(By Adebayo Folorunsho-Francis)

Following complaints from several quarters, the Medical and Dental Council of Nigeria (MDCN) has openly declared that no doctor should be seen conducting personal advertisements or distributing souvenirs bearing inscriptions of particular health institutions, with a view to obtaining patients.

In a strongly worded press release signed by its registrar, Dr Ibrahim Abdulmumini, the MDCN explained that it is a long-standing tradition in the profession that doctors should refrain from self-advertisement.

“This has been so because of the appreciation by the profession that advertising could become a source of danger to the public, in that a doctor who was successful at achieving publicity might not in fact be the most appropriate doctor for a patient to consult,” he said.

The registrar noted that the complaints so far received showed medical and dental practitioners were either ignorant of the provisions of medical ethics code on advertising or merely disregarded them. He added that such adverts might also precipitate unwholesome rivalry among practitioners.

Speaking further, Abdulmumini remarked that any registered practitioner would be compelled to appear before the Panel and Disciplinary Tribunal, if he is found to have advertised himself, whether directly or indirectly, for the purpose of obtaining patients or promoting his own professional advantage.

“A practitioner shall also be subject to proceeding if for any purpose of procuring, sanctioning or acquiescing in the publication of notices commending or directing attention to the practitioner’s professional skill, knowledge, services or qualifications or deprecating those of others” he stressed.

The MDCN boss explained that health education is a component of primary healthcare, which is the cornerstone of the National Policy on Health, adding that doctors are often required to provide health education to the public in both the electronic and the print media.

“Doctors who get involved in performing such function should not use the occasion for self-advertisement. They should merely present their materials in such a manner as to only serve the purpose of public enlightenment on the health issue under focus,” he emphasised.

The registrar further warned that any medical or dental practitioner found to be engaged in or encouraging professional touting would be subject to proceedings before the Panel and Disciplinary Tribunal.

He noted that such act includes, but not limited to, use of canvassers and displaying of cards or calendars in hotels, banks or any other such venues.

“Practitioners are not allowed to produce or distribute calendars, key holders, wall clocks, trays and such other gift items because such items are promotional in nature and are likely to excite unwarranted and unhealthy competition among practitioners,” he cautioned.

 Do you agree? Hear what the septuagenarian has to say.

Pharm. Moses Chiedozi Azuike was registrar / secretary of the then Pharmacists Board of Nigeria (1982-1985) and one of the few pioneer staff of the National Agency for Food and Drug Administration and Control (NAFDAC) when it was established in 1993. In this interview with Adebayo Folorunsho-Francis, the 75-year-old Fellow of the Pharmaceutical Society of Nigeria (FPSN) explains why he thinks the pharmaceutical profession has experienced a giant leap after suffering untold repression, amid threats from several quarters. Below are excerpts from the interview:

Tell us a bit about yourself, especially your early days.

I was born on 21st August 1938 in Egbu, Owerri North Local Government, Imo State.  Presently, I am married and have four daughters and two sons (not forgetting my six grandchildren). I had my secondary school education at St. Augustine’s Grammar School Nkwerre, Imo State, from 1953 to 1957.Thereafter I attended the then Nigerian College of Arts Science and Technology, Ibadan branch (1958-1960) and the University of Ife, now Obafemi Awolowo University (1961-1964).

When did you qualify as a pharmacist?

I became registered as a pharmacist in June 1964, having obtained the Joint Diploma in Pharmacy from the University of Ife and the then Pharmacists Board of Nigeria. I later returned to the University of Ife during the 1966/67 academic session and obtained the B.Pharm (Hons) degree in June 1967.

Tell us more about how you started your pharmacy career.

My working career, which spanned over 34 years, was entirely within the Federal Public Service. I started as a hospital pharmacist at the General Hospital, Lagos (1964-1966). After the Civil War, I worked briefly at the Federal Medical Stores in Oshodi (1971). I left later to work at the Pharmaceutical Inspectorate Unit and the Narcotics Unit in Yaba. I was registrar/secretary of the then Pharmacists Board of Nigeria from February 1979 to December 1986. Thereafter I was moved to the Federal Ministry of Health Headquarters, Ikoyi, as assistant director and later deputy director responsible for drug control. I became one of the pioneer staff of the National Agency for Food and Drug Administration and Control (NAFDAC) on its establishment and take off in 1993. I retired from the agency in August 1998 as the pioneer director of Narcotics and Controlled Substances Directorate. Thereafter I served as consultant to the agency until December 2000.

There is a school of thought that says you spent a greater part of your service on foreign mission. How true is this?

Well, in the course of my career in the public service, I was privileged to be a beneficiary of a number of training programmes, particularly in the area of drug control. In 1975, I was a beneficiary of the United Nations Fellowship for a training course at the UN Training Unit Centre, Geneva, Switzerland. The training was on Drug Control Administration for participants from Africa, Asia, the Middle East and the Caribbean.

In the course of that programme, I was privileged to undertake a study tour of the workings of some international and national organisations with significant roles in international drug control. These included the headquarter office of INTERPOL, then at St. Cloud, France; the U.K. Metropolitan Police, Scotland Yard, London; and the U.K Customs Training School in South end- on-Sea, near London. In 1987, I participated in the monthly International Visitors Programme of the United States Information Agency. This was a first-hand study of the strategies adopted in control of drug problems in the United States of America at government and community levels. The programme afforded me the opportunity to visit several US cities, including Washington D.C, Atlanta, New York, Philadelphia, Minneapolis and San-Francisco.

Looking back, can you confidently say studying Pharmacy was a good decision for you?

Yes, I can confidently say that I made a good decision to study Pharmacy. I believe I have had a fulfilled career as a pharmacist.

What was the profession like in your day, compared to today’s practice?

It is now 49 years since I came into the profession. As expected, significant changes have occurred since then. The number of practitioners has increased. At the time I qualified, there were less than 800 names in the register of the Pharmaceuticals Board. Today, I guess we have not less than 15,000. The population of the country has also increased. I remember that at the beginning of my career, both the imperial and metric systems of weights and measures were in use. Today, all measurements are in the metric system. The days of grains, minims and fluid ounces have given way to millilitres, milligrams and grams. The 1960s, 70s and early 80s were the eras of compounding of medicines in hospital and community pharmacies. It was then common to observe on the shelves several Winchester bottles of extemporaneously prepared expectorants, haematinics, purgatives, diuretics, antidiarrhoeals etc. from which individual patient prescriptions were filled. Solid oral preparations (tablets and capsules), which were supplied by the industry in packs of 100s and 1000s were counted out and wrapped with paper for individual patients. It was not until the mid-1980s that plastic dispensing envelopes were introduced into use in Nigeria – courtesy of the proprietor of Kakaki Chemists Ltd, Lagos.

What else has changed since then?

Local pharmaceutical manufacturing industries have increased in number, especially since the 1980s. Due to advancement in technology, local and foreign companiesare now supplying their products in individual patient packs, that is, in sachets and small containers of liquid preparations. Compounding rooms are no longer desirable in most pharmacies. Public perception of the pharmacist has also improved. The mostly one-room chemist shops of those days are giving way to properly planned community pharmacies in the towns and cities in Nigeria, even though the spread to rural communities is yet to be satisfactory.

Are there intrigues and controversies concerning pharmacy practice that still evoke memories of the past?

In the quest for proper professional recognition, pharmacy practice in Nigeria has had to go through a number of controversies. Even today, there is controversy over the role of the pharmacists in the National Health Insurance Scheme (NHIS). This is yet to be settled to the satisfaction of pharmacists.

In my early days in the profession, pharmacists were poorly remunerated in the public service. The major controversy therefore hinged on the demand to be placed on scale A salary level. The demand was based, not only on the high entry requirement of three G.C.E. “A” Level passes for admission into pharmacy school, but also on the duration of the course and schedule of duties.

Can you elaborate on these issues?

The powers that be at the time were not well disposed to granting the demand for proper remuneration, even after well-articulated memoranda were submitted to commissions set up by government to review the civil service set up. That demand was eventually acceded to in 1969 through the white paper issued on the Elwood Commission report, which incidentally did not make a favourable recommendation. After that, the next struggle was on extricating the profession from the shackles of medical doctors in the Ministry of Health and upgrading the status of the Federal Chief Pharmacist to that of a Director on salary grade level 16. At that time, Pharmacy was a Division within the Directorate of Medical Service. The Federal Chief Pharmacist, whose grading was on salary grade level 15, reported to the Permanent Secretary through the Deputy Chief Medical Adviser (DCMA).

During this period, there was sustained controversy over the role of pharmacists within the Ministry. The antagonists of the profession canvassed for pharmacists to be stripped of their drug control responsibilities (inspectorate activities, drug registration, and drug quality evaluation functions) and rather be confined to drug procurement, storage, distribution and supply in public health institutions. They were however disappointed when in 1980, the Pharmacy Division was upgraded to the status of a Directorate with a Director on salary grade level 16. The achievement was mainly as a result of well-structured argument in the memoranda submitted to the government by the then Federal Chief Pharmacist, Dr. P.O. Emafo. His efforts received support from well-meaning individuals and pharmacists such as Prof. William Osisiogu (a pharmacist) then Federal Commissioner of Water Resources, and late Augustine Nnamani (pharmacist/lawyer) then Attorney General and Federal Commissioner of Justice.

Still, the controversies over the role of pharmacy in the Ministry did not abate. It came to a head in 1988 when the then Minister of Health merged the Pharmaceutical Services Directorate and the then Food and Drugs Administration and Control Directorate to form the Food and Drug Administration and Control Department, with a pharmacist as the director.

Merging two offices together can sometimes muddle things up. Did this particular union survive?

The officers of the two departments retained their official titles either as pharmacists or as scientific officers. This was to elicit another controversy in future. When some aspects of the functions of the department were carved out to form the National Agency for Food and Drug Administration and Control (NAFDAC), there was controversy over what was to be the official title of the officers of the agency, given their multidisciplinary backgrounds. The controversy however did not last long, as wise counsel eventually prevailed and everyone accepted the “Regulatory Officer” title which is applicable in NAFDAC today.

Over the years, you must have seen many PSN presidents come and go. Was there one who really left a lasting impression on you?

I have very good impressions of most of the PSN past presidents. Among them, however, the late Sir Sam Agboifo stands out as the one of whom I have the most lasting impression. This may not be unconnected with the fact that I had a much closer personal and official relationship with him than anyone else.

His tenure was from 1982 to 1985. At that time, I was privileged to be the registrar/secretary of the then Pharmacists Board of Nigeria; and also from 1983 to 1987, secretary-general of the then West African Pharmaceutical Federation. I worked closely with him at the level of the Pharmacists Board, the Council of Pharmaceutical Society of Nigeria (PSN) and that of the West African Pharmaceutical Federation. He was a selfless leader who pursued any course he believed in with doggedness

What do you think of the incumbent PSN president, Pharm. Olumide Akintayo?

Pharm. Olumide Akintayo is a young and dynamic pharmacist. I feel he is well-fitted for the position he now holds. He did not just stumble on it. He had been deeply involved over the years in the affairs of PSN in Lagos, as well as those of the Association of Community Pharmacists.  He carried out an impressive election campaign last year, with a clearly articulated manifesto. He is yet to complete a year in office and my assessment is that he has not disappointed his admirers. He will surely have a successful tenure.

What was the level of your involvement in pharmaceutical activities?

I have had the privilege of being involved in a number of pharmaceutical activities, which include:

·    Secretary-general of the West African Pharmaceutical Federation (WAPF) 1983-1987.

·    Chairman, Nigeria Chapter of the West African Postgraduate College of Pharmacists (WAPCP) up to 2006.

·    Chairman, Faculty of Social and Administrative Pharmacy, West African Postgraduate College of Pharmacists (2003-2007)

·    Member, Examination Committee of the West African Postgraduate College of Pharmacists (WAPCP) (2003-2007).

·    Resource person, Mandatory Continuing Professional Education (MCPE) programme for the re-certification of Pharmacists.

·    Ex-officio member of the Council of Pharmaceutical Society of Nigeria (PSN) by virtue of my position as registrar/secretary, Pharmacists Board of Nigeria (1979-1986).

·    Member, Executive Committee of Pharmaceutical Society of Nigeria  (PSN) Lagos State Branch (1975-1977).

·   Member, Editorial Committee of the Pharmaceutical Society Journal (1975-1980).

·   Member, Planning Committee of the Golden Jubilee Conference of the Pharmaceutical Society of Nigeria (1977).

·  Member, PSN Committee on  Draft Memorandum to Federal Government of Nigeria for the establishment of the National Institute for Pharmaceutical Research and Development (NIPRD) 1986.

Are there some major awards given to you in recognition of your selfless services?

Yes! The awards include election as one of the foundation fellows of the West African Postgraduate College of Pharmacists in 1991; Merit award from the Pharmaceutical Society of Nigeria, Lagos State Branch (1993) and fellowship of the Pharmaceutical Society of Nigeria (2006).

How do you see the annual PSN National Conference?

There has been considerable improvement of the annual PSN conferences, in terms of organisation and attendance. This, no doubt, is a reflection of advancement in the country, generally.

If you were not to be a pharmacist, what other profession would you have opted for?

I would probably have opted to be an engineer, as my knowledge of mathematics at the school certificate level was above average. However the choice of pharmacy was inspired by a few close relations and acquaintances who, before me, were pharmacists.

Is there any particular age when an active pharmacist should retire?

I do not think one can prescribe a particular age for the retirement of an active pharmacist. It will depend on the type of activity the pharmacist is engaged in. Those in paid employment will disengage, in accordance with the terms of their employment. Thereafter, they can continue to be active in pharmacy affairs and practice, as long as they are in good health and are able to render invaluable services. Those who are self-employed, particularly in the community practice, should hold on to their practice and involvement in pharmacy affairs, as long as they are in good health.

As an elder in the pharmacy profession, what is your advice to young pharmacists?

I advise them to be focused and hardworking. They should endeavour to be professional in whatever aspect of pharmacy practice they choose to be. The future of the profession is bright. It is brighter today than in 1964 when I qualified. It will be better in the future. They should be determined to overcome every obstacle and controversy they will encounter.

To enhance professionalism and reduce stress in daily business operation of community pharmacies in Nigeria, Electrokingdom Limited, an innovative software company, has introduced ElectroClerk Pharmacy Software, which it said will help make life easier for community pharmacists.

Speaking with Pharmanews at the 32^nd Annual National Conference of the Association of Community Pharmacists of Nigeria (ACPN), held at the Cultural Centre, Calabar, Cross River State, recently, the chief executive officer (CEO) of the company, Mr. Morak Bamigboye-Aje, disclosed that the software is specifically made for community pharmacists, as it affords them the opportunity to operate their pharmacies without stress, adding that it also saves time and resources.

“We encourage all community pharmacists to move with the trend, because with our pharmacy software, your patient’s medical records can be kept, so that your patient gets up-to-date messages on their phones on how to take their drugs and when to take them. It also enables you to receive alerts on your daily sales report, while you can connect to your database online and get all the information you desire about your pharmacies. It goes beyond that, as it also helps you to keep accurate records of your inventory, product expiry dates, and allows you to monitor the frequency of your sales, even when you are not around.”

According to him, the software is useful to those who are just setting up pharmacy outlets and those who are already established in the profession. “The steps are very easy, as they only require that the person should buy our software and install it on his or her computer, which may be more than one or two. It does not take more than three minutes to install and it can be done by the pharmacist or any other person. By the time the person tries to activate it, an activation code would be sent to the person’s phone number. So, if it is successful, the person can start using the software,” he said.

The Electrokindgom boss explained that the most beautiful thing about the software was that it does not require annual renewal fee or licence fee, saying that the person only needs to buy the software for one outlet at a time and it can work for as many computers as possible. “However, as we all know that software as a technology keeps evolving, if you have a version this year, an upgraded version may come out next year. This does not mean that you would have to throw away the old version that you have. All you have to do is to buy an update at a very cheap price, or you may decide to keep using the old one that you have, since it doesn’t change anything. It is just like having an old model phone that is serving you and wanting to buy a new model.”

While expatiating on some other products that the company sells, apart from ElectroClerk, he explained that the company, which was established in 1998, started by writing customised software for companies, but decided at a point to start writing unified software for companies. “At that point, anybody can walk into our company and when they mention the kind of business they do, we would give them the software that works with it. So, apart from pharmacy software, we also sell school software for primary, secondary and tertiary institutions, which enables the schools to monitor their payments online, upload and check their school results and do so many other things. We also haveElectroClerk for bookshops, for general commerce, microfinance and cooperative institutions.”

Speaking on the company’s relationship with the ACPN in both Rivers and Lagos States, he said the software had been bought in bulk by both states, adding that Rivers State had already sold the first batch that they bought to their members. “Presently, the software is sold at just fifty thousand naira, outside the conference, but at conferences like we are now, the price varies. Meanwhile, it is advisable that states buy in bulk, like Rivers and Lagos States are doing. When they buy in bulk, it reduces the price and the pharmacists would have to buy from their associations,” he said.

He stated further that labelling is very easy when using the software because it redresses irrational drug use and medication errors.  “So, community pharmacists who are yet to buy into this innovation are encouraged to do so, as a pharmacistshould be able to show a difference in his practice from that of ordinary drug hawkers,” he said.

He said that the slogan of the company is “making life easier”, adding that his firm is determined to put smiles on the faces of every pharmacist in this country. He hopes that, in the long run, no community pharmacist would have any other choice than to adopt this innovation.

    (By Yusuff Moshood)

To ensure qualitative pharmaceutical research and development in the nation’s tertiary institutions, the Association of Industrial Pharmacists of Nigeria (AIPN), has launched a two-million-naira research grant, to assist faculties of pharmacy, nationwide.

The AIPN’s national chairman, Dr. Lolu Ojo, while speaking with Pharmanews at the formal launch of the grant at the Pharmacy House, Lagos, recently, lamented that the banes of the nation’s tertiary institutions, over the years, have been poor funding, infrastructural decay and the likes.

While commending pharmacy lecturers for their tenacity of purpose and forbearance, Ojo said that the hope of AIPN was that the humble contribution of the two million naira research grant would trigger resurgence of research activities in the faculties of pharmacy throughout the country.

The AIPN boss also thanked Prof. Fola Tayo for accepting to be the coordinator of the grant project.

Also speaking at the occasion, Pharm. Olumide Akintayo, president of the Pharmaceutical Society of Nigeria (PSN), commended the AIPN leadership for initiating the project.  He noted that giving a research grant to faculties of pharmacy in Nigeria is a laudable project, adding that the PSN would also look into how to reinforce the idea.

The chairman of the PSN Board of Fellows, Pharm. Ade Popoola, in his remarks at the occasion, also commended the AIPN leadership for the various innovations it had introduced since inauguration, and lauded Dr. Lolu Ojo for taking the association to the next level.

While praising AIPN for the research grant initiative, he prayed that the successor of Dr. Lolu Ojo, as national chairman, would sustain all the wonderful projects of the Lolu Ojo-led executives.

Presenting the guidelines for proposals from the faculties of pharmacies to get the research grant, Prof. Fola Tayo, the grant coordinator, also commended the Lolu Ojo-led executives of AIPN for the grant idea, adding that the initiative would greatly help to ensure that research work done by the lecturers in the faculties of pharmacy in the country had industrial and commercial impacts.

While calling on faculty members to come forward and apply for the grant, the coordinator urged applicants to strictly follow stated guidelines, adding that failure to follow the guidelines would result in automatic disqualification.

He also added that the selection process is strictly on merit, noting that attempts to lobby or influence the process would not only result in disqualification but also a ban on future application from the indicted applicant.

Amongst the dignitaries present at the occasion were: Prof. Olukemi A. Odukoya, dean, Faculty of Pharmacy, University of Lagos; Prof. C.P. Babalola, dean, Faculty of Pharmacy, University of Ibadan and Prof. (Mrs) G.O Onawunmi, dean, Faculty of Pharmacy, Obafemi Awolowo University, Ile-Ife.

(By Adebayo Folorunsho-Francis)

In this interview with Adebayo Folorunsho-Francis, Pharm. Obiora Ezekwesili, technical and manufacturing director of AfrabChem Nigeria poured out his heart on the scourge of malaria, perennial neglect suffered by indigenous pharmaceutical producers and why the government needs to invest heavily in the local manufacturing industry in Nigeria.

Read the excerpts below:

In view of the World Malaria Day, can you boldly say Nigeria is winning in its fight against the scourge?

Well, I think the campaign against malaria is partially successful in Nigeria. So much has been done in this area but, unfortunately, organisations keep changing. Most of the anti-malarial drugs you see around tend to lose potency seven years later and new ones are brought in to replace them. It is quite hard for you to see a drug that cuts across generations or that stays long enough.

It appears many still prefer Chloroquine to Artemisinin-Based Combination Therapies (ACTs) despite the embargo placed on it. How do you react to this?

Embargo or not, I don’t see anything wrong with that. Besides, top pharmaceutical companies like AfrabChemstill produce Chloroquine drugs, to provide relief for babies and the demand is still growing. Those saying that it is no longer relevant don’t fully understand what they are saying. What works for somebody might not work for another. For instance, in most hospitals you visit today, Chloroquine is still effectively used, even though the doctors may not tell you this.

How wouldyoureact to complaints about the high cost of ACT drugs?

As a Nigerian, I am not in support of federal government-subsidized ACT. Why go all the way to India to make such arrangement? Why not invest here locally? It is a good thing that the price is shooting up now. This should make the government to start looking inward and conclude logistics to invest wisely in our manufacturing sector.

Are you saying Nigeria has the capacity to produce these drugs here cheaply?

Yes! In fact, I am insisting that the solution lies in the local industry. The government can even set up these facilities on their own, without contribution from private bodies. After all, if Ghana can boast of having one that was built by her government, why not Nigeria? Besides, it is bound to also throw up employment opportunity for the masses.

What is your view about pharmacists’ struggle against drug counterfeiting in the country?

To be frank, counterfeiting is a global problem, and not an issue for Nigerian local drug producers alone. That said, I bought this idea of Mobile Authentication Services (MAS). NAFDAC has instructed that every anti-malarial product should now carry a scratch panel for patients, and for those buying them to clarify the authenticity. From what I have seen so far, I think it is effective. You can fake things but you cannot fake that! Counterfeiting is a problem of discipline. There should be a proper way to do what you have to do.Follow NAFDAC guidelines and directives, use right distribution channels and rest assured that your products are safe.

Tell us a bit about the state of pharmaceutical manufacturing companies in Nigeria

Well, all I can say is that local manufacturers in Nigeria are still doing well. For instance, I visited a company in Denmark where about 10 Nigerian local pharmaceutical firms were nominated, as part of WHO pre-qualification plan. I was happy that about four of those companies were approved. Unfortunately, the support from government is just not there, unlike India, Pakistan and other countries, where their governments placed restriction on the number of drugs to be imported into those countries. As I said, our local industry is still growing but could have gone faster than the present state. Government should learn to encourage indigenous manufacturers in the areas of power, infrastructure, regulation, investment and technology transfer.

What is the role of PMG-MAN on this issue?

The Pharmaceutical Manufacturers Group of the Manufacturers Association of Nigeria (PMG-MAN) is, in fact, trying and constantly liaising with the government. I must commend the current executives of the association. They have been up-and-doing. But as I mentioned, the government is still expected to do more. Go and check the records, you will see that the biggest companies in the world are pharmaceutical companies. All I am saying is that local manufacturers need encouragement. Our government should back local pharma producers, financially and morally.

Do you want to accomplish something in life? Be like the stonecutter. Jacob Riis says, “Look at the stone cutter hammering away at the rock, perhaps a 100 times without as much as a crack showing in it. Yet, at the 101st blow, it will split in two and I know it was not the last blow that did it, but all that had gone before.” Whatever you want to accomplish in life will require persistence. Champion race car driver Rick Mears says, ”To finish first, you must first finish.”

All things come to those who persistently go after them. Perseverance is the result of a strong will. Stubbornness is the result of a strong won’t. Montesquieu said, “Success often depends on knowing how long it will take to succeed.” The secret of success is: never let down and never let up. Consider what Proverbs says: “Seest thou a man diligent in his business? He shall stand before kings.”

Many times, success consists of hanging on one minute longer. Calvin Coolidge said, “‘Press on’ has solved and always will solve the problems of the human race.” You will find that persistent people always have this attitude: they never lose the game, they just run out of time. Compte de Buffon says, “Hold on; hold fast, hold out. Patience is genius.”

Joel Hause said, “You may be whatever you resolve to be. Determine to be something in the world and you will be something. ‘I cannot’ never accomplished anything, ‘I will try’ haswrought wonders.” Herbert Caufman adds, “Spurts don’t count. The final score makes no mention of a splendid start,ifthe finish proves that you were ‘an also ran’.”

Keep in mind the words of Hamilton Holt: “Nothing worthwhile comes easily. Half effort does not produce half results. It produces no results. Work, continuous work and hard work, is the only way to accomplish results that last.” No one finds life worth living. You must make it worth living.

Ralph Waldo Emerson said, “The great majority of men are bundles of beginnings.” I agree with Charles Kettering when he said: “Keep on going and the chances are you will stumble on something perhaps when you are least expecting it.” Be like the bulldog: “The nose of the bulldog is slanted backwards, so he can continue to breathe without letting go” (Winston Churchill).

Persistence prevails when all else fails. The truth is that persistence is a bitter plant, but it has sweet fruit. Joseph Ross said, “It takes time to succeed because success is merely the natural reward of taking time to do anything well.” Persistence is the quality that is most needed when it is exhausted. Victory always comes to the most persevering.

Culled from Know Your Limits – Then Ignore Them by John Mason

(Pharm Nelson Okwonna)

A good examination of the Hippocratic Oath will reveal the depth of understanding from which the health care professions have developed. It shows theintentionality of the practitioners, their communal spirit and the wholesome mind with which they approached the sacred art, our sacred art.

It is in the light of the above and with particular emphasis on the individuality of this oath that we would consider if we have done the best for our patients in these modern times.

Have We Done No Harm?

In the management of cancer, diabetes, high blood pressure and other chronic diseases, can it really be said that we have done no harm to our patients? This discourse will raise mostly questions and may not succeed at presenting a particular set of answers.

At the just concluded Pharmanews workshop on “Alternative Medicine Management Approachesfor Cancer and Other Chronic Diseases”, these questions and many more came to bear. Have chemotherapy and radiotherapy really brought sustainable good to our cancer patients? Can we satisfactorily walk away, convinced that we have done the best for them? Have we factored all the causes that could predispose our patients to ill-health in the management of diseases? Is our approach more disease-focused than health-focused? Do the answers to these questions matter?

Let us take hypertension, for example. 95 percent of the cases are idiopathic – of no known cause. Have we focused on addressing this position of disadvantage, as much as we have focused on bringing the pressure down, by every means possible?

The story was told of a man who went fishing. As he got to the riverside, he found another fisherman who was doing something quite intriguing – he was throwing back the big fishes into the water and keeping the small ones. Puzzled, the man had to entreatthe fisherman to explain his action. The fisherman smiled and explained that he had an 8-inchfrying pan, and therefore couldn’t keep the big fishes.

Our 8-inch frying pan

In 2006, T. Colin Campbell released a book titled “The China Study”. The book was based on a huge epidemiologic study of diet and health done in China. The book’s major thesis is that we could prevent or cure most diseases (heart disease, cancer, diabetes, autoimmune diseases, bone, kidney, eye and other diseases) by eating a whole-food plant-based diet, drastically reducing our protein intake, and avoiding meat and dairy products entirely.The project was done in collaboration with Oxford University, and did give very important support for plant-based foods.

Not everyone agrees with Colin Campbell and this article is not to take a position on the matter.However, the aim is to demonstrate a factual position that what we eat really does matter. In his book, “The Outliers”, Malcolm Gladwell began by telling us a story of an immigrant community in the United States of America, which seemed not to ever have certain cardiovascular incidents. The medical state of this community baffled medical experts who couldnot find a single explanation for its uniqueness.After much fuss, someone arrived at an obvious answer – the community itself was the reason. The communal life, faith and manner of the members of the community accounted for their health status.

Today, we know that we do not have the best of diets or environmentsin Nigeria (two factors that play critical roles in determining our health status); hence, the increase in chronic diseases like cancer and diabetes is not particularly surprising. A recent report by the Business Monitor International stated that the growing incidence of chronic diseases and the purchasing power of middle class Nigerians would account for the projected increase in the pharmaceutical business in Nigeria. The point to note from the report is that the bad news of increasing chronic disease rates is relatively predictable and the aim of this article is to ask if we arenot seeking for solutions with an 8-inch frying pan.

What works?

In his opening remarks at the Pharmanews workshop earlier mentioned, the lead resource person, Dr Ladeinde, began by saying that he was not an advocate of traditional, alternative or orthodox medicine but rather of what works. I quite agree; it is our personal responsibility, as enshrined in the Hippocratic Oath, to find what works best for our patients and not necessarily what makes the most money. As it stands today, a hypertensive patient or a diabetic patient is more of an economic index for revenue generation than a problem that must be addressed. I seek not to trivialise an important issue or desecrate the hallowed altars of our noble practice but to rather ask deep, probing and perhaps disturbing questions – is our current approach working well enough? Can it meet our needs in the next ten years?

One recurring theme that undergirded the message by Dr Ladeinde is that, to help the patient, we must find ways to increase the ability of his body to fight disease; we must channel all our resources in aiding the most exquisite and resilient force on earth – nature. It is true that humans do not die; they kill themselves.What works is that which gives the human body increased ability to heal itself. To find it, in many cases, we may have to first change our frying pans.

Albert Einstein once observed that “the problems we face today cannot be solved on the same level of thinking we were at when we created them.”

Look around and you’ll see that is true. The world keeps getting more and more complicated. Does that discourage you? It doesn’t have to. Many years ago, I came across a quote that made a tremendous impression on me. It said:

I am your constant companion. I am your greatest helper or heaviest burden. I will push you onward or drag you down to failure. I am completely at your command. Half of the things you do you might just as well turn over to me and I will be able to do them quickly and correctly. I am easily managed-you must merely be firm with me. Show me exactly how you want something done and after a few lessons I will do it automatically.

I am the servant of all great men; and alas, of all failures as well. Those who are great, I have made great. Those who are failures, I have made failures. I am not a machine, though I work with all the precision of a machine plus the intelligence of a man. You may run me for profit or run me for ruin-it makes no difference to me. Take me, train me, be firm with me, and I will place the world at your feet. Be easy with me and I will destroy you.

Who am I? I am habit!

The good news is that, no matter how complicated life gets or how difficult problems may seem, good thinking can make a difference – if you make it a consistent part of your life. The more you engage in good thinking, the more good thoughts will come to you. Success comes to those who habitually do things that unsuccessful people don’t do. Achievement comes from the habit of good thinking. The more you engage in good thinking, the more good thoughts you will continue to think. It’s like creating a never-ending army of ideas capable of achieving almost anything. As playwright, Victor Hugo, asserted, “An invasion of armies can be resisted, but not an invasion of ideas.”

Every year, I talk to tens of thousands of people on the subjects of leadership, teamwork, and personal growth. I’ve found that many of them believe good thinking is so complicated that it lies beyond their reach. But in truth, it’s really a very simple process. Every person has the potential to become a good thinker. I’ve observed that…

•          Unsuccessful people focus their thinking on survival

•          Average people focus their thinking on maintenance

•          Successful people focus their thinking on progress

A change of thinking can help you move from survival or maintenance to real progress. Ninety-five percent of achieving anything is knowing what you want and paying the price to get it.

Portrait of a good thinker

So, how do you pay the price to become a good thinker? For that matter, what does a good thinker look like? You often hear someone say that a colleague or friend is a “good thinker,” but that phrase means something different to everyone. To one person, it may mean having a high IQ, while to another it could mean knowing a bunch of trivia or being able to figure out whodunit, when reading a mystery novel. I believe that good thinking isn’t just one thing. It consists of several specific thinking skills. Becoming a good thinker means developing those skills to the best of your ability.

In Built to Last, Jim Collins and Jerry Porras describe what it means to be a visionary company, the kind of company that epitomises the pinnacle of American business. They describe those companies this way:

A visionary company is like a great work of art. Think of Michelangelo’s scenes from Genesis on the ceiling of the Sistine Chapel or his statue of David. Think of a great and enduring novel like Huckleberry Finn or Crime and Punishment. Think of Beethoven’s Ninth Symphony or Shakespeare’s Henry V. Think of a beautifully designed building, like the masterpieces of Frank Lloyd Wright or Ludwig Mies van der Rohe. You can’t point to anyone single item that makes the whole thing work; it’s the entire work-all the pieces working together to create an overall effect-that leads to enduring greatness.

Good thinking is similar. You need all the thinking “pieces” to become the kind of person who can achieve great things. Those pieces include the following eleven skills:

•          Seeing the wisdom of big-picture thinking

•          Unleashing the potential of focused thinking

•          Discovering the joy of creative thinking

•          Recognising the importance of realistic thinking

•          Releasing the power of strategic thinking

•          Feeling the energy of possibility thinking

•          Embracing the lessons of reflective thinking

•          Questioning the acceptance of popular thinking

•          Encouraging the participation of shared thinking

•          Experiencing the satisfaction of unselfish thinking

•          Enjoying the return of bottom-line thinking

As you become acquainted with each skill, you will find that some you do well, others you don’t. Learn to develop each of those kinds of thinking, and you will become a better thinker. Master all that you can – includingthe process of shared thinking, which helps you compensate for your weak areas – andyour life will change.

Culled from Thinking for a Change by John C. Maxwell