AFARA 360

DIABETIC FOOT ULCER AND AMPUTATION

The right leg of Iya Rashidah was amputated last week. It was a devastating experience. Two months earlier, Iya Rashidah was making amala, turning it inside a pot while using her feet against two napkins to hold the pot steady on the floor. The usual way.

Unknown to her, a right toe was touching the pot directly & got heated up. That's where the problem started. The wound did not heal, the toe became black & dead, & the death spread gradually upwards.
----------------

On average, 1 in every 14 people in the world are diabetic. Diabetes is a deadly disease with a variety of life threatening complications if not well treated, including stroke, heart attack, blindness, kidney failure, and foot wounds that often result in amputations.

The truth is that this handicapping complication is preventable.
---------
The most important risk factor for developing diabetic foot wound is poor blood sugar control. Poor blood sugar control leads to a variety of abnormalities like nerve (neuropathy) and blood vessel (peripheral vascular disease) impairments. These together with weak immunity present in diabetics predispose them to foot wounds. The wounds may not heal easily & then progress to a stage when some body tissues become dead (gangrenous) and amputation becomes inevitable.

It is important to note that at this stage (when there is dead, black tissue, i.e. gangrene formation), failure to amputate puts the patient’s life at serious risk. The dead & harmful tissues will spread in the blood, cause severe sepsis & eventually the person's death.
--------------
Prevention is better than cure.
Here are 6 things to help prevent amputation. Tell someone & share!:
1. Good blood sugar control. She must be strictly compliant with her medications (drugs or insulin injections) & dietary modifications.

2. She must ensure regular specialist clinic attendance. The specialist will help to monitor her progress & review her medications & check for complications.

3. Good foot care practices
o Daily foot inspection, including the sole of the foot (using a mirror). She must check her foot every day or ask someone else to help her if her sight is impaired.
o She must wash her foot every day and towel dry it.
o She must always wear a footwear, even when she is indoors.
o But she should avoid the following footwear: Dunlop slippers and other slippers with soft soles (sharp objects may pe*****te), high heel shoes, footwear with open front (may easily have a wound if hit her foot against something), and tight wears including socks.
o Avoid applying the foot on hot materials, eg avoid Iya Rashidah's method of making amala

4. Good nail care practices
o When she wants to trim your nails, pls do so after a bath or following brief immersion in warm water, to make them soft. Nail cutter should be used, NOT razor blade!
o Nail manipulations (fixing, etc) of any form (especially for females) should be avoided
o Use of lubricants for dry foot is encouraged

5. Early medical intervention should be sought for any foot complaints or injury.
o Seek medical care immediately!
o Don't treat at home
o Don't wait till the leg or hand turns black
o Don't put 'gbere' (traditional cuts). It introduces infections into the wound.

6. Yearly comprehensive foot examination at the hospital is highly recommended

In conclusion, diabetic foot wounds (we call them ulcers) and resultant limb amputation is a severe debilitating complication that is preventable by strict blood sugar control and good practices.
Tell someone today.

Thanks Dr Oloso Aqib Afolabi for original submission.

It was not just an Honor, but also a Privilege to Partner With .404b2 on the Diabetes Awareness and Screening (Access to Diabetes Care .

A Special Thank You to and his team and the Entire Afara Medical Team.

#13 Caesarean Section (CS)
By Dr Ibiwumi A E-Bibi

Edima was my classmate in primary school. I saw her recently with her 6-year-old bound to the wheel chair due to Cerebral palsy. She said her only regret in life is refusal to deliver her child through CS.

According to Edima…"the doctor pleaded with my husband and I to sign the consent for a CS. He said it was necessary to save my child’s life because I had a small pelvis, and it would be difficult for the baby getting through the narrow passage.
We declined the surgery for religious reasons. I rebuked the CS, that I was going to birth naturally & never by operation.
Eventually on the D-day, I labored for 36 hours and my baby didn’t cry for about 10minutes after delivery. We have been in and out of the hospital seeking help for him since then. They say he may be needing the wheelchair forever."

Dear people,
Caesarian delivery is a process by which a woman delivers her child through surgery, by an incision on her abdomen. There are several reasons your doctors may decide that CS is the safest way for you to give birth. It may be because you're very short or have a small pelvis like Edima. Placenta problems, severe hypertension, or some conditions in the mother. It may be because the baby is distressed, or labour is not progressing well.

People who deliver their babies through CS are not cursed, not weaklings and are also Hebrew women. CS is just another method of delivery, like va**na delivery. One is not better than the other. As long as both mother & baby are healthy.

Make the right decision when you're advised to. Give every baby the ability to transition into the outside world without harming baby or you in the process.


-Dr Ibiwumi Atolagbe is an alumnus of the College of Medicine, University of Ibadan. A Primary care physician $ Public Health professional in Health Administration and Health Policy.

Medicine and SPIRITUAL HEALING
By Dr Oluranti Johnson Richard

4-year old Aduni was brought to the hospital by her parents with complaints of fever and neck stiffness which started before the child became unconscious. After the necessary examination and lab tests, the doctor explained to the parent that the child had meningitis. Treatment was started and the child was starting to get better. Glory to God!

While the medical team were still basking in the euphoria of the success of the treatment, the father came up with a stern request to discharge his daughter. He had gone to consult a spiritualist who told him all the child needed was spiritual intervention. All efforts to counsel the parent proved abortive.

Poor Aduni was taken away against medical advice.

5 days later, she was rushed back to the emergency room. But it was too late. Aduni was dead already.

My dear patients,
I'm not against African healing method or prayers. Prayer is necessary, prayer is very effective. I believe in the supernaturals, I believe in God.

But, please, don't keep a sick person anywhere apart from the hospital. Let the sick person be receiving care in the hospital while the spiritual healers engage in spiritual warfare/appeasing of the gods, on behalf of the sick, from the spiritual homes. The effect will reach the sick person in the hospital.

This is called joint effort. aka Team work.

Remember, the force of the supernatural can travel any distance within seconds....to reach the sick person and heal her.


-Dr. Oluranti J. Richard, an alumnus of the University of Ibadan College of Medicine is an author and public health commentator, focusing on promotion of women's health and allied matters. He's a passionate advocate for a healthy & friendly doctor-patient relationship.
Cc Oluwatunase Oluranti Racheal Oluwatopraise

#11 Paracetamol is not a cure
By Dr Adenike Ogunde Oluleye (Paediatrician, University College Hospital, UCH, Ibadan)

Mother brings 3yr old to the hospital. The child is very ill, pale (palms & under-feet are almost white), breathing fast & in a coma!

Dr: When did his illness start?

Mother: He started with hotness of the body, for over a week now. Off and on. But I have been giving paracetamol.

Doctor examines baby, & does some tests. Confirms child has severe malaria and very low blood levels (severe anaemia). Child receives appropriate medications & blood transfusion. He makes a full recovery and he goes home.

Dear parent,
Paracetamol is not a cure for fever. Fever means hotness of the body,& it is a sign that something is going on in the body. Paracetamol may relieve the fever temporarily but will not cure the underlying cause.

It is important that every fever in a child is properly investigated & treated. If not, it may result in complications and you end up spending much more thousands of Naira on a condition that could have been easily treated with cost-effective oral medications.

In this boy's case, paracetamol relieved the fever but did not cure malaria. Hence it became severe, the boy became very sick, lost consciousness & even needed blood transfusion.

-Dr Adenike Ogunde Oluleye

The newly chartered Lagos Knights of the Blind Cyber Lions Club @ campaigned on solagoskobcyberlccial media to raise awareness on childhood cancer and provide emotional support to children and families affected by childhood cancer through impactful messages of hope.

In partnership with an NGO advocating for high quality, safe and patient-centered care, the club will also distribute fliers with childhood cancer facts and preventive measures.

The Charter President, Lion Olawale Olapegba MJF, NLCF commented on the first project of the Club “Beyond giving food and gifts to cancer patients, the world needs messages of hope to these brave kids. We saw the need to go for gold - to identify and connect with them, their families, and the medical teams. This is more about meeting emotional needs and ”

#10: The danger of non-expert advice
Two quick stories:

Story 1) Mrs A: I've got this terrible headache. For over a month now. I've used all sorts, but it's still there.
Mrs B: Ha, I know that one. I had exactly that type of headache in December. The doctor gave me these drugs a, b, & c. After using the drugs, headaches disappeared. Take, write down the names, you should use it too.

Unfortunately, Mrs A has a tumor in the head, something more serious & entirely different from what Mrs B had. In fact, one of the drugs will cause severe complications in Mrs B.

Story 2) There is this woman, & her new baby developed jaundice (yellow eyes & skin). Her neighbour advised her to put the baby under the flourescent light/bulb in the house. Because it is similar to the phototherapy light that is used in the hospital to treat jaundice.
The little baby ended up having irreversible brain damage!
Read her full story here: https://bit.ly/2PRJphA

Simple takeaway: apply caution in taking non-expert advice. Apply caution in self-medication. Both can harm.

-drsaidah

#9 Auxiliary nurse: Jack of all trades, master of harm.

Mrs Tope is not feeling fine. She calls Anty nurse, the auxiliary nurse on the next street. Anty nurse gives Mrs Tope drips for 2days, several injections & 6 satchets of drugs. She even collects blood in a syringe and tells Mrs Tope she will test it.
Anty nurse- the nurse, the doctor, the pharmacist & the lab scientist. Jack of all trades.

Mrs Tope feels better and goes back to work.

Some weeks after, Mrs Tope lands in hospital after she collapsed at home. She had diabetes, she was in coma and her kidneys were failing.
------------

Dear Patients,

Know that 'auxiliary nurse' is just a fancy name for a quack.
Someone who can kill you.
Because she doesn't quite know what she's doing
Because she doesn't understand the human body
And she doesnt know the science behind the treatment she's giving you.
She was trained by quacks, merely by observing trial & errors, in private hospitals that employ her as cheap labour.

If the treatment doesn't kill you, it could kill you slowly. And like in Mrs Tope's case, you'd think you have been treated. When in actual fact, the illness is still there, spreading & getting worse.

It's your life. Why entrust it to an auxiliary nurse?

NB: 1) In some countries, like the UK, auxiliary nurses play a genuine role as health assistants. Their training is sound & their practice regulated.
Until Nigeria gets to that stage, protect your life, protect your organs.

2) Kudos to all registered nurses who are well trained & enforce ethics of the profession. We love you.

-drsaidah

In this new month, Your Joy will be complete, Victory Songs will not cease from your Mouth and Each New Day will bring you closer to the Fullness of your Destiny.

Happy New Month!!!

#8 Body SCAN or SCAM?
By Dr Khadijah Folake-Sanni Tijani

So, there is this new oracle, or sorry, technology.

Just pay a bill of 3000 naira and place your palm on the machine. It analyses your entire body and bam! It gives you an instant rundown of all the problems in your body! Lol!

Even if you don't have any ailment, the machine will manufacture one for you because, of course, the vendors are also selling the remedy for that 'ailment'. You don't need to be a skeptic like me to know that something is wrong somewhere...

There was once a man told his 'amino-acids' are low!

At least, go for a second opinion (like a laboratory test or speak to your doctor) before you start bombarding your system with that remedy.
- Dr KT

#7 Tell the truth.
By Dr Oluranti Johnson Richard

Few weeks ago, Mrs XY came to the hospital with labour pains....

Doctor: Have you 'seen water' (drained liquor/ baby-water), and when did this happen?

Mrs XY: I saw water 2 hours ago.

Fast forward....Mrs XY delivered her baby 4 hours after hospital arrival.

Next day, baby developed high fever, & shortly after her eyes and skin turned yellow. Baby became really sick!

The doctor knew something was wrong & interrogated further. Mrs XY then owned up that she had 'seen water' since over 2days.
----------------------------
Dear patient,
Please when you go to the hospital, be ready to tell the true story about your complaints to your doctor and nurse.

Hiding some truth or telling lies will delay or hinder your care and can lead to the doctor making a wrong diagnosis and of course, a wrong treatment entirely. Telling your doctor the whole truth will help him/her to know what other question(s) to ask you, which laboratory test(s) to request for, help make an accurate diagnosis and hence a specific treatment and make you get well faster.

Had Mrs XY told her doctor the truth, she would have been given specific treatment immediately and the baby too would probably be given some preventive treatment after birth.

It pays to tell your doctor the whole truth, it is from the information you give the doctor that he/ she will know what treatment to give you.
Your doctor is a scientist, not a magician.


-Dr. Oluranti J. Richard, an alumnus of the University of Ibadan College of Medicine is an author and public health commentator, focusing on promotion of women's health and allied matters. He's a passionate advocate for a healthy & friendly doctor-patient relationship.
Cc Oluwatunase Oluranti Racheal Oluwatopraise

"...I’m a victim of your strike
Dear Nigerian Medical Doctors,
This is an open call, not blind from your pains, but urging you to have a rethink...In 2008, I started having issues with my sight. Thought it’s minor and visited nearby private clinic in Lagos. In 2009, the average was getting bad. So, I visited Lagos State University Teaching Hospital (LASUTH).
After series of test, I was told to come back in the next 9 months before I can meet a consultant. Going back for my next appointment, medical doctors were on strike and I had to go back to the old nearby clinic. In 2010, I already lost one eye and in frustration, I stopped going to LASUTH when I was told to queue again for another 6months.
I attempted UCH Ibadan between 2010 and 2011. Again, between this period, I only met an ophthalmologist once and in the process of struggling to get appointment with a retina consultant, medical doctors went on strike again.
In 2012, I approached one of the biggest private eye hospitals. Before they concluded on surgery, I needed to use one of the labs in the Lagos state government hospital for test. Around same period, medical doctors went on strike again. Though I later undergone the surgery, but too late. I lost total sight same 2012.
You see, the entire salary and other demands you are asking for was later given to you, but I had lost my precious sight and cannot regain it. But this is neither about Rasak nor regret. There are thousands of lives that we have lost owing to incessant strike by medical doctors. Hundreds have become persons with disability owing to this. I know them. I often meet them. And their tales break my heart.
Unfortunately, insecurity has led to hundreds of persons death daily, yet our government cannot prioritise strengthening our health system to save life’s. If majority die, who will they govern? And who will pay the tax for them to pay you?
This piece is an appeal to all striking medical doctors in Nigeria. Please, shield your sword. Nobody life is worth losing to unavoidable causes. Let’s deploy other innovative methodologies of pressurising government to provide your demands. And I hope one day, Nigerian citizens and youth will rise to helping essential workers like yourself demand for change.
The wealth of a nation is in the health of its citizen. You are life savers, not killers.
"

I'm just sharing. Stories of how healthworker strikes are impacting citizens on a longterm basis. I don't know who is to blame for the strikes. And who it is doesn't matter after all.
-drsaidah

#6 by Dr AbdulAzeez Tunde Lawal

Get tested for HIV!
If you think you’re at risk of HIV, go for a test.
If you think you're not at risk, get tested. It will put your mind at rest.
You've heard this before & have never done it? Go get tested.
Then, subsequently, you do it once a year.

There is no other way to know; & the test is quick, easy, & often free. Just a needle prick.

Early diagnosis and early treatment is better. It is the only way one can live with HIV and not suffer from it. HIV is no more a death sentence. With drugs, people live a completely healthy lifestyle.

HIV no dey show for face.
Don't catch it, don't spread it. Get tested!
-Dr AbdulAzeez Tunde Lawal

Dr AbdulAzeez Lawal, a prize-winning medical graduate of the University of Ibadan with experience in HIV/AIDS and TB care, is committed to efforts at raising an AIDS-free generation in Africa. He tweets from

Happy New Month! 🥳🥳🥳🥳

#5 Malaria: 5 giveaways

If you're reading this, then you have likely survived malaria couple of times.🏅But do you know these 5 simple things that will save you a lot of hassle and been scammed?🥇:

1)The correct treatment of choice in Nigeria is Artemether-Lumefantrine. It's what is commonly sold as Coartem, Lonart, Amatem, etc. The other alternative is Artesunate-Amodiaquine ( sold as Camosunate).
NB: Above drugs (Artemisinin Combination Therapy) are a combination of 2drugs. Malaria is no more treated with just 1 drug, such as Fansidar.

2) Chloroquine tablets/injections: is no more the treatment for malaria. Malaria has become resistant to it, so it is not effective anymore. Ask to confirm that's not what you're being given in clinics that give you unlabelled medicine satchets.

3) If an auxiliary nurse or clinic gives you injections for only 1 or 2 days, & says that's all. It's a scam. Treatment is for at least 3 days. And after injections, you still have to use the combination therapy mentioned in number 1 above.
(By the way, why are you taking injections? See #2 of this series)

4) Some private clinics tell you it's typhoid. It is very very very very very likely that you only have malaria. They tell you it's typhoid so they can admit you, give you drips and so you can pay heavily.

5) Note: not all fevers are malaria. Fever is one of the first ways the body reacts when there is an illness. So, it could be something else. That's why we recommend testing (Malaria Rapid Diagnostic Test). Your doctor will explore other causes depending on what you complain of.

If you're correctly treated, you'll be sick less often. And together, we can gradually eliminate malaria in Nigeria. Down to ZERO.
-drsaidah

#4
Dear patients,

We know you use these drugs.
Some years back, it was Trevo,
Now, it's Cellgevity.

You believe these drugs are miracle-medicines
They cure all. Diabetes, Cancer, Arthritis, Infertility & what-have-you.

Just a few things we want you to know:

First, there is no such drug as these that truly is a cure for all diseases.

Those who push it your way, do so not out of love, but because it's business for them.

There are many convincing stories of how these miracle-medicines cured cancer and HIV. Maybe we should start telling you stories of how these same people eventually end up in our clinics with complications, terminal disease and at the point of death.

These supplements delay & distract you from seeking correct care or cure.

Don't fall prey.

Ultimately it's your choice, but we just wanted to put it out there so you know.
-drsaidah

From kidnapping to housing,
To the price of rice,
Everything impacts health.
In fact, did you know?
Your health is determined-
Not by the hospitals,
Nor doctors or nurses-
But by the environment in which you're born,
you grow, live, and work

#3
Medical Tests are Necessary

When your doctor requests you to do some tests, it's to help him reach an accurate diagnosis and plan your treatment.

Don't run away from them.
Dont be penny-wise and pound-foolish.
Dont run to those who would treat you blindly, give you a concoction of several drugs and cause more harm.

I once met a woman complaining about her baby in the waiting area.
"Ara gbigbona yi naa ni. Ko si n kanmi. (It's this fever. Just fever. Nothing else)." The babe looked frail, unwell & fast breathing. He looked 4months old, but was infact 8months old.

She lamented how some months earlier, a doctor had treated the fever and requested blood tests and body scans. She chose not to do them, & anyway 'my boy is fine. It's just the fever. He sleeps well, he eats well.'
So here she is now, trying out another doctor/hospital. In between, she had tried other things, but the fever returned.

It's obvious there was something more serious causing the fever. Something halting his growth. HIV, congenital heart disease or something else.
So, of course, in addition to examining the babe, the doctor would require tests.
-------------------

Takeaway: The next time your doctor requests tests, it's because you need it. And yes, feel free to ask us why you need it.
-drsaidah

#2
Ok. Let's face it.
You think if you haven't had injections, you cannot be fully well?
You think the clinic or nurse giving you injections is doing you good and knows work better?

Don't be deceived.

--> It's 2021, but people are still getting infected with hepatitis or HIV through reused needle injections.
--> Some people are wicked, what they're giving you is just sterile water. Yes, water, 'omi', 'ruwa', 'mmiri', that's it.
--> Some are even more wicked, they give you what will harm you. Gentamicin 960mg stat. That one goes for the kidney, destroying it small, small.
--> Or they'll give you the one that pains you straight into the bone. Chai! Doesn't mean it's more effective. It's probably Analgin or Novalgin that has been banned since.

--> Anyways, those that even do it right, you may still get a buttock abscess. And in the very least, you'll pay double or triple for the same drug you can swallow.

Why not just use your 'tablets'? Injections are not to be abused. They should be used only in special conditions:
-You're vomiting and cannot take tablets
-In an emergency
-Some few special conditions.
It's 2021. Wake up & stay woke.

#1
Believe it or not.😜
Med school was tough,
But U were the reason we stuck.

At nights & weekends, on call
Our wives, husbands & kids, our beds
We desert,
U are the only reason we would.

On our feet in theatre, for hours
Without food, & not taking a p*e,
We keep our eyes on the prize: your health.

We are here, everyday, because of u.
We love you, we really do.
---------------

PS: We acknowledge there are systemic inefficiencies working against you appreciating us.😟

A rerun of our series will be going live soon!

This high-impact health education posts were first published in 2019/2020, and we are publishing it all over again so that people can revisit the insights therein and many more people can benefit therefrom!

Enjoy. Share with others. Ask questions and drop comments. Be health-empowered!

Hey you, aburo Pinocchio! You believed this when 'they' forwarded to you? 🤣



Design: Husseni Muhammed Adeniyi

Shouldn't we be testing more? Are we living in blissful ignorance?

WORD-on-da-Street
We did a quick walk-through the streets of a community in Lagos yesterday, to get a pulse on the opinions of people in the markets & streets are.

Overall: 🕎practically every adult has heard about the new disease in town. Popularly called Corona, Krona.✔🔆

Below are some of the ridiculous things we heard:
1. My God is bigger than Corona
2. Buhari. This Buhari's time is tough sha. Nah his time we dey see bad bad things.
3. Coro for where? We are prayer warriors in this country.
4. Corona, why now? We have our own problems already- no light, no money…
5. Corona be kiaful, nah Nigeria you dey go
6. It can't survive in Nigeria. (Reasons posited include: we have immunity. There are very potent herbs. The hot weather. Black skin.
7. Are we sure there is any Corona? It's a way to siphon funds
8. No, I don't believe any of it. There is no Corona

Our recommendation
While the awareness has gotten better, there's a lot more needed.
>>>The government should employ targeted means of reaching people at the very grassroots.

>>>You. Spread the message. Warn your neighbors. Call your parents. Share the current status with them.

Cases of are increasing in Nigeria. And this is the best advice we can give you.

What challenges do you have staying at home? Share with us.

Anxiety and fear doesn't help much in times. Share some positivity, people! It's not all gloom.

It’s tremendously comforting to see some good news surrounding coronavirus for once. Share the positivity. Tag someone who needs a little positivity right now 🙏🏽❤️