First Lagos Uber ride.

So,t oday I got my first Lagos Uber ride.

Yeah, not the first…But a Lagos first!

Gave the driver a five star because in the craziness that Lagos is, getting me to the programme ahead of schedule was commendable.
So , I thought to share with friends. 
Instead of taking the regular taxis when going from mainland Lagos to the Island area… Lekki for instance, you can simply pick an Uber. Click on the link and you can get N1000 towards your first ride.
You will need a GPS enabled phone and the Uber app; which you can download from  Google Play Store.

Install the app and follow the instructions to get your first ride.

Now , I did not take a photo while in the car, because I did not want to embarrass the cool driver as well as myself . Now , isn’t that hilarious?
So , instead, you get to see my face… a little bit #smiles… Heading back to base here … Lagos and I do not gel so well…#sadface
Ciao!

#SaveNaijaHealthcare: the genesis…

This evening I really do not know whether to cry or just mope…

I will instead tell the story of the genesis. Perhaps , we will have some well meaning Nigerians who will take it upon themselves to #SaveNaijaHealthcare.

Nigerians deserve to know the truth… About the major reason why healthcare in Nigeria sucks. There is a major conflict in the Nigerian healthcare sector and teamwork is a dream not even shared by up to 50% of healthcare staff.

FMC Owo, was where I first experienced this firsthand. A Pathologist , Dr Omotayo refused to allow the then CEO/Registrar of the Medical Laboratory Science Council of Nigeria (MLSCN); Prof. Emeribe access into the Histopathology lab. Prof. Emeribe was there to inspect and accredit the facilities which were being used for training students and interns as well as render services to Nigerians.

This inspection like the PCN (Pharmacists) is a statutory function of the MLSCN.
It was that day I learnt that in Nigeria , if you are a Medical Laboratory Scientist on Level 15, you can not be the HOD of the Department so long as there is a Doctor even if he is on Level 12… 

Until recently when an NICN judgement proclaimed MLS as a distinct profession, able to self administer herself; this was the status quo. Many versatile MLS that could have made the Nigerian Medical Laboratory space a pride to behold have been handicapped.

Would you believe that shortly after that incident Prof. Emeribe was removed as the Registrar , MLSCN and a ban placed on medical laboratory inspection in Nigeria?

You say wow, right?

So, the proliferation of substandard labs , which are operated by quacks and charlatans is a direct result of this.

Many times when I want to make posts about #UHC4AllNigerians, I pause …
Because…
The sad truth is the hospitals available to majority of the masses are moribund messes… Incapable of giving appropriate care at an affordable cost. Instead , patients get diverted to private facilities not even as good as the government ones.

The maintainance of quality and appropriate standards is rarely the concern of most of the administrators. 

Do you know who they are? Some Medical doctors who act like they belong to a cult and seek to upturn the wheels of justice.
You do not believe?

Please read the first letter (photo 1) , then read the following conversation, followed by the second letter (photo 2)

Have you read the letter in Photo 1?

Then , please read this next one (copied below): 

Copied from Mdcan blog

[17/04, 06:47] The CMD of NAUTH Nnewi, last two weeks appointed a Laboratory Scientist as Director of Laboratory Services in the Pathology Department of NAUTH Nnewi. 
He did this without informing me or NMA, and without informing MDCAN or Pathologists. 
He, then, created the Office and put the logo of NAUTH with the title of Director of Laboratory Services, at the door. 
Then, he called the Pathologists to a meeting and informed then that, henceforth, all letters to Pathology will be routed through their Director. 
When he was asked by the Pathologists the reason for his act he had 3 lousy reasons to give:
1. He was written, by a lawyer, to explain his reasons for not complying with the NICN Ruling on MLS Services and Department; and that he did not want to ignore the NICN Ruling, so he made the appointment;
2. He was scared of threats to his life;
3. He did not want to allow an industrial unrest in NAUTH. 
All three reasons are empty and lousy depositions, because the anti-theses are more cogent than all his theses. 
The Pathologists never informed the NMA; but, it appeared that someone told MDCAN NAUTH, who went last week to see the CMD. When a further enquiry was made on the outcome of their meeting, the MDCAN said that the CMD had assured them that the Laboratory Scientist, without a Directorate or Department of MLS, was only due for promotion to the post of Director and that was what he did. And that there was *_no cause for alarm_*. 
I only heard all these thrash two days ago, through a reliable whistle blower on ground; and so, I sent a quick message to the CMD asking him the import or indications for his anti-professional act. When he was not forthcoming, he has not responded till now, I escalated the communication to my SEC. And a concatenation of NMA activities became activated. 
It was only then, that the MDCAN NAUTH Chairman decided to call for an Emergency Meeting in a week’s time (Friday 21/04/2017)!!!!!!; and to us, that was woeful. 
On account of this conspirators tardiness, I have summoned an Emergency NMA SEC for 48hours’ time (Tuesday 18/04/2017) and made contacts with the National NMA and MDCAN and given them my update. 
I have also advised the NAUTH MDCAN EXCO to resign, _en masse_, by Tuesday, while asking our Ethics and Disciplinary Committee to dust up her papers. 
Just recall that the ruling of NICN on this issue in JUTH is under appeal with a stay of execution and that what the CMD has done is contempt of court. Even at that, the MDCAN SAN had applied to be joined in the original case against the FMC Asaba, while appealing the ruling in Jos. 
The National body of Pathologists, I was informed, is fully aware and embarrassed by the events in NAUTH NNEWI, and has prepared their local group for a meeting with the CMD on Tuesday (18/04/2017) afternoon. I have advised the attending MDCAN team to that meeting to ask the CMD to cancel and withdraw the Appointment Letter to the Lab Scientist and shut down that Office before any further talks. And to have their EXCO resign _en masse_ after that. 
In between we have been going to Court with agents of the State Government for frivolous tax demand notices. Just yesterday afternoon we had to release a colleague locked up by officers of the State CID on accusations of murder, just because a mismanaged patient who was referred to his clinic died at resuscitation. 
In the midst of all these, the CMD preferred to work against a profession under my watch. I guess you can appreciate the tasks that are engaging me at Easter.

#copied#

The result of the above is the letter in Photo 2.

The other day when a friend ; Dr Chukwuma Oraegbunam was advocating for peace and unity among healthcare professionals on another post I made celebrating the Biomedical Scientists Day, little did I know something else was brewing.

At this point it is crystal clear that the Ministry of Health in collaboration with the Nigerian Medical Association do not really care about Nigerians getting the best healthcare possible. An unbiased Ministry of Health would obey the NICN court judgement . Do you know that as we speak there is no Directorate of Medical laboratory services in the Ministry of Health? There are just too many anomalies which are undoubtedly contributors to the pathetic state of Nigerian Healthcare. 
The Association of Medical Laboratory Scientists deserves commendation for going to court successively , winning the legal cases and going through the process of getting justice by the rule of law. 

The people who seat and continue to thwart justice , should know that though justice may be slow… It always comes…

One big question begging for answer now is “who will #SaveNaijaHealthcare?
Can President Buhari be the one ? Or do we wait for another?

What is all the fuss about?… Read to find out!

The 15th of April each year is observed as International Biomedical Laboratory Science Day since the first edition in Oslo, Norway in 1996.
The day is set aside by International Federation of Biomedical Laboratory Scientists to enlighten the public on the crucial role the Biomedical Laboratory Scientists also known as Medical Laboratory Scientists play in health care services, health research, health administration and management.
In Nigeria, medical laboratory scientists are trained and certified professionals who studied medical laboratory science for 5 years and subsequently undertake a one year compulsory internship, which is a thorough practical drill on general laboratory practice. Upon completion on internship, the graduate medical lab scientist proceeds for one year national youth service corp. In Nigeria, they are certified and licenced by the Medical Laboratory Science Council of Nigeria
The theme for this year’s Biomedical Laboratory Science Week is Antimicrobial Resistance: Biomedical Laboratory Scientists Respond to the Global Threat. Antimicrobial resistance is today a major public health burden.
 Microorganisms are modifying their genetics to alter their susceptibility to hitherto effective drugs. This phenomenon is aided by:

1. The overuse of antimicrobials. People take medications without due prescription by licensed professionals. It is unfortunate today that all sort of professionals today prescribe drugs to unsuspecting patients. 

2. Another reason is medication without prior laboratory tests. Unless a lab confirmation of an infectious agent is established, any treatment initiated amounts to guess work and can predispose to drug resistance. Prescriptions without lab confirmatory tests is a great disservice to the unsuspecting public and must be avoided by all. Patients must begin to demand quality and holistic medical services by saying NO to this malpractice. 
3. Again, another reason is the veterinary use of antimicrobials in feed composition as fish and poultry growth enhancers. The use when not regulated exposes the organisms to suboptimal concentrations of drugs which with subsequent exposure fail to kill the organisms as a result of the onset of drug tolerance. 
4. Again, the inability of people to take the full course of their drugs is another factor. Some patients when given a 5 day prescription, abandon the treatment half way when they begin to feel better thinking they are okay. At this stage, the plasma concentration has not hit and stabilized at a peak to ensure complete clearance of the agent. With the discontinuation of the medication, the organisms recover from the initial shock and develop resistance against same drugs such that subsequent exposure to them does not kill the organisms any more.
6. Nosocomial emergence. The use of disinfectants in hospitals and medical laboratories must be reviewed. This will include quality assurance from production of disinfectants, composition for usage in hospitals, duration of stay in disinfectant jars and processes of inactivation and eventual discard. These processes when scientifically observed, will eliminate the breeding of drug resistant organisms in the hospital settings.
Lastly, It is important to note that development of resistance by organisms as a result of genetic mutation is largely responsible for emerging and reemerging infectious agents. This is because a mutant varies genetically from the original or parent organism. When this genetic variation as reflected on the 16S ribosomal RNA does not show more than 70% DNA- DNA homology with existing strains of the organisms, the mutant is then identified as an entirely new organism and named as such. This phenomenon is responsible for the recent emergence type C strain of meningitis ravaging Nigerians. In summary, antimicrobial resistance could lead to evolution of new organisms which will not only defy treatment with existing antimicrobials but also lead to vaccine failure as available vaccines fail to protect against emergent strains of organisms.
The above concern is the reason for the emphasis on this area by Medical Laboratory Scientists today worldwide.
Solomon Chollom.

Chairman, Assocaition of Medical Laboratory Scientists of Nigeria, NVRI Vom

Distinguished Medical Laboratory Scientists

RE: EXPERTS WORRY OVER SUPREMACY BATTLE BETWEEN PATHOLOGISTS, LAB. SCIENTISTS 

RE: EXPERTS WORRY OVER SUPREMACY BATTLE BETWEEN PATHOLOGISTS, LAB. SCIENTISTS 
I read with keen interest the article by one AZOMA CHIKWE. The article passes as one of those banalities that often appear on topical issues to muddy the waters the more and this one typically added nothing new positively to the narratives of the discourse between Medical Laboratory Scientists and Pathologists. Yes, it contains some historical facts about the humble origin and evolution of the profession of Medical Laboratory Science as we know today but so what? Every profession has evolved. There is nothing to be ashamed of in that. God did not create any profession in His 7 days of creation! No profession was created on day 1 or any day for that matter. Today’s medical doctor evolved from the fads of medieval times that ripped off sick people. Everyone has a past and we Medical Laboratory Scientists are not ashamed of our own. I wonder if some of our doctors ever gave a thought as to why Hippocrates had to institute the oath that all aspiring doctors these days have to take before practice? That doctors had a hand in the creation of Medical Laboratory Scientists is certainly nothing to be too excited about. That was only a necessity and we in humility acknowledge that debt of gratitude to the medical profession but the time to let loose the leash is overdue.

 

By the way how did Pathology evolve? The well-known Scientists of old, Virchow, Pasteur, Koch, Ehrlich e.t.c. were they Pathologists? Let us not be too carried away by our own self-interest. In the practice of medicine today, it is recognized and acknowledged that no one individual would have all the knowledge and skills to handle all the myriads of issues arising from today’s modern lifestyle. So, it would have been necessary to develop other health professions if they did not exist by now. It is indeed these other professional contributions that give essence to the art and science of medicine today. That Medical Laboratory Science has grown so much in its short history is indeed a CREDIT to the great efforts of its founding fathers and those who came after them in nurturing what has now become something of an envy of some members of the health fraternity. But we must realize that this development has been in parallel with advances in medicine, so much so that the roles and expectations of Medical Laboratory Scientists have grown out of all proportion to what would have been achievable in the past. Instead of applauding the growth and contribution of the profession of Medical Laboratory Science to the development of medicine as it is today, these few are in their myopic mind plotting its downfall. It is not a moot fact that 70% of today’s disease conditions can be defined by a laboratory result! These unwearied contributions of the laboratory to decision making by today’s doctors rather than depending on anecdotal and subjective opinion is a glory we all need to bathe in, not disparage.
 We are not unaware of the “rivalry” that exists between family physicians and the Pathologists (are Haematologists, Microbiologists etc. Pathologists too?); even there is a strong argument among eminent doctors that doctors who work in the lab are not clinicians but, we will put all that in the “parking lot”. Perhaps the worry of the lab doctor is this unsubstantiated fear that Medical Laboratory Scientists want to push them out of the laboratory! The origin of this fear is hard to fathom, but this is paranoia of a specie that feels threatened by the fact that it is unable and unwilling to come to terms with development in the work place and face the reality of our times. One would expect the lab doctors, by their training to be more discerning even though we live in a nation agog with rumours and social media frenzy! That the Medical Laboratory Scientists like members of other health professions have grown by dint of hard work to a position whereby they can work shoulder to shoulder with the lab doctor in a non-hierarchical manner and rule their own world (drawing from Glo!) as members of the same team in a non-master/servant relationship may be the worry of some lab doctors.
 
The unfortunate case of Baby Eniola of LUTH in 2016 has been bandied around by lab doctors too often to justify their misplaced claim to headship of the laboratory. Whereas this was indeed the classical case of what happened when they were unable to provide leadership and management in the laboratory and at the same time preventing the right custodians of laboratory matters from taking ownership of their responsibilities (a case of a dog in a manger, you may say). In stating their alternative facts (apologies Kellyanne Conway) they have often failed to indicate that in this particular case that Medical Laboratory Scientists lost their jobs while the lab doctors only walked away with a slap in the wrist.
 

One fact that we have failed to realize or chose to deliberately overlook is that these days, the extreme complexity of laboratory procedures often makes it necessary for the physician to rely on the Pathologist for assistance. The Pathologist performs the role of interpreting and correlating for the physician the results obtained by the Med. Lab. Scientist in order that he may fully utilize them in the treatment of the patient .While it therefore follows that the lab doctors operate at the interphase of the laboratory and the clinic, thus they and the Medical Lab Scientists must work together with the physician as members of a team whose goal at all times is better patient care. There is no doubt that the most effective medical laboratories are where the Medical Laboratory Scientists/Pathologists work in a collaborative environment sharing knowledge, information and utilizing the skill sets of both groups. Frequently, laboratories end up with a combative culture if this opportunity is lost. Unfortunately, this appears to be the case with Nigeria at the moment.
 
In 2006, a highly respected surgeon had circulated a document in which he claimed other health professionals were clamoring for the doctors’ job. This clearly shows the mindset of many doctors in Nigeria which is an indication that they are completely unfamiliar with developments in the workplace around the world. Even though this doctor gentleman later withdrew his claims and apologised for conceiving such ideas, damage had been done and some of his minions still hold to those opinions these days. Tenaciously holding on to the past will not help matters. In England, Nurses with adequate expertise and skills act as Nurse- Practitioners – see patients and write prescriptions. That would almost tantamount to blue murder here in our country. Medical Laboratory Scientists of sufficient bent read and interpret histopathology/cytology slides as Consultants. Should this happen here, some people would become psychiatric. It is time to drop this EGO toga!
 
 Medical Laboratory Scientists remain faithful and ready to engage in conversation with anyone working to build our system. We BELIEVE Pathologists are respected Medical Consultants who rather than ASPIRE to become Medical Laboratory Scientists should look for more rewarding tasks to give them job satisfaction and self actualisation instead of just expecting to supervise the Medical Laboratory Scientists at work and signing laboratory result forms of work carried out by these medical laboratory scientists. No profession can supervise the work of another. This is the reality of the day. The point is, if we cannot change the reality on ground, it becomes necessary that we change the eyes with which we see reality. The world is moving on and our health indices will remain what they are if we do not embrace developments in the health arena. Enough has been said for the wise.
 
Consultant Pathologist Umaru complained about blood touts. That we do not have a National Blood Service in Nigeria today is certainly not the fault of any Medical Laboratory Scientist. For over 5 decades the idea of building a blood service in Nigeria has been on the drawing board. Eminent Nigerians (Chief Emmanuel Iwuayanwu for example) many doctors and medical laboratory scientists have WORKED TIRELESSLY for its actualization over the years. The only evidence for their hard work is that during the period of Prof Eyitayo Lambo (a non-medic) as Hon.Minister of Health and with funding and the kind assistance of the people of USA under PEPFAR, he was able to develop many infrastructure and set up 17 operational centers in the 6 geo-political zones of the country that we have today.
There is a national blood policy that has been denied the necessary translation into law in form of a National Blood Service bill to set up an operational agency free from the red tape of the Civil Service. This is because new Ministers (all Medics and Professors for that matter) believe the NBS will take away the jobs of teaching hospital departments that run an uncoordinated, haphazard service whose safety cannot be guaranteed. Meanwhile Nigeria is signatory to World Health Assembly resolution No WHA2872 of 1975 which advocated a centrally coordinated national blood service. The NBS in England is one of the essential components of the NHS. Teaching Hospitals in Nigeria are nowhere comparable to those in England. Blood would have been available for President Mohammadu Buhari should he have needed it in England. He wouldn’t have had to mobilize tout donors as we often do here before he could access safe blood. It could happen here too if only “the powers that be” would allow it. In the meantime, Nigerian experts have worked with WHO in developing thriving blood services even in tiny countries like the Seychelles! This is the tragedy of our country and some people would like us to continue in this manner. The solution is for members of the medical profession to accept that it’s a different world we live in now. These are exponential times and lamentations no matter how genuine would not help matters.
 There are clear differences in the roles and responsibilities of the MLS and Pathologists but both must work together for improved patient care. There must be mutual respect and recognition that will enable them build strong work ethics and develop a new order of a more efficient medical laboratory eco system. As baseball enthusiasts are wont to say it’s time to “call a big time out”.

 Paraphrasing the words of Martin LUTHER KING Jnr. The time has come when the sons of former slaves and sons of former slave owners will sit down together at the table of brotherhood. Yesterday is not ours to recover, but tomorrow is ours to win.

 

Godwin IHIMEKPEN,

Ihimekpen1949@yahoo.com
P.S.
Reading this rejoinder reminded me of the photo I took recently in Bodija, Ibadan –  of a lovely flower blooming in a bed of green …

We are all different, but in our diversity lies our collective let us embrace it. Meanwhile, who here is an horticulture afficionado? What is the name of this beautiful pink bloom?

On gender and career possibilities…

In Nigeria, when a woman works in the hospital, then she is automatically a nurse… Never mind if she spent 8 years getting her degree (plenty thanks to NUC and ASUU). No, she must be a nurse!
A man in brown scrubs is automatically a doctor… never mind if he is a health assistant and just a step above the regular cleaners. Afterall, the male brain is best suited for the medical sciences…
Yeah, it is 2017… But, the perceptions of quite a lot of Nigerians about gender and career possibilities remain largely unchanged.
 Within this past week, I have been referred to as a nurse more than 3 times.Each time, but the last one , I politely corrected and told them I m a Medical Laboratory Scientist (MLS)… to blank stares suggesting that being an MLS is equal to being an alien.
So what to do?
Gender apparently still determines the career options a woman is likely to explore…In 2017?
Should a woman be restricted in her options? These are just random musings of mine. Or should men?
I hope the day will come when a man being a nurse is not seen as an aberration… I hope that day comes quickly when gender is not a factor for career possibilities.
May that day come quickly.
Till then, let’s keep the bonds of friendship. 
  So, hello, how are you my dear friend? Have you eaten? Let’s share a cup of tea and continue to oil the wheels of conversation.


On Politics… and Propaganda.

For a long time now, I have known that propaganda (big word for lies and half truths) go hand in hand with politics.

Unscruplous politicians use it to smear the reputation of perceived opponents… a lot of times in fact, the victim is portrayed as the wicked hunter.

While the hunter pretends to be the victim.
Until recently though, I was never a victim and therefore did not really understand how much it could hurt.

But , terribly painful and hurtful it was… it nearly brought me to tears.
To see someone I d considered a brother lie blatantly, ostensibly because we were not in the same political camp.

That hurt, a lot.
Then , I got really angry and took action.
Instead of disregarding the lies and carrying on as if it did not matter, I decided to express my displeasure and insist on correction of the observed wrong doing.

Like every lie, propaganda, if allowed to fester eventually becomes a cankerworm and manages to obliterate the truth in the minds of the people who have been constantly exposed to that propaganda.
So, it s best to nip it in the bud! Fast!! How?

Simply say the truth and keep proclaiming it. Truth and propaganda never go in the same direction.
You may not gain friends in the short term, but in the long run, you would have done a lot of good for the community you belong to.
Spent the better part of the weekend ruminating on “is it possible to be a politician and not be affected by propaganda?”
I m still wondering…