Tuesday, May 26, 2015

Children’s Day: What hope for the Nigerian child?

My boss, a female and former minister of health, who was the key note speaker, had delegated me to represent her and deliver the lecture due to her international engagement about the same period.
At the meeting, it was said that we were not far from achieving the Millennium Development Goals. The hope of the participants were raised that there was hope for the future if all stakeholders could make concerted efforts towards the realisation of the MDGs.
By December 31 of this year, the MDGs — eight in number — would have come to an end without much being achieved, and they would be replaced by Sustainable Development Goals which are over 17 in number.
The SDGs are a proposed set of targets relating to future international development. They are to replace the MDGs once the latter expire at the end of this year.
This year’s Children’s Day is a call for reflection — a call on government, philanthropists, health workers and everyone involved in the care of children, especially as the health indices of Nigerian children are still below the standards expected on global scale.
While on a rural posting at a popular National Paediatric Centre in Ogun State, I had taken unusual steps that kept a pre-term neonate alive despite our resource-constrained situation.
I had three pre-term newborns that were on admission. They included a set of twins, with one of the twins permanently on oxygen. At about 4a.m. on this fateful day, I noticed that the oxygen gauge on the cylinder was indicating that in the next 30 minutes to one hour, it would finish.
I started brainstorming on what to do next, since the earliest time the cylinder could be refilled was the following morning, which was about five hours away. I was optimistic that the child would survive, so I put a call through to one of the three biggest private hospitals in the town. Alas! I was told by the medical director of one of the hospitals that the only oxygen concentrator (a machine that delivers 100 per cent oxygen from atmospheric air) they had was being used by an adult in critical condition. Then I quickly made a call to the second biggest hospital in the same town, but no response.
I placed a call to the medical director of my hospital, but her number was said to be unavailable as a result of network failure. By then, it was almost getting to 5a.m. The baby-patient who weighed a mere 1.35kg was already having cyanosis, meaning that the palms, lips, and the soles of his feet were already turning blue due to lack of oxygen — a sign indicating that the worst might happen soon.
At this point, I had to do something unusual because the breathing was already reducing.
The mother who was also awake all night was already panicky because she was made to be aware of what was going on. The nurses were on their toes, and the vital signs were checked every 15 minutes while the pulse oximeter reading was not encouraging.
The oximeter was already ringing alarms, meaning an urgent attention needed to be given. I gave the baby some medication to support his respiration.
The ambulance driver could not be reached on time, so I grabbed the key, which was normally kept at the nursing station. I put on the ignition, the siren and the gadgets inside the ambulance, including the neonatal resuscitation kits. Together with the nurse and the mother, we headed for the hospitals in town in search of oxygen.
When we got to the first hospital, I requested to see the MD who resided within the hospital premises. The nurse told me he was not around. I called him on the phone, but I was told the last cylinder of oxygen finished the previous night. Within me, I thought of the Devil Factor. I said ‘The devil is a liar!’
I quickly thought of the nearest teaching hospital, which was about 30 minutes away. This would have been the best idea, but the highway was notorious for robbers around that time of the day and the road had some death traps, potholes and the rest.
We headed to the state hospital. While still on the way, I called the Head of Paediatrics Department who said there were oxygen concentrators but no electricity to power them! I was told the way out for the parents of the baby was to bring their own generator, filled with enough fuel to power the oxygen concentrator.
The baby’s dad went in search of a generator. It was then about 6:30a.m. We then contacted a senior matron who worked in the same hospital. She drove down to meet us with a full cylinder of oxygen, with a simple instruction that we refill it after use. That was the turning point.
We quickly connected the oxygen to the baby in the ambulance and we headed back to our own hospital. Within half an hour, the pre-term newborn picked up, and the palms, soles and lips turned back to pink. He cried and lifted up the limbs. The mother, the nurse, and I were all happy.
At the management meeting later that week, I relieved the event to the management, which commended the medical team. The matron who gave out the cylinder full of oxygen was contacted and appreciated. The hospital later procured two oxygen concentrators and a giant oxygen cylinder that delivers oxygen centrally to many babies from different points via pipeline at the same time.
The baby was discharged and the parents took him home in good health, weighing 1.5Kg. We followed him up for one year. He did not have any disability, and his growth was normal. His hearing test was satisfactory. The baby survived.
As we mark the Children’s Day today, this is a call on all stakeholders to increase efforts at improving Nigeria’s child health indices. We, as a nation, have not met the Millennium Development Goal 4: Reducing child mortality by a third.
Children still die of diarrhoea, neonatal tetanus, birth asphyxia, severe jaundice, severe malaria, meningitis, and complications of measles, just to mention a few.
We need help! I believe the incoming government will continue from where the outgoing one stopped, since government is a continuum. India did it, and they were able to eradicate polio. Nigeria can also do it. We did it with the Ebola Virus Disease; we can do it again! 

THE CRY OF NIGERIAN CHILDREN!


Kindly request for the excerpts of my lecture on ''The Nigerian Child a future in peril'' via my e mail address: roayad@yahoo.com.

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