Wednesday, 27 May 2009
Wednesday 27th already!
Today had another early start, this morning we had to return to Ketu, this time to appear on a morning TV show, as a result of yesterdays radio show. I nervously got ready and I felt slightly more anticipation about this as live TV is less forgiving than a radio show. Femi picked me up at about 07.30, and on the drive to Ketu we discussed the points that we wanted to try and get across, including the need for donations to sustain the charity and to help it grow.
When we arrived we were greeted by the make-up artist, who proceeded to powder our faces ready for the studio lighting (even Femi benefited from a touch of make up!). It is children’s day here in Nigeria and we were linked to this theme. The presenter welcomed us and asked many questions, about my trip, how I was finding Nigeria, what are then main issues I have noticed regarding health, and how could the government improve things in Nigeria. To this last question I felt I had to reply with the fact that I am not a politician and do not know enough about these issues to answer and I added that I would hope to come back to the country so thought it best not to get on my soap box, potentially up setting the government.
Our slot went on for about 20mins and in this time Femi and I was able to get across quiet a bit of information with regards to Wish for Africa and the future plans for Optimal Medical Centres. We were able to mention certain things that would make an immediate difference such as a portable scanner, generators, descent medical supplies/equipment, text books, skilled people to come and share there knowledge and train staff. I pointed out that many people can do something. If I am capable of doing this with odds stacked against me such as newly qualified, work commitments, family, white, female etc then others could too, each offering what ever gift the have.
After this we headed again to the clinic in Ketu, today was antenatal clinic, so I went in with Dr Yussuf to observe and question practices. I also give them a sonic aid to be used within this clinic and demonstrated its use. It soon became apparent how much they don’t do, that we do in the Uk, and the primary reason was cost that would have to be passed on to the patient. In this and other deprived areas people just can’t afford the additional cost of things that are routinely done back home. Scans are rarely done unless true indication (no dating or anomaly scans). Blood is tested for HIV and Hep B but if they don’t routinely do full blood counts. At this clinic routine urine testing with a dip stick is not done again due to increasing the cost. Although folic acid and iron is given to all, assuming that most have poor diets and will require it. From the world health organisations recommendation all women receive prophylactic malaria which payment for medication is subsidised.
I was able to have an immediate influence on encouraging them to measure the fundal height (routinely women are measured from top of there pubic bone to where the top of the womb is felt roughly weeks = centimetres, so if you were 28weeks you’d measure 28cms +/- 2/3cms). They just do a visual inspection and use fingers which is a good skill to keep but it’s simple enough to do both and allows for accuracy in detecting too much or too little growth.
The women also liked the fact that they could also hear the heat beat when we used the sonic aids. One woman who had three previous miscarriages possibly due to her being Rh neg (blood group) and not receiving anti D in her first pregnancy (something that helps your body stop building up antibodies and potentially causing problems with future pregnancies). When I found the heart beat that although she was about 32 weeks pregnant she had not heard before, she gave a huge smile and tears came to her eyes. Something else fairly simple that we take for grated in the UK.
Back to the Anti D issue, this is something that is offered to all women that have a negative blood group in the UK, during their pregnancy and if the baby is a positive blood group they will be given it again after delivery. If this woman had wanted it here, she enquired to the cost at the pharmacist and it was between 10-12,000 naira (about £40-45). An average weekly wage in this area is probably about £10! The minimum wage here is 5000 naira a month (£20) but this as with most things is not well enforced.
This woman’s case also lead us into discussion on her delivery, she had previously had a caesarean section but (probably due to cost again) was keen to have a normal delivery. We spoke about how she would have to be watched (I hesitate to say monitored!) and not be allowed too long a labour this time. This allowed me to point out the lack of consistency in their paperwork with regards to the recording of times when things occur and the potential indications for these omissions. Dr Yussuf was very receptive of my comments and suggestions, he was also happy to show his staff how to measure women and how to use the sonic aid etc.
My evening ended in the restaurant of my hotel, a nice quiet meal I thought. Well Manchester United v Barcelona on the tele and a room full of very excited men. All shouting for Man Utd and of course as an avid fan myself I couldn’t but join in! Disappointed by the score I headed up to my room. I received a text from Michelle, our mid week church cell group were meeting at hers. This meant only one thing skype cell, which was great as friends from China are heading back this week and another friend is going to Russia for a week so a great opportunity to pray and be part of home. Thanks all x.