31 July 2008

Nigeria: Life Expectancy - Why Country is Not Improving

Lagos — If there is any country that is unserious with the healthcare system and other issues of human interest, no doubt it is Nigeria. Government has so much trivialised all matters, including the lives of the people. Various administrations have come and gone, yet no improvement on the health sector. Promises made by government officials on how to revamp the health sector have ended unfilled.

Government has also failed to understand that there can be no meaningful achievement on the seven-point agenda of President Musa Umaru Yar'Adua, without addressing the multi-faceted problems facing the health sector.

For instance, the Federal Government has recently realised that N37 billion health centre contract awarded by the past administration of former president Olusegun Obasanjo was in error. The contract is said to have been revoked because it did not follow due process. Nonetheless, observers said that even if such contracts had been allowed to be executed, nothing special would have been done.

While the waste in the health sector continues, life expectancy of many Nigerians is seriously dropping, experts said. According to a recent data, America life expectancy has surpassed 78 years in 2006, but it still lags behind 30 other nations. The good news is America life expectancy is improving faster than in the past.

The increased life span, the information said, could be attributed to falling mortality in the leading causes of death such as heart diseases, cancer, accidents and diabetes. A reduction in flu-related deaths, due to a mild flu season in 2005, also helped boost the 2006 statistics. Demographers say Americans may be catching up on leading nations after experience declines in the top 15 leading causes of death. Yet, it's somewhat difficult to comprehend that America life expectancy is similar to that of Portugal, the Republic of Korea, or Cuba, according to World Health Organisation (WHO) measures.

But in the case of Nigeria, WHO reported that the average life span of Nigerians is now 47. This is a drop of 20 years from the previous report in the 60s when the average life span was 67 years. Whichever way, there are Nigerian experts that has solution to some of these problems challenging the country's healthcare. One of such experts is Prof. Udoh Obioha, a Nigerian born-American trained bariatric physician. According to him, solution to these age-long problems also requires the political will of the government and the contributions of experts to turn things around.

He said if the life span of most Nigerians should improve, there should be accurate diagnosis of ailments, something that is obtainable in other developed countries. He said laboratory test of patience's specimen contributes about 80 per cent successful management of the illness, saying that if there is no laboratory test and accurate results, doctors will depend on guess work which might eventually lead to wrong judgment and death.

"Most untimely death of patience in the country is largely due to wrong diagnosis, because treatments do not go with diagnostic tests, and even if they do, most times it is diagnosed for a different thing. The Nigerian doctors in diaspora working at countries with good healthcare system are making these diagnoses early because they have the diagnostic backup. Whereas, in Nigerian doctors sometimes miss the point because they lack the equipment," Obioha said.

According to him, he has witnessed a lot of complaints from individuals who had such misleading results. He said most life threatening diseases can be treated with minimum amount of money if the healthcare infrastructure is put in place with equipment to detect ailments accurately and timely.

In a comparative analyses between Nigerian and the U.S, he said currently there are only 20, 000 practicing physicians and surgeons in a country of about 140 million people, and most of these practicing surgeons and physicians he said are house officers and NYSC doctors, who after service, leave the country for greener pastures.

On the other hand, US with a population of about 300 million people have over one million practicing physicians and surgeons. However, the country's healthcare, he said is in crisis, and requires serious and urgent attention to rescue it from total collapse if the people must attain a considerable high level of life expectancy.

He said it is no longer news that Nigeria was rated as the third worst healthcare system in the world after a survey of 200 countries was conducted by WHO. Nigeria healthcare system, Obioha said was only better than two countries, namely, Sudan and Somalia which were in civil war.

Liberia and Sierra Leone which has fought two decades of civil war according to him has better healthcare systems than Nigeria. The situation, he noted is really pathetic and calls for urgent intervention before the productive population is decimated by preventable diseases such as cancer, hypertension, obesity, cardiovascular diseases, among others.

Speaking on some of the issues mentioned as factors that decrease life span, he said cancer is an issue of paramount concern because of the havoc it has caused to most Nigerians in recent time. He said early diagnosis of cancer can be carried out by annual physical examination for three most common cancers in the country. These include, breast, prostrate and colon cancers.

"These can be detected by annual physical examination which will consist for the breast, mammogram. Then for colon, a yearly conoscopy and for prostrate cancer, a yearly prostrate specific antigen (PSA) tests for men. Without the basic infrastructure in the healthcare system, we will continue to lose people at a very early age," he said.

For obesity, experts said it is bad news for both the body and mind. Not only does it make a person feel tired and uncomfortable, it can wear down joints and put extra stress on the other parts of the body. When a person is carrying extra weight, it's harder to keep up with friends, play sports, or just walk between classes at school. It is also associated with breathing problems such as asthma and sleep apnea as well as problems with hips and knee joints that may require surgery.

Nonetheless, to tackle the multi-faceted problems created by obesity, which has become a common sickness in the country, the bariatric physician said obesity is a serious chronic disease. He defined obesity as an excessively high amount of body fat in relation to lean body mass. Put differently, he said obesity is an excess of total body fat, which results from caloric intake that exceeds energy usage. Measurement used to assess health risks of obesity is Body Mass Index (BMI). Obesity he said is the second leading cause of preventable death followed by smoking.

The environment from Obioha's point of view exerts much pressure on people than what it used to be. "The environment is over-empowering the genre, which is called toxic environment because it is loaded with a lot of toxic foods, alcohols, high dense fats and a lot of processed and refined carbohydrates with no fibres.

"People are not eating enough fibres, which has led to chronic degenerative diseases. People who lived before us had to fight against infectious diseases, not this type of diseases we are dealing with today. Because the complications are very expensive to treat, what we should be doing is to start awareness creation from primary and secondary schools, then to the tertiary levels," he said.

Apart from environmental causes, they are other predators of obesity which he enumerated as follows, low metabolic rate, low fat oxidation, sedentary lifestyle and low sympathetic activity. Others are low socio-economic class, overweight parents, insulin sensitivity and cessation from smoking.

There is no sickness from Obioha's point of view that can not be treated in Nigeria, especially weight related problems. His temporary stay in the country, he said is to see how he can contribute his quota towards improving some of the healthcare challenges facing the country. With more than 27 years of experience in bariatric medicine, he has helped thousands of people reach their weight-loss goals especially in the US.

The health sector according to experts is non-existent compared to what is obtained in the developed world. They also identified complete non-existent of emergency clinics and diagnostic centres, a situation they said requires emergency.

"People die as a result of minor things. For instance, a gun shot on sensitive part of the body or accident, and other serious attacks will automatically lead to death because there are no emergency treatments to rescue such a person. When we talk about emergency treatment, we are not talking about buildings and ambulances inscribed with 'emergency' on them. No, we are talking about the experts and equipment prepared to rescue lives.

"A think-tank committee, comprising people who have international healthcare background should be constituted by the government. There are thousands of doctors in Nigeria who want to transform the healthcare. Such people should be given opportunity to make things work," Obioha said

But in as much as some of the leaders prefer to travel abroad for medical check-up and treatment of minor diseases, the country will not get it right health wise. There is need to increase the life span of Nigerians, just like other countries.

According to Dr. Emeka Ozokwelu, a gynecologist, the life span of most Nigerians will increase when there is adequate investment in hospitals, in terms of provision of modern equipment. He explained that banks and multi-national organisations can invest in hospitals that show high level of seriousness by providing modern diagnostic equipment and resources.

He said there is need for government to show more political will and discourage government officials from traveling overseas for medical attention, which ordinarily they can do in the country. He said that can not be achieved when there are no modern equipment like CT scan machines which he said is expensive.

The health insurance policy which is in progress Ozokwelu said should be pursued vigorously and sustained. "Every other aspect must be improved. There are certain delays that increases high mortality rate in the country. The traditional health attendance, Churches and also Nigerians living far away from medical facilities, affect so many things and reduces the life span of Nigerians. Others are bad roads, lack of modern infrastructure and power supply, among other things," he said.

He however advised Nigerians to learn how to relax in order to reduce stress, which could arise from a lot of factors such as long traffic jam, power outage, poverty and other threats to life. Health education, he said is important and should be designed to help people know more about their health, new drugs and eating habits.

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