Historic health plan led by Africans for Africans

Historic health plan led by Africans for Africans

On a dusty road in Ghana’s bustling capital Accra, history was made recently.

In a landmark first, world-renowned African health experts, professionals and academics converged under a single, newly-formed health organisation, African Forum for Research and Education in Health (AFREhealth), to map out solutions to tackle the continent’s health challenges – led by Africans, for Africans.

It was a defining moment as African health solutions have almost always been guided by Western experts.

The continent’s leading health figures debated and discussed a continent-wide campaign to tackle key bottlenecks to health solutions in Africa. At the heart of this was the clarion call to African governments to prioritise health care in their countries, to do more to retain local health professionals and curb the exodus of their skills to foreign markets, and for more investment in supporting African health research to ensure locally-relevant- and- led health solutions.

“An African-led think tank in health is the game-changer for the continent,” Ghanaian-born AFREhealth chairperson, Professor Peter Donkor, told delegates.

Nurses, doctors, community health workers, surgeons, professors, health ministry leaders, government ministers – came together for the first time, under one umbrella body with a common cause: improving the health outcomes in Africa as a continent.

Despite the differences in cultures, languages and governments, there was a common thread in the representing countries health direction: a growing shift to a primary health care (PHC) approach, a concept at the heart of South Africa’s National Health Insurance (NHI) system expected to replace the curative health care approach in the next nine years.

The PHC system relies heavily on community care and prevention of diseases, hence the need for more basic services at clinic level.

It is a system aimed at raising awareness of health issues and driving prevention. For this approach to work, South Africa will need more nurses and doctors trained as family physicians, and willing to work in rural areas.

It is a formidable challenge.

Latest reports indicate a rise – 60% – in the number of doctors and nurses leaving Africa to work in Organisation for Economic Co-operation and Development countries which include most of Europe. Added to this are reports of more South African graduate doctors refusing to work in state health care facilities, while foreign doctors remain more willing to work in rural areas.

A recent study by Econex revealed up to 80% of newly-qualified doctors chose not to work in public health facilities. South Africa is addressing this, through its Cuban health partnership, which sends hundreds of its medical students to Cuba each year to train as family physicians.

“The idea is to drive exposure of community health care, in line with the impending requirement of the NHI system and to encourage retention at rural level. But there are no guarantees they will take the bait and remain loyal. “South Africa is not alone. The exodus of local health skills is a serious concern across the continent, as graduates leave for more lucrative markets. It’s a key concern weighing heavily on the mandate of AFREhealth and one the organisation is well aware of.

“We know our continent faces a brain drain and while we will never stop it, we can do more to manage it better,” says renowned Ghanaian professor and key AFREhealth member, Francis Omaswa.

“One of the ways we can do this is to encourage the World Health Organisation Global Code of Practice on the International Recruitment of Health Personnel, which promotes voluntary principles and practices for the ethical international recruitment of health personnel, taking into account the rights, obligations and expectations of source countries, destination countries and migrant health personnel.”

Campaigning internationally for countries to adopt the code of practice while working towards creating an environment which retains health professionals locally are some of the plans being rolled out to combat the skills shortages on the continent.

“It won’t be easy. We will need to increase rural health experiences of our medical students and ensure they have an enabling and supporting environment to assist in their experience. But it has to be done,” says deputy chairperson and Stellenbosch University’s Professor Marietjie de Villiers.

Until now, collaborations in health on the continent have been largely driven by funding commitments to international donors. While this worked, Africa remained hamstrung by not being able to set a local agenda, often frustrated by stringent international criteria.

“We must stop this reliance on international funding to resolve Africa’s problems. We need Africa to rise and not to look at Harvard and Oxford solutions to what is happening in Africa,” said Liberia’s Professor Vuyu Kanda Golakai.

With funding on the decline from international donors, African health leaders embarking on the mission to go it alone will need to drum up more support locally if they are to succeed.

The mission to “lead with African health solutions by Africans” cannot be left to them alone. It is a collective responsibility and an obligation on all African governments and educational institutions to support if the continent is to benefit.

Resource-constrained environments where health workers often have to do so much with so little can only be understood by those who share similar experiences. AFREhealth will need Africa behind it if it is to become a global leader in African health solutions. It’s not an impossible feat

* Teke is a communications consultant.

Meet Sandile Kubheka, the Youngest Medical Doctor in Africa

Meet Sandile Kubheka, the Youngest Medical Doctor in Africa

Stories of the success of young Africans are inspiring. They tell us of young spirits that are daring to battle the odds just in order to further the development of the continent. One such inspiring story is that of Sandile Kubheka.

In 2013, Sandile Kubheka made history in South Africa and on the continent as well by qualifying to be a medical doctor only at the age of 20. His success story still endures up to this day, as does his daring ambitions. He graduated with a Bachelor of Medicine and Bachelor of Surgery (MBChB) from the University of KwaZulu-Natal. Sandile had distinctions in obstetrics and gynaecology. The young and passionate doctor had already made his mark, a lasting legacy.

Sandile Kubheka commenced his formal education at the tender age of five. At age 15, he matriculated from Siyamukhela High School and from then he enrolled for a Medicine degree. He graduated from the UKZN as the youngest graduate, and at that time was very elated that he had also become the first person in his family to acquire a medical degree. He is the youngest in a family of five children.

Striving towards answering the call to heal patients suffering from tuberculosis, HIV and diabetes is something that motivated him to embark on such an amazing journey, and he continues to do so. When he enrolled at UKZN’s Nelson R Mandela School of Medicine, he served in the Rural Development Club, the Happy Valley Clinic and on the Medical Student’s Representative Council. It has always been his passion to heal people that has propelled him to great levels of success. He was selected by his classmates to receive the Yashiv Sham Bursary for having compassion and caring qualities and the Enid Gordon Jacob Good Fellowship Prize for character and good conduct.

He enjoys working with rural communities and also enjoys giving back to the community. In 2016 he said, “I love working especially with rural communities which often don’t have easy access to medical treatment. I assisted in registering the Happy Valley Clinic as a Non-Profit Organisation during my student years and will continue to work with disadvantaged communities in the future. I’ve had a very humble upbringing and my mum, who raised me and my four siblings on her own, greatly assisted in keeping me grounded. I am the first to qualify as a doctor in my family.”

Kubheka has always repeated that he is very proud to be a beacon of hope for the young generation. He did his internship at Grey’s Hospital and he has openly expressed his wishes to enroll for a Master’s degree in endocrinology.

Doctor Sandile Kubheka is a clear attestation that age has got nothing to do when it comes to making meaningful contributions and change in society. He dared it all, and the hope he continues to inspire in young people is of high magnitude.

India making a strong statement in medical tourism: Rita Teaotia

India making a strong statement in medical tourism: Rita Teaotia

India has started to make its presence felt very strongly in the medical tourism sector that was initially dominated by developed countries like the US, Singapore and Malaysia, Commerce Secretary Rita Teaotia said today.

She was speaking at a conference here on the third edition of ‘Advantage Healthcare India’ Summit, slated to be held in Bengaluru on October 12-14.

Over 70 countries and 600 buyers from Africa, the Middle-East, Europe, the US, the UK, and Asia are set to take part in the event. The summit is meant to promote India as a premier global healthcare destination and streamline healthcare services export.

The government, she said, has liberalised rules to make it “very easy” for foreign tourists to get a visa for medical treatment in India. “Last November, the Government of India actually liberalised the visa regime to make it very easy now to get a visa for medical treatment. If anybody is still facing any problems on that, we would be happy to support them,” Teaotia said at the conference organised by Ficci here.

However, she suggested that the domestic healthcare industry should come together and analyse the policy interventions needed to boost the sector’s prospects. “… The domestic (healthcare) industry must also come together to talk about what it is that we need to do together, what are the policy interventions we need or the regulatory framework we need in order to serve our clients much better, whether they are domestic or international to look at the quality issues,” the secretary added.

Ficci Secretary General A Didar Singh, who also spoke, felt that medical value travel can be a USD 9 billion opportunity for India by 2020. “To fully exploit this potential, the country needs to diversify its sources of medical tourism and create a strong value proposition for foreign patients by focusing on parameters like cost effectiveness, alternative medicine, clinical outcomes, tourism friendliness, accreditation, and patient centricity,” he said.

Advantage Healthcare India 2017 will showcase the country’s medical capabilities and create opportunities for collaboration between India and other nations to boost healthcare services export. The medical value travel industry has emerged as one of the fastest growing segments of Indian tourism industry. According to a Ficci-IMS report, more than 500,000 foreign patients seek treatment in India each year, making it a key medical tourism destination in Asia.

Africa: Study Links Malaria Rapid Diagnostic Tests to More Antibiotic Prescriptions and Finds Ignored Results

Africa: Study Links Malaria Rapid Diagnostic Tests to More Antibiotic Prescriptions and Finds Ignored Results

Malaria experts say the use of rapid testing is a major asset in the tool kit of malaria fighters. Further research and improvements in after-test treatment are required, because transitions to use of new medical technologies typically raise more questions, whose answers lead to additional advances. Below is the text of the press release issued by the American Society of Tropical Medicine and Hygiene.

Study Links Malaria Rapid Diagnostic Tests to More Antibiotic Prescriptions and Finds Ignored Results

Scientists find curbing the overuse of antimalarial drugs often replaced by overuse of antibiotics instead; study also reveals puzzling cases of malaria patients testing positive yet going untreated

Oakbrook Terrace, Ill. (August 7, 2017)—Rapid diagnostic tests (RDTs) for malaria are reducing overuse of malaria medications but may also produce a range of unintended results, according to a comprehensive new study published today in the American Journal of Tropical Medicine and Hygiene. An analysis of more than 500,000 patient visits across malaria-endemic regions of Africa and Afghanistan found that in most settings, introduction of RDTs improved antimalarial targeting, but negative test results prompted a shift to antibiotic prescriptions. Even more concerning: a substantial number of patients who tested positive for malaria appeared to go untreated.

Researchers from the London School of Hygiene and Tropical Medicine (LSHTM) found that, overall, RDTs are effective at limiting—though not eliminating—what had been a common practice: routinely prescribing powerful malaria medications known as artemisinin combination therapies (ACTs) to patients presenting with fever but without malaria, which could accelerate the emergence of ACT-resistant malaria.

“But we found that in many places a reduction in the use of ACTs was accompanied by an increase in the use of antibiotics, which may drive up the risk of antibiotic-resistant infections,” said Katia Bruxvoort, PhD, MPH, an assistant professor at the London School and the lead author of the study. “We also don’t yet understand why some patients who tested positive for malaria were not treated with ACTs.”

The scientists believe the shift to antibiotic use after ruling out malaria, which also was explored in a March study in The BMJ that included analysis of some of the same patient visits, may indicate that many patients and providers are not comfortable with what might be the best approach to treating many fevers when malaria has been ruled out: taking a fever-reducing drug (like ibuprofen or paracetamol) and drinking plenty of fluids.

“A key challenge is that we don’t currently have a reliable way to determine which fevers are evidence of a bacterial infection that requires a specific antibiotic treatment and which fevers will resolve with supportive care only,” Bruxvoort said.

Bruxvoort and her colleagues analyzed drug prescriptions written from 2007 to 2013 in 562,368 patient encounters documented in 10 related studies—eight from sub-Saharan Africa and two from Afghanistan—conducted by the ACT Consortium, a global research initiative investigating key issues around anti-malarial drugs.

This expanded analysis also revealed:

• In most areas studied, which included clinics in Ghana, Cameroon, Tanzania, Nigeria, and Uganda, antibiotics were given to 40 to 80 percent of patients who had tested negative for malaria.

• In many areas, a negative test for malaria was only partially effective at limiting ACT prescriptions. For example, in two areas, Cameroon and Ghana, 39 to 49 percent of patients who tested negative for malaria still got ACTs.

• Overall, 75 percent of patients studied left the clinic with either an antibiotic or an ACT.

Even more surprising, the scientists said, was finding that in five of the eight African studies included in this analysis, more than 20 percent of patients who tested positive for malaria were not prescribed ACTs.

“Drug supply issues did not seem to be a problem in most of the areas where these patients sought treatment,” Bruxvoort said. “There might be other reasons either patients or providers are not using ACTs in these contexts, but the issue of undertreating malaria, even when there is clear evidence of the disease, is troubling and deserves further study.”

Use of RDTs for malaria has soared since 2010 as officials from the World Health Organization have sought to reduce unnecessary prescriptions for ACTs, thought to be a major factor in the rise of drug-resistant malaria in Southeast Asia. In Africa, which accounts for the large majority of the world’s malaria infections, ACTs have been a major factor in the 60 percent drop in malaria deaths over the last 15 years. Experts fear those gains could be rapidly reversed if ACT-resistant malaria spreads across the continent.

Meanwhile, overuse of antibiotics is implicated in the global rise of antibiotic-resistant infections that are becoming one of the world’s biggest public health challenges. A report last year commissioned by the United Kingdom estimated that 700,000 people die each year from infections caused by drug-resistant microbes.

“In addition to the important concerns raised by this study, it demonstrates the value of researchers who carefully follow the real-world impact of malaria innovations like rapid diagnostic tests,” said Patricia F. Walker, MD, DTM&H, FASTMH, and President of the American Society of Tropical Medicine and Hygiene. “The number of patient encounters documented here is extraordinary and provides an unvarnished assessment of why treating a patient who walks into a clinic with a fever remains a complex challenge. Technology alone cannot solve complex health problems; community and provider education, as well as health system changes, must occur hand in hand to improve patient outcomes.”

About the American Society of Tropical Medicine and Hygiene

The American Society of Tropical Medicine and Hygiene, founded in 1903, is the largest international scientific organization of experts dedicated to reducing the worldwide burden of tropical infectious diseases and improving global health. It accomplishes this through generating and sharing scientific evidence, informing health policies and practices, fostering career development, recognizing excellence, and advocating for investment in tropical medicine/global health research. For more information, visit astmh.org.

About the American Journal of Tropical Medicine and Hygiene

Continuously published since 1921, AJTMH is the peer-reviewed journal of the American Society of Tropical Medicine and Hygiene, and the world’s leading voice in the fields of tropical medicine and global health. AJTMH disseminates new knowledge in fundamental, translational, clinical and public health sciences focusing on improving global health.

Africa: IGAD Member States Approve Medicine Regulatory Harmonization Initiative

Africa: IGAD Member States Approve Medicine Regulatory Harmonization Initiative

Home to about 266 million people the east and horn of Africa region is well known, among other things, for the large scale movement of people. In most cases the movement of the people is cross border.

The people usually carry various commodities while traveling across borders. Among the commodities they carry include medical products. But this mode of drug transaction is considered unsafe as it increases the vulnerability to substandard and falsified drugs.

Ethiopia, the epicenter of the region has felt the dangerous consequences of the cross border illegal drug trafficking and has been taking actions earlier. FMHACA, an authority in charge of the issues works in collaboration with the Ethiopian Revenue and Customs Authority and Federal Police Commission to control the trafficking of pharmaceuticals in 17 customs checkpoints of the country, says Samson Abraham Public Relations and Communication Director with FMHACA.

For this end it has established a system where it can standardize drugs. Furthermore it has established excellence center.

Even though Ethiopia puts in place its own regulation and standards for medicine, it is likely to face challenges from the regional countries as IGAD member countries where the drugs are trafficked illegally do not have harmonious standards for the pharmaceutical supplies in their respective countries. Taking this into consideration Ethiopia took the initiative for the formation of regional level initiative in charge of standardizing pharmaceuticals in the region and controlling the movement of substandard and falsified drugs, according to Samson.

Established in 1986 to coordinate anti drought efforts of the region, Intergovernmental Authority on Drought (IGAD) has been working as an umbrella organization of countries of the region. It undertakes concerted activities of the region in political , economic and social spheres.

As part of its overall responsibility it has recently embarked up on coordinating the countries to formulate a proposal which aims to establish a regional level Medicine Regulatory Harmonization Initiative.

During a three day workshop that took place here in Addis Ababa from August 1-3 the medicine regulation harmonization initiative of IGAD has been approved by the member states and was welcome by donors and partners including the World Bank, World Health Organization (WHO) and donor nations.

Speaking on behalf of IGAD Executive Secretary Fathia Alwan, Health and Social Development Acting Director of IGAD said the just approved proposal to establish medicines regulatory harmonization initiative is in line with IGAD Regional Strategic framework and Implementation Plan 2016-2020 that provides an overall guidance of how IGAD intends to deliver its mandate and incorporates the priorities given in the African Unions Agenda 2063 and Sustainable Development Goals.

The movement of substandard and falsified medical products and illegal trade in medicines in the region is mainly facilitated by the movement of people, she noted.

Alwan reiterated that the presence of unregulated substandard and falsified medical products and illegal trade in medicines circulating with in IGAD member states is a serious public health threat which must be prevented and controlled in order to spur confidence on our public heath care systems and programs.

The IGAD-MRH initiative aims at harmonizing regulatory system, guideline and processes for regulation of medicines in accordance with internationally recognized standards in the coming five years.

WHOs Dr. Mike Ward said lack of health related infrastructure, shortage of qualified human and financial resources and lack of capacity to enforce regulatory provisions are some of the factors that hinder access to safe, efficacious, quality and affordable medicines.

Mike noted that the development of the project proposal is a critical milestone in the process of the establishment of harmonization program in the region and raised concern on the continuity of the support from member states and mobilization of the financial support for the implementation of proposal are vital.

He indicated that WHO attaches special importance to regional medicine regulatory harmonization initiatives as they reduce cost and time of regulatory activities, increase confidence in product safety, efficacy and quality, promote interdependence in regulatory decisions and in building regulatory capacity and ultimately improve access to medicines.

He finally indicated that WHO will continue providing technical guidance and support to the IGAD – MRH initiative.

The successful implementation of the initiative will not only to alleviate the illegal movement of drugs but also increase the availability of more options for medicine as all countries use uniform standards, according to Samson.

South Africa grows share of global nuclear medicine market

South Africa grows share of global nuclear medicine market

The global nuclear medicine market, which includes radioisotopes and medical equipment, was valued at over US$11-billion in 2016, and is now projected to reach nearly US$20-billion by 2021.

Nuclear medicine uses tiny amounts of radioactive isotopes (radioisotopes), mostly for medical imaging to view the structure and function of organs, bone, tissue or systems in the human body. Imaging obtained from nuclear medicine often allows disease to be identified at a much earlier stage, while therapeutic applications of medical radioisotopes allow for targeted, non-invasive treatment.

South Africa currently has the largest body of nuclear medicine practitioners and nuclear medicine centres in sub-Saharan Africa, including nuclear medicine departments at 12 tertiary state hospitals.

Globally, demand for nuclear medicine is being driven by increases in the incidence of cancers and cardiovascular disease, and by the growing number of new applications for medical radioisotopes including the study of neurological and psychiatric diseases. Medical radioisotopes are used in a number of branches of medicine including oncology, cardiology, neurology, and endocrinology specifically thyroid conditions. Around 90% of all nuclear medicine procedures performed each year are for diagnosis or evaluation.

Underpinning this market is one key medical radioisotope: molybdenum-99 (Mo-99). The daughter product of Mo-99, technetium-99m (Tc-99m), is used in over 40 million nuclear medicine procedures every year. [See below for more]

There are currently fewer than five sites in the world capable of producing commercial volumes of Mo-99. Pelindaba-based SouthAfrican company NTP Radioisotopes, a subsidiary of Necsa, is one of these; and currently, with global partnership agreements, supplies between a quarter and a third of the entire global demand of Mo-99. The group’s role has become even more significant with the 2016 exit of the Canadian NRU reactor from production.

NTP has been one of the top three global producers of Mo-99 for some time, and posted group revenues of over R1,2-billion for the 2015/16 financial year – almost R1-billion of which came from the sale of medical radioisotopes and radiopharmaceuticals. The state-owned company expects to exceed this figure for 2016/17. “We have managed to grow our market share for Mo-99 through continued investment in our production, and by working with our partners to cover the supply gap,” explains Precious Hawadi, NTP Group Executive: Finance.

The group has a market footprint covering 50 countries around the world, and is also a significant earner of foreign exchange for South Africa.

NTP Group MD Tina Eboka explains that the group’s success has been built on “excelling in manufacturing, processing and moving an extremely time-sensitive radiochemical to our customers around the world. What NTP does is, it provides the foundational material for a global, multi-billion dollar nuclear medicine industry. And there are only a few companies in the world that can do what we do. Without South Africa’s contribution to nuclear medicine, the whole health system could not function.”

NTP is also one of only a few vertically integrated medical radioisotope manufacturers in the world, and plays an even more unique role in South African manufacturing where it acts as both primary producer and beneficiator of its product. NTP’s advanced manufacturing capabilities and pioneering technology have even been exported to other countries. South Africa’s proprietary process for the use of low-enriched uranium in the production of Mo-99 has been licensed to the Australian Nuclear Science and Technology Organisation (ANSTO), which is also one of NTP’s key partners.

The Molybdenum-99 value chain
Mo-99 is produced through a process of nuclear fission inside a nuclear reactor and has a half-life of 66 hours, meaning it cannot be stockpiled and has to constantly be manufactured in fresh batches.

Mo-99 decays into a ‘daughter’ isotope called technetium-99m (Tc-99m), which is the most common diagnostic medical radioisotope in the world, used in over 40 million nuclear medicine procedures each year. Tc-99m has a half-life of just six hours, making it safe for use, and emits low-energy gamma rays that are ideally suited for imaging using gamma cameras such as those used in SPECT (single-photon emission computed tomography) imaging.

Because of the short half-lives of the radioisotopes, nuclear medicine practitioners use something called a Tc-99m ‘generator’ – this is a medical device that contains a feedstock of Mo-99, from which specific doses of Tc-99m can be eluted as required. The Tc-99m is then labelled with specific pharmaceutical agents (creating a ‘radiopharmaceutical’), that targets specific areas or systems in the body. The labelled Tc-99m is injected into the patient and, as it travels through the body, it gives off a small amount of gamma radiation that can be seen by gamma cameras.

Unlike X-rays, nuclear medicine enables practitioners to observe organs and systems as they function, right down to a molecular level. The same labelling technology also allows nuclear medicine practitioners to treat certain conditions using medical radioisotopes.

NTP Radioisotopes manufactures two other medical radioisotopes, iodine-131 (I-131) and beta-emitter lutetium-177 n.c.a. (Lu-177), which have both diagnostic and therapeutic applications. NTP also produces a number of non-reactor based medical radioisotopes, and pioneered the use of cyclotron-based FDG F-18 in South Africa, which is used for cancer diagnosis.

About NTP Radioisotopes
NTP Radioisotopes SOC Ltd is a subsidiary of the South African Nuclear Energy Corporation (Necsa) and is a leading manufacturer and supplier of radiation-based products and services including essential medical radioisotopes. This proudly South African corporate citizen is situated at Necsa’s nuclear facility at Pelindaba west of Pretoria, and serves customers in 50 countries around the world. NTP has strategic partners and associates ranking among the world’s leading providers of nuclear technology products, nuclear imaging services, and pharmaceutical producers and suppliers.

German institution signs MoU to design, operate medical varsity in Akwa Ibom

German institution signs MoU to design, operate medical varsity in Akwa Ibom

The University of Hamburg [UKE], Germany and Thompson & Grace Medical University [TGMU), at the weekend, signed a partnership agreement in Uyo.

The memorandum of Understanding (MoU) was to “design and operate the medical facilities,” which would be located at Afaha-Obong, in Abak Local Council Area of the state.

While the Dean of the Medical Faculty of the University of Hamburg [UKE], Prof. Uwe Koch-Gromus signed on behalf of his institution, Dr. Isaac Thompson Amos signed for his group.

Others who witnessed the signing were the German envoy to Nigeria, Ambassador Schlagheck, Vice Dean of the medical faculty, Prof. Ansgar Wilhelm Lohse, foremost pediatrician and former Medical Director of the Altona Children’s Hospital, Prof. Frank Nobert Riedet and CEO of RES Public Affairs, Corporate Affairs and Consultant to the project from Berlin, Germany, Mr. Armin Huttenlocher.

Others included Projects/Technical Services of TGIL, Mr. Ekemini Amos and President/CEO of XEQ Solutions, Plano, Texas, U.S.A. Dr. Emmanuel Umoh. Earlier, the two sides held a seminar, “How Education, Health and Medicine Can Be Transformed to Benefit Nigeria and Africa.”

Amos explained that the partnership would enable both parties to jointly “develop and provide structure, curriculum and practical programme, as well as administrative and management processes for the medical varsity and specialty hospital.

He stressed that the facilities would also enjoy “training and support in capacity building in the areas of medical education, clinical research and healthcare delivery management and administration.”

According to the proprietor, the partnership would further enable the health facilities to benefit from “increased number of competent physicians and professionals and facilities to meet the health needs of a rapidly changing Nigerian society.”

Koch-Gromus said the UKE, located in Hamburg, Germany signed the MoU with T&GIL, with head office in Lagos: “For the development of academic cooperation in international education in areas of mutual interest and expertise.”

A Professor of Paediatrics and former Chief Medical Officer of the University of Uyo Teaching Hospital, Emmanuel Ekanem, said the idea of a medical university was in order.

St. Nicholas nephrologist bags renowned fellowship for medical innovation

St. Nicholas nephrologist bags renowned fellowship for medical innovation

Only a few months after making the London Stock Exchange’s (LSE) list of Africa’s fastest growing companies, St. Nicholas Hospital has yet again been celebrated for the outstanding contributions of its consultant nephrologist, Dr. Ebun Bamgboye, who has been admitted as a Fellow of the 499-year-old Royal College of Physicians, London.

Founded in 1518, the Royal College of Physicians is the oldest medical college in England which plays a pivotal role in raising medical standards and shaping public health policies.

Its prestigious Fellowship is conferred on medical professionals who have made outstanding contributions in medicine, and is held by some of the most innovative physicians across the world. CEO and Medical Director of St Nicholas Hospital, Dr. Dapo Majekodunmi, said: “Such an honour is a rarity for private practitioners and particularly those from an emerging economy.

Dr. Bamgboye represents all that is good about persevering with medical practice as an indigenous practitioner and is a great example of what we can achieve on our own shores with the correct support and framework. As a key member of the St Nicholas leadership team, Dr. Bamgboye is integral to the delivery of good medical practice and the improvements needed to assure that St Nicholas delivers world-class medical services in Nigeria.”

Dr. Bamgboye who heads the Dialysis/Transplant Unit of St. Nicholas and serves as its Clinical Director, has developed one of Nigeria’s most prestigious and functional Dialysis Units which receives referrals from around the world. He is also the Head of the St. Nicholas Renal Transplant Unit credited with performing over 60% of all kidney transplants in Nigeria and the West African sub-region. In his capacity as Clinical Director, Dr. Bamgboye is responsible for supervising the Medical arm of the Hospital.

He has also been a major influence in the recent expansion of St. Nicholas Hospital, which includes St. Nicholas Specialist Hospital at Maryland, Ikeja and the St Nicholas Hospital Clinics at Victoria Island and Lekki Free Trade Zone.

He is currently a member of the International Society of Nephrology, the European Dialysis and Transplant association, the American Society of Nephrology and the Advisory Board, St. Nicholas Hospital, Lagos. Dr Bamgboye was the 13th President of the Nephrology Association of Nigeria from February 2014 to February 2016, and is the current President of the Transplant Association of Nigeria as well as the Court of Governors, Lagos State University College of Medicine (LASUCOM).

New research on disability in Africa by UEA

New research on disability in Africa by UEA

The resultant stigma leaves disabled people vulnerable to neglect and abuse – with sexual abuse reported by 90 per cent of people with learning difficulties. Many disabled children are kept ‘locked up’ at home – often for their own safety. But the more that communities come into contact with disability, the more awareness and understanding grows.

Meanwhile medical explanations for disability are beginning to emerge, with increasing numbers of families seeking medical advice for children with disabilities rather than consulting a witchdoctor. The ‘Preparation of Communities: Using personal narratives to affect attitudes to disability in Kilifi, Kenya (Pre-Call)’ project was set up to promote disability awareness in small communities in a rural part of Kenya, by encouraging a process of reflection and education. The research team at the Kenya Medical Research Institute (KEMRI) led focus groups to find out how cultural beliefs and knowledge shape people’s understanding of disability.

The discussions involved 21 community groups located across the five constituencies of Kilifi County, bordered one side by the Indian Ocean coast and stretching into the rural interior. A total of 263 participants were involved who observed Christianity (70 per cent), traditional religious practices (20 per cent) and Islam (10 per cent). Lead researcher Dr Karen Bunning, from UEA’s School of Health Sciences, said: “Information on the medical causes of childhood disability are not widely available across communities in low-income countries and understanding is generally poor.

“In Namibia for example albinism is explained by the mother having sex with a white man or a ghost. And in Guinea-Bissau, epilepsy is widely thought of as being caused by evil spirits, or sometimes as a punishment for wrongdoing. “We found that disability is often explained by things like extra marital affairs invoking a curse, witchcraft, supernatural forces such as demons or ghosts affecting the child, and the will of God. “Curvature of the spine or limbs represented the effects of a curse, saliva production was linked to demons and ill-gotten financial gain.

“The different explanations represent a real mixture of traditional, religious and biomedical beliefs,” she added. “And while biomedical factors such as inherited conditions or antenatal care were increasingly talked about, these explanations did not negate other culturally-based accounts.” The findings reveal that underpinning all of these explanations is a desire to make sense of disability and, particularly for carers, to improve the given situation. And where an explanation of wrongdoing or the presence of an evil force might result in a visit to a local witchdoctor, a medical attribution might be followed with a visit to a medical centre. The project also looked at the challenges faced by people with disabilities and their carers.

Dr Bunning said: “What tends to happen is that these types of cultural beliefs affect how individuals with disabilities view themselves and how other people see them.Attributing the child’s condition to some form of malevolent preternatural force by reference to demons, evil spirits and witchcraft contributes to the view of disability as both undesirable and unacceptable. “People with disabilities in Africa have poor access to health provision, low school attendance, limited employment rates and low wages. More extreme consequences include neglect and abuse – with sexual abuse reported to occur at some time in the lives of 90 per cent of the population with learning difficulties.

People with communication difficulties are at a high level of risk because they are less able to report abuse. “We found that children with disabilities are often kept apart from the local community in restricted environments – contributing to the social distance between them. Although in many cases this is to protect them from abuse and keep them safe. “The burden of caring for family members with disabilities also led to discrimination by association,” she added. “And the stigma associated with people with disabilities is so great that it also extends to anyone trying to help.

The implication being that anyone offering help would also give birth to a disabled child. “But we found that the more people come into contact with disability, the better their understanding. Real life encounters with people who have disabilities can be a really positive step, so raising disability awareness in small communities can really help.”

‘The perception of disability by community groups: Stories of local understanding, beliefs and challenges in a rural part of Kenya’ is published in PLOS ONE on August 3, 2017 . The research was led by UEA (UK) in collaboration with the Kenya Medical Research Institute (Kenya), the University of Oxford (UK) and the London School of Hygiene and Tropical Medicine (UK)

Mediclinic enters the primary healthcare market

Mediclinic enters the primary healthcare market

Mediclinic Southern Africa has expanded its base into the primary healthcare market by buying into the Intercare group of companies. The latter operates 18 multidisciplinary medical and dental centres, four day hospitals and three sub-acute and rehabilitation hospitals in South Africa

The investment comprises a minority shareholding in the medical centres and a controlling interest in hospital side of the business. Intercare will continue to manage all the facilities under its own brand.

Strategic sense

Given the swing towards preventative medicine as a means of reducing soaring costs and the burden of disease on an already stressed healthcare system, and the focus on primary healthcare in the National Health Insurance white paper, it makes strategic sense for the private hospital group to expand its interests into this space.

“We believe that this is the ideal opportunity to partner with an experienced and innovative leading role player in the primary healthcare market. The addition of the sub-acute and primary elements to Mediclinic’s healthcare offering will complement the services available through our specialist orientated, multidisciplinary acute care facilities,” Koert Pretorius, CEO of Mediclinic Southern Africa, said.

“Intercare has a clear vision of reinforcing primary healthcare’s essential role within the continuum of care. They have been innovative in the introduction of several patient-centred initiatives within the sub-acute and primary care environment.”

“Over the past 15 years Intercare has developed an integrated business model with medical and dental practitioners and the primary healthcare needs of the patient at its core,” said Dr Hendrik Hanekom, CEO of the Intercare group.

Both transactions are subject to several conditions, including Competition Commission approval of the Mediclinic acquisition of the controlling shareholding in the day hospital and sub-acute and rehabilitation hospitals owned by Intercare.