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Words of the Day.

Socrates: “My advice to you is get married. If you find a good wife, you will be happy; if not, you will become a philosopher.”

Socrates was a classical Greek (Athenian) philosopher.

Uche H. Okafor

Drug Addicts are the victims.

Philip Seymour Hoffman was a talented American actor and director. He was also an Academy Award Winner. It was therefore a shock when it was announced that he had lost his life to drug addiction. Large amounts of Heroin and a number of prescription pills were found. This was one of the many tragedies that had befallen individuals due to the use of illicit drugs and abuse of prescription pills.
Unfortunately, there is a high possibility that many more deaths could occur in the future as a result of drug addiction. Many individuals now see these drugs as a route of escape from their many problems. The pressure is intense, many had difficult times growing up at home and many have succumbed to peer pressure. It is now common to see people purchase these drugs at exorbitant and ridiculous amounts. Some may resort to stealing to keep up. Celebrities, behind all that classy pictures painted in public, are also significantly affected. We only want to see the beautiful parts of their lives but many are also afflicted with issues of drug addiction. The pressure of keeping up with their new found fame and the associations they keep make them easy targets. These drugs keep them going. A day without these substances feels like a day in hell. That is what addiction does. In many cases, their bank accounts take a significant hit.
I have seen individuals who could not stay at work or continue working beyond 10am if they had not had a stick of cigarette or other substances which they have become addicted to. Codeine seems to be a new trend now. Hence, the popular cough syrup, Benylin (with Codeine) is no longer a cough syrup. When you see someone practically drinking that cough syrup repeatedly like his or her life depended on it, you will get a better picture of what I am trying to say.
The dangers of drug addiction cannot be over emphasised. We now know that addicts, whether friends or foe, take these substances together. It is not uncommon to see more than five addicts sharing needles to get these drugs injected into their bloodstream as this way it has a faster onset of action. Sit back for a minute and think about the dangers of that alone. Then you begin to understand the implication. These drugs can cause respiratory depression and even death if the individual is unlucky. If the individual is relatively lucky, so many diseases could be gotten from sharing needles and syringes. These include various forms of Hepatitis Virus, HIV/AIDS and many others. Many also end up engaging in unprotected sexual practices which are usually unplanned because some of these drugs fuel sexual desires.
I’ve been made to understand that there are many drug rehabilitation centres in Nigeria but the big question is, how many of them function at optimal capacity? Or better still, how many of them function at all? It is not uncommon in the Western World to see addicts get admitted in rehab centres for long periods as they seek help. There seems to be a conscious effort to try and assist them in getting over their addiction. Many are lucky and never relapse. They come clean and ultimately, a life is saved.
Over here, it is not so straight forward. Only very few people (mostly health professionals) have an idea of where the rehabilitation centres are located in the country. And many of these centres only act as artifacts, as an avenue and means to steal public funds rather than been a tool to help these troubled individuals. We also do not have a quality programme which effectively educates individuals on the dangers of consuming these illicit substances and informing addicts of how and where to seek help for their addiction. We only have few posters and billboards thrown hundreds of kilometres apart nonchalantly telling us that drug kills and that it is also an offence to take them.
Sadly, rather than offering help to these individuals, drug addiction has been criminalised. Anyone seen taking these nefarious substances are arrested, locked up and subsequently beaten. Could they have been taken to one of the rehab homes? Arresting an addict does not cure the addiction. It is common knowledge that members of the law enforcement agencies are not exactly saints. Individuals arrested for consuming drugs could be released after paying a “token” to these officers of the law. Hence, some never get to court. It ends at the police station. He then goes back to his old ways until he meets his end.
Drugs are illegal but the major culprits should be those who ensure these drugs remain in circulation. Tougher sanctions should be meted out on drug dealers. They are perhaps an important reason this trend is on the increase. Drug dealers do not kill people but they provide them a mean which could take their lives and hence should take some form of responsibility.
Russel Brand, a drug addict in recovery, summarised it nicely. In his words,“If drugs are illegal, people who use drugs are criminals. We have set our moral compass on this erroneous premise, and we have strayed so far off course that the landscape we now inhabit provides us no solutions and greatly increases the problem.”
Philip Hoffman’s death and many others before him reminds us of the fatal dangers associated with addiction. He died alone with no one beside him. Think of those many addicts, the ordinary man or woman who has succumbed to addiction. Addiction is an illness and only when you come to terms with what it does to these individuals will you truly appreciate how grave the situation is; how it kills them slowly and gradually take away everything they have including their fortune, family and friends.
Finally, our youths must be educated on the dangers of taking these drugs and dealers must be clamped down with ruthless efficiency. Addict should be helped to get on the long road to recovery. Functional rehabilitation centres should be established and affected individuals encouraged to use them. As a community and country, our attitude also has to change. They should not be discriminated against.

Uche H. Okafor

Conficius: “In a country well governed, poverty is something to be ashamed of. In a country badly governed, wealth is something to be ashamed of.”

Conficius was a Chinese teacher, editor, politician, and philosopher of the Spring and Autumn period of Chinese History.

In many parts of the world, poverty has become a significant and important member of the society. There seems to be a total disregard of the plight of the masses. The leaders seem more interested in increasing the level of their wealth.
I’m confident things will surely get better. The only problem is when? Soon hopefully.

Uche H. Okafor

Words of The Day.

George Burns: “Don’t stay in bed unless you can make money on it”.

George Burns (1896-1996) was an American comedian, actor and writer.

It’s a new day which offers plenty of opportunities. Let’s grab it.

Uche H. Okafor

Views change quickly in football. It is common knowledge that a football manager is only as good as his last result. Reactions to results at any stage of the season tend to change, swinging from euphoria, anxiety, disappointment and sometimes to pure delirium. It was not surprising to see fans calling for Wenger’s head after the debacle at the Merseyside.
Arsenal was poor today. And that is putting it mildly. The defeat was deserved and very comprehensive too. And that is what you get when your players play as poorly as ours did today. It was a total thumping. The starting eleven today at Anfield was more than capable to give Liverpool a run for their money. They were embarassingly inept, playing like nothing was at stake. When Ozil kept giving the ball away as frequently as he did today, then you realise we were in for big trouble today. All Arsenal needed to do to handle Liverpool’s high pressing was swift purposeful forward passing and use the OX as an outlet. We failed to perform the very basic skill of passing. Today, the players let down the fans, the club and the manager.
Unsurprisingly, my timeline on Facebook and twitter has been filled with fans calling for Wenger’s head on the back of this defeat. In case, we have forgotten, this is the same man who has kept Arsenal close to or at the top for a very long time this season and is currently just one point off Chelsea. It is now a recurring event to see fans slate Wenger whenever we lose and hail him as a genius when we win. He is seen as the sole reason why we have won nothing.
The manager can do very little if his players refuse to turn up or show any desire during the game. It’s one week of preparation thrown out of the window. After all, you can take a horse to the stream but you cannot force it to drink water. This was probably one of those games when the manager would have taken off all eleven players at half time if he had the chance. A worrying aspect in our game recently has been our inability to start as strongly as we did against Napoli. We tend to believe we can up our game in the second half. Do I believe it’s an excellent tactics? Not exactly.
Injuries have not helped either. Perhaps we missed the passion and fight of Flamini with the drive and determination of Ramsey. But no need for excuses. Every team has injuries. It is just a function of how you manage them over the season that matters. We have shown we can do that over the last 6months.
We could have brought in a striker during the recent transfer window. The “Draxler-mania” seems to have died off a bit. But would an injured Draxler have scored five goals today at Anfield and helped us win 6-5? Transfers help but if we cannot bring in quality players, then it is important we bring in short term solutions or no one at all. The difficulty in offloading Chamahk, Park and the World Greatest (Bendtner) must act as a constant reminder to us on how funds can be wasted on wages and transfer fees whenever we panic in the transfer window. Only someone with proven quality or potential to improve should be bought.
This defeat offers valuable lessons. It shows anytime we have an off day, we will be punished. It is high time Arsenal stood up and be counted. For 25weeks, we have managed to stay among the frontrunners, this is certainly not a time to feel sorry and blow this chance. The league isn’t won in February luckily. Man City dropping points today offers hope that this league is far from over and we can have a say in this league if we get our acts right.
Finally, the Arsenal fans must support the team and stop sounding like people expecting an implosion. The players need to give us something though in the next game. Today was a mess. The league is a marathon, and not a sprint. Time to get ready for Man U.
Have a nice day.

Uche H. Okafor

We blame the devil too much.

Our culture and our belief have influenced the way we react to events, especially the very unfortunate ones. We are quick to blame our neighbours for our misfortune. This is especially true if we had recently or previously been involved in a confrontation with them. We place the blame for all the series of unfortunate events that befall us on them. We have been told of how witches fly at night looking for innocent people to prey on. We are told of how a powerful and wicked medicine man derived joy in afflicting people with illnesses and ensured that calamities befell different people who crossed his path. It is also not uncommon to be told of how a man “blocked” the destiny of a young man, making sure that the man never progressed in life. This could have been a young man who was lazy to work while others were working. It could have also been a man who rejected the chance to grab quality education like his peers when the opportunity arose. We have grown up to be told of stories of how our grandfather was killed by his young brother over a piece of land. Our grandfathers may have been old, may have been men who drank to stupor, who took tobacco in different forms and may have been obese as well. Could all these have predisposed him to a stroke or any heart diseases?

Our grandmothers may have been wealthy, a big-time trader. Suddenly, she may have different some vague abdominal discomfort over the years and vaginal bleeding at some point in her life. She may have also had a running battle with her neghbour at the market where she sells her goods. When her health began to deteriorate, we quickly looked for a scapegoat. Her neighbour just had to be the source of her predicament. She was jealous of our grandmother’s success and couldn’t stand the idea of seeing her make such progress in life. It seemed like a very convenient thought. We push the blame to her when she passes on; her neighbour may have been taken to different shrines to swear that she was not responsible for the old woman’s demise. Different concoctions are prepared for her to drink at these shrines, concoctions which may be too toxic for her liver to metabolize. When the concoction kills her, we beat our chest and say with certain but ignorant authority that she was responsible for the death of our grandmother. Could our grandmother have had a problem with her reproductive organs? Could it have been a cancer or a tumour? Could she have had an ovarian cancer or endometrial cancer or what have you?

Over the years I have come in contact with people who have found it very convenient to blame their misfortune on someone else. I came across a young lady few years ago who had brought her five year old son to the hospital due to the little boy’s inability to walk for a few months and a swelling on his back. The little boy had Tuberculosis of the spine. During our chat, I tried to enquire if the boy had at some point in his life had cough for a long time. And then the story began. She told me about her old landlord who hated her and her husband. She said her landlord had made up his mind to take the little boy’s life. He had a cough for about three months which deferred all orthodox and unorthodox medication. The boy was however never investigated for tuberculosis. They even went to various churches all to no avail. She later met a prophetess who told her the man who owned the house where they lived was responsible for her son’s predicament. They moved out and after some months, the cough subsided and stopped. Hence, she “confirmed” what she was told. But what has happened over two years was that the bacilli responsible for the tuberculosis had quietly and skillfully spread to the spine. All attempt to convince her that her old landlord had no hand in that cough proved abortive and swiftly fell on deaf ears. In this case, she has erroneously blamed a man, who she sees as the agent of the devil, for the chronic cough her son had.

My sister and I got into a discussion a couple of weeks ago. She was sad and felt sorry for a young lady who had lost her life to breast cancer. Like every cancer, the prognosis of breast cancer is better if it is detected early. A lump in the breast should be an alarm signal for every lady. It should be a reason to see a doctor quickly to get investigated and seek a definitive cure if available. In short, the earlier the better. No drama. Unfortunately, the first thing some women in this environment tell their doctors when they are told of the diagnosis is “It is not my portion. The Lord I serve cannot allow me have Breast cancer”. They are carried away by the religious programmes they watch on television, how women have found cure to their problems. Don’t forget, these pastors even claim to have cure for HIV/AIDS. They practically spend the next one or two years in churches seeking divine touch and favour. They drink numerous bottles of anointing oil, kegs of holy water are sprinkled and they are “transferred” to the supernatural realms. They, however, return to the hospital when it has metastasized (spread) to other vital organs including their brain. At this point, there is no way back. Can I ask a question? Is it fair that such women end up blaming the devil for such final but fatal outcome? Don’t we blame the devil too much? Such deaths could have been avoided.

Have you had of the concept of the “Hebrew woman”? I was educated on this phrase this year. When I heard it for the first time, I was curious; I really wanted to know what it meant. And then I was educated. A Hebrew woman in our local setting here is used to describe women who were able to give birth to their children through the vaginal route and not through caesarean section. I later got to find out that this was a thing of pride for women here, especially the uneducated women. For them, it was vaginal delivery or no way else. It is not uncommon to see a woman who has had about two or three previous caesarean section insisting she wanted to give birth to the next baby via the normal vaginal route, regardless of the fact that having that number of previous caesarean sections is an absolute contraindicated for vaginal deliveries. But for her, it is so important for her to enter the “league of Hebrew women”. So they try to avoid the tertiary health centres and specialist hospitals. They go to traditional birth attendants or midwives who may agree to supervise such vaginal deliveries at little cost. In most of them, there are almost always complications, the most important of which is uterine rupture and is usually associated with severe blood loss. Many of these intending Hebrew women lose their life and that of the baby even before they can get access to a doctor who can do an emergency caesarean section and/or hysterectomy. Her children are left behind with a father who is never at home. He may get married to another woman. He needs someone to take care of him, his house, his children and someone to warm his bed at night. She comes in and has her own children and may end up maltreating the children of the late woman. The late woman’s children face an uncertain future and severe hardship. The woman has lost her life because she failed to do the simple thing she was asked to do.

Finally, I recognize that there may be bad people everywhere who derive joy in other people’s downfall. I understand that fact. I also know that some people may actually never rest until they bring us to our feet. But in most cases, almost every time, we have control of our destiny. It is high time we stood up, took responsibilities and did the appropriate things that define the course of our destiny. We must as a matter of urgency begin to realize this and stop placing the blame solely on the feet of our neighbours who we feel do not like our faces. Our neighbours may be too occupied thinking of their problems. The fact they do not reply when we say hello does not mean they hate us. They perhaps have too many issues to think about. I feel blaming the devils and others for our predicaments all the time is weak. Do you think so too?

 Let me know your thoughts.

Uche H. Okafor

Nigeria: My Utopian Dream?

To say Nigeria is a complex nation is putting it mildly. Whenever you have a country made up with people with divergent cultures, religion and views, there is always bound to be some form of conflicts and disagreement especially if the tolerance level of all its citizens isn’t exactly topnotch. The unity is often tested and decisions we take especially when it comes to elections usually depend on several factors. Most of the time, we seems to be more bothered about where the contestant comes from rather than on his ability to do the job. A Yoruba is more likely to vote for a Yoruba man or an Igbo man doing same for an Igbo contestant and this is done with total disregard of the consequences of voting a leader who is inept, inexperienced and one without a well thought out planned.

Therefore, a man who has no experience whatsoever or has no plan could win an election, not because he delivered a wonderful manifesto, not because he was able to convince the electorates that he was the best candidate available. He would win because he had the advantage of coming from a particular ethnic group who feel it is ‘’their turn’’. Hence, we are so comfortable voting mediocrity and ineptitude above common sense and competence, choosing a man or woman even if he has shown clearly with his actions in the past that he will be a disaster.

I watched with interest as the events leading up to United States Presidential election unfolded. I saw two men with great ideas go head to head in their quest to become President of arguably the greatest nation on earth. With every debate, the American people really understood what each of them stood for and were able to make informed choices and decide which path they wanted their countries to follow. It was not important to them that Barack Obama was from Chicago or that Mitt Romney was from Massachusetts. It did not matter to them if one of the contestants had a Kenyan father. All they wanted was a President they felt convinced could do a great job; a president who could feel their hearts beat and one who would work his socks off just to ensure that things got better regardless of the approach he decided to take. While the debates and campaigns were going on, you could see two men who were genuinely concerned about their country.

 In Nigeria, the story is not usually straight forward. Presidential candidates skillfully avoid presidential debates because they really have no clear agenda on how to make a nation or state forward. Their campaign rallies are stage managed where people are given hundreds or thousands of naira; some are given cups of rice, beans or various items. During the election campaign, an important aspect of the candidate’s speech is normally that his senatorial districts or an ethnic group has never held such position. You will not be surprised to find out that such people have no clear plan on how they intend to run the office if they are elected. We are persuaded to choose them simply because they come from a certain area. The zoning policy often never brings forward the best candidate. The man who is willing to die for this country never gets the chance to contest for two major reasons. He may not come from the geo-political zone to which that position has been zoned to. But most importantly, he is almost never chosen. The candidate who is allowed to contest is usually chosen from the elites and by the elites. When he gets into such positions, he is expected to keep fueling the bank accounts of these elites who have handed him the ticket to such office. Hence, funds which should have been spent on an entire nation ends up in the bank accounts of these political “godfathers”, “godsons” and their cohorts.

Unfortunately, the men who have clear ideas on how to move the nation forward may never get the chance to do so. This is because sometimes, the geo-political zones they come from may only be qualified to get such positions after about twenty years or more. In that time, he is likely to keep lobbying to ensure he remains relevant when that time comes. He becomes compromised, money changes hands and his ideals and belief are thrown out of the window. He soon understands that to get to that position, he must do what others do. He could be lucky to get a government appointment and he embezzles funds running into billions of naira which he intends to use to fuel his campaign when the time comes. Therefore, a man who only dreamt about changing his country could lose his way and become like one of them. The reality of the situation in our country means that the best man never gets the job.

We have also not helped matters really. I have come to realize that most citizens of my country are more interested in how colourful a man’s posters and billboards are. We are also more concerned about how much the man has and how much money he has to throw around during the campaign. Nobody really bother about how his policies, if he has any, will affect the lives of the citizens and children yet unborn. That is the problem we face. Have we ever sat down to look at the bigger picture and complete package? What does this man has in stock? Does he have a plan to improve the standard of education in the country? Will young graduates be able to compete for job positions with people from other countries by virtue of the quality of education they have received? Will poverty remain a regular and constant fixture in our environment if he becomes president or governor? Does he or she have a plan to tackle the issues of power supply in our country? And more importantly, does he have an idea about how to keep us safe? These are just few of the questions we fail to ask and we do not seem interested in getting the answers.

A frightening occurrence I have noticed is where politicians get people to register in a state in the months leading to the general election. Voter identification cards are then exchanged for stipends, usually not more than few thousands of naira and little refreshment. This offers the politicians an opportunity to manipulate elections in their favour. Armed with those cards and stolen ballot boxes, they get down working with their thugs and stuffing these stolen boxes. Unfortunately, all these are done with the aid of the electoral officers, the same body or individuals who are meant to be the fair umpire that ensures we have credible elections. Come to think of it, will any man or contestant hand over such money to voters just to win elections if he has no intention of embezzling funds when he gets there? Will he ordinarily part with such amount of money if he was not involved in an election process? He is only taking advantage of the unbelievable level of abject poverty in our society to get into office and when he gets into office, he will see to it that he gets richer than he was before the last election. He is expected to settle those big wigs who got him into office and also keep enough funds to repeat the process when he seeks re-election.

I look forward to seeing my country make hard changes. I hope that we do not listen to people who will come forward and tell us that their ethnic group, senatorial zone or local government area has never held certain position and hence it should be their turn to get the seat even if they do not have someone who is adequately qualified to hold it or someone who has an idea of what the position entail. I look forward to a time when people from Nigeria will vote for a candidate who has proven beyond all doubts that he can handle the pressure of leadership positions and still chart a course towards prosperity and progress; a leader who understands that crude oil should not be our only source of significant revenue generation. Can we have a leader who is sincerely and genuinely bothered about the level of stark unemployment in the country? Can we have a leader who can convince young individuals with his actions that the grass is not greener in foreign countries?

Finally, if we can get over this hatred religious groups have for each other, if we can as a matter of urgency get over the distrust ethnic groups have for each other, we can make giant strides. If we can look at the bigger picture and realize that our brother from our village, town or state is not necessary the best candidate and then admit it by voting for someone else who is better suited for the job and more qualified, nothing can stop us. If we can look beyond the cups of rice and beans we receive during campaigns from these corrupt politicians and the money we receive to sell our votes and ask questions and decide which direction we need to and must take, we will make progress. If we can get to a point where a Hausa man will vote for an Igbo man, an Ibo man vote for a Yoruba man or a Yoruba man vote for a Hausa man even when someone from their ethnic group is involved in that same election, our country will be better. A lot of people, like my friend Andrew, think all these happening are synonymous to utopia but I am hopeful. I am an idealist. Things would never change without effort. It starts with us. The time is now.

Uche H. Okafor

IMG-20121012-WA0002

I am not normally very observant, but who wouldn’t observe this. I had gone to the market with my friend to buy foodstuffs. We wanted to celebrate her 24th birthday the next day with African salad and “ugba” (Oil Bean). We decided to go to the big market at Nnewi in Anambra State. Her boyfriend had sent her some money from the UK to celebrate. When converted to our local currency, it turned to be quite a lot of money.

However, regardless of this, we had to do the obligatory “pricing”- bargaining on every single item we needed until both the buyer and seller were worn out. Funny thing is that a lot of what we bought was condiments, in the price range of fifty to one hundred naira, yet we would price to the nearest ten naira. At some point, I got tired and asked my friend to keep moving while I stayed back at one of the shops where we purchased some items and watched our bags. Apparently where I decided to pitch tent annoyed her neighbour, who bluntly told me I was blocking her goods from the view of passers-by. Pointing to a seat at the corner, she instructed that I move our bags to a different position and sit down. Slightly peeved, I moved the bags but refused to sit on her bench, choosing instead to sit on one belonging to the lady who had sold an item to me earlier, just as a show of defiance.

Few moments later, I had forgotten about it all and my mind was miles away. Then something happened. Some women across the road were trying to pass a message to the woman who had asked me to move. The market however was too noisy; hence she could not hear them. They were obviously agitated and frantically moving their goods but she unfortunately still did not understand or realize what was unfolding around her. Suddenly two hefty men- one pushing a wheel barrow came to her stall and seized  goods she left by the roadside. In retrospect, the women were trying to warn her to take her goods off the roadside and into her stall because that was the market regulation. The goods that were seized included a tray of ukpaka, among other condiments, the sum of which could have amounted to about one thousand naira. In the middle of that chaos, they put the goods into their wheel barrow, all the while shouting and were about to zoom off when the woman started struggling with them. She was not going to let them seize her goods without putting up some form of resistance.

To my surprise, these young boys pushed the woman to the floor and when she got up, pushed her a second time and zoomed off. She returned to her stall visibly angry and shaken, raining curses on them and threatening to call down whichever authorities. At that moment, I began to wonder. I had always thought that the less privileged and the young ones in our society and Ibo community specifically, were more respectful of their elders. I still think so. I just know now that the scramble for money can cause anything. Here is a woman old enough to be their mother. But more importantly, here is a woman whose profit for a month may not even be enough to purchase those items that were seized. I suddenly felt very ashamed of myself for bargaining to the last kobo. After all, the ten naira that I spent a minute trying to beat is worth much less than a minute of my service.

If, like me, you find that you are one of those who sometimes tries to beat the price of goods from traders who are much worse off than you  are, maybe next time you should reconsider and just leave that negligible fifty naira for the trader. It will go much farther in serving her family. If you would not leave it for compassionate reasons, leave it because you have a semblance of pride.

Enjoy your day.

 

 

MaryAnn E. Umeche.

Works at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra.

   

Hear All Evil But Say Nothing

Life is full of choices and secrets. The life of a doctor is unique. Having the knowledge, skill and expertise to keep an individual alive or prolong that life is a blessing. In the course of practicing, you learn that certain information about your patient must be kept a secret, regardless of how unpalatable they may be. Many of the things a patient tells you must never leave the consulting room. It is common knowledge that many happy families have secrets littered around which if exposed changes and affects how relatives relate to one another. Many family ties are broken beyond repair because when these secrets come out in the open, there are elements of doubts, disappointments and distrust. Depending on the content, there may be no way back. Questions are asked and we wonder what else is being hidden from us?

Few years ago, I got out of medical school. During the induction ceremony, we were excited to join a group of men and women who could affect lives. It finally became clear to us that our actions or inactions could determine the outcome of a disease and go a long way in determining whether an individual got worse or better.  In the midst of all that euphoria and excitement, right in front of our families, relatives, friends and teachers, we were asked to read the Physician’s Oath. With our hands raised and broad smiles on our faces, we recited with pride in our voice:

·         I solemnly pledge to consecrate my life to the service of humanity;

·         I will give to my teachers the respect and gratitude that is their due;

·         I will practice my profession with conscience and dignity;

·         The health of my patient will be my first consideration;

·         I will respect the secrets that are confided in me, even after the patient has died;

·         I will maintain by all means in my power, the honour and the noble traditions of the medical profession;

·         My colleagues will be my sisters and brothers;

·         I will not permit consideration of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient;

·         I will maintain the utmost respect for human life;

·         I will not use my medical knowledge to violate human rights and civil liberties, even under threat;

·         I make these promises solemnly, freely and upon my honour.

It was quite possible that many of us never really understood the implication of every word and sentence of the oath. We were just too happy to receive the provisional license to practice medicine; our reward for all the physical, mental and emotional stress we had endured while in medical school. I sat down a few days later and thought about that line “I will respect the secrets that are confided in me, even after the patient has died”. The details were clear and precise. The implication was a patient had the right to confide in a doctor and also add that he or she didn’t want anyone, regardless of how close he or she was to that person, to become aware of what had just been discussed in the course of the consultation. I will offer two imaginary scenarios.

Amanda is getting set for her wedding to Dave. The arrangement for the wedding was in full swing and everyone was looking forward to the big day. Dave had insisted there was going to be no sexual relationship until after they had been joined in holy matrimony. He wanted it to be special. However, for almost a year, Amanda had been feeling ill. Symptoms included a recurrent and stubborn cough, fever and unexplained weight loss amongst other symptoms that had become untreatable. He advised Amanda to see his cousin, Amanda, in clinic. Then she walks into the clinic, not as family but as a patient. Then all necessary laboratory investigations are carried out and there seems to be some problems, which luckily can be solved. HIV screening is also done and then there is an even bigger problem. She is HIV POSITIVE. She is told of the result and she is in shock and weeps uncontrollably. When she becomes relatively calm, she looks at her doctor and says, “You must not tell him. If you do, he will leave me. I can’t let that happen”. It must be pointed out that this conversation isn’t an informal chat. She is speaking with a doctor in a hospital. As the Physician’s Oath clearly states, she is entitled to a right to confidentiality. The doctor is in a fix. It is a difficult choice, his patient or his cousin? The oath is quite clear. He can say absolutely nothing unless she wants him to. In countries where litigations are strong and common, he can lose his license if he discloses without the consent of his patient. Later that day, his cousin wants to know how his fiancée is doing and the outcome of the laboratory investigations. The doctor offers him solutions to other minor problems, leaving the HIV aspect, and reassured him that all was well. Unfortunately, he can only advise Amanda to try to disclose to Dave. It’s difficult; he lives with the guilt, knowing that he has kept such vital information away from his poor cousin. Would he have reacted or acted differently if he was his sibling? And would you?

Jennifer has been married for about three years now. However, she has been unable to get pregnant following this union. What her husband is unaware of is that the last time his sweet Jenny saw had her menstrual flow was two years before the wedding (about five years ago). She has somehow managed to deceive him for three years and he actually thinks his wife always has a normal cycle. Five years ago, Jenny had an induced abortion after she got pregnant for a guy she had met at a club. Attempts to find the mystery man when she found out about the pregnancy proved abortive. She had the pregnancy terminated by an auxiliary nurse at a local pharmacy store close to the university she attended then. She had an incomplete abortion with other complications. This was finally taken care of in a proper health facility. But, not everything returned to normal. The damage had been done. While her husband keeps the faith, believing that God’s time is the best, believing in the infinite mercy of God, there is a problem he may never find out. Jennifer is at the Obstetrics and gynaecology clinic to see a doctor because she is under enormous pressure from her mother-in-law and her husband’s siblings to deliver a child. She needs a solution to this dilemma. She tells the doctor the truth and accepts that the problem would certainly be from her. She is however scared of her husband’s reaction if he finds out and insists that this conversation doesn’t get out of the room. She is instead focused on looking for solutions.

The consequences of revealing a patient’s secrets to a relative or friend could be devastating. Families could be broken and friendships lost in the process. This could be ties and bond which have been built over many years. Don’t forget, those we reveal secrets to may be incapable of keeping these sacred details to themselves. They are never settled until they tell a friend who in turn tells another friend. And a chain of communication with connections at different levels is started. Many patients could become victims of stigmatization due to their health status. That should never happen. But you live with the guilt. You know that by keeping these secrets to yourself, you expose innocent people to even greater danger in the future. Unfortunately, they may remain oblivious of the health details of their loved ones for the rest of their lives.

Finally, the job entails you say nothing. Patient can only be advised to disclose such details to their loved ones so that they too can seek help where necessary. They however cannot be forced to reveal these sensitive details if they do not wish to do so. The final decision ultimately rest with the patient. If they vehemently refuse, then for the doctor it’s a case of ‘’hear all evil but most importantly say nothing’’.    

 

Have a good day.

Uche H. Okafor.

Offer A Hand

Several weeks ago, I got into a thought-provoking discussion with a Lebanese man whom I had come across in my line of duty. During our conversation, he told me about how he had stayed in Nigeria for quite a long time, twenty four years to be precise, and how he actually felt like a Nigerian. And then he said sometime. In his words, ‘’one bad thing about Nigerians is that you people like to spend money on burial ceremonies than on treatment’’. I sat back and thought deeply about what he had just said.

He made a point; a very valid point. It is common to see people die in hospitals simply because they couldn’t afford the cost of treatment either in terms of purchasing drugs or doing laboratory investigations. Such drugs and results of laboratory investigations could have gone a long way in affecting the outcome of the disease positively and improving the prognosis as well. When such men or women die, members of their nuclear and extended families hold series of meetings on how to give such individuals a befitting burial. An expensive casket, made from quality wood and glass, is purchased sometimes running into tens and hundreds of thousands of naira. The cost of the cloth the dead man or woman will put may actually be enough to pay for some of the laboratory investigation or purchase some of the drugs which could have prolonged the life of the deceased.

Furthermore, the amount required to provide food and drink to ‘’celebrate a life well spent’’ is frightening, sometimes even absurd. And then there is the small matter of the “Aso-Ebis”. So when you take stock of the amount spent in planning a burial, you realize that the cost of keeping an individual alive is much cheaper when compared to carrying out the funeral rites. This is even more perplexing if the cause of death is an illness that could have been cured with a fraction of the funds which would be spent on the burial ceremony. And we all sit there, mourning vigorously, giving eulogies about a man or woman whom we did little to save. Making and giving speeches about a man who lived a good life and stating further: “God gives and God takes, He knows best”.

So I sat and wondered.  Could such funds have been diverted to paying the bills and give the individuals a good shot at survival? Do we feel that giving a man a befitting burial is much more important than keeping the man alive? Does an expensive casket translate into a life well spent or will that show gratitude to God for a life well spent? Will the dead man look down from heaven with gratitude for the efforts his relatives put in to ensure that his burial remains the talk of the town for weeks, months or even years to come? So, while a man, who died a pauper, is lying in state in his transparent glass coffin, we should sit back in the midst of all the euphoria and ask ourselves some questions. Were we fair to this man? Could we have done more for him? Or do our actions portray us as hypocrites?

It is common knowledge that many people see opening churches as a huge investment with potentials for profits. Certain people see it as an avenue to generate limitless funds. Nowadays, pastors buy the most expensive cars and private jets with reckless abandon while members of the congregation live in abject poverty. In case you are unaware, many of those individual live a life of uncertainty, unaware of what the future holds. They think every day, how do I provide the next meal for my family? How do I pay my little child’s school fees or pay for her medical bills if something goes wrong? What about the utility bills and the next rent? How long will I be able to put a roof over my head? Will I ever become a proper bread winner? While these pastors preach about faith, hope and prosperity with their clean and well starched suit at the pulpit every Sunday, many of those they preach to continue to wallow in abject poverty. Don’t forget, you are expected to sow ‘’series of seeds of faith” and more importantly, different covenant seeds because we need to be in a covenant with God. The common rhetoric is if we do all these, we will be his responsibilities, he will let no harm befall us and will provide all our needs according to his riches in glory. These various collections at the church further dwindles their lean purses.

So I thought to myself, can’t these pastors and churches be that source of blessing to members of the congregation. For examples, can those seeds of faith be used to provide clothes, food and perhaps funds to clear bills for people that are impoverished? How will a private jet or expensive cars driven by a man of God affect the life of an individual positively?  This is not to say that religious organizations are not offering a helping hand. I believe that they can do so much more. Can more churches and mosques offer scholarship programmes to intelligent youths whose parents cannot afford to send them to the university? The fact that the most expensive tuition fees are being charged by institutions of learning owned by religious bodies, says it all. Can committees be set up within these religious bodies to tackle poverty and bring it to its knees? Can they attempt to offer hope to those who think that their tunnels have no end, not to mention light? Can they?

The news of music producer OJB’s poor state of health has spread pretty quickly. Some renowned entertainers have offered some form of assistance to save his life. He is lucky that he is/was a star. If he wasn’t, then his chance of survival would have been bleak. If he was an average Nigerian with a kidney problem, would D’Banj have offered N7million? Would Don Jazzy have offered a support of N1 million, not to mention P square and others?

Finally, it is high time we realized that we are nothing without the next guy. We need a hand to keep moving and someone close to you may just need your hands to help them steady their feet and set them on a path towards prosperity. Hopefully, we will offer a helping hand to others regardless of their social standing, and more importantly, in times of difficulty.