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Curbing cancer through early detection

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From all indications, the ravage of cancer has been on the increase in recent years. Hardly a day goes by without someone dying of a type of cancer. In Nigeria alone, it is reported that no fewer than 80,000 people die from various forms of cancer annually, with an estimated 10 people dying from it every hour.

Yet, judging by reports from other developed countries, the rate of cancer deaths doesn’t have to be so high – provided that strategies and facilities are put in place for early detection and management. These strategies will be considered here, but first, let’s have an understanding of the scourge.

Cancer is a class of diseases characterised by out-of-control cell growth. There are over 100 different types of cancer, and each is classified by the type of cell that is initially affected.

Cancer harms the body when damaged cells divide uncontrollably to form lumps or masses of tissue called tumours (except in the case of leukaemia where cancer prohibits normal blood function by abnormal cell division in the blood stream). Tumours can grow and interfere with the digestive, nervous, and circulatory systems, and they can release hormones that alter body function.

Tumours that stay in one spot and demonstrate limited growth are generally considered to be benign. More dangerous or malignant tumours form when two things occur:

  • A cancerous cell manages to move throughout the body using the blood or lymph systems, destroying healthy tissue in a process called invasion
  • That cell manages to divide and grow, making new blood vessels to feed itself in a process called angiogenesis.

When a tumour successfully spreads to other parts of the body and grows, invading and destroying other healthy tissues, it is said to have metastasised. This process itself is called metastasis, and the result is a serious condition that is very difficult to treat.

Why cancer spreads

Scientists reported in Nature Communications (October 2012 issue) that they have discovered an important clue as to why cancer cells spread. It has something to do with their adhesion (stickiness) properties. Certain molecular interactions between cells and the scaffolding that holds them in place (extracellular matrix) cause them to become unstuck at the original tumour site, they become dislodged, move on and then reattach themselves at a new site.

The researchers say this discovery is important because cancer mortality is mainly due to metastatic tumours, those that grow from cells that have travelled from their original site to another part of the body. Only 10 per cent of cancer deaths are caused by the primary tumours.

The scientists, from the Massachusetts Institute of Technology, say that finding a way to stop cancer cells from sticking to new sites could interfere with metastatic disease, and halt the growth of secondary tumours.

 

Malignant cells are more agile than non-malignant ones

Scientists from the Physical Sciences-Oncology Centres, USA, reported in the Scientific Reports (April 2013 issue) that malignant cells are much “nimbler” than non-malignant ones. Malignant cells can pass more easily through smaller gaps, as well as applying a much greater force on their environment compared to other cells.

Professor Robert Austin and team created a new catalogue of the physical and chemical features of cancerous cells with over 100 scientists from 20 different centres across the United States. The authors believe their catalogue will help oncologists detect cancerous cells in patients early on, thus preventing the spread of the disease to other parts of the body.

Prof. Austin said “By bringing together different types of experimental expertise to systematically compare metastatic and non-metastatic cells, we have advanced our knowledge of how metastasis occurs.”

What causes cancer?

Cancer is ultimately the result of cells that uncontrollably grow and do not die. Normal cells in the body follow an orderly path of growth, division, and death. Programmed cell death is called apoptosis, and when this process breaks down, cancer begins to form. Unlike regular cells, cancer cells do not experience programmatic death and instead continue to grow and divide. This leads to a mass of abnormal cells that grows out of control.

Carcinogens

Carcinogens are a class of substances that are directly responsible for damaging DNA, promoting or aiding cancer. Tobacco, asbestos, arsenic, radiation such as gamma and x-rays, the sun, and compounds in car exhaust fumes are all examples of carcinogens. When our bodies are exposed to carcinogens, free radicals are formed that try to steal electrons from other molecules in the body. Theses free radicals damage cells and affect their ability to function normally.

Genes – the family type

Cancer can be the result of a genetic predisposition that is inherited from family members. It is possible to be born with certain genetic mutations or a fault in a gene that makes one statistically more likely to develop cancer later in life.

Other medical factors 

As we age, there is an increase in the number of possible cancer-causing mutations in our DNA. This makes age an important risk factor for cancer. Several viruses have also been linked to cancer such as: human papillomavirus (a cause of cervical cancer), hepatitis B and C (causes of liver cancer), and Epstein-Barr virus (a cause of some childhood cancers). Human immunodeficiency virus (HIV) – and anything else that suppresses or weakens the immune system – inhibits the body’s ability to fight infections and increases the chance of developing cancer.

What are the symptoms of cancer?

Cancer symptoms are quite varied and depend on where the cancer is located, where it has spread, and how big the tumour is. Some cancers can be felt or seen through the skin – a lump on the breast or testicle can be an indicator of cancer in those locations. Skin cancer (melanoma) is often noted by a change in a wart or mole on the skin. Some oral cancers present white patches inside the mouth or white spots on the tongue.

Other cancers have symptoms that are less physically apparent. Some brain tumours tend to present symptoms early in the disease as they affect important cognitive functions. Pancreas cancers are usually too small to cause symptoms until they cause pain by pushing against nearby nerves or interfere with liver function to cause a yellowing of the skin and eyes called jaundice. Symptoms also can be created as a tumour grows and pushes against organs and blood vessels. For example, colon cancers lead to symptoms such as constipation, diarrhoea, and changes in stool size. Bladder or prostate cancers cause changes in bladder function such as more frequent or infrequent urination.

As cancer cells use the body’s energy and interfere with normal hormone function, it is possible to present symptoms such as fever, fatigue, excessive sweating, anaemia, and unexplained weight loss. However, these symptoms are common in several other maladies as well. For example, coughing and hoarseness can point to lung or throat cancer as well as several other conditions.

When cancer spreads, or metastasises, additional symptoms can present themselves in the newly affected area. Swollen or enlarged lymph nodes are common and likely to be present early. If cancer spreads to the brain, patients may experience vertigo, headaches, or seizures. Spreading to the lungs may cause coughing and shortness of breath. In addition, the liver may become enlarged and cause jaundice and bones can become painful, brittle, and break easily. Symptoms of metastasis ultimately depend on the location to which the cancer has spread.

 

 

 

Classification of cancer

Cancers are categorised into five broad groups.

Carcinomas are characterised by cells that cover internal and external parts of the body such as lung, breast, and colon cancer.

Sarcomas are characterised by cells that are located in bone, cartilage, fat, connective tissue, muscle, and other supportive tissues.

Lymphomas are cancers that begin in the lymph nodes and immune system tissues.

Leukaemias are cancers that begin in the bone marrow and often accumulate in the bloodstream.

Adenomas are cancers that arise in the thyroid, the pituitary gland, the adrenal gland, and other glandular tissues.

Another classification is according to the affected organ as listed below:

Types of cancer

  • Bladder Cancer
  • Brain Cancer
  • Breast Cancer
  • Cervical Cancer
  • Colorectal Cancer
  • Lung Cancer
  • Melanoma
  • Non-Hodgkin’s Lymphoma
  • Ovarian Cancer
  • Pancreatic Cancer
  • Prostate Cancer

 

Diagnosis of cancer

Early detection of cancer can greatly improve the odds of successful treatment and survival. Physicians use information from symptoms and several other procedures to diagnose cancer. Imaging techniques such as X-rays, CT scans, MRI scans, PET scans, and ultrasound scans are used regularly in order to detect where a tumour is located and what organs may be affected by it. Doctors may also conduct an endoscopy, which is a procedure that uses a thin tube with a camera and light at one end, to look for abnormalities inside the body.

Cancer testing

Extracting cancer cells and looking at them under a microscope is the only absolute way to diagnose cancer. This procedure is called a biopsy. Other types of molecular diagnostic tests are frequently employed as well. Physicians will analyse your body’s sugars, fats, proteins, and DNA at the molecular level. For example, cancerous prostate cells release a higher level of a chemical called PSA (prostate-specific antigen) into the bloodstream that can be detected by a blood test. Molecular diagnostics, biopsies, and imaging techniques are all used together to diagnose cancer.

After a diagnosis is made, doctors find out how far the cancer has spread and determine the stage of the cancer. The stage determines which choices will be available for treatment and informs prognoses. The most common cancer staging method is called the TNM system. T (1-4) indicates the size and direct extent of the primary tumour, N (0-3) indicates the degree to which the cancer has spread to nearby lymph nodes, and M (0-1) indicates whether the cancer has metastasized to other organs in the body. A small tumour that has not spread to lymph nodes or distant organs may be staged as (T1, N0, M0), for example.

TNM descriptions then lead to a simpler categorization of stages, from 0 to 4, where lower numbers indicate that the cancer has spread less. While most Stage 1 tumours are curable, most Stage 4 tumours are inoperable or untreatable.

Cancer treatment

Cancer treatment depends on the type of cancer, the stage of the cancer (how much it has spread), age, health status, and additional personal characteristics. There is no single treatment for cancer, and patients often receive a combination of therapies and palliative care. Treatments usually fall into one of the following categories: surgery, radiation, chemotherapy, immunotherapy, hormone therapy, or gene therapy.

 

 

Surgery

Surgery is the oldest known treatment for cancer. If a cancer has not metastasised, it is possible to completely cure a patient by surgically removing the cancer from the body. This is often seen in the removal of the prostate or a breast or testicle. After the disease has spread, however, it is nearly impossible to remove all of the cancer cells. Surgery may also be instrumental in helping to control symptoms such as bowel obstruction or spinal cord compression.

Innovations continue to be developed to aid the surgical process, such as the iKnife that “sniffs” out cancer. Currently, when a tumour is removed surgeons also take out a “margin” of healthy tissue to make sure no malignant cells are left behind. This usually means keeping the patients under general anaesthetic for an extra 30 minutes while tissue samples are tested in the lab for “clear margins”. If there are no clear margins, the surgeon has to go back in and remove more tissue (if possible). Scientists from Imperial College London say the Knife may remove the need for sending samples to the lab.

Radiation/radiotherapy treatment

Radiation treatment, also known as radiotherapy, destroys cancer by focusing high-energy rays on the cancer cells. This causes damage to the molecules that make up the cancer cells and leads them to commit suicide. Radiotherapy utilises high-energy gamma-rays that are emitted from metals such as radium or high-energy x-rays that are created in a special machine. Early radiation treatments caused severe side-effects because the energy beams would damage normal, healthy tissue, but technologies have improved so that beams can be more accurately targeted. Radiotherapy is used as a standalone treatment to shrink a tumour or destroy cancer cells (including those associated with leukaemia and lymphoma), and it is also used in combination with other cancer treatments.

Chemotherapy

Chemotherapy utilises chemicals that interfere with the cell division process – damaging proteins or DNA – so that cancer cells will commit suicide. These treatments target any rapidly dividing cells (not necessarily just cancer cells), but normal cells usually can recover from any chemical-induced damage while cancer cells cannot. Chemotherapy is generally used to treat cancer that has spread or metastasised because the medicines travel throughout the entire body. It is a necessary treatment for some forms of leukaemia and lymphoma. Chemotherapy treatment occurs in cycles so the body has time to heal between doses. However, there are still common side effects such as hair loss, nausea, fatigue, and vomiting. Combination therapies often include multiple types of chemotherapy or chemotherapy combined with other treatment options.

Immunotherapy

Immunotherapy aims to get the body’s immune system to fight the tumour. Local immunotherapy injects a treatment into an affected area, for example, to cause inflammation that causes a tumour to shrink. Systemic immunotherapy treats the whole body by administering an agent such as the protein interferon alpha that can shrink tumours. Immunotherapy can also be considered non-specific if it improves cancer-fighting abilities by stimulating the entire immune system, and it can be considered targeted if the treatment specifically tells the immune system to destroy cancer cells. These therapies are relatively young, but researchers have had success with treatments that introduce antibodies to the body that inhibit the growth of breast cancer cells. Bone marrow transplantation (hematopoietic stem cell transplantation) can also be considered immunotherapy because the donor’s immune cells will often attack the tumour or cancer cells that are present in the host.

Hormone therapy

Several cancers have been linked to some types of hormones, most notably breast and prostate cancer. Hormone therapy is designed to alter hormone production in the body so that cancer cells stop growing or are killed completely. Breast cancer hormone therapies often focus on reducing oestrogen levels (a common drug for this is tamoxifen) and prostate cancer hormone therapies often focus on reducing testosterone levels. In addition, some leukaemia and lymphoma cases can be treated with the hormone cortisone.

Gene therapy

The goal of gene therapy is to replace damaged genes with ones that work to address a root cause of cancer: damage to DNA. For example, researchers are trying to replace the damaged gene that signals cells to stop dividing (the p53 gene) with a copy of a working gene. Other gene-based therapies focus on further damaging cancer cell DNA to the point where the cell commits suicide. Gene therapy is a very young field and has not yet resulted in any successful treatments.

Using cancer-specific immune system cells to treat cancer

Scientists from the RIKEN Research Centre for Allergy and Immunology in Yokohama, Japan, explained in the journal Cell Stem Cell (January 2013 issue) how they managed to make cancer-specific immune system cells from iPSCs (induced pluripotent stem cells) to destroy cancer cells.

The authors added that their study has shown that it is possible to clone versions of the patients’ own cells to enhance their immune system so that cancer cells could be destroyed naturally.

Hiroshi Kawamoto and team created cancer-specific killer T-lymphocytes from iPSCs. They started off with mature T-lymphocytes which were specific for a type of skin cancer and reprogrammed them into iPSCs with the help of “Yamanaka factors”. The iPSCs eventually turned into fully active, cancer-specific T-lymphocytes – in other words, cells that target and destroy cancer cells

Prevention of cancers

Cancers that are closely linked to certain behaviours are the easiest to prevent. For example, choosing not to smoke tobacco or drink alcohol significantly lower the risk of several types of cancer – most notably lung, throat, mouth, and liver cancer. Even if you are a current tobacco user, quitting can still greatly reduce your chances of getting cancer.

Skin cancer can be prevented by staying in the shade, protecting yourself with a hat and shirt when in the sun, and using sunscreen. Diet is also an important part of cancer prevention since what we eat has been linked to the disease. Physicians recommend diets that are low in fat and rich in fresh fruits and vegetables and whole grains.

Certain vaccinations have been associated with the prevention of some cancers. For example, many women receive a vaccination for the human papillomavirus because of the virus’s relationship with cervical cancer. Hepatitis B vaccines prevent the hepatitis B virus, which can cause liver cancer.

Some cancer prevention is based on systematic screening in order to detect small irregularities or tumours as early as possible even if there are no clear symptoms present. Breast self-examination, mammograms, testicular self-examination, and Pap smears are common screening methods for various cancers.

Targeting cancers for new drug therapies

Researchers at The Institute of Cancer Research reported in Nature Reviews Drug Discovery (January 2013) that they have found a new way of rapidly prioritising the best druggable targets online. They managed to identify 46 previously overlooked targets.

The researchers used the canSAR database together with a tool and were able to compare up to 500 drug targets in a matter of minutes. With this method, it is possible to analyse huge volumes of data to discover new drug targets, which can lead to the development of effective cancer medications.

The scientists analysed 479 cancer genes to determine which ones were potential targets for medications. Their approach was effective – they found 46 new potentially “druggable” cancer proteins.

Not only will this approach lead to much more targeted cancer drugs, but also considerably cheaper ones, the authors added.

Having examined cancers generally, we shall zero in on breast cancer, because of its common occurrence among women, the world over. The essence of this is for proper enlightenment, as well as keeping women abreast of early detection techniques.

Breast Cancer

More than 261,000 women are diagnosed with breast cancer each year, according to the American Cancer Society, making it the second most common malignancy in women after skin cancer. While all cancers arise from an uncontrolled growth of abnormal cells, each patient’s treatment and prognosis can differ radically depending on her type of breast cancer, how advanced it is and a variety of other factors.

Symptoms and Types

All breast cancers are not created equal, either in symptoms or category. Though some cases emerge without any noticeable symptoms, breast changes that warrant a doctor’s attention include a lump, swelling or thickening; dimpling or skin irritation; breast pain; nipple pain or an inverted nipple; red or flaky nipple or surrounding skin; or a discharge other than breast milk, according to the National Breast Cancer Foundation.

It is important to note that even these symptoms don’t necessarily mean a malignancy is present and often signal a benign condition, such as a cyst or infection.

Just as breast cancer has many symptoms, the disease is comprised of many specific types. Defined by whether it begins in the lobules or ducts, the parts of the breast responsible for milk production, these types include:

  • DCIS, or Ductal Carcinoma in Situ. This non-invasive malignancy is the earliest and most curable form of the disease because is confined to the duct and rarely spreads. DCIS comprises about 20 per cent of all breast cancers, invasive and non-invasive, diagnosed annually.
  • IDC, or Infiltrating Ductal Carcinoma, is an invasive malignancy because it has spread beyond the ducts. It accounts for almost 80 per cent of all invasive breast cancers. IDC appears as rounded or star-shaped areas on mammograms, with the star-like lesions signalling a poorer prognosis.

The remaining five types of invasive breast cancer comprise about 20 per cent of all total cases. According to the National Breast Cancer Foundation, they include the rare and aggressive Inflammatory Breast Cancer, or IBC, which unlike other forms is often visible on the outside of the breast. IBC causes the breast to look red or inflamed due to blocked lymph vessels in the skin and mimics certain breast infections such as mastitis.

Diagnosis and Tests

Breast cancer screening tests, which are done on symptom-free women, can help to diagnose early cases. Early detection methods include clinical exams by medical professionals, self-breast exams and screening mammograms, which are recommended for women age 40 and over, according to the American Cancer Society. Women with a family history of the disease can also undergo genetic testing to determine if they are at increased risk of developing it.

If a screening method reveals possible breast cancer, several tests can help confirm or disprove the diagnosis. These include:

  • Imaging tests such as mammograms, MRI scans or breast ultrasound. Each of these methods produces internal pictures of the breast that help doctors see a potential mass.
  • Biopsies, which entails taking cells from suspicious lumps to study in a pathology lab to determine if they are malignant. Cells are extracted through special needles or during surgery.

If cancer is confirmed, doctors will assess the cells to determine key information such as the type of cancer and its grade, which signals how fast it is growing. They will also learn if the tumour is caused by a genetic mutation passed through families or is hormone receptive. According to the American Cancer Society, the presence of hormone receptors on breast cancer cells usually indicates a better prognosis because certain drugs can prevent oestrogen or progesterone from promoting cancer growth.

Typically, women with a positive breast cancer diagnosis will also undergo a battery of tests to determine if the cancer has spread to surrounding tissues, organs or bone. Common sites for breast cancer metastases are the bones, the lungs and the liver.

 

 

Treatments & Medications

With more than 2.5 million breast cancer survivors in the United States, it’s clear that researchers have developed effective treatments and drugs that can either cure the disease or prevent it from quickly recurring. Treatments either target the cancer locally or systemically, depending on the location of the breast tumour, its size and the extent of the disease.

Local treatments include surgery and radiation, which attempt to remove or destroy the cancer in the breast without affecting the rest of the body. Surgery can include a breast-sparing lumpectomy or the more aggressive mastectomy, which removes the entire breast and is usually done in more advanced cases, according to the National Breast Cancer Foundation.

Systemic treatments are given by mouth or through the bloodstream and target cancer cells throughout the body. These include chemotherapy, which uses toxic drugs such as cyclophoshamide (sometimes referred to by its brand name, Cytoxan) or methotrexate. Cancer fueled by the hormones oestrogen or progesterone can be treated with hormone suppressors such as tamoxifen or raloxifene (Evista).

More recent systemic treatments include biological therapy, which uses the immune system to fight the cancer and targets breast cancer cells containing high levels of a certain protein. Commonly used biologics are bevacizumab (Avastin) or trastuzumab (Herceptin).

Depending on a variety of factors, including type and stage of cancer, her care regimen might include only one of these treatments or a combination of several.

Prevention

Some breast cancer risks, such as age and heredity, can’t be controlled. But as with so many other diseases, eating right and exercising can help lower the chances of developing breast cancer. According to the Mayo Clinic, other risk-reducing tips include:

  • Limiting alcohol intake to less than one drink per day
  • Limiting dietary fat
  • Maintaining a healthy weight
  • Foregoing hormone therapy at menopause
  • Limiting exposure to pesticides and antibiotics

Collated by TemitopeObayendo with additional information from Webmd.com and livescience.com

 

Pharmacy Plus rewards outstanding staff

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Rep awarded N1m for overall best performance

By Adebayo Folorunsho-Francis

As a befitting honour for a sterling performance, Emmanuel Ubah, PharmacyPlus medical representative (Rivers/Bayelsa) has been rewarded with cheques totalling N1 million for coming first in two categories of the company’s awards.

The award ceremony which took place during PharmacyPlus 2014 Annual National Sales Meeting at Solab Hotel & Suites, Ikeja, on 24 January, had all the regional managers, medical representatives and staff as well as stakeholders in attendance.

Ubah, who won in both the Reload Multivitamin Best Performance and the Overall Distribution categories got a cheque of N500,000 for each award.

Other winners in the Reload Multivitamin Best Performance category were Olumide Olutade (won N300,000 for emerging second) and Pharm. Ijeoma Uchem (N100,000 for coming third); while the Overall Distribution category also saw Don Michael (with N300,000 reward) and Esther Ibeanuka (N100,000) come second and third respectively.

Giving his award acceptance speech, Ubah expressed appreciation to the management for encouraging him since joining the company.He also challenged his colleagues to continue striving towards excellence.

“I have always believed that everything happens for a reason” he gushed.“Many of you know the challenges before I was officially engaged by PharmacyPlus. Secondly, between last year and 2014 alone, I was robbed and involved in accident in the course of my work. But look at me now! Today, I am going home as a ‘millionaire!’”

Earlier in his remark, Pharm. Chukwuemeka Obi, PharmacyPlus’ chief operating officer, charged his staff to continue to work hard because it is always a rewarding commitment.

“I urgeyou to take your work seriously,” he counselled.“I am happy in particular with the progress we made in 2013 and we can surpass that, God helping in 2014. There is always a reward waiting for every hardworking person in PharmacyPlus Ltd,” he stressed.

The three-day meeting was also used as a forum to spell out the way forward for the company in2014, with all the senior managers presenting their plans for the year.

Pharmanews gathered that the interactive meeting was developed in-house by the sales and marketing team, and it confirms the company’s commitment in developing its most valuable asset – people.

PharmacyPlus Limited was incorporated in 2003 as a subsidiary of the parent company – J3 Group – with the mission to engage in franchising, importation and distribution of OTCs and healthcare products.

Being a WACN Fellow has many benefits – Okelola

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(By Temitope Obayendo)

 In this exclusive chat with Pharmanews, Mrs Mojisola Okelola, chairperson of West African College of Nursing (WACN), Nigeria chapter, reveals all there is to know about WACN. She also highlighted the advantages Fellows of the institute have over other nurses.

Below is the full text of the interview:

 Tell us about yourself, especially your early years

 My name is Mrs Mojisola Titilayo Okelola. I am the current chairman of the West African College of Nursing (WACN), Nigeria chapter. I am a psychiatric nurse. I retired as an Assistant Director of Nursing Services at the Federal Neuro-Psychiatric Hospital, Yaba, Lagos.

I did my psychiatric nursing training at the Federal Neuro-Psychiatric hospital Abeokuta. I
had my general nursing training at the Lagos University Teaching Hospital, Idi Araba.
I did my nursing administration and management at the University of Benin, Benin City. I also attended the Administrative Staff College of Nigeria (ASCON) where I did my Advanced Management Course. I am a member of the Nigerian Institute of Management.

I am someone who is consistently growing and takes time to continue learning even though it’s not a direct requirement for the job. I had my BNSc. from the Open University of Nigeria.
I find that many times my professional growth is based on what I studied directly and indirectly in relation to my work.

Why did you choose nursing as a career?

My motivation to choose nursing as a profession was from my mum, who observed that I was a kind, caring and happy child. She encouraged me so much to the extent that she personally went to collect the School of Nursing form for me. Being a nurse has offered me the opportunity to help others and make a difference in their lives on a daily basis. I like working often one-on-one with patients and assist them to recovery and rehabilitation.

When you help others, empathise with them, as well as exercise patience and dedication towards them, it makes you emotionally stable, fulfilled and happy in life.

As the WACN chairperson in Nigeria, what are the objectives of the institution?

The objectives of WACN are: to promote excellence in nursing education (basic and post basic level) and maintain the standard of nursing within the sub-region; formulate and support nursing educational programmes; contribute to the improvement of health care within the West African sub-region; plan and implement continuing educational programmes for nursing personnel; and promote and encourage research in the field of nursing.
In fulfilment of these objectives, WACN plans and implements workshops and seminars throughout the sub-region. Its major activities are carried out through its five constituent faculties, namely:

1. Medical surgical nursing, with three sub-areas: critical nursing (accident and emergency, intensive care, peri-operative nursing, special care babies nursing); palliative nursing (terminally ill (HIV/AIDS, Cancers etc.) rehabilitation); and adult nursing (non-communicable diseases).
2. Reproductive health nursing (MCH)
3. Mental health/psychiatric nursing
4. Community health nursing
5. Faculty of administration, management.

What are the benefits of being a Fellow of WACN and what qualities make a Fellow differ from a non-Fellow?

At WACN, efforts are put in place to ensure that our Fellows gain certain qualities that set them apart from non-Fellows. Chief among these are leadership and management skills. The goal of the WACN is to strengthen the public health sector of the West African sub-region. One way of doing this is to provide a platform for members to meet and share ideas about how to improve the health care sector. Members do collaborate on issues that affect the health care sector.

Fellows envision the future and lead the way in nurturing productive personnel. We don’t stop seeking additional professional growth and opportunities to make a difference in our profession. Fellows are encouraged to be politically conscious. Fellows are also encouraged to read professional journals and to attend continuing education courses in the nursing field.

We also run workshops – faculty by faculty, zone by zone, as well as branch by branch. Constant continuing education enhances the knowledge of nurses and this in turn improves the quality of care that patients receive. These workshops and seminars provide the platform for advancements in the field of medicine and caregiving to be discussed.  Therefore it is important to stay abreast of current research to make sure patients are given the most up-to-date treatment.

As a Fellow of WACN, you are able to demonstrate confidence at all times. Self-confidence is essential in leadership. As a Fellow, the courage is always there for you. You are willing to take calculated risks as a good leader. As a Fellow, you are able to communicate clearly and consistently and remember to listen.

Recently, nurses and other health care workers planned an industrial action which was suspended eventually. Do WACN Fellows believe in strike as a tool for pressing their demands?

It is important to listen to the voices of heath care providers, including physicians, nurses and pharmacists, before policies that affect the health sector are formulated. For us to have a healthy nation, we must reform the health care sector. Workers in the sector ought to be treated better. The recurrent issues of understaffing, overworking and underpaying employees should be addressed. These are not only detrimental to the workers but also to the patients who depend on the attentive care of their medical providers.

When government promises to do things to improve the health sector, it should fulfil its promise and should not wait until the workers go on strike or until it notices there is an impending strike. And those at the helm of affairs in the Ministry of Health should not give preferential treatment and engage in discriminative practices amongst various professionals. We all have our professional roles to play in the health sector.

What are some of the challenges of WACN and how can they be resolved?

We have our challenges in the institution, chief among which is finance. Our small subvention is not regular and even when it comes, it is late. Our offices at the headquarters (6, Taylor Drive Yaba, Lagos) are not well-equipped.

Also some institutions refuse to sponsor nurses for courses and workshops thereby denying them the opportunity to gain much-needed knowledge.

What’s your advice to nurses across the nation?

My advice to nurses across the nation is to remember that our profession is a calling and, so, when there is a misunderstanding between the nurses and the government, we, as advocates of our clients, should embrace dialogue.

 

 

 

 

 

 

 

How regular visits to hospital save lives – Dr. Oladipupo

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(By Yusuff Moshood)

In this recent interview with Pharmanews, Dr. Gentry Albert Oladipupo, a general practitioner medical officer at All Souls Hospital, Agege, Lagos, spoke on the common health conditions bringing patients to the hospital. He also explains what can be done to reduce hospital visits for these conditions, while urging Nigerians not to wait until they are ill or bedridden before visiting hospitals.

                Below is the full text of the interview:

 What are the common health conditions bringing patients to hospital in this area?

The most common condition bringing patients to hospital is malaria.  Not only in this part of the country, but in the country as a whole. Malaria is endemic.  This is basically because of the huge presence of mosquitoes in the environment.  As such, people come down with malaria quite often.  The worst hit is the young age group.  They are the most affected and it is sometimes very serious when they are affected.

Another regular condition I have observed is hypertension.  This is becoming very common among people of middle age and the elderly.

Other common health conditions, depending on the age group, are diarrhoea, typhoid and gastroenteritis. The reason we have more cases of typhoid is because of the poor sanitation habits of our people. People eat contaminated food and ingest dirty water.  This is why typhoid and gastroenteritis are common.

How can the incidence of these health conditions be reduced?

For malaria, government is already doing quite a lot to fight the disease through the Roll Back Malaria Campaign. An example is the campaign urging people to sleep under insecticide-treated bed nets.  The use of insecticides to kill mosquitoes is also good. For me, all you need to avoid malaria is to kill the mosquitoes.  As long as you rid the environment of mosquitoes then you avoid malaria.

The government also needs to ensure that there is improvement in the drainage system. We must have flowing gutters, not stagnant water in the gutters, which enables the mosquitoes to breed.

For typhoid and gastroenteritis, our people must avoid contaminated foods and ensure good hygiene when cooking or preparing foods.

 How correct is the assertion that Nigerians don’t go to hospital until their health condition worsens?

This is true to a certain extent.  It is basically because of poor economic conditions and low level of understanding on health issues. People in this country don’t like going to the hospital routinely.  Even when people are sick, if it is not so serious as to keep them in bed, they still don’t go to the hospital.  Besides, the level of poverty is high in the country and people are always concerned about how they will raise money for consultation and treatment. What they resort to is self-medication which doesn’t help and it is only when they are down completely that they are brought to the hospital.  Sometimes, it is already too late to help them because of serious complications.

  Tell us some of the challenges you experience as a general practitioner medical officer?

I have explained one of the challenges earlier, which is the attitude of our people to coming to access health care on time. Another challenge I have observed is availability of genuine drugs.  The incidence of fake drugs is becoming an issue in this country. Sometimes, when you prescribe drugs to patients and you are expecting a good outcome, the patient still comes back without feeling better; then you discover that it is because the medicine is not effective.

Some drugs in the market which are said to contain, for example, 100mg of the active ingredients only have 50mg. So if you prescribe such and expect the patient to get better, you will find that the symptoms will still persist. It is a serious problem, and even though NAFDAC is trying, more still needs to be done.  We need to improve on our drug monitoring system.

Some people are even bypassing NAFDAC to bring fake drugs through the borders. We need to improve our surveillance on drug importation and ensure only genuine drugs are in the system.

 What is your advice to people on seeking medical intervention when they are unwell?

My advice is that people should develop the habit of visiting hospitals routinely. People should not wait until they are down completely before coming to the hospital. Once you observe any symptom of ill health, you should come to the hospital because you stand a better chance of resolving that health challenge if tackled early.

 

Experts advocate safe medicine use at INSUM forum

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(By Adebayo Folorunsho-Francis)

Eminent pharmacists, health officials and stakeholders in the health care sector recently converged to discuss ways to curb arbitrary use of medicines in the country.

The inaugural consultative forum under the auspices of a non-governmental organisation, Initiative for Safe Use of Medicine (INSUM), was held at Nigerian Institute of Medical Research (NIMR) on January 29, 2014.

In attendance were Pharm. Akintunde Obembe, chairman, Lagos branch of the Pharmaceutical Society of Nigeria (PSN); Pharm. (Sir) Ifeanyi Atueyi, managing director of Pharmanews Ltd; Dr. S. O. Tanimowo, a community physician; Pharm. Bisi Bright, chief executive officer of Livewell Initiative; Dr. Tony Anyanwu, physician and endocrinologist at the Lagos University Teaching Hospital (LUTH), Idi Araba, and a host of other dignitaries.

Describing medicines as substances, including vaccines, used in the diagnosis, treatment or prevention of a disease, Pharm. (Sir) Ifeanyi Atueyi, the keynote address speaker, lamented that the use of medicines in the country had largely degenerated into a state of abuse.

He was however quick to add that, in modern times, medicines have greatly changed the way in which diseases are managed and controlled.

“Many years ago, there were no remedies for diseases like polio, diphtheria, whooping cough, tuberculosis, schizophrenia, and other related illnesses. Today, therapies for these are relatively commonplace interventions which have yielded immeasurable benefit,” he said.

He further disclosed that despite these benefits, all medicines are known to have side effects.  “In the words of Paracelsus, all things are poison and nothing is without poison; only the dose makes a thing not to be a poison,” he noted.

Using Nigeria as a focal point, the Pharmanews publisher noted that a typical case in such medicine abuse was the date rape and subsequent murder of Cynthia Osokogu involving the use of Flunitrazepam (Rophynol®), a potent short-term prescription–only Benzodiazepine hypnotic that causes strong amnesia.

“Sad as it was, this would not have happened if there was sufficient control to the access to such a potent drug,” he pointed out. ““There are other reported cases of adverse drug reactions such as abortion or miscarriage resulting from misuse of Misoprostol, and common ones like liver damage from arbitrary use of paracetamol.”

The eminent pharmacist however said that with the proposed implementation of the drug distribution guideline in July 2014, there is renewed hope that the menace would be curtailed.

Atueyi also took a swipe at unethical use of advertisement and bogus claims by pharmaceutical companies which he said encouraged use of medicines without prescription.

Also sharing the same view, Pharm. Ibrahim Oreagba, a senior research fellow at the College of Medicine, University of Lagos, declared that fostering safe use of medicine begins with patient-oriented practices.

One of such practices, according to him, was pharmacovigilance which came into being afterthe thalidomide tragedyof the 1960s. He also urged pharmacists to spend some time counselling patients on the use of drugs.

“I am happy INSUM has taken up this challenge. This is why I think we need more NGOs that will focus more on sensitive health issues like this,” he stated.

In appreciation of the speakers, Pharm Dotun Amosun, INSUM Board of Trustees chairman, remarked that he was happy with the turnout of participants as the consultative forum was meant to foster partnership of individuals, organisations and stakeholders in the health care sector.

“The main objective of INSUM is to promote and support the safe and appropriate use of medicines in Nigeria through advocacy, research and public education,” he said.

In the same vein, Dr. (Mrs) Nkiru Asoegwu, INSUM Board of Trustees vice chairman,also drummed up support for the initiative, saying, aside targeting nurses, doctors and several other health care players, there was need to take the programme to the broadcast media and also make it dominant on the social media.

“I believe there are lots of people out there whom I am sure will benefit from this Initiative,” she stressed.

On how she came up with such a laudable initiative, Pharm. Nneka Egbuchulam, founder and project director of INSUM reminisced that she simply observed that people had too many questions about how to use their medicines and that they often ended up making wrong choices. That, according to her, made her decide to start an initiative that would address the disturbing trend.

 

 

The power of goal-setting

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Imagine playing football or hockey in an unmarked field or rink with no goal posts. It would be a hopeless endeavour, with nothing to be gained, with no goal to strive for and not a score to be attained. We must have purpose in our lives and goals to strive towards; for a strong passionate purpose is the flame that sets the soul on fire.

Everyone must have a goal. Ralph Waldo Emerson is often quoted as saying, “The world makes way for the man who knows where he is going.”

The dramatic significance of setting goals is illustrated by a study that was conducted in 1953 at Harvard University. The University gave a questionnaire to the class of 52 asking them about their goals or if they had any. The result was 3 per cent had written goals, another 10 per cent had goals but they weren’t in writing and 87 per cent had no goals at all. Twenty years later, in 1972, they gave out another questionnaire to the same grads and the results were as follows:

The 3 per cent who had written goals had a combined net worth in excess of the other 97 per cent combined.

The main reason for great success in any endeavour is clear, specific, and measurable goals written down and backed by a written plan and a burning desire to accomplish them. The primary reason for failure and underachievement is vagueness, confusion and the inability to decide exactly what it is that you desire. As sales trainer, Tom Hopkins, says, “You must be specific to be terrific.” ZigZiglar says, “Most people are wandering in generalities rather than meaningful specifics.”

Goal Setting

The fact is you can’t hit a target you can’t see and, worse still, how can you hit a target you don’t even have? Denis Waitley writes, “Most people spend their time in tension-relieving activities rather than goal-achieving activities, getting no closer to the goals they haven’t even set for themselves.”

If you don’t know where you’re going, any road will take you there. A person without clear, specific goals is like a ship without a rudder blown about in a constant sea of indecision and confusion. A person with clear, specific goals, written down with time lines, on the other hand, is like a ship with a rudder, sailing straight and true to its destination port.

It’s incredible how fast your life will improve and be enhanced by becoming intensely goal-oriented. When choosing your goals, let passion and excitement be your guide. They are the physical translation of the vibrational resonance that is your true, core natural being. Whatever your goal is, you must plan to win, prepare to win, and then you can legitimately expect to win.

The reason writers make so much money writing stories and the movie industry is so enormous is because most people never realise their dreams. They’ve given up and become disheartened. Regarding their dreams, most people wish to avoid confrontation. When you ponder and think about what sets most men apart, you’ll discover it is goals.

There are two great tragedies in life, however. The first is never to have had great goals, and the second is to have fully reached them without setting more goals, so that tomorrow holds no eager anticipation of challenge. Napoleon Hill said, “Cherish your visions and your dreams as they are the children of your soul, the blueprints of your ultimate achievement.” In the Book of Proverbs, it states, “Where there is no vision the people perish”; and of course the flipside of that is, where they have a vision and goals, the people prosper.

Listen to what the late great Malcolm Forbes had to say about this, “When you cease to dream, you cease to live.” Cease to live? That’s strong! Do you know anyone who has ceased to live? Abraham Maslow said, “The history of the human race is the story of men and women selling themselves short.” The reason people settle for far less than what is possible for them is that they have become consciously or unconsciously convinced that there is nothing or very little they can do to change things. In reality, the only limitations on what you can accomplish are your imagination, desire and your ability to set and achieve goals. Remember Napoleon Hill’s famous words, “Whatever the mind of man can conceive and believe, it can achieve.” And I would add that you must be heart-aligned as well.

Mark Victor Hanson says, “The secret to goal-setting is how much and when.” A goal in writing makes every day exciting. Regarding goals and the achievement therein, ZigZiglar says, “It’s your moral responsibility to set and achieve high goals since others who see us will either draw inspiration from us and decide to do likewise, or they draw discouragement from us because they see us not doing the most with our abilities.”

All depressed people share the following three negative thought patterns: 1. They have a negative view of themselves; they have low self-esteem. 2. They have a pessimistic outlook of their experience. 3. They have a negative outlook regarding their future; they have no goals.

If you are successfully setting and realising your worthy goals, it’s impossible to be depressed.

 

Culled from SUCCESS TO SIGNIFICANCE by Richard Carswell

Health wonders of wheat germ oil

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(By Pharm. Ben Chukwudile)

You may already be familiar with wheat as it is the major ingredient in wheat flour, wheat bread and other wheat-based foods. But there is certainly more to the wheat grain than you already know.

The wheat grain consists of three parts: the husk, the germ and the endosperm. Wheat germ oil is extracted from the germ of the wheat kernel, which makes up only 2.5 per cent of the weight of the kernel. Wheat germ oil is particularly high in octacosanol – a 28-carbon long-chain saturated primary alcohol found in a number of different vegetable waxes.

Octacosanol has been studied as an exerciseand physical performance-enhancing agent. Very long chain fatty alcohols obtained from plant waxes and beeswax have been reported to lower plasma cholesterol in humans.

Wheat germ oil is also very high in vitamin E (255mg/100g), and has the highest content of Vitamin E of any food that has not undergone prior preparation or vitamin fortification.

Although the germ of the wheat forms only 3 per cent of the weight of the grain, the benefits of wheat germ stem from the fact that it contains almost 25 per cent of the total proteins, vitamins and minerals of the wheat grain. It is a very sensitive kind of oil that tends to degrade if not stored with care. It should be kept away from high temperatures because if exposed to extreme temperatures, it may turn rancid. However, if kept properly, the shelf life of wheat germ oil can be extended up to a few months.

Wheat germ oil has a high content of vitamins A and D. It is also rich in protein and lecithin. As cooking oil, wheat germ oil is strongly flavoured, expensive and easily perishable.

Good Source of Vitamin E

Vitamin Eprotects the body against free radicals and is an important weapon in the fight against premature aging, cancer and heart disease. The vitamin E in wheat germ oil works with the minerals selenium and zinc for powerful antioxidant protection.

The vitamin E in wheat germ oil is effective as a topical agent as well. The high antioxidant content can facilitate regeneration and healing in the skin, while protecting against future damage. Many people have noticed remarkable improvement by applying wheat germ oil to treat dry skin, sun spots, wrinkles, scars, stretch marks, psoriasis and eczema.

Although its vitamin E content may be its most outstanding benefit, wheat germ oil also contains other valuable nutrients.

Component g/100g
Linoleic acid (Omega-6) 55
Palmitic acid 16
Oleic acid 14
Linolenic acid (Omega-3) 7

 

Essential Fatty Acids

The essential fatty acid, alpha-linolenic acid, in wheat germ oil fights inflammation, while protecting the cardiovascular and immune systems. Wheat germ oil contains other highly beneficial essential fatty acids, such as stearic acid, which has been shown to produce positive effects on lipid profiles;and oleic acid, which protects the heart.

Lecithin

This phospholipid is vital for heart health, brain function and liver health.

Benefits of Wheat Germ Oil

There are many benefits of wheat germ oil. It is very useful for the skin.It fights ageing of the skin and promotes skin health by improving blood circulation. It is very popular for external application due to its beneficial effects on the skin. Hence, it is increasingly finding place in the manufacture of skin care products. The various nutrients present in it improve the immune and nervous systems.

Additional Health Benefits

If you are still wondering what wheat germ oil is good for, consider the following:

  • Wheat has been called the staff of life, and the oil from the germ of the wheat has long been used by people with a variety of health concerns.
  • The Doctor’s Research TM states, “Wheat germ oil protects and nurtures the skin;it is a laxative and reduces lipids. It is a valuable dietetic because of the high level of polyunsaturated acids and vitamin E. Chinese medicine uses it for night sweats, whereas “flatulence, constipation, itching, and menorrhagia are indications for use in Indian medicine.”
  • Recent research confirms that wheat germ oil can help reduce oxidative stress. Wheat germ oil is one of the most concentrated sources of vitamin E.

  How to Use

There are many ways to use wheat germ oil externally. For skin care, you can apply this oil to remedy dry skin. Wheat germ oil, being excellent for dry skin, can be applied twice, daily. It can be applied after bath in the morning and once more in the night before sleeping. What‘s more, it can also be taken orally as a supplement. Wheat germ oil can also be taken in capsules especially if you find swallowing the oil disagreeable.

Caution

  • Keep in mind that wheat germ oil is not meant to replace other healthy fats in your diet. Rather,it should be thought of as a beneficial supplement.
  • It is susceptible to rancidity; but if kept refrigerated in an opaque, airtight container, it will last several months. Using wheat germ oil for cooking is not recommended.

In summary, wheat germ oil has antioxidant abilities as well as a variety of substances shown to be beneficial to health. Therefore wheat germ oil or the supplement is the product to consider when looking for the health benefits these substances provide.


RESEARCH/REFERENCES

  1. Lee R Wheat Germ Oil Perles. Lee Foundation for Nutritional Research, Milwaukee, circa 1950
  2. Irmiak S, Dunford NT. Policosanol contents and compositions of wheat varieties. J Agric Food Chem. 2005;53(14):5583-6
  3. Oil, wheat germ. USDA National Nutrient Database for Standard Reference, Release 19, 2006
  4. Traber MG. Vitamin E. In Modern Nutrition in Health and Disease, 10th ed. Lippincott Williams & Wilkins, Balt. 2006:396-411
  5. Traber MG. Vitamin E. In Modern Nutrition in Health and Disease, 9th ed. Williams & Wilkins, 1999:347-362
  6. Wheat Germ Oil (Octac osanol)” (http ://www . nutrasanus.com/wheat-germ. html).
  7. Ola. A. Megahad and Omayma S. El Kinawy (2002). “Studies on the extraction of wheat germ oil by commercial hexane” (http://grasasyaceites.revistas.csic.es/index.php/grasasyaceites/article/download/339/342). Grasas y Aceites 53 (4): 414—418. Retrieved 2010-05-18.
  8. Wheat Germ Oil” (http://www.nutros.com/nutrients/wheat-germ-oil/). Nutros. Retrieved 2010-05-18. . 8. A “Is Wheat Germ Oil Good for Scar Diminishing?” (http://oilyoily.com/is-wheat-germ-oil-good-for-scarsdirninishing/). OilyOily. Retrieved 22 August 2013.

Manage diabetes, heart diseases with African cherry

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 (By Temitope Obayendo)

At a glance, the African cherry appears rather small and insignificant in comparison with many other fruits. Yet experts on nutrition have repeatedly affirmed its uncommon nutritional benefits, as well as its efficacy in the prevention and management of diabetes and heart diseases.

Botanically called Chrysophyllum albidum, the African cherry (also known as African star apple) belongs to the Sapotaceae family. It is popularly called agbalumo among the Yourbas, while the Igbos called it udara.

C. Albidum is sub-spherical in shape, about 3cm in diameter, usually 5-celled and contains an edible, sweet fruit-pulp. The skin or peel is orange to golden yellow when ripe and the pulp within the peel may be orange, pinkish, or light yellow. Within the pulp are at least five seeds, which are not usually eaten.

The fleshy pulp is usually eaten as snack and it has been found to have high contents of ascorbic acid. It is also acclaimed to be an excellent source of vitamins, irons and flavours to diets.

In Benin, where researchers recently focused on the used pattern of the fruit, the African cherry occurs on ferallitic soils. It is a lowland rain forest tree species, which can reach 25 to 37m in height at maturity with a girth varying from 1.5 to 2m. Its nature occurrence has been reported in diverse ecozones in Nigeria, Uganda, Niger Republic, Cameroon and Cote d’ Ivorie.

In a chat with Professor Ignatius A. Onimawo of the Department of Biochemistry, Ambrose Alli University, Ekpoma, Edo State, on the nutritional contents of C. Albidum for human consumption, he said the fruit serves as a good source of calcium, with each serving providing an individual with 10 per cent of the daily requirement.

Onimawo, who is professor of nutritional biochemistry, asserted that the calcium lends strength to human’s bones and teeth, and may also lessen symptoms of premenstrual syndrome, such as cramping and abdominal bloating.

“This fruit also contains 5 per cent of the daily recommended value per serving of vitamin C and vitamin A. Additionally, one serving of cherry serves up to  2 per cent of iron, a mineral vital for oxygenating your body, that you need every day”, he explained.

Speaking on other health benefits of the African cherry, the expert noted that cherries may have particular benefits for diabetics. Citing a research published in the September 2009 edition of the African Journal of Pharmacy and Pharmacology, he said the result indicated that the leaves of the fruit reduced glucose levels in diabetic rabbits, the same function that insulin in the human body performs.

However, he said more research is needed to determine the effectiveness of cherry leaves to control diabetes in humans.

Onimawo further referred to a study by researchers at the Department of Biological Sciences, College of Science and Technology, Covenant University, Ogun State, Nigeria. The study showed that the local cherry fruit lowered blood sugar and cholesterol, and could be useful in preventing and treating heart diseases.

“Methanolic extracts of the cotyledons from the seeds of chrysophyllum albidum led to the isolation of eleagnine, tetrahydro-2-methylharman and skatole,” he said. “Eleagnine was found to be the main compound responsible for its antimicrobial activity. Eleagnine was further shown to exhibit anti-nociceptive, anti-inflammatory and antioxidant activities. The seed cotyledon has been reported to possess anti-hyperglycemic (lowers high blood sugar) and hypolipidemic (lower blood cholesterol) effects.”

The researchers, who investigated the effects of oral administration of the leaf extract of the African cherry on biochemical and haematological parameters in albino rats for 16 days, wrote: “In conclusion, the study has demonstrated that the leaf extract of Chrysophyllum albidum may not cause any adverse effect on the biochemical and haematological indices of toxicity. Moreover, the extract was found to possess anti-platelet and hypoglycemic (lowers blood sugar) properties and might be employed in the management of myocardial infarction (heart attack) and diabetes mellitus, respectively. Further investigation is needed to establish the anti-platelet property of the extract.”

Onimawo, a public health nutritionist, also quoted from another study conducted by researchers at the Forest Research Institute, Ibadan, Oyo State, which showed that the African cherry leaves exhibited strong antibacterial activity against common bacteria isolates.

Titled, “Antibacterial Activity and Phytochemical Screening of Chrysophyllum Albidum Leaves”, the study was published in the Asian Journal of Food and Agro-Industry.

Since the fruit is seasonal, and always available in the summer, Onimawo advised that the fruit pulp could be extracted and packaged in bottles and stored in refrigerator for proper preservation. And now that fruit is in abundance, he urged people to consume it liberally as a great source of phytochemical.

Nutritional Contents

According to Onimawo, the proximate composition analysis of C. Albidum is as follows:

Moisture 66.67 per cent; carbohydrate 78.34 per cent; protein 5.66 per cent; fibre 4.50 per cent; fat 9.83 per cent; ash 2.12 per cent and total energy value 420.42 kcal. The ascorbic acid content is 19.68 per cemt.

The anti-nutrients composition are: oxalate 4.95mg, saponins 3.66 per cent, cyanogenic glycoside 0.17 per cent, phytate 0.02 per cent and tannins 0.03 per cent.

Additionally, a research on “Evaluation of proximate compositions and mineral elements in the star apple peel, pulp and seed” by Ukana D. Akpabio, Aniekan E. Akpakpan, and Godwin N. Enin of the Department of Chemistry, University of Uyo, Akwa Ibom State, suggests that the African star apple fruit is an edible fruit of uncommon nutritional benefit.

In the study, recently published in the Journal of Basic and Applied Scientific Research, the peel, pulp and seed were analysed to determine the proximate composition and mineral elements. The findings showed that the pulp contains greater amounts of crude fibre, fat, ash and caloric value, while greater amount of moisture was found in the peels.

Carbohydrate content and crude protein was higher in the seed. Mineral elements composition revealed that the pulp has greater amounts of sodium and iron, while the peel contains greater amounts of potassium and zinc. Calcium and magnesium were higher in the seed.

Moisture contents of the star apple peel, pulp and seed were 47.95 per cent, 32.65 per cent and 26.55 per cent respectively with an average of 35.76 per cent. This clearly shows that the peel contains much moisture.

Moisture content is one of the most important and most widely used parameter in food processing; hence, the star apple’s seed can easily be processed and preserved, since it contains less moisture.

Crude protein contents of the star apple peel, pulp and seed were 6.68 per cent, 4.73 per cent and 8.75 per cent respectively with an average of 6.73 per cent. The Food and Nutrition Board of Nigeria (1972) recommends 56kg of protein per day in the diet of adult men weighing 70kg and 40kg for women weighing 56kg of body weight.

The Fat contents of the star apple peel, pulp and seed were 8.94 per cent, 10.00 per cent and 3.45 per cent respectively with an average of 7.46 per cent.  Fat is an excellent source of energy, enhances transport of fat soluble vitamins, insulates and protects internal tissues and contributes to vital cell processes.

Folklore Uses

The star apple is a folk remedy in several countries, although no research exists to confirm this. The seeds of the fruit may be useful in reducing fevers and treating diarrhoea. Some people also eat the fruit to reduce the inflammation associated with laryngitis and pneumonia. Other uses, including treatment for hypertension, tooth abscesses, heart problems, intestinal issues and cancer exist; but it is strongly advised not to eat star apple for any medical condition without first consulting a qualified physician.

Fibre

Eating a serving of star apple contributes 3g of fibre to the recommended daily intake of 25 to 38g. Fibre provides bulk to your diet, a factor that can make your stomach feel fuller for longer. This can keep you from eating too much, and it may help you lose weight. This nutrient can also help protect you from diabetes and some forms of cancer.

Daily Nutrition

1-cup serving of fresh star apple contains 67 calories. Eating star apple as a snack is a good choice as it provides no fat and the calories are low; however, these may not be enough calories to ease hunger pains or boost energy levels, as between-meal snacks are meant to do. The Diet Channel notes that 100 to 200 calories per snack is best. Consider eating an oz. of cheese or a tsp. of peanut butter to boost the number of calories into this range.

One serving of star apple also has 15g of carbohydrates, or 11.5 per cent of the 130g suggested for daily consumption by the Institute of Medicine.

References:

Journal of Basic and Applied Scientific Research, 2012

Journal of Ethnobiol Ethnomed. Oct. 2012

 

Making it big in the Nigerian economy

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 Not too long ago, I watched a speech presented by Elon Musk at Oxford University, England. Elon Musk is the CEO of Tesla motors (electric car company) and SpaceX, co-founder of PayPal and current chairman of Solar City.

In the presentation, he spoke of the achievements of Tesla, how despite vested interests in the energy business, the company was able to develop an electric car that outperforms most standard SUVs. Their ground-breaking work with Model S and now Model X (to be out later this year) has earned Elon Musk numerous awards, including Fortune Magazine’s Man of the Yearand MarketWatch’sCEO of the Year. Mr Elon has also found more than a six billion dollar fortune taking on seemingly impossible business projects.

No doubt, the energy business is changing and Elon Musk is among those leading this change. But the major point to note from his exploits and those of others like him (Jeff Bezos of Amazon, Steve Jobs of Apple, Mark Zuckerberg of Facebook and Bill Gates of Microsoft) is that the global business arena is now knowledge-based and that the great CEO of the future will be donning an academic gown. He may not have a university degree or a PhD but chances are that he will be technically savvy in at least one field.

In Musk’s presentation, he emphasised starting from the first principles, breaking down the variables and asking if “success is a possible outcome?”

Today, I wish to ask that question of the innovation-driven business landscape in Nigeria.

The Nigerian scenario

Nigeria’s Global Competitiveness Index as ranked in the 2012-2013 Global Competitiveness Report is 115th of the 144 countries studied. The Global Competitiveness Report presented by the World Economic Forum measures 12 pillars of competitiveness as shown in the spider web summary below:

 12 pillars of competitiveness

From the above, it is easy to see where the country is wobbling. The report (that is, the Global Competitiveness Report) categorises the countries of the world into three broad categories:

  1. Factor-driven;
  2. Efficiency-driven; and
  3. Innovation-driven

Nigeria was categorised as a factor-driven economy along with 37 other economies. These economies compete on their factor endowments—primarily low-skilled labour and natural resources. In other words, our biggest assets are our raw materials.

From the report, some examples of other factor-driven economies include India, Ghana and Kenya.

Significance of being a factor-driven economy

 The significance of our present scenario is that our GDP is a reflection of our raw productivity – in other words, our inefficient, minimal innovation productivity.

The challenge

The challenge therefore is in achieving efficiency and innovationin our productivities.In the pharmaceutical industry, this is a real and present challenge. If we can achieve this, Nigeria can multiply her GDP by five.

According to the competitiveness report, the barriers we must overcome include:

  1. Access to financing
  2. Corruption
  3. Tax rates
  4. Poor work ethic in national labour force
  5. Inadequate supply of infrastructure
  6. Inflation
  7. Policy instability
  8. Inefficient government bureaucracy
  9. Tax regulation
  10. Foreign currency regulations
  11. Inadequately educated workforce
  12. Crime and theft
  13. Insufficient capacity to innovate
  14. Government instability
  15. Poor public health

The global market

Before considering the possibility of initiating projects that will deliver this efficiency and innovation, it will be good to evaluate the Influence of the global market.

Despite the data presented in theabove report, Africa(and Nigeria in particular) is still the beautiful bride at the moment for international businesses and the reason is quite simple – a growing middle class with a huge disposable income (as a result of our fairly large crude oil-induced GDP). The only problem is that companies coming to Africa need not sell Africa’s products and services. The point is, without a deliberate effort, this current attractiveness may not make much difference other than that we can live like our friends in the West and eventually get caught up in debt.

Foreign firms

If you operate a foreign firm, a good business strategy will be to find ways to meet the needs of the market at present and to strategically position your firm within the productive chain of the nation. In other words, provide efficiency and innovation to Nigeria’s crude materials.For example, startbusinesses that deal in consumables, plastics, pharmaceuticals, toiletries, stainless steel, telecommunication, hospitals, diagnostics, shopping marts, cars, etc. Then continue to innovate around products and processes.

We are seeing a whole lot of this already and at the rate things are changing, the future will be remarkably different.

Nigeria: Does ownership matter?

For a Nigerian, the question will be “does ownership matter?” Does it matter who provides the innovative products and services? Well, it depends on the way you look at it, though I have decided to leave the nationalistic side of the discourse for another day.

Is success a possible outcome?

I believe it is, with the right management capacity, technology and finance–hence, my earlier reference to Elon Musk.

The ability to find finance for technological processes that offer innovation and efficiency to product or service delivery in Nigeria is key to achieving success within our context. Firms coming to Nigeria would have to do exactly this same thing – find the right management to deploy relevant technology in Nigeria and bankroll them.

No doubt, there are challenges to finding skilled people in Nigeria but I believe the real question is “who is doing the finding?” Who is building the team? This question is important because at the end, the character and dispositions of these individuals, much like that of Elon Musk, would influence all of us tremendously.

The team builders

Finding success in our horizon will be done by great teams; in other words, we all need to find a good team or create a good one.

Ideal team components

  1. Innovation – Processes and products
  2. Management – Proven ability/potential to lead the team and deliver
  3. Finance – Ability to raise money

Thesummary

There are lots of challenges and opportunities in Nigeria at the moment, and this calls for able leadership. In the pharmaceutical industry, it is even much more. The onus however is on finding management teams that have the integrity and character to raise finance and lead the technical team members to achieve outstanding success. I believe these leaders are really the scarce resources; their task is an earnest one and their cause is indeed noble.
 

Secrets of staying young and fit

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I visited a friend some time ago, and was impressed with his collection of souvenirs from different countries.  He travels regularly to Kenya, South Africa, Ethiopia, Paris, London and other parts of the world for business and acquires mementoes during the trips. A portion of his living room looks like a museum.

I thought of my own interest during travels. I don’t very much appreciate paintings and carvings and therefore do not spend money on them. Instead, I buy books as souvenirs. I like to remember places with books purchased there. And, usually, I indicate the location and date on the books.

In my library, I have some books that I bought during my recent travels. These include:  “I Declare” by Joel Osteen, North Carolina, 6/10/12; “The 15 Invaluable Laws of Growth” by Brian Tracy, Chicago, 20/09/12; and “Standing Tall” written by a colleague, Dr N. K. Ebube in Philadelphia, 20/09/13. My Holy Bible was dated 1/10/13, Orlando, Florida. This was another gift from my wife on my 73rd birthday.

Returning from Washington to Lagos via London on Sunday, 6th October, 2013, I bought “20 Years Younger” by Bob Greene at the Heathrow Airport. It proved to be a very engaging in- flight reading material.

Usually, when I invest in a book, my primary objective is to improve my knowledge on that subject. Secondly, I try to apply the lessons I have learnt to myself. Thirdly, I share that knowledge with others.

“20 Years Younger” is an appealing title for a book. Everyone wants to look younger than their age. Incidentally, there are two ways to describe age. There is the chronological (calendar) age, which is determined by the date of birth.  The other is the biological age, which reflects the rate at which we are getting older. Everyone’s desire is to reduce the biological age and live healthy long life.

Bob Greene, an exercise physiologist, believes strongly that exercise is the ultimate anti-ageing weapon.  He made it clear that you can halt or even reverse the ageing process of your body through exercise.

Much of what we think of as ageing – wrinkles, weight gain, memory loss, lack of energy, certain types of illnesses – is not primarily attributable to the passage of time. Rather, it’s a direct result of sedentary living, poor diet, lack of sleep, insufficient (or nonexistent) skin care, too much stress, and even a defeatist attitude to life. Therefore, it stands to reason that if you reverse those habits – if you sufficiently exercise your body, eat longevity-promoting foods, sleep soundly and adequately, protect and nourish your skin, and improve your outlook on the world – the signs of ageing will reverse themselves, too.

Living longer is important, but the ultimate goal is to live longer and live well into your later years. Through the science of ageing it has become clearer that by making certain lifestyle choices you can slow down the effects of ageing.

However, the big question has been, “Why do we age and eventually die?” Several evolutionary theories have been propounded on the issue. But one major theory not based on evolution has to do with the cumulative effects of damage to the body. This is the free radical (oxidative stress) theory of ageing. Over the years, injury from simple wear and tear, sun damage, a poor diet, smoking, pollution, and even the body’s own metabolic processes, add up to promote ageing and eventual death.

Oxidative stress refers to the injury done to DNA, cells, and tissues in the body by free radicals. The free radicals are molecules with unpaired electrons that are produced when the body metabolises oxygen. They are also produced in our personal environment, e.g., through sunlight, smog, high altitude, exposure to X-ray, toxins in food and water, pollen, ozone, moulds, dust, and so on.

In their incomplete state, free radicals become thieves, trying to steal electrons from nearby molecules and wreaking havoc along the way. The body has the ability to absorb free radicals and repair the damage they do, but its defence system tends to weaken over time, leaving it vulnerable to disease.

We need free radicals to live, but they are also the bane of our existence. Free radicals damage can impair the immune system and result in various types of cellular damage. Such cellular damage is associated with many of our degenerative diseases like arthritis, some types of cancer, heart attacks, hardening of arteries, Parkinson’s disease, cataracts etc.

  Based on this theory, what do we do to fight the damaging effects of the free radicals?

Free radicals are rendered harmless by antioxidants. An antioxidant is a substance that can donate an electron to a free radical without becoming dangerous itself. An antioxidant puts an end to the rampage of cellular and bodily destruction. Antioxidants can saturate our cells and tissues and protect against free radicals, if taken in sufficient amounts.

The body makes special antioxidant enzymes, but you can also get many antioxidants in foods (especially fruits and vegetables) and nutritional supplements.

NAFDAC tips Strides Vital for WHO pre-qualification

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By Adebayo Folorunsho-Francis –

It was a pleasant surprise when a team of National Agency for Food Drug Administration and Control (NAFDAC) inspection officials, led by its Director General, Dr. Paul Orhii, recently visited the premises of Strides Vital in Adeniyi Jones, Lagos.

Among the visiting NAFDAC team were Mrs Stella Denloye, NAFDAC director of laboratory services and MrsEdosaOgbeide, NAFDAC deputy director, Port Inspection Directorate, Drug Port Division.

The team was taken round on facility inspection to sections like quality control laboratory, microbiology laboratory, granulation and mixing, compression, blending, coating, blister packing room and packing hall.

Commending the company for sustaining its good manufacturing practice (GMP) and improving generally since the last visit (during Prof. Dora Akunyili’s era), MrsOgbeide disclosed that she was pleased that a lot of positive things had taken place over the years.

“I know Strides Vital is one of few companies with good GMP in this country. It even gladdens my heart to hear that your company is putting up a new structure aside from the old warehouse, to commence on production of your proposed ARVs,” she said.

Mrs. Denloye, on her part, also counselled the company to put necessary documents on scale safety, system suitability and other needs in place, to prevent inspectors from erroneously thinking the company had certain skeletons to hide.

In appreciation of the observations, Mr. Matthew Philips, Stride’s operations manager, said the suggestions of the NAFDAC team were much esteemed, as the management clearly understood that the opinions of inspectors were vital for improvement.

Making his own contribution, Dr. Orhii said that he was impressed with the inspection, as no major flaw was noticed.

“If two of my most critical inspectors can see little or no flaw, what more can I say?” he asked rhetorically. “I am even more surprised that, given the whole lot of progress we saw here today, Strides Vital was not included in the earlier WHO pre-qualification list we submitted. But God willing, I am hoping we could have you on the next one. Your management has done well! I also thank you for accepting us, given the short notice we gave. Please be free to ask our inspectors questions or invite us whenever you have issues to clarify,” he said.

Thanking the NAFDAC boss, MrAnoop Kumar, regional head of the company, noted that quality had always been Strides’ watchword.

“Even when we started out, Nigeria was our first market, before establishing our presence in other 55 countries across the globe. The country is like a second home to the management, as well as to many Indian investors,” he emphasised.

Leading change in a knowledge economy

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(By Pharm. Nelson Okwonna)

“Money motivates neither the best people, nor the best in
people. It can move the body and influence the mind, but it
cannot touch the heart or move the spirit; that is reserved
for belief, principle, and morality. As Napoleon observed,
‘No amount of money will induce someone to lay down their
life, but they will gladly do so for a bit of yellow
ribbon.'” – Dee Hock (founder of VISA)

 

Leadership

Leadership at the centre is all about causes. They reveal who the leader is, and the things that matter to him. Basically then, the best of leaders are those with the best causes.

This illustration reveals how effective team leaders function:

Pharmaceutical Business

These leaders lead from the centre. They tell the team “why” they have to do the things they are doing. The outer part, “what”, shows their products and services; while the inner part, “how”, shows their operative strategy. The core is where leadership begins.

A great leader is one with a great cause and who goes about it in the best possible way. The process of leadership is about influence and there are three ways to influence individuals: compulsion, manipulation and persuasion.

The first two are against the free spirit of man and the inherent laws of nature. Brute force has always worked with lower animals but never with man. Manipulation, on the other hand, can be very effective but is always devoid of charity which is the vitality of life; hence it is not in line with the basic nature of reality and cannot produce lasting results.

Compulsion says “do this or…”. It thrives on the strength of the leader. If the leader is strong enough then he is compelling enough. Actions are taken not because of the desire to act, but for fear of the penalty for inaction. The strength could be derived from position, financial clout or from emotional dependence.

 

Persuasion appeals to the good judgement of an individual; it presents facts and figures and aims to convince the other party to tow a given line. Persuasion seeks to inspire the follower to follow simply because in so doing he will also find good for himself. No doubt, a persuasive leader at times will need to compel obedience but he knows he must not dwell on that and if he must then that particular team member would need to be changed.

LEADERSHIP IN A KNOWLEDGE ECONOMY

In the agrarian and industrial era, the landowners and the employer of labour had the balance of power in their favour and could manipulate or compel labour to act in their interests. Despite the development of labour unions, the employer of labour still had a greater bargaining chip and could exploit the labour greatly.

This was possible because of the abundance and ease of mobility of labour; it was relatively easy to find a replacement for a factory worker at a very short notice as the contribution was either semi-skilled or unskilled labour.

As the industrial era led to the computer era, the degree of skill possessed by labour increased dramatically. Consequently, employers of labour started paying closer attention to human resource management as the individual roles of these employees became much more of a determinant to the outcome of the enterprise. The ease of replacement became considerably reduced.

In this era, the employee earned much more and could afford to stay off work for a considerable duration of time while looking for a more satisfactory employment. The relationship between employer and employee became more of a partnership and the salary was no longer the greatest bargaining chip. Other factors like insurance, availability of crèche facility, maternity leave, holidays, management disposition and location of the enterprise became important considerations for the choice of where to offer services.

In this knowledge era, the individual, and not land or money, is king, as the contribution of knowledge workers has become the determinant of the success of any enterprise. The leader of nearly every successful business is essentially a knowledge worker and a great business is one with many of such leaders on its team.

Here, the enterprise is “the team”, and the preoccupation of the chief executive officer is more of providing leadership for this team, to persuade team members to not only stay with the team but to contribute their knowledge. Many times, this leader would have to identify individuals needed for building a particular kind of team and to go about persuading them to join the team.

Leaders who are willing to contribute consistently to the society in this era must realise that the game has changed very much. The words of Jesus Christ has become much more relevant in the market place: “He that wants to be the greatest, let him be the servant of all”.

Leadership is serving the need of the team; it is keeping them happy and focused on the vision. A lot of employers and managers are yet to grasp this understanding and have inevitably shot themselves in the foot. They have succeeded in employing unwilling hands. In such organisations, the staffs are there simply because they have nowhere else to go. These leaders have missed the privileges that come from operating in a knowledge economy, and they have deprived their firms of the magic that pooled intellectual capital can create.

In a business particularly, the challenge of leadership is to discover that strategic reward system that rewards impressive efforts effectively. When this reward system is not in place the leader will oftentimes find that his employees leave to build companies that will compete with his. The result is that both firms produce at suboptimal levels. A new shift in leadership in our era comes with the realisation that a firm may never be able to own the intellectual capacity of an individual completely and this intellectual capital matter greatly. The responsibility therefore is to create structures that allow certain key individuals to own or have a certain degree of ownership on the results of their intellectual capacities; this will lead to decreased human resource turnover rates.

To achieve this, the organisational structure of the organisation may need to change.

PERSUADING THE STAFF

Much more than ever, great staffs are hard to find. Individuals with the rare combination of integrity, passion, competence and commitment are rare to find and they do not migrate to manipulative or compulsive systems. If you find them in such manipulative teams, it wouldn’t be for long.

Persuasion, therefore, is the act of convincing relevant individuals to join the cause of your organisation. It is retaining their respect by giving them due respect for their potentialities and capacities. It is refusing to belittle anyone.

This can be achieved using some time-tested approaches:

  • By effectively communicating the vision of the enterprise.
  • Communicating the personality, values and passion of the leader.
  • Standardising the compensation plan: salaries, equity, capacity development, etc.
  • Regulating the structure of the enterprise.

 

INFORMATION FLOW

In this information age, intellectual capital is becoming an investable entity that can be quantified in monetary terms. The level of knowledge or the corporate IQ of your firm is a reflection of the corporate information flow and processing in your organisation.

Everybody knows that the boss doesn’t know it all. Even if he does, everybody also knows that he cannot be there all the time. Every day there is new information in your area of business and chances are that the staff know many things the boss needs to hear. The key is building an atmosphere that makes such contributions possible.

A staff’s ability to contribute positively to the firm would depend on the level of information available to him or her. It is the job of the leader to paint the big picture for the team and dare them to make the necessary contributions.

Bill Gates in his book “Business at the Speed of Thought”, introduced the concept of the Digital Nervous System (DNS). The DNS occurs when thinking and collaboration are significantly assisted by computer technology. The “nervous system” of an organisation should be horizontal enough to share information with employees. When the employees can get the most information from the organisation and the organisation can get the most information from the employees, the corporate IQ becomes the collective IQ of its employees/associates.

This information flow system assumes that employees want to do a good job, which is the absolute truth. Most times employees do want to do a good job.

OF INTEGRITY, AUTHENTICITY AND CANDOUR

Without integrity, a leader cannot be authentic (real) and phony leaders cannot sustain a character of information flow in any system as they cannot stand discovery. Integrity, authenticity and candour are therefore cardinal attributes for the viability of the points earlier made.

Leadership, as explained from the outset, is about causes. “It is all about love” says Tom Peters, and I agree.

Love is defined as passion, enthusiasm, appetite for life, engagement, commitment, great causes and determination to make a difference, shared adventures, growth, and an unshakable appetite for change.

To communicate this passion, the leader must be real (authenticity) and talk real (candour). He must be able to see eye to eye with his team members and to motivate them to the next level.

Sound like an impossible job?

Welcome to the club! Attempt is the first virtue; go out there and do it!

Pharmacist organises HIV/AIDS campaign for students

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 By Adebayo Oladejo –

Zonal coordinator of the Association of Community Pharmacists of Nigeria (ACPN), Oriade Zone, Amuwo Odofin Local Government Area of Lagos State, Pharm. ObyIkwu, has advised stakeholders in the country’s health care sector to rise up to the challenge of reducing the scourge of HIV/AIDS, which she said had affected over 3.1 million people, so far, in the country.

Speaking with Pharmanews during the HIV/AIDS Awareness Campaign programme for primary and secondary schools in AmuwoOdofin Local Government, Lagos, held last December, Pharm. Ikwu, who is also the organiser of the programme, lamented that Nigeria had the second highest number of people living with HIV/AIDS in the world, adding that the greater percentage of infections were among the young people.

Speaking further, Ikwu, who is also the managing director of Lopez Pharmacy and Stores Limited, explained that the programme was organised in commemoration of the 2013 World AIDS Day with the theme “Share Responsibility: Strengthening Results for an AIDS-Free Generation”. She explained that she chose to focus on secondary and primary school students because the World Health Organization (WHO) had decided to focus on the adolescents, so as to enlighten them on the current challenges regarding the scourge of HIV/AIDS.

In her lecture, Pharm. Oby explained the nature and transmission patterns of the human immuno-deficiency virus (HIV), while also advising the students to abstain from ungodly relationship and affairs that could lead to pre-marital sex. “This will not only save you from contracting HIV/AIDS,” she counselled, “it would also prevent you from contracting other sexually transmitted diseases (STDs). Also, you should avoid sharing needles, syringes and any other sharp object, while you should also ensure blood is duly certified HIV-free before transfusion.”

On the suitability of the programme to the students, the organiser noted that it was important to catch the students young, so that as they grow, they get more information about the infection and also tell the coming generations about it.

While citing funding as the major challenge of her project, Ikwu quickly added that the joy she derives from her relationship with the students has been her motivating factor. “As community pharmacists, we are the first port of call in any community, and we should make it a duty to affect the community where we practise and this is exactly what I enjoy doing most,” she said.

Another speaker at the programme, MrsAnurikaAdetunji, a biochemist, remarked that the programme was very important and timely, considering the disturbing rates of decadence among youths. “If you are privileged to see what these little children are doing in secret, you will be baffled; so this is the best time to catch them.

This kind of awareness programme should not only come once in a year but as many times as possible. There should be more awareness programmes about HIV/AIDS in all primary and secondary schools across the nation. They should tell them about the growing trends, the implications and how they can protect themselves,” she stated.

She further emphasised that “the reason HIV/AIDS is growing at an alarming rate is ignorance. Many people do not know that AIDS truly exists. They think it is an agenda of the western people to reduce our population and scare us, but it does exist. HIV/AIDS awareness is needed most in schools, mosques, churches, market places and everywhere because the disease burden is increasing every day and people really need to be aware of its existence.”

Recounting the lessons learnt at the programme, one of the participating students, YahayaIsah said, “I have really learnt a lot today, especially the issue of stigmatisation against those who have it [HIV] and how to ensure it does not spread.”

Another student, Ruth Christopher, from De Ultimate School, said one important thing she learnt at the programme was the ABC strategy of preventing HIV/AIDS, which comprise: Abstinence, Being faithful and Condom usage.  “We learnt that we could abstain from sex, be faithful or always protect ourselves with condom; but based on the fact that we are still young, we have been told that abstinence is the most important method to adopt.  We are told to avoid being lured into having sex. Today’s programme has helped to remind us of what we have heard before that AIDS is real,” she said.

Stakeholders say best pharmacy practice not realistic in Nigeria

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By Adebayo Oladejo –

Stakeholders at the recently concluded Association of Community Pharmacists of Nigeria (ACPN), Lagos State chapter’s Continuing Education Conference have expressed concerns that the dreams of achieving excellent pharmacy practice and best possible medicine in Nigeria may not be achievable in a while.

The conference which held last December at NECA House, Agidingbi, Ikeja, Lagos, was graced by notable personalities in the Nigerian pharmaceutical industry.

Speaking on the theme of the conference “Good Medicine, Excellent Practice: Myth or Reality?”, chairman of the conference, Pharm. Ebenezer Adeleke, said for the country to have excellent pharmacy practice and safe medicine, there must be a conducive environment for the practitioners to operate. “Some people believe that good medicine and excellent pharmacy practice are not possible in this country, while others believe it is possible, but in reality, we need to examine and re-examine the way we practise,” he noted. “Are we doing the right thing in the right way? Is there an enabling environment to achieve this purpose? And we must also note that we cannot achieve the desired result without the cooperation of the people.”

Continuing, he said, “We are happy now that the Pharmacists Council of Nigeria (PCN) has been reconstituted and we believe that there will be a conducive environment for us to operate henceforth; but I want to implore the National Agency for Food and Drug Administration and Control (NAFDAC) not to rest on its oars, as there are still issues of fake drugs in the country, while some people still produce drugs from their toilets.”

While delivering the keynote address titled “Good Medicine, Good Practice: Myth or Reality?, Pharm. AzubikeOkwor said it was not easy to assure good medicine and good pharmacy practice in the country because there were still challenges of widespread counterfeiting, poor storage facility, poor quality assurance during manufacturing and problem of electricity, coupled with the problem of excessive decomposition of active ingredients, as a result of exposure to high temperature and high humidity, among others.

The respected pharmacist and immediate past president, Pharmaceutical Society of Nigeria (PSN), also revealed that, while he personally believed in excellent practice and safe drugs, such expectations might not be achievable yet, due to various challenges facing the pharmaceutical industry.

“How do we have good practice when most private medicine outlets still prefer to engage the services of untrained staff in the provision of pharmaceutical service to the populace? When most of them still sell prescription medicines to patients without prescriptions, or when medicines are not appropriately labelled or not labelled at all? He asked rhetorically.

Okwor however noted that, with a focused approach, as exhibited by many other communities of pharmacists across the globe, it was still possible to attain the goal. He added that the country desperately needed a comprehensive strategy that would unify the efforts of all the stakeholders, including the government, drug companies, health care professionals, regulatory agencies, civil societies, judicial system and the citizens, to combat poor quality medicines and create the enabling environment for pharmacists to serve the society optimally.

He also commended the ACPN, Lagos State chapter, which he described as the most vibrant and active technical group of the Pharmaceutical Society of Nigeria. “Lagos State is a pacesetter state and so also is the ACPN Chapter of the state,” he said. “Also, the leadership of the chapter is usually God-given from year to year, and I am always impressed with what they are doing to move the practice of pharmacy forward in this country.”

Speaking earlier with journalists, Pharm. AminuYinkaAbdusalam, chairman, ACPN, Lagos, said the essence of the seminar was to reactivate the members’ knowledge base and to update them on the new trends in the practice of pharmacy. He explained that the seminar was an annual programme, adding that in Nigeria, the level of expertise of pharmacists had yet reached the level of other specialists like oncologists, opticians and so on. This, he said, necessitated the need for training and retraining, so as to be relevant and as well follow the dynamics in the development of pharmacy practice in Nigeria. He added that the training strategy was not only happening at the state level, but also at the zonal areas of the state.

Speaking on the choice of the theme of the conference, Aminu disclosed that having excellent practice and good medicine is possible, depending on the conduciveness of the environment but also argued that there were so many factors militating against it. “It is really a complex situation,” he said, “but we pray that, in due course, we will have a well-developed infrastructure and constant power supply that will make our environment conducive in Nigeria. If you travel to some African countries, you will find out that the level of practice there is somehow encouraging than what we have here, because apart from the fact that the society is so free, almost everybody is selling medicine in Nigeria. ”

“Also, in terms of enforcement,” he emphasised, “we are not observing up to 30 per cent of the enforcement in this country and therefore exposing members of the public to the danger of inappropriate medicine and that is why you see that today, there are lots of chronic ailment coming up. So, it is high time those in the position do something about these challenges and rise up to the situation before it gets out of hand.”

Other dignitaries at the event include: Pharm. Olufemi Ismail Adebayo, national chairman, ACPN; Pharm. Bisi Bright, one of the guest speakers; Pharm. DejiOshinoiki, chairman, Board of Trustees, Lagos State PSN; Pharm. AkintundeObembe, chairman, PSN, Lagos State; Pharm. Regina Ezenwa; Pharm. GbengaOlubowale; Pharm. Anieh Felix Anieh, among others

Olpharm bags Lagos Merit Award -promises to do more on maternal health in 2014

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By Yusuff Moshood –

In recognition of its outstanding performance and contribution to health care delivery in Lagos State, Olpharm Nigeria Limited was recently awarded the 2013 Lagos State Health Merit Award.

The award was presented by the State Governor, BabatundeFashola, during an event held at City Hall, Lagos, last December.

According to the state government, the award was conferred on Olpharm for providing exemplary support in health care services and for loyalty and dedication to duty.

Speaking with Pharmanews in an exclusive interview on the award, Pharm. Johnson Olusetire, managing director/CEO, Olpharm Nigeria Limited, said the company was grateful to God for the privilege of being singled out among all the pharmaceutical companies in Nigeria and given the award.

He added that the company was glad and proud to be recognised for contributing to health care services, not only in Lagos State but in the whole country, stressing that the company, along with its principal partner, Ajanta-India, had been at the forefront of the national malaria control programme of the Federal Government of Nigeria and had also participated actively in the malaria programme of WHO, UNICEF and the Global Fund for more  than two years.

The Olpharm boss disclosed further that the company, with its product, Olpharm Baby Zinc, had also been at the forefront of the WHO and UNICEF diarrhoeaprogramme.

He stated further that with the Olpharm Baby Zinc, the only product certified by the United States Pharmacopoeia (USP) for diarrhoea in Nigeria, the company had consistently demonstrated its commitment to WHO and UNICEF programmes of helping to provide quality health care to the under-five. This, Pharm. Olusetire said, would help the government and other partners in meeting the Millennium Development Goal 4.

The Olpharm helmsman also assured that aside consolidating on its programmes and success in helping to achieve the MDG Goal 4 through the provision of quality medicine and care for the under-five, the company would equally focus more on maternal health care in 2014.

He revealed that the company would introduce products for maternal health care in the New Year to help complement efforts of the federal and state governments to reduce maternal mortality in the country.

He also stated that Olpharm, in partnership with Ajanta, would also expand its scope in anticancer products because the incidence of the ailment had been on the increase in the country, adding that the country was already involved in fighting the condition through partnership with teaching hospitals and some private and specialist hospitals.

Novartis Pharma introduces Coartem 80/480

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By Adebayo Folorunsho-Francis –

In a bid to encourage patients complete the full course of treatment for malarial infection, Novartis Pharma has launched one of its biggest anti-malarial brands, Coartem® 80/480.

In a colourful event held at the Muson Centre recently, Mrs Vera Nwanze, head of Novartis Pharma (Nigeria & Ghana), explained that the new-look Coartem 80/480 has been specially designed to reduce the number of tablets to be taken from the old regime of 24 doses to six.

Among the dignitaries who attended the ceremony were Mrs Maureen Edigbeyi, representative of NAFDAC; Pharm. Bola Oyawole, representative of the Pharmaceutical Society of Nigeria (PSN); Pharm. Olufemi Adebayo, chairman of the Association for Community Pharmacists of Nigeria (ACPN); and Pharm. IfeanyiAtueyi, chairman of the occasion.

According to Nwanze, people often dislike swallowing a large number of tablets and therefore miss a dose or stop treatment altogether, leaving them vulnerable to re-infection by the malaria parasite.

This view was further affirmed by Dr Linus Igwemezie, executive vice president and head of the Novartis Malaria Initiative, who hinted that Nigeria has one of the highest incidences of malaria globally and, together with the Democratic Republic of Congo, it accounts for over 40 per cent of deaths from malaria worldwide.

“The launch of Coartem® 80/480 in Nigeria marks a new chapter in this battle, and promises to benefit many people with a convenient and quality treatment for malaria,” he said. “For over a decade, Novartis has been a pioneer in the fight against malaria. Besides, the rapid review and approval of the new formulation by the Nigerian health authorities has enabled it to be the first country to launch Coartem® 80/480.”

Commenting on how the new product can be distinguished from counterfeits, Igwemezie added that the Coartem® 80/480 packs feature an additional level of security popularly known as Mobile Authentication Service (MAS) label, which allows people to verify that the product is genuine.

“All the buyer simply needs to do is to scratch off the label to reveal a unique 12-digit number, which can then be texted, without cost, to 38353. Within seconds, a response is received, which informs them whether the code is valid,” he stressed.

In his presentation, Pharm. Atueyi declared that although reports on HIV/AIDS are said to be frightening, that of malaria is quite devastating.

“It is sad to note that the North Central and North Western parts of this country are worse hit. Only the South East can be truly said to be relatively free of the scourge.

“Chloroquin has fallen out of favour. Artemether-Lumefantrine is now regarded as the first line of treatment. I commend the effort of Novartis and challenge them to do more in the area of R&D because there is no guarantee that ACT will last forever,” he urged.

Atueyi also lauded Igwemeziefor  his active role in the Nigerian Association of Pharmacists and Pharmaceutical Scientists in the Americas (NAPPSA) which brings together Nigerian pharmacists in the USA every year.

Community pharmacy beyond drug selling – Agbude

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 (By Adebayo Oladejo)

In this exclusive interview with Pharmanews, Pharm. George Agbude, managing director, Teglo Pharmacy Nigeria Limited, Iju Agege, and zonal coordinator, Association of Community Pharmacists of Nigeria (ACPN), Iju/Agege Zone, shared some of his experiences from the early days as a fledgling pharmacist to the present day as an established community pharmacist.

He also spoke about some of the major challenges facing the practice, especially in his zone and the state in general.

Read the interview below:

How long have you been in the community practice and how was it when you started?

I have been in this practice since 1991; but at that time, I was still working with people, but in 1996, my own pharmacy, Teglo Pharmacy was born. However, it was not easy when I started because finance is always a major challenge to most community pharmacists. Still, I was a bit lucky when I started because I had worked with some senior colleagues and that had made me to know so much about community practice; and by the time I was ready to take off with Teglo Pharmacy, I had gained enough experience and made so many friends in the industry. In fact, my advice to our young ones who are aspiring to go into community practice is that they should strive to serve under the tutelage of an established community pharmacist for a period of, at least, five years before they establish their own pharmacy. By the time I started, how to raise capital, knowing where to buy quality drugs and so many other useful considerations were no longer problems for me and that was because I had gained enough experience from 1991 to 1996.

How lucrative is community pharmacy practice business in this part of the state?

Community pharmacy practice, as a matter of fact, is very lucrative but very challenging. It’s very challenging in the sense that you have to give up a lot of things for the practice to succeed. For instance, you open your pharmacy in the morning and close in the evening.You stay there almost throughout the day and, all your life, you nurture and grow it, and that is a very big challenge.But, then, it is very lucrative, provided you do it according to how you are supposed to do it and with God on your side, you can be a very successful person in it. In fact we have a lot of successful people in the practice and they are all doing well.

 How would you assess community pharmacy practice in this part of the country?

Community pharmacy practice in this part of the country is highly challenging.Challenging in the sense that we have to contend with lots of charlatans and patent medicine dealers. It is normal in this part of the country that, once somebody retires from work, the next thing they think of is to start community pharmacy and this has been a major challenge. These people are not professionals and they are not formally trained in the aspect drug-selling.They see it as merebuying and selling, which community pharmacy is not, as it involves professionalism. The patients need to be counselled.We need to see the patient, evaluate pharmaceutical care in terms of the drug the person is using and how best we can help the person. So, those quacks infiltrating the profession are causing a lot of havoc to the profession and they are not giving us access to really assist the masses in terms of their health care challenge.

Finance is another area that is hampering the growth of community pharmacy in the country. Community pharmacists are meant to cater for the needs of the people of our community; but in a situation where we are financially handicapped…and the banks are not really helping our situation because the condition they give most times could be more than what most practitioners can cope with. So, it has been a great challenge on our part.

Meanwhile, the practice is very interesting as it affords us opportunity to meet with lots of people, both rich and the poor and it makes us popular among the people of our community. I have had opportunities to meet with several people – couples, families – and I have interacted with them, counselled them, advised them and they have become like family to me.

Talking from the perspective of our zone, finance has been a great challenge to us. Also, when you go to our markets at night in this area, you see so many women with different kinds of baskets full of all assorted capsules for treating any ailment. This is a big challenge because people take all these drugs and before they know it they break down with different kinds of health challenges and when they come to us for remedy, we may not even know where to start from because they have taken lots of drugs and you are confused as a professional. So, to me, it’s a big challenge because I feel that this area needs to be looked into.

Recently,too, I have discovered that many young people are going down with kidney problems and I believe that all the drug abuse and misuse are some of the factors responsible for it.

Do you think ACPN, Lagos, is actually living up to expectations as an umbrella body for community pharmacists in the state?

They are really trying, especially when compared with other state branches across the federation.They are a pacesetter branch and I give them kudos for what they are doing. Recently they helped community pharmacists in the state to access Fidelity Bank loan so as to overcome the problem of finance. They have discovered that most of our colleagues want to practise but are limited by finance; so they helped them to access this soft loan and I give them kudos for that.

Do you have the statistics of all the registered community pharmacy outlets in this zone?

We are about to carry out the zonal mapping.Although we did it sometime ago, we want to update it this time around.But let me be sincere with you: there are more unregistered shops than the registered ones. I wouldn’t want to give a statistics until we are done with the new mapping of genuine pharmacies. Meanwhile, during the daytime, there are more registered pharmacies than the unregistered ones; but at night, there are more unregistered shops than the registered ones – these are the people who sell provisions during the day but suddenly turn to pharmacists at night.At night, they display more drugs in their shops than even most pharmacists.

What are the most common health conditions patients in this area come to the pharmacy for and why is this so?

Malaria has been a big challenge to everybody – not only the people of this area because, from the statistics available to us, malaria is a big challenge everywhere. However, environmental factors and other factors could be responsible for the rise in malaria cases in this area.The area is densely populated and the gutters are not flowing; there are stagnant gutters everywhere.Also the drainage system is bad and, generally, thelow level of environmental hygiene is not helping matters at all.

Malaria can be prevented if the drainage system is working well, if the bushes around are cleared and if there is availability of treated mosquito nets for people to use. So, to be sincere, we sell more of malaria drugs than any drug here.In fact, it is second to paracetamol.

If you were not a community pharmacist, which other areaofPharmacy would you have gone into and why?

If I was not in community practice, I would have loved to be in the industry because I believe in challenges; and that is the area I would have loved to work so as to explore and task my brain on so many things.

Who is your role model in pharmacy practice?

I don’t have a specific one but I have role models in this practice,including Prince Julius Adelusi-Adeluyi of Juli Pharmacy, Pharm. Ike Onyechi of Alpha Pharmacy, and Boluke Pharmacy. In fact, I mentioned Boluke pharmacy because of the way she came up – she started from the rough bottom and, today, she is making it big and we all look up to her.

How do you see the war on fake drugs and what other strategies can be adopted to effectively tackle this menace?

Fake drugs in Nigeria is a big issue and if the war must be won, the federal government must develop the nerve to really stand and fight it. I see fake drug as a cartel business in Nigeria and, from top to bottom, many people are involved because the mega drug business is not a business any person can go into.So,the federal and state governments and all other parastatals should have the nerve to stand and fight it; and if we must succeed in the war, it has to start from the federal government and there has to be punishment for those who trade in fake drugs. If we start doing that, even though we may not be able to wipe it out, we can curb it to an extent because so many people have suffered from it.

If the government can be bold enough to take some steps like impounding the drugs and sending culprits to about 20 years imprisonment, I am sure others would be scared to go into it because of the punishment.

Also on the part of the National Agency for Food and Drug Administration and Control (NAFDAC), the proliferation of fake drugs had started reducing at one time but, recently, it seems the problemhas resurfaced. Also this their new Mobile Authentication Service (MAS) doesn’t seem to be working as there are times you send it and the result you get is that the product is not genuine and you get confused because the drug came directly from the company and this has happened with Lonart and Ampiclox. In fact, ACPN has complained about it so many times.So I think the only way out is that drug fakers should be severely punished and the government should not spare anyone.

Pharm. George Agbude

 

Why pharmacists are not good businessmen – Pharm. Adedipe

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(By Adebayo Folorunsho-Francis)

 

Chairman of Drugfield Pharmaceuticals Limited, Pharm. Ayodele Adedipe, is not a run-of-the-mill pharmacist. With a vast experience spanning over four decades in pharmaceutical manufacturing, Adedipe is one pharmacist you just cannot ignore.

In this interview with Adebayo Folorunsho-Francis, the 80-year-old former chairman of the Manufacturers Association of Nigeria (MAN) spoke on why pharmacists need to specialise and why he thinks local manufacturing is the way forward.

Enjoy the excerpts:

 

Tell us a bit about yourself

Ayodele Adedipe was born in Lagos on 24 July, 1934, into the family of Mr and Mrs John Bankole  Adedipe of Ibadan. I had my primary education at Government School, Epetedo, Lagos, and gained admission into Kings College, Lagos, on full boarding scholarship in 1949. By 1953, I got a pass with grade one in my School Certificate and proceeded on government scholarship as one of the pioneering students into the newly established Pharmacy course at the Nigerian College of Arts, Science and Technology, Ibadan, which became the forerunner of the Faculty of Pharmacy at University of Ife (now Obafemi Awolowo University) Ile-Ife.

How active were you back then at the Nigerian College of Technology?

Quite active. I was elected Assistant Secretary of the Students Union in 1956. I also served as the firstNational President of the All Nigeria United Nations Students and Youth Association. This position gave me the opportunity to attend the international conference of the Worldwide United Nations Students Association in Berlin, West Germany.

When was your first official assignment as a qualified pharmacist?

That was around 1959 when I joined the federal civil service as a government hospital pharmacist at the General Hospital, Lagos. I was subsequently posted to Federal Medical Stores, Oshodi. By 1962, I was appointed acting federal medical storekeeper. That same year, I was transferred to the then newly-established Federal Pharmaceutical Manufacturing Laboratory, Yaba, as a production pharmacist.

Sometimes, God has a way of doing things. In 1963, I won a British Commonwealth Scholarship to undergo internship as a production pharmacist for six months with Boots Pure Drugs Company at Boots Production Factory in Beeston, Nottingham, England.

Why did you decide to leave the civil service?

My decision to leave the civil service for Haco Nigeria Limited, Apapa (a member of John Holt Group and manufacturer of cosmetics and allied products) in 1965 was a personal decision. I started as assistant production manager before I got promoted to the post of technical manager in 1967. Interestingly, that same year I moved to Wellcome Le Petite Nigeria Limited, Ikeja, as a product manager. As time went by, I was appointed as the company’s representative at the Manufacturers Association of Nigeria (MAN), Ikeja branch, where I served in several committees. In fact, I was appointed to further render my service as a company representative at the Nigerian Employers Consultative Association (NECA).

It appears your active participation in MAN brought you some level of recognition?

As you can see. In fact, by 1970, I recalled winning another scholarship to study production management at ILO International Centre for Advanced Technical and Vocational Training in Turin, Italy, for a period of thee months. Shortly after my return from Europe, I was officially elected a member of MAN’s executive council.

Was that when you became MAN chairman?

No. I was made chairman of MAN, Ikeja branch of Fire Service from 1975 to 1977 and 2nd vice chairman of MAN (main body).

We understand you were running it withsome other notable appointments.

Your observation is right. During this period, I also served as representative on several boards such as Yaba College of Technology, Nigerian Youth Service Corps and Faculty of Pharmacy, Ile-Ife (1975-1977). I was also instrumental to the implementation of the first phase of Indigenisation Decree as a representative of NECA.

 You are yet to mention anything about PSN-related events. Is it possible you didn’t participate much in the area of pharmaceutical activities?

That is not true.I was chairman of the Lagos branch of the PSN(from 1975 to 1978) and a member of the Pharmacists Board of Nigeria (1976-1978). I once served as a member of PSN National Secretariat Building Committee (1982-1985) and was mostly responsible for acquiring the land allocation at the Profession Circle, Victoria Island, for the project. I was gladdened by the letter of commendation issued me by the council of the PSN. I reached what I can call the pinnacle when I was elected Deputy President of PSN (1982-1985).Lest I forget, I was also appointed member of a task force tagged ‘The Drug Panel’ organised under Prof. Gabriel Osuide by the then Gen. MurtalaMuhammed’s administration.

With all these activities happening at the same time, how did you cope with your official work at Wellcome?

Well, what more can I say? I left Wellcome Nigeria to set up Fountain Pharmaceutical and Chemical Supplies Limited in 1977. The company was a pure wholesale organisation which took over from J. L. Morrison Nigeria the sale and distribution of Wellcome products in Lagos, Ogun and Ondo markets for a period of 20 years. Lest I forget, I have also been privileged to serve on the Health Management Boards of Lagos State (1979-1983) and Ondo State (1991-1992).

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

Whenever I am asked this kind of question, I always reply that nothing is permanent in life. Back in my day, we were more of pioneers. Today, lots of changes have taken place. One, the economy of Nigeria is different. Two, the socio-political aspect too is not the same. Simply put, I consider myself lucky in life. It is unfortunate that military intervention has seriously retrogressed this country. Back in the day, the likes of Professors. Osuide, Akubue and Dr Emafo were given scholarship to study abroad. But I wasn’t interested as I preferred manufacturing.

Tell us about Drugfield Pharmaceuticalswhere you are currently

There is nothing much to discuss about Drugfield, other than to say I have served on the board of the company as a director for over a decade before I was currently made the chairman. It was here that I came in contact with the late Fred Adenika.

Do you mean the late Fred Adenika, former PCN chairman?

Of course. He was then the chairman while I was a director. His death was really painful. Such a very nice fellow he was! But again, that is what life is all about. Isn’t it? Drugfield is one of the leading pharmaceutical manufacturers specialising in production of ointments and sterile products. As expected of any serious company, KunleEkundayo(the managing director) is a highly committed person. He was the one who invited me to Drugfield in the first place. It wasn’t an easy route. We also thank God for people like Prof. Dora Akunyili. She really helped in the fight against counterfeiters who almost made mincemeat of us with fake drugs. The frustration from these fakers has forced many pharmacists to shun local production. But, in truth, manufacturing is the way to go in this country. We have no ready-made materials. At least, we are proud to have started the process of bringing in students for production training.

What informed your decision to study Pharmacy, or were you influenced?

Back in King’s College, my favourite subjects were Chemistry and History. However I wanted a profession that would give me freedom. I would have opted for history and ended up in one big organisation. But I fancied embracing self-employment more than anything. In fact, I had the option of studying History at the University of Ibadan. Instead, it dawned on me that Pharmacy was a better choice for me.

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

I cannot really speak for all. But I have worked as a deputy with Pharm. SamuelAgboifo who in my opinion did really well.

 You seem to advocate manufacturing as the way forward for the Nigerian economy. How come Nigerian manufacturers are not getting it right?

The reason is simple. It is because we are inconsistent. For instance, we produced mosquito repellent (NIAM Herbal Cream) which initially moved well in the market. Unfortunately, there was no follow-up because some people started playing politics with it. At a point, I got Drugfield involved in the project; it still didn’t get the right attention.

 What advice do you have for upcoming pharmacists?

They need to stay focused. As much as possible, they should look for areas of specialisation (either in community, distribution, academia or even hospital pharmacy). They must learn and specialise in any defined area chosen. For instance, the people packaging Moringa herbal preparations are not pharmacists. Yet they are doing well.These are the type of people government should encourage and back up.

Are you saying pharmacists are not good investors?

If you ask me, I will tell you that we pharmacists are not good businessmen. If there are areas where we are not good enough, what stops us from inviting professionals to help us generate ideas?But we don’t bother thinking about all these. We have no business quarrelling with doctors. I know things have not changed but opportunities abound out there. Let us seek and get them. But when we eventually get them and realise they are too big to handle, let us look for areas of specialisation.

Make drugs accessible to Nigerians, Okwor urges FG

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(By Adebayo Oladejo)                                                                                                         

Immediate past president of the Pharmaceutical Society of Nigeria (PSN), Pharm. Azubike Okwor, has urged the federal government to ensure that every citizen, regardless of financial status, has easy access to quality drugs.

This, he said, would help to achieve the desired improvement in health care delivery in the nation.

Okwor made the assertion while addressing journalists at the Association of Community Pharmacists of Nigeria (ACPN, Lagos) Continuing Education Seminar, held at NECA House, Ikeja, Lagos, last December.

According to him, irrespective of whatever the government may have done to develop the health care sector, all would be in vain if only the rich have access to quality health care.

“Various agencies like the United Nations and others have declared that access to quality drug is a human right and that people should have unhindered access to quality drugs at all times,” he declared.“In fact, some people can hardly live without drug; so it is a human right.But the question is, have we made it a human right in Nigeria?  The answer is no. Are we working to make it a human right in Nigeria? Nobody knows yet.”

Also speaking on the efforts of the ACPN in ensuring that the approved pharmacy emblem is available to every registered community pharmacist in the country, Okwor said, “The pharmacy emblem is an age-long project and a product of the Pharmaceutical Society of Nigeria (PSN), with the aim of helping Nigerians identify the places where quality pharmaceutical care can be accessed.”

He also added that the challenge currently confronting the association is the issue of fakers who have infiltrated the practice, parading themselves as practitioners and even fabricating the PSN pharmacy emblem.

“A lot of charlatans are faking the emblem and it has been a big issue that has to be resolved on time. In doing so, the PSN itselfneeds to go back to the drawing board and ensure that every community pharmacist has the emblem, so that our effort at channelling the patients to where they can get suitable and quality drugs would be accomplished,” he noted.

While calling on reputable community pharmacists who are yet to acquire the emblemto do so in good time, Okwor further counselled pharmacists to go out of their way to ensure they get drugs for their pharmacies from genuine sources.

The former PSN president also suggested ways in which pharmacists and regulatory agencies can work together to build a sound and mutually-beneficial relationship.  “We must work with the agencies and the agencies themselves should get interested in getting people to comply with regulations, without necessarily applying punitive measures,” he said.  “I’m happy we have a new Chairman for the board of the Pharmacists Council of Nigeria (PCN); and I am very sure he is somebody who will ensure that they work with pharmacists to help them build up whatever practices they have, so as to meet up with the standard they are going to be setting for pharmacists. I think that is the best way to get people to obey regulations.”

 

 

 

Roses Ministry donates food, drugs to widows

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By Adebayo Oladejo –

About 1,000 widows benefitted from a free health screening and donations of food items, clothing materials and drugs at the annual Widows Day programme hosted by the Roses Ministry, a faith-based organisation.

The programme was held last December at the secretariat of the Nigeria Population Commission (NPC), Surulere, Lagos.

Founded in January 2007 by Mrs Regina Ezenwa, a renowned Fellow of the Pharmaceutical Society of Nigeria (FPSN), Roses Ministry focuses on showing God’s love to the hurting and vulnerable in practical ways.

Speaking on how she came up with the vision to start the foundation, Pharm Ezenwa said the ministry was the result of a divine call she received, adding that, since inception it had indeed come a long way. “We have five children on scholarship and people are collaborating with us to achieve our goals,” she said.

On the reason for giving out free drugs to those who needed them, she said, “We don’t want anybody to die from lack of drugs. You can even ask those around if anybody paid for her drugs. No! Besides, all the pharmacists you see dispensing drugs here today are volunteers residing or running their stores in Surulere. They even came with free drugs to show solidarity and identify with the programme,” she noted.

Ezenwa further explained that at the commencement of the Widows Day some years back, only about 50 widows were in attendance. In subsequent years, however, the number grew to about 100; but by 2012, the number had increased to 500, which eventually was doubled by the last edition of the programme.

She said the number keeps rising because virtually all the women were coming along with fellow widows who had not heard of the ministry through ‘word of mouth.’

When asked about the major challenge of the ministry, the pharmacist emphasised funding. She said, “I must confess that the money spent so far were donations from members and friends who are doing well. We actually budgeted for about 700 bags of rice, drugs and textile materials to cater for 700 participants, but as you can see, the people out there are surging towards a thousand and we don’t know how many more that will still come. We might have to further divide the bags of rice, as well as wrappers among the participants. We are hoping next year will be different. But in all, God has always been there for us. We have never failed. He is a provider.”

She also seized the opportunity to make a clarion call to potential volunteers and well-meaning donors who were interested in standing up for the cause of the widows in society.

Also speaking on the annual event, MrsUgochi Roland-Opara, coordinator of the widows’ department, said that in order to focus more on the aged and vulnerable women among the lot, every last Thursday of November was set aside to celebrate widows and that parts of activities that make up the event include fellowship and sharing of the Word of God, free medical screening by doctors on ground, free drug dispensing (mostly malaria, antibiotics, blood tonic, multivitamins and pain relievers) by volunteer pharmacists and free distribution of household items like bags of rice, textiles, toiletries and vegetable oil.

According to her, where cases like elevated blood pressure or other complex health challenges were discovered, they were immediately referred to doctors for consultation and prescription.

“Roses Ministry represents so many things. You need to come on such Thursdays to listen to the women’s testimonies on how they have been blessed. Many even call us on phone to personally appreciate our efforts at giving them a new lease of life,” she said.

Roland-Opara also disclosed to Pharmanews how the not-for-profit ministry started an empowerment programme, which features practical sessions like soap liquid production, beads-making, fashion designing, fish smoking and hair dressing, to train the women.

“What we do basically is to bring in experts to train them. Once through, the ministry establishes them with the needed equipment and machine. Today, many of them are doing quite well in their chosen field,” she said on what keeps the ministry going, despite obvious challenges, Opara intoned: “It could be quite stressful. But the joy of seeing these people doing well is enough to keep us going. Meanwhile, my advice to other widows who are not able to avail themselves of this opportunity is to keep trusting God, as he never fails those who truly serve him,” adding that the “divine hand that touched these ones [2013 participants] will also touch them one day.”

In her appreciation to the Roses Ministry, one of the beneficiary widows, MrsEuchariaOkereke, said she heard about the ministry three years ago and, since then, her life had changed for the better. “The ministry is truly God sent and it has changed my life for good. I have four children and the ministry, apart from feeding and catering for us, are also sponsoring my son at the university,” she enthused.

Also speaking in the same vein, another beneficiary, Mrs Alice Elikwu, said, “My husband died in 2003 and life became hell for me and my three children; but when I joined the ministry, they turned my life around and they have been taking good care of my children, as well.”

NAFDAC seeks collaboration on herbal medicine standardization

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 By Temitope Obayendo –

To bridge the gap between the discovery and clinical development of herbal medicines in Nigeria, the Director General, National Agency for Food and Drug Administration and Control (NAFDAC), Dr Paul Orhii, has called for a strong collaboration between the research & development institutions and pharmaceutical companies.

This, according to him, would help to bridge the gap between the discovery and clinical development of herbal medicines in the country.

The NAFDAC boss made the call in Abuja at the opening ceremony of the recently held HerbFEST 2013, a herbs, health foods and natural products expo, which also featured a workshop on bio-entrepreneurship and investment opportunities for herbal, food and natural products.

Speaking on the topic: “Registration, Regulation and Development of Herbal Medicinal/Natural Food Products: Hidden Strategies to Making It Work”, DrOrhii said a close and complementary relationship between the academic community and the industry is critical to ensuring a robust national pharmaceutical research capacity for the development of medicinal products.

“The relationship between the academia and the pharmaceutical companies is complementary and naturally lends itself to the formation of joint research enterprises,” he stated.

Explaining further, he said while the academia brings strong insight into the fundamental mechanisms of disease along with expertise in patient care and clinical practice, the industry possesses the knowledge and tools to translate basic research discoveries into practical applications in patients. Collaboration between both sectors will therefore indicate a synergistic relationship between academic research and commercial activity.

The agency helmsman also urged the research institutions and the pharmaceutical industries to learn from the examples of India and China, by embarking on indigenous phytomedicinesstandardisation and have a local agenda for such research and development.

On standardisation and quality control of herbs in Nigeria and Africa, as a whole, he noted that there was a need for deliberate policy on medicinal plants standardisation, including the procedures and methods for sourcing, collecting, drying, processing, packaging etc. of raw materials from the field to the bottle, covering planting, manuring, tendering to harvest and storage of raw materials.

“We must have QC (quality control) and standardise extraction procedures and preparation of biomass to dosage form. Factors such as the use of fresh plants, age and part of plant collected, period, time and method of collection, temperature of processing, exposure to light, availability of water, nutrients, drying, packing, transportation of raw material and storage, can greatly affect the quality, and hence the therapeutic value of herbal medicines,” he stressed.

He also noted the indispensability of regulation, asserting that since herbal medicine is multicomponent, it would be difficult to isolate each plant. This therefore validates the need for standardisation, a strategy the Indians adopted for their Ayuvedic medicine and China for their TCM.

Orhii, who also appealed to manufacturers and processors of natural products to abide by the agency’s guidelines on registration of their products, decried the difficulties encountered in the process of regulating the activities of product manufacturers.

“Although Nigeria has a national policy on traditional medicine and NAFDAC regulations cover requirements for registration of natural products, with guidelines, getting manufacturers/ processors to comply is still a herculean task, as control is incorrectly perceived to be ”discouragement” and “bottlenecks”. However, we cannot continue to lament on the ”burden” of regulatory compliance, because it is a necessary tool for guaranteeing safety and quality,” he pointed out.

Ministry of Health signs MoU with NAPPSA

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By Adebayo Folorunsho-Francis –

Representatives of NAPPSA and FMOH in a group photograph with the minister of health after the signing ceremony

In what many health professionals in the Diaspora have described as a laudable move, the Prof. Onyebuchi Chukwu-led ministry of health has officially entered into a memorandum of understanding with the Nigerian Association of Pharmacists and Pharmaceutical Scientists in the Americas (NAPPSA), as well as inaugurated a technical committee to drive its execution.

The ceremony, which took place at Chelsea Hotel in Abuja late last year, was witnessed by several members of NAPPSA and other health officials.

Speaking at the event, minister of health, Prof. Chukwu, said that the objective of the memo was to collaborate with Nigerian health professionals, in order to contribute to the education and training of manpower in health, research, service delivery, skills transfer, quality assurance and investment, which would translate into enhanced quality health care service delivery.

“In 2012, I had the opportunity of attending the NAPPSA conference in Chicago, in which challenges confronting health care in Nigeria were discussed,” he said. “I am therefore excited to note that your association has decided to respond to the clarion call of well-meaning Nigerians for contributions that will impact positively on the transformation of health care system in the country.”

It is expected that the MoU will provide a unique opportunity for information and expertise sharing in such areas as health education, pharmacy and pharmaceutical education, career and professional development, pharmacy practice and governance, pharmaceutical products and medical device importation, as well as pharmaceutical manufacturing testing and distribution.

Aside from NAPPSA, the Federal Ministry of Health had also, in 2012, entered into memoranda of understanding with many health-related diaspora associations like the Medical Association of Nigerians Across Great Britain (MANSAG) and Canadian Association of Nigerian Physicians and Dentists (CANPAD). Others were Association of Nigerian Physicians in the Americas (ANPA), National Association of Nigerian Nurses in North America (NANNNA) and Nigerian Nurses Charitable Association in the UK (NNCA-UK).

Improving the health sector in 2014

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For the Nigerian health sector, the year 2013 ended on an ominous note with the five-day warning strike (December 18 to 22) embarked on by the Nigerian Medical Association (NMA) to press home some of its demands.

The association had threatened to commence an indefinite strike action from January 6, 2014, if the Federal Government (FG) failed to meet its demands, among which were: establishment of a Hospital Development and Intervention Fund for health infrastructure upgrade, appointment of a Surgeon General of the Federation, and expansion of the universal health coverage.

However, it was good to hear the news early in the year that the association had announced the suspension of its plan to embark on an indefinite strike, following the agreement between it and the government, and to allow for the implementation of the MoU reached with the FG. This is a good sign for the New Year.

Still, it must be emphasised that, to chart a new course for the health sector in 2014, ensuring industrial harmony is crucial. This is because the sector was bogged down last year by several industrial strike actions.

It must equally be emphasised that it is essential that the government accedes to the legitimate demands of the NMA. However, in doing this, the government must refrain from unwittingly creating more disharmony in the health sector by treating the issues raised by the NMA in isolation. The challenges facing the health sector, as a whole, must be tackled, with due consideration for health care professionals, other than the medical doctors. To do this, the government must involve all the health care professionals in its efforts to devise and implement strategies for progress.

The Nigerian government has a major role to play in helping to promote team spirit in the health sector. Already, the Nigerian Union of Allied Health Professionals (NUAHP), whose members comprise pharmacists, physiotherapists, radiographers, medical laboratory scientists, dietitians, occupational therapists, dental therapists, dental technologists, nurses, optometrists, health information officers, medical social workers, among others, is disputing the decision of President Goodluck Jonathan to appoint a Surgeon General of the Federation, who will be a medical practitioner.

The NUAHP, in a signed statement by its secretary and president, O. C. Ogbonna and F. Faniran, said it was wrong for the president to take such an important decision without a proper stakeholders’ conference, adding that the NMA constitutes just 10 per cent of the workforce in the health sector, while the NUAHP members constitute the remaining 90 per cent.

This contentious issue must be carefully addressed, to avoid inadvertently creating a new crisis in the health sector, while trying to solve another.

Nevertheless, aside from ensuring industrial harmony in the sector, there are also several other challenges facing the health sector that must be surmounted to make the sector better this year. The first is the nation’s polio eradication efforts. While we note that the efforts of government to rid the country of the epidemic were seriously hampered in 2013, as a result of insecurity in some northern states, the FG must devise a way to eradicate polio, in spite of this challenge. Nigeria remains the only country right now with on-going transmission of all 3 serotypes (wild polio virus type 1, wild poliovirus type 3, and circulating vaccine-derived poliovirus type 2) and our inability to eradicate polio has continued to give the nation a bad image globally.

Also, although recent statistics from the Federal Ministry of Health on maternal mortality indicated that maternal mortality ratio has reduced over the years, it is worrisome that the country is still one of the nations with the highest maternal mortality in the world.

To tackle this problem and also reduce the child mortality rate, the National Primary Health Care Development Agency (NPHCDA) must do more to revive and transform primary health care delivery system in the country. This first port of call in the health system must be strengthened to provide quality health care to millions of Nigerians at the grassroots.

Also, quite a lot must be done, in terms of preventive medicine. The outbreak of cholera late last year in some states of the federation and its attendant casualties in a 21st century Nigeria is a sad commentary for us. Cholera and some other diseases killing and maiming Nigerians can be prevented with proper education, enlightenment and immunisation.

It is our opinion that 2014 offers Nigeria a great opportunity to turn around the health sector for good, as it is the last year available to work on achieving the health components of the Millennium Development Goals (MDGs). Consequently, deploying resources and strengthening strategies to ensure these goals are met will be quite beneficial in transforming the Nigerian health sector this year. It is also the way to go to save Nigerians dying from many preventable and treatable health conditions.

Mandela day and Nigerian children

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In July 2013, I attended a programme organised by Aspen Nigeria. It was tagged International Nelson Mandela Day.  Aspen, whose headquarters is in South Africa, held the programme with the theme “Make Every Day a Mandela Day,” to celebrate the 95th birthday of the late Nelson Mandela.

That was the first time I would be part of any event connected with the great Mandela and, even though the African elder statesman was not enjoying the best of health at that time, I never thought he would exit the world a couple of months after that event.

When the news broke on December 5, 2013 that Mandela had passed on, the first thought that came to my mind was what transpired at the Aspen-organised event. The event was unique because Aspen decided to use the Mandela birthday celebration to educate pregnant women and nursing mothers on child nutrition. The one-day nutrition advocacy campaign held at Massey Street Children Hospital, Lagos Island, was, for me, a roaring success and an example of corporate social responsibility worth copying by other companies.

Even though the event was held on a rainy day, the hall was filled to capacity. More interestingly, the event was not only graced by the usual crowd I often see at health events (health professionals, eminent personalities, well-to-do individuals and so on); over 90 per cent of the audience was made up of the real people it was organised for pregnant women and nursing mothers at the grassroots level.

The participants were educated by the health professionals, including pharmacists, doctors and a nutritionist, on how to take good care of themselves and ensure proper nutrition for their infants.

The event was equally unique because it was not the usual one-way, speech-presentation type of enlightenment campaign. It was quite interactive and the pregnant women and nursing mothers fully participated, as discussions were encouraged even in the local dialect.

As part of the event, a quiz competition was also featured and the participants were asked questions on child nutrition.  Those who answered correctly were given various gift items.  However, all the women were winners as all went home with gift items from Aspen.

Perhaps, more important to me is the fact that an organisation decided to use the opportunity of the birthday of Mandela to call attention to a segment of our population that is in dire need of attention.

According to WHO, at least 225 million of the world’s children under the age of five suffer from acute and chronic malnutrition, a condition that is life-threatening and undermines children’s health and development. Nutrition, it must be emphasised, is related to most of the Millennium Development Goals (MDGs).  Consequently, efforts aimed at reducing child mortality and improving maternal health must seriously address nutrition issues for pregnant women, nursing mothers and children.

The late Nelson Mandela was an example worth emulating in many respects. One of such was his commitment to children. When Mandela stepped down as president of South Africa in 1999, after serving just one term, he continued to work with the Mandela Children’s Fund, an organisation he established in 1995.  He supported the Fund until his demise. This is perhaps why the decision of Aspen to mark his birthday by organising a nutrition advocacy campaign for pregnant women and nursing mothers was so fitting.

While I urge Aspen to continue with the laudable initiative, I also enjoin other organisations to emulate the exemplary footsteps of the company.

A similar initiative for children worth commending is the Osun State government’s schools feeding programme, tagged O-MEALS.  The state government is spending millions of naira to provide nutritious meals for primary school pupils.  According to reports, about 250,000 children benefit from these mid-day meals in schools across the state.

I was in Osun State last December and a number of people I spoke to about the state government’s programme were quite excited about the initiative.

These laudable initiatives should not just be commended; they must be emulated. Other state governments and organisations should be encouraged to take up the challenge.  If children are indeed the leaders of tomorrow, everything must be done today to ensure they are well prepared and equipped to lead tomorrow. And I dare say that ensuring they are well fed is the first step in this direction.

The best way to make every day a Mandela day for children is for all Nigerians to contribute positively to child nutrition daily.

Mandela day and Nigerian children (Polemic)

In July 2013, I attended a programme organised by Aspen Nigeria. It was tagged International Nelson Mandela Day.  Aspen, whose headquarters is in South Africa, held the programme with the theme “Make Every Day a Mandela Day,” to celebrate the 95th birthday of the late Nelson Mandela.

That was the first time I would be part of any event connected with the great Mandela and, even though the African elder statesman was not enjoying the best of health at that time, I never thought he would exit the world a couple of months after that event.

When the news broke on December 5, 2013 that Mandela had passed on, the first thought that came to my mind was what transpired at the Aspen-organised event. The event was unique because Aspen decided to use the Mandela birthday celebration to educate pregnant women and nursing mothers on child nutrition. The one-day nutrition advocacy campaign held at Massey Street Children Hospital, Lagos Island, was, for me, a roaring success and an example of corporate social responsibility worth copying by other companies.

Even though the event was held on a rainy day, the hall was filled to capacity. More interestingly, the event was not only graced by the usual crowd I often see at health events (health professionals, eminent personalities, well-to-do individuals and so on); over 90 per cent of the audience was made up of the real people it was organised for pregnant women and nursing mothers at the grassroots level.

The participants were educated by the health professionals, including pharmacists, doctors and a nutritionist, on how to take good care of themselves and ensure proper nutrition for their infants.

The event was equally unique because it was not the usual one-way, speech-presentation type of enlightenment campaign. It was quite interactive and the pregnant women and nursing mothers fully participated, as discussions were encouraged even in the local dialect.

As part of the event, a quiz competition was also featured and the participants were asked questions on child nutrition.  Those who answered correctly were given various gift items.  However, all the women were winners as all went home with gift items from Aspen.

Perhaps, more important to me is the fact that an organisation decided to use the opportunity of the birthday of Mandela to call attention to a segment of our population that is in dire need of attention.

According to WHO, at least 225 million of the world’s children under the age of five suffer from acute and chronic malnutrition, a condition that is life-threatening and undermines children’s health and development. Nutrition, it must be emphasised, is related to most of the Millennium Development Goals (MDGs).  Consequently, efforts aimed at reducing child mortality and improving maternal health must seriously address nutrition issues for pregnant women, nursing mothers and children.

The late Nelson Mandela was an example worth emulating in many respects. One of such was his commitment to children. When Mandela stepped down as president of South Africa in 1999, after serving just one term, he continued to work with the Mandela Children’s Fund, an organisation he established in 1995.  He supported the Fund until his demise. This is perhaps why the decision of Aspen to mark his birthday by organising a nutrition advocacy campaign for pregnant women and nursing mothers was so fitting.

While I urge Aspen to continue with the laudable initiative, I also enjoin other organisations to emulate the exemplary footsteps of the company.

A similar initiative for children worth commending is the Osun State government’s schools feeding programme, tagged O-MEALS.  The state government is spending millions of naira to provide nutritious meals for primary school pupils.  According to reports, about 250,000 children benefit from these mid-day meals in schools across the state.

I was in Osun State last December and a number of people I spoke to about the state government’s programme were quite excited about the initiative.

These laudable initiatives should not just be commended; they must be emulated. Other state governments and organisations should be encouraged to take up the challenge.  If children are indeed the leaders of tomorrow, everything must be done today to ensure they are well prepared and equipped to lead tomorrow. And I dare say that ensuring they are well fed is the first step in this direction.

The best way to make every day a Mandela day for children is for all Nigerians to contribute positively to child nutrition daily.

Neimeth Launches Pyrantrin Choco

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By Yusuff Moshood –

Neimeth International Pharmaceuticals Plc has launched a new antihelminthic (deworming agent), Pyrantrin Choco.

The new drug, a chocolate flavoured variant of Pyrantrin, a brand of Pyrantel Pamoate, was unveiled during an official media launch held last December, at Neimeth head office in Lagos.

Speaking with Pharmanews at the event, the corporate communications manager of Neimeth, Chinenye Okoronkwo, stated that Pyrantrin Choco, the first deworming agent in the Nigerian pharmaceutical market with a chocolate flavour, was formulated to effectively expel the six commonly occurring intestinal worms, including roundworm, hookworm and threadworm.

The new drug, she said, works by effecting instant neuromuscular blockage of worms, which induces paralysis and consequent excretion of the worms through peristalsis. “With this,” she noted, “the drug obviates the possibilities of worm migration/excitation, which are characteristic of some other deworming agents. This way, negative consequences (e.g. worms coming out through the mouth or nose etc) are averted.”

The Neimeth communications manager stated further that Pyrantrin Choco is the outcome of dedicated and consistent research and development efforts aimed at giving consumers flexibility of choice and enhancing therapeutic compliance in children, due to its pleasant taste.

She assured that the launch of Pyrantrin Choco would help change the face of antihelminthic prescription in Nigeria as patients’ positive compliance with therapeutic specifications would help reduce the overall worm burden on the society and prevent negative health consequences of worms infestation, which could be life threatening.

She further stated that Pyrantrin Choco is packaged in consumer attractive eco-friendly packs, which add immense value to the global fight for the preservation of the environment through eco-friendly practices.

Dignitaries present at the launch were Pharm. Emmanuel Ekunno, managing director/CEO, Neimeth International Pharmaceuticals Plc; Mr Christ Emeje, the finance director; and Dr. Nkeiruka Asumah of the Federal Medical Centre, Ebute Metta, Lagos, among others.

Worm infestation is a global problem. It is generally fuelled by poverty and other socio-economic constraints.

Accolades as Uwaga becomes NIM president, chairman of council

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Leading professionals and respected Nigerians including former Governor of Lagos State, (Alhaji) Lateef Kayode Jakande, former Minister of Commerce and Industry, Chief Bola Kuforiji-Olubi, boardroom guru, Dr. M. O. Omolayole, and PSN President, Pharm. Olumide Akintayo, were among those who witnessed the investiture of Pharm. (Dr.) Nelson U. O. Uwaga as the 19th president and Chairman of Council of the Nigerian Institute of Management (NIM).

Dr. Uwaga isthe first pharmacist to rise to the prestigious position.

Leading the rain of accolades on Uwaga at the ceremony held at Muson Centre, Onikan, Lagos, last December, the outgoing president and Chairman of Council of the NIM, Chief (Dr.) Michael Olawale-Cole, described his successor (Uwaga) as a man of integrity and a go-getter. He said that having worked with Dr. Uwaga, he was convinced that the respected pharmacist would take the NIM to the next level.

Also speaking on behalf of the past presidents of NIM, Dr. M. O. Omolayole, congratulated Dr. Uwaga for emerging as the new helmsman of the institute, adding that the new president hadset a record as the first pharmacist to be asked to pilot the affairs of the institute.

He urged Dr. Uwaga to strive to ensure the NIM flag keeps flying high.

In his first address as President and Chairman of Council of NIM, Dr. Uwaga pledged to help take the NIM to a higher level.

The highlight of the occasion was the investiture of Dr. Uwaga, and the presentation of certificates to other elected Governing Council members.

Other dignitaries at the memorable occasion were Pharm. (Sir) Ifeanyi Atueyi, Pharm. Lere Baale, Pharm. Ade Popoola, Pharm. Jimi Agbaje, among others.

Dr. Uwaga is a former president of the Pharmaceutical Society of Nigeria (PSN) and an alumnus and member of the National Institute of Policy and Strategic Studies (NIPPS), Kuru, Jos, Nigeria.

He holds the Fellowship of the Pharmaceutical Society of Nigeria (FPSN), the Nigerian Institute of Management (FNIM) and the West African Postgraduate College of Pharmacists.

He is presently the Chairman/CEO of Barata Pharmaceuticals & Co. Limited and a senior lecturer (Adjunct) at the Faculty of Pharmacy, University of Port Harcourt.

 

Do you check your alignment?

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What does the septuagenarian mean by alignment? Does he mean physical or spiritual alignment? Relax and enjoy this edition of reflection.

My first employment was with Pfizer Products Ltd. (now Pfizer Pharmaceuticals Ltd.) in 1964, as a medical representative, in Lagos. At the end of orientation and training, the new “med reps” were assigned Peugeot 403 for their territories. My first driver, Chika, was a young man with about five years of driving experience and he actually taught me to drive. I remember him for his counsel to always use the side mirror. He would repeatedly say, “Oga, ‘pimp’, ‘pimp’ before you move out.” (He meant ‘peep’).

I also remember the second one, Anthony, for “alignment”. He was fond of talking about alignment and strongly believed that wheels must be properly aligned at all times. Sometimes, while driving, he would comment that the car tended to move towards one side, instead of straight, and that the problem was with the alignment. Each time we vulcanised a tyre or moved one or two tyres around, he insisted on alignment thereafter. Anytime he noticed an abrasion on any part of the tyre, he complained of alignment. He told me that poor alignment could damage the tyres and even cause accident on the highway.

Anthony talked so much about alignment that, after some time, I strategically took over the initiative from him. Anytime we were ready to go out I would ask, “Anthony, have you checked alignment?” After car service, I would ask, “Did you check alignment?” I thought and talked about alignment so much that it started having a deeper meaning to me.

I have realised that alignment should not only be applicable to wheels of cars.  It should also apply to my life and yours, as well. The question should be: Are you properly aligned to the purpose of God for your life?

You are out of alignment if you are not at the location God wants you to be or doing what God has not planned for you. You may be doing what God wants you to do but not at God’s own time. You are out of alignment if you maintain a relationship that is not of God. All the so-called good works you do may amount to nothing in God’s eyes, if your heart is far from Him.

Many wicked people flourish and prosper in the eyes of the world but are unfortunately not really in alignment with God’s purpose for their lives. There are fake or counterfeit blessings given by Satan. Hidden beneath such blessings are grave sorrows. This is why you should not envy them or fret because they appear to be prospering.

Wicked people must receive the reward of their evil deeds. The Bible says, “For they shall be soon be cut down like the grass, and wither as the green herb.”  (Psalms 37:2). It further says, “For evil doers shall be cut off… For yet a little while and the wicked shall be no more; indeed you will look carefully for his place, but it shall be no more.”

Wickedness is disobedience which takes you off divine alignment.  Alignment with God’s will and purpose brings blessings, as you are guided in the right direction to do the right thing at the right time. The Holy Spirit becomes your teacher and counsellor.

Many a time, we come to a point where a decision is critical and we are tempted to consult others for advice and guidance, while we keep God away. This is dangerous. In fact, Prophet Jeremiah says people who do such are under a curse because they put their trust in mortals. I have learnt that the right thing to do in such situations is to present your challenge to God and wait for His revelation and guidance. If He tells you to meet Mr. X, do so, then Mr. X becomes a vessel He has chosen to use in that particular case.

Don’t rush to Mr. X because he is influential or powerful. God does not depend on such strengths to achieve His purpose. Psalm 147:10-11 says, “He does not delight in the strength of the horse; He takes no pleasure in the legs of a man, the Lord takes pleasure in those who fear Him, in those who hope in His mercy.”

Sometimes your faith may be challenged by circumstances beyond your control and you begin to fear and doubt the effectiveness of your alignment. In such cases, your confidence and hope in God will give you joy and peace of mind.  Life is full of challenges and storms which affect everyone at one time or another. But the difference is your attitude, response and result of the storm. The storm will not have any adverse effect on you, if you are properly aligned.

One message of hope is offered by Prophet Isaiah in Chapter 43.  In verse 2 he says, “When you pass through the waters, I will be with you; and through the rivers, they shall not overflow you.  When you walk through the fire, you shall not be burned, nor shall the flame scorch you.” Hebrews 13:5 also assures us that God will never leave or forsake us, especially in times of trouble.

Your access to divine help is guaranteed at all times, if you are aligned with God’s will for your life. Just call on Him and He will quickly answer you. He knows your need even before you call. With Him around you, you should not fear what any man can do to you because He has the final decision in all things and the supreme authority over all things. Nothing happens without His approval. Just fear Him and you have nothing else to fear.

You need to take delight in the things that please God and He will satisfy your desires, which are in alignment with His will. Meditating on the Word of God and living accordingly will always provide wisdom to go through life successfully. The promises are that you will be like a tree planted by the rivers of water that brings forth its fruit in its season. As the leaves of such tree never wither, so will your life continually flourish; and whatsoever you do shall prosper (Psalm 1:1-3).

How to manage body pain/rheumatism/arthritis

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“Rheumatism” is derived from the Greek word “rheuma,” which means a swelling.

It refers to an acute or chronic illness, which is characterised by pain and swelling of the muscles, ligaments and tendons or of the joints. It is a crippling disease, which causes widespread invalidism, but seldom kills.

This disease affects men and women, both young and old. Quite often, it extends to the heart and the valves, and the lining of this vital organ becomes inflamed. It is the most common cause in 80 per cent of the cases of valvular organic diseases of the heart.

Rheumatism, perhaps, more than any other disease, although readily diagnosed, is never the same in any two individuals. There are too many variations in the development of the disease.

Broadly speaking, however, rheumatism, which may be acute or chronic, can be roughly grouped into two classes. These are: muscular rheumatism, which affects the muscles; and articular rheumatism, which affects the joints. The muscular variety is, however, far less common than that affecting the joints.

In the acute form, it is found among children and young people. But in the chronic form, it is generally confined to the adults.

 

Arthritis: Not a Single Disease

Arthritis literally means joint inflammation. Arthritis is not a single disease. Arthritis refers to a group of more than 100 rheumatic diseases and other conditions that can cause pain, stiffness and swelling in the joints.

Any part of your body can become inflamed or painful from arthritis. Some rheumatic conditions can result in debilitating, even life-threatening complications or may affect other parts of the body, including the muscles, bones, and internal organs.

The two most common types of arthritis are osteoarthritis and rheumatoid arthritis. The incidence of arthritis increases with age, but nearly three out of every five sufferers are under age 65.

If left undiagnosed and untreated, many types of arthritis can cause irreversible damage to the joints, bones, organs, and skin.

 

Osteoarthritis

Osteoarthritis, also known as degenerative joint disease, results from wear and tear. The pressure of gravity causes physical damage to the joints and surrounding tissues, leading to:

  •         pain
  •         tenderness
  •        swelling
  •        decreased function

Initially, osteoarthritis is non-inflammatory and its onset is subtle and gradual, usually involving one or only a few joints. The joints most often affected are the:

  •            knees
  •              hips
  •             hands
  •             spine

Risks of osteoarthritis increase with age. Other risk factors include joint trauma, obesity, and repetitive joint use.

 Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease that occurs when the body’s own immune system mistakenly attacks the synovium (cell lining inside the joint). Rheumatoid arthritis is a chronic, potentially disabling disease which causes:

  •   joint pain
  •  stiffness
  •  swelling
  •   loss of joint function

While the cause remains elusive, doctors suspect that genetic factors are important. Rheumatoid arthritis can be difficult to diagnose early because it can begin gradually with subtle symptoms.

 

Juvenile Arthritis

Juvenile arthritis is a general term for all types of arthritis that occur in children. Juvenile rheumatoid arthritis is the most prevalent type of arthritis in children. There are three major types:

  •    polyarticular (affecting many      joints)
  •    pauciarticular (pertaining to        only a few joints)
  •    systemic (affecting the entire    body)

Signs and symptoms of juvenile rheumatoid arthritis vary from child to child. No single test can conclusively establish a diagnosis. Juvenile arthritis must be present consistently for six or more consecutive weeks before a correct diagnosis can be made.

 

Psoriatic Arthritis

Psoriatic arthritis is similar to rheumatoid arthritis. About five per cent of people with psoriasis, a chronic skin disease, also develop psoriatic arthritis. In psoriatic arthritis, there is inflammation of the joints and sometimes the spine.

 

Fibromyalgia

Fibromyalgia syndrome is a painful condition characterised by muscle pain, chronic fatigue and poor sleep. The name fibromyalgia means pain in the muscles, ligaments and tendons. Fibromyalgia is a type of soft tissue or muscular rheumatism and does not cause joint deformities.

 

Gout

Gout is a painful type of arthritis that causes sudden, severe attacks of pain, tenderness, redness, warmth, and swelling in the joints, especially the big toe. The pain and swelling associated with gout are caused by uric acid crystals that precipitate out of the blood and are deposited in the joint.

 

Pseudogout / CPPD

Pseudogout, which is also known as Calcium Pyrophosphate Dihydrate Deposition Disease (CPPD), is caused by deposits of calcium phosphate crystals (not uric acid) in the joints. CPPD is often mistaken as gouty arthritis. Since CPPD is a different disease from gout, treatment is not the same as gout.

Scleroderma

Scleroderma is a disease of the body’s connective tissue that causes thickening and hardening of the skin. It can also affect the joints, blood vessels and internal organs.

Lupus / SLE

Systemic Lupus Erythematosus (SLE) is an autoimmune disease that can involve the skin, kidneys, blood vessels, joints nervous system, heart and other internal organs.

Symptoms vary, but may include a skin rash, arthritis, fever, anaemia, fatigue, hair loss, mouth ulcers, and kidney problems. Symptoms usually first appear in women of childbearing age, but, can occur in children or older people. About 90 per cent of those affected are women.

 

How to Recognise Signs and Symptoms of Arthritis

Because there are over 100 different types of arthritis, symptoms of the disease can be variable, but there are certain signs which point to the disease.

You might suspect you have arthritis if you have signs and symptoms which include the following:

§             Persistent joint pain.

§             Pain or tenderness in a joint       which is aggravated by                  movement or activity, such as    walking, getting up from a             chair, writing, typing, holding      an object, throwing a ball,                            turning a key.

§             Inflammation indicated by           joint swelling, stiffness,                                redness, and/or warmth.

§             Inflammation: The Battle                              Within

§             Joint deformity.

§             Loss of range of motion or                           flexibility in a joint.

§             Unexplained weight loss.

§             Extreme fatigue, lack of                                energy, weakness or a feeling   of malaise.

§             Non-specific fever.

There are over a 100 types of arthritis and you could have one or more of them. Your     doctor can make a definitive diagnosis of arthritis by assessing your medical history, performing a physical examination, ordering specific laboratory tests, and x-rays.

 

Diagnosis of Arthritis

An accurate diagnosis precedes appropriate treatment of arthritis. With over 100 types of arthritis, early symptoms can overlap and diagnosis can be difficult.

When diagnosing, your doctor will look for very specific signs, symptoms, and disease characteristics. Your doctor will also consider your medical history, physical examination, blood tests and imaging studies.

 

Medical History and Clinical Symptoms

Your medical history consolidates information about past medical conditions and your current medical condition. To obtain your medical history, you will likely be asked to fill out a written questionnaire at your first appointment.

Be ready for your medical history by having a list of current medications, medication allergies, past and present medical conditions you are being treated for, and the name of your primary doctor and other specialists, along with their contact information.

Keep a symptom diary. A symptom diary can help you keep track of pertinent facts about your condition and also help you track changes that may occur. With the diary, you are more inclined to give your doctor a good overall picture of the symptoms you are experiencing.

 

Physical Examination

Your doctor will perform a physical examination to try to see any visible signs and symptoms that point to arthritis:

§             Redness/warmth around a joint               (inflammation)

§             Joint stiffness or tenderness

§             Joint fluid or swelling

§             Bumps or nodules

§             Pattern of affected joints (e.g. symmetric or asymmetric)

§             Limited range of motion

§             Fever

§             Fatigue

 

Laboratory Tests

After a medical history and physical examination have been completed, your doctor will likely need more information. Blood tests can provide more specific information and often serve to confirm what the doctor suspects is the diagnosis. Blood tests are also used to monitor disease activity and treatment effectiveness after a diagnosis has been established.

 

Treatment of Arthritis

An effective arthritis treatment regimen can help manage the disease. There are many treatment options which you should know about. Over time, you may try several different treatments and change your treatment plan. Finding the best treatment for you can be a long process.

 

Goals of arthritis treatment

The goals of arthritis treatment are to:

  •    Decrease arthritis symptoms
  •  Slow progression of the disease
  •  Prevent or minimise joint  damage and deformities
  •  Maintain joint function
  • Preserve mobility and range-of-motion

People with early symptoms of arthritis are often inclined to self-treat with over-the-counter medications, topical creams, or conservative measures such as ice and heat. The Arthritis Foundation recommends seeing a doctor if you have joint pain, stiffness, or swelling which persists for two or more weeks, whether or not your symptoms began suddenly or gradually. Only a doctor can diagnose arthritis. An accurate diagnosis is needed so treatment can begin.

A rheumatologist (arthritis specialist) will help you understand all of your treatment options and also help you steer clear of unproven remedies. Discuss the potential benefits and risks of each treatment option with your doctor.

 

Arthritis Medications

Medications are considered traditional treatment for arthritis. Depending on the severity of your arthritis symptoms when you first consult with your doctor, one or more medications will likely be prescribed.

Drug classes used to treat arthritis include:

  •   NSAIDs (nonsteroidal anti-inflammatory drugs)
  •  COX-2 Inhibitors
  •  Pain Medication (analgesics)
  •  Corticosteroids
  •  DMARDs (disease-modifying anti-rheumatic drugs)
  •  Biologic Response Modifiers (i.e. Biologics)

Injections into a Joint

There are several types of injections which can be given locally into the joint. Viscosupplementation is a procedure that involves the injection of gel-like substances (hyaluronates) into a joint (currently approved for knee) to supplement the viscous properties of synovial fluid. The five types are:

§             Synvisc

§             Orthovisc

§             Supartz

§             Euflexxa

§             Hyalgan

Local steroid injections can be used for a specific, painful joint.

Three steroid injections per year into a joint is the maximum allowed by most doctors. Steroid injections were used long before viscosupplementation became a treatment option. Both are still used though, depending on patient preference.

 

Natural Treatments

Some people are more interested in natural treatments than traditional medications. If you prefer a natural approach to treating arthritis, it’s still imperative that you tell your doctor what you are taking or what you want to try. There are many natural treatment options, also referred to as alternative treatments, which are popular but not fully endorsed for effectiveness and safety. Be aware.

  •  Acupuncture / Acupressure
  •  Biofeedback
  •  Chiropractic
  •  Magnets
  •  Massage
  • Meditation
  • Tai Chi
  • Yoga
  •  Supplements such as fish oil,

glucosamine, chondroitin, MSM

 Complementary Medicine

The terms complementary medicine and alternative medicine are sometimes used interchangeably. The difference is that complementary treatments are used together with your usual treatment regimen. Alternative treatments imply that they are used instead of your usual treatment.

Regular exercise is strongly recommended for arthritis patients. Exercise can reduce pain and improve physical function, muscle strength, and quality of life for people with arthritis.

Eating a nutritious diet is important for maintaining ideal weight and for bone health too. There is no known diet which can cure arthritis, but eating well is important.

Stress management may also be useful as a complementary treatment. Reducing stress helps to reduce pain and stiffness associated with arthritis.

 

Surgical Options

Joint surgery is usually considered a last resort treatment option. Joint surgery is typically considered if other more conservative treatment measures are unsatisfactory or have stopped working. When joint damage is severe and when pain interferes with daily activities, joint surgery may be an option with the goal of decreasing pain and restoring function.

Pain Relief

Pain is debilitating and can greatly interfere with daily living. Better treatments are always being sought, so people living with arthritis pain can achieve pain relief.

 

When symptoms affect normal activities

If symptoms are severe enough to interfere with normal functioning and your ability to perform usual activities early in the course of rheumatoid arthritis, you may bite the bullet and go to the doctor. The disruption in your life serves as the incentive to consult with a doctor.

If symptoms are not terribly disruptive, you may choose to wait before consulting a doctor. It is really quite simple  is there a sense of urgency? A sense of urgency, or lack of, dictates when a doctor is consulted.

 Explanation of Symptoms

How did your aches and pains begin? Was there an event, such as an injury, that caused your symptoms? Did the symptoms begin gradually or suddenly, without obvious cause?

Typically, patients who feel comfortable with the explanation of their symptoms will wait before consulting a doctor. For example, if you walked into a wall and you developed aches and pains, you are more likely to give the symptoms a chance to subside on their own. But if there is no logical explanation surrounding your symptoms, you likely will choose to see a doctor, so the symptoms can be evaluated.

 

Knowledge of Rheumatoid Arthritis and Treatment Options

If you know much about rheumatoid arthritis, you know that an accurate diagnosis and early treatment is essential. Early treatment with DMARDs (disease-modifying anti-rheumatic drugs) and biologics may help prevent joint damage and subsequent disability.

With new treatments  treatments that were marketed since 1998  the prognosis for rheumatoid arthritis is better. Realising that early treatment is important, is it not worth consulting a doctor and agreeing on your treatment regimen, so you can be assured that you are on the right path?

 

Attitude towards the medical profession

If you have had positive experiences with doctors in the past, you are more likely to consult with a doctor about your aches and pains  sooner rather than later. If you have respect for doctors in general, and if you trust those you have had in the past, you likely will not balk at getting your symptoms checked out.

The problem occurs if you have a history of bad medical experiences, or if you find it difficult to trust doctors. There are even conspiracy theorists who think doctors like to keep us sick because drug companies give them kickbacks to do so.

 

Point to Remember

Simply put, if your symptoms are interfering with normal life, if you understand that early treatment is important, and if you trust your doctor to know what to do and how to help you, you are more likely to see the doctor.

 Misconceptions about arthritis

There are many misconceptions about arthritis. The most common misconceptions about arthritis seem to persist. Patients need facts and valid information, not myths and misconceptions, so they can better manage their illness.

 

Misconception #1 – Arthritis is an old person’s disease

Fact: Anyone can have arthritis.

The most common misconception about arthritis is that it is a disease only of old people. In actuality, arthritis can affect anyone at any age, not just the elderly, including children, young adults and middle-aged people.

Arthritis is not age or gender specific. There are over 100 different types of arthritis and related rheumatic conditions and some are more commonly found in particular groups.

Rheumatoid arthritis, fibromyalgia, and lupus are more commonly found in women than men. Gout and ankylosing spondylitis appear more often in men than women. In terms of gender, psoriatic arthritis affects men and women nearly equally. Older people are more inclined to have osteoarthritis, the degenerative form of arthritis.

 

Misconception #2 – Arthritis is induced by a cold, wet climate

Fact: Climate itself is neither the cause, nor the cure.

It has long been theorised that arthritis is caused by a cold, wet climate. Moving to a warm, dry climate has been regarded by some as the cure. Logically, one can infer that if a warm climate cured arthritis, no one in other warm regions would have arthritis. Bone rubbing on bone after cartilage has worn away causes pain in any climate. However, warmth can be soothing. People without arthritis often feel better in warm climates too.

Warmth may relieve symptoms of arthritis, as does soaking in a hot-tub or taking a hot shower.

 

Misconception #3 – Arthritis can be cured

Fact: There has been no scientific evidence that a cure for arthritis exists.

The notion that arthritis can be cured is a fallacy. To date, there is no known cure for the disease. Much has been discovered, in terms of better treatment options and slowing down the disease progression, but nothing yet has been found to successfully halt the disease. Since there are so many different types of arthritis, the prognosis varies.

Since arthritis is a lifelong process, the importance of gaining knowledge and understanding of your own health condition cannot be overstated.

 

Misconception #4 – Arthritis is caused by a poor diet

Fact: There is no scientific evidence that specific foods prevent or cause arthritis.

There has been an abundance of speculation about the importance of diet with regard to arthritis. It is certain that a nutritious, well-balanced diet and ideal weight maintenance improves overall health and wellness for everyone. There are a few examples where there is a definite diet connection, such as between high uric acid levels and gout.

There is no scientific evidence, though some specific foods prevent or cause arthritis. Good diet does not prevent arthritis. Unless a person is found to have a particular food allergy which causes their arthritis to flare, there is no proven direct link between a particular food source and arthritis.

 

Misconception #5 – Arthritis consists of only minor aches and pains

Fact: Arthritis consists of much more than just minor aches and pains.

It is another common misconception that arthritis exhibits only minor aches and pains. Television commercials, which claim that a couple of aspirin or another over-the-counter pain reliever takes away the minor aches and pains of arthritis, tend to mislead the public.

Such advertising, along with a lack of knowledge about the disease, expand some people’s unawareness of the more complex forms of arthritis, which require more aggressive forms of treatment.

 Misconception #6 – “You felt fine yesterday… why so tired today?”

Fact: There is variation in the duration and severity of the symptoms of arthritis.

Since arthritis is a disease characterised by periods of flares and remissions, it is often difficult for the family and friends of an arthritic person to comprehend why they feel so much better or so much worse on any particular day. The inconsistency of arthritis can even lead some people to believe the disease is “all in your head”.

Arthritis is characterised by a mix of good days and bad days. Some days, the joint pain and fatigue is more exacerbated. A balance between rest and activity may be necessary to best manage living with arthritis.

 

Misconception #7 – “You have arthritis, you can’t….”

Fact: There is much a person with arthritis CAN do.

The limitations that arthritis imposes on an individual can cause people closest to them to become overprotective. Sometimes people do too much to try and help the person with arthritis. The disease does interfere with some physical ability, but certainly the arthritic person should not be viewed as totally dependent and invalid.

A certain amount of help and dependence is likely to be required. It must be remembered though that it is best to maintain as much independence as possible for both physical and emotional reasons.

Report compiled by Adebayo Folorunsho-Francis with additional information from Dr. Zashin, author of “Arthritis Without Pain” and About.com Health’s Disease and Condition content.

Lady pharmacists visit, donate gifts to children’s hospice

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 By Adebayo Oladejo

It was a moment charged with warm emotions as the Association of Lady Pharmacists (ALPs), Lagos State Chapter, recently paid a courtesy visit and distributed gifts and food items to children at the Hearts of Gold Children’s Hospice, Surulere, Lagos.

According to Pharm. Modupe Ologunagba, chairperson of ALPs Lagos, the association chose to visit the centre, which is acclaimed as the first and only children hospice in Nigeria, to show love to the children and to further advise parents in the state and beyond against wrong use of drugs.

“We have discovered that most of the challenges these children are facing were as a result of drug abuse and misuse by their parents” she said.”Meanwhile, they (the children) were helpless in that situation and unfortunately they met themselves in this condition. All we can do is to pray that God gives them the grace to bear the condition and also that God gives them perfect healing from above.”

She added that the association, apart from donating food items, would also ensure that it contributed its professional knowledge and expertise in ensuring that the condition in which most of the children found themselves were improved.

“We have discovered that apart from donating food and material items to these children, we also need to do a lot of health interventions for them because we found out that some of them have issues that has to do with medications and in our own little way, we intend to collaborate with some pharmaceutical organisations and some philanthropy groups so that we can continually support these children with medications that are necessary for them,” she stated.

Ologunagba also used the opportunity to commend the Lagos State government for noticeable improvements in the healthcare sector in the state, especially in the aspect of children health care.

In her own remarks, the national public relation officer of the association, Pharm. (Dr) Ugochinyere Ogudu, disclosed that there was need to pay serious attention to the challenges of drug abuse and misuse in the country.

“Our major challenge as custodians of drugs is the problem of irrational use of drug,” she bemoaned.”Nigerians need proper orientation on how to handle drugs and the rational ways of using drug. Therefore, our association has being doing everything possible to spread the gospel of rational use of drug and, in this regard, we have been to so many secondary schools to educate our young ones on drug use and also to discourage them from the use of hard drugs.”

In a related development, the Lagos State Association of Councils Vice Chairmen from the 20 local governments and 37 local council development associationsin Lagos State, under the name “Conference 57” were also at the hospice to demonstrate their concern for the children. While addressing the ALPs and staff of the hospice, the chairman of “Conference 57”, who also doubles as vice chairman, Mosan–Okunola Local Council Development Association, Hon. Opeyemi Akindele, said the purpose of their visit was to celebrate with the less privileged rather than wasting public funds on jamboree that would not benefit the citizens.

“We also are fathers and mothers,” he observed,”and we also have blood running in our veins and when we were voted in, we made promises that we are going to give back to the society and as well ensure that we sacrifice our time, our money and everything within our power to serve them better. So, what we are doing today is in furtherance of what Senator OluremiTinubu, who also has a foundation that takes care of children is doing.”

Opeyemialso used the opportunity to implore the gathering to always look for ways to assist the government in its developmental efforts. “We should not wait for government to do everything for us but rather we should try in our own way to do something for the society. We should all go back home and have a change of heart and search our consciences and ask ourselves, ‘what have we done to put smiles on the faces of the less privileged?’ We need personalities, we need philanthropists and we need corporate bodies to come to the aid of these children and we pray that God will give us the heart to give.”

While thanking the two visiting groups,founder of the hospice,Mrs LajaAdedoyin, expressed gratitude for their kind gesture towards the children. She noted that the children were always delighted to receive visitors.

“The visit proved enjoyable for the children as they received gifts of food, toiletries and love, and we believethat every human being deserves to be loved because that is what God asks of us ,” she enthused.

The Heart of Gold Children’s Hospicewas founded in 2003 to cater for abandoned and orphaned children suffering from diverse severe congenital, physical and mental disabilities.

The power of uncommon knowledge

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I was brought up in my village to be God-fearing, detesting telling lies or appropriating anybody’s property. My mother, who was deeply religious, provided guidance in spiritual matters.

One day, after school, I was going to the stream to fetch water. Incidentally, I was alone in that sloppy and winding path to the stream when I sighted a short palm tree with ripe fruits. I quickly moved closer to see whether some fruits had fallen to the ground.  According to our village custom, as long as the palm fruits were on the ground, anybody could pick them up, regardless of who owned the tree. But if you climbed up to pluck the fruits, it was considered stealing.  Therefore, I picked up the fruits on the ground.  But the tree was short and had some ripe fruits ready to fall.

Although I was not good at climbing, I was tempted to climb up to harvest more fruits and needed to do it quickly before someone came near. I looked around and didn’t see anyone going to or returning from the stream. So I climbed as fast as my hands and legs could carry me. However, as soon as I started plucking the fruits, I heard a loud, cranky voice that seemed to come from heaven: “This boy, continue what you are doing; I can see you!”

I panicked and jumped down automatically. It was the tree owner who spoke. He had been on top of another, much taller palm tree a few yards away, watching me. I abandoned both the ones I legitimately collected and the ones I stole, grabbed my water container, and scurried down the stream.

I might be about ten years old when I had this stealing experience, but I clearly remember the incident today. That experience helped to make me appreciate how God sees us, talks to us, and even knows the thoughts and desires of our hearts. He is omnipresent and omniscient, and knows what will happen in future.

Since we are created in the image of God, He imparts a bit of His knowledge to some people.  We term this the gift “the word of knowledge”. This is the power a person divinely receives to know the thoughts, desires, plans and actions of another person.

In 2003 I had a burden to have a building for my office and residence but did not want to borrow money for that purpose.  I was thinking, worrying, desiring, and praying for money for the project but had no solution to the problem.

On March 15, 2003, I went with the burden to the Full Gospel Business Men’s Fellowship International Leaders Advance held at Cannanland, Ota, Ogun State. That night, the District Coordinator, Barr.Wole Olufon, led the prayers. One prayer point was for families. He invited men who had challenges in their families to come out for special prayers.  My own problem was clear to me – the project. But I said in my mind that even though I had no specific family problem, things could be better. Moreover, there was nothing to lose. Therefore, I seized the opportunity, stood up and joined about seven other men who lined up in front.

Barr. Olufon prayed for us one after the other. When he came to my turn, he hesitated, looked up and received a word for me. “You have a burden; something is disturbing you…a project?” “Yes, a building project,” I instantly said. “But I don’t have the money for it.”  “God is telling you that you have delayed this project for too long and you should go and start the building immediately.” Thereafter, he still prayed for my family.

The embarrassing aspect of this episode was that Olufon did not whisper his utterances to me; he said it all to everyone’s hearing through the microphone.  My fear was that my friends would then be asking me about the project and make me uncomfortable if it did not come through.  But I consoled myself with the fact that it was not me who made the pronouncement. Olufon should be responsible for his statements.  Or God should be held responsible for not honouring His own word. My feet were wobbling as I returned to my seat.

Exactly two months and one week after, God took over control of the project. The foundation of the building was laid on June 9, 2003. The ground floor was completed in December 2005 and the first floor completed in December 2006.  God miraculously provided all we needed to complete the building without borrowing.

Do you wonder how Apostle Peter knew that Ananias and his wife sold their possession for a higher amount of money than they declared?  It was a clear demonstration of the spiritual gift of the word of knowledge. After all, Peter was not involved in the negotiation for the sale of that property. (You may read this story in Acts, chapter 5).

How would you feel if you knew what your life would be in the next two or three years? How would your friend regard you if you could reveal to him the dangers of the trip he was planning to embark on? How many positive steps would you take and how many destructive ones would you avoid if you had foreknowledge of the possible consequences of your decisions?

One other story reported in 2 Kings, chapter 5 is instructive. Here, Gehazi, the servant of Elisha, demonstrated his greed and dishonesty by collecting some gifts from Naaman after Elisha had refused to accept them. Later, Gehazi pursued Naaman and lied to him that Elisha had changed his mind and asked for some of the gifts. He collected and carefully hid them. When Elisha confronted him, he denied going anywhere. Then Elisha said to him, “Did not my heart go with you when the man turned back from his chariot to meet you? Is it time to receive money and to receive clothing, olive groves and vineyards, sheep and oxen, male and female servants?” (verse 26).

How did Elisha know of the evil plans and activities of Gehazi? According to Elisha, his heart went with Gehazi, meaning that he knew everything Gehazi was thinking, planning and executing. This, indeed, is a powerful spiritual gift.

You need divine knowledge more than any other kind of knowledge you may acquire in life. Knowledge from above, applied with wisdom, assures you of a sound, secure, successful and satisfying life.

The conscience, curiosity and innovation

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“We hold these ‘truths’ to be self-evident.”

When Thomas Jefferson wrote the above statement, America and, indeed, the greater part of the world, were ushered into a dimension of living based on the mental awareness and agreement with an unwritten code of principles based on conscience. It was these principles that drove trade, discovery and human relations. By them, the richest nation in the world was built.

Martin Luther King, Jnr, had to draw inspiration from same principles to help win the war against racial discrimination.

“We hold these ‘truths’ to be self-evident.”

Note that the statement is personalised – “we” hold them to be self-evident.Truths are not tangible materials and cannot be held by the hands but with the mind. They are also not “self-evident” by themselves till we hold them in our minds. Not holding them does not deny their presence except that we cannot experience the good in them.

WE HOLD THEM IN OUR MINDS

Obviously, by Thomas Jefferson’s thinking, some things were simply the right things to do (as determined by his conscience) and his mind agreed with them (self-evident). When we talk of evidence, we imply reason (the mind). The American Declaration of Independence and the self-evidencing truths proclaimed also brought God to the discussion (beginning of wisdom). The declaration read in part “…endowed by the Creator to certain inalienable rights”. This means that there must be an anchor to “truth” or it would be an opinion. Thus, with regard to morals, individuals can mentally assent to and appreciate certain virtues simply because they are right (a qualitative term qualified by the conscience).

THE POINT

It is not only morals that are self-evident. To appreciate this, let us consider a growing individual, organisation or civilisation.Growth implies that we come across certain truths previously beyond our reach. These truths could be ideas on how our world is, how people behave, how business is done, what is right about dating and marriage, etc.

There is an interval between a man’s awareness of truth (conscience) and the period it becomes self-evident (mental assent).  It is called the Arena of Faith.

Today, it is a self-evident truth that planes can fly in the air faster than the speed of sound; but at a certain time the possibility of a flight first existed as “awareness” in the mind of the Wright brothers and some other individuals. A computer operating system is an evidenced truth which initially was just”awareness” to someone earlier.

Innovations come first as”awareness” akin to moral awareness of truth with or without rational or scientific backing. The individual interacts with this “awareness” of which he is maybe inept at explaining but convinced nonetheless — the arena of faith.

To mentally conceptualise and bring about a practical demonstration of a man’s awareness, his mind must be involved. To bring about a change in seen circumstances, the mind must first be transformed. For centuries, the United States of America demonstrated that the moral values embedded in the “self-evidencing truths” can make a nation great. Businesses and breakthroughs were built based on those truths. Sadly, we are also seeing the destruction that has arisen because those truths have become perverted. Though they are still there, few men now hold them to be self-evident.

Faith is the mental agreement with unseen realities. To some, this awareness comes from dreams, intuition, sixth sense or just a knowing of how things should be. To others, it comes from analytical reviews of events and results from nature, science and scripture. The responsibility, however, is for the recipient to have the mind to hold the “awareness”. The mental capacity to translate this awareness to practical facts or material realities is one that is born out of skills or an ability born out of training. In other words, it is not enough to be aware. One has to retain the capacity to translate such awareness. This awareness is always born out of the spiritual but is always translated by the mental, thus the case for mental development.

THE AFRICAN SCENARIO

In Africa, as the agent of change intercedes for a nation’s plight in prayers, as one deliberates on issues that concern one’s nation, one becomes exposed to certain “awareness of truth”, that is, certain things which have to be and are right. Our responsibility is to make these truths evident.

As we become “aware” (conscience not limited to morals) of certain things that ought to be, let us not separate the mind from it. Africa is waiting for you and me to make certain truths self-evident.

CURIOSITY, SCIENCE AND THE AGENT OF CHANGE

Nobel laureate Professor, Warner Arber of the University of Basel, Switzerland, was once asked his source of motivation. He answered: “It is my personal curiosity that drives me; curiosity that is stimulated by each new finding. New questions are constantly being thrown up and you can’t pursue them all. You have to be selective and, usually, you intuitively choose those questions that provide the greatest motivation.”

I have often thought of what motivated men like Galileo and Sir Isaac Newton. What was the source of their curiosity? Was it boredom? Did they perceive that any good was to come from their understanding?

This curiosity is a necessity for invention. Prof. Arber, at the time he made the above statement (1994), was working on microbial evolution and it is deducible not only from his experience but from objective data that there is always an interplay between a man’s curiosity and the nature of the man himself. An African challenge is a diminished capacity for, and an investigation of our curiosities. For instance, to verify and maximise the information in this article, a degree of extra research would be necessary. Very few people have the time, will or the resources for such endeavours.

The “survival” posture does not allow for that, neither does entertainment. Much more than lack, entertainment has robbed us of the immense rewards that come from investigating things that interest us within our limited means. This “amusement posture” is deadly.

Another limiting factor is when the sole purpose of an enterprise is to create money and not necessarily value. The difference in attitude is critical. It is the same reason some learned professors in the universities are not contributing much to the GDP. Once the aim of showing up in the marketplace is monetary, one unwittingly places a cap on the quality and quantity of the output.

It is always better to see enterprise as service to society. This posture makes the work itself the pleasure – one that is immediately satisfying yet without limits. Money becomes compensation and incentive for more work without the unnecessary pressures that preoccupation with money entails.

With such a disposition, money is channelled towards addressing certain curiosities, as seen with the iPod, iPad and BlackBerry devices. Necessity is not always the mother of invention, but curiosity is. The desire to satisfy his own curiosity against all odds was what sent man flying in the first place.

QUESTIONS ARISING

What really is the best option for a private venture-powered energy solution in my nation? What should be the nature of the public-private partnership? What of research issues? Are there tax shelters for research and development in this and other sectors? Can there be? How best do I attract foreign investments within the current legal and political framework? What of health care research? What are we missing?

Who really are the policy makers? Which business will benefit from the cheap labour in Nigeria? What of the West African market? Are there patented materials that can help my work? Is there an opportunity in the pool of distressed but skilled Africans in Diaspora?What can we do to improve the quality of what our enterprise or organisation is offering? Do we need to partner with a local university or partner with a research team? What is the nature of such partnerships? How can a researcher scientist reap maximum benefits from the result of his work while helping a business make more profits? Isn’t research supposed to solve domestic problems? Why are they not solving such problems? Is this failure not an opportunity? What do I need to know to be of help? Do I need more training? Can I apply these to my small business?

Considering the trained human resource in some developing African nation like ours, are there potentials for technology transfers? Where? What should be the nature of such transfers? Are there examples of such transfers? How did the Asian tigers emerge? What had to be sacrificed? Is that method reproducible in my nation and region? If yes, why not? What competencies do I need to gain to be able to contribute positively to such possibilities?

A LOT TO ASK

The questions are wide and varied, and, like Prof Arber said, you are intuitively led to those that provide the greatest motivation. It doesn’t cost a dime to think! Just ask questions, find the answers, and ask again.

If Joseph, the son of Jacob, the son of Isaac wasn’t thinking like this, he wouldn’t have offered Pharaoh of Egypt the proposal that got him the plum post of Prime Minister. Yet, the Pharaohs don’t give appointments. Often, you would get only one unsolicited opportunity, and your offer would reflect the quality of your private deliberations. I believe the young Joseph had been deliberating on issues of state and sustenance. Had he not been deliberating, he wouldn’t have had a clue on grain preservation and the percentage to propose. He would, at best, have been offered the headship of astrologers and magicians for his dream interpretation capacity.

Remember that Pharaoh didn’t ask Joseph for the solution, he asked for an interpretation. Joseph made a proposal because he was concerned; his concern allowed him to access the creative.

Who are you?  What are your convictions and curiosities? Know that you cannot pursue them all at once but you must pursue. In the words of J.F. Kennedy, “We may not be able to achieve these in a day, in a year or in a thousand years, but let us begin, let’s begin.”

Adapted from “The Third Source of Innovation” in “The Heart and Art of Innovation” by Nelson Okwonna, Onel Media Services, Lagos, 2012.

 

Pharmacy practice in Nigeria has improved considerably – Pharm. Ekoh

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By Adebayo Folorunsho-Francis

 A Fellow of the Pharmaceutical Society of Nigeria (FPSN), Pharm. Omezue Anthony Ekoh is not your regular pharmacist. He was chairman of Ebonyi chapter of the PSN in the 70s shortly after the end of the civil war and chairman of Anambra State chapter of Association of General Pharmacists of Nigeria (AGPN) in the 80s. In this interview with Adebayo Folorunsho-Francis, the 74-year-old pharmacist explains some of the challenges they faced in his time and the struggle to uphold the profession.

Tell us a bit about yourself, especially your early days

I was born at Afikpo North Local Government Area of Ebonyi State in 1939. I attended Government Primary School, Afikpo in 1945 and proceeded to Government Secondary School (also in Afikpo) in 1953. I was equally admitted into Nigerian College of Arts, Science and Technology, Enugu in 1958 and Nigerian College of Arts, Science and Technology Ibadan (later University of Ife, Ibadan campus) in 1960 from where I qualified as a Pharmaceutical Chemist in 1963.

What is your work experience like?

I cut my teeth with Boots Company Nigeria Limited, Lagos in 1963 as Medical Representative. I also worked with Alpha Chemist and Rainbow Chemists (both in Port Harcourt) in 1965 before relocating to East Central State in 1970 at the end of the civil war. After the war, I had a brief stint with East Central State Ministry of Health before I decided to start my own pharmacy, Eastern Drug Company in 1970 at Abakaliki. The company was later incorporated in 1976 with the name Ekoh Drug Company Limited with its head office at Abakaliki. By God’s Grace, I remain the managing director/superintendent pharmacist of this company to date.

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

Unless I want to deceive you, studying Pharmacy was a good decision for me and I made my son study Pharmacy. To date, I am still engaged in community pharmacy.

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

Pharmacy profession in my days was very challenging. It was not well known then. We had to fight many battles to survive.

Are there some disturbing issues that tend to evoke memories of the past?

In our days, there were many colonial medical doctors and other professionals. There was hardly anything like pharmacist in government and other conventional hospitals. Back then, colonial doctors had to make do with dispensers and other lower health care providers. The nearest to what you may call a pharmacist in those days were dispensers trained in Yaba. Their situation was not good enough especially for those of them who worked in government’s health care centres. Besides, the rivalry between pharmacists and doctors who regarded them as inferiors made the plight of pharmacist more pathetic. However, I am glad to say it boldly that pharmacists can hold their heads high anywhere in Nigeria today. The fight continues anyway.

What are the challenges facing pharmacy practice in Nigeria and how can they be surmounted?

From the look of things, I can conveniently say that the greatest challenge facing the pharmacy profession today is drug distribution and the inability or lack of political will by relevant authorities to enforce pharmacy laws. It is also sad to know that pharmacy practice in all ramifications has become an all comers’ affair. It is no secret though that many investors who fail in other businesses often resort to drug selling. I must concede that there is an appreciable improvement today though. However, I am also of the opinion that with the expected commencement of mega drug distribution centres throughout the country, hopefully there will be sanity in drug distribution and control very soon

How best do you think the issue of fake drugs and counterfeit medicine can be curbed?

I don’t see this as a problem. The issue of fake drugs and counterfeit medicines can drastically be reduced by enforcing existing laws and enacting additional laws on the control of drugs and ensuring that only qualified and registered personnel are allowed to deal in drugs. Drugs should only be distributed and dispensed from duly registered and inspectable premises. Secondly, open market, street and moving vehicular sale of drugs by unqualified hands should be prohibited by clear and adequate legislation and defaulters adequately and instantly punished.

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

The way I see it, some of the PSN Chairmen did their best for Pharmacy but could not achieve the projected result because of many challenges and the Nigerian attitude of indiscipline and selfishness. For instance, I know Pharm. Azubike Okwor did his best during his tenure and from what I have seen so far, the current president (Olumide Akintayo) is doing his best.

What is your impression about the incumbent PSN president?

I cannot specifically say much on that. But I know Pharm. Olumide Akintayo is doing his best and I believe that before the end of his tenure, his effort will yield positive results.

 Tell us more about your activities in the profession?

I am presently a fellow of PSN and have been involved in several aspect of pharmacy practice especially at the regional level. At various points in time, I was chairman of Ebonyi chapter of the PSN in the 1970s, chairman of Anambra State chapter of Association of General Pharmacists of Nigeria (AGPN) in the 1980s as well as vice president of Anambra State Cooperative Pharmacists among others.

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

Well…none is as important to me as the honour of Fellow bestowed on me by the Pharmaceutical Society of Nigeria (FPSN).

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

Medicine has always been on my mind long before I opted for Pharmacy as a study. However due to certain turnout of events, I chose the latter. But Medicine is another profession I have serious admiration for.

 Is there a particular age you think an active pharmacist should retire?

A lot has been deliberated on this. But if you ask me, I think 85 years is enough for anybody to consider as retirement period given the fact that our body is no longer what it used to be.

 

Expert identifies key factors to tackle malnutrition

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By Adebayo Folorunsho-Francis

Teresa Pounds, a clinical assistant dean for clinical pharmacy education at the Mercer University College of Pharmacy, Atlanta, United States, has suggested that development of appropriate behaviour and physical change interventions can prevent malnutrition.

Speaking on the theme, ‘Malnutrition and Nutrition Support of Adults in the Healthcare System: Role of the Pharmacist’ during a presentation at the recently concluded annual conference of the Nigerian Association of Pharmacists and Pharmaceutical Scientists in the Americas (NAPPSA), Pounds noted that malnutrition was a persistent worldwide issue and thus continued to influence health outcomes.

Pounds, who is a pharmacy residency programme director, remarked that poor nutrition played a role in at least half of the 10.9 million child deaths each year (approximately 5 million death are related to malnutrition).

“Malnutrition of pregnant women in developing countries is the cause of 1 out of 6 low infant birth weights. Out of  925 million people malnourished in 2010, close to 26 per cent of them reside in sub-Saharan Africa,” she said.

According to her, malnutrition could be defined as a combination of varying degrees of over or under nutrition and inflammatory activity leading to a change in body composition and diminished function.

While justifying the United States World Food Programme Hunger Map 2012 statistics that placed 5 – 14 per cent of children under five years in Nigeria as malnourished, the scholar warned that malnutrition could lead to high rate of morbidity and mortality among children, retarded growth, impaired intellectual development, altered mental status and increased rate of infections.

“It is therefore in the interest of all that the risk factors associated with malnutrition should be recognised and addressed,” she stressed.

Sense of purpose brings surge of passion

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 Do you think you have the vision and purpose, to arrive at your destiny in life? Check out this inspiring article to spur you purpose in life.

For years, I thought there was something wrong with me.  People seemed to move slowly and get very little done. Conversely, most people around me were frustrated at the pace I set and felt that I didn’t like or appreciate them. I constantly wondered why people lived the way they did and never “moved on” with God. It seemed to me that the world was mediocre, and that most people didn’t want to live any other way.

Then I realised: I’m not crazy. It’s just that most people have no sense of destiny. They get up in the morning to make a living, not to fulfil destiny. They have no purpose other than to pay the mortgage, buy a new TV, keep a job, and make it until next month. That’s why they feel blah about life.

Disturbing Irony

With the knowledge, skill and opportunities we have in our modern society, you’d think we’d be the most excited people in the history of the world. But when you look at the faces on the freeway every morning or into the heart of the average person you don’t find excitement. You find depression, boredom, and frustration.

A lack of purpose is to blame and, on a larger scale, a lack of destiny. We don’t have a deep motivating drive to do our jobs well or to grow. We work to get by, and getting by isn’t very exciting or motivating. When we get a sense of a higher calling in life, a purpose established by God before the foundation of the world a destiny that He has set for us then we can get excited, enthused, and motivated every morning.

As a teenager I had no Christian training and no vision for my future. The most fearful day of my life was the day of my high-school graduation, because I had no idea where I was going or what I would do with my life. I felt lost and consequently unmotivated. I’d say to my mother, “There’s nothing to do.” When she would suggest various activities, from cleaning the barn to fixing the fence, I would groan and try to ignore her. Without vision, a person wanders aimlessly and without motivation.

Our cities are full of people with great potential who probably will never get out of their environment, because the young people there are not being taught they have a potential destiny in God. They hang out at the street corner, bored, because they feel useless and have no purpose. No amount of government subsidies, no welfare or educational programme will motivate or change a person who has no vision, purpose, or destiny.

My destiny must be translated into goals that give me a reason to get up and go to work every day. The finish line is the life goal or grand finale that I am striving for; but every day I take small steps that keep me moving toward the finish line. If I do not have daily goals and steps that I can take on a regular basis, I have not yet clarified my destiny. It’s still foggy, or I’m just on a fantasy trip and have no intention of finishing my life’s course. Make the vision clear and plain (Habakkuk 2:2-3). Write it down in simple steps that you can start on today. This will begin the motivation process that will build and intensify until it carries you all the way to the finish line.

Divine Influence

The word enthuse comes from two Greek words: in and theos. It means “to be in God.” If you are in God, in God’s will, in God’s destiny plan for your life, you will be excited and motivated! There is no greater motivation than to realise that you are doing what God established for you to do before the foundation of the world. When you wake up every day, you know that God has great things for you to accomplish, and all you have to do is walk in paths that He prearranged and made ready for you (Ephesians 2:10).

You will have no problem being motivated whenyou focus on the destiny God has established for you. No matter whatarea of work you feel the Lord has called you to, it will be exciting andmotivating to you because you will be “in God,” in theos, enthused with the power of travelling your destiny course.

I know computer analysts who are excited every day of their lives. I know homemakers, teachers, administrators, technicians, and builders who are motivated by a sense of destiny and purpose that keeps them going toward the finish line. You too can be energised, driven, and motivated by the power of travelling destiny’s course.

 

Culled from FULFILLING YOUR GOD GIVEN DESTINY by CASEY TREAT

 

 

Dexa Medica holds symposium on corticosteroids

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It was a notable convergence of top practitioners in the health industry as Dexa Medica Nigeria organised a symposium on corticosteroidsat Westown Hotel, Lagos, recently.

Amongst the key names that graced the event, which was also used to formally launch Dexa Medica Nigeria, were Dr. Cyril Chukwu, consultant chest physician from the department of medicine, Lagos University Teaching Hospital (LUTH), who was also chairman of the occasion; Dr. Ige Adegbola, consultant family physician, Federal Medical Centre, Idi-Aba, Abeokuta; Pharm. Steve Onya, managing director, Chi Pharmaceutical Ltd; and Mr Anndy Sembiring, head of marketing and sales, overseas business unit, Dexa Medica, Indonesia.

In his keynote address, Dr. Ige Adegbola, who spoke on the topic, “Update in Corticosteriod Management: The Role of Methylprednisolone as Anti-Inflamatory Agent”, said that corticosteroids, which are anti-inflammatory medications, can be used to treat different health conditions.

He explained further that the medications can be used to treat allergic reactions like asthma, dermatitis, allergic rhinitis and urticarial, adding that they are also indicated in the treatment of collagen-vascular disorders like lupus erythematosus, rheumatoid arthritis as well as eye diseases like allergic conjunctivitis, choroiditis and optic neuritis.

Other conditions corticosteroids are indicated for, according to Dr. Adegbola are: GI diseases, haematological disorders, neurological disorders, pulmonary diseases, renal disorders, skin diseases, thyroid diseases, organs transplants, inflammation of bones and joints and infections like septicaemia, because corticosteroids are occasionally helpful to suppress excessive inflammation.

Mr Dony Hendrawan, product manager, overseas business unit, Dexa Medica, Indonesia, spoke on some of the brands from the stable of Dexa Medica.  He said that the company are bringing products like Remopain, an NSAID with high efficacy as an analgesic; Stimuno, an adjuvant therapy that helps the immune system as well Glimvaz, indicated for the treatment of diabetes mellitus, among others, to help improve the healthcare delivery Nigerians.

Hendrawan stated that Dexa Medica has done bioequivalence studies for all its products, adding that the company is offering high quality products that are comparable to the original brands in efficacy and safety and are affordable and available all over the country.

Dexa medical holds symposium on corticoteriods management

L-R: Dr. Ige Adegbola, consultant physician, Federal Medical Centre, Abeokuta; Pharm. Steve Onya, managing director, Chi Pharmaceutical Ltd; and Mr Anndy Sembiring, head of marketing and sales, overseas business unit, Dexa Medica, Indonesia, during a symposium on corticosteroids organised by Dexa Medica Nigeria and held at Westown Hotel, Lagos, recently.

 

 

Prof. Igwilo counsels students on health career choice …as Roses Ministry holds 2013 Youth Seminar

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By Adebayo Folorunsho-Francis

 In line with the vision to raise a generation of youths that are morally upright and God-fearing, no fewer than 400 students from 17 secondary schools in Lagos State were invited for the 2013 edition of the Roses Ministry Youth Seminar, held at the conference hall of National Population Commission, Surulere, Lagos, on October 23.

Tagged ‘Challenges of Growing Up,’ the one-day seminar also featured the topic, ‘Present Health and Socio-economic Challenges that Prepare Youth for the Future’ as well as quiz contest, sex education, and praise and worship.

In attendance were Professor (Mrs.) Cecilia Igwilo of the Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, University of Lagos, who was the guest speaker; Pharm. Ernest Okafor, managing director of Nemitt Pharma Limited; Apostle Alex Bamgbola, deputy chairman, Rose Ministry’s Board of Trustees, among others.

Addressing students at the event, Prof. Igwilo reminded them that the vision of the future places greater demands on them, especially those preparing for careers in medicine and nursing, adding that they would be expected to be skilled in the assessment of their patients’ health in the context of the community and family as they understand the biological basis of disease and therapeutic options.

Prof. Igwilo counsels students on health career choice 2

The don also commented on the state of the Nigerian health sector, stressing that despite noticeable improvements, several challenges still needed attention.

“Challenges such as 1 billion people lacking access to health care systems, 36 million deaths each year caused by non-communicable diseases like cancer, diabetes, cardiovascular diseases etc; over 7.5million children under the age of 5 die from malnutrition and mostly preventable diseases each year,” she said.

The professor also disclosed that health professionals were worried about the rapid spread of HIV/AIDS and other chronic diseases. Citing UNAIDS reports, she said that as at 2008, an estimated 33.4million people were living with HIV, 2.7 million were with new infections and 2 million peopledied from the disease.Tuberculosis was also reported to kill 1.7million people each year with 9.4million new cases a year. Also, about1.6million people still die from Pneumococcal diseases every year, making it a number one vaccine-preventable cause of death worldwide.

Other worrisome cases, she noted, include malaria, which causes some 225million acute illnesses and over 780,000 deaths annually; and miseasles, which killed about164,000 people(mostly children under five) in 2008, even though effective immunisation costs less than 1 dollar and has been available for more than 40 year.

She further explained that malaria had recently been shown to be a major constraint to economic development. “Malaria also hampers children’s schooling and social development through both absenteeism and permanent neurological and other damage associated with severe episodes of the disease,” declared, adding that “the simple presence of malaria in a community or country also hampers individual and national prosperity due to its influence on social and economic decisions. The risk of contracting malaria in endemic areas can deter investment can affect individual and household decision-making.”

On her part, Mrs Chineze  Ajoku, head of Roses Ministry youth department, told Pharmanews that the seminar had become an annual affair where guest speakers were invited to address students selected from various schools in Lagos as their own contribution to raising future godly leaders for the country.

“For instance in 2009, we brought in professionals from Mass Medical Mission (MMM), a not-for-profit and non-governmental organisation to screen young female undergraduates on cervical and breast cancers in University of Lagos (UNILAG) for free,” she recalled. “In 2010, we brought in doctors and focused on sexually transmitted diseases. By 2011, we invited secondary school students and aired a video clip on abortion and its inherent danger which was facilitated through the aid of MMM again.”

In addition, the Roses Ministry head noted that the ministry thought of doing something different from the previous ones in 2012 which perhaps explains why it decided to focus on issues like drug abuse, peer pressure, alcohol and dating for this year’s edition, since such issues constitute primary areas of challenge for today’s youngsters.

While appreciating sponsors of the event – Nestle, Seven-Up Bottling Company, Rozec Pharmacy, May & Baker, GSK, Dufil Prima Foods, as well as individuals who donated cash and gifts, Ajoku remarked that there was still room for improvement and called for further participation of corporate bodies to help shape Nigeria’s future leaders.

For the results of the quiz contest between participating schools, Bedrock College emerged first, while Aquinas College and Rainbow College occupied the second and third positions respectively. To reward their efforts, three trophies were given to the winners, while certificates of participation were issued out to all the 17 participating schools.

 

The 86th Annual National Conference of the PSN

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The 86th Annual National Conference of the Pharmaceutical Society of Nigeria (PSN), tagged “Harmony 2013” with the theme, “Evolving Best Practices in Patient Care”, held at the Kwara State Government Banquet Hall, Ilorin, Kwara State, on 4-8 November, will go down in the history of PSN as one of the most memorable.

There were many positives about this national conference. First and, perhaps, most noteworthy is the huge number of pharmacists that turned out for the conference. Attendance at this conference was indeed great compared to recent PSN conferences, as pharmacists from all over the country came in droves to be part of the conference.

The conference was also made quite glamorous with the presence of notable personalities led by the hosting governor, Alhaji Abdulfatah Ahmed, executive governor of Kwara State. The dashing and amiable helmsman of Kwara State with his presence and simple carriage added much colour to the opening ceremony.

Also, the presence of the chairman of the opening ceremony, Hon. Justice Mustapha Akanbi, former president, Court of Appeal and former chairman, Independent Corrupt Practices & Other Related Offences Commission (ICPC), as well as that of the eloquent Prince Julius Adelusi-Adeluyi, former minister of health, equally made the event remarkable.

Perhaps more than any other personality, the Emir of Ilorin, Alhaji (Dr.) Ibrahim Sulu Gambari added significant spice to the opening ceremony with his presence.  The revered traditional ruler was intermittently and lovingly hailed “Shehu” by participants at the opening ceremony.

The leadership of the PSN, the Conference Plannning Committee (CPC) and the Local Organising Committee (LOC) also did  well, with a number of innovations that made the conference interesting and enjoyable.  The choice of the Kwara State Banquet Hall was particularly a commendable one as the hall was spacious and conducive enough to accommodate pharmacists at the opening ceremony.

The provision of a public address system outside the conference hall was also quite innovative and impressive, as it enabled participants outside the hall to be part of all the proceedings.

The exhibition ground was also a positive because it was quite large and allowed exhibitors and participants to interact without hassle.  Also, the provision of air-conditioned exhibition booths for some companies is also novel. In future, this is perhaps the ideal that should be considered for all exhibitors.

The organisers should also be commended for the provision of free internet service to participants and for constantly updating participants on conference events through short message service (sms).

Also, the visible sign of security operatives around the venue was exceptionally reassuring.

We must also commend the keynote address speaker, Prof. Fola Tayo, for presenting a very illuminating paper on the theme of the conference. Same goes for other speakers at the plenary sessions for their educative papers.

It should be pointed out however, that there were certain aspects of the 86th PSN Conference that could have been better, and it is imperative for organisers of the next conference, holding in Uyo, Akwa Ibom State, to note these in order to make the conference even more special.

First and most important is the need to improve the registration procedure. Several of the pharmacists present at the event had a hard time registering and getting conference materials.  The process was quite distressing for some pharmacists who were eventually unable to get their full conference materials for one reason or the other.  The fact is that PSN can and indeed should be able to have a seamless registration process for its annual conference.

Another area of challenge was unavailability of parking space for vehicles. The parking space in the conference venue was not large enough to accommodate vehicles.  For subsequent conferences, organisers should ensure there is a better arrangement for parking of vehicles.

A major distraction was also constituted by the excessive number of hawkers, selling of all sorts of things at the conference venue.  It is advisable to better manage the activities of these traders in subsequent events, so as not to turn the PSN annual conference exhibition to a common open market.

Despite the few observed lapses, however, the ‘Harmony 2013’ conference will continue to be remembered by many pharmacists. The challenge is for the organisers of the 2014 PSN Annual Conference to ensure they improve on the achievements of the conference in Kwara State.

 

Biofem organises workshop on management of diabetes – Introduces two products to tame diabetes

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     By Adebayo Oladejo

Biofem Pharmaceuticals limited, in partnership with Structured Healthcare Initiative (STRUHI), recently organised a workshop on management of diabetes mellitus at the Lagos Chamber of Commerce and Industry Conference and Exhibition Centre, Alausa, Ikeja, Lagos.

The one-day capacity building programme was graced by three distinguished speakers, which include Dr Anthonia Ogbera, an endocrinologist and associate professor of medicine, Lagos State College of Medicine (LASUCOM); Dr Ifedayo Odeniyi, a lecturer and consultant endocrinologist, Lagos University Teaching Hospital; and Pharm Modupe Oyawole, assistant director of pharmaceutical services, Lagos State University Teaching Hospital (LASUTH).

While delivering a lecture on the topic, “Diabetic Neuropathy: Clinical Perspective”, Dr Ifedayo Odeniyi defined diabetes mellitus as a disease of metabolic dysregulation, most notably abnormal glucose metabolism, accompanied by characteristic long term complications. He added that the complications include retinopathy, nephropathy and neuropathy.

Explaining further, the consultant endocrinologist asserted that diabetic neuropathy is the presence of symptoms or signs of peripheral nerve dysfunction in people with diabetes after other causes have been excluded. He noted that causes of diabetic neuropathy include metabolic factors such as high blood glucose, long duration of diabetes, abnormal blood fat levels, and possibly low levels of insulin.

Ifedayo also explained that diabetes mellitus is not a death sentence but a challenge to healthy living, adding that if patients know their condition and manage it properly by working hand-in-hand with their doctors, they can live for as long as possible.

Speaking in the same vein, Dr Anthonia Ogbera explained that, diabetic neuropathies are the most common complications of diabetes mellitus, adding that neuropathy reduces the quality of life of a diabetic individual. According to her, secondary complications of neuropathies are serious and can lead to situations like falls, fractures, amputations and even death.

Concerning the risk factors for the development of diabetes mellitus, Ogbera disclosed that nutritional factors, poor glycaemic control, cigarette smoking, alcohol, hypertension, dyslipidemia and hypertryglyceridemia are the modifiable risk factors. She added that old age, gender (male especially), height, family history of neuropathy disease, longer duration of diabetes as well as angiotensin-converting enzyme genotype are the non-modifiable risk factors. She also observed that the only key to preventing neuropathy in diabetes mellitus is to maintain good glycaemic control.

In her own contribution, Pharm. Modupe Oyawole, assistant director of pharmaceutical services, Lagos State University Teaching Hospital, who delivered a paper on the topic: ‘Drug Adherence in Diabetes Mellitus’ disclosed that the common belief that patients are solely responsible for taking their treatment is misleading and most often reflects a misunderstanding of how other factors affect people’s behaviour and motivation to adhere to their medications. She explained that adherence is a multi-dimensional phenomenon determined by the interplay of factors, which include: social economic factors, healthcare team and system-related factors, condition-related factors, therapy related factors and patient-related factors.

She further noted that among patients with type 2 diabetes mellitus, adherence to prescribed medications has been reportedly low, while insisting that better adherence promotes better outcomes and that non-adherent patients are more likely to require hospitalisation and incur higher healthcare costs. “As multiple studies employing large managed care databases have demonstrated, improvements in outcomes and reductions in costs related to the management of diabetes require focused, concerted efforts toward facilitating treatment adherence…Non adherence takes its focus from several sources, including the patient, the health system, the health care team as well as the disease and the drugs. Resolving non-adherence issues therefore requires the input of all stakeholders because the positive correlation between non-adherence and poor treatment outcomes makes a case for stricter medication adherence for the diabetic patient in order to improve their quality of life and delay the onset of complications. It is important to ensure that non-adherence is not only resolved, but it is prevented,” she said.

Speaking earlier with Pharmanews in an interview, Pharm. Olaide Soetan, regional manager (Lagos), Biofem Pharmaceuticals, said the motive behind the programme was to further enhance the good relationship the company already had with doctors and other medical professionals and as well to build capacity in the non-teaching hospitals, especially in Lagos State. “This is the second time we are doing something like this and we actually organised this based on the feedback we got from the previous one and this time around, we are taking it much higher than the first one,” she revealed.

She also said that the company had identified some problems in the management of diabetes mellitus, especially in terms of diabetes neuropathy, noting that the options that were available for treatment were very limited. She disclosed, however, thatBiofem has been able to profer solution to the challenge through the introduction of two major products, Biopentin, which is a combination of Gabapentin and Methylcobalamin; and Biobetic, which is a combination of Alpha-LipoicAcid and Methylcobalamin, into the market for the management of diabetes neuropathy.

Asked about the distinguishing qualities of the products and the company’s strategy to guard against counterfeiting, she explained that the products are relatively new and are being introduced at a time when there are not many competing brands. “I want to say that the products are coming to fulfil a yearning need that has been in the market, especially for the management of diabetes neuropathy,” she said. Before the arrival of these products, so many patients had been suffering in silence, but we believed  that with the arrival of the two products, patients and even the medical practitioners can heave a sigh of relief because these are trusted products they have been yearning for. Talking about faking, we have no problem at Biofem because apart from the fact that we were the first company that pioneered the Mobile Authentication Services (MAS), we as well have it as a principle that all our products must carry the MAS symbol, so that any of our customers can conveniently confirm the authenticity of the product instantly”.

“Biofem is a research-oriented company,” she continued,   and we don’t just introduce products into the market anyhow. We focus on some important areas and diabetes is one of the important areas where we have decided to pitch our tents. At Biofem, we have drugs that offer solutions to all forms of problems arising from diabetes and, apart from the new products, we also have over seven different products that are tailored towards the management of diabetes.We are using this opportunity to tell all medical practitioners that what they have always yearned for is now at their doorsteps.”

Biofem Organises workshop on management
Cross section of participants and some facilitators at the workshop

My forty years of PSN conferences

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By Pharm. Ifeanyi Atueyi

 I am uniquely blessed to have attended PSN annual national conferences from 1973 to 2013 without interruption. During this period, I had the opportunity of serving   as Editor-in- Chief, National Secretary, unofficial executive committee member, chairman and member of several committees for a total period of 17 years. I also had the privilege of delivering the keynote address in Bauchi 2004. I have, therefore, closely followed the trend of our conferences and can make some informed observations.

PAST RECOLLECTIONS

In the early days, precisely the 70s and 80s, the conferences were truly scientific, professional, and dignifying, in all aspects. The scientific session, in particular, was a forum for the then faculties of pharmacy to present their research works. The contributions of the academics were monumental and very educative.

I recall clearly that exhibitions started with a few pharmaceutical companies that had new products in their stable. Well-trained product managers and medical representatives made the presentations in their booths. Samples were professional ones and not for sale. They were produced and labelled as such.  When more companies developed interest in exhibitions and started giving sales stock as samples, only registered participants, who had ‘sample cards’ issued by PSN, were attended to.

Then there were the delightful cultural shows, which were both regular and refreshing. In fact, it was actually the cultural shows and tours of peculiar places of interest that made one to remember the conference.  For example, I cannot forget the Bagauda Lake in Kano 1974, the Yankari Game Reserve in Bauchi 1986, and the Atilogwu dance in Enugu 1991.

Moreover, the climax of the conference used to be the Closing Banquet. With strong presence and support of the state government, specially invited guests, police band, sumptuous dinner and pleasant toasts, the night became memorable. A main feature of the Closing Banquet was the reading of the Communiqué.  In my positions as Editor-in- Chief and National Secretary, I was very much involved in the Communiqué. The Communiqué committee had a very busy time throughout the conference to get it ready for the Closing Banquet.

These and many other striking features made the conferences worth anticipating and remembering.

PRESENT REALITIES

Certainly, a lot has changed about PSN conferences over the years. On a positive note, there has been a steady increase in the number of participants at the conference, which indicates a cheering rise in the number of pharmacists in the country.

That aside, funding of the conference has also improved tremendously, compared to what it used to be. For instance, when I was the Editor-in- Chief (1974 -1978), the revenue  generated from adverts in the journal was a major source of income to the Society. Today, exhibitions, product presentations, sponsorships, goodwill messages and adverts in the conference programmes have become robust sources of income.

Also, there has been introduction of a few innovative ideas, such as the authorisation of commercial photographers who, during conferences, take snapshots and produce the photographs instantly for participants. During the last conference, I noted at least 10 accredited photographers in the hall. They provided good and indispensable services.

I must not fail to mention that the election of PSN Fellows experienced the greatest crisis at the 1987 conference in Sokoto. Up to that time, the list of the nominees approved by the National Council was presented to the AGM for consideration and ratification.  Unfortunately, a clique sowed a seed of confusion in the minds of some members and the process was completely frustrated.  Fortunately, this incident led to exclusion of the AGM from the election of Fellows. The decision of the National Council is now simply presented to the AGM. This, also, is a good development.

However, it should be noted that these positive developments are significantly outweighed by the extent of anomalies that have, in recent years, continued to blight the brilliance associated with the conference.

To begin with, there seems to be nothing academic in our conferences anymore. The only semblance of academic input are commercial presentations by pharmaceutical companies.Expectedly,most of the presentations are biased.

Again, young pharmacists of today would find it hard to imagine a PSN conference without exhibitions.But it may interest them to know that, in the beginning, there were no exhibitions, no product presentations, and no company sponsorships. And even though conferences were not as bubbling or lucrative as they are today, they were professionally and economically managed.

That aside, I think the number of presentations during sessions of the conference these days is so high that they are beginning to constitute a nuisance.Granted that more income is being generated, but some precious values of the conference are being speedily eroded.

Furthermore, apart from the fact that companies attending conferences in recent times load their vans with sales stock, the whole conference venue has become a vibrant market for all sorts of articles. Petty traders now invade the entire premises. Some participants spend most of their conference time doing business with the companies.

Commercialisation has taken the shine away from the opening session.  Product presentations have brought in money but have also destroyed the glamour, peace and joy of the session. The presenters are even frustrated sometimes because they try in vain to get the attention of participants who are busy chatting and greeting themselves. The greatest mistake that could be made is slotting in an important paper during that noisy period, as was done this year for NAPPSA presentation. Nobody cared to listen to the lady from Atlanta, USA.

For the photographers, while it is true that they render good services, their mode of delivering such services is at best appalling as they constantly contribute to the disorganisation of the event by jostling to sell their photographs during sessions.

Also, cultural shows which used to be the pride of the hosting state are fast disappearing, as they are constantly relegated to the background.

PERTINENT RECOMMENDATIONS

To restore the glory of the conference and make it what it is supposed to be in purpose and pattern, the following recommendations should be considered:

1.    The Nigerian Association of Pharmacists in Academia (NAPA) should resurrect as a technical section of the PSN and demonstrate its presence as other sections during our conferences.

2.    The PSN can decide to accept only the number of presentations it can effectively accommodate.

3.    Activities of photographers in the hall should be controlled. A booth should be provided for them outside to sell their photographs.

4.    Documentation of our conferences should be done regularly for record purposes. The year/date, city/state, theme and keynote speakers, etc., should all be noted.

CONCLUSION

It has been said that change is constant. Therefore, the quality and features of our conferences must be changing. But such changes must be desired improvements. Professionalism and commercialism should have their rightful places.  We must bear in mind the principle of Constant And Never-ending Improvement (CANI). This should be the watchword in all our subsequent conferences.

 

Ifeanyi Atueyi KSC, FPSN, FPCPharm., FAPharm.

Health minister tasks PMG-MAN on optimisation of industry potentials …as PMG-MAN holds Pharma Expo 2013

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By Temitope Obayendo

 Honourable Minister of Health, Prof. Onyebuchi Chukwu, has disclosed that the expected developments in the pharmaceutical industry may not be achieved, if stakeholders fail to identify opportunities in the sector or harness its resources for the benefits of the masses and the nation as a whole.

Prof. Chukwu made this remark at the opening ceremony of the Nigeria Pharma Manufacturers Expo 2013, held at the Lagos Television premises, on October 17, 2013. The event was organised by the Pharmaceutical Manufacturers Group of the Manufacturers Association of Nigeria (PMG-MAN) in partnership with GPE Expo Private Limited of India.

The minister, who was represented by Dr. Paul Orhii, DG, National Agency for Food and Drug Administration and Control (NAFDAC), said it was imperative for PMG-MAN and other stakeholders to have a strategic plan on how to ascertain the potentials of the sector, as well as develop measures to optimise such.

“The current efforts and direction of the key players in this sector does not indicate readiness for the optimisation of the sector,” he noted. “A situation where the difference between manufacturers and importers has become blurred and it is no longer possible to say who is an importer and who is a manufacturer of medicines is not encouraging.”

He has also urged members of PMG-MAN to demonstrate additional capability through the acquisition of new and emerging technology and skills for the production of widely-used products to stimulate government to strengthen the protection of local manufacturers. He highlighted the benefits of investing in new technology and skills to include: additional competency and trust of the consuming public, acceptance of respective companies by companies in other sectors, as well as advancement of research and development through collaboration with the various centres of research in institutes of learning.

Chukwu however commended the PMG-MAN for its resilience in sustaining the programme since commencement in 2008. He also assured members that efforts by companies to achieve WHO prequalification would continue to receive the support of the government.

Speaking on the theme of the exhibition: “Optimising the Potentials of the Nigerian Pharma  Sector”, Chief Bunmi Olaopa, chairman PMG-MAN, said pharmaceutical manufacturers in Nigeria had invested over N70 billion naira towards processing the Expression of Interest for WHO-prequalification for their products in the last four years.

Sounding quite optimistic, Olaopa said the investment would soon start yielding results with expected prequalification of some of the products by WHO.

“Going by the huge investment made in the industry in the last four years,” he said, “we expect that as many as five Nigerian pharma manufacturers will have products pre-qualified by the WHO in 2014”.

Olaopa who noted that such products of interest like anti-retroviral drugs, Artemisinin-Combination Therapies (ACTs), Fluconazole capsule, injection and oral rehydration are now locally manufactured, said that, with over 150 manufacturing companies, the nation’s pharmaceutical manufacturing industry has the potential to become a powerhouse in Africa with the capacity to supply regional needs as well as participate in international tenders.

Biofem Pharma boss, Femi Soremekun, celebrates 50th birthday

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By Adebayo Folorunsho-Francis

On November 14, 2013, all roads led to Sheba Hall, Mobolaji Bank-Anthony Road, Maryland, venue of the 50th birthday celebration of Mr. Femi Soremekun, chairman of Biofem Pharmaceuticals Limited.

The colourful event featured citation of the celebrant, praise and worship, presentation of gifts, comedy session and goodwill messages from friends, family members, pharmacists, admirers and several clients of the company.

Notably in attendance were Pharm. Ade Popoola, chairman, PSN Board of Fellows; Pharm. Gbenga Falabi, incumbent chairman of Association of Industrial Pharmacists of Nigeria (NAIP); Pharm. LoluOjo, past chairman of NAIP; Pharm. Ernest Okafor, managing director of Nemitt Pharma Limited; and Pharm. Lekan Asuni, managing director of GlaxoSmithKline (Pharma) Limited.

Describing the personality of Soremekun, Popoola remarked that the celebrant was a philanthropic soul who had touched so many lives with his generosity.

Another pharmacist, Pharm. Okafor noted that Soremekun had been a good and dependable friend.

“I am happy that God has rewarded his labour with love to others. I have found him a gentleman and an astute businessman who has impacted positively on the lives of many. I therefore rejoice with him today as he celebrates his 50th year,” he enthused.

Pharm. Lekan Asuni lauded Soremekun’s achievements in the pharmaceutical field as well as in life. Describing him as a hardworking and dependable person, he prayed for God to grant him good health and mercies.

Pharm. Lolu Ojo, past chairman of Association of Industrial Pharmacists of Nigeria (NAIP); Pharm. Gbenga Falabi, incumbent chairman of NAIP; and Pharm. Lekan Asuni, managing director of GlaxoSmithKline (Pharma) Limited at the event
L-R: Pharm. Lolu Ojo, past chairman of Association of Industrial Pharmacists of Nigeria (NAIP); Pharm. Gbenga Falabi, incumbent chairman of NAIP; and Pharm. Lekan Asuni, managing director of GlaxoSmithKline (Pharma) Limited at the event

 

Winning the battle against HIV/AIDS and STDs

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HIV (human immunodeficiency virus) is a virus that attacks the immune system, the body’s natural defence system. Without a strong immune system, the body has trouble fighting off disease. Both the virus and the infection it causes are called HIV.

White blood cells are an important part of the immune system. HIV invades and destroys certain white blood cells called CD4+ cells. If too many CD4+ cells are destroyed, the body can no longer defend itself against infection.

The last stage of HIV infection is AIDS (acquired immunodeficiency syndrome). People with AIDS have a low number of CD4+ cells and get infections or cancers that rarely occur in healthy people. These can be deadly.

But having HIV does not mean you have AIDS. If HIV is diagnosed before it becomes AIDS, medicines can slow or stop the damage to the immune system. With treatment, many people with HIV are able to live long and active lives.

Causes of HIV

HIV infection is caused by the human immunodeficiency virus. You can get HIV from contact with infected blood, semen, or vaginal fluids. Most people get the virus by having unprotected sex with someone who has HIV. Another common way of getting the virus is by sharing drug needles with someone who is infected with HIV.

The virus can also be passed from a mother to her baby during pregnancy, birth, or breast-feeding.

HIV doesn’t survive well outside the body. So it cannot be spread by casual contact such as kissing or sharing drinking glasses with an infected person.

Symptoms of HIV

HIV may not cause symptoms early on. People who do have symptoms may mistake them for the flu or mononucleosis. Common early symptoms include:

·      Fever

·      Sore throat

·      Headache

·      Muscle aches and joint pain

·      Swollen glands (swollen lymph nodes)

·      Skin rash

Symptoms may appear from a few days to several weeks after a person is first infected. The early symptoms usually go away within 2 to 3 weeks.

After the early symptoms go away, an infected person may not have symptoms again for many years. Without treatment, the virus continues to grow in the body and attack the immune system. After a certain point, symptoms reappear and then remain. These symptoms usually include:

·      Swollen lymph nodes

·      Extreme tiredness

·      Weight loss

·      Fever

·      Night sweats

A doctor may suspect HIV if these symptoms last and no other cause can be found. Treatment usually keeps the virus under control and helps the immune system stay healthy.

Diagnosis of HIV

There are tests that detect HIV antibodies in urine, fluid from the mouth (oral fluid), or blood. If a test on urine or oral fluid shows that you are infected with HIV, you will probably need a blood test to confirm the results. If you have been exposed to HIV, your immune system will make antibodies to try to destroy the virus. Blood tests can find these antibodies in your blood.

Most doctors use two blood tests, called the ELISA and the Western blot assay. If the first ELISA is positive (meaning that HIV antibodies are found), the blood sample is tested again. If the second test is positive, a Western blot will be done to be sure.

It may take as long as 6 months for HIV antibodies to show up in a blood sample. If you think you have been exposed to HIV but you test negative for it, get tested again. Tests at 6, 12, and 24 weeks can be done to be sure you are not infected.

Meanwhile, take steps to prevent the spread of the virus. If you are infected, you can still pass HIV to another person during this time.

Some people are afraid to be tested for HIV. But if there is any chance you could be infected, it is very important to find out. HIV can be treated. Getting early treatment can slow down the virus and help you stay healthy. And you need to know if you are infected so you can prevent spreading the infection to other people.

You can get HIV testing in most doctors’ offices, public health clinics, hospitals, and Planned Parenthood clinics. You can also buy a home HIV test kit in a drugstore or by mail order.

 

 Statistics on HIV/AIDS in Nigeria

Information available from the National Agency for the Control of AIDS (NACA) puts HIV prevalence among the Nigerian population at 3.6 per cent.

National median prevalence among pregnant women is 4.1 per cent.

About 3.1 million people are living with HIV in Nigeria.

About 300,000 new infections occur annually with people aged 15–24 contributing 60 per cent of the infections.

1.5 million People living with HIV require ARVs using the new WHO guidelines.

Only 30 per cent of people living with HIV who need antiretroviral (ARVs) have access to it.

Less than 30 per cent of pregnant women have access to PMTCT services.

Women, Girls and HIV

HIV is the leading cause of death and disease among women of reproductive age (15 – 49 years).

In sub- Saharan African, 60 per cent of the people living with HIV is female (while women make up 50 per cent of the global epidemic).

In Nigeria, prevalence among young women aged 15–24 years is estimated to be three times higher than among men of the same age.

Females constitute 58 per cent (about 1.72 million) of persons living with HIV in Nigeria.

Each year, 55 per cent of AIDS deaths occur among women and girls.

Treatment of HIV

The standard treatment for HIV is a combination of medicines called highly active antiretroviral therapy (HAART). Antiretroviral medicines slow the rate at which the virus multiplies. Taking these medicines can reduce the amount of virus in your body and help you stay healthy.

It may not be easy to decide the best time to start treatment. There are pros and cons to starting HAART before your CD4+ cell count gets too low. Discuss these with your doctor so you understand your choices.

To monitor the HIV infection and its effect on your immune system, a doctor will do two tests:

·      Viral load, which shows the amount of virus in your blood;

·      CD4+ cell count, which shows how well your immune system is working.

If you have no symptoms and your CD4+ cell count is at a healthy level, you may not need treatment yet. Your doctor will repeat the tests on a regular basis to see how you are doing. If you have symptoms or some other health problems, you should start treatment, whatever your CD4+ count is.

After you start treatment, it is important to take your medicines exactly as directed by your doctor. When treatment doesn’t work, it is often because HIV has become resistant to the medicine. This can happen if you don’t take your medicines correctly. Ask your doctor if you have questions about your treatment.

Treatment has become much easier to follow over the past few years. New combination medicines include two or three different medicines in one pill. Many people with HIV get the treatment they need by taking just one or two pills a day.

Caution during treatment

·      Don’t smoke. People with HIV are more likely to have a heart attack or get lung cancer.

·      Eat a healthy, balanced diet to keep your immune system strong.

·      Get regular exercise to reduce stress and improve the quality of your life.

·      Don’t use illegal drugs, and limit your use of alcohol.

·      Learn all you can about HIV so you can take an active role in your treatment. Your doctor can help you understand HIV and how best to treat it. Also, consider joining an HIV support group. Support groups can be a great place to share information and emotions about HIV infection.

Prevention of HIV

HIV can be spread by people whether they know they are infected or not. To protect yourself and others:

·      Practice safe sex. Use a condom every time you have sex (including oral sex) until you are sure you and your partner are not infected with HIV or other sexually transmitted infection (STI).

·      Don’t have more than one sex partner at a time. The safest sex is with one partner who has sex only with you.

·      Talk to your partner before you have sex the first time. Find out if he or she is at risk for HIV. Get tested together and retested 6 months later. Use condoms in the meantime.

·      Don’t drink a lot of alcohol or use illegal drugs before sex. You might let down your guard and not practice safe sex.

·      Don’t share personal items, such as toothbrushes or razors.

·      Never share needles or syringes with anyone.

What are Sexually Transmitted Diseases?

Sexually transmitted diseases, commonly called STDs, are diseases that are spread by having sex with someone who has an STD. You can get a sexually transmitted disease from sexual activity that involves the mouth, anus, vagina, or penis.

Types of STDs

·  Genital herpes

·   Human papilloma virus/genital warts

·  Hepatitis B

·  Chlamydia

·  Syphilis

·  Gonorrhoea (“clap”)

Chlamydia

Chlamydia is the most common bacterial sexually transmitted disease (STD) in the U.S. alone. Scientists believe it’s twice as common as gonorrhoea and 30 times as common as syphilis. The good news is that chlamydia is easily cured by antibiotics. The bad news is that 50 per cent of women who contract the disease don’t know they are infected and 30 per cent develop serious complications such as damage to the fallopian tubes (the tubes that connect the ovaries to the uterus)

Symptoms of Chlamydia

Often, chlamydia will present no symptoms. When symptoms are present, common ones include (in men): A clear or whitish yellow discharge from the tip of the penis; a frequent urge to urinate or a burning sensation while urinating; redness at the tip of the penis; (in women): mild discomfort that you may mistake for menstrual cramps; vaginal discharge that may have a bad smell; bleeding between periods; painful periods; pain when having sex ; itching or burning in or around the affected part.

Diagnosis of Chlamydia

There are a few different tests your doctor can use to diagnose chlamydia. He or she will probably use a swab to take a sample from the urethra in men or from the cervix in women and then will send the specimen to a laboratory to be analysed. There are also other tests which check a urine sample for the presence of the bacteria.

Treatment of Chlamydia

If you have chlamydia, your doctor will prescribe oral antibiotics, usually azithromycin (Zithromax) or doxycycline. Your doctor will also recommend your partner(s) be treated as well to prevent reinfection and further spread of the disease.

With treatment, the infection should clear up in about a week or two. It is important to finish all of your antibiotics even if you feel better.

Women with severe chlamydia infection may require hospitalisation, intravenous antibiotics (medicine given through a vein), and pain medicine.

After taking antibiotics, people should be re-tested to be sure the infection is cured. This is particularly important if you are unsure that your partner(s) obtained treatment. Do not have sex until you are sure both you and your partner no longer have the disease.

Genital Herpes

Herpes is caused by the herpes simplex virus (HSV). HSV-type 1 commonly causes fever blisters on the mouth or face (oral herpes), while HSV-type 2 typically affects the genital area (genital herpes). However, both viral types can cause either genital or oral infections. Most of the time, HSV-1 and HSV-2 are inactive, or “silent,” and cause no symptoms, but some infected people have “outbreaks” of blisters and ulcers. Once infected with HSV, people remain infected for life.

Transmission of Genital Herpes

HSV-1 and HSV-2 are transmitted through direct contact, including kissing, sexual contact (vaginal, oral, or anal sex), or skin-to-skin contact.

Genital herpes can be transmitted with or without the presence of sores or other symptoms. It often is transmitted by people who are unaware that they are infected, or by people who do not recognize that their infection can be transmitted even when they have no symptoms.

 Treatment of Herpes

There is no treatment that can cure herpes, but antiviral medications can shorten and prevent outbreaks for whatever period of time the person takes the medication.

Prevention of Herpes

The consistent and correct use of latex condoms is the best protection. However, condoms do not provide complete protection, because a herpes lesion may not be covered by the condom and viral shedding may occur. If you or your partner has genital herpes, it is best to abstain from sex when symptoms are present, and to use latex condoms between outbreaks.

Genital Warts and HPV

Warts are caused by viruses and can appear anywhere on the body. Those that show up in the genital area are caused by the human papilloma virus, commonly called HPV, and are easily transmitted by sexual contact.

Description of Genital Warts

Genital warts look like small flesh-coloured, pink or red growths in or around the sex organs. The warts may look similar to the small parts of a cauliflower or they may be very tiny and difficult to see. They often appear in clusters of three or four, and may grow and spread rapidly. They usually are not painful, although they may cause mild pain, bleeding, and itching.

Genital Wart Symptoms

Like many STDs, HPV does not always have visible symptoms. But when symptoms do occur, warts may be seen around the genital area. In women, warts can develop on the outside and inside of the vagina, on the cervix (the opening to the uterus), or around the anus. In men, they may be seen on the tip of the penis, the shaft of the penis, on the scrotum, or around the anus. Genital warts also can develop in the mouth or throat of a person who has had oral sex with an infected person.

Genital Wart Diagnosis

Your doctor may perform the following tests to check for genital warts and/or related STDs:

·      An examination of visible growths to see if they look like genital warts

·      Application of a mild acetic acid (vinegar) solution to highlight less visible growths

·      A complete pelvic exam and Pap smear (for women)

·      A specialized test for HPV, collected in a way similar to a Pap smear

·      Biopsy of cervical tissue to make sure there are no abnormal cells that could develop into HPV-related cervical cancer; a cervical biopsy involves taking a small sample of tissue from the cervix and examining it under a microscope.

·      Examination of the rectum

Sometimes female patients are referred to a gynaecologist (a doctor who specialises in female reproductive health) for further testing and biopsy.

Hepatitis B

Hepatitis B is a serious disease caused by the hepatitis B virus (HBV). Infection with this virus can cause scarring of the liver, liver failure, liver cancer, and even death.

Hepatitis B is spread in infected blood and other bodily fluids such as semen and vaginal secretions. It is spread in the same way that the virus that causes AIDS (HIV) is spread but hepatitis B is 100 times more infectious.

Signs and Symptoms of Hepatitis B

Symptoms of acute infection (when a person is first infected with hepatitis) include:

·      Jaundice (yellowing of the skin or whites of the eyes and/or a brownish or orange tint to the urine)

·      Unusually light coloured stool

·      Unexplained fatigue that persists for weeks or months

·      Flu-like symptoms such as fever, loss of appetite, nausea, and vomiting

·      Abdominal pain

Often, symptoms occur one to six months after exposure. An estimated 30 per cent of those infected do not have any symptoms at all.

People with chronic active hepatitis experience similar symptoms, but their fatigue is much more severe, and they can have confusion or disorientation.

Hepatitis B Diagnosis

If your doctor suspects that you may have hepatitis B, he or she will perform a complete physical exam and order blood tests to look at the function of your liver. Hepatitis B is confirmed with blood tests that detect the virus.

If your disease becomes chronic, liver biopsies (tissue samples) may be obtained to detect the severity of the disease.

Treatment of Hepatitis B

If you get to a doctor shortly after the exposure, you’ll often receive immediate immunization with the first in a series of three shots with the hepatitis B vaccination and a shot to boost the immune system to fight off the infection.

Also, take extra care of your liver! Now is not the time to drink alcohol, or take Tylenol (acetaminophen) because they can harm the liver. Check with your doctor before taking any other medications, herbal remedies, or supplements as some of them can worsen liver damage.

If your hepatitis persists beyond six months and is active (chronic active hepatitis), your doctor may prescribe much more aggressive treatment. If it’s chronic but not active, your doctor may just watch you closely.

People with chronic active hepatitis are treated with a combination of drugs like the following:

·Interferon.

The immune system boosting medicine interferon is injected daily, several times a week, or weekly for up to a year. Interferon does have some undesirable side effects, including: fatigue, depression, and loss of appetite and it can lower the number of white blood cells. There are two types of interferon: interferon-alfa (Intron) and peginterferon alfa (Pegasys).

·Epivir.

Another drug often given in combination with interferon is lamivudine (Epivir). This drug is taken orally once a day. Usually, this drug is well tolerated, but it can cause a worsening of liver functioning in rare instances.

·Hepsera.

This drug is taken by pill once a day and works well in people whose disease doesn’t respond to Epivir. It can cause kidney problems especially in people that already have kidney disease, but it can occur in anyone. ·           

Baraclude.

This drug is taken by pill daily and studies are showing it may be one of the most effective antiviral drugs available for hepatitis B.

Viread (Tenofovir):

A once daily pill.  It is also used to treat HIV and is used in patients who have both HIV and Hepatitis B.  It can also be used as a single agent for Hepatitis B.

Hepatitis B in pregnancy

A pregnant woman can spread the hepatitis B virus to her baby at the time of birth. (It is unlikely that an infected woman will spread the virus to her baby during pregnancy.)

Many babies infected with hepatitis B develop long-term liver problems. All newborn babies should be given the vaccine for hepatitis at birth and two additional booster injections during their first year of life.

Prevention of Hepatitis B

The best ways to try and avoid becoming infected with hepatitis B include:

·      Get vaccinated (if you have not already been infected).

·      Use condoms every time you have sex.

·      Wear gloves when touching or cleaning up body secretions on personal items, such as bandages/band aids, tampons, and linens.

·      Cover all open cuts or wounds.

·      Do not share razors, toothbrushes, manicuring tools, or pierced jewellery with anyone.

·      Do not share chewing gum or pre-chew food for a baby.

·      Make certain that any needles for drugs, piercing, or tattooing are properly sterilised.

·      Clean areas with blood on them with one part household bleach and 10 parts water.

Syphilis

Syphilis is a highly contagious disease spread primarily by sexual activity, including oral and anal sex. Occasionally, the disease can be passed to another person through prolonged kissing or close bodily contact. Although this disease is spread from sores, the vast majority of those sores go unrecognized. The infected person is often unaware of the disease and unknowingly passes it on to his or her sexual partner.

Pregnant women with the disease can spread it to their baby. This disease, called congenital syphilis, can cause abnormalities or even death to the child.

Syphilis cannot be spread by toilet seats, door knobs, swimming pools, hot tubs, bath tubs, shared clothing, or eating utensils.

Syphilis is caused by the bacteria Treponema pallidum.

How Is Syphilis Treated?

If you’ve been infected with syphilis for less than a year, a single dose of penicillin is usually enough to destroy the infection. For those allergic to penicillin, tetracycline or doxycycline can be given instead. If you are in a later stage of disease, more doses will be needed.

People who are being treated for syphilis must abstain from sexual contact until the infection is completely gone. Sexual partners of people with syphilis should be tested and, if necessary, treated.

Gonorrhoea

Also called the “clap” or “drip,” gonorrhoea is a contagious disease transmitted most often through sexual contact with an infected person. Gonorrhoea may also be spread by contact with infected bodily fluids, so that a mother could pass on the infection to her newborn during childbirth. Both men and women can get gonorrhoea. The infection is easily spread and occurs most often in people who have many sex partners.

What Causes Gonorrhoea?

Gonorrhoea is caused by Neisseria gonorrhoea, a bacterium that can grow and multiply easily in mucus membranes of the body. Gonorrhoea bacteria can grow in the warm, moist areas of the reproductive tract, including the cervix (opening to the womb), uterus (womb), and fallopian tubes (egg canals) in women, and in the urethra (the tube that carries urine from the bladder to outside the body) in women and men. The bacteria can also grow in the mouth, throat, and anus.

Gonorrhoea symptoms in women

·      Greenish yellow or whitish discharge from the vagina

·      Lower abdominal or pelvic pain

·      Burning when urinating

·      Conjunctivitis (red, itchy eyes)

·      Bleeding between periods

·      Spotting after intercourse

·      Swelling of the vulva (vulvitis)

·      Burning in the throat (due to oral sex)

·      Swollen glands in the throat (due to oral sex)

In some women, symptoms are so mild that they escape unnoticed. Many women with gonorrhoea discharge think they have a yeast infection and self-treat with over-the-counter yeast infection drug. Because vaginal discharge can be a sign of a number of different problems, it is best to always seek the advice of a doctor to ensure proper diagnosis and treatment.

Gonorrhoea symptoms in men

·      Greenish yellow or whitish discharge from the penis

·      Burning when urinating

·      Burning in the throat (due to oral sex)

·      Painful or swollen testicles

·      Swollen glands in the throat (due to oral sex)

In men, symptoms usually appear two to 14 days after infection.

How Is Gonorrhoea Diagnosed?

To diagnose gonorrhoea, your doctor will use a swab to take a sample of fluid from the urethra in men or from the cervix in women. The specimen will then be sent to a lab to be analysed. You also may be given a throat or anal culture to see if the infection is in your throat or anus. There are other tests which check a urine sample for the presence of the bacteria. You may need to wait for several days for your tests to come back from the lab.

Gonorrhoea and chlamydia, another common sexually transmitted disease, often occur together, so you may be tested and treated for both.

Can Gonorrhoea Be Cured?

Yes. Gonorrhoea can be treated and cured.

How Is Gonorrhoea Treated?

To cure a gonorrhoea infection, your doctor will give you either an oral or injectable antibiotic. Your partner should also be treated at the same time to prevent reinfection and further spread of the disease.

It is important to take all of your antibiotics even if you feel better. Also, never take someone else’s medication to treat your illness. By doing so, you may make the infection more difficult to treat. In addition, tell anyone you have had sex with recently that you are infected. This is important because gonorrhoea may have no symptoms. Women, especially, may not have symptoms and may not seek testing or treatment unless alerted by their sex partners.

Don’t have sex until you have completed taking all of your medicine. Always use condoms when having sex.

What Happens if I Don’t Treat Gonorrhoea?

Untreated gonorrhoea can cause serious and permanent problems in both women and men. In women, if left untreated, the infection can cause pelvic inflammatory disease, which may damage the fallopian tubes (the tubes connecting the ovaries to the uterus) or even lead to infertility, and untreated gonorrhoea infection could increase the risk of ectopic pregnancy (when the fertilised egg implants and develops outside the uterus), a dangerous condition for both the mother and baby.

In men, gonorrhoea can cause epididymitis, a painful condition of the testicles that can sometimes lead to infertility if left untreated. Without prompt treatment, gonorrhoea can also affect the prostate and can lead to scarring inside the urethra, making urination difficult.

Gonorrhoea can spread to the blood or joints. This condition can be life-threatening. Also, people with gonorrhoea can more easily contract HIV, the virus that causes AIDS. People with HIV infection and gonorrhoea are more likely than people with HIV infection alone to transmit HIV to someone else.

Prevention of Gonorrhoea Infection

To reduce your risk of gonorrhoea infection:

·      Use condoms correctly every time you have sex.

·      Limit the number of sex partners, and do not go back and forth between partners.

·      Practice sexual abstinence, or limit sexual contact to one uninfected partner.

·      If you think you are infected, avoid sexual contact and see a doctor.

Any genital symptoms such as discharge or burning during urination or an unusual sore or rash should be a signal to stop having sex and to consult a doctor immediately. If you are told you have gonorrhoea or any other STD and receive treatment, you should notify all of your recent sex partners so that they can see a doctor and be treated.

Source:WebMD Medical Reference

 

 

Prof. Mbang Femi-Oyewo wins 2013 May & Baker Professional Award

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Professor (Mrs.) Mbang Femi-Oyewo, MFR, former deputy vice chancellor of Olabisi Onabanjo University and Fellow of the Pharmaceutical Society of Nigeria (FPSN), has been announced winner of the 9th edition of the May & Baker Professional Service Award in Pharmacy.

The award presentation took place at the opening ceremony of the 86th PSN Conference which held at Kwara State Government Banquet Hall in Ilorin, Kwara State on November 7, 2013.

Brimming with smile and waving to the applauding audience, Femi-Oyewo mounted the stage to receive the award which comes with a certificate, a plaque and a cash prize of N250,000.

Born in Benin City, Edo State on April 4, 1951, Femi-Oyewo hails from Henshaw Town, Calabar but grew up in the Western Region, due to the nature of her father’s job.

She had her early education in Benin City and later moved to Abeokuta for her primary education. She started her secondary school in the same town but finished at Queens College, Lagos, from where she proceeded to the Federal School of Science.

In 1976, she obtained a Bachelor of Pharmacy (B.Pharm) degree from the University of Ife (now Obafemi Awolowo University) Ile Ife. She also bagged a Master of Philosophy from the same school in 1980. She proceeded to England for her Ph.D which she obtained from Victoria University of Manchester, England, in 1982.

Winner of the  previous edition of the award was Pharm. (Lady) Adaeze Omaliko, managing director of Malix Pharmacy, Onitsha in Anambra State.

Stroke is medical illness, not spiritual attack – Dr. Gbiri

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By Adebayo Oladejo

As Nigeria joined the rest of the world to mark this year’s World Stroke Day on October 29 a neuro-physiotherapist and lecturer in the Department of Physiotherapy, College of Medicine, University of Lagos, Dr. Caleb Ademola  Gbiri, has identified ignorance of  the cause of stroke as one of the major reasons people die of the illness in the country.

The University don who spoke with Pharmanews in an exclusive interview in his office, disclosed that the myth that stroke is a spiritual attack is what makes many of its victims run to spiritualists and religious leaders, rather than certified medical personnel.

According to him, the fact that it is possible to medically explain the cause, characteristics and management of stroke is enough reason to show that there is nothing spiritual about the condition. He added that stroke is better managed in the first six to 12 months if the person reports to the hospital immediately, assuring that such individual has a higher chance of returning to normal life irrespective of the cause of the ailment.

The medical expert who has also worked with the Federal Neuro-Psychiatric Hospital, Yaba, Lagos, further disclosed that stroke is putting a lot of economic burden on the country, as it is depleting the nation’s workforceby incapacitating people who are supposed to be useful to the nation.

Below are excerpts of the interview;

What does having a stroke mean?

Having a stroke, in a very simple explanation, is a sudden attack of the brain that either results in death or leads to paralysis of one function of the body or the other. However, while it commonly presents itself as a paralysis of one side of the body, it is not limited to that.It might just be a small fraction of the body that will be affected; and, sometimes, there might not be paralysis of any part of the body but the vision, speech and sometimes the mouth might just be impaired.In a nutshell, stroke occurs when bloodflow in the body has been obstructed or there is a rupture in the artery that feeds the brain.

What are the conditions that predispose one to stroke?

The conditions that predispose individuals to stroke are so many and we have classified them into two groups: modifiable and non-modifiable factors. The modifiable factors are the ones that we can do something about so as to limit our possibility of developing a stroke.For example, being overweight and obese are modifiable risk factors that we can do something about. Being hypertensive is another factor;so also is not getting enough sleep.Others include, smoking, drinking of alcohol and lack of exercise, diabetes, among others. One can do so many things to guide against these modifiable factors.

For the non-modifiable factors, age is one.Although stroke can occur at any age, it is most common at an advanced age.There is also the gender factor – nothing can be done about this. Fortunately, however, the modifiable factors constitute about 80 percent of stroke cases – which implies that stroke is preventable if the necessary things are done.

Based on your experience as an expert, which of these conditions are the most common reason why people develop stroke?

I will say high blood fat, being obese and overweight, followed by hypertension and diabetes in that order. If someone smokes and drinks alcohol, it is very easy for the person to develop hypertension or diabetes.So all these lifestyle issues are intermingled. Although in some cases, diabetes and hypertension run in some families, one can still do something about it to prevent it from developing into stroke.

Is there hope for people suffering from stroke?

Yes!There is hope for those suffering from stroke.One important thing that we need to tell our people is that stroke is preventable, provided we live a good lifestyle. Meanwhile, for those who have stroke, the best thing to do is to go to the hospital and get treated immediately. However, for those who have suffered stroke for a while now, it is not too late as they can still go back to the hospital and get treated. An individual can recover fully from stroke without having any visible disability; I could say that boldly because I have treated many people who recovered from stroke and are doing well.

The best thing an individual should do when they have a stroke is to go to the hospital and ensure that treatment is initiated early. The concerned individual should also ensure to adhere to medical instructions and prescriptions. What I am saying categorically is that stroke is both manageable and treatable, irrespective of what causes it.

Are there statistics for people living with stroke in Nigeria?

We don’t have a national statistics for people living with stroke in Nigeria, unlike in the developed world; but we have what we called hospital-based statistics.This hospital-based statistics only account for people who reported to the hospital. We cannot account for people who went to herbalists, churches and other places like that.But for those who reported to the hospital, what we have is about 0.001 percent of the total population.So if the total population is 168 million, it means about 168,000 people are suffering from stroke or have suffered stroke.

Is it true that stroke only affects the rich?

No, stroke affects anybody irrespective of their age, gender or economic status. The only reason people think it mostly affects the rich is that the rich are the ones who are likely to visit hospitals; the poor ones would stay back at home or visit spiritualists. Also, the poor may not have money to buy those junks from eateries all around or buy expensive wines; but the fact remain that stroke affects anybody, whether rich or poor.That aside, stroke is a major burden globally. This is why October 29 of every year has been declared World Stroke Day.

Do you think we have facilities to take care of stroke in Nigeria?

Our stroke management in Nigeria is actually at the sub-optimal level; that is, it is lower than expected. Stroke care is supposed to be a care in a concentrated unit, but we don’t have any stroke unit in Nigeria, not even in any of our teaching or general hospitals. Meanwhile, a stroke unit should involve every specialist that is involved in stroke management because it requires a multi-disciplinary approach in management.So what we are advocating for now is that government should establish stroke units, at least in every tertiary health institution or in every major city in the country.

Talking about experts who are competent, we have them in abundance in the country; but the facilities are not there to work with, unlike those people in the developed world who have better facilities to manage any case of stroke.

 

NANNM president laments rot in health sector

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Not a few people doubted the ability of Nurse Abdrafiu Alani Adeniji to pilot the affairs of the National Association of Nigeria Nurses and Midwives (NANNM) when he emerged as president of the group in 2012. However, within just a year in office, he has repeatedly proved himself a capable captain of NANNM. Recently, he led a protest against the imposition of a medical doctor as the chairman of the Nursing and Midwifery Council of Nigeria, a position which has now been ceded to Nurse (Alhaji) Musthafa Jumare.

In this exclusive chat with Temitope Obayendo, the NANNM helmsman condemns the gross injustice and corruption in the health care sector, as well as negligence of the role of nurses.

Below is the full text of the interview:

Could you briefly introduce yourself?

I am Nurse Comrade Abdrafiu Alani Adeniji, national president, National Association of Nigeria Nurses and Midwives (NANNM) which is the professional association and trade union organisation for all registered nurses and midwives in Nigeria.

As the president of NANNM, how far have you gone in achieving your goals for nursing and what are the strategies on ground to see your vision accomplished to the letter?

The goals of my administration for the pursuance of my set manifestoes are based on the philosophy of the organisation in Article III (a) which read thus:

“The National Association of Nigeria Nurses and Midwives believes in activities which will bring about positive changes required in making nursing profession more responsive to health needs of individuals, families and communities. It is the belief of the Association that the broad interest of its members should be protected and well represented before contemporary professions, employers and the public at large. The Association believes in continuing education of the nurses and nursing research as a major way of attaining perfection in nursing practice. The Association believes in promoting unity, co-operation and understanding among its members and other working class organizations generally.

My Vision and Mission as documented in my manifesto are as follows: Vision – to lead Nigerian nurses/midwives to the next level of being virile professional body representing the interest of her members across the boarders. Mission – to provide adequate qualitative, democratic and responsive leadership in discovering our latent potentials, minimising our weakness, harmonising our strength and reconciling our differences.

Regarding achievements, we have put in a lot of attention to our membership drive, mobilisation and organisation cutting across nurses in Federal, State and Local governments and those of our members in private practice. We met an ongoing reconciliation among the national leadership and members in the Federal Health Institutions who, until then, had contracted out of NANNM; but, today, our peacemaking and reconciliation has brought them back to the fold of NANNM.

It was during this regime that the long-awaited provisional (temporary) accreditation was given to Nursing Science programme at National Open University of Nigeria and the first graduation of thousands of Nurses with Bachelor of Nursing Sciences came into reality. The association leadership is leading the stakeholders in nursing education in contributing a great deal in ensuring that our Bachelor of Science graduates are allowed to do clinical posting in form of internship after 5years of academic and clinical trainings in the University to sharpen their professional skills.

We have always defended the rights and privileges of our members and protected them from exploitation in the labour markets. We hold regular programmes like the celebration of Annual Nurses Week which incorporates continuing education programmes and social interaction. We have also succeeded for first time in recent years to hold separate celebration of the International Midwives Day in Abuja on 4-7 May, 2013 along with collaborating partners. Gaps in midwifery education, legislation, association and practices were identified and solution proffered.

We have participated in international programmes like the West African College of Nursing in Liberia, African Midwives Conference in Kenya, International Council of Nurses in Australia (also in May, 2013) and International Council of Midwives workshop for leaders in Ghana between October and November this year. All these programmes are done with the good will of the employees and members of Nurses and Midwives Association. Our staff welfare has been stepped up and we hope to do more to motivate them for higher performances. Our main strategies are investing in manpower development and regular consultation with elders and leaders of thought, as well as regular meetings and in-service trainings. Some of our members are presently undergoing in-service training both in Nigeria and abroad.

What is your opinion about the recurrent doctors’ strike in the nation?

Recurrent industrial disharmony leading to strike is not limited to medical and dental practitioners alone. Nurses, laboratory scientists, physiotherapists and other health care personnel are also involved in strike actions at different times.

I think generally it’s due to maladministration of health care services in Nigeria. It has a characteristic nature of lopsidedness, inequity, monopolisation of power and absence of team spirit which health care delivery services require, and as is the case in other countries.

My opinion is that all stakeholders in health care services should be allowed to participate in health care administration in Nigeria. If resident doctors are on strike because they want an improvement in health care infrastructural development, it is in right direction. It is the concern of all the health care professionals that our health care facilities are equipped with modern equipment, and that infrastructures are developed to meet modern standard.

 There is always this power tussle in the health sector, where the doctors are always assuming the headship of the group.  How true is this assumption and how can it be rectified?

Injustice, corruption and inequitable distribution of health care resources have led to total collapse of genuineness and sanity in the health care Industry. Health care industry is a demonstration of the coming together of many professionals with collaboration and interdependency for efficiency and better health care services results. This working together is known as team work. It has the patient at the centre while other health professionals contribute their quota to oil the wheel of the smooth running of the system. But self-centredness, personal aggrandisement and ill-feeling have destroyed the team spirit where professionalism has been replaced with ‘proffesionism’ as theorised by professor Iyaji, in one of his research works on team spirit in health care industry.

The headship of health care services delivery is not the birth right of only one group of professionals, and no good result or patient recovery can be attained with a destroyed team spirit. It is affecting quality of health policy formulation, implementation and appraisal. It is also the cause of inequity and the incessant strike in the industry.

In other countries, other health care professionals other than medical and dental practitioners are allowed to contribute their own professional expertise to health care management. At the levels of Federal Ministry of Health, Board of Management of Teaching Hospitals, Federal Medical Centres, research institutions and other institutions collaborating with and allied to health services, this is like a taboo. The inordinate ambition and desire to stick to colonial/expatriates salary relativity which existed when very few doctors practising in Nigeria were from foreign and developed countries of the world because Nigeria had no indigenous practitioners.  the key elements of the present day remuneration and endless struggle in Nigeria health care system is still based on expatriates salary relativity. Remuneration world over are based on quantum and quality of services you rendered.

International best practices allowed for all healthcare care professionals to have a stake in the efficient management of the health care services. In India, the Minister of Health is not a medical doctor; he holds M.Sc. degree in Zoology. In Botswana, currently, the Minister of Health is an accountant who took over from a nurse who was a Minister from 2003-2009; she also took over from another professional colleague (nurse). No wonder the country has witnessed tremendous development and advancement in health care services. Botswana is rated by WHO as one of the best in Africa in health care status.

In UK the present Secretary of State for Health holds a Master of Art in English Language; in USA, the Officer In-charge of the Department of Health and Human Services (equivalent to our own Minister of Health) in 2009 holds a bachelor degree in arts and a master degree in Public Administration. Coming down to Nigeria, it is on record that the tenure of many non medical doctors at the helms of Federal Ministry of Health witnessed stability and harmony as epitomised by the leadership of Admiral Patrick Koshoni, Admiral Jibril Ayinla, Prince Julius Adelusi Adeluyi, Prof. A.B.C. Nwosu and Prof. Eyitayo Lambo.

What is the position of NANNM concerning the National Health Bill, and National Health Insurance Schedule?

The National Health Bill is very necessary for efficient management of health care Nigeria. But the same factor of lop-sidedness and anti-multi-professional practices dimension has brought about the challenges it is facing today. NANNM, as a professional association, has participated in various attempts to correct the anomalies contained in the draft Bill like in section one subsection one, where the bills seeks to eradicate the roles and responsibilities of various professional regulatory bodies. This is not the best for Nigerian health system. Also Section eight, subsection two that entails establishment of National Tertiary Hospital Commission, as well as subsection four of same section eight, show that there is no fair representation of the health professionals in the commission.

The area that touches on sourcing fund for primary health care services seems to impinge upon the Nigerian federal system of government and administration that allows for relative autonomy of states and local governments. These and others are few of the offending clauses in the Health Bill that need to be corrected.

The same maladministration is applicable to the National Health Insurance Scheme.  The Act that established the scheme did not take into consideration the relevance of other health care professionals in the selection of board members, criteria for selection of the executive secretary, and even in setting out the rights of nurses in day-to-day running of the scheme.

For example, the World Health Organisation describes a nurse as “a person having received authorised education and training, has acquired knowledge, skills and attitudes in the promotion of health, the prevention of illness and care of the sick.  Thus making her/him an integral member of the health system, he/she is capable of solving within his or her competence of solving the health problems which arise in the community.”

The nurse has independent, interdependent and dependent roles in health care services. Often, the dependent roles of nurses are used for their placement in the scheme of things, including remuneration.  World over, nurses serve pivotal roles upon which other health professionals revolve to have access to patients and clients.  But, in Nigeria, it is irritating that even in remuneration, the classification is doctor; pharmacist/physiotherapist/laboratory scientist; nurses and others. You can imagine that kind of injustice.  It shows that nurses are the most deprived frontline health care professionals.

It has been opined that to assess the efficiency of health care system in any country you should just simply do an appraisal of the kind of treatment and placement of their nurses and midwives.  Without placing nurses and midwives on a higher pedestal like other health care providers, the outcome will be below average and continue to nosedive.  Even if nurses do not agitate, the law of natural justice will demand for redress, failure of which will make heaven fight for the oppressed.

It was in the news recently that the federal government was trying to impose a doctor as the national leader of nurses.  What steps have been taken to resist this move?

You mean the position of the chairmanship of Nursing and Midwifery Council of Nigeria, where a medical doctor was proposed? Well, it is either that it was a mistake as we were made to believe by the Honourable Minister of Health, or that it was just an experiment to see whether they could achieve another incursion into another profession to assert their hegemony, further subjugating and causing more havoc.

In any case, Nigerian nurses unequivocally rejected the move, though we had long expected the council inauguration. But it is better that we do not have a council in place than having a medical doctor in that position.  It is not a personal issue but one that borders on natural laws and world best practices.  What would a medical doctor know about nursing and midwifery services? Though medicine and nursing are twin-sister profession, they are expected to move side by side without one impinging on the roles and responsibilities of the other.

It has to be said that no amount of resources expended on development of medical sciences will be seen to yield commensurable result if nursing sciences are left behind as it is today.  How can you explain the huge investments in medical sciences, which have not in any way helped our bad and retrogressive health status in Nigeria among the committee of nations in Africa?

Still on the issue of appointment of a medical doctor to be the national leader of nurses and midwives, it was a bad dream that couldn’t have come to reality.  If it had, then posterity would not have forgiven us and generations yet unborn would have cursed us.  In fact, it would have been aiding, abetting and propagating high level quackery punishable under the law.

I am happy to inform you that a better option has been offered in person of a professional, Nurse (Alhaji) Musthafa Jumare as the chairman of Nursing and Midwifery Council of Nigeria. We are only awaiting the inauguration of the council and we pray that the council succeeds in the task ahead. However, the Nursing and Midwifery Registration Act (as amended) Cap 143 LFN is due for a review and the process has been kick-started to block the loopholes contained therein.

Record has it that the rate at which health practitioners abandon the shores of Nigeria to seek greener pastures is alarming.  Do you think there can be a permanent solution to this problem?

The movement of skilled manpower in health care system abroad in search of greener pasture is erroneously called ‘brain drain’.  I see this word as ill-motivated. The movement of skilled manpower from an area of low premium, low motivation and bad remuneration to a place of higher premium value and motivation could be known and addressed as ‘labour mobility’.  This is not only related to fiscal or monetary value.  It also entails the fact that in other countries where these people migrate to, the Nigerian nurses that are treated and rated very low in Nigeria are rated higher, well-placed and respected and, of course, also well-paid.

The solution to this for us in Nigeria is to study and adopt the treatment, placement, payment and respect being given to our nurses where they migrate to. We need a level of social-re-engineering in our value system for nurses.  We equally need to be equitable in our policy formulation.  If nurses are motivated and not caged, they will oblige to stay in Nigeria, their fatherland, and contribute their quota.

It is highly appalling that the traditional roles of midwives – that is, to take care of pregnant women, diagnose and treat associated illnesses, prepare them for delivery and eventually take the delivery – are denied them today in most of our teaching hospitals.  Yet we are suffering from high maternal mortality rate and demoralising infant mortality rate. The perverted course of social justice has to be re-ordered in favour of equity, fair play and re-enthronement of justifiable jurisdiction scope in Nigerian health care professional practices.

Nurses in Nigeria need to be accorded rightful position in the scheme of things.  Nurses need to be remunerated with a scale commeasurable to the quantum of the skills, knowledge and expertise we contribute to quality health care services and day to day running and administration of health care services in Nigeria. They need to be provided an encouraging working environment to stem the tide of workplace hazard for nurses, provide infrastructure, equipment and some social amenities to make work environment more favourable for nursing practices especially in primary health care services.

If there will be efficient primary health care services in Nigeria, we have to go to the forgotten healer of promotive and preventive health care services in Nigeria by empowering the community midwives and public health nurses whose roles are being eroded today in primary health care.

Could you mention some other challenges of the health sector as they affect NANNM?

The challenges are numerous. They include but not limited to: lack of equipment in our hospitals, acute shortage of skilled manpower, quackery, inadequate funding (it may interest you to know that, presently, Nigeria still budgets below the WHO benchmark for health), corruption, destruction of team spirit, incessant industrial strike, low ebb of technological advancement in health and low or under reporting of health care issues and incidences. These are general health care challenges in Nigeria today.

In nursing profession in particular, the bad image of nurses and nursing in Nigeria, absence of unified scheme of services for professional nurses, non-implementation of I.A.P award since 24 years ago and utter neglect of National industrial court judgement are few challenges that are confronting nursing profession in particular.

Of morals, ethics and law: the tripod of pharmacy practice

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By Pharm. (Barr.) Steve Okoronkwo

 The practice of pharmacy in Nigeria is very challenging. Indeed, the pharmacy profession is viewed by many as embattled, if not endangered, in Nigeria. Pharmacy, arguably, has the reputation among the professions of having the highest number of intruders and quacks. The pharmacist’s first-line competitors are not his or her fellow pharmacist but quacks masquerading as pharmacy professionals.

While pharmacists are trying to wrestle their profession from the grip of intruders, they are also faced with a more important obligation of ensuring that their practice conforms to global best practices. The international best practice of pharmacy is anchored on the trinity of norms – morals, ethics and law. This keynote address attempts to highlight and contextualize these concepts with a view to elucidating on the concepts. It espouses the place of each of these norms in the day-to-day practice of pharmacy while examining the nexus between these norms and how they affect the pharmacy practitioner.

WHAT ARE MORALS, ETHICS  AND LAW?

Morals, Ethics and Law are distinct, yet related concepts. Morals are principles of right and wrong conduct; they define a person’s character. Man is said to obtain his morals from his interaction in society. On the other hand, morality connotes something that is embedded in nature itself, and enunciates personal principles which enable the individual to choose between right and wrong1. It has beenargued that morality is subjective, that it lacks the quality of being objective. What is moral to one person may be immoral to the other. Individual morality also changes with time and situations. Views on morality may differ from person to person and from one clime to another. Some people even inject religious elements into moral considerations.

Ethics, on the other hand, is the science of morals. It is a framework, a systematic and reasoned basis for making statements about morality.² To address a question from an ethical perspective is to reflect on the morality of a situation and weigh the impact on others of one’s action – whether one can justify one’s action to a higher authority.³ Ethical relativism posits that individuals must decide what is ethical based on their own feelings as to what is right or wrong. Accordingly, if a person meets his own moral standard in making a decision, nobody can criticize him or her for it. However, this theory has been criticized on the basis that an action that is generally thought to be unethical (e.g dispensing a generic in place of a brand and charging the patient for the brand) would otherwise be ‘ethical’ if the perpetrator thought that it was in fact ethical.

Ethics is an advanced expression of morality and is thus more sophisticated than morals. While morally one can support almost anything, ethics emphasizes a social system in which those morals are applied; therefore reason is required to ethically justify one’s action. Ethics point to standard or codes of behaviour expected by the group to which the individual belongs; it is a benchmark below which the individual is notpermitted to descend, otherwise he becomes a pariah liable to be ostracized from society.

An action is said to be unethical where it runs counter to a reason-based, systematic code of conduct that is agreed by members of a group. Such unethical conduct has been described as “in famous conduct in a professional respect.” In the English case of Allison v GeneralCouncil of Medical Educationand  Registration (1894) 1QB750 where a medical doctor, Mr. Allison, engaged in extensive public advertising to attract patients, the Council considered such conduct as capable of bringing the entire medical profession into disrepute. In a case of infamous conduct in a professional respect brought against the doctor, the court stated that an infamous conduct in a professional respect is said to have occurred where a medical practitioner, in the pursuit of his profession, has done something with regard to it which would be reasonably regarded as disgraceful or dishonorable by his professional brethren of good repute and competency.

It is submitted that the definition of “infamous conduct” in a professional respect in Allison’s case could be adopted in the pharmacy profession. However, what constitutes the symptoms of an “infamous conduct” will depend on the norms of each profession and facts of each case.

Ethics operates at a higher pedestal than morality. Where there is a conflict between a person’s moral belief and the society’s ethics, the latter prevails. Ethics can call morality into question and cause it to change. Society requires a code of ethics in order to provide for order, prevent or minimize general or large-scale conflicts within society, reduce strife between individuals, and provide a basis for settling conflicts between competing values. According to Vivian Weil, “a profession’s ethical standards must be compatible with our common morality, but they go beyond our common morality. You could say that they interpret our common morality for the specific details of work of a particular occupational group.”

For example, though a lawyer’s personal moralsis to the effect that murder is reprehensible, the ethics of the legal profession demands that every person charged with murder must be offered a vigorous professional assistance in defence of the charge of murder. This has its underpinning in the sanctity of human life and the constitutional provision that an accused is presumed innocent until his guilt is established by a competent court of justice.y Untilsuch pronouncement, the moral opinion of the lawyer or that of any other person does not count.

Similarly, some pharmacists – especially those in corporate setting – are often confronted with the dilemma of carrying out corporate policies that are in direct conflict with their own deeply held personal values (for example, dispensing a “morning after” contraceptive). In the celebrated case of Pierce v Ortho Pharmaceutical Corporation 417 A. 2d 505(N.J. 1980), the corporation (Ortho) filed a drug application with the Food and Drug Administration (FDA) to test Loperamide on human beings. Evidence showed that Ortho acted lawfully and ethically in conducting all research relating to Loperamide in seeking the approval of FDA to test the drug on humans. Dr. Pierce (who was employed by the company as the Director of Medical Research) voiced her disappointment with Ortho’s decision to test the drug on human beings because she believed the high level of saccharin contained in the Loperamide (44 times greater than the level permitted by law in soft drinks) would pose danger to the subjects. She even cited the Hippocratic Oath which states,”I will prescribe regimen for the good of my patients according to my ability and my judgment and never do harm to any one”. Ortho relieved Dr. Pierce of her position. She sued Ortho to recover damages for wrongful termination. At the Supreme Court, the court upheld Dr. Pierce’s dismissal by Ortho. The court said: “An employee does not have a right to continued employment when he or she refuses to conduct research simply because it would contravene his or her personal morals. An employee at will who refuses to work for an employer in answer to a call of conscience should recognize that other employees and their employer might heed a different call”. The court also noted that “chaos would result if a single doctor (employee) engaged in research were allowed to determine, according to his or her individual conscience, whether a project should continue. To hold otherwise would seriously impair the ability of the drug manufacturers to develop new drugs according to their best judgment”. This landmark case and others of that ilk show the supremacy of ethics and law over morals. However, Cristina Alarconhas argued that a code of ethics should never replace individual conscience. According to the author, individual conscience must always underpin action, even in the presence of professional codes, standards or guidelines.¹¹

Law, according to Webster’s Collegiate Dictionary, is a binding custom or practice of a community, arule of conduct or action prescribed or formally recognized as binding or enforced by a controlling authority.¹²Law and ethics are usually misunderstood as the same. The correct position however is that law asserts supremacy over morals and ethics. For one thing, law is prescriptive and binding. Morals and ethics, on the other hand, are suggestive and oftentimes not binding; laws carry with them sanctions or punishments for violation; morals and ethical violations are frowned upon but do not exert finite sanctions.

However, law, ethics and morals are not diametrically opposed. Indeed, they are not mutually exclusive either. The separation of law on the one hand and morals and ethics on the other is oftentimes merely as to form than substance. Most laws represent a codification of morality, and it is precisely a breach of ethics that has prompted the enactment of many laws. Ethics therefore is the philosophical basis for laws, rules and regulations. ¹³

Pharmacy is a social profession and pharmacists often face situations that raise moral, ethical and legal considerations. Therefore, the question whether the conduct of a pharmacist is immoral, unethical or illegal cannot be answered in abstraction.It must be situated within the context and dialectics of the eternal interaction between morals, ethics and law.

CODES OF ETHICS: PHARMACY AS A SOCIAL PROFESSION

A Code of ethics, according to WiseGeek, is a set of guidelines designed to set out acceptable behaviour for members of a particular group, association or profession.¹t  Codes of ethics clarify what social and moral behaviour is and is not acceptable by professional peers. Because they belong to a group, they are usually written out to avoid ambiguity. Society requires a Code of ethics to provide for order.¹u  Codes of ethics are instruments of persuasion both for members of a profession and the public. They also enhance the sense ofcommunity among members of a group with common values and a common mission.

According to RichardT:”The very exercise of developing a code is in itself worthwhile; it forces a large number of people to think through in a fresh way their mission and important obligations they as a group and as individuals have with respect to society as a whole”.¹v  Codes of ethics are tools which groups or organizations use to evaluate their members and to hold them accountable to a set of predetermined guidelines and standards.

According to International Pharmaceutical Federation (FIP)Statement of Professional Standards Codes of Ethics for Pharmacists, a profession is identified by the willingness of individual practitioners to comply with ethical and professional standards which exceed minimum legal requirements.¹w  Codes of ethics of a profession therefore define acceptable behaviour for members, promote high standards of practice and provide a benchmark for members to use for self-evaluation. Codes of ethics establish a framework for professional behaviour and responsibilities and also serve as a vehicle for occupational identity.Code of ethics is a mark of occupational maturity.

The practice of pharmacy has the characteristics of an occupation as well as a profession. It is commonplace therefore for a person who is engaged in an occupation to refer to himself or herself as a professional – after all, a person’s profession could equally be his or her occupation. However, ethical obligations and guidelines distinguish professions from occupations. The question whether pharmacy is a profession argues the distinction between a profession on the one hand and a business on the other hand. This argument also stresses how the two are compatible within the role of a pharmacist and brings to the fore how a Nigerian pharmacist in particular can develop his or her professional characterand remain ethical in the chaotic practice environment dominated by quacks. Ethical commitment is a counter balance to commercialism and competitioninherent in pharmacy practice. Accordingly, profitability does not preclude the ideals of professionalism.

Ethics reflect the soul of each profession. Consistent ethical behaviour creates a positive image of the individual that extends to the image of the profession. Conversely, unethical practices and decisions create a negative image of and diminish trust and credibility about the individual; it then raises suspicion about the individual’s profession. The recognition of these facts prompted the issuance by the FIP of the statement of professional standardsrelating to codes of ethics for pharmacists. The FIP, by this statement,states andreaffirms the basis of the rules for and responsibilities of pharmacists. These obligations are rooted in moral principles and values, and are to guide the national associations of pharmacists in formulating their individual codes of ethics. The Codes of ethics are to guide pharmacists in their relationship with patients, other health professionals and the society generally. Whether the Code of ethics for pharmacists in Nigeria is in consonance with the FIP Statement of Professional Standard Codes of Ethics for Pharmacists is a moot point.Suffice it to note that a Code of ethics will not solve all ethical challenges. Further, ethical codes are fundamentally based on moral suasion. It is therefore not surprising that laws are enacted to aid the enforcement of morals and ethical codes, given the coercive nature of laws and regulations.

PHARMACY LAWS IN NIGERIA

Pharmacy law is generally defined as a body of information about drugs, drugs distribution and drug therapy.¹x The law sets out the responsibilities for pharmacists and for others who are formally involved with medications. Pharmacy law provides a mechanism through which adverse outcomes are reviewed by affording responsible persons an opportunity to account for their actions and avoid liability through satisfactory accounting.

Pharmacy Law exists for a purpose. Pharmacists, as professionals, enjoy a lot of prerogatives and employ a lot of discretion in their practices.In exercise of these discretions, pharmacists wield so much influence and power. Pharmacy Law mediates the interface between a pharmacist’s exercise of professional powers and discretion and the society’s interest. Legal regulations and restrictions on the use of drugs and on pharmacists show the peculiar nature of drug beyond mere commodity. Having laws regulating the activities of pharmacists is also a way of putting checks on the privileges which the society accords to those who practice pharmacy.

Pharmacy practice in Nigeria is regulated at the federal level. The Pharmacists’ Council of Nigeria (PCN) – which has the primary responsibility of regulating and controlling the practice of pharmacy in Nigeria in all its aspects and ramifications¹y is a creation of the Federal Government of Nigeria. Having one body, namely the PCN, controlling the practice of pharmacy in the entire federation assures of uniformity in the standard of practice throughout Nigeria.

Pharmacy laws in Nigeria are from a variety of sources. These laws and regulations are quite complex and numerous for complete assimilation by an average pharmacist. According to Adenika,the laws on pharmacy have grown unwieldy. The renowned author opines that these laws are bedeviled by overlap, repeated repeals and flagellations.²<” His observation is not surprising given that most of these laws came into being mostly during the military regime, which has been dubbed by many as the dark era of Nigeria’s political history. Be that as it may, the greatest challenges facing pharmacy laws in Nigeria are the twin but related factors of non-adherence (what may be termed inadvertent infractions) to the laws and ineffective implementation of sanctions by the regulatory bodies. It is postulated that the incorporation of ethical values into these laws will reduce the incidence of infractions.

A law is adjudged good or bad depending largely on its compatibility with thegeneral morality of the society. Similarly, the image of a society is enhanced by the extent of obedience to laws by its members. Aristotle(in Politics 1294936)posits: “But we must remember that good laws if they are not obeyed do not constitute good government. Hence there are two parts of good government one is the actual obedience of citizens to the laws, the other part is the goodness of the law which they obey”.²¹ While harmonization of the several laws on pharmacy is being pursued, it is more important that pharmacists adhere to the extant laws if pharmacy must retain its position in the league of respected professions in Nigeria.

THE CONFLICT OF MORALS, ETHICS AND LAW IN PHARMACY PRACTICE

The conflict between morals, ethics and law in the practice of pharmacy results in what has been dubbed the moral/ethical dilemma, ethical/legal dilemma or moral/legal dilemma. Conflicts between law and ethics or between morals and ethics is commonplace in every facet of pharmacy practice. Since the greater percentage of this audience is made up of community pharmacists, I will dwell more on the conflicts that occur in community pharmacy practice.

Community Pharmacy is the section of pharmacy practice that serves all pharmacists owners, managers and employees practicing in a community environment. The section members are pharmacists practicing in independent and chain settings,home healthcare, franchise or supermarket pharmacies, and office-based sites.²²

Community pharmacy, also known as retail pharmacy, represents one of the largest and special group categoriesin pharmacy practice. The community pharmacy section is the largest of the FIP sections.²³ In Nigeria, community pharmacists account for over seventy percent of all the registered pharmacists.²t

Pharmacists are the undisputed custodians of drugs. However, there is no segment of the pharmacy practice which fulfills this role of custodianship better than community pharmacy. Whereas the hospital pharmacist fills prescription generated from the particular hospital where he or she works – and may as a result be used to such class of drugs that are usually prescribed in that hospital – a community pharmacist stocks almost every drug, as he or she is likely to receive orders/referrals from various hospitals. While the hospital-based pharmacist may become an authority on certain classes of drugs, a community pharmacist needs to be a “Jack of all drugs and master of all”. The custodian’s role of the community pharmacist is quite challenging as he/she needs to keep abreast of new drugs introduced into the market almost on a daily basis. This challenge is made tougher given the poor implementation of the laws that attend drug regulation in Nigeria. Drugs and other regulated products are easily purchased without qualms. Moreover, with the out-of-stock syndrome prevalent in most hospitals and government-owned health institutions, there is always a spill-over of prescriptions to the community pharmacies. Conflict of morals and law may arise in the community pharmacist’s discharge of his/her professional duty because in an attempt to meet the various needs of the customers, patients, hospital and the community, the community pharmacist may stockeven unregistered drugs.

 

Pharm. (Barr.) Steve Okoronkwo, managing director, Altinez Pharma made this presentation during the 21st Annual National Conference of the Association of community Pharmacists (ACPN) Anambra State

 

HerbFest 2013: Stakeholders canvass passage of traditional medicine bill – As NAFDAC seeks collaboration on herbal medicine standardization

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By Temitope Obayendo

 Rising from a three-day scientific conference, stakeholders at the recently concluded herbs, health foods and natural products expo, HerbFest 2013, have called on the National Assembly to expedite action on the implementation of the Nigerian traditional medicine bill before it.

This was contained in a fifteen-point communiqué issued after the conference.The statement was jointly signed by the organisers of the programme, namely, the Bioresources Development and Conservation Programme (BDCP), Nigeria Natural Medicine Development Agency (NNMDA) and the International Centre for Ethnomedicine and Drug Development (InterCEDD).

Participants at the conference themed: “Development of Novel Natural Products as Dietary Supplements, Phytomedicines and Nutraceuticals”, lamented how their various efforts aimed at sensitising the public on the use of herbal medicines in the country had been impeded by the non-implementation of the National Traditional Medicine Policy and the passage of the Nigerian Traditional Medicine Bill before the National Assembly.

It was also recommended by stakeholders at the meeting that the media, NGOs, Not-for-profit organisations and relevant government agencies should be engaged in aggressive awareness, sensitisation and reorientation campaigns on the importance of promoting indigenous medicinal/natural products in Nigeria.

The conference further advocated special and adequate training programmes on packaging and branding for Nigerian entrepreneurs involved in the production of natural products, dietary supplements, phytomedicines and nutraceuticals, in order to raise standard and make their products globally competitive.

The industry key players also called on relevant regulatory agencies to collaborate with stakeholders in order to develop a unique and uniform Standard of Reference in line with international standards for the production of herbal/natural products which is important for Quality Assurance.

“Government should facilitate interest-free loans and waivers on import duty on equipment, and other necessary materials used in the production of herbal products, in order to reduce cost of production,” they urged; adding that “in line with Agricultural Transformation Agenda (ATA), there is need to promote commercial cultivation of medicinal plants which will lead to job and wealth creation.”

The participants also urged pharmacists across the country to ensure the existence of a well-established Pharmaco-vigilance operation for herbal medicines, in order to monitor and evaluate the adverse effects on users.

The event, which was well-attended by top functionaries in the health sector, had Prof. Olusegun Adewoye, immediate past director general/chief executive, National Agency for Science and Engineering Infrastructure (NASENI), as the chairman of the opening ceremony; while the special guest of honour, Prof OnyebuchiChukwu, Honourable Minister of Health, was ably represented by Prof K. S. Gamaniel, director general/chief executive of National Institute for Pharmaceutical Research and Development (NIPRD). Mrs. Rabi Jimetamni, permanent secretary, Federal Ministry of Science and Technology, who declared the event open, was represented by Dr M. T. Gwaza.

Other dignitaries at the event were T.F. Okujagu, director general/chief executive, Nigeria Natural Medicine Development Agency; Prof. Maurice Iwu, chairman,Bioresources Development Group (BDG), who delivered the keynote address titled “Food as Medicines”; Prof. Elijah Sokomba, former national coordinator,Bioresources Development and Conservation Programme; Mr.Denzil Philips, founder/director, African Association of Medicinal Plants Standards; Mrs.Hauwa Keri, representing the director general/chief executive of National Agency for Food and Drug Administration and Control (NAFDAC), Dr Paul Orhii;Dr W. Siyanbola, director general/chief executive, National Center for Technology Management (NACETEM); Hajiya Zainab Sherif, managing director, Nigerian Medicinal Plants Development Company, and others.

Meanwhile, to bridge the gap between the discovery and clinical development of herbal medicines in Nigeria, Director General, National Agency for Food and Drug Administration and Control (NAFDAC), Dr Paul Orhii, has called for a strong collaboration between the research and development institutions and pharmaceutical companies.

Speaking on the topic: “Registration, Regulation and Development of Herbal Medicinal/Natural Food Products: Hidden Strategies to Making It Work”, Dr Orhii said a close and complementary relationship between the academic community and the industry is critical to ensuring a robust national pharmaceutical research capacity for the development of medicinal products.

“The relationship between the academia and the pharmaceutical companies is complementary and naturally lends itself to the formation of joint research enterprises”, he stated.

Explaining further, he said while the academia brings strong insight into the fundamental mechanisms of disease along with expertise in patient care and clinical practice, the industry possesses the knowledge and tools to translate basic research discoveries into practical applications in patients. Collaboration between both sectors will therefore indicate a synergistic relationship between academic research and commercial activity.

The agency helmsman also urged the research institutions and the pharmaceutical industries to learn from the examples of India and China, by embarking on indigenous phytomedicines standardisation and have a local agenda for such research and development.

 On standardisation and quality control of herbs in Nigeria and Africa as a whole, he noted that there was a need for deliberate policy on medicinal plants standardisation, including the procedures and methods for sourcing, collecting, drying, processing, packaging etc. of raw materials from the field to the bottle, covering planting, manuring, tendering to harvest and storage of raw materials.

“We must have QC (quality control) and standardise extraction procedures and preparation of biomass to dosage form. Factors such as the use of fresh plants, age and part of plant collected, period, time and method of collection, temperature of processing, exposure to light, availability of water, nutrients, drying, packing, transportation of raw material and storage, can greatly affect the quality, and hence the therapeutic value of herbal medicines”, he stressed.

He also noted the indispensability of regulation, asserting that since herbal medicine is multicomponent, it would be difficult to isolate each plant. This therefore validates the need for standardisation, a strategy the Indians adopted for their Ayuvedic medicine and China for their TCM.

Orhii, who also appealed to manufacturers and processors of natural products to abide by the agency’s guidelines on registration of their products, decried the difficulties encountered in the process of regulating the activities of product manufacturers.

“Although Nigeria has a national policy on traditional medicine and NAFDAC regulations cover requirements for registration of natural products, with guidelines, getting manufacturers/ processors  to comply is still a herculean task, as control is incorrectly perceived to be ‘’discouragement” and “bottlenecks’’. However, we cannot continue to lament on the ‘’burden’’ of regulatory compliance, because it is a necessary tool for guaranteeing safety and quality”, he pointed out.

Health professionals laud Novartis as Voltaren clocks 40

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By Adebayo Folorunsho-Francis

Plaudits came the way of Novartis Pharmaceuticals Limited as the company celebrates 40 years of Voltaren (Diclofenac sodium), one of its foremost products.

Speaking at a colourful ceremony to mark the landmark achievement at Protea Hotel, Ikeja, Lagos on October 23, 2013, Pharm. (Mrs) Vera Nwanze, managing director of Novartis Pharma stressed that the company was pleased to announce the product’s 40-year success story.

She described Voltaren as a class of medications known as non-steroidal anti-inflammatory drugs (NSAIDs) that reduce pain, swelling, and inflammation for people with rheumatoid arthritis, osteoarthritis, and degenerative joint diseases of the hip.

Speaking in the same vein, Dr Adebule Gbolahan, consultant orthopaedic surgeon, Lagos State University Teaching Hospital (LASUTH) and chairman of the occasion, commended Novartis’ effort at raising the standard and sustaining the quality of its products, especially Voltaren, over the course of its 40-year reign.

Gbolahan who was a former chief medical director at the National Orthopaedic Hospital, Lagos, noted that many people – especially colleagues and patients often ask him why he preferred prescribing Voltaren ahead of other brands of diclofenac sodium.

“I never fail to tell whoever cares to listen that Voltaren is a product I can identify with easily because of its efficacy over the years,” he declared.”I am not saying this because I happen to be the chairman of today’s event. It is a fact! I would have even loved to have the presence of physiotherapists in this place to corroborate what I am saying.”

On his part, Prof. Femi Adelowo, consultant physician and rheumatologist, Lagos State University Teaching Hospital, relived to the audience how he cut his teeth as a rheumatologist in London around 1973, almost the same time Voltaren test was being conducted through random sampling on some animals to ensure its efficiency.

“Ever since it came into the market, Voltaren has wormed its way into the health of health officials” he attested.”I congratulate Novartis Pharma on her success so far in the area of pain management.”

Expressing gratitude for the numerous accolades showered on Novartis Pharma, Pharm. Oluwole  Ajao, head of marketing (Established Medicines) of the company, emphasised that Voltaren (diclofenac sodium) had taken care of unmet needs in pain and arthritis management.

While explaining that the benefits of diclofenac outweighed the risk, Wole however conceded that the key challenge in the society remained the absence of an NSAID that could completely wipe out chronic pain and arthritis.

According to him, the coming of Voltaren, available in oral, gel and ophthalmic solutions, had given birth to other sister brands like Cataflam, Flotac and VoltFast, and presently available in 140 countries worldwide.

Other eminent health professionals at the event include Prof. Olayemi Sunday, consultant physician and clinical pharmacologist at the Lagos University Teaching Hospital (LUTH); and Pharm. (Mrs) Nike Adekoya, chief pharmacist, LUTH. Also in attendance were scores of doctors, pharmacists and nurses.

 

FG canvasses foreign investment in health sector …as NAPPSA holds annual conference

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Honourable Minister of State for Foreign Affairs, Prof. Viola Onwuliri, has described the country’s pharmaceutical and health care sector as a lucrative investment destination for the international community.

She stated this at the 2013 annual Scientific Conference and Exposition of the Nigerian Association of Pharmacists and Pharmaceutical Scientists in the Americas (NAPPSA) held in Philadelphia, Pennsylvania, on September 19-22, with the theme: “Global Trends in Health care Delivery: Partnering and Building Sustainable Pharmaceutical Bridges.”

Prof. Onwuliri was at the conference to represent President Goodluck Jonathan, alongside a high-powered team, comprising three federal ministers, the Director General of the National Agency for Food and Drug Administration and Control (NAFDAC), Dr Paul Orhii, and several senior government officials.

The minister disclosed that President Jonathan was reiterating his invitation to NAPPSA and its members to partner with his government to advance the pharmaceutical sector and delivery of improved health care to all Nigerians.

Also speaking at the conference, the Honourable Minister for Industry, Trade and Investment,Dr.OlusegunAganga, gave an illuminating presentation on the topic, “Opportunities for Trade and Investment in the Nigerian Pharmaceutical Sector”, while Prof. Chinedu Nebo, Honourable Minister of Power, Federal Republic of Nigeria gave an equally engaging presentation on”Infrastructural Requirements for Transforming the Nigerian Healthcare Sector”.

The conference keynote address was delivered by Prof. OsagieImasogie, founder and senior managing partner, Phoenix IP Ventures LLC, Philadelphia, PA, USA. Speaking on the topic,”Building a Sustainable Innovative Pharmaceutical Sector: Lessons for the Emerging Economies,”Prof.Imasogie presented data to supportemphasis on the need for the Nigerian government to invest in the local pharmaceutical sector, both as an economic matter and to provide improved health care to its people.

In response to President Jonathan’s call, NAPPSA, through its president,FunmiAjayi, Ph.D., and immediate past president, NnodumIheme., RPh, commended the commitment of the FG in ensuring a successful outcome of the 2013 NAPPSA Conference, adding that the Association was delighted to accept President Jonathan’s renewed call for partnership, in order to advance healthcare innovation and delivery to the people of Nigeria.

The Association seized the opportunity to call on the president to order reopening of dialogue on prior partnering initiatives, including the 2011 Health Care Summit held in Abuja by NAPPSA. It also requested the federal government to develop and implement a “roadmap” to make Nigeria a major participant in the worldwide pharmaceutical enterprise, adding that such initiatives would help to alleviate poverty and achieve Nigeria’s Millennium Development Goals (MDGs).

NAPPSA further entreated the president to designate a position for NAPPSA to the Governing Board of PCN.

NAPPSA is a US-registered non-profit organisation, which serves Nigerian pharmacists, pharmaceutical scientists, allied scientists and the academia in the Americas.

 

The heart of enterprise

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Imagine you were in a state-of-the-art conference room and a renowned research and business development mogul was about to address the audience on his business principles.

Your pen was out and you made sure there was enough space on your notepad. Then he strode in, everyone suddenly became very attentive. Then with little ado, he mounted the podium and began to speak. Perfect silence prevailed as you took notes on his lecture entitled, “My School of Business.” Meanwhile, having been informed of the topic earlier, you had modified it into “The Abrahamic School of Business.” That had a deeper appeal to you as it reminded you of the speaker himself who happened to be a “FATHER” in the field of business.

Below are excerpts from the notes you took at the lecture, together with your observations on the gestures of the speaker and the reactions of the audience:

The primary reason for the vision is for growth — to make us partake of a different nature. You must be aware of who you are and why you are what you are.

 (Speaker pauses, and then continues)

 You must leave home. This implies emotional, spiritual and financial independence. The greatest hindrance to immense business capacity and thought is the entitlement mentality. Nobody owes you anything. You are indebted and responsible to God and humanity for resourcefulness. You’re not entitled to financial provisions from uncles, siblings and parents even when they think you are. The vision demands that you leave those.

 Establish a line of dependence – it is between you and God. Be responsible and get ready for the difficult times. The time of separation is a time of self-discovery and it is said that hardship introduces a man to himself.  Hardship does not imply poverty (though poverty is very much hardship). Hardship is a seed’s first day in the soil. It is the shedding of the seed coat — a degeneration that reveals the stuff within: life. It is designed to train you and not to kill you. Learn from it.

 Be independent, dependent then interdependent. After declaring your independence of people and establishing dependence on God as your source and authority structure, you will need to learn interdependence.  An independent man does not bend to the whims and opinions of others when they are not aligned with his God-dependent values. He is interdependent enough to listen to the advice and opinions of certain people (not everyone) but independent enough not to be coerced to any decision, indecision or hurried decision.

 our interaction with people should be born of choice and not under any duress or certain obligations. Dependence on God entails you don’t place yourself at anyone’s mercy or trade your honour and glory for rights or privileges.

 You are in business to be a blessing, to create value for humanity. You are blessed to bless. This posture assures that your own needs are met already; you will find this true when you adopt this mentality. It is a man’s gift that will make room for him, a man’s offering – a man’s talent. We are successful when we make our gifts (our unique abilities) our gifts (our proposals) to the society. Be a priest and a king. Remember the Melchizedek posture; the king of righteousness is the priest of the Most High.

 Come out to the King’s valley and present bread and wine to those returning from battle. Offer processed products, not raw materials; don’t come with flour and eggs, come with bread…and wine. Your bread and wine are the finished products and services you must offer to your clients.

 Do not be materialistic – let your internal scoreboard be more important than the external scoreboard. Never judge things by sight alone; be spiritual. Obey your spirit and divine instructions. Heed your “gut-calls”. It is your soul’s duty to be loyal to its own desire.

 There is no one-man army and you’ll need an army to win most of your battles. Therefore, you need to work with people but don’t expect all of them to share your values. You’ll have to work with folks who don’t share similar values. Respect agreements and deal charitably with everyone.

 Never forget that legal matters matter. File patents, sign non-disclosure agreements, memorandums of understandings, have witnesses and don’t have optimistic opinions about human commitments. Try and have guarantees when possible but don’t be embittered when you’re disappointed. Yes, get a lawyer. If you cannot afford one, have one as a friend or on your board. You can go the whole length and go to a law school! Anything you do, seek legal counsel.

 Eschew strife – it will kill you. Your kind cannot bear strife. It robs a man of his creative potential, changes his path of dependence and drains the hearty spirit that great enterprise demands. Let the acid test be your willingness and even readiness to give 99 per cent of your fortune away. Don’t hand over dynastic fortunes to your offspring; give them the intangible resource that made you great.

 Never forget to daily speak those things you believe – even when they seem impossible because faith will work in your heart even with doubt in your head. Speak and do not relent, you’ll be amazed how long I did.

 (He pauses and takes a drink…)

  Let your vision be global

(He said this with so much calm that you almost didn’t hear, but then the audience exploded, thrilled by the force of the oratory)

 Let your vision be global. Seek to bless the whole world.

(The hall was quiet again)

 Seek to be a blessing to your nation and to all the nations of the earth. Create products that will bless the ICT world, the health care industry, the insurance sector, pharmaceutical, banking, real estate, media, commerce, energy, entertainment, hospitality… These are the nations. For every industry, there is a culture and a language. They are more important than the geographical nations; bless both. In every sphere of influence, decipher the dream of the future and interpret it. Don’t stop there, though. Make a thorough proposal to the king or the management system. That is often a sufficient demonstration of your capacity to execute. We did that in Egypt. The king’s name was Pharaoh.

 Your proposals must be articulate and should create value. Before you ask, “what’s in it for me?,” find out if it will bless the king or he will not buy it. The king will not mind to crown you if you will make him greater. You must have an abundance mentality; there are plenty of resources on the earth. Be willing to give of your intangible resource and folks will supply your tangible needs.

 The way to be an owner is to create, and every creator is a father. That is why I am called Father Abraham. I have created in every sector, industry and nation.

 Every solution is looking for a man to stand behind it and such men are scarce. Be the man. You will need to begin locally and small, but have a global perspective. When you get to a land, walk through the land/industry. Do your due diligence, learn, research, collaborate and innovate. Keep developing competence and stay creative. Fatherhood is creation. Creation is ownership. The results of ownership will increase your purchasing/exchange power.

 Always allow compassion to move you to action. I’ve learnt that in helping others you meet your Melchizedek.

 See the invisible, embrace it.

 

Your vision, character, values, creativity and passion are invisible. Value the invisible resources above the visible. They are the sources of the visible. Things don’t happen to you; things happen because of you. We are not victims, we are creators.

 Your thoughts are things, don’t mess with them.

 (He adjusts the microphone)

I must tell you to forgive yourself when you make mistakes. There are things about your life you can never change, such as where and how you were born, some of the things that have happened to you and some of the things you did. Look at the past and please do well to heal yourself. Lock the door and say goodbye to these things.  There are things, however, you need to go back and resolve: some relationships and grave mistakes. Resolve them as soon as possible. After then, move on.

 I am not perfect, nobody expects you to be either; but let your intentions be perfect.

 In closing, always remember that the true test of character is persistence against odds. It will be required that you persevere at that which you believe and please never give up.

Thank you.

The arena resounded with a thunderous ovation as all stood to applaud. The revered “father” smiled and quietly walked out of the auditorium. You sat down to assess your notes. You resolved it was time to CONQUER!

 

Adapted from “The Abrahamic Posture” in “The Heart and Art of Innovation” by Nelson Okwonna, Onel Media Services, Lagos 2012.

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