Features
Kidney Transplant: LASUTH Rekindles Patients’ Hope Of Survival
Minister of Health, Dr Isaac Adewole
When doctors from the
Lagos State University Teaching Hospital (LASUTH) successfully conducted the first kidney transplantation in the institution in November, it further raised the hope of survival for patients living with kidney conditions.
The surgery carried out on a 56-year-old man on November 11, 2015 by a team of nine doctors, involved the patient’s 26-year-old nephew who donated one of his kidneys.
From statistics, it is known that no fewer than 37 million Nigerians, representing 23 per cent of the population are suffering from various stages of kidney diseases.
Simply put, one in every seven Nigerians is suffering from one form of kidney disorder, according to Dr Ebun Bamgboye, the President, Nigeria Association of Nephrology and Chief Medical Director, St. Nicholas Hospital, Lagos.
The virulent nature of the diseases has left Nigerian patients with many challenges in treating kidney problems, leading to many who are indigent dying untimely.
The few who are wealthy travel overseas for treatment on regular basis leading to capital flight of several millions of Naira from the country.
The burden and the belief in the old dictum that “health is wealth’’ led the former governor of Lagos State, Mr Babatunde Fashola-led administration to move to alleviate the plights of those suffering from kidney disease.
The administration then conceived a modern Cardiac and Renal Centre (CNC) in the state.
To realise the feat, the government upgraded the Ikeja General Hospital to a University Teaching Hospital, the Lagos State University Teaching Hospital (LASUTH), affiliated to the Lagos State University (LASU).
And subsequently, it upgraded the Gbagada General Hospital to an annex of LASUTH.
Sooner than later, it started the N5 billion CNC project in 2008 and completed it in 2013 at the Gbagda Annex of LASUTH.
The centre today offers hope of survival to the many Nigerians suffering from kidney disease.
Patients can now heave a sigh of relief as they will not have to source for millions of Naira to travel for treatment overseas before they can find solutions to their ailments.
It is in the public domain that between 2008 and 2014, the Lagos State Government under Fashola, sponsored very sick people overseas at tax payers’ expense.
There were 28 renal cases that benefited from the state’s gesture. Also there were 11 renal cases that were sponsored for kidney transplant, dialysis and post-transplant immunosuppressant at St. Nicholas Hospital in Lagos.
It is pertinent to state that prior to the LASUTH, Ikeja, achieving the breakthrough, St. Nicholas Hospital was the only institution offering the service in the country.
But with the realisation of the dream by LASUTH, the pains of raising so much money to go for treatment overseas will be reduced.
The CNC operation has begun to attract the best medical personnel in the treatment of renal treatments to return to Nigeria to render their services.
Thus, brain gain is beginning to garner momentum as against the brain drain syndrome the country suffered from some years ago.
Fashola at the inauguration of the centre described it as the best in Africa, built and equipped with the best modern facilities obtainable in the developed countries of the world.
“The centre is equipped with 24 dialysis bed stations, 20 beds for recovery and general ward use, two high dependency wards with five beds each for patients who have come out of the intensive care.
“Five beds for patients in intensive care, four post-surgery beds for patients who just finished surgery, two post cathlab beds and two surgical theatres built to the most contemporary standard to cater for people who are critically ill.
The theatres will also serve as lecture rooms for students and where kidneys and hearts can be removed and transplanted.
“There are cameras fitted into the surgical scumps which will project images and voices of what is happening in the theatre to the ground
floor,’’ he said.
The Commissioner for Health, Dr Jide Idris, says the idea of establishing the CNC was to lessen the burden of communicable disease in the state.
Before the successful transplantation, barely seven months after the CNC was opened, the centre, arguably a pacesetter in Nigeria’s health industry, was already offering services to renal patients.
The giant strides of Mr Babatunde Fashola’s administration, in the health sector of Lagos State, has today opened a new vista for saving the lives of people with kidney conditions.
The team of LASUTH doctors who performed the unique feat are Dr Jacob Awobusuyi, who led them, Dr Oduanyo Ikuero, Dr Funmilade Omisanjo, Dr Kayode Abolarin, all Neophrologists.
Others are Dr Theophilus Umeizudike, Dr Mumuni Amisu, Dr Tunde Akinola, Dr Biyi Majekodunmi, Dr Adebanjo and Matron Adamson and LASUTH pharmacists among others.
They were unambiguous in telling the world that they were set to conduct more of such surgeries; so, it is for Nigerians to take advantage of that and help to save people dying of kidney diseases.
In doing that, they also believed that it would to an extent save the country the huge capital flight and attract medical tourism to Nigeria.
Some members of the team spoke about their experiences, future of transplantation in Nigeria and other sundry issues on kidney disease.
The Head of the transplant team, Dr Jacob Awobusuyi, a Consultant Nephrologist and Associate Professor of Medicine, said the experience was quite educative, satisfying and rewarding.
Awobusuyi, who obtained his Bachelor of Medicine and Surgery at University of Ilorin in1983, said: “I never thought I could enjoy the cooperation of the entire hospital and this made me appreciative of a fully motivated staff, who contributed immensely to the success of the first kidney transplant.
“ The team is composed of highly motivated doctors, surgeons and nurses who were all up to the task.
“The nurses had to sacrifice a lot by staying back for three days without going home to take care of the kidney transplant recipient. We are ready for future transplants.
“We already have some lined up for the next transplant; we are looking at the middle of January for the next set of transplants if they pass the test,’’ he said.
Awobusuyi had his post-graduate studies at University of Ilorin Teaching Hospital, after which he started working with the Lagos State Health Management Board in 1994 as a Consultant Nephrologist.
Awobusuyi is also the pioneer Head of Gbagada Dialysis Centre and many general hospitals in Lagos State.
Dr Theophilus Umeizudike, Consultant Nephrologist, LASUTH, said it was meant to be the flagship of his career and a way of contributing to the society by giving life to people.
“After my experience in Germany, I said to myself this can be adapted to our local practice here. So, I and my colleagues started tinkering on this for about three years.
“Sometime last year, we had a team from Sao Paulo in Brazil that told us that what we have in facilities are comparable to what they have in Brazil.
“With this we are told, we can have transplant in LASUTH. We signed a Memorandum of Understanding (MOU) for them to give us technical support and help us with the procedure.
“We went to Brazil for some training and returned home. This year we realised that we have garnered enough experience to be able to have the first transplant.
“This we proposed with a team of indigenous doctors and surgeons who are working in LASUTH. We want to give Lagosians the opportunity of local content,’’ he said.
Umeizudike said they were confident about this because those that often travelled to India came back home to continue with their recuperation with some coming back worse off.
“We offer a comparative cost-advantage over treatment done abroad, and people need also to be convinced that treatment here is
guaranteed, of quality and cost-effective.’’
Umeizudike also said that carrying out the transplant here could put a check on medical tourism associated with kidney transplant in Nigeria.
“If people can be honest with themselves, they should appreciate that kidney transplant is available locally at a cheaper cost. We are confident about our capability when it comes to the operation.
“Before we had the operation, we were confident that the operation would be successful and we are happy to see that the patient who had been on dialysis is now normal.
“ It is a success story and we are happy that the patient is recuperating well.
“It is not easy to do a transplant because things may go wrong but we thank God we are able to overcome and the complication rate at low level,’’ he said.
On the future of transplant and the risk factors of kidney disease, he said that “in most transplant centres abroad like Cambridge in England, they do one live transplant donation every week which is usually on Tuesdays and that is about 50 to 52 in a year.
“Apart from that, there is deceased donation where someone dead can have the kidney harvested and given to people on waiting list, which happens anytime.
“Here, we may look at having at least one in every month and when we are more stable and have the capacity we will look at having two in a month.
“As time goes on, we can then have one every week which is what we are aiming at ultimately,’’ he said.
Umeizudike said the prevalence of kidney disease in Nigeria was largely due to the lifestyle of the people and dietary habits.
“Studies done in Nigeria showed that about 15 to 25 per cent of the Nigerian population may likely have kidney problem because of their style of living.
“In Nigeria, the major cause of renal failure is hypertension followed by diabetes, and also a condition of infectious disease and inflammation affecting the kidney function and structure.
“Also our diets are beginning to move away from what it used to be, we now consume complex carbohydrates and simple sugar. Other causes are HIV and urinary tract infections.
“The age susceptible to renal failure is usually, in developed world, about 60 years and above but in Nigeria it is between 30 and 40 years,’’ he said.
Comparing the cost between dialysis and transplant, Umeizudike said transplant is cost-effective and manageable compared to dialysis.
“Dialysis is initiated in people with renal failure. It is a process whereby the patient’s blood is passed through blood filter which removes nitrogenous waste from the kidney.
“A dialysis for the first time costs about N60, 000 to N70, 000 because of various tests that will accompany it but after the first
session, it drops to N20, 000 and N25, 000.
“Renal failure is not a death sentence, but very expensive to manage and treat. After treatment, we look at the survival rate of the graft
between 95 and 98 per cent.
“After five years it drops to 80 per cent and by 10 years between 60 and 70 per cent and if the first one failed there is option to have a second transplant,’’ he said.
Umeizudike said that transplant allowed the patient to recover from erectile dysfunction and for the females they would be able to conceive again.
He started his journey in medical practice by obtaining his first degree in 1995 at University of Ibadan, and had his post-graduate at Lagos State University Teaching Hospital in 2007.
He was awarded the Fellowship of West African College of Physicians in 2008.
Olarenwaju writes from News Agency of Nigeria (NAN)
Akojede Olarenwaju
From the fore going, the fight against drug trafficking should be treated as an international challenge with open collaboration, if the world leadership must win the fight!.
The circumstances or should I say the improvement on drug related activities are modifying and updating on daily basis. A close friend of mine in the United States of America who recently visited Jamaica, came with a lot of complicated information about drug trafficking and transaction. Being a qualified Nurse in US and on a visit to the Reggae Country (Jamaica), she said she was put aback when a man approached her and introduced himself as a Pharmacist. According to her, she immediately picked interest due to her professional background. To her, a business partner is birthed. But she was shocked to the narrows on learning that drug dealers or traffickers and subriquited Pharmacist in that Country. From her account, they ( The Jamaican Pharmacists), are the first set to people to meet and greet you at the Airport. No government or authority challenges them in the open due to the sophisticated nature of their transportation
Come to think of it, who would want to attack a Pharmacist on duty? Nigerians are not left out in the improvement on drug deal. A chat with a confident in the National Drug Law Enforcement Agency ( NDLEA) Rivers State Command, so revealed. The Officer draw my attention to the movement of Dispatch Riders. He said part of the reasons they ride with almost speed equivalent of the thunder lightning, is to meet up with the appointment of delivering hard drug consignment to a client of theirs. According to him, those guys popularly referred to as Yahoo Boys are the ones who now payroll dispatch riders so that they can deliver their consignment ( hard drugs) on schedule no matter the sort of traffic or weather condition. The fear of loosing rich clients and that of the unknown treatment that may come of the Boys, as the officer puts it, drives the Riders crazy thus the reason to speed even at the expense of their lives.
The account of a prominent Party Promoter, Wayne Anthony, as obtained online recently, also pointed out that ‘No Legislation Will Stop Clubbers From Doing Drugs’ Party promoter, Wayne Anthony, arrived in Ibiza, a Spanish Island in 1988, at the same time as dance music and the party drug ecstasy. Despite hallucinating badly enough to make him give up the lifestyle forever, he says laws will never stop clubbers taking drugs. “I don’t think you can control these things,” said former party promoter Wayne Anthony. He arrived in Ibiza in 1988 and began setting up club nights and raves in some of the island’s most iconic venues. In the years that followed, the sleepy Spanish island turned into a raver’s haven of clubbing and hedonism, with party drugs like ecstasy commonly found. “What Ibiza represented was this beautiful, hot island which was visually stunning and we knew you could party there quite legally,” said Wayne. “You didn’t have to look over your shoulder. You could just be as free as you possibly could be.”
That freedom came with a price. Along with the lavish clubs, all-day-benders and hot Spanish sun came drug cartels and crime. The city transformed into one the world’s most vibrant party capitals, “fuelled by a dangerous and lucrative drugs trade which drew as many criminals to its shores as it did party animals”. Wayne, one of the contributors to the documentary, spoke to Sky News ahead of its release.”I’m not going to sit here and say the cartels aren’t there. They are all there and they’ve been there from the ’90s,” said Wayne. But he said most people tried to ignore the organised crime going on around them. According to Wayne, clubbers usually took the approach of: “‘Give me 10 E’s . Behind the scenes of the filming of Ibiza Narcos with Wayne Anthony. Behind the scenes of the filming of Ibiza Narcos with Wayne Anthony. Hallucinating giant spiders Although he described the Balearic island as the “motherland”, it was eventually a bad experience with drugs that convinced Wayne it was time to leave Ibiza.
He’d been partying for days when he realised he’d taken too many drugs. A friend told him to drink cough medicine, dangerous advice that he now says could have killed him. “I saw the worst hallucination I’ve ever seen in all of my life. I ended up locking myself in the villa with all the shutters down. When he sobered up, he realised he had “come to the end” of his party life on the island. “I never looked back. I never took another drug. I got away from the club world.” ‘I don’t think you’re going to be able to stop it’ Despite his life-changing experience, he doesn’t think criminalising drugs is a good idea – or particularly effective. “If you’re old enough to vote for who’s going to be a world leader, if you’re old enough to put your name down on debt for 25 years, I feel like you should be old enough to govern what you put inside your own body, you know?” said Wayne.
Back to Nigeria, some illicit drugs worth over N30billion seized at Onne Port in Rivers State.
This blood chilling development forced the Federal Government to declare a state of emergency at the Onne Port, following what authorities described as repeated incidents of importation of dangerous cargo, including arms and ammunition through the said port. To this effect, the government said it was immediately implementing emergency protocols at Onne Port for the next three months by conducting thorough examinations of all suspected containers in the premises.
The Comptroller-General of Customs, Bashir Adeniyi, in charge of the port via a press conference, said it henceforth, unveiled the seizures of illicit goods by the Nigeria Customs Service, Area 2 Command, Onne in Eleme Local Government Area of Rivers State. In defence for his action, Adeniyi said the recurring incidents posed a threat to national security, adding that the health of citizens at the Onne Port is increasingly being used as a destination for dangerous and illicit cargo, describing it as a disturbing trend.
The customs boss stated, “Earlier today, I joined numerous stakeholders to take a significant step towards the cause of trade facilitation through the inauguration of upgraded facilities provided by the West Africa Container Terminal, Onne. “As I express delight that trade facilitation is getting traction in Onne Port, I cannot help but call your attention to a grave concern. This has to do with the repeated incidents of national security breaches unfolding in Onne Port. I appreciate your presence, as we all have a shared responsibility in safeguarding our national security. As we are all aware, the policy thrust of Mr President supports the re-energising of our business environment to drive faster import clearance and grow our capacity for exports, Our emphasis has been to promote initiatives that speak to Trade facilitation and economic development. “It is a matter of regret that criminal elements in the international supply chain are exploiting our pro-trade stance to commit atrocities bordering on national security breaches”.
“The attempts to test our will through the importation of dangerous cargo through this port has necessitated the declaration of a state of emergency in Onne Port, coming on the heels of a seizure of a huge cache of arms a couple of months ago. It is disheartening that perpetrators have not backed down on their illegal acts. Recent intelligence and seizures have revealed a disturbing trend; Onne Port is increasingly being used as a destination for dangerous and illicit cargo. The scale and nature of these illegal importations pose a significant threat to our national security and the health of our citizens. Today, we are here to showcase yet another series of significant seizures made by the diligent officers of the Area 2 Command. On display are twelve containers of illicit goods intercepted through a combination of intelligence gathering, inter-agency collaboration, and meticulous physical examination. Seizures on Display include: Three (3) x 40-feet containers: Containing 562,600 bottles of 100ml cough syrup with codeine and 3,150 pieces of chilly cutters, with a Paid Duty Value (DPV) of N4,716,573,846.
“Others are, three x 40-feet containers containing 380,000 bottles of 100ml cough syrup with codeine, 24,480,000 tablets of Royal Tramadol Hydrochloride, 5,350,000 tablets of Tapentadol and Carisoprodol, and other items, with a DPV of N17,432,506,000 were seized”.
According to the report, more seized items were, “Five (5) x 40-feet containers; Containing 892,400 bottles of 100ml cough syrup with codeine, 1,300,000 tablets of 50mg Really Extra Diclofenac, 7,250,000 tablets of 5mg Trodol Benzhexol, and other items, with a DPV of N8, 128,568,295,90. This very action of the Nigeria Customs Service, further complicated the hope of how soon the fight against drug trafficking could be brought to a halt owing to its high profile nature.
Another hair-raising report of the illicit drug deal has it that when NDLEA bursted a Snake-Guarded Shrine Used For Storing Illicit Drugs sometime ago in Edo State. This very news report was published in The Tide Newspaper on June 24, 2024. According to the report, NDLEA said its operatives uncovered a shrine, guarded by a snake, being used for storing illicit drugs, during an operation in Edo State. The Agency in a statement by its spokesperson, Femi Babafemi, added that its operatives discovered a specially constructed large hole in a wall, hidden behind wallpapers and fetish objects used for drug storage. It further noted that methamphetamine, Loud, Colorado and Arizona, all strong strains of cannabis with a total weight of 8.743kg among others, were recovered from the shrine.
To be cont’d
King Onunwor
The persistent clash between farmers and herders in Nigeria has been a longstanding issue. These conflicts, often, over resources like land and water, have led to loss of lives, destruction of property, displacement of large numbers of people, deep-seated mistrust between communities and insecurity. Herders, traditionally nomadic, move their livestock in search of grazing land and water. Farmers, on the other hand, require the same resources for their crops. This competition often leads to clashes, especially in areas where land is becoming increasingly scarce due to population growth, climate change, and environmental degradation. As these clashes intensify, there has been a growing call for sustainable solutions. Two weeks ago, President Bola Tinubu took a bold step towards tackling the issue by inaugurating the Presidential Committee on Implementation of Livestock Reforms and creating the Ministry of Livestock Development.
The committee which has the president as the chairman and the former Chairman of the Independent National Electoral Commission (INEC), Professor Attahiru Jega as the deputy chairman has the mandate to address obstacles to agricultural productivity and open up new opportunities which benefit farmers, herders, processors, and distributors in the livestock-farming value chain as well as propose recommendations aimed at fostering a peaceful co-existence between herders and farmers, ensuring the security and economic well-being of Nigerians.The establishment of the Ministry of Livestock Development was part of the recommendations of the National Livestock Reforms Committee. Part of the 21 recommendations submitted to the president include: “This agenda should include the establishment and resuscitation of grazing reserves as suggested by many experts and well-meaning Nigerians and other methods of land utilisation.
“Create the Ministry of Livestock Resources in line with practice in many other West African countries. In the alternative, Federal and State Governments should expand the scope of existing Departments of Livestock Production to address the broader needs of the industry,” among others. Experts in the agricultural sector have posited that the livestock industry can create millions of jobs directly in farming, processing, and distribution, and indirectly in related sectors like feed production, veterinary services, and marketing. It provides livelihoods for rural populations, helping to reduce poverty and improve the quality of life in rural areas. It also increases the Gross Domestic Product (GDP) and foreign exchange earnings through the exports of livestock and livestock products such as meat, dairy, wool and leather.
According to them, a well-funded livestock industry supports the growth of agro-processing sectors, such as meat packing, dairy processing, and leather manufacturing, adds value to raw products and creates additional economic activity as well as stimulates the development of supply chains, including logistics, packaging, and retail, contributing to broader economic growth. It enhances economic resilience by diversifying the agricultural sector and providing a buffer against crop failures or other agricultural shocks and many more. Some other agriculturists have also opined that the livestock industry in Nigeria is currently underdeveloped and that by the creation of the ministry of livestock development will open up the industry which will be a huge money spinner for Nigeria.
Reports have shown that a Livestock Ministry can play a pivotal role in mitigating conflicts between farmers and herders by implementing policies and programmes aimed at fostering coexistence and sustainable resource management. The Ministry can work towards clearly demarcating grazing routes and farming areas. This would reduce instances of trespassing and accidental crop destruction, a common flashpoint for conflict. While introducing rotational grazing systems can ensure that land is used sustainably, preventing overgrazing and land degradation, establishing water points and boreholes specifically for livestock can reduce competition for water resources. Similarly, promoting the development of pasturelands through reseeding and controlled burns can improve grazing conditions.
According to a veterinary doctor, Dr Andrew Obadiah, by providing training for herders on sustainable livestock practices and for farmers on conflict resolution, both parties can understand the importance of coexistence. He said that extension services of the ministry can offer advice on improving livestock health and productivity, reducing the need for large herds and extensive grazing. “Setting up local committees involving both farmers and herders to mediate disputes can provide a platform for dialogue and peaceful resolution. Encouraging community-based conflict early warning systems can help prevent clashes before they escalate”, he emphasised.For Mrs. Stella Ugwu, a farmer, having a ministry dedicated to the development of the livestock industry can help in diversifying income sources for both farmers and herders and in turn reduce dependence on land.
”For instance, promoting agro-pastoralism can provide farmers with livestock and herders with agricultural produce”, she explained, adding that providing incentives for adopting sustainable practices, such as subsidies for fodder production or crop insurance, can ease economic pressures. Ugwu was however of the opinion that the creation of a new ministry to handle livestock affairs was uncalled for, since the job can effectively be done by the Technical and Service Department of the Federal Ministry of Agriculture and food security and its equivalent on the states level.In some countries, the establishment of a Livestock Ministry or similar bodies has shown promising results. For example, Ethiopia’s Ministry of Agriculture includes a dedicated department for livestock which has successfully implemented programmes to improve pastoral livelihoods and reduce conflicts.
In Kenya, the establishment of the National Drought Management Authority has helped manage resources better, thus reducing clashes between herders and farmers during dry seasons.The president of Miyetti Allah Cattle Breeders Association of Nigeria (MACBAN), Othman Ngelzarma, sees the Ministry of Livestock Development achieving the same feat for Nigeria in the near future. He told newsmen that, “MACBAN expresses its deepest appreciation to the Federal Government for creating a ministry of livestock to unlock the trillion-naira livestock economy and create qualitative and productive jobs across the value chain to improve the Nigerian economy. With this development, MACBAN believes the hope of the Nigerian pastoralists is now achieved under the Renewed Hope Agenda.
However, the Middle Belt Forum took a different view of the proposed Ministry of Livestock Development, saying it was not enough to sustainably resolve the decades-long farmers-herders crisis in the country. According to the National President of the association, Mr. Bitrus Pogu, what is needed to end the perennial farmers/herders clashes is a deliberate action by regulatory bodies and the government to stop criminal elements from carrying out deadly attacks on innocent Nigerians, mainly farmers. Hear him: “If the reason for creating the Ministry is to stop clashes, I think it is wrong because all of these attacks and killings that are happening have nothing to do with conflicts between farmers and herders. “Farmers have never connived at any given time to go and attack herders, but rather, criminals who happen to be Fulani gang up and attack farmers, kill, maim and chase them out of their ancestral homes.
“Then, the Fulani will come and occupy them. So, it is more about invasion, criminality, and terrorism. And the majority of those they hire to do these evils are not even those who have cattle. So, a deliberate action has to be taken by the government against the perpetrators, which will address the criminality.” Mr. Pogu suggested that the government should adopt ranching for productivity and enduring peace between the pastoralists and farmers in particular and the entire country in general.While the establishment of a Livestock Ministry presents a viable solution, it is not without challenges. Funding constraints, bureaucratic inefficiencies, and corruption can hamper its effectiveness. Additionally, deeply ingrained cultural practices and mistrust between farmers and herders can be difficult to overcome.
Critics argue that without a holistic approach that includes land reform, climate change adaptation, and broader economic development, a Livestock Ministry alone may not be sufficient. Therefore, it must work in tandem with other governmental and non-governmental bodies to ensure comprehensive solutions. “A dedicated Livestock Ministry, with its focus on sustainable resource management, conflict resolution, and economic incentives, offers a promising avenue to address the root causes of these clashes. However, its success depends on effective implementation, adequate funding, and the cooperation of all stakeholders involved. With the right strategies and commitment, devoid of any political or selfish interest, it can play a crucial role in fostering peace and prosperity in affected regions”, they advised.
Calista Ezeaku