Epunchng - Most read newspaper in Nigeria Sunday, August 13, 2017 - Page 55

Sunday August 13, 2017 Health+ T his topic is one that should worry every Nigerian. At the end of our lives here in sub-Saharan Africa, how do we want to be cared for? Do we want to be cared for in a hospital, or at home or a hospice? Or do we indeed want to be taken care of in a home for the elderly or indeed in a hotel? Depending on what the choices are, do we have the necessary funds to indulge in such care? If indeed we do, is the infrastructure available? In some of the most perplexing set of circumstances to ever confront a health practitioner is the very real difficulty of extending excellent health care to people who are at the end of their lives. Recently, yours truly was called upon to help arrange a facility to look after a nonagenarian and it was embarrassing, to put it mildly, that no facility in metropolitan Lagos could offer such care without asking for an arm and a leg. It was an eye-opener. In what is perhaps the fastest growing metropolis on the African continent, there are less than three score beds (less than 60) in intensive care units spread across the metropolis to cater for a population of 18 million people. It is frightening in the scale of inadequacy not to mention the human toll this very sad inability costs the nation on an annual basis. More to the point is the attitude of health planners across the country to the development of modern hospitals when they build interesting edifices but fail spectacularly on a regular basis to properly equip such hospitals with adequate manpower and equipment. To the nation at large, one would say that perhaps ignorance is bliss. End of life care is defined by the medical, nursing and physiotherapy arms of health care as the range of positive health interventions that ought to guarantee a reasonable quality of life at the end of one’s life in a comfortable environment that ensures minimum pain and discomfort. To many, such institutions are for the people who have lived a full life in relatively good health and now wish to enjoy the care of professional care-givers. Others have no choice in the matter and would sooner or later be confined to such a state because they are recognized as being terminally ill and therefore can only endure a certain level of meaningful existence at the hands of experts. Such expert care would then be determined depending on what the precipitating factors are. For terminally ill people, age is not a barrier. People of all ages can fall into this category particularly when they suffer from cancer, AIDS, mental illness and incurable disease conditions. The key is to make a proper diagnosis of the condition and keep the family and close relatives informed such that they can make informed decisions based on what they know. In our country, these kinds of people are either in the hospital or they are at home; there is no middle road where middle-level health-care professionals can look after them under the overall guidance of a supervising hospital or ministry. For those who can still be saved, there is a crying need for more intensive care units in as many hospitals as possible, particularly where there are specialists who have already acquired the requisite training to deliver such care. And you need to sell off a house Dear Doctor, I read your piece on vomiting which appeared in July 2, 2017 edition of SUNDAY PUNCH. My concern is not on vomiting rather it is on a major disorder in my body respiratory system. Over the past two years, I wake up every morning having catarrh while I feel an itch in the upper part of the mouth and I try using my tongue several times to scratch it. This happens every morning for at least 20 minutes. But after brushing, it will suddenly stop. The catarrh does not always come with running nose. Please, what would you advise me to do? Thanks. xxx@xxx.com It is a minor issue and the only problem as far as I can see is that you have failed to seek a doctor’s advice and possible treatment. That is where you ought to begin. If your doctor is unable to help you, he can refer you to an Ear, Nose and Throat surgeon for examination and treatment. Such a problem as you have described may be an allergic condition or an infection. A proper examination will determine which one it is. Dear doctor, thank you for all your responses. Please is this situation normal: End of life care and family cars in order to be able to afford such care for your loved ones. In some cases, the sheer demands for the care of terminally ill people is so overwhelming for the families concerned that they simply abscond from the hospital thus leaving their relatives behind or they take them home only to abandon them to their fate. There is no dignity in the final days and no expression of love, not because they are heartless but because they are simply too overwhelmed even by their own immediate needs that they simply become thick-skinned. It is frankly depressing and the scope of the problem is grossly under- reported. Societies are rated in their index of affordable health care by the measures they undertake to care for the people at the extremes of age; the very young and the elderly. In addition, there must develop a comprehensive and organized pattern for taking care of the vulnerable people who most need managed care whether in the hospital as a form of extension services at any of the locations we have itemized above. Such a purposeful attempt at ensuring a comprehensive health care for all the population subgroups does not appear to be the case anywhere on the continent except in South Africa and that says a lot for the system which the Afrikaner regime left largely in place to mirror the system in operation in Western Europe has in effect been demolished by the advent of majority rule. Even so, the world stood in absolute awe at the level of care which Nelson Mandela got at the end of his Ask the doctor I ate a light food from morning till evening and I did not go to the toilet. The next day, I took solid food and, in the process, I experienced a great urge to go to the toilet. In addition, I have noticed that the rate at which I go to the toilet is more at my present age (mid-20s) compared to when I was around 14. Thank you. xxx@xxx.com Your question is vague. 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