Sunday, 8 December 2019

Why I hated practising Medicine in Nigeria


I signed up to study Medicine and Surgery because it seemed like the most logical thing to do. I was a science student in secondary school and all my mates were either going to study Medicine or Engineering in university. The girls were more inclined to Medicine, so I joined the bandwagon. 

After trudging through an unexciting clinical journey in medical school, one that got me contemplating dropping out severally, I got my M.B.B.S. I survived housemanship in a teaching hospital, lazed away National Youth Service year in a primary care centre and became a job seeker for many months before landing in the private sector. 

I hated practising Medicine in Nigeria for the following reasons. I always didn't feel competent. I hated not knowing exactly what to do and not having reference points. As a medical practitioner everyone expected you to perform some magic; magic that you weren't trained for. As long as you are called doctor, they expected their ailment to end with you, not willing to be referred to a specialized institution. I didn't like the great expectation, the lack of support as a medical officer, often working alone, the fact that apart from the clinical pressure of functioning as a general practitioner without appropriate training, I had to deal with financial pressure as well. I had to decide/communicate the cost of treatments and factor that along with the size of the patient's pocket in making a clinical decision. 

In the places I practised, we had no universal guidelines. We were still using outdated protocols, lab results were unreliable. Poverty of the people would not allow us perform necessary but expensive investigations. Deaths were hardly investigated. So many preventable deaths were not avoided. Housemanship made sure I had a fat pocket but didn't train me well enough as a physician. I was more trained in running ward errands like chasing up investigation results than in the management of the sick - a total waste of doctor skill. Children suffered pain unnecessarily when we could have given numbing agents before bleeding them. Patients would endure multiple needle pricks to get several blood samples when only one prick most times would suffice with the appropriate equipment. Our medicine was crude; too crude to be human. I thought we were causing more pain than alleviating it. I couldn't bear practising like that for the rest of my life. It depressed me. I would rather spend my life making music, writing stories, bringing happiness, than watching the sick deteriorate and not offering much help, but worsening their debility. 

Now on the other hand, I've seen civilization in medicine here in the UK and this excites me. There is strong support. No one is left alone to tackle a case they are not trained for or fully confident about. As you work, you get trained on the job, while making a satisfactory living. Working hours are regulated also. You get enough breaks to recuperate from on-call hours. Theatre lists are not cancelled due to delay in laundry department providing scrubs. Skills are well maximized. Nurses administer IV drugs, so the junior doctors are freed to attend to higher skilled jobs. Hospitals are not shut down due to inter-professional feud or strikes. There are standard guidelines for every condition, for example the NICE guidelines or local hospital guidelines.  You are not expected to memorise the doses of all medicines. You are encouraged to check the BNF before prescribing. There are regular audits and quality improvement projects to keep us on track.

I could go on and on to compare the health system I witnessed in Nigeria to that of UK, but it is obvious Nigeria is centuries behind. Nigeria needs those that have seen the light, those that have tasted and imbibed best practice in a system that works to lead the way. So why should doctors in Nigeria not leave in search of light? The bone of contention should be why the ones that have the light are not coming back to guide the "blind". This is not different from other sectors. Sectors that have made progress have people there that have been trained in developed countries. Check the CVs of top performers in Finance or Business in Nigeria you will see that most of them have had foreign exposure. So doctors should not be criticised for going out to get proper training, rather we should be talking about how those that have been trained in these developed countries can give back to their country of origin.

Dear Lord, send labourers into Nigeria's health sector. We need to make advancements.

NB: This post by no means intends to belittle the work of faithful sound medical practitioners currently in Nigeria, making the best out of the harsh working environment and system. This is me telling my experience of how I turned from hating Medicine to loving it and a call for Nigerians in diaspora to think on how we can improve the Nigerian health system.

NICE - National Institute for Health and Care Excellence
BNF - British National Formulary

Radiant ~ December 2019

Saturday, 9 November 2019

To Help or Not: My Dilemma on a Headless Being

I saw a headless person walking today at the King’s Cross Train station.

Like Moses attracted to the burning bush, this piqued my interest. So I looked more intently at the strange sight. Apparently it was an old woman who was bent over so much I couldn’t see her head from the back. I wondered how she coped with life.

As I observed, I saw that she struggled to look up to the destination board. She kept going to the back hoping it would be easier to see. I knew she needed help, so I walked towards her. She tried to signal for help from 2 girls that passed her but they looked at her and went their way. She was saying, ‘no I’m not begging you for money’ when I approached. 

"Where are you going to?", I asked.

"Oh thank you very much", she said, "I’m going to Stoke. Can I use my freedom bus pass here?"

"No. It works on buses", I answered though not knowing really what freedom bus pass meant, "You may have to buy a train ticket".

"How much is it?"

"I don’t know. We’ll have to ask the authorities".

"How long is it by bus?"

So I brought out my phone to ask google. But first I typed, ‘can I use my freedom bus pass on trains?’ and I was surprised to learn you could use it on buses, trams, trains and underground. It is a free travel pass for the disabled and elderly. 

I quickly chipped in, "you can actually use your pass on trains". 

"But I will rather take a bus for sight seeing". 

So I checked distance between King’s cross and Stoke-on-Trent (I assumed that was what she meant by Stoke) by bus. I also checked the distance by train. 


"It is 5hrs by bus and you have to change several buses. It is easier to go by train but you have to go from Euston station".

"5hrs?". She was surprised.
"I’ve gone there by night bus and it was 2 hrs. I’m going to see my grand daughter. She works in a hospital there. Please take me to the bus stop".

"Which one?"

"The one near McDonalds. I’ll take a bus to Whitechapel and from there I can get a bus to Stoke".

My train was about 12 mins away. I calculated leaving the station to guide her to a bus station and getting back on time to meet my train. 

"Ok. Give me that". I took her hand luggage and walked in front of her while she followed. Shortly after, I looked back and saw her almost going to hit the wall headlong. 

"No!" I shouted. "This way."

I needed to stay closer to her so she could see me to follow. 

I worried how she was going to take several buses to Stoke on Trent on her own. When we got close to the bus stop she asked me to give her her luggage. 

"Are you sure you know your way from here?"

"Yes, I will take bus 205". 

I couldn’t see 205 written anywhere on the stop. But I was running against time to catch my train. So I gave her her hand luggage and said good luck. 

On my way back I prayed to God to please help her. 

When I got into my train I worried if I shouldn’t have done more for her. She clearly was going to struggle. How would she cross the road? How would she get to Stoke on Trent on her own? She didn’t even have a map with her. I wonder if anyone would even help a black old hunched up woman. They might think she was a beggar. Did I just miss an opportunity to attend to angels as the Bible says?

Should I get off the train which was to leave in 1 min to go find her and make sure she gets on the Euston train going directly to Stoke on Trent? I will have to forfeit the appointment I’m running to meet in King’s Lynn. I might have to buy another train ticket. Will I find her there? Am I even sure it is Stoke on Trent she meant? Is there another place called Stoke? I googled to check and couldn’t find.

While pondering these, the train began to move. Opportunity lost.

I could only pray God sends her help.



Radiant ~ November 2019
Photo credit - IG @bencantini

Sunday, 3 November 2019

Spinach sauce

Ingredients




Ingredients

Spinach - 4 Tesco packs
Carrot - 2 medium-sized
Mixed bell peppers - red, yellow, green 
Scotch bonnet pepper - 2 or 3
Shrimps - 1 pack
Crayfish - 2 table spoons
Onions - 3 medium sized
Vegetable oil - 1 cup
Garlic - 3 cloves
Thyme
Knorr cubes
Knorr Aromat all purpose seasoning
Salt

Cut and wash your spinach and set aside in a drain to drain water. Spinach brings out a lot of water, so you might even want to perboil it and drain the water first.

1. Put some vegetable oil in the pan. 
2. Add a little salt.
3. Fry onions, scotch bonnet pepper, garlic cloves.
4. Add chopped carrots and fry till moderately tender.
5. Add raw shrimps and fry till pink.
6. Add diced mixed bell peppers.
7. Add spices - thyme/rosemary leaf, knorr cubes, all purpose seasoning, salt to taste.
8. Add spinach in stages and stir. It tends to shrink so don’t worry about the size of your pan/pot.
9. Taste for salt and adjust.
10. Sprinkle ground crayfish (optional).

Meal is ready. The above quantities can serve 7 adults.

Serve with boiled rice, yam or potatoes.



Radiant ~ November 2019
Do you like this recipe, I’d love to hear from you. Please leave comments below.



Wednesday, 24 July 2019

Boots On The School Ground


We woke up to terrifying gunshots. I made a beeline for the floor as my mum had once told me, "when there is a shooting, lie flat on the ground". My heart was racing. I could hear it beat. We weren't sure how close they were. What the hell is happening? The shelling went on for ages. Fear and dread were palpable. We quietly climbed back to our beds after some hours of silence and slept half awake till dawn. Everyone hurried out of dorm in the morning to find out what had happened. 

Armed robbers had visited the staff quarters. A teacher was shot in the eye. The military had exchanged fire with them, hence the numerous shots we heard over our heads. We were relieved but sad about our teacher. He had been taken to the hospital and we prayed desperately for him. What if the robbers had entered the dormitory? It wouldn't be the first time strangers appeared in our yard. Usually, it would be peepers who preferred real pornographic scenes to fiction. 

That would not be the last time we had boots on the school ground. Well, the next time it was not to defend us. We were being chased out of school with our half packed bags at mid day. The SS3 boys had led a riot the night before to Princi's house over their colleague who was suspended "unjustly". On their way back, probably having not gotten the audience they had hoped for, some decided to make a visual statement by vandalizing the offices in the administration block. That was not the original plan. 

The following day, we girls woke up as usual, went to school that morning and quickly found out this was not an ordinary day. First strange thing was that the dining hall was full of girls. Where were all the boys? Apparently, the riot was the beginning of the protest. The SS3 boys had called a lockdown. No male was allowed to leave the hostel. Somehow they still managed to smuggle food into their dorms. We went to our classes and saw the aftermath of the previous night's rampage. Even teachers did not have balls to come to class. One of my class girls decided to be heroic. She wrote on our board, "We are in solidarity with the boys". Little did we know that that simple act of recklessness would list us among the ringleaders of the riot with consequences.

At 12 o'clock an emergency school assembly was called. All students were expected to report to the multi-purpose hall. It was brief. SS3 students including me were handed out suspension letters bearing our names and given thirty minutes to leave the school premises indefinitely. We thought we were still dreaming until we saw military trucks (or so I thought. I later heard they were the mobile Police) in school. Wow! This Princi meant business. Panic mode activated. People were running helter-skelter. We packed the few things we could. Those with illegal phones started making calls. A few of us contacted our school guardian who helped us inform our parents and took us to the car park where five of us got into a bus going East. We split ourselves in two when we got to Enugu and slept in our friends' houses as it was already 10pm. I got home in Onitsha the following day.

We were suspended for two weeks and the school authority demanded a parent to accompany the child on return and for us to sign a memorandum of understanding. I was among the ringleaders given extra two weeks, just for being present in a class of girls deemed in solidarity with the boys' actions. I heard some blokes did not go home and that on the return day, they hired some local men who pretended to be their dads. 

For more of my high school posts, click here. Were you ever suspended, caught in the middle of a riot or wrongfully punished in secondary school? What were the circumstances? Please share your comments below.


Radiant ~ July 2019


Glossary:
Princi - Principal
SS3 - Senior secondary level 3

Thursday, 18 July 2019

Mandela Day 2019


Different words come to mind when you hear the name Nelson Mandela - Hero, Icon, Courage, Leader, Sacrifice, Freedom, Prison, President, South Africa and many more.
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Around the world, monuments, stadiums, bridges, roads, parks and gardens, restaurants and streets have been built or named after him. At least 8 movies that depict his story have been filmed. My best scene is always when he came out of prison holding his wife, Winnie, on the left, his right fist pumped in the air, with numerous freedom believers following behind. If you've not seen any, I'll recommend Winne Mandela or Mandela: Long Walk To Freedom.

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There are many positive lessons from the life of Madiba, as he is also called. He had his regrets as well. However, his life has been nothing short of inspirational and this is reflected in his words too. Here are my top 10+1 Nelson Mandela quotes:
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1. "There is no passion to be found playing small - in settling for a life that is less than the one you are capable of living."
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2. "We must use time wisely and forever realise that the time is always ripe to do right."
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3. "I never lose. I either learn or win."
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4. "As we let our own lights shine, we unconsciously give others the permission to do the same."
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5. "Education is the most powerful weapon which you can use to change the world."
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6. "Do not judge me by my successes, judge me by how many times I fell down and got back up again."
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7. "No one is born hating another person because of the colour of his skin, or his background, or his religion. People must learn to hate and if they can learn to hate, they can be taught to love, for love comes more naturally to the human heart than its opposite."
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8. "May your choices reflect your hopes, not your fears."
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9. "Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness, that most frighten us."
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10. "Poverty is not an accident. Like slavery and apartheid, it is man-made and can be removed by the actions of human beings."
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11. "It always seems impossible until it's done."
Which is your favourite?
Picture: Mandela's statue@Parliament Square, London.