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Nigerian Physicians and Our Right to Know

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Fr. Godswill AgbagwaChioma called again! You remember her? The woman her boss was pressing for an affair (See http://theleaderassumpta.com/category/columns/ethics-corner/ or www.csaaeinc.org/blog for full story). I thought she was going to talk about this affair.  No. This time it was about her sick mother. “Could you please pray for her, she is in a hospital at Owerri”, she said. I know her mother, a 65 year old “rural woman”.  I called this woman. “Mama, what’s the matter?” “The Doctor has not told me anything”, she answered. “What medication has he given you?” “He did not tell me, he just said that I will be fine.” I have heard this several times, especially from poorer and less educated Nigerians.

Regardless of what their (the physicians) reasons are, it is no longer a matter of conjecture that it is in the best interest of the patient for the physician to ‘carry her along’ (as we say in Nigeria) in her own plan of care. There are several reasons for this, but let us consider a few. A good care plan begins with proper diagnosis, followed by treatment (if possible) and in some cases, some kind of check-up to ascertain extent of healing.

Ethically, and in some places legally too, a patient has a right to be properly informed of her diagnosis because it is the first reason why she is consulting a doctor, nowadays at a very high fee. In some cases the doctor can tell a patient her diagnosis right away or order for tests to confirm or rule out his suspicions. The patient’s right to know requires the physician to tell patient what he suspects, believes or has confirmed to be her diagnosis. Except if patient is unconscious and there is no family member, beginning treatment without first briefing patient or family member on diagnosis may be an abuse of human dignity and breach of contract. Even when the patient or family has not asked for it – often out of naivety – a physician should still properly disclose diagnosis to patient or authorized family member. It is her right!

Apart from the fact that patient has a right to be informed of her diagnosis because she deserves to know and has paid for it, a patient properly informed of her diagnosis which often includes possible causes, symptoms and effects of the illness, can bring useful information towards her treatment. For instance, I noticed that Chioma’s mother was coughing a lot. Cough can be caused by several things, but can also be a symptom of other illnesses. Assuming hers was caused by something that she ate, she could easily identify this and be treated apropos.

Furthermore, properly informing patient of her diagnosis can help her prevent such illness in the future. For instance, in the past, I used to occasionally salivate whenever I ate certain foods. Because this was not frequent, I could not say exactly what kind of food that caused it, so my doctor asked me to watch out for certain foods. One afternoon, I drank orange juice and the salivating started. Now I know that orange juice was the cause, but how would I have known had my doctor not properly informed me? Except if a doctor wants a patient to return to him over and over again for treatment, as a way of making money, I think that for preventive purposes, a patient  should have access to proper information regarding her diagnosis.

Beyond diagnosis is treatment (if necessary). It is a shame that so many Nigerians are given several doses of medications a day by physicians without even knowing at least the name of the medicines they are being given. Again, a patient has the right to know what is going into her body because it is her body. Ethically, the physician is bound not only to disclose to a patient the name of whatever medicine he is administering but also to properly inform patient on what it will do for her, the side effects and any other alternatives available to her. Here is one reason for this requirement:

On January 2, 2011, we rushed a woman to a nearby clinic in Ikeduru LGA of Imo State about 12 midnight. Our first shock was that the nurse would not dial the on-call physician’s number because the physician (who is also the sole owner of the clinic) had ordered her not to call his number in the middle of the night. The second shock – and one of the reasons for this article – was that the nurse would not let us know the kind of medications that she wanted to administer to the woman. I was so upset that I did not let her administer the medications unless she told us what she was about to administer. Then she told us that it was against their policy in the clinic to let patients and their families know what medications they  administer. Well, that policy did not work with us. After much pressures from me, she now showed us the medications: tetracycline and others. Fine, but guess what. This woman was very allergic to tetracycline and her children know this. Imagine what would have happened to her had we not insisted.

I am worried that Nigerian patients may actually be dying more out of this kind of  mistreatment, than from other causes. Unfortunately, many Nigerians are not even aware of this. Many blindly trust that every physician will always administer the right medication. We know this is not true, not just in Nigeria, but across the globe. Besides the fact that the patient knows best how a medication works for her and so needs to know what she is taking, it may also be important for her to have a second opinion to be sure she is taking the right medication, in the right dosage and at the right time for her illness, since physicians can also make mistakes. Nigerian physicians therefore must not wait for a patient to ask for this information, it should be a standard practice.

Mid last year, an optician visited one Catholic parish in Owerri. He examined people and gave out some eye drops to those he thought needed them. The news came to me. I asked for the name of the eye drop. Guess what: The optician removed the labels on the eye drops so there was no way anyone could know. I called the optician to find out why. He told me that they removed the labels so patients would not go to the pharmacy to refill the eye drop on their own. While it is possible for patients to do this given the dysfunctional nature of the Nigerian health system, this is a rash reason to deny patients the right to know the name of the eye drop. If these physicians are truly concerned about this unprescribed refilling, they can work with the pharmacists and the health ministry to regulate it. I think there may be more to this policy than a genuine concern for the safety of patients.

 
Fr. Godswill Agbagwa – wrote from The Catholic University Of America, Washington DC.
Follow this article online at www.csaaeinc.org/blog

ARTICLES

VAL-IN-TIME

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VAL-IN-TIME

 


The 2018 Valentine’s Day coincides with Ash Wednesday, and there is some panic in that sense. Many see that as a clash, not sure how correct that is. On its own, Valentine’s Day evokes a feeling of amusement, merrymaking and revelry. Ash Wednesday, on the other hand, elicits austerity, introspection and reflection. It introduces the forty days of prayer, fasting and abstinence to commemorate Christ’s suffering and death. Different dioceses and churches have put out some directives to the faithful regarding the primacy of Lent over Valentine’s Day. For instance, the Archdiocese of Baltimore in the United States reminds the faithful that despite Ash Wednesday coinciding with Valentine’s Day, Ash Wednesday will be observed as a day of fasting and abstinence. Wow! The big questions: is the Church canceling this year’s Valentine’s Day celebration or should it be postponed? Do lovers not have to exchange gifts on that day as usual? The susurrations are many. Some say Christ has hijacked the day as though it’s different from other days. Others insinuate that the church wants to strip the day of its mundane connotation. What exactly is happening?

From a religious perspective, Valentine’s Day seems to be flagrantlymis-celebrated. But in a sense, it can also be said to be a celebration that bridges the gap between young people in the world and the church because it is all about love notwithstanding how it is interpreted. Saint Valentine died for love; martyred under the emperor Claudius 11 because he embodied Jesus. He embedded Christ’s love thus, “This is my commandment: love one another as I have loved you. There is no greater love than this: to lay one’s life for one’s friends” (John 15:12-13). According to sources, Saint Valentine was either a priest of Rome or the former Bishop of Terni, Narnia and Amelia, a town of Umbria, in central Italy. Valentine used the opportunity of his imprisonment to spread the good news about Jesus. He converted the judge prompting him and his family, his forty-four-member household (family members and servants) to get baptized.

 

“There is really no clash between Valentine’s Day and Ash Wednesday because Christ is our capital “VAL-IN-TIME”. Christ is the “Beginning, the first-born from the dead”,…and through whom God reconciles all things to himself (cf. Col. 1:18-19). Valentine’s Day represents God’s love whereas Lent makes that love available to God’s creatures.”

On the other hand, Lent is celebrated the world over. In the Church, it is a special forty-days period marked by prayers, fasting and almsgiving. This practice follows from Christ’s forty days’ fasting in the desert immediately after his baptism. He “was led into the desert to be put to the test by the devil. He fasted for forty days and forty nights” (Matt. 4:1). Fasting is about mortification of our bodies, abstinence from the things we naturally crave for. Prayer is a channel to stay connected with God, a weapon against temptations from the devil. Almsgiving expresses our faith in God, who “loved the world and gave his only Son…” (John 3:16).Through almsgiving, we are able to extend God’s love beyond our comfort zone. In Lent, believers are invited to give up pleasurable goods for the sake of those in need. The United States Bishops Conference remarks, “We are called not just to abstain from sin during Lent, but to true conversion of our hearts and minds as followers of Christ”.

So, what connects Valentine’s Day with Lent? The first thing that comes to mind is love. Valentine’s Day is Lover’s Day, that’s obvious. It originates from the idea that Saint Valentine was imprisoned for love; performing weddings for soldiers who were forbidden to marry and for ministering to Christians who were persecuted under the Roman Empire. Prior to his death, Valentine was said to have written a letter to the judge’s daughter whom he healed and which he signed, “Your Valentine”. This seemed to be the spark for what is known today as “Lovers Day”.

Love originates from God. In his love, he invites us to love one another. Valentine’s Day becomes that great opportunity to love. Love is the elevation of the human being to that divine resemblance injected at creation. That’s what Saint Valentine sacrificed his life for. He believed in God’s love and dignified it through the sacrament of marriage. He understood the futility of the flesh without God’s love. He realized that mortality is symbolized by the ash (Ash Wednesday) and transformed into immortality in Christ who is our eternal Val. In Saint Valentine, agape and filial love overcame eros or erotic love much orchestrated by mis-celebrated lover’s day. Love is not a commercial venture. It is not just about watching movies together. It is not just about giving flower to one’s love. It is a commitment, a sincere gesture. Love is a relationship.

Secondly, Valentine’s Day seems to remind us of the oneness of humanity despite faith affiliation. For instance, Saint Valentine is commemorated in the Anglican community, as well as in Lutheranism on February 14. The Lutheran Service Book commemorates Valentine on this date. The Eastern Orthodox Church also allows their members named Valentino (male) or Valentina (female) to observe their name day on February 14 following the Western calendar. And universally, it is celebrated as Lover’s Day.

Therefore, if Lent celebrates Christ’s sacrificial love, then love becomes a gift for us and for one another. Lent draws our attention to God’s love made visible in Christ. Lent focuses our attention on the need to sacrifice for one another. It invites us to authentic love as demonstrated by Saint Valentine, who guided the Roman soldiers to the true meaning of love. Lent tells us that we are all lovers for God’s sake as Pope Francis puts it, “…a favorable season for opening the doors to all those in need and recognizing in them the face of Christ.”

There is really no clash between Valentine’s Day and Ash Wednesday because Christ is our capital “VAL-IN-TIME”. Christ is the “Beginning, the first-born from the dead”,…and through whom God reconciles all things to himself (cf. Col. 1:18-19). Valentine’s Day represents God’s love whereas Lent makes that love available to God’s creatures.

The great lesson from these apparent co-events is to enlighten us that our life should become a spectrum of Valentine. Sacrificing for those we love should be an ongoing process. Giving up what we value for the sake of love should be a life commitment. Praying for loved ones should be a constant practice. Scripture says, “When the completion of time came, God sent his Son, born of a woman, born subject of the Law, to redeem the subjects of the Law” (Gal. 4:7). That’s the meaning of Valentine- Christ, our capital and eternal VAL came at the appointed time to save us. Saint Valentine also died for the Roman soldiers because he understood the mandate of Christ, “There is no greater love than this: to lay one’s life for one’s friends” (John 15:12-13). So, both Ash Wednesday and Valentine’s Day celebrate one and same thing- GOD”S LOVE in our midst. Love doesn’t come and go; as Saint Paul says, “Faith, hope and love remain, these three; but the greatest of them is love” (1 Cor. 13:13). That’s Valentine. That’s Ash Wednesday. That’s Lent. That’s our life.

Fr. Vincent Arisukwu
wrote from USA

 


 

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As October 1 draws near

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As October 1 draws near

Conventionally, October 1 means the first day of the tenth month of the year in the Gregorian calendar. And ironically, it is the month of the introduction of the calendar by Pope Gregory (X111) in 1582. For some, it is their birthday, or perhaps pertains to some joyous occasion in their lives. But for the SouthEasterners, particularly the Igbos in northern parts of Nigeria, October 1 has lots of negative and apprehensive implications.

 

In the interest of the international community, and for those ignorant of the ugly developments in Nigeria, the Northern Youth Forum met in one of the northern states called Kaduna, and on June 6, issued a stern warning to over eleven million Igbos residing in their states to vacate the North before October 1, 2017 or face forceful eviction and possible harm. The ultimatum came days after the stay at home exercise in the Southeast by the Indigenous People of Biafra (IPOB) to commemorate their fallen heroes in the South East on May 30, 2017. The Biafran people are simply asking for freedom, and emancipation from years of manipulative and exploitative rule. Put in the perspective of the old Israelites, the Biafran people want to go from Nigeria. The question is, “Is the northern youths’ declaration intended to facilitate this move? The answer is no. The northern youths’ approach is rather to get the Igbos forcefully evicted; just throw them out. Send them home by force. If they fail to leave, frustrate them, if possible annihilate them. This seems to have become the fate of the Igbos as it recalls for them their post-civil war experience in 1970.

 

Before getting back to the October 1, one might wonder two things here: 1) what constitutional rights the northern youths have to eject the South-easterners from the north. 2) what actions the Nigerian government has taken to address or reverse this utterance. On the first issue, at least till this moment, Igbos are still legal citizens of Nigeria. Igbos have the same constitutional rights to reside in any part of Nigeria. They are not contravening any immigration laws by residing in the North. The issue is that the North seems intimidated by the very industrious nature of the Igbo tribe since Igbos are practically sprinkled all over the world in possibly a dominant way. The second issue is that the Northern Youth Forum is being vindictive. They are using this ultimatum as vendetta: “If the Igbos are agitating for freedom, and still have most of their people in our lands, then let us frustrate them”. The “let us frustrate them” philosophy has always been a ploy used in Nigerian politics, and one major reason why the Biafra agitation is growing. The Nigerian political system grossly disfavors the Igbo tribe, and works to the benefits of the North. Since the Igbos still thrive in their educational endeavors, businesses and professions, they are an ongoing target. They ought to be frustrated.

 

What actions have the Nigerian government taken? Clearly, the body language of the President Buhari-led administration is Hausa. It seems supportive of this ultimatum though in a mischievous way. Sincerely, the approach of the Nigerian president towards the Biafra agitation is at most described as disappointing. The lack of openness to dialogue and engagement can be said to be an undiplomatic approach for a viable solution to an issue of national interest. Sad to say, that is what brought Nigeria to this current state of pity and quagmire, and has attracted international opprobrium. For instance, on his return after a hundred days of medical treatment in the UK, Mr. President stated in his address that the issue about Nigeria’s unity is “non-negotiable”. Part of his statement reads, “I was distressed to notice that some of the comments, especially in the social media have crossed our national red lines by daring to question our collective existence as a nation”. Non-negotiable? Come to think of it. Even a husband cannot tell his wife in the house that her agitations are non-negotiable, not even parents to their children in today’s world. What about a president to his fellow citizens? For your information, the Igbo of Nigeria is about 18% of its total population of about 177 million Nigerians, that is approximately 32 million people. But Biafra is not just the Igbo agitation, and Mr. President says, it is non-negotiable. I see that as some form of administrative suicide.

Back to October 1. From the foregoing, October 1 is like an Octopus for the Southeasterners and particularly for the Igbos in the north. In its original sense, October 1 used to be the most celebrated day in Nigeria. It is the day Nigeria gained her independence from the British rule. As a child, we used to dream of this day of independence. We rolled out in well ironed school uniforms for march past and parades, enjoyed the best ice cream, met fellow students from other schools and reminisced the story of freedom told us by our parents who experienced the colonial masters from Britain. October 1 stood for freedom at the time.

 

That freedom is almost reversed today. For some, October 1, 2017, should be deleted from the calendar. It portends death alarm. The history of the northern threats against the Igbos in the past shows that they have always made due their heinous threats. They have masked in several monstrous, carnivorous forms- Boko Haram, Fulani herdsmen, Jihadists. The Igbos have always been the preys. So, for most of the Igbos in today’s North, October 1 is the day they march to their grave in an untimely manner. Such persons are not willing to leave. They plan to embark on their regular businesses as usual but ready for no other than to see to its logical conclusion. For some, October 1 signifies panic attack. Those in this group are in a state of constant insomnia. They imagine it’s going to be dicey. They might lose their property. They plan to hibernate in the area and perhaps resurface at some point. Those in this group think that things would calm down in the end. For some still, October 1 is a day of blame and regrets. Those here feel they are going to take all the blame from their brothers and sisters, kinsmen and friends for not heeding to the Hausa threats, for not vacating the north as quickly as they could. For some others, October 1 is a day for forced exit from their businesses, forced withdrawal from of their children from schools and departure to an unfamiliar home. This group is already leaving the north tactically. They have conveyed most of their properties and children home, perhaps intend to take the night bus to the east on September 30th. For others, still, October 1 is a day that marks a tribal war between the dare devil Hausa- Fulani hegemony and the already victimized Igbos. The air of uncertainty looms large.

 

But another question is, “Why don’t the Igbos vacate the North for peace to reign?” This is mostly the opinion of those who view domiciling from an impersonal perspective. I have had time to speak with many Igbos in the North, and wondered the rationale behind their continued stay. Think of a parent with seven children. Such family has lived all their lives in the North. Their business, education, properties, etc., are all located in the North. They have no investment in the Southeast, have no home, and not guaranteed any shelter back home. They have nothing to live on if they return. Someone wakes up and unwarrantedly commands them to leave. It may sound easy to say, “Why not come back”, but the intricacies of coming back are overwhelming. Importantly, they have the constitutional rights to reside in any parts of the country of their choice. They are citizens with legal rights and privileges. Friends, it’s like someone from Florida living in Texas, or a person from Indiana moving to Michigan. So, why should they be forced to leave? They can only leave if Biafra is legitimately established as an independent nation.

 

Why this article at this time? First is because October 1 is fast approaching. Just perhaps, for the international community to be aware of the various shades of Nigeria’s October 1, and to recognize the threats against human life in Nigeria today. Unfortunately, crimes against humanity in Nigeria are given less attention by the international community. It’s as if human lives in Nigeria don’t matter anymore. The mainstream media’s attention is focused only on Europe, Asia and the Middle East. I guess that Nigeria’s oil is not flowing as before. Insidiously, there is pogrom in Nigeria on a daily basis. There is genocide on a daily basis. There is constant killing of innocent persons in Nigeria on a daily basis, mostly because of ethnic affiliation, especially if they are Igbos. The difference between what is happening in Nigeria and the 1994 Rwandan genocide is that the Nigerian approach is very tactful, systematic but deliberate. People are hungry but no longer worried about hunger. They have no light but no longer complaining about that. They have terrible road networks but have come to live with such. Millions are unemployed but poised to make a living. Now, they are being killed, tortured in their numbers because they want to dialogue for the sake of their freedom.

 

Let the international community consider Nigeria before it is late. North Korea is considered a threat because it is perceived to devalue innocent lives. On Thursday, April 7, President Trump ordered a military strike on the Syrian government airbase in response to alleged chemical weapons attack by the Assad-led government that killed dozens of civilians. President Trump said he was disheartened at the killing of innocent civilians and helpless women and children. Worse things are happening in Nigeria now. Innocent (particularly Igbo) people are dying in Nigeria. They have no powers of their own, they have no hope.

 

If not nipped in the bud, October 1 may represent a day that everyone kept quiet to an impending doom in a nation with over a hundred and eighty million lives at stake. October 1 might mean ACTION or INACTION for the Igbos in the Northern part of Nigeria.


Fr. Vincent Arisukwu, writes from the USA.

 

 

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FACE TO FACE

Brightening up ALVAN with a Blessing

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Face to face column with Patience Ejimofor.

Getting the top job was a surprise to Dr (Mrs) Blessing Ijioma, despite a revelation she had earlier.

“It never crossed my wildest imagination that I’d ever be the provost. I am not from Imo State, and Alvan was still an Imo-State institution. I thought it was one of those revelations. But as years went bye, things started unfolding, with the Federal government taking over Alvan,” said the Abia-born, mother of five, beautifully attired in a traditional outfit and pouring over files.

It was a surprise to the Methodist preacher, a doctor of food science and technology because she was chasing purpose rather than position. But when the opportunity came for her to seek the exalted office of Provost, she boldly stepped forward.

Three years ago, the Assistant Provost became Provost and last November, she led the college to its 50 years anniversary, a milestone she’s proud of.

“I t makes me feel very happy. I think it’s also divine that by the time the first female provost is on seat Alvan also reaches 50 years. I feel fulfilled. I am really happy,” the soft-spoken woman said, barely looking up.

Dr (Mrs) Blessing Ijioma

Dr (Mrs) Blessing Ijioma

Dr Ijioma had just returned from a meeting and preparing for another. She had visitors waiting and an important courtesy call to attend.

The Provost didn’t look at all flustered and her office was nice and cool.  But the same can’t be said about the seat she’s occupying as the first female boss.

“It is hot but not so hot by the grace of God. If you’re anchored on God and you are self confident and know what you’re supposed to do, and do it, there’s no reason to want to prove yourself. In fact Jesus said, ‘if you don’t believe in me, believe the work that I do. It’s the work that testify of me’,”  wife of Sir Chukwuemeka Ijioma, added.

A former HOD and Dean, Dr (Mrs) Ijioma is mindful that she is setting a precedent at the college, as the first woman to hold the big job. She knows that her performance could open the door wider or shut it for future female aspirants. She’s therefore careful not to give detractors a chance to say – a ‘woman can’t do it!’

“As Dean, I didn’t encounter any opposition because there had been other female deans in other schools of the college, so there was nothing significant. Also, being a deputy provost didn’t quite raise an eye brow, people didn’t bother too much. But when I became the provost- it was unexpected that a female will emerge,” she explained, calmly.

“The first reaction was ‘could she perform? Can she do it? Can she meet with the challenges?’ But then, I settled down with my management team and we have been able to prove that a woman can do it by the Grace of God and the support of those around. So those who said, ‘a woman can’t do it’ are gradually changing their mind and attitude’.

Additionally, she adopted an all-inclusive management style, where she tries to draw everyone who has a contribution to make towards the growth development of ALVAN.

“I consult with my management team. My deputy is male, my registrar is female – incidentally the first female.  We consult and deliberate. I am not afraid of my team because I have nothing to hide. I try to operate an open door. I go beyond the management team to bring in all those who have something to offer, who have ideas and are willing to join,” she also said.

Those who insist that women can’t work together and don’t support each other may have a chat with the ALVAN boss.

“I have never had my women not supporting me. In fact, they are excited because it’s when the first female succeeds that others will have the desire and confidence that they can do it,” she added.

Support may not be 100 per cent, and never is, but Dr Ijioma has enough goodwill and experience to enable her to do her job well.  On the flip side, ALVAN is happy unlike Aso Rock, where President Jonathan has been told recently to ‘watch his back’.  Mrs Ijioma has received no such warning and has nothing to watch except the upheaval in the country’s education system. The Nsukka alumnus, a strong scripture union member in her day, admitted that all is not well in the nation’s classrooms, including her own. Many students have thrown in the towel, preferring to buy certificates instead of study for it, while some lecturers choose to sell books to students rather than teach them.

“It makes us feel very bad when we think of how we burnt the midnight oil, and then to see what is happening now. Students are not even ready to work hard again and society has not done them well. Merit, honesty, hard work have been thrown overboard because people can get certificates without going to school. Those who sell in the market can go to miracle centres and get their certificates,“ she said, sadly.

“Before the war, facilities were not wonderful but the teachers were dedicated and students were ready to work … I can only do my best by insisting that the lecturers do their work – that they no longer come into the classrooms, introduce their book, give one or two lectures and disappear to wait for examination. We also make sure the students attend lectures and do their exams and if there’s exam malpractice, they are punished,” she added, promising expulsion to any student caught cheating.

Dr Ijioma is gradually changing the landscape of the college with the construction of new classroom and administration blocks. The provost is also trying to strengthen the college academically, clean up teaching and learning as well as motivate students to earn their certificates. Imo’s number one teacher training college still trains the trainer, runs its traditional NCE programmes and offers degrees from the University of Nigeria.

“You can see what is happening – we are trying to increase the number of classrooms, labs and equipment that both students and lecturers can use. This will make learning easier and many students are trying to learn. The Nigerian youth is not totally bad. The problem is society. There’s a proverb which says, brighten the corner where you are, that’s what we’re trying to do,” she concluded – a true blessing in disguise.

 

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