor healthcare delivery in Nigeria is theAfact
health authorities and professionals are largely unaccountable to
the
patientsandthegeneralpublic.So,wehostedourfirste-conferencewhere
weengagedthreeemergingleadersinhealthpolicyfromNigeriaandIndia to
thrash out the question: How do we evolve an accountable healthcare
system founded and funded to serve the patient? Seye Abimbola, Laz
Ude Eze and Agrima Raina discussed the concept and practical issues
of accountability focusing on primary health care. Ac c o rd i n g
to S eye Abimbola, doctoral s t u d e n t i n H e a l t h S y s t e
m s & P o l i c y University of Sydney, Accountability is being
o b l i g e d t o a c c e p t r e s p o n s i b i l i t y &
transparently disclose resourceusefor&results of health
activities. A c c o u n t a b i l i t y i s patients able to d e m
a n d responsibility f r o m providers and having affordable
recourse to legal action for malpractice. According to Agrima, in
order to fix the pervasive problem of frustrated patients and
relatives assaulting and battering doctors in Indian hospitals, the
medical curriculum must be
revisedinordertoarmdoctorswithpertinentcommunicationskillswhile the
government should also increase healthcare funding to increase
doctor-patient ratio. Laz, a public health physician with wide
experience in health programmes strengthening, emphasised the need
for every Nigerian to take interest in how health facilities
function and be aware of minimum healthcare package as stipulation
in primary health care policy in order for them to be able to make
demands for excellentserviceprovision. n the 8 May 2015, WHO
released its biennial update of the essential medicine list to
include new regime for tuberculosis (TB),Ohepatitis C and cancers.
The WHO list usually serves as a model for governments and health
institutions because of the established quality, drug safety,
efficacy and cost-effectiveness of the medicines included.
Hepatitis: 5 antivirals were added including
sofosbuviranddaclatasvir; Cancers: 16 new medicines including
trastuzumab forbreastcancer; Tuberculosis: 5 more including
bedaquiline and delamanid to target multi-drug-resistant TB. TB
remains one of the world's most deadly infectious diseases with
over 95% of TB deaths occuring in low- and middle-income countries.
So the hard work is not the medicine list but ensuring those
medicines are actually available to patients. Some of which h i g h
p r i c e s c u r re n t ly m a ke unaffordable and thus
inaccessible to thepeoplewhoneedthemmost. Accountability in
healthcare e-conference Biennial update of the essential medicine 5
1. The Guardian suggests that Britain recorded its hottest day in
June since August 2003. Temperatures are soaring across the country
and at the popular Heathrow airport it rosetoabout37degrees. 2.
Since June 20th when the extremely hot weather condition lasting
several days began, health officials say about 100,000 people have
been affected in Pakistan, killing 1 out of every 10 affected
individuals. Hundreds of causalitieswerealsorecordedinIndiaearlier.
3. The World Metrological Organization (WMO) & World Health
Organisation (WHO) have also just published a global guidance t o a
d d r e s s HeatHealth and development of a p p r o p r i a t e
interventions or H e a t - H e a l t h W a r n i n g Systems.
People have been advised to avoid working in the sun for too long,
take a lot of water, make use of available coolingpointsandtakeany
affected person to a health facility after giving the first aid
i.e. cooling the victim. http://www.who.int/glob
alchange/publications/W MO_WHO_Heat_Health_Gu idance_2015.pdf?ua=1
Heat Wave Report
7. news + updates Consultant Pharmacists Provide Enhanced
Long-Term Care Services medical therapies, Dr. approach tend to
play a Hardestyexplained. more administrative role within their LTC
teams, These changes have working with other LTC p r o m p t e d m
a n y leaders to make financial and operational c o n s u l t a n t
decisions. In this capacity, strategic pharmacists to take on
pharmacists have been responsible for a more operational role
implementing a number of initiatives focused in LTC, expanding
their on public health, such as drug reevaluation focus to include
both policies and improved electronic health individual patients
and record (EHR) utilization. The role of a patient populations.
strategic consultant pharmacist is not only to With recent shifts
in identify problems, but to develop solutions,any consultant
pharmacists are long-term care, we're starting to see
Dr.Hardestyexplained.t a k i n g o n n e w r o l e s a n d
consultantpharmacistsplayamoreactiveroleresponsibilities in the
shifting long-M in improving public health, Dr. Hardesty said. She
noted these responsibilities are notterm care (LTC) landscape,
allowing them to They are partnering with executive and without
their complications, however,perform a number of enhanced services.
regional leaders to develop and implement necessitating cooperation
between strategicConsultant pharmacists are integral to LTC,
solutionstobroaderhealthproblems. and tactical pharmacists.
Strategicaccording to Jennifer L. Hardesty, PharmD, pharmacists can
face difficulties inFASCP, the Chief Clinical Officer and Corporate
Dr. Hardesty categorized these enhanced implementing their
initiatives, making itComplianceOfficerforRemediSeniorCare. service
as either tactical or strategic. The challenging for them to keep
up with day-to- consultant pharmacists who take a more day
operations, Dr. Hardesty stated. ForAmong other responsibilities,
consultant tactical approach are more involved with them to be
effective, they often need supportpharmacists are tasked with
reviewing each direct care, treating patients on an individual
fromtacticalpharmacists.patient's medications and care process, as
basis. In addition to performing medicationwell as auditing the
administration and regimen reviews and patient assessments, No
matter which approach consultantstorage of medication. These
services tactical pharmacists put a great emphasis pharmacists
take, the enhanced services theyhave become particularly important
on educating patients and implementing are offering point to a
greater role for them toas LTC patients are increasingly
cost-saving initiatives. Working on the play in the future of LTC,
Dr. Hardestytreatedinoutpatientsettings ground also enables
tactical pharmacists concluded. Consultant pharmacists are to forge
a stronger partnership with other extremely valuable resources, she
said. AsEach day, there are 1,383,700 LTC faculty members, Dr.
Hardesty added. LTC continues to change, their enhancedresidents in
nursing homes, and 713,300 Tactical pharmacists' on-site work
allows serviceswillbecomeevenmoreessential.residents in residential
care communities, Dr. them to build long-term relationships
withHardesty said at the 2015 American Society of administrators,
nurses, and prescribers, Dr.
ByRyanMarotta,AssistantEditorConsultant Pharmacists Forum in
Baltimore, Hardesty stated. Everyone works together asMaryland.
There's a huge opportunity for a team, which contributes to a
successful LTC Culled from Pharmacy Times. See more at:consultant
pharmacists to make a difference partnership.in long-term care.
Yet, consultant pharmacy services have been significantly affected
by Compared with tactical pharmacists,changes in the acuity of
residents, lengths of consultant pharmacists who take a
strategicstay, electronic health records, and complex
http://www.pharmacytimes.com/news/Con
sultant-Pharmacists-Provide-Enhanced- Long-Term-Care-
Services#sthash.hKXeqqeU.dpuf esearchers sought to project the
Annals of Internal Medicine (04/21/15) Vol. 162, No. population
effect and cost 8, P. 533 Odden, Michelle C.; Pletcher, Mark J.;
Coxson, effectiveness of statin therapy in PamelaG.;etal.Radults
aged 7594 years. The intervention was statins for primary The
American research shows that prevention based on LDL cholesterol
threshold of cholesterol lowering statins (e.g. atorvastatin - 4.91
mmol/L, 4.14 mmol/L, or 3.36 mmol/L; Lipitor brand by presence of
diabetes; or 10-year risk score of at least Pfizer), if prescribed
7.5%. All adults in this age group in the National for old men and
Health and Nutrition Examination women aged 75- Survey have a
10-year risk score greater 94years can prevent than 7.5%. According
to the study onset of or death due results, primary prevention
strategies to heart attack and with statins would prevent
myocardial other heart diseases. infarctions and coronary heart
disease S u c h t re a t m e n t deaths and be cost-effective, as
long as would also help save cost of there is no effect on
functional limitation healthcare in addition to or cognitive
impairment. Treatment of t h e a f o r e m e n t i o n e d all
adults aged 7594 years would prevent benefits. However, in spite
105,000 (4.3%) incident MIs and 68,000 of the potential benefits of
(2.3%) CHD deaths at an incremental cost preventing heart diseases
per disability-adjusted lifeyear of $25,200. using statins, adverse
A small increase in geriatric-specific effects of the drug in old
people (e.g. muscle adverse events could offset pain affecting
mobility etc.) would make all cardiovascular benefits, the
itspotentialbenefitsnotworthit. researchersnote. In lay terms: Cost
Effectiveness of Statins for Primary Prevention in Older Adults
health & politics today, July/Oct 2015 7 1st oich e c image
credit: google.com image credit: google.com 9 8
8. food + health tips with Sisi Jemimah Jemimah Adebiyi is the
author and recipe developer at sisijemimah.com, a food blog which
features delicious family friendly recipes with detailed and
carefully illustrated preparation methods. She is legal case
researcher by day and an unbridled food enthusiast by night. She
blogs at sisijemimah.com Twitter: @sisijemimah Ican't believe I'd
lived almost all my life without tasting Coconut fried rice until
earlier this year. I'd always had a mental image of rice and
coconut milk not being a good combo so I stayed away. Anyway, I
tried it out forthefirsttimeinFebruaryandIwassold! The recipe is
pretty simple, very similar to traditional Nigerian fried rice.
Most rice recipes require chicken or beef stock but this one
doesn't and you still get the same delicious taste as with stock.
To achieve this, you'll need raw chicken fillet; you'll get more
details as you read on. You can use either breast or thigh though I
find thigh absolutely more flavourful compared with breast. Coconut
fried rice is bound to be a hit at any party. It
addsclassaswellandswaysfromtheusualJollofriceandfriedricenormpopularatmostparties.
Now,coconutfriedrice,let'sgetstarted! Ingredients which stands out
in fried rice) 3 cups of rice 1 teaspoon minced garlic 2 cups/
500ml coconut milk 1/2 teaspoon white pepper 1cup raw diced
chicken(preferably thigh fillet) 1/2 teaspoon cumin 1/2 cup baby
prawns 1/4 teaspoon black pepper 2 tablespoon Coconut oil and 1
teaspoon olive oil 1/4 teaspoon cayenne pepper 1 large carrot
chopped 1/4 teaspoon mixed herbs 1/2 small green and red pepper
chopped 1/2 teaspoon each Curry, thyme, 1/2 cup green peas Salt to
taste 1/2 cup sweet corn 2 Knorr chicken cubes or any bouillon
cubes 1/2 small chopped yellow onion you prefer. 1/2 small size red
onion (you can use just one type of 1/4 cup desiccated coconut
(optional) onion, I like yellow for taste and red for the colour ce
ok ca on m u o t t ri w c o e h with fun! hicc kee nht .etanira m 1
2 ecirehthsa w tos ck klimtunoco cehtdda 3 o marinate, mix the
olive oil, cumin, one Knorr cube, black pepper, cayenneTpepper and
mixed herbs, let it refrigerate for at least an hour. The chicken
can be marinated for as long as possible though I always marinate
overnight to allow the chicken soak up the flavours from the spices
better I'll suggest at least an hour. After it's been marinated,
take it out, dice it into bits and set aside. hen, wash the rice
thoroughly and leave to drain in a colander.T ext, into a heated
pot, add the coconut milk stock and Nsome water. It's better to use
fresh home-made coconut milk for this recipe, it tastes so much
better and creamier. Also add 1/4 teaspoon curry, thyme, salt,
white pepper, one Knorr cube and bring to a boil on medium heat.
Stir, add the rice, cover the pot and let it boil till soft. health
& politics today, July/Oct 2015 8 CONQUERING FEARS RECIPE
culinary at a time ONE
9. hile that's boiling, add the coconut oil into a frying pan
Won low-medium heat. Now, add the onions, saut for a minute, add
the garlic and one Knorr cube, saut till fragrant. Then add the
diced chicken, one Knorr cube and fry till the chicken loses its
pinkness and turns brown. Add the carrot, saut for another minute,
then add the chopped peppers, green peas, sweet corn, prawns and
red onions. Stir for 5 minutes but be careful not to overcook your
veggies. Switch off the heat when it's fully done. The natural
flavours of the chicken is released and then incorporated into the
veggies which then goes into the cooked rice (Nothing is wasted!).
Cooking it this way creates a juice which replicates chicken stock
and ends up tasting extra flavourful. heck the rice at this time,
when the liquid is all dried up and the Crice soft, stir lightly to
add the fried veggies and chicken. Stir till all are fully
combined. Adjust seasoning and salt if necessary. Reduce the heat
and steam for a further 2-3 minutes or turn off and let it steam
with the residual heatand it's ready. ext, into a heated pot, add
the coconut milk stock and some Nwater. It's better to use fresh
home-made coconut milk for this recipe, it tastes so much better
and creamier. Also add 1/4 teaspoon curry, thyme, salt, white
pepper, one Knorr cube and bring to a boil on medium heat. Stir,
add the rice, cover the pot and let it boil till soft. food +
health tips with Sisi Jemimah 4 5 Check the rice at this time Add
the coconut oil 6 health & politics today, July/Oct 2015 9 s we
round off this session partcanbeusedincooking,themilk, also
essential for bone formation and good on making coconut fried the
water, flesh, oil, sugar. The leaves cellhealth. rice, let's talk
coconut. Yes! and husks on the other hand areACoconut palm is one
of the usedforfurniture,decorationandas Coconut (and its' milk)
contains a type of very few trees that gives its' brooms for
cleaning. Isn't that fat called Lauric acid. Unlike other entirety
for living. Almost all its amazing,nothingliestowaste! saturated
fats, Lauric acid is used up more rapidly by the body and are less
likely to be Coconut milk, which is the key stored as fat. It is
also changed in the body ingredient for this recipe is highly into
a highly beneficial compound called nutritious with commendable
monolaurin, an antiviral and antibacterial health benefits. It is
rich in vitamin that destroys various disease causing B, vitamin C
and E as well as organisms. minerals like iron, selenium,
sodium,phosphorus,magnesium. Although the British Heart Foundation
recommends swapping coconut oil with Now, let me explain what all
that less saturated ones live olive oil, it is now means. Vitamin C
helps boost your thought that consumption of coconut milk immune
system by fighting against may help protect the body from
infections. infections and promoting wound For this recipe we have
used both coconut healing. Vitamin E promotes healthy and olive
oil. So you get all the benefits skin while B and iron helps in
blood however formation. The other minerals are Food is ready!
Presentation Temitope Ojedokun Ensure you take your 5 portions of
fruits and vegetables daily
10. health & politics today, July/Oct 2015 10 Kidney
disease affects millions of people around the world. It is
important for you to maintain healthy kidneys as it is such a
crucial organ which helps your body remove toxic metabolic wastes
e.g. urea, drug metabolites, blood pressure regulation and blood
formation via the synthesis of an hormone called erythropoietin. We
present to you some natural fruits/herbs that help keep your
kidneys healthy. food + health tips Natural foods that help cleanse
your kidneys eets contain a lot ofbetaine, antioxidants and
Bnutrients that increase urine acidity. Increase in urine acidity
helps the removal of calcium phosphate and struvite
whichcancausekidneystones. 1 photocredit:
http://www.ideadigezt.com/ et a glass of warm water. and squeeze
the juice of four lemons Gintoit.Andyoucanenjoyadrink rich in
citrine, a chemical which acidifies your urine thereby clearing
your kidneys of substances which may causepainfulkidneystones. 2
ater is the number one and readily available kidney Wdetoxifier.
For most people water is almost free and within reach. Yet many
never take advantage of it to improvetheirhealth. How much water
should you drink? Well, 8 glasses of water daily is generally
recommended, but people living in countries with hot weather
obviouslyneedmore. One sure way of knowing youve had sufficient
water is when your urine is cleari.e.withoutcolour. 3 nions are
every womans companion! They are household seasonings. You can eat
onions Oraworcookedaspartofyourmeal. Yes, onions are rich in
flavonoids notably quercetin which helps prevent cholesterol
deposits in blood vessels. A powerful antioxidant, quercetin mops
off free radicals from your system and protect your kidneys
againstcancer.Italsopreventsheartdisease. Also, low potassium
content of onions means they are kidney-friendly and your kidneys
wouldnt wear outtryingtogetridofexcesspotassium. 4 Diabetes risk
and how you microwave your food cientists at New York University
have plasticmaterials,youincreaseyourexposure found that harmful
phthalate to toxic phthalate as small amounts enters Schemicals
from plastic materials get your food. It is safe to use aluminium
wrap into the food we eat. Phthalates (DINP & andwaxpaper.
DIDP) thought to be safe are used by industries to strengthen
plastic materials, Also avoid washing plastic food containers in
but have been found by Professor Leonardo the dishwasher, because
phthalates can leak Trasande and his colleagues at NYU to be out.
associated with insulin resistance (a risk factor for diabetes) and
small increases in Also, check the recycle symbol on plastic
bloodpressure. containers and avoid those labelled numbers3,6or7.
Whenyoumicrowavefoodinorcoveredwith
11. Nigerian doctors had not been able to make reasonable
contribution to healthcare delivery in the last two years as a
result of incessant strikes. Addressing health workforce crisis and
strikes in nigeria: a policy framework cover story with Opeyemi
Akindele health & politics today, July/Oct 2015 11 1 H
etc.sincemanydonotreporttothehospitalorhealthcentres.uman resource
is the most important factor in any institution. It is even more
important in a health Barely half of births are attended by skilled
health personnelsystem since it deals directly with human life and
(midwives,nurses),andthat'smuchworseintheNorthwesternhealth. Health
workforce is the driver of health system region where only 3 out of
10 women are delivered by skilledperformance and takes the largest
share of health budget. birth attendants on average. Currently,
Nigeria is 40% short ofTherefore, it is imperative that issues
affecting human its 2015 maternal mortality target (250 per 100,000
liveresources for health in Nigeria be once and for all be births),
according to the Nigeria MDG 2013 Report. Malariaaddressed by the
Buhari administration if any progress which accounts for 1 in 10
maternal deaths still remains a bigmust be made in the Nigerian
health system under his issue due to poor living conditions,
endemic fake antimalarialsadministration. In this essay, I take on
a problem that has and the failure of the government to improve
access
healthcare.effectivelybroughttheNigerianpublichealthcaresystemto
The only good news that has emerged from theits knees incessant
strikes embarked upon by various Nigerian health system seem to be
the successfulunions in the health sector. My analysis and
commentary eradication of Guinearevolves around the triangle of
[inadequate] health Wo r m i n 2 0 1 3 ;
afunding,thegovernmentandhealthworkersunions. development which,
albeit commendable inHealth system is a complex arrangement of
coordinated itself suggest that we arepersonnel, departments and
activities geared towards decadesbehind.disease management and
health improvement. The WHO defines a health system as all the
activities whose primary As observed by thepurpose is to promote,
restore or maintain health. There president of Medical andare three
key functions of any health system as delineated D e n t a l C o n
s u l t a n t sbytheWHO: Association of Nigeria ( M D C A N ) , D r
S t e veimprovingthehealthofthepopulationtheyserve Oluwole,
Nigerian doctorsrespondingtopeople'sexpectations had not been able
to makeproviding financial protection against the costs of ill-
reasonable contribution tohealth. healthcare delivery in the last
two years as a result
ofUnfortunately,healthsysteminNigeriaisquitefarfromthis incessant
strikes. Or whatideal. Nigeria's health outcomes are among the
worst in the value could a large, butworld, and it contributes the
lion's share to many of the hardly working contingentheart-rending
morbidity and mortality statistics in West of health professionals
canAfrica and sub-Sahara Africa. Most Nigerians who seek add to a
people in need ofhealthcare in public health facilities do so
because they their services? It washave no affordable and decent
alternative. The level of without a shred of shamedistrust for
health professionals among Nigerians is high,
thatmanyhealthprofessionalsspokeafterPatrickOliverperhapslikeneverbefore.
Sawyer the Liberian-American diplomat imported the deadly Ebola
virus to Lagos in July 2014: Thank God we werWhile Nigeria has one
of the largest health workforces in e on strike! That's how bad the
Nigerian health system hasAfrica, the state of healthcare is very
bad nonetheless. I
gone.Wearenotpreparedtorespondtoemergencieswhetheritmean VERY BAD,
at least for over 80% Nigerians who is an epidemiological threat to
the country or a threat to the lifecannot afford decent, dignifying
healthcare from private ofanindividual.providers. In 2000, the
World Health Organisation (WHO) ranked Nigeria's health service
performance 187th In the 21st century where it is unimaginable in
many countriesposition among 191 countries in its publication
Health that health professionals would leave the dying unattended
forSystems: Improving Performance- far below many less even one
hour, Nigeria's unions of health professionals haveendowed
countries. Today, nothing much has changed. made an ignoble
competition out of industrial strikes whileAccording to the
Nigerian Bureau of Statistics, infant continuing to earn their
relatively fat salaries within the civilmortality and under-5
mortality rates are still high, service. There is no other sector
of the Nigerian state, howeverespecially in rural areas where 67
and 105 children die out rickety, that has witnessed
inter-professional wrangling andof every 1000 born alive
respectively. There is sufficient regular industrial strikes that
can come close to that of theground to believe that these official
child mortality figures
healthsector,particularlythehospitalsector.may be less than the
actual number of children who die daily of malaria, typhoid,
diarrhoeal diseases, pneumonia,
12. health & politics today, July/Oct 2015 it is possible
to r e v e r s e t h i s terrible trend by creating a robust health
workforce p o l i c y w h i l e executing same with a sincere p o l
i t i c a l w i l l across all levels of government. Y ou could
count how many days Nigerian health Nigeria, was never implemented
as intended or at least, not professionals were at work in the year
2014. If their seentohavebeenimplemented. national unions were not
on strike, those at a particular federal or state institution would
be on strike due Moreover, it is fair criticism of the document to
assert that to some local issues with their chief medical nowhere
is industrial strike given due attention as a major
director/hospital management. Then their sister unions in
militating factor improving access to health services or a other
parts of the country would abandon their patients and
wildaffronttopublicstewardshipandaccountability. life-saving duties
in order to show solidarity for their striking colleagues. The
government is indifferent. Health Since the much touted National
Health Bill has been assented workers are adamant. Who cares about
babies who timely by former President Goodluck's administration, it
is equally surgery could have saved from permanent deformity,
important for robust and sustainable national human prolonged pain
or even needless death? How about tens of resources for health
policy be formulated and implemented.
thousandsofmotherswhorequireregularantenatalcare? Such a document
may also be adopted or adapted by state ministries of health. The
policy should Strikes and union/solidarity meetings address health
workers' strike while constituteasignificantpercentageofthetime
encompassing health workforce resident doctors are supposed to
spend in performance monitoring and evaluation, their training to
become medical consultants. health facility performance assessment,
The gap created when pharmacists are on hospital rating/ranking
based on clearly strike is happily filled by charlatans and defined
criteria and a working model for quacks who help helpless patients
inter-professional co-operation and complicate their conditions by
giving drugs teamworkamongclinicalprofessionals. they know next to
nothing about. Nurses, m e d i c a l l a b o r a t o r y s c i e n
t i s t s , If the problem of industrial strike is not
physiotherapists, others turn down patients addressed as a matter
of urgency, the and expectant mothers who are always told much
hyped National Health Bill would to access affordable antenatal
care in soon join the league of policies and governmenthospitals.
legislations that never made the differencetheywereintendedtomake.
The tales are endless. Our health system is weak and terribly so.
However, it is possible Some well-meaning Nigerians have said to
reverse this terrible trend by creating a
thewaytogoistomakeanyformofstrike robust health workforce policy
while action by health workers illegal. Indeed, executing same with
a sincere political will healthcare is an essential service which
acrossalllevelsofgovernment. should not be denied anyone who needs
it. However, that view would leave health National Human Resources
for Health workers at the mercy of an indifferent Strategic Plan
2008 to 2012 is a key policy document drafted government or
insincere politicians who often fail to meet by the Federal
Ministry of Health (FMOH) under the short- legitimate demands of
health workers. A workable policy lived administration of Professor
Adenike Grange. The
wouldbeonewhich,ononehand,compelsthegovernmentto publication was
perhaps produced in response to an earlier provide excellent
working conditions (not falling below publication on the state of
health workforce in Nigeria set/agreed minimums) and welfare
package for all cadres of published by the Africa Health Workforce
Observatory. In health workers without which they may legitimately
principle,thestrategicplanfortheNigerianhealthworkforce withdraw
some of their services (and for no other reason); was designed for
improving on access (to health services), while demanding
accountability, excellent health services stewardship and
accountability. Very insightful analysis of
andtruecommitmenttoworkfromhealthworkers. health workforce
disparities across geopolitical zones, the key challenges of
recruiting and retaining health
Thetimeisnowtostopplayingpoliticswithhealthcare. professionals as
well as practical solutions were discussed. Sadly, but
unsurprisingly, the Human Resources for Health Strategic Plan 2008
to 2012, like many other policies in Addressing health workforce
crisis and strikes in nigeria: a policy framework cover story with
Opeyemi Akindele 2 photo:www.lifeway.com 12
13. health & politics today, July/Oct 2015 13 cover story
with Wole Oladapo A s great as the effect that
HippocraticOathtakenbydoctors conflicts of interests In most of the
stories, some is sure not a license to take between medical doctors
sections of the Hippocratic Oath medicaldoctorsandtheirservices a n
d a u t h o r i t i e s [the health of my patient shall be for
granted. The Oath does not governments, ministries, my first
consideration; I will provide a cheap tool for departments,
agencies, and maintain the utmost respect for blackmailing doctors.
Nowhere in professional bodies have on the human life] are often
invoked the Oath is it stated that doctors people, public knowledge
of the against the doctors' strike to should be subjected to
degrading conflictsislimitedinmostcasesto describe the action as
inhuman and inhuman treatment in the what the media publish. Even
and insensitive to patients' name of service to humanity. If
manypolicymakersarenot better plights. Only careful media do
doctors' service is that critical, aware as they are often manage
to condemn the strike their concerns must also be individuals drawn
from fields without casting aspersion on the t r e a t e d a s s u
c h b y a l l other than medicine. That is why practitioners of the
noble stakeholders, most especially in the role of the media in
finding a profession. From all indications,
timesofindustrialcrises. lasting solution with a human face this
kind of reporting has not to the nagging problem of medical yielded
sufficient desirable What then should the media do
doctors'incessantstrikeactionsis outcomes as the role of the media
better? If the justifications crucial. No other time is this need
inresolvingdoctors'strikehasnot provided by doctors for their more
imperative as whatever beenrecognisedasinfluential. strike are
considered insufficient concerns the health of the citizens or
unjustifiable, it is not enough to isamatteroflifeanddeath.
Thereisneed,therefore,formedia simply say that. Rather than adopt
practitioners to evolve a reporting an episodic frame in their
reports Duty calls that the responsible style that recognises the
rights of (treating each strike as an media treat health
independent event), issues as important media practitioners need b
u t s a d l y, i t i s to provide an in-depth problematic knowing
analysis of the current t h e n a t u re t h a t situation in the
light of importance should history.Havethedemands take. How then
can been made earlier? How the media mediate did the government
medical doctors' r e s p o n d t o t h o s e strikes such that it
demands then? How did will preserve the the public respond? What
all the stakeholders affected bydignity and interest of the were
the views of other doctors' strike. The media publicprofession and
at the same time professionals in the health sector sphere must
serve as a publickeep the citizens at the heart of its
aboutthosedemands? forum where issues leading toreporting? d o c t
o r s ' s t r i k e s a r e There is need to track how the
contextualised in the light ofWhenever doctors in Nigeria situation
gets to the present history, global standards inembark on a strike,
the following condition. History provides us medical practice and
standards inare the usual news headline: with a wealth of
experience other professional practices in theCrisis Deepens, As
Lagos Doctors needed to well understand the health sector. A
reporting styleStrike Enters Day Six and present. If there is a
persistent that pitches doctors againstNigerian Doctors' Strike
Selfish, recurrence of doctors' strike, we p a t i e n t s , o t h
e r h e a l t hIllegal and Unethical Say Nurses. need to know how
different professionals, governments andThe media often do more to
stakeholders have kept their sides the public will do nobody
anydisplay social empathy in their of the promises and agreements
good as it cannot by any meansreporting: they visit hospitals, that
suspended the previous compel or persuade the doctors tointerview
patients and caregivers, strikes. This will provide a shift their
grounds when theirand keep a public record of the
directionfor'progress'reporting. demands are not yet met.
Thevictimsofthestrike. There is need, therefore, for media
practitioners to evolve a reporting style that recognises the
rights of all the stakeholders affected by doctors'strike.
Mediating Doctors' Strikes in Patients' Interest: What Should the
Media Do Better? photo:googleimage 1
14. A nother important angle to rivalry is responsible for many
of health faculties and departments reporting doctors' strikes is
thehavocsthataredonetopatients inNigeria. p r o v i d e d b y g l o
b a l i n h o s p i t a l s . U n t i l t h o s e standards in
medical c o n t r o v e r s i a l i s s u e s a r e This is where
the patients come in. practice. In August 2014, The satisfactorily
resolved, we cannot If the public is furnished with Nigerian
Medical Association hope for a functional health sector. detailed
and balanced information released a document enumerating Doctors'
strike always triggers about doctors' strike and a proper the 24
reasons why Nigerian such issues into public discourse. context for
understanding and doctors went on strike. Many The media can
appropriate the interpreting the information, the media outlets
made that the opportunities a crisis period offers stage is set for
making issues headline of their stories about the to explore how
inter-profession resulting in doctors' strike a public strike the
subsequent days. Most of relationships are maintained in concern.
If members of the public the media outlets that published or
functional health sectors to push understand the justifiability of
the aired the story simply relayed the such models to the front
burner of demands made by medical doctors, reasons as hard as the
NMA national health politics. For those demands become those of
presented them. This approach is instance, is it the practice the
public as well, since the health not very useful for properly
everywhere in the world that only system is designed for the
patients, understandingthosedemands. medical doctors could be CMDs?
If thepublic. it is a national peculiarity, is it The media can
help the If the public lend their public to understand support to
the demands, how the issues raised by the demands become NMA are
addressed in unavoidable for the countries with a healthy
government and other health sector. If NMA stakeholders. Then, the
demands that medical fight for a functional health doctors be paid
a sector becomes everyone's minimum of #100,000 fight. The Ebola
outbreak as monthly hazard in Nigeria reminded us allowance, the
media again that the sacrifices should tell us what being made by
medicalpossible that it be managed obtains in other climes just as
they professionals in the delivery ofpeacefully? How do other
dowiththesalariesandallowances their services are in every sensec o
u n t r i e s h a n d l e s i m i l a r of political office
holders. They overwhelming. That some medicalcontroversies in their
health should also examine the criteria professionals had to pay
thesectors? Exploring angles such as used by NMA to arrive at such
highest price to save the countrythese will provide us with points
of figures. How do countries with a from the scourge of
terriblereference when assessing the functional health sector
manage diseases like Ebola is a call to bothsituations in our
health sector. All residency training for medical the government
and the entireof these efforts are important doctors? Responding to
the country to re-examine the honourbecause the world is gradually
demands of medical doctors from a we accord the noble
professions.discarding the idea of professional global perspective
will provide all I n s t e a d o f p i t c h i n g t h esuperiority
and embracing that of the stakeholders with clearer stakeholders
against one anotherprofessionalinterdependence.
lensesforviewingthedemands. when reporting doctors' strike, media
practitioners should try toMost schools in developed The most
sensitive aspects of find a common ground amidstcountries adopt
multidisciplinary doctors' strike are the issues that conflicting
interests and provide aorientation in developing their concern
other professionals in the unitedfrontfordemandingabetteracademic
curriculum. If this is not health sector. The Nigerian health
andfunctionalhealthsectorforall.yet the practice, now is the time
to sector is characterised by rivalry set it as an agenda, most
especially among its constituents. Sadly, this for medical schools
and other If the public lend their support to the demands, the
demands become unavoidable for the government... then the fight for
a functional health sector becomes everyonesfight. cover story with
Wole Oladapo health & politics today, July/Oct 2015 Mediating
Doctors' Strikes in Patients' Interest: What Should the Media Do
Better? 2 14
15. esearch on womens experiences during pregnancy, and
particularly during labour shows that women across the world
receive disrespectful treatments. Disrespectful treatments range
from neglect, verbal abuse to coercion (like coercive caesarean
sessions) or even spanking and unwarranted episiotomy (an incision
between the vagina and the anus). This disturbingRphenomenon can
potentially cause a rise in maternal/child mortality from
complications in labour when women begin to
substitutedisrespectfulhealthcarewithunassistedorhomedeliverieswithunskilledattendants.
Having served in some government hospitals myself coupled with
reports from friends and families, I have witnessed first-hand how
nurses in particular maltreat or neglectwomeninlabour. Manydont
showempathyallinthenameofbeingmothers themselves i.e. they think if
they had been through labour, why should another woman be treated
specially. This is not to say that is always the situation, however
disrespectful maternal care is not uncommon in Nigeria and has
remained largely unexplored. Imagine someone who is paid to take
care of you raining insults on you (e.g. Didnt you know it would
turn out like this when you were doing the thing...) when they
should be reassuring their clients. I doubt I would be able to
paint the exact degree of apathy on our female labour wards in
Nigeria, therefore, I have inserted a true life story in here, as
Despite growing evidence and reports of poor or disrespectful
maternal care, currently there is no international consensus on how
disrespect and abuse should be defined and measured. We need to
understand the root of this problem, could it be work stress, poor
attitudes or lack of sufficient staff or lapses in health workers
training? Understanding, measuring and preventing abusive and
disrespectful care is a research agenda that remains unexplored. In
many instances policies to promote respectful maternal care have
notbeenadopted,areunspecific,andareyettobetranslatedintosignificantaction.
Olutosin Oladosu-Adebowale shares her own
experienceofdisrespectfulmaternalcareinNigeria. arrived just in
time took the baby from When the time came for me to deliver At the
hospital, there was not a single his arms. I dont know how, but by
some my first daughter, my maternal doctor. The room was crowded
with miracle of God he was able to revive my grandmother took me
aside and told me women in various stages of delivery. We
daughter.Relieved,Ifellasleep. tositdown. were forced to labor on
benches, as there was only one bed. When the baby I woke in a pool
of bloodthe nurses had There is no pain as that of child birth,
crownedatthebirthcanal,womenwould forgotten to stitch my vagina
where the she said. It is indescribable. Delivery can
betransferredtotheonlyavailablebed. episiotomy had been performed.
I only be done by God. Put your faith in recovered after eight days
in intensive him.Asforthedoctorsforgetthem. A nurse sternly warned
me not to push, care. despite my babys insistence on coming Her
words made me deeply afraid for into this world. When I could not
take it These horrible experiences happened in what I was to
experience next, and my any further, I screamed and the nurse
oneofthelargesthospitalsinLagos.Iwas
motherswordsonlyconfirmedmyfears. almost hit me. "I told you not to
push! No lucky to survive. My daughter, whom we
spaceforyoutodeliver!" named Oluwatobiloba meaning 'God is a Has
she explained everything to you? Great King', was lucky to survive.
Every shesaid.Itwillbepainful. The pain of attempting to stop my
labor day, women are sacrificed at the altars of
mademecryoutinmorepain.Ipulledmy medicalnegligenceinNigeria. True
to their words, my labor was the husband aside and gave him these
most horrific experience of my life. My instructions: "If I die,
ensure that you I could quote statistics of maternal relatives
prepared me for the physical take me back to my village for burial.
I do deaths in my country, but they would be pain, but I was not
alerted to the not want to be buried in Lagos, or in your useless:
official numbers do not conditions I would meet in Nigerias
village."Herespondedwithahiss. represent the actual quantity of
healthcarefacilities. casualties we see daily. I call on our When
my baby was finally delivered, she government to commit to proper
funding I went to the hospital to deliver my could not breathe. The
nurse looked at and staffing for our health care system. daughter
on April 25, 2002. Pain gushed me straight in the face and said,
"Witch, We must all come together to reduce the out of me like the
flow of a river. I you have killed your daughter." She number of
women and infants buried in screamed, expecting soothing handed the
baby to my husband and said, thegraveyardsofNigeria
medicationstoreducemypain,oratleast "She is a still birth. Your
wife killed your soothing words to help me through. child."
ByOlutosinOladosu-Adebowale. Instead, one of the nurses shouted at
me: Source:http://www.impatientoptimists. "Shut up! It is time for
you to know that a I began to cry as my husband wrapped a org/
babys head is bigger than a mans scarf around the baby to prepare
her for manhood." burial. But suddenly, a doctor who Disrespectful
treatments of women during : a major barrier to utility of
hospitals for baby delivery childbirth Women & Development with
Temitope Ojedokun health & politics today, July/Oct 2015 15
Shut up! It is time for you to know that a babys head is bigger
than a mans manhood."
16. Allocation to health dropped by 17 billion (approx.
85million USD) in 2014 to 262 billion naira. ccording to the United
Nations, the ultimate have been enrolled under the National Health
responsibility for healthcare lies with the Insurance Scheme in ten
years of its existence government. Claiming that the Nigerian
(2005-2015). However, 60 per cent coverage hasAgovernment has
recorded abysmal performance in been achieved in many African
countries that healthcare provision is not a matter of comparing it
launched their health insurance programme after to developed
countries such as Switzerland where thelargesteconomyinAfrica.
health insurance coverage is 99.9%. Nigeria fails woefully even
when compared to other African Conversely, politicians know how to
take care of countries. Nigeria's economic prosperity does not
their own health at the expense of the public. In May
matchitsgovernment'sshareofhealthexpenditure, 2014, Nigerians were
shocked to learn through which is a little over 20% compared to
Egypt and media reports that an outgoing governor (Godswill South
Africa where government spending on health Akpabio of Akwa Ibom
state, now a senator of the average40%. federal republic) and his
wife would be getting annual health insurance coverage to the tune
of Barely a year after the United Nations launched the 100million
naira (about 600,000 USD) after leaving Millennium Development
Goals, African heads of office. Knowing they have not made any
reasonable states converge on Abuja from April 26-27, 2001, at
provision or funding for a decent healthcare service the invitation
of the former President Olusegun in hospitals, Nigerian politicians
almost always Obasanjo, for a conference where they affirmed
chatter private jets or take the next available flight their
commitment to fight HIV/AIDS, tuberculosis to Dubai, India, Germany
or other medical tourism and improve healthcare delivery for their
citizens. destinations. This happens in a country where The 26th
point in the Abuja Declaration reads: "we children die because
pledge to set a target of allocating at least 15% of their mother
cannot our annual budget to the improvement of the health afford to
pay for sector". Till date, the percentage of annual budget malaria
treatment that goes to health in Nigeria is less than half of the
which often cost less 15%thatwaspledged14yearsago. than 1500 naira
(about 6USD). Governmentspendingonhealthhas,formosttimes, been
around 5% of budgetary allocation since 1999 While health workers
when a democratic government was ushered in. In s o m e t i m e s c
i t e 2014,6%(262billionnairaor1.7billionUSD)ofthe government's
failure national budget went to health, over 80% of which to
provide Nigerians is meant for paying salaries and buying petrol
and w i t h a d e q u a t e diesel to power hospitals, research
institutes, healthcare as their health ministry, departments and
agencies. Only a reason (or a main little is left for improving
access to healthcare and reason) for going on a quality of care,
purchase of essential medicines, strike, we know that it provision
of new health facilities, diagnostic is only to give an altruistic
face to their own struggle equipment, medical and surgical devices.
As a for higher salaries or higher salary competition as result,
the health insurance scheme only covered the case may be. In any
case, if health workers' those in the formal sector mainly
government unions were to fight for better healthcare for employees
who are barely 4% of the entire Nigerians, denying and depriving
the same people population. access to healthcare by refusing to
work is not the way to go about it. It is Nigerians who should go
all The vast majority of Nigerians pay for health care out
protesting against an unjust, unfair and out-of-pocket, accounting
for about 75% of health oppressive government while unions of
health expenditure. Private health insurance is purchased
professionals and civil societies should champion for a privileged
few who are employed by good advocacy and mediation as they
interface between companies such as multinationals. Of over 160
themassesandthegovernment. million people, only about 6 million
(about 3%) cover story with Opeyemi Akindele Failure of government
to finance healthcare Addressing health workforce crisis and
strikes in Nigeria: some key issues health & politics today,
July/Oct 2015 16 1 image:www.idssociety.org
17. The mentality is that when you work for the government,
hard work isn't worth it. urthermore, Nigerian health workers go on
by poor healthcare service. The poor masses continue strike because
generally they do not earn as tobearthebrunt. much as they should.
As a result, even whenFhealth workers are not on strike, they do
not work On other hand, Nigerian senators earn about 1 million
enthusiastically or put in their best. The mentality is USD a year
with great healthcare packages while that when you work for the
government, hard work representing a people isn't worth it. Morale
is low as workers are not of whom 70% wallow motivated. in extreme
poverty living on less than Many Nigerians would rather not
patronise public 1.25 USD per day- hospitals because they are
repulsed by the poor w i t h o u t s o c i a l attitudes of nurses
and fagged out resident doctors security or health who shout at
their patients. Salaries and wages earned i n s u ra n c e . Wa rd
by a worker have been referred to as "hygiene factors" councillors
flaunt that influence performance, morale, and motivation by their
largesse before Hertzberg, Mausner, and Snyderman in their book The
theirconstituencies. MotivationtoWorkpublishedin1959. Consequently,
the Health workers in Nigeria earn less than their general feeling
among colleagues in neighbouring countries. A physician health
workers is that employed by the federal government may earn up to
if politicians who $1000 at entry level, a pharmacist or
physiotherapist appear to do less, and earns about $700 per month.
Nurses, medical have not improved the laboratory scientists, others
earn even less. Those lot of Nigerians earn employed by the state
or local government generally so much, then the earn much less. Yet
the cost of living -cost of decent government must accommodation,
school fees, electricity etc.- continue have enough in its coffers
to pay health professionals to rise. In order to improve their
income, many health whoprovidehealthservicestothepublic,sometimesat
professionals engage in side activities and private the risk of
their own lives. Hence, for Nigerian health practice to the
detriment of public service. Since workers strike is the most
effective way they can practitioners are engaged in two ventures
none of squeeze funds out of the pockets of an unyielding which
gets their best, even private practice is plagued government cover
story with Opeyemi Akindele health & politics today, July/Oct
2015 17 image:Debamboozled Remuneration lags behind rising cost of
decent living Addressing health workforce crisis and strikes in
Nigeria: some key issues 2
18. t is not uncommon that government's insincerity other. Key
factors that will affect how much is available when it comes to
implementing agreements it for the government to spend of health
include but not Isignedwithhealthworkers'unionsleadstostrikes.
limited to: rising internal and external debts, huge spending on
fuel subsidy, skyrocketing cost of
WesawhowpoliticalgimmicksplayedbyNyesomWike governance, declining
demand for crude oil and (as education minister) kept university
students out of reduction in flow of development assistance for
health school in 2013 when the Jonathan administration (DHA).
failed to execute the agreement it signed with the
AcademicStaffUnionofUniversities.
Onewaythegovernmentcanboosthealthfundingsoas to provide fair,
robust and satisfactory Similarly in the hospital sector, in order
to save its face salary/allowances package to all cadres of the
health and stop public outcry, it is not unusual for the Nigerian
workforce is via total removal of oil subsidy so that the
government to sign an agreement to pay better salary billions of
dollars saved can be invested in healthcare. packages with striking
JOHESU or NMA even when it Also, ministries and agencies serving
duplicate or knows it would not be able to meet the demand or
similar functions should be merged while savings in sustainit.
runningcostsshouldbeinvestedinhealth. Health workers' unions too,
who have become However, how much of additional budgetary
allocation accustomed to the cunning of politicians, would only to
health should go to increasing health workers' say they suspended
the strike whenever they cut any salaries rather than healthcare
capital projects may promising deal with the government. So, by the
time need to be debated, especially in a situation whereby the
going gets tough and the promised salary packages NMA and JOHESU
continue to competitively demand or due allowances are not
delivered, the unions soon forhighersalariesoutofjealousy.
makeafreshcallforstrikeaction. Apart from pervasive
irresponsibility among Noteworthy is the fact that chances are high
that the politicians, higher salary demand competition by NMA
government may find it difficult to increase and sustain and JOHESU
partly explains why a government bogged payment of health workers
salary while investing down by salary payments may sometimes fail
to meaningfully in universal health coverage at the same implement
agreements it signed "under the duress" of time; and if prudent,
evidence-based health economics anindustrialaction. is not applied,
one might be done at the expense of the cover story with Opeyemi
Akindele health & politics today, July/Oct 2015 18 Government
insincerity in implementing agreement with health workers unions 3
OF CLEAR LANGUAGE IS THE GREAT ENEMY INSINCERITY George Orwell
Addressing health workforce crisis and strikes in Nigeria: some key
issues
19. he lion's share of government expenditure on community
better are not at the forefront of striking health personnel goes
into salaries and unions' agenda. And if they are, they are only
used as a Tallowances earned by health workers in the pretext to
give a human face to their struggles. Or how hospital sub-sector.
Yet, shockingly, it is the same
canyouclaimtobeonstrikeforaltruisticreasonswhen hospital sub-sector
(which gets the lion's share of our you are depriving the same
patients you want to be budgetary allocation on health) that also
goes on strike better served of healthcare, apparently for selfish
for salary related reasons most frequently. What often reasons?
comes as a rude shock to patients and the general public is that
health workers go on strike out of While it is true that Nigerian
health workers are not jealousy. remunerated as much as their
colleagues even in some African countries, it is also true that
health workers in Unfortunately health professionals in Nigeria
have the Nigerian government employment are better paid been
pitched against each other by their union leaders relative to other
civil servants. Sadly, many health and associates who do not have
the interest of workers have not justified the current level of
salary Nigerians at heart. Doctors under the aegis of the NMA they
earn by their input into the health system, would go on strike with
fresh demands should the efficiencyandworkethics. government agree
to a pay rise for nurses, pharmacists, medical laboratory
scientists, optometrists, To address this facet of health workers'
strike, the physiotherapists and other health workers under the
government may need to review the various salary
JOHESUumbrella.JOHESUinturnwouldmountthreats structures in the
entire civil service (i.e. all ministries, to shut down all public
health facilities all over Nigeria
departmentsandagencies).Apartfromusingacademic
shouldthegovernmentappeartocutaperceivedbetter qualification or
level of study as a yardstick to dealwithNMA-medicaldoctors'union.
determine what a cadre of workforce should earn, their respective
contribution to the economy should be It's the same way a kid would
ask for more portions measured by experts and factored into
deciding how whenever their mother adds more to the meal served
muchshouldoneearnrelativetotheother. the other child/ren: one group
or union contends with the government that it has agreed to an
unfairly robust For instance, the contribution of teachers to
improving salary and benefit package with the other group, national
health outcomes has been underestimated resulting in a strike by
the group which felt cheated. over the years, leading to poor
remuneration of And then counter-strike by the other party should
the teachers compared to others workers with same
governmentaccedetotheformer'sdemand. university qualification e.g.
health professionals. And within the health workforce, those whose
contribution According to some government officials, the ever
rising to national health and the economy has been demand for
higher salaries by health workers is underestimated (hence paid
much less relative to pushingthegovernmentbeyondwhatitcanreasonably
othersworkersinthesamesector)e.g.midwivescanbe afford. Patients'
interests and the thirst to serve the adequatelyremunerated. cover
story with Opeyemi Akindele health & politics today, July/Oct
2015 19 Unhealthy igher salary among health workers competition for
h4 image: www.getrealphilippines.com Addressing health workforce
crisis and strikes in Nigeria: some key issues
20. SouthAsia Afestivalofstrikes Indian Medical Association
study divulges ratio might become stiffer in future. he resident
doctors of ten that over 75% doctors experience Moreover, frequent
strikes over the issue of government hospitals in Delhi went
workplace violence in India. On the other security would make the
matter worse for Ton one-day strike from 10 am to 4 pm hand,
literature reveals other attributing thealreadysufferingpatients.
on 20th February 2015. Over hundred factors such as communication
gaps, lack of nursing homes and hospitals in Panvel, presence of
senior doctors and shortage of ImpactofstrikeonhealthcareinIndia
Maharashtra supported by Association of doctors in the hospital.
The proposals to Thousands of patents flocking the Medical
Consultants called a daylong strike inculcate the communication
skills module government hospital with a slight hope of on 6th
April 2015. Tamil Nadu chapter of in the medical curriculum have
failed to being seen by the doctors is the usual scene Indian
Medical Association along with maketheirwayforward. on days of
strike. Some of them might have its 33,000 members called a 24-hour
travelled miles from their villages for the strike on 2nd May 2015
along with health facilities at the hospital. 3,500 members of
Indian Dental These people are often forced Association by staying
away from to stay back until the strike is duties. Meanwhile, Tamil
Nadu Government called out as neither can they Doctors
Association's 16,000 members travel back and forth again nor
supported the strike by working with black they can afford it. On
the other arm badges. Indian Medical Association's hand, most of
the emergency Lucknow chapter called a 12-hour strike on s e r v i
c e s a r e u s u a l l y 8th May 2015 crippling the services at
all operative. Nevertheless, theMoreover, shortage of doctors
continues to diagnostic and pathology centres, clinics, scheduled
surgeries andhaunt the healthcare sector. The limited
andprivatehospitals. outpatient department facilitiesavailability
of doctors during night hours, often remain suspended. Althoughand
multiple cases being reported in the This is a slice from cake of
protests and complete shut down for all the healthemergency at the
same time have led to strikes by doctors this year. However, the
services for long period is an extreme rarity,brawls in the past.
The unavailability of the important issue is the reason for these
but shutting down the usual outpatientsenior doctors for
interaction with the strikes. These different strikes were called s
e r v i c e s l e a d s t o c o n s i d e r a b l efamily members
of the patient is another by different groups of doctors in
different inconveniencetothepatients.common source of conflict. The
junior states on different incidents but for one doctors reporting
the condition of the same reason, security. All these strikes were
Other reasons for health workers'patient to the family are often
foreseen as sparked by various incidents of attacks
strikeinexperienced by the relatives and against the doctors by
relatives or friends of Demands such as salary hikes,
timelyconsideredassofttargets. patients for different reasons. The
doctor on payment, better facilities, and living duty at Lifeline
Hospital, Maharashtra was conditions, etc. have traditionally being
theMeasurestostopassaultandbattery brutally beaten on death of a
65-year-old major reasons for strikes by the healthcareFrom time
and again doctors have been woman patient in Intensive Care Unit
(ICU) professionals. Health workers and nursesdemanding security in
the hospitals to on ventilator by her relatives. A often complain
about the dismal wages.prevent such acts of violence from the
gastroentologist in Allahabad was admitted Whereas, doctors often
protest againstgovernment authorities. Escalation in the
toICUafterbeingbeatenondeathof80-year working conditions,
equipments, facilitiesnumber of guards for a few days is all what
oldseriouslyillpatient. and policies. However, in this scenario,
itthey did manage before another such would be rather overwhelming
if doctorsincidence happens. Although some state Manycauses would
have been indulging in strikes forgovernments have passed
protection bills, Hospital is a place for compassion, not reasons
more than protecting themselvesexecution remains questionable. A
blind collision. The relatives do need to and their lives. At least
in those cases,approach from the government might force understand
that it is impossible to assure a reasons like duty, ethical
prerogatives,doctors to migrate from this daunting cent percent
success in every medical saving lives could be cited as more
thanprofession. With more doctors openly procedure. Studies
indicate unexpected
reasonablereasonstocriticisesuchstrikes.discouraging their children
to take up this deaths as the major cause of violent challenging
profession, the doctor patient behaviour from the relatives. An
ongoing Assault on doctors by frustrated patients and relatives, a
major cause of strikes embarked upon by Indian doctors. with Dr
Agrima Raina health & politics today, July/Oct 2015 20 ...The
doctor on duty at Lifeline Hospital, Maharashtra was brutally
beaten on death of a 65-year-old woman patient Photo credit:
www.thehindu.com
21. SouthAsia with Dr Agrima Raina Ending open defecation in
India: long way ahead India's flaw: Agrima tells us why public
health has remained a casualty despite all the progress in many of
fields. Photocredit:sunuptimes.com squatting every now and then at
a considerable distance from the track defecating in open. This
practice is more grieve for women who simply cannot afford the
luxury to openly defecate in open. We have to spot where most men
are going andessimists claim that world is in a the world but a
casual visit to one of the then go in the opposite direction to
find amess. Optimists however differ. Their scores of slums would
reveal the darker side
desertedplaceinfieldstodefecate,explainscontentionisthatprogressinscience,
of the picture. Indias financial capital,P Laxmi, a labourer from
outskirts of Delhi.technology and communications has Mumbai offers
a stark contrast to its high- The plight of women does not end at
findingcomparatively made the world a better rise towers in the
slums where people live suitable place, but fears of privacy
andplace to live in. Optimists are right in their like sardines
cramped in one shack, making sexual abuse haunt them every day.own
belief. Their belief emanates from their every effort to just
survive. For them caring Meanwhile dangers of snakebites and
wormair-conditioned chambers located in highly about health and
sanitation is a luxury they infestations remains to be quite
common.developed metros in the world. Obviously, can simply not
afford. Kolkata, the cultural Moreover, many teenage girls drop out
ofthey are far from factual realities. The capital of India is no
better nor is the IT schools when they start menstruating
duegroundrealitiesareentirelydifferent. capital, Bangalore. Smaller
cities are to lack of toilets taking a toll on
educationobviouslyevenworse. andfutureoftheseyounggirls.The overall
living conditions of a very large number of the people on the
planet remain Nearly 600 million people defecate in the Prime
Minister Narendra Modi launched aextremely pathetic, to say the
open in India. This lack of sanitation facility massive cleaning
and sanitation campaignleast. This pitiable condition of can
commonly cause diarrhoea and aimed for cleaner surroundings asthe
people, who cannot afford well as build sanitation facilitieseven a
morsel of food, makes throughout the country. Thethe pessimists to
conclude that programmetargetstobuild12millionthe world, is in a
mess. Public health is Toilets in current fiscal year and morea
major causality .There has been than 110 million toilets in next
fiveremarkable progress in various fields years with budget of 600
billionincluding agriculture, medical
IndianRupees.Anumberofbusinessresearch, diagnostic means and houses
as well as NGOs have alsocommunication, to name a few that
intestinal infestations and diseases like pitched in to build
toilets in villagesconcern a common person, but sanitation
hepatitis, cholera, typhoid among others. and school.
Advertisements haveand hygiene have remained a major Every minute,
more than 1 million litres started rolling on television for
thedilemma demanding an imperative and
humanexcremententersthelongestriverof importance of building
toilets in everyimmediate solution. That is why public the country,
Ganga. A WHO report claims household. Women organisations
havehealth has remained a casualty despite all loss of nearly
Rs.6500 (approx. $104) per initiated campaigns urging women
totheprogressinavarietyoffields. person in India due to highly
preventable demand constructing a toilet in the house diseases
caused by lack of hygiene. If beforemarriageifitislacking.To get a
clearer picture of the state of public affluent households having
access to proper health, one has to travel through the dark
sanitation and hygiene are excluded, this However, a more daunting
task in theand dingy mud lanes of Asia, Africa, Latin figure rises
to almost Rs. 12,000-15,000 per horizon is change. A change in the
centuriesAmerica and other continents and reach an person. These
diseases cause much more old practices of relieving themselves
underobjective conclusion. Despite all the tall than poor health,
which is, loss of income. the open skies. Meagre toilet building
wouldtalks, sometimes doling out cash incentives Due to illness, an
auto rickshaw driver may probably not solve the problem, or say
yes,by international agencies and even the UN not be able to go for
work causing the may be for females, but what about thoseagencies,
hygiene and sanitation remains a worthy daily income, which is
quite men who love their freedom in the naturalmajor concern in all
under-developed, least necessary to feed children. Things get even
surroundings? They would still be out there.developed, developing
and even many areas worse for the lone bread earners of the Mass
media campaigns on importance ofindevelopedcountries. family adding
them to vicious chain of toilet use perhaps would be the next on
list povertyandillhealth. for building clean and healthy
surroundingsTake for instance India, the largest for the future
generations. Though, road isdemocracy and a fast developing
country, An early morning walk along the tracks of
farahead,atleastthejourneyhasstarted.which has made marvels in
space worlds fourth largest train network, Indian technology.
Indian political capital New Railways will force you to notice men
Delhi looks like the most developed place in Nearly 600 million
people poo in the open in India...WHO says about $104 is lost per
head to preventable diseases. health & politics today, July/Oct
2015 21
22. The heart of the problem Manyunansweredquestions?
Indiaindenialmode Healthissues A recent WHO study of 1600 cities in
the world divulges that New Delhi has the most polluted air, even
worse than Beijing. The city's average annual PM2.5 level was
whooping 153micrograms per metre cube of air as compared to 56 in
Beijing. This figure is way above the safe limit of 25 micrograms
per cubic metre of air within 24-hour time scale as demarcated by
WHO. What is even more alarming is appearance However, the greatest
impact on health is due to As result, Delhi Transport Department of
other Indian cities on the list like Patna, long-term exposure
affecting the quality of life. introduced one of the largest fleets
of eco- Gwalior, and Raipur with 149, 144 and 134 These
particulates can even lead to premature friendly busses in the
world all running on PM2.5 levels respectively competing with Delhi
deaths in people with pre-existing heart and CNG. Due to consistent
law enforcement, strict for the top spot in this pollution race.
These are lung conditions. PM2.5 is potentially emission norms were
enforced; outlived and somewhatless-developedthanthecapitalofthe
carcinogenic and may cause lung and other polluting vehicles were
phased out from city country with much lesser vehicles and lesser
cancers as well. Meanwhile studies also link roads. However,
despite all these measures still urbanisation. excessive PM2.5
exposure to arteriosclerosis running, the pollution monster is
back. Delhi is andevenprematurechildbirths. no more that 'green and
clean' and yes, that is Meanwhile, the financial capital of the
country, theuglyorratherpollutedtruth. Mumbai scored way less than
its counterpart However, these excessively high levels of PM2.5
'greener Delhi' with 45 micrograms despite could be linked to ever
increasing vehicular If one goes out of the air-conditioned cabins
and being the biggest competitor of Delhiin terms of traffic in
Delhi, which alone accounts for about cars to walk along a busy
congested Delhi road, development and urbanisation. However, even
8% vehicles in the country. Delhi boasts of more lungs will
definitely tell the reality. Same air that Mumbai fails to fall
into the safe-zone category vehicles than the three metropolitan
cities of sustains life has become a massive killer. A
ofPM2.5levels. Mumbai, Kolkata and Chennai put together. As
government of India study reveals about 2.63 of March 2015, Delhi
has more than 8.8 million million people suffer from Acute
Respiratory PM2.5 level refers to the fine particulate matter
registered vehicles in the city, besides vehicles Diseases in the
country due to air pollution.
inairhavingdiameterof2.5micrometresorless
fromotherneighbouringcities. Global Burden of Disease by WHO
identifies air which are only visible via electron microscope.
pollutionassixthmostdangerouskillerinsouth PM2.5 are generally
composed of toxic organic Moreover, Five National Highways pass
through Asia with India alone accounting for a quarter of compounds
as well as some heavy metal the Capital, making Delhi as a major
trading and its share. Moreover, 15-16% of asthma patients
primarily resulting from automobile smoke or distribution centre in
the north. On an estimate, in Delhi are children, which 40 years
back was a burningplantsoryardwastes. 78% fruits and vegetables,
49% fuel and 47% meagre2%. food grains traded in Delhi are destined
for So, why are these tiny particles important? Well, otherstates.
these particles are so small that they can easily According to a
study by Chittaranjan National penetrate deep into lungs and blood
stream and Cancer Institute conducted in 2010, more than may reach
vital organs such as brain, kidney, Amidst this, India is still in
the denial mode for 40% schoolchildren in Delhi have reduced lung
liverandspleen. Delhi having the most polluted air in the world;
function. These figures raise many unanswered perhaps due to
successful pollution control questions. Are Delhites breathing
highly measures undertaken in the past. Delhi's contaminated air
for years? Will they be Exposure to high concentrations of PM2.5
may compressed natural gas (CNG) revolution a
compelledtodosoforyearsorevengenerations
exacerbatetheheartandlungconditions.Short- decade ago along with
plantation drives to come? Will most of them have respiratory term
exposures can cause symptoms like cough,
definitelyhaditsimpactontheenvironment.All problems sometime in
lives? Are they wheezing, shortness of breath, difficulty in the
public vehicles started using CNG or other susceptible to lung
cancer more than others breathing and even asthmatic attacks.
Children cleanerfuelssince2001. are? Clearly, cost of pollution
control is much andelderlybeingtheworstaffected.
cheaperthanthecostofthepollutiondamage. Death by : Delhi's killer
air.breath SouthAsia with Dr Agrima Raina health & politics
today, July/Oct 2015 22
23. WhatisPM2.5? Where does PM2.5 comefrom? H ow i s a i r s a
f e t y measured? W h a t P M s i z e i s dangerous? greatest
health risks. Particulate matter, or PM, Because of their small is
the term for particles size (approximately found in the air,
including 1/30th the average dust, dirt, soot, smoke, width of a
human hair), and liquid droplets. fine particles can lodge P a r t
i c l e s c a n b e deeplyintothelungs. suspended in the air for
long periods of time. Some particles are large or dark enough to be
seen Sources of fine particles as soot or smoke. Others include all
types of a r e s o s m a l l t h a t combustion activities
individually they can only (motor vehicles, power be detected with
an plants, wood burning, electronmicroscope. e t c . ) a n d c e r
t a i n industrial processes. Many manmade and Particles with
diameters In addition to air quality natural sources emit PM
between 2.5 and 10 data, EPA guidance on the directly or emit other
micrometers are referred The PM2.5 standards are PM2.5 designations
pollutants that react in toas"coarse." based on averaging air
process also discusses the atmosphere to form quality measurements
other important factors, PM. These solid and liquid S o u r c e s o
f c o a r s e both annually and on a 24 including emissions of
particles come in a wide particles include crushing hour basis. The
annual pollutants that lead to rangeofsizes. or grinding
operations, standard for PM2.5 is met P M 2 . 5 f o r m a t i o n ,
and dust from paved or whenever the 3 year population, commuting
unpaved roads. Other average of the annual patterns, and expected
particles may be formed m e a n P M 2 . 5 growth, that states
should Particles less than 10 in the air from the c o n c e n t ra
t i o n s f o r evaluate in order to micrometers in diameter
chemical change of gases. designated monitoring determine whether a
(PM10) pose a health They are indirectly sites in an area is less
than c o u n t y i s a l i k e l y concern because they can formed
when gases from or equal to 15.0 g/m3. contributor to the area's be
inhaled into and burning fuels react with The 24 hour standard for
airqualityproblem. a c c u m u l a t e i n t h e sunlight and water
vapor. PM2.5 is met whenever respiratory system. These can result
from fuel the 3 year average of the Adapted from the US Particles
less than 2.5 combustion in motor annual 98th percentile of E n v i
r o n m e n t a l micrometers in diameter vehicles, at power
plants, values at designated P ro te c t i o n A g e n c y :
(PM2.5) are referred to as and in other industrial monitoring sites
in an http://www.epa.gov/pm "fine" particles and are processes.
area is less than or equal designations/faq.htm#0 believed to pose
the to35g/m3. Do you know the of the air in your ? Here is why you
ignorant is not bliss! PM2.5 city health intelligence Most of us
want our country to become an industrial hub, creating wealth. But
when that happens, you may no longer take innocent breaths. Air
pollution is such a threat to our health. health & politics
today, July/Oct 2015 23 infographic:www.tceq.texas.gov