GlobalHealthAfrica

Archive for the ‘Medicine’ Category

Blood Screenings: How much is too much to prevent Hepatitis C?

In Diseases, Medicine on June 1, 2014 at 4:01 pm

Global Health Africa blogger, Udo Obiechefu, discusses the impact of Hepatitis C in Africa and the crucial role that blood screening can play in HCV prevention.

With the recent introduction of Solvaldi and Olysio as high efficacy treatment options for newly acquired cases of the hepatitis C virus (HCV), now is an important time to visit the hepatitis C landscape on the African continent. The global prevalence of hepatitis C is currently estimated at 3%.Sub-Saharan Africa is estimated to have hepatitis C prevalence between 0-14 percent. There is a dearth of data available on HCV in Africa and this lack of information is due to low reporting rates and inefficient surveillance.

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Image by Associated Press (AP)

The cost of care associated with medications is high with little use for those chronically infected with the virus. Although the recent advent of both Solvaldi and Olysio are promising (Solvaldi exhibits a 90% cure rate for those recently infected), there is still an almost insurmountable barrier to care. A twelve-week treatment of Solvaldi costs roughly $84,000. Olysio comes in at a slightly more economical rate of $66,000 per twelve-week course. With these figures in mind, one may see the task of addressing HCV in economically depressed regions as near impossible. Although treatment therapies for those living and recently infected on the African continent may be difficult, it is important to take note of the efforts that can be made in prevention of the virus.

Stronger measures must be made in blood screening efforts since blood transfusions have proven to be the primary method of infection on the African continent. We have to look no further than the high HCV rate (17%) among those with sickle cell anemia in Africa. Hladik et al. investigated HCV prevalence utilizing a set of 2592 plasma donations in Central Uganda. Over 4% of specimens proved positive for HCV. Screening for hepatitis C can be a costly investment, with an estimated cost of $782 per screening. More must be done to close the financial gap to make HCV screening for blood donations in Africa a regularity, as opposed to a scientific interest for potential journal submissions. $782 is not worth a lifetime of chronic illness, especially with treatment options limited and costs high.

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Spotlight: Organizations Making a Difference in African Healthcare

In Community Health, Healthcare, Medicine on April 22, 2014 at 3:25 am

Global Health Africa aims to spotlight organizations that are making a difference in African healthcare. In this post, GHA Blogger Udo Obiechefu sheds light on the work the Nigerian Healthcare Foundation accomplishes during its medical missions. 

Although much of the emphasis on improving health care in Africa is placed on governments and large scale international aid organizations, it is important to note the important work that is done by foundations and organizations who do not receive a large portion of the spotlight. These organizations, at times, are the primary source of medical treatment and attention for many Africans, young and old. In this piece, I speak with the Executive Director of the Nigerian Healthcare Foundation (NHF) in an effort to shed light on the work the organization accomplishes during its medical missions, gain a better understanding of the challenges they face, and provide insight into their operations.

Name: Ijeoma Obilo

Current title and years in current role: Executive Director (10 years)

Over the course of the NHF’s existence, important medical missions have been made by the foundation to Nigeria. What health care issues have been found to be the most prevalent?

The healthcare issues range from minute health check-ups to severe health complications that require surgery. We have seen it all. The majority of our patients do not have access to healthcare. They do not have the financial means to pay for medicine and health check-ups. So when the NHF arrives on the ground with our medical team and supplies, we go straight to work. On average, we treat almost 200 patients a day and provide them with food, necessities for their children, medicine and more.

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As a follow-up to the first question, has there been any noticeable improvement in any key health outcomes over the course of the NHF’s missions to Nigeria?

Yes, the improvements are shocking! Many of the children that visit our mobile site are malnourished and after just two weeks of the NHF being on the ground, you can visibly see the difference in the children and the adults. They gain weight and they look more healthy and vibrant. Not only do we provide medical care, we also provide 2-3 square meals a day to whoever comes to receive medical attention. We provide children and young people with school supplies and also provide nursing mothers with vitamins and baby essentials. We believe in treating the body, heart and mind.

What are some of the typical obstacles that arise during mission trips? How are they overcome?

Our mission trip is a truly inspiring and life changing experience for anyone who joins us. Some of the obstacles that often arise during our mission trips are being able to provide enough medicine for those that we treat. When the word spreads that the NHF has arrived, hundreds of people come daily from neighboring towns and villages to seek treatment. We want to be able to treat as many people as possible and to date have not turned anyone away, and we never will.

What is the reception like from the local government/community?

The community welcomes us with open arms! They are truly appreciative of our services and benefit immensely from our free health care services. We provide medication, hygiene necessities, treat ailments and more. They are receiving care from highly trained doctors, medical residents and health practitioners. At least we can attest that they are receiving care at least once a year because we exist. Hopefully we will be able to build a clinic so that we can see patients all year round and they can receive necessary health treatments. We look forward to partnering and collaborating with Imo State government on more initiatives.

What, in the opinion of the NHF, are the key issues facing Nigerian healthcare in the next 20 years.

Access to quality care which can be achieved through affordable and safe healthcare within Nigeria.

Improving Preventive Care Training in African Medical Schools

In Healthcare, Medicine on December 3, 2013 at 3:53 am

Two years ago, the Medical Education Partnership Initiative (MEPI) was launched to increase the quality, quantity and retention of health care workers and the faculty needed to train them. The program is investing about $130 million over five years through direct awards to African institutions in a dozen countries. Within this initiative is the emphasis of preventive care training at medical schools. In Africa, the correlation between preventive care training and non-communicable diseases is particularly important.

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Unhealthy diets and physical inactivity are key risk factors for the major non communicable diseases such as cardiovascular diseases, cancer, and diabetes. While Africa faces a double burden of infectious and chronic diseases, infectious diseases still account for at least 69% of deaths on the continent. If there is to be a shift in focus from curative to preventive care, the medical school curriculum must include nutrition and physical activity education. So far, MEPI has led to a fundamental change in the way African institutions and government leaders approach medical education.  Institutions are changing curricula content and expanding the breadth and depth of subject matter that emphasize the importance of preventive care.

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In Durban, South Africa, the University of Kwa-Zulu Natal (UKZN) is expanding its approach to the HIV/AIDS epidemic. The university has packaged a series of workshops called “Me and HIV,” to enhance sensitivity about HIV/AIDS among health workers. These workshops examine the myths, realities, attitudes and perceptions of HIV/AIDS, prevention strategies and how to help people learn to live with their condition. Emphasizing the importance of preventive care through medical school is crucial in creating sustainable prevention-oriented physician practices. The role of the physician is vital since patients cite their physician most often as the one who influenced them most to make a health behavior change. If MEPI remains successful, medical education in Africa will have a positive impact on people’s health in the continent.

Africa’s Struggle With Medical “Brain Drain”

In Healthcare, Medicine on October 15, 2013 at 5:37 pm

In this post, Guest Blogger, Udo Obiechefu provides an inside look at Africa’s brain drain by interviewing an African-born physician studying overseas. Enjoy!

The “Brain Drain” is a common term used to describe the flight of human capital or the large scale emigration of individuals with technical expertise and/or education from a given region. Sub-Saharan Africa has been one of the chief victims of the brain drain over the last half century. It is estimated that one-fifth of African-born physicians and one-tenth of African-born nurses are currently practicing overseas. In this post, I sit down with Femi Taiwo, a current Master’s of Public Health candidate and former Senior Medical Officer with the Federal Medical Center in Lagos, Nigeria, to discuss his own story, his thoughts on Africa’s brain drain crisis, and his beliefs on what would encourage young, African medical professionals to return or choose to stay on the continent.

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Name: Femi Taiwo

Age: 38

Degrees Earned:  MBBS (Nigeria, 2004), MPH (US, Dec. 2013)

Positions Held: Worked as a general practitioner (Senior Medical Officer) with Federal Medical Center, Lagos, Nigeria and also with a private clinic in Lagos (locum).

What was your motivation for choosing to further your education overseas?

  • My motivation was the desire for capacity building and to improve my then current job skills. Also, job satisfaction and good remunerations were among other factors considered.

Would you encourage more African medical professionals to move abroad or to practice their trade on the continent?

  • Yes, even though it is a decision for individual. I encourage more African medical professionals to move abroad even if it is for a brief period to see how things are being done differently. After this, they can return home to add value and expertise to medicine being practiced on the continent.

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Do you feel the quality of education in Nigeria adequately prepares medical professionals for the population they serve? Please explain

  • To some extent, yes. Nigeria is a developing country which is very rich in both human and natural resources, but due to poor and corrupt leadership, it’s medical practice is still very rudimentary. There are not enough hospitals and the few that exist are ill-equipped. A large percentage of the populace is living below the poverty line. So, the medical education is on par with the reality of the socioeconomic and political reality of Nigerian society. Here is an example: if a patient presented with a complaint of a persistent headache, here in the United States, a brain CT scan must be requested as part of the initial evaluation. The medical education in Nigeria and a host of other African countries will not teach that because of the socioeconomic situations of the vast majority of the populace (Remember, the majority of patients pay from their pockets because they lack medical insurance). Another example would be that in Nigeria, you would rather ask for a blood film for the malaria parasite because as they say “common things occur commonly”. It would amount to a total failure for any medical student in Nigeria to say that a brain CT scan will be his or her first line of investigation in a case of persistent headache.

What incentives do you think would encourage those in healthcare to stay in-country?

  • Incentives to keep those in healthcare to stay in-country would be to provide opportunities for self development, increase job satisfaction by providing updated medical equipment and technology, and provide adequate and commensurate remuneration. All the above can only be achieved if there is transparent governance, so political reform to ensure responsive, transparent governance is fundamental to achieving these aims.

What do you believe is the most pressing issue in African healthcare today and how can it be improved?

  • The most pressing issue in African healthcare today is access to quality care which is compounded by a lack of qualified health workers. This is made worse by the continuing brain drain and poor socioeconomic situation created by bad leadership across Africa. Solutions to this myriad of problems will have to begin by ensuring transparent governance, stop/reduce the brain drain in the health sector, improve the conditions of service, train more health workers, build more clinics and hospitals, and improve the socioeconomic conditions of the people through gainful employment.

References

Boahene, Kofi. “How African Doctors Can Cure Medical ‘brain Drain'” CNN. Cable News Network, 16 Apr. 2013. Web. 16 Sept. 2013.

“Africa the Loser in Brain Drain.” ITOnline RSS. N.p., 28 Nov. 2011. Web. 16 Sept. 2013.

Mullan, Fitzhugh. “The Metrics of the Physician Brain Drain.” New England Journal of Medicine 353.17 (2005): 1810-818. Web.

Traditional vs. Modern Medicine

In Medicine on August 4, 2013 at 6:51 pm

In this post, Guest Blogger, Udo Obiechefu attempts to start a conversation on the risks and rewards of traditional and modern medicine. Enjoy!

It is estimated that over 70% of West Africans rely on traditional medicine for treatment of both communicable and non-communicable diseases. There has been debate in recent years over the belief that traditional medicine should be given a more legitimate place within the structure of West African healthcare. Traditional medicine offers many positive aspects to healthcare. Despite the criticisms of some traditional methods, many techniques used, especially those involving the use of herbs and roots, have scientific support and proven clinical success.  The problem with traditional medicine lies in the belief of many that it should be the primary source of medical care. This belief that traditional healers are the first and last line of defense against an illness can lead to potential life threatening medical emergencies.

A study conducted in three ECOWAS (Economic Community Of West African States) nations found that 60% of children suffering from malaria related fever were first treated with herbal medicines. This can be a dangerous situation. Heavy reliance on traditional means can bring about damaging results when a life is in danger. This also holds true in regards to women’s healthcare. For instance, treatment for miscarriages are often performed by traditional healers when procedures of this nature should only be performed by properly trained medical personnel.

Despite the issues, there is room for traditional and modern methods to work together. Most ECOWAS nations are in the process of developing policies and regulations for traditional medical care. Instead of working against traditional methods, many healthcare systems are looking to work with traditional healers. Given the lack of access of many West Africans to quality hospitals, it is important to take advantage of the medical solutions already in place.

References

Atlas of African Health Statistics 2012. Raw data. World Health Organization. Regional Office for Africa, Republic of Congo.

Busia, Kofi. “Overview of Traditional Medicine in ECOWAS Member States.” The  African Health Monitor 13 (2010). Web. 13 Nov. 2012.

<http://ahm.afro.who.int/issue13/HTML/article2.html>.

“Traditional Medicine Fact Sheet.” WHO. World Health Organization, Dec. 2008. Web. 29 Mar. 2013.

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