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Why Should A Doctor Embark On Strike? (2)

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THE SUPPORT STAFF IN THE HOSPITALS

Nurses: The origin of the present day nursing dates back to the late 18th century and was popularized by Florence Nightingale. Their Nightingale pledge stated among other things that, “with loyalty will I endeavour to aid the Physician in his work and devote myself to the welfare of those committed unto my care”. It has gradually evolved as a science, producing indispensable members to the healthcare team.

Pharmacists: These are also important members in the healthcare delivery system, relatively new science in medicine. Until recently, pharmacists were rarely needed in the hospital setting because the knowledge of the use of drugs is integrally part of medical training (medicine and surgery). However with the advancement in science and the development of several pharmacological molecules, the need for pharmacy as a science arose, primarily for the production of safe pharmacological products of dependable quality, that would be made available to patients, not necessarily the day to day patient’s care.

Medical laboratory scientist: This is another important support staff in the hospital setting. They were meant to assist the doctor in making laboratory investigations of patients. They assist in safeguarding the laboratories and assist the Laboratory Physician in their duties. They may also perform other minor investigations as may be assigned to them by the physician, and present such results to the physician for interpretation and subsequent application to patients’ care.

The Radiographers: These support staffs assist the physician in the diagnostic imaging, like X-Rays. The results are also sent to the doctor for review and subsequent application.

Optometrists: They assist the eye physicians in investigating visual problems and preparing the requisite glasses.

Orthotics: They assist the orthopaedic surgeons in taking care of patients with orthopaedic problem.

There are other support staff in the hospitals like the Morticians, administrative and works staff, etc. They all work together, giving instructions down the ladder along the respective group of staff. One good thing is that most of the support staff use their time to acquire more certificates like masters, and doctorate degrees.

THE CONSULTANT PHYSICIAN/SURGEON

This refers to the physician who has beenspecially trained in the recognition of disease through history taking, physical examination, diagnosis and prognosis, and the treatment thereof. This is after thorough grooming in anatomy, physiology, biology, pathology and pharmacology etc. He will upon graduation pursue any line of specialization and possibly sub-specialization which will take several but variable number of years. He is primarily the person the patients come to consult. The resident doctors and house officers in his team help him co-ordinate the teeming patients while learning to become specialists themselves.  This specialization is to improve the accessibility and quality of health care, and is very essential as obtainable in countries that mean well for their citizens.

There are many specialties in medicine and in surgery

In medicine- neurology for brain and nervous tissue diseases; cardiology – heart diseases; nephrology- kidney diseases; rheumatology – joint diseases; laboratory medicine conducts laboratory tests and apply them to patient care; family medicine is into community medicine/public health; Paediatrics etc. In surgery, there are: neuro surgery for the brain; cardiothoracic surgery for chest and lungs; urology for genitals; ophthalmology for eyes, ear-nose and throat; orthopaedic surgeons, plastic surgery and many others, each having respective subspecialties.

In Nigeria there are very few specialists, no talking yet of subspecialists. There are about 70,000 Nigerian doctors, more than half are practicing outside Nigeria. Of the remaining half, less than 3000 are specialists while about 16000 are undergoing various specialist programs. The remaining are either in General practice or have taken other lines of livelihood, like business.  The doctors in Nigeria are a far cry to the teeming 170,000,000 Nigerian citizens. The patient-doctor ratio of 20,000 patients to 1 doctor is far from the WHO recommendation of 800 patients to one doctor.  Then, stopping the training and specialization of doctors is like reversing to the antiquities and is highly laughable. How can we just destroy the future of medical practice?

THE SITUATION IN HOSPITALS IN NIGERIA

The state of most Nigerian hospitals is highly deplorable. Most of them are run down due partly to selfishness of the administrators, and partly to leadership tussles. In some mission hospitals, the priest or the Reverend Sisters would want to lord it over the workers, which, as usual would not go down well with some physicians, especially when wrong decisions are taken. When the Government Teaching Hospitals started, the Chief Medical Director was said to be a Medical Doctor who has acquired the requisite medical training, and is most likely a consultant.

RECENT EVENTS

In recent times, there have been unwarranted tussle for who is to be called consultant in the hospitals. The hospital support staff came together under the umbrella of Joint Health Workers Union (JOHESU) to propagate a conspiracy theory. Their sole aim is to uproot the age long supremacy and reign of Medical doctors. They lose sleep nightly plotting how to destabilize the health sector and blackmail Physicians as not capable of managing the hospitals. They make outrageous demands, which are often times coincided by the Government, at the detriment of the overall healthcare delivery system and the patients in particular.

For instance, they demanded that Government should pay them Teaching allowance from a certain grade level, including those who do not in any way get themselves involved in training, like the administrative staff, drivers, porters etc.This is not rational.

Moreso, they requested that at a certain level in their career, they should be called consultants, that is, a person the patient comes to consult, in the simplest sense of it. Which implies that at a certain time, a pharmacist, a lab officer, a medical record keeper, a driver, a porter, a gateman, a cleaner will be called a consultant. This invariably means that when the slot for the post of a medical director is opened, any of the above will be eligible to vote and to be voted for. Does it not sound ridiculous? This is without being oblivious of the fact the Federal Government has accepted to pay them specialist allowance even to their members who do not have any specialist training beyond the baseline senior school certificate or first degree. This cannot happen in an organized system.

In their quest for a consultancy status, the medical laboratory scientists are requesting that they should be allowed to have a postgraduate medical college, akin to that of physicians, and produce Fellows too like physicians. This would have been a laudable move, if not for the fact that there are already existing Faculty of Laboratory Medicine, that had been in existence and produces enough manpower for the requisite specialization laboratory services. Therefore, such move can only increase the already existing rivalry between the physicians and the Medical Laboratory scientist, without adding any value to patient care. They can alternatively pursue their career and can become professors in their chosen field, which is purely for academic purposes and should be encouraged.

The most interesting thing is that most of the support staff in the hospital have studied past their first degree and have meritoriously attained the doctorate degree, and are proudly referred to as “doctors”, which is highly commendable.  They are not satisfied with being called “doctors”, they aspire to become consultants too,

To be contd.

 

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The Data of Forgiveness

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The Universal Character of Salvation

The most important ingredient in today’s media economy is data. The amount of data available determines how much and how long we can work or play on the internet. Currently, many of the service providers offer unlimited data plans but we know that those “unlimited” plans are not always unlimited. Sometimes, your download speed can get slowed down when you cross a certain point. Today, however, Jesus gives us the divine model of an unlimited plan. It is the unlimited bundle of compassion and forgiveness which never gets slowed downed shut down for maintenance. The theme for this week is that we must learn to forgive without limits no matter the injury committed against us.

In Matthew’s Gospel, today’s teaching on unlimited forgiveness comes after Jesus had told his disciples the parable of the wandering sheep, so it is plausible that some would have wondered among themselves how many times a good shepherd should go after the same sheep if it keeps wandering away. In those days, people believed that forgiveness was limited to three times only – a fourth transgression was not to be forgiven. So, by asking Jesus how many times he should forgive his brother, Peter was probably aiming to increase the limit to seven times. And Jesus makes it clear that we are to forgive others, “not seven times but seventy-seven times” (Matt. 18:22).That means we must dispense an unlimited data bundle of mercy.

In Jesus Christ, we have the forgiveness of a debt we could never pay. Sin is an offence against God and a direct rebellion against his authority and creation. The debt of 10,000 talents mentioned in today’s parable symbolizes the magnitude of the offence that sin causes in God’s eyes, but he is always willing to forgive without limits. However, we can easily cut ourselves off from God’s river of mercy when we refuse to forgive others. We end up restraining God’s mercy and putting ourselves under strict justice. To unfold his mercy without compromising his justice, God leaves each person free to choose between the two. If we insist on strict justice when we are offended, we bring God’s strict justice upon ourselves. But if we offer an unlimited bundle of mercy to others, we draw God’s unlimited data of forgiveness upon ourselves.

The secret to forming a forgiving heart lies in recognizing the evil of our sin and the immensity of God’s goodness in forgiving us. Until we see the ugliness of our ingratitude and selfishness, we will never appreciate the generosity of God’s forgiveness. Let us examine ourselves now to see how much forgiveness we are giving. Is there someone we still cannot forgive even after they have expressed sorrow for their actions? Have we judged someone too harshly because of something they said or did that we did not particularly like? How many times have we failed to help somebody because we are still dwelling on an injury that we suffered many years ago? How many times have we treated someone differently based on preconceived notions or stereotypes? These are some of the factors that shackle us like chains and that disrupt the unlimited data of divine grace in our lives. When we close ourselves off to people or dismiss them based on our preconceptions, mistaken judgments, and prejudices, not only do we make them suffer, we suffer as well.

But it does not have to be that way. Jesus came to free us from and the burden of sin and unhappiness. Forgiveness is like mercury, which runs away when it is held tightly in the hand but is preserved by keeping the palm open. When we lose forgiveness, we lose the ability to give and to receive love because love is the foundation of forgiveness. And since God is the foundation of love, whoever refuses to forgive automatically rejects the love of God. This is the essence of today’s parable and it is highlighted by the contrast between what was owed by each man. The wicked slave owed his master some 10000 talents. In gold terms, that is 350 tons and at today’s price, he owed his master USD21.8 billion. This was way more than King Solomon made in a year which was 666 talents of gold or USD1.45 billion in today’s value (cf. I Kings 10:14). So, this unforgiving servant owed his master what no individual could never payback. In contrast, his fellow servant owed him the equivalent of one talent of gold or USD2.1 million; so a man who was forgiven $21.8b could not let go of $2.1m, and his wickedness landed him in the hands of torturers.

Dear friends, forgiveness is an act of compassion which is expressed in the free choice to pardon one another’s shortcomings every day, and to also pardon ourselves for own mistakes Forgiveness transcends the fear of being wounded again; it is a deliberate act in imitation of the redemptive work of Jesus, the advocacy of the Holy Spirit, and the loving kindness of the Father. The whole point of today’s parable is that our Father in heaven will do the same to anyone who refuses to forgive others. Whoever refuses to forgive is doomed to a life of bitterness, and as the ugly trend continues, the person ends up building invisible walls of resentment around themselves, thereby blocking off not just one’s relationships with other people but with God as well. Forgiveness is not just an emotional expression or a sense of righteousness; it means being merciful not only when there is an explanation or apology, or a promise of amendment from the offender, but even when the offence is deliberate, and the offender is adamant. Forgiveness is a precious gift of grace, which does not depend on the worthiness of the receiver. Forgiveness is what we called to do, and the Lord’s grace is sufficient for us in that regard. Amen.

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Imo Deputy Governor’s giant strides towards revitalizing agriculture

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Imo Deputy Governor's giant strides towards revitalizing agriculture
By Joy Opara

The increasing cost of Agricultural products in Imo State in recent times has continued to be a major source of concern to the citizens of the state.

A critical appraisal of the development of Agriculture in this state reveals that successive governments had neglected this major sector of the economy, over three decades now, and this has adversely affected the revenue of government.

In line with the vision of the “shared prosperity” government of the Hope Uzodinma administration, the revolution of agriculture is among its cardinal programmes for which a high powered committee (on agricultural master plan for Imo State) has been set up.
For the purpose of resuscitating all moribund agricultural industries and facilities in the state, it is not surprising that this committee is headed by a world class Professor of Agriculture and Deputy Governor of Imo State, Prof. Placid Njoku.

The need to diversify the economy cannot be over-emphasized. It is a well known fact that there is no better and more sustainable means of diversifying the economy than through agriculture. It would be recalled that after the inauguration of his committee, the deputy governor went into action, first by visiting all moribund agricultural facilities in the state, which included Adapalm in Ohaji/ Egbema LGA, Avutu Poultry farm in Avutu, Obowo LGA, Songhai farms, Okigwe road, Owerri, ADP farms in Nekede, Owerri West. Others are Acharaubo farms in Emekuku, Owerri North, Imo Rubber Plantation in Obiti, Ohaji/ Egbema, amongst others.
Prof. Njoku in one of his speeches during the tour described agriculture as the economic base of most countries of the world. Considering the dwindling oil revenue, he said it should be a source of worry to people of good conscience that the vision of our founding fathers to generate revenue, food security, economic advancement, industrialization, employment and eradication of poverty was destroyed by successive governments.
The Deputy Governor, who not only is acknowledged as one of the greatest professors of Animal Science, a renowned Agriculturist and former Vice Chancellor of a leading University of Agriculture, the Federal University of Agriculture, Umudike, made it clear that the present government led by Governor Hope Uzodinma is desirous to return agriculture to its former glory.

The Ikeduru-born technocrat and farmer per-excellence said that the 3R Mantra of this administration namely: Reconstruction, Rehabilitation and Recovery is a base for making the dream of Imo State as the food basket of the nation come true.

Noting that government is a continuum, the deputy governor promised that his committee will build upon what is already on ground by rehabilitating the ones that could be rehabilitated and bringing in new facilities where necessary to ensure that the passion of the governor towards agricultural revival is achieved.

Meanwhile, in most of the establishments visited by the committee, it was discovered that indigenes of the communities had badly encroached into the lands and converted them to personal use. Investigations by the committee revealed that agents of some past governments in the state connived with the communities to make it possible, for their personal aggrandizement.

The deputy governor, whose humility has become legendary pledged his total support to the Governor, Senator Hope Uzodinma whom he described as God sent to right all that were done wrong by the previous administrations in the state. He called on all to give this administration the needed support to rewrite the history of Imo State in gold, especially the agricultural sector.

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Child Abuse: A case of betrayal of reciprocal trust

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Child Abuse: A case of betrayal of reciprocal trust
By Christian Uzoukwu

Some years ago, while as a kid, I fell out with my father due to an occasion of sheer disobedience and on that very day, I was given no food and was ultimately battered by hunger. Child abuse includes both acts of commission and omission on the part of parents, guardians as well as care-givers.

These acts have led to a lot of actual and threatened harm meted out on countless number of children. In 2014, the WHO made an estimate of 41,000 children (under the age of 15) that are victims of homicide and other related offences. This estimate, as expounded by this world body is grossly below the real figures due to the views of the society in relation to corporal punishment experienced by children. Girls are always most vulnerable to different forms of child abuse during unrests and in war-thorn territories.

Cases of child abuse can be established in some deadly human vices such as child trafficking, child labour, forced adoption as seen in the one-child policy prevalent in China. In the Asian country, women, by law are only allowed to have one child. Local governments would sometimes allow the woman to give birth and then they would take the baby away stating the mother violated the one child policy. Child traffickers, often paid by the government, would sell the children to orphanages that would arrange international adoptions worth tens of thousands of dollars, turning a profit for the government.

Other striking examples of child abuse are the various forms of violence against the girl-child which involves infanticide, sex-selective abortions, female genital mutilations (FGM), sexual initiation of virgins in some African cultures, breast ironing in some parts of Cameroon – involving the vicious use of hot stones and other tools to flatten the breast tissue of girls who have attained the age of puberty. As if those were not enough, female students are also subject to maltreatments in countries like Afghanistan and Pakistan. This is not to talk of recurring kidnapp of female students in some parts of Nigeria, as we saw in the case of Dapchi and Chibok schoolgirls.

Based on simple analysis, child abuse can be defined as “all forms of physical and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment or commercial or other exploitation, resulting in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power”.

This definition by WHO also falls in line with the definition propounded by the United States Centres for Disease Control and Prevention, which says that child abuse are acts of commission. This commission includes “words or overt actions that cause harm, potential harm, or threat of harm to a child”, and acts of omission (neglect), meaning “the failure to provide for a child’s basic physical, emotional, or educational needs or to protect a child from harm or potential harm.

In Nigeria, most cases of child abuse have become cumbersome due to the fact that these acts of abuses are regarded as mere punishments to unruly young ones and by so doing, should be justified and doesn’t call for any further discussion and/or scrutiny. According to various statistical studies and researches, child abuse is a vast societal cankerworm and has four profound tentacles viz:

Physical Abuse: this involves undue hitting, beating, kicking, shaking, biting, burning, strangling, insertion of pepper into the eyes and pubic regions of children, maltreatments from house-help(s) and seniors at boarding/day schools, suffocating and forcing children to live in unwholesome conditions.

Sexual Abuse also includes persuading a minor into acts of sexual intercourse, exposure of the child’s private parts, production of child-related pornographic contents and actual sexual contacts with children.

Psychological Abuse of children can be seen in cases of excessive scolding, lack of proper attention that children should be receiving from their parents and guardians, destructive criticisms and destruction of a child’s personality.

Neglect of children can also lead to children dropping out of schools, begging/stealing for food and money, lack of proper medical care for minors and realities of children looking like ragamuffins.

Consequently, the causes of child abuse can be judiciously related to sex, age, personal history, societal norms, economic challenges, lack of Rights’ Protection Agencies, parents battling with traits of alcoholism and family size. These causative agents of child abuse can bring untold effects upon the society at large and these effects can be emotional, physical and psychological as the case may be, giving rise to individuals with dissociative lifestyles.

Furthermore, the treatment of individuals who have been malformed with respect to the abuses they experienced abinitio, can be a long process because it involves behavioral therapy and other forms of neoteric therapies. Treatments of psyche-related problems are not just a one-day process due to the long-lasting effects of abuses on various conscious mental activities. It is also noteworthy to point out that, prevention is always better than cure and holding fast to this true reality, entails that agencies who have the responsibility of protecting the rights of children must continue to do the needful which requires proper oversights of parent-child relationships.

To conclude this piece therefore, we must agree that untold hardships have been a great challenge for children especially in Africa and some parts of Asia. Children with long histories of abuses turn out to become societal misfits. To this end we encourage that: Children should be given a free platform to express themselves on many topical issues and issues relating to their existence.

Children should also be allowed to freely ask questions on any issue, no matter, how weird it seems to be.

Governments should make regulations outlawing societal norms and values that might amount to child abuses.

Corporal punishments by parents, guardians and care-givers should be discouraged at all levels, thereby making parents/guardians/care-givers who seem to be incorrigible, to face the full weight of justice enshrined in the law of the land.

Education system (both conventional and unconventional) in Nigeria should be able to train up young ones into becoming critical, analytical and evaluative individuals with a view of defending the vulnerable.

And again, since children are said to be leaders of tomorrow, it is pertinent to note that to secure their future, their present existence must be cherished and protected.

Christian Chimemerem Uzoukwu
08100029867 / 09025760804
Admin Critical Thinkers’ Forum.

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