Tag: exercise

  • GENERAL ADVICE TO WOMEN ON SEX SUBJECTS

    GENERAL ADVICE TO WOMEN ON SEX SUBJECTS

    In this lesson the writer seeks to direct the attention of his women readers to certain subjects upon which the average woman is not well informed, and upon which she usually requires sound, sane, clean, frank information. In many cases women hesitate to ask even their family physicians for such information, and, although there is no rational reason for it, they even shrink from consulting better informed and capable women concerning these subjects.

    Sexual Feeling. Owing to erroneous teachings, and irrational prejudices arising from ancient distorted and perverted ideals of sex, many women have grown to maturity under the erroneous belief that it is a sign of immorality, or at least low ideals and depraved nature, for a woman to experience sexual emotions or feelings, wishes or desires. So true is this that even many married women seek to withhold from their husbands the knowledge that any sexual feeling is experienced by the wife.

    Such a belief is of course absurd. It is as natural for a woman to experience normal sexual feeling as it is for her to experience any other feeling aroused by natural instincts and organism. Without such instinct and the feelings arising therefrom, there would be no mating or marriage, and no perpetuation of the race. The woman experiencing such feelings should not allow herself to imagine that she is depraved or perverted, or immoral in thought and feeling. Incredible as it may appear to a normal, healthy-minded man, it is true that thousands of young women have lost self-respect, and have lapsed into a morbid state of mind, because of the occasional manifestation of their normal sexual feeling.

    This does not, of course, mean that the woman must necessarily manifest into action the feeling experienced by her. On the contrary, she must acquire self-mastery and self-control, just as she must in other phases of her life. It may help some women of this kind to realize that the sex feeling and impulses, arising unbidden (and often unwelcomed) from the depths of their subconscious mentality, are essentially creative impulses. If the woman be unmarried, or if married and placed under conditions in which the marital relation with the husband is impossible or undesirable, then she can transmute this creative energy in some form of creative work—in work which leads to the creation, manufacture, building-up, or composing something. There is a hint here which will prove a great blessing to the woman who will understand and apply the principle suggested—for many other women have found it so.

    As for the married woman, there is no reason whatsoever why she should seek to withhold from her husband the knowledge that she is possessed of normal, natural, healthy sexual feeling. In fact, the withholding of such information, and the concealment and deception arising therefrom, has often done much to bring marital inharmony between husband and wife. If there is any deception to be practiced in the marital association of husband and wife, it should rather be in the opposite direction, i. e., in the direction of pretending the emotional feeling when it exists only partially or is absent. The last matter, however, is one for the exercise of the judgment and conviction of each individual woman; but the first mentioned admonition is one which should be observed, as it is based on honesty, truth, and good judgment as well.

    Alcohol and Sexuality. It needs no extended argument to convince the average person that an individual will do things when under the influence of drink that he or she would not do when perfectly sober. It is an old saying that “When the wine is in, the wits are out.” But there is a deeper connection and relation between alcoholic drink and sexual indiscretions than is usually realized by the average person. Besides the commonly known weakening of will-power and self-control arising from the influence of strong drink, there are certain influences concerning the sexual nature and arising from the presence of alcohol in the system, which are not known to most persons. So true is this that the writer has thought it well to utter a few words of warning to his women readers concerning these things.

    In the first place, there is an exhilarating effect arising from certain kinds of liquor, wines, and other forms of alcoholic drinks, which manifests directly in an excitement of the sexual centers and organism. In many cases a strong sexual excitement, absent at other times, is aroused, and the person is carried away with the force of passion unknown under other circumstances. Added to this the weakened will-power arising from too much drink, and we have an explanation of many cases of “mistakes” of women. It would appear that women are even more susceptible than are men to unusual sexual excitement arising from alcoholic drinks; and that, therefore, they should be especially cautious in the indulgence in such drinks, particularly when in the company of strange men, or men careless in regard to sexual morality and respect for women in their company.

    But there is still a deeper reason, based upon the latest discoveries in psychology, why caution in this respect should be observed by women. We allude to the discovery that alcohol first affects the mental and emotional tendencies of more recent racial acquirement, acting so as to paralyze and inhibit the activities thereof, and to thus release the activity of the more primitive emotions and motive activities. Thus, the woman under the influence of alcohol finds that the more recent racial traits, such as sexual control, restraint, sexual morality, conventional observations, etc., are practically temporarily paralyzed in inhibitual—or to use the current slang phrase, are “put out of commission” for the time being; and, at the same time, the old elemental, savage, barbaric, “cave man” instincts, habits, and methods of action, are brought to the surface, and proceed to manifest their activity if opportunity be granted for the same—and the opportunity is usually granted. This being seen to be true, it is seen that the woman so under the influence of liquor is, for the time being, little more than a “cave woman,” or barbarian, with all the lax sex morality of the latter, and with all the tendencies to manifest into activity the primitive impulses arising in her nature and demanding expression. Added to this the weakening of will-power always accompanying the alcoholic influence, it is seen that the woman under the influence of strong drink is an easy prey to designing men, and a willing victim to her own lower passions.

    An authority of sex subjects says: “That Bacchus, the god of wine, is the strongest ally of Venus, the goddess of love, using the term Love in its physical sense, as the French use the word ‘amour,’ has been well known to the ancient Greeks and Romans, as it is well known today to every saloon-keeper and every keeper of a disreputable house. And all measures to combat venereal diseases and to prevent girls from making a false step will only be partially successful if we do not at the same time carry on a strong educational campaign against alcoholic indulgence. * * * Of what use are warnings to a girl, when under the influence of a heavy dinner and a bottle of champagne, to which she is unaccustomed, her passion is aroused to a degree she has never experienced before, her will is paralyzed and she yields, though deep down in her consciousness something tells her she shouldn’t? She yields, becomes pregnant, and is in the deepest agony for several months, and has a wound which will probably never heal for the rest of her life. Of what use have all the lectures, books, and maternal injunctions been to her? * * * I believe that the sex instinct can be stimulated artificially beyond the natural needs, and among the artificial stimulants of the sex instinct alcohol occupies the first place. And bear in mind that alcohol produces even a stronger effect upon women, in exciting the sexual passion, than it does on men. Women are more easily upset by stimulants and narcotics, and that is the reason why it is more dangerous for women to drink than it is for men. It is impossible to give statistics and exact or even approximate figures. But there is no question in my mind, in the mind of any careful investigator, that if alcoholic beverages could be eliminated, the number of cases of venereal infection would be diminished by about one-half. And what is true of venereal disease is also true of the seduction of young girls. Alcohol is the most efficient weapon that either the refined Don Juan or the vulgar pimp has in his possession.”

    Our advice to the woman who is asked to drink liquor when in the company of a man outside of her immediate family circle is emphatically this: DON’T DO IT!

    The Menstrual Period. As strange as it may appear to those women who have had the advantage of intelligent maternal advice, it is a fact known to all physicians that many mothers permit their young daughters to enter into the stage of puberty, with the accompanying menstrual flow, without having first instructed the daughter as to the meaning and character of this phenomenon of her nature, and without having given her advice concerning the proper care of herself during this period.

    Physicians constantly experience cases in which the young girl to whom the first menstrual flow having come, without previous knowledge on her part, has supposed it to be the result of a wound, or of a diseased condition, and has attempted to stop the flow by the application of cold water. Even where a partial knowledge has been attained by the girl, she is found to lack the knowledge of the proper hygienic care of herself during the period. The mothers in such cases are criminally negligent, and have alluded a false modesty or prudery to interfere with a natural and necessary maternal duty.

    The approach of the first menstruation is often accompanied by unusual physical, mental and emotional changes in the young girl. Her nervous system is affected, and she is apt to become irritable or morbid, or even somewhat “flighty.” Her appetite may become irregular, and there is often present a craving for indigestible food. A physical languor is often experienced, and there may be pains in the back and legs, chilliness and headaches, and a general upsetting of the usual physical condition, accompanied by a manifestation of peevishness and irritability. These unpleasant symptoms usually disappear when the periodical menstrual flow is permanently established. In fact, they are frequently superseded by the awakened energy and heightened spirits of healthy, normal adolescence.

    The time of the beginning of the menstrual period varies according to climate, race, condition of health, and temperament. In the tropical countries, menstruation begins from the tenth to the fourteenth year; in temperate countries, from the thirteenth to the sixteenth; in cold countries, from the fifteenth to the twentieth year. The Italian, Hebrew, Spanish, or French girl is apt to menstruate earlier than the English, German, or Swedish girl. The Negro girl menstruates early, as a rule. The full-blooded girl usually menstruates earlier than the anemic one.

    Normally, menstruation should proceed naturally and without pain or suffering. When pain or suffering is experienced in connection with menstruation, it is simply because of some lack of health in the general system; and when such general health is restored, the trouble ceases. Painful menstruation is called “dysmenorrhea,” and arises from several causes, principal among which are the following: Errors in diet, errors in dress, undue exposure, constipation, lack of proper exercise, or to a contracted or congested condition of the Uterus or the Fallopian Tubes. The pain, however, cannot be considered as a feature of normal menstruation, for the latter is no more painful than a normal movement of the bowels—the painful condition results from abnormal conditions, the removal of these conditions resulting in the cure of the complaint.

    Dysmenorrhea should be treated by the discarding of all unhygienic clothing, tight shoes, etc., and their replacement by rational clothing; the dietary should be carefully scanned, and improper articles replaced by nourishing elements of food—discard the pastries, pickles, confections, and stimulants, and substitute sensible articles of diet; if constipation is present, remove it by eating articles of food which promote free movements of the bowels, and drink more water each day; take a proper amount of exercise—housework is as good a form of exercise as any; many authorities advocate the free drinking of water prior to and during the menstrual period—some going so far as to say that where there is painful menstruation there is always a lack of a proper amount of water taken into the system. In some cases Dysmenorrhea is due to disorders of the general nervous system, and treatment therefore should be sought at the hands of a capable physician.

    Amenorrhea, another disorder arising in connection with the menstrual process, consists of the retention or suppression of the menses, or of “scanty” menses, or occasional “skipping” of the periods. This condition is apt to be manifest in cases of extreme obesity or “fatness;” the nervous system being burdened with superfluous flesh, its menstrual rhythm is often affected. Suppression of the menses also sometimes results from exposure and disturbing mental emotions. The most approved treatment is that of remedying the abnormal general physical condition, proper diet, and the use of hot drinks, hot sitz baths, and hot enemas about the time of the beginning of the normal period.

    Menorrhagia, another menstrual-period disorder, consists of very profuse flowing—it is, in fact, a mild form of hemorrhage. It usually arises from general debility, shocks, too violent exercise or labor, and also in many cases from undue and too frequent sexual intercourse. Sometimes the excessive flow occurs during the regular menstrual period, while in other cases it may manifest itself out of season—sometimes as often as two or three times a month. The duration of the normal period of menstrual flow, however, varies greatly among different women; the normal period may be said to last from two to six days, so what might be an excessive flow for one woman would be only normal for another—temperament plays a large part in determining the quantity of the menses.

    Some of the accompanying symptoms of Menorrhagia, or profuse flow, are lassitude, shortness of breath, faintness, dizziness, headache, irritability and nervousness, and often also leucorrhea between periods. The general treatment consists in measures calculated to bring the general health of the woman back to the normal. The building up of the general system, by means of nourishing food, proper exercise, etc., will almost always result in curing this disorder.

    A well-known authority has well said: “The hygiene of menstruation can be expressed in two words: Cleanliness and Rest.”

    So far as Rest is concerned, the woman need not be urged to take it at this period—that is, if she is able to do so. Care should be taken not to exercise unduly at this time, and under the head of exercise may be included dancing, horseback riding, and automobiling, as well as the more common forms of athletic work.

    It would seem that common sense and the general desire for cleanliness and daintiness would cause all women to observe the plain hygienic laws of Cleanliness at the time of the menstrual period. And, indeed, it is probable that such would be the case were it not for the fact that some ancient superstitions still exert their power over the mind of many women, in regard to the use of water during the menstrual period. While it is true that cold baths, or cold-water bathing, are not advisable for the average woman during the menstrual period (although some especially robust women bathe and swim as usual during this period), this prohibition does not apply to the use of warm water during the period. Lukewarm baths are permissible at this time; and the woman should wash the external genital parts with warm water, with soap if desired, every morning and evening of the period. A vaginal douche of lukewarm water is an excellent adjunct to the bathing of the parts.

    It is astonishing to meet with the superstitious prejudice existing in the minds of some women concerning the use of the vaginal douche; these good creatures seem tothink that it is either unnatural and unhealthy, or else is something “not respectable,” and fit only for the use of immoral women. These women should get in touch with modern hygienic methods, and learn to use the douche at least during their menstrual periods. At this time, if the plain rules of cleanliness are not observed, there often occurs a decomposition of the blood which has gathered in or about the genitals, and an offensive odor is manifested. Some women, while feeling distressed about this odor, are afraid to use lukewarm water in washing themselves, owing to some old unexplored superstition handed down from the great-grandmother’s time.

    The napkins should be changed at least every morning and evening. Unclean napkins may lead to infection, and it is probable that many cases of leucorrhea have their origin in lack of cleanliness concerning the napkins, cloths, or rags, used during menstruation. It may seem almost incredible to the average woman reader, but physicians know of cases (usually among the poorer and more ignorant foreign classes) in which the girl is instructed by her mother, grandmother, or aunts, that she must wear the original cloth or rag during the entire period, as she will “catch cold” by a change to a clean, fresh cloth while the flow continued. Imagine the result of such a practice! This last is an extreme instance, of course, but it will serve to show the absurd and harmful notions prevalent concerning this important natural function, and its incidents.

    Leucorrhea. A very common disorder among women is that known as Leucorrhea, or “the whites.” It consists of a discharge from the Vagina, or the Uterus through the Vagina. It is, in fact, of a catarrhal nature, and results from an over-secretion of the mucus fluids which, in proper quantity, keep the mucus membrane of the said organs in good condition. The discharge manifests in various shades and degrees of consistency. From the character of the discharge, physicians are able to determine whether it comes from the Vagina or the Uterus. The discharge from the Vagina usually is a light creamy fluid; that from the neck of the Uterus is a sticky, thick fluid flowing rather freely; that from the lining of the Uterus is alkaline, and generally precedes and follows menstruation; and that accompanying ulceration of the womb is semi-purulent and offensive in odor.

    Leucorrhea has many causes, among which may be mentioned the following: getting chilled feet or body, particularly during the menstrual period; over exertion and overwork standing on one’s feet; chills following dancing in overheated rooms; excessive worry or emotional strain, etc. It is a quite common complaint, and some assert that fully twenty-five per cent (perhaps more) of all women suffer from it to at least some extent.

    The general treatment of Leucorrhea consists of the building up of the entire system by the proper hygienic methods. Constipation should be removed, and the system is built up by the proper articles of food, exercise, etc. The use of the proper douches are also advised by the best practitioners. Physicians also treat inflamed areas by local treatments consisting of painting the Vagina or neck of the Uterus with certain medicinal solutions. Certain suppositories and douches are also employed in some cases. It is always better to consult a good physician in these cases, particularly where the trouble is aggravated or of long standing.

    A popular writer on the subject gives the following prescription for a vaginal injection: White Fluid Hydrastics, 2 ounces; Borax, 1/2 ounce; Distilled Witch Hazel Extract, 1 pint. Use of this preparation one ounce, diluted in a pint of lukewarm water, as a vaginal injection, taken twice each day.

    A well-known authority gives the following advice concerning treatment of Leucorrhea: “One of the simplest things is an alum tampon. You take a piece of absorbent cotton, about the size of a fist, spread it out, put about a tablespoonful of powdered alum on it, fold it up, tie a string around the center, insert it in the vagina as far as it will go, and leave it in twenty-four hours. Then pull it gently by the string and syringe yourself with a quart or two of warm water. Such a tampon may be inserted every other day or every third day, and I have known where this simple treatment alone produced a cure. In some cases, however, douches work better, and the two best things for douching are: tincture of iodine and lactic acid. Buy, say, four ounces of tincture of iodine, and use two teaspoonsful in two quarts of hot water in a douche bag. This injection should be used twice a day, morning and night. Of the lactic acid you buy, say, a pint, and use two tablespoonsful to two quarts of water. The lactic acid has the advantage over the tincture of iodine that it is colorless, while the iodine is dark and stains whatever it comes in contact with. Sometimes I order the use of the tincture of iodine and the lactic acid alternately: for one douche the tincture of iodine, for the next the lactic acid, and so on. When the condition improves, it is sufficient to use one teaspoonful of the tincture of iodine and one tablespoonful of the lactic acid to two quarts of water. These injections are quite efficient and have the advantage of being perfectly harmless. One point about the injections: they should be taken not in the standing or squatting position (in which position the fluid comes right out), but while laying down, over a douche pan. The douche bag should be only about a foot above the bed, so that the irrigating fluid may come out slowly; the patient, after each injection taken in the daytime, should remain at least half an hour in bed (in the nighttime she stays all night in bed.) This gives the injection a better chance to come in contact with all the parts of the vagina, and a portion of it comes in contact with the cervix, where it exerts a healing effect. Avoid the use of patent medicines.”

    Uterine Displacement. The woman suffering from Uterine Displacement should, of course, consult a competent physician and be governed by his advice. The following suggestions, however, will be found to be of service in many cases:

    In the case of Prolapsus, or falling of the womb, many women have found great relief, and in many cases permanent improvement, by taking occasional rests in bed for an hour or so, with the feet and lower part of the legs raised at least eight inches above the level of the head. In this plan, the Uterus is replaced by gravitation. Some authorities advise practicing waist-breathing while lying in this position, thus exercising the abdominal muscles. Dr. Taylor says: “Increase the pump-like action of the chest, and it will be found that the displaced viscera will return to their normal position.” Some have also found relief from the use of alum-water vaginal injections once or twice each day. The alum-water is prepared by dissolving one heaping teaspoonful of powdered alum in a pint of lukewarm water. This last treatment often strengthens the vaginal muscles whose yielding has at least partially been the cause of the falling womb.

    In cases of Retroversion, in which the Uterus is turned or bent backward, the “knee and chest” position will often aid in causing the organ to regain its normal position. In this position the woman kneels, and rests her chest upon the bed, thus causing the hips to be elevated.

    In cases of Antroversion, in which the Uterus is turned or bent forward, relief is often obtained by the woman resting upon the back, using a pillow to elevate her hips.

    Intercourse During Menstruation. It would seem that the natural esthetic repulsion to the exercise of the marital relations during the menstrual period should be sufficient to deter men and women from indulgence at this time; but many seem to have overcome this instinctive repulsion, and to these a stronger reason must be given—and the reason is at hand. The reasons in question are as follows: first, that congestion of the Uterus and Ovaries sometimes results from this unnatural practice; second, that the man may possibly contract an inflammation of the urethra by infection from the degenerated membrane, tissue, blood, etc., of the menstrual flow; and third, that such practices may result in the aggravation of discharges from the woman, such as leucorrhea, etc.

    Intercourse During Pregnancy. The best authorities advise total abstinence from sexual intercourse during the period of pregnancy; but in view of the fact that such abstinence is very difficult for most men, and that few will persist in it, it is thought well to point out the fact that at least an extreme moderation is desirable in such cases. A leading authority says on this point: “During the first four months of pregnancy, no change need be made in the usual sex relations; their intensity should be moderated, their frequency need not. During the fifth, sixth, and seventh months, intercourse should be indulged in at rarer intervals—once in two or three weeks—the act should be performed without any violence or intensity. During the eighth and ninth months relations had best be given up altogether. And this abstinence should last until about six weeks after the birth of the child. During this period the uterus undergoes what we call involution; that is, it goes back to the size and shape it had before pregnancy, and it is best not to disturb this process by sexual excitement, which causes engorgement and congestion.”

    Sterility in Women. Sterility, or barrenness, i. e., the inability to bear children, is frequently met with among married people. It is usually blamed upon the woman, whereas in at least one-half of the cases the fault is with the man.

    The causes of sterility in women are usually one or more of the following: Inflammation of the Fallopian Tubes, which may have been caused by gonorrhea or ordinary inflammation—in some rare cases childbirth has been known to set up an inflammation in this region, which has prevented the woman from future childbearing—the inflammation causes the tubes to clog up or become closed, so that no more ova can pass through them from the ovaries to the womb; in some cases, also, severe cases of leucorrhea have caused sterility, as the discharge is sometimes fatal to the life of the spermatozoa and destroys them; in other cases misplacement of the womb causes sterility; also severe inflammation of the neck or mouth of the womb operates in the same way, in some cases. In cases of sterility, the woman should have an examination made by a competent physician, and it often will be found that the cure of the disorders above noted will work a cure of the sterility.

    But, in all cases of sterility, it will be found that the husband should be examined as well as the wife—in fact, many authorities insist that the husband should be examined first. Venereal diseases frequently produce sterility in the man, although he is loath to admit this and is apt to place the blame entirely upon the woman.

    Miscarriage and Abortions. The terms “miscarriage,” and “abortion,” respectively, mean the expulsion of the fetus from the womb before its natural time of delivery. In common usage, the term “miscarriage” is usually employed to indicate instances in which the premature delivery has occurred without any voluntary act on the partof the woman, or other persons acting with her permission; the term “abortion” being reserved for instances in which the miscarriage has been voluntarily produced.

    When the fetus dies within the womb of the mother, it is usually expelled spontaneously within a few days or even a few hours. Some women suffer from certain weakness which result in habitual miscarriage; such women seem unable to carry the child for the full natural term, and lose it at some time during the period of gestation. Like results often arise from certain diseases, principal among which is syphilis. In some cases the physician produces what is known as “therapeutic abortion,” for the purpose of saving the life of the woman—this is sanctioned by medical custom and by law. Other forms of abortion, performed for the purpose of preventing the progress of the gestation, and designed for the destruction of the embryo or fetus, are known as “criminal abortion,” and are punishable by several legal penalties.

    Abortions are frequently followed by severe illness, invalidism, or even death for the woman. Many women have had their entire lives ruined by this evil practice. It is one of the curses of modern civilization, and one which must be removed by means of rational instruction and education along the lines of sexual science if the race is to be prevented from deterioration. The subject will be further considered in the subsequent lessons in this book.

    The best advice to those who have contemplated the performance of abortion is simply this: Don’t; Don’t; DON’T!

    PRIVATE Sex Advice to Women By R. B. Armitage, M. D.

    For Young Wives and those who Expect to be Married.

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  • COVID-19 And Nigeria’s Pathetic Leadership Deficit By Ugochukwu Ejinkeonye

    COVID-19 And Nigeria’s Pathetic Leadership Deficit By Ugochukwu Ejinkeonye

    COVID-19 And Nigeria’s Pathetic Leadership Deficit By Ugochukwu Ejinkeonye 1

    COVID-19 And Nigeria’s Pathetic Leadership Deficit By Ugochukwu Ejinkeonye 2


    There is no better warning about the growing confusion that seems to be gradually beclouding the federal government’s response to the coronavirus challenge than the belief it betrayed last week that, perhaps, all it needs to calm the fears and apprehensions of Nigerians about its ability to halt the spread of the virus is to reel out a catalogue of activities President Buhari was said to have undertaken so far concerning the pestilence, whether the people felt their impact or not. 

    Now, if your family is starving badly, do you solve the rumbling signs of biting hunger in their stomach with some wild tales of the efforts deployed by you so far to feed them, or just keep quiet, give them food, and they will see and feel for themselves that you have played your role responsively and effectively?  Or if you must talk, tell them something you have done whose benefits they can readily verify and identify with. 

    Indeed, some Nigerians are beginning to achieve the conviction that there must be something about being in government in this country that seems to diminish the reasoning ability of people once they get in there and deprives them of the capacity to realize when they have stopped making sense or even become downright annoying. This is very pathetic. 

    And so, last week, presidential spokesperson, Mr. Femi Adesina, issued a document entitled: “COVID-19: What President Buhari Has Done And Is Doing.” And, I suppose that with the release of that handout, the virus immediately received a deadly blow and vanished from the country! Aren’t we so blessed? Why then are Nigerians not on the streets celebrating the unprecedented feat? 

    A prominent item on Mr. Adesina’s list is the president’s March 29 broadcast. And what exactly did the broadcast achieve? The two things I can readily remember now is that Gen Buhari had announced the continuation of the school feeding programme for pupils who are all at home now due to the closure of schools as part of the efforts to contain the spread of the coronavirus. Probably, nobody remembered to inform him and his speech writers that school children were on compulsory holidays, or are they going to send the food to them in their homes? Or, perhaps, somebody is trying to find a justification for the billions of naira we will be informed later was spent on the exercise?  

    Also, the president proclaimed the lockdown of Lagos and Ogun states and the Federal Capital Territory (FCT).  And when he was through, he returned to his hideout – where only a few privileged eyes and ears see and hear from him, and then come out to tell us what they think he has said or done.

    Now, what exactly was the lockdown meant to achieve?  Okay, as social interactions are reduced, the chances of spreading the virus decrease.  Yes, but what else?  Has anyone seen any evidence that there were any plans to use the stay-at-home period to access the people and step up medical tests to determine how many people have become infected with the virus and how they could be attended to? 

    The government that was boasting that it was “adequately prepared” to tackle the virus was later to prove when the virus eventually arrived that it was only making empty claims as usual.  A country of 200 million people has yet to demonstrate any capacity to test even a reasonable fraction of one percent of her population. And somebody is publishing a document to tell us what the president was supposed to have done or is doing. As if such boring tales will remove the cloud of gloom hovering over Nigeria? 

    Again, in a country where electric power is just an unaffordable luxury for many, how can a leader just lock down some states and return to his hideout to continue his “vacation” that was rudely interrupted by the loud, persistent and widespread demands that he should address his country even though some other presidents were doing daily briefings and leading the war against the virus from the front?  As the markets closed and movements became restricted, how are those who could afford to buy and stock food items at home preserve them without electric power?  

    What of the greater population which depend on daily earnings for their survival?  What is the government’s plan for them? Okay, we are hearing of palliatives that have been extended to this category of people and the billions of naira that have already been transferred to their accounts?  Now, who has encountered the happy recipients of the twenty thousand naira (N20, 000) said to have been given to each of them?  Are there really existing data showing the social and economic status of every Nigerian which is in the possession of the authorities?  So, all the “poor and vulnerable” Nigerians now have bank accounts whose details are known to the government?  So, why then are too many Nigerians very suspicious of these claims as shown in their social media comments? And why is such a rare display of kindness by this government not being celebrated? Or have the funds (if indeed any were shared) ended up in the hands of the same people who have more than enough to need them while those who are genuinely deprived remain terribly famished? 

    Already, the biting hunger out there is forcing a growing number of people to defy the no-movement decree and soon, the whole effort might be defeated, and the country will return to square one.  Information Minister, Mr. Lai Mohammed, is threatening that the lockdown may be extended if Nigerians fail to behave themselves. But what he should rather have done is to hasten to school himself to realize that there is always a price to pay when leaders leave the country they claim to be governing in great disarray only to suddenly wake up when there is an emergency to grope for fix-quick solutions. 

    A few days after the president’s broadcast (that is, Tuesday, March 31), Daily Independent carried a front page lead story about 26 Americans who came into the country through the Murtala Mohammed International Airport and headed to Calabar without being screened.  Now, who cleared their trip to the country and why were there no health officials available to screen them and ensure they were quarantined for 14 days before being allowed to fly to Calabar?  Is it because they are Americans or clients of the Nigerian National Petroleum Corporation (NNPC) or both?  Does that automatically exempt any of them from being a carrier of the virus which is presently ravaging their own country?  What kind of government claims to be fighting a virus with one hand and using the other hand to be undermining the efforts being deployed to contain it? 

    Okay, the Minister of Health, Dr. Osagie Ehanire, has just announced that an 18-man Chinese team of medical “experts” will soon arrive the country to “assist” Nigeria in the fight against the coronavirus.  Now, is it the federal government that asked China for help or was it China that volunteered their assistance?  Indeed many Nigerians are vehemently opposed to this gesture at this time.  Our own local medical experts have not shown any signs of being overburdened by the work, so what difference are these 18 Chinese doctors and nurses going to make?  Will they, like the 26 privileged Americans, also be given express entry into the country or will they be isolated for 14 days as should be the case, before they would be allowed to start rendering their “assistance”?  

    Do we really need this Chinese gift now or is it that the government lacks the liver to politely decline their offer of help, despite the widespread apprehension among the citizenry about their involvement (since many Nigerians, habour strong fears that the gesture might turn out a Greek gift)? Even the umbrella body of Nigerian doctors, the Nigerian Medical Association (NMA), has come out to strongly oppose the coming of the Chinese medical team.  Is it that our government is too intimidated to say NO to China’s offer probably because it has yoked itself so much with crushing debts due to its excessive borrowings from them – debts, whose positive effects on Nigerian lives many are yet to see? 

    I raise these points because, although, Nigeria has recorded one of the lowest deaths from coronavirus, it was the stubborn refusal of the government to close our borders when it became very necessary and urgent (and despite calls from well-meaning Nigerians) that led to the explosion in the number of confirmed cases that the country has recorded today.  In saner climes, the government should have profusely apologized for that terrible miscalculation that is costing the nation so much now. 

    But it now has another opportunity now to gratify the yearning of Nigerians and reject the Chinese offer even if it is well-meaning and the fears about it are misplaced. 

    Now, what lessons is the government taking away from the scourge of coronavirus? Will they see the need to equip our hospitals this time and upgrade at least few of them to world standard now that they have realized the folly of always waiting to use public funds to send themselves and their families abroad to treat even minor ailments?  For the first time in Nigeria, the naïve and largely misguided Nigerian leaders have found out that it is not always safe to seek solutions for health challenges outside the country and that there is afterall no place like home. This is hoping that the lesson will endure and be redemptive. 

    *Ugochukwu Ejinkeonye, is a Nigerian journalist and writer. (scruples2006@yahoo.com) 

    Opinion

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  • Strategic Options in a Shaky 2012 Economy

    Because of 2011?s whopping economic headlines–soft economy, unemployment, limited bank credit and a falling sky, or so it seemed–creating a business strategy for 2012 will be more than just an exercise in good business. The U.S. retailer has been designing these–for better or worse–for years.

    This article explores some options for the US jewelry retailer — any retailer for that matter — for 2012.

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  • #BeActive for the UN International Day of Sport for Development and Peace

    #BeActive for the UN International Day of Sport for Development and Peace

    FIFA has joined forces with the United Nations (UN) and the World Health Organization (WHO) in supporting the #BeActive campaign launched on the UN International Day of Sport for Development and Peace to encourage people to be #HealthyAtHome as the world comes together in the fight against COVID-19, today and every day.

    WHO recommends all healthy adults do at least 30 minutes a day of physical activity and children at least 60 minutes per day. As part of this, #BeActive and remain #HealthyAtHome include the following suggestions along with any other form of recreation
    to stay healthy at home:

    #BeActive for the UN International Day of Sport for Development and Peace 3

    1. Taking some online exercise classes,
    2. Dancing,
    3. Playing active video games,
    4. Jumping rope, and
    5. Practising muscle strength and balance training.

    “We are delighted that football is strongly supporting the International Day of Sport for Development and Peace by asking everyone to #BeActive and to remain healthy at home during this difficult time,” said António Guterres Secretary-General
    of the United Nations. “FIFA has asked the football community, from member associations and clubs, to players and fans, to show their support, to put their rivalries aside and to show a new solidarity so we can overcome the coronavirus.
    This is an important lesson not only for today, but for every day.”

    “More than ever, especially now, one thing must be clear to everyone, health comes first,” said FIFA President Gianni Infantino. “FIFA is delighted to support both the United Nations and the World Health Organization in amplifying
    the #BeActive campaign today, and we are encouraged that the football community is also playing an active role in ensuring the message understood globally. For the first time ever, we are all on the same team and together, with team spirit and
    positive energy, we will win.” 

    “WHO is proud to collaborate as part of the UN family with FIFA and football lovers worldwide to promote the importance of being active for both physical and mental health,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “The #BeActive campaign supports WHO’s drive to help people be healthy at home.”

    The campaign kicks off with Real Madrid CF, FC Barcelona, Liverpool FC and Manchester United FC asking football fans to set aside their rivalries and to come together to #BeActive in order to defeat the coronavirus. Other clubs, including Club América,
    CD Guadalajara, Beijing Guoan FC, Shanghai Shenhua FC, Mohun Bagan AC, East Bengal FC, Melbourne City FC, Sydney FC, Auckland City FC, Team Wellington FC, CA River Plate, Olympique de Marseille, TP Mazembe, CR Flamengo and SE Palmeiras will also
    join the initiative in the coming days.

    As part of the campaign, world-famous players share the following message: “At this time, even rivals need to stick together. We have to keep our distance, but we do not lose our focus. We can show solidarity by being active, and active means
    following the guidelines from the WHO.”

    The video campaign will
    be published on various FIFA digital channels, with regular subsequent updates from clubs and players across the world during subsequent days. #BeActive is also being supported with graphics toolkits for the 211 FIFA member associations and various
    media agencies to facilitate additional localisation and to further amplify the message.

    WHO, the UN’s specialized health agency, and FIFA, football’s world governing body, collaborate closely to promote healthy lifestyles through football globally and launched the “
    Pass the message to kick out coronavirus” campaign last month to share advice effective measures to protect people from COVID-19.

    The video campaign can also be downloaded here for editorial purposes.

     

     

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  • The Thing Called Intuition

    The Thing Called Intuition

    Men, as each one is aware of, are disposed to query this superior intelligence of ladies; their egoism calls for the denial, and they’re seldom reflective sufficient to get rid of it by logical and evidential evaluation. Moreover, as we will see a bit afterward, there’s a sure specious look of soundness of their place; they’ve pressured upon ladies a synthetic character which nicely conceals their actual character, and girls have discovered it worthwhile to encourage the deception. But although each regular man thus cherishes the soothing unction that he’s the mental superior of all ladies, and notably of his spouse, he always provides the mislead his pretension by consulting and deferring to what he calls her instinct.

    That is to say, he is aware of by expertise that her judgment in lots of issues of capital concern is extra delicate and looking out than his personal, and, being disinclined to accredit this higher sagacity to a extra competent intelligence, he takes refuge behind the doctrine that it is because of some impenetrable and intangible expertise for guessing appropriately, some half mystical tremendous sense, some imprecise (and, in essence, infra-human) intuition.

    The true nature of this alleged intuition, nonetheless, is revealed by an examination of the conditions which encourage a person to name it to his support. These conditions don’t come up out of the purely technical issues which are his every day concern, however out of the rarer and extra basic, and therefore enormously harder issues which beset him solely at lengthy and irregular intervals, and so supply a check, not of his mere capability for being drilled, however of his capability for real ratiocination.

    No man, I take it, save one consciously inferior and hen-pecked, would seek the advice of his spouse about hiring a clerk, or about extending credit score to some paltry buyer, or about some routine piece of tawdry swindling; however not even essentially the most egoistic man would fail to sound the sentiment of his spouse about taking a companion into his enterprise, or about standing for public workplace, or about combating unfair and ruinous competitors, or about marrying off their daughter. Such issues are of huge significance; they lie on the basis of well-being; they name for one of the best thought that the person confronted by them can muster; the perils hidden in a incorrect resolution overcome even the clamors of vainness. It is in such conditions that the superior psychological grasp of ladies is of apparent utility, and needs to be admitted. It is right here that they rise above the insignificant sentimentalities, superstitions and formulae of males, and apply to the enterprise their singular expertise for separating the looks from the substance, and so train what is known as their instinct.

    Intuition? With all respect, bosh! Then it was instinct that led Darwin to work out the speculation of pure choice. Then it was instinct that fabricated the gigantically advanced rating of “Die Walkure.” Then it was instinct that satisfied Columbus of the existence of land to the west of the Azores. All this instinct of which a lot transcendental garbage is merchanted is not any extra and at least intelligence—intelligence so eager that it might probably penetrate to the hidden fact by way of essentially the most formidable wrappings of false semblance and manner, and so little corrupted by sentimental prudery that it is the same as the much more tough job of hauling that fact out into the sunshine, in all its bare hideousness. Women resolve the bigger questions of life appropriately and shortly, not as a result of they’re fortunate guessers, not as a result of they’re divinely impressed, not as a result of they practise a magic inherited from savagery, however merely and solely as a result of they’ve sense.

    They see at a look what most males couldn’t see with searchlights and telescopes; they’re at grips with the necessities of an issue earlier than males have completed debating its mere externals. They are the supreme realists of the race. Apparently illogical, they’re the possessors of a uncommon and delicate super-logic. Apparently whimsical, they hold to the reality with a tenacity which carries them by way of each section of its incessant, jellylike shifting of kind. Apparently unobservant and simply deceived, they see with vivid and horrible eyes. In males, too, the identical cruel perspicacity generally exhibits itself—males acknowledged to be extra aloof and uninflammable than the overall—males of particular expertise for the logical—sardonic males, cynics. Men, too, generally have brains. But that may be a uncommon, uncommon man, I enterprise, who’s as steadily clever, as always sound in judgment, as little postpone by appearances, as the typical ladies of forty-eight.

    Extract from IN DEFENSE OF WOMEN by H. L. Mencken

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  • Covid-19: 4,577 Malaysians overseas brought home

    Covid-19: 4,577 Malaysians overseas brought home

    Covid-19: 4,577 Malaysians overseas brought home 6

    KUALA LUMPUR: A complete of 4,577 Malaysians overseas have to this point been brought home by the repatriation train funded by the federal government, with contributions from political events, personal sector and people.

    However, Deputy Foreign Minister Datuk Kamarudin Jaffar (pix) stated in a press release at the moment, there have been nonetheless 3,026 Malaysians reported to be nonetheless stranded in 45 nations, with the most important variety of 1,446 in India.

    “Of the 3,026 stranded Malaysians, 2,016 are tourists or short-term visitors. The rest are Malaysians who are residing in other countries because of work or studies, but have made plans to return during the Movement Control Order (MCO) period, they can be categorised as stranded non-critical (persons),” he stated.

    Kamarudin who can be chairman of the Foreign Ministry’s Covid-19 Team stated among the many nations with a excessive variety of stranded Malaysians had been Thailand (259 individuals), Australia (152), New Zealand (149), Pakistan (144), Vietnam (131), Arab Saudi (121), Philippines (97), Sri Lanka (61) and Nepal (50).

    He stated two chartered Malindo Airlines flights, OD 210 and OD 212, which brought again 344 Malaysians stranded in Chennai arrived on the Kuala Lumpur International Airport at the moment at 4.35am and 5.10am respectively.

    He added that the Foreign Ministry was additionally coordinating efforts to carry again the rest of Malaysians who’re nonetheless stranded in India and 7 chartered Malindo flights are anticipated to reach on April Three to five.

    “Prior to this, the Foreign Ministry and the Malaysian Consulate-General in Chennai coordinated nine Air Asia flights and two Malindo Airlines to bring back 2,361 Malaysians who were stranded in India in an effort supported by funds from the Malaysian Indian Congress (MIC),” he stated.

    Meanwhile, 310 Malaysian college students in Indonesia arrived home yesterday on a number of business flights and 126 extra college students are scheduled to reach at the moment at Stulang Laut, Johor, by ferry from Batam.

    All returned home on their very own initiative and expense, with the cooperation of the Malaysian Embassy in Jakarta and the Consulate places of work as facilitators coping with the Indonesian authorities and airways.

    Kamarudin harassed that any determination to carry again sponsored college students was topic to situations within the affected nation and consideration of the sponsoring physique.

    He stated efforts had been additionally being made to carry again Malaysians stranded within the Middle-Eastern nations, and discussions had been being held by Malaysian leaders with the related nations.

    “Today, (Foreign Minister) Datuk Seri Hishammuddin Tun Hussein contacted Saudi Crown Prince Mohammad Salman who is also Deputy Prime Minister and Defence Minister of Saudi Arabia to discuss efforts to bring back our citizens stranded there as well as the welfare of Saudi Arabians in Malaysia,” he stated.

    Separately, the federal government acquired 1,000 COVID-19 check package models from Brunei Darussalam, offered by Acting High Commissioner of Brunei Darussalam in Malaysia, Pengiran Asnawi Arbi Pengiran Dato Paduka Hj Sharifuddin.

    “The Brunei Darussalam Government was one of the first to express the intention to contribute to Malaysia in the efforts to curb the spread of the Covid-19 pandemic.

    “The Brunei contribution is also reflective of the special relationship of 36 years of diplomatic ties and the high level of commitment between the two countries as members of Asean in tackling the Covid-19 crisis,” he stated. — Bernama

    Covid-19: 4,577 Malaysians overseas brought home
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  • Diet and exercise will keep your brain young – depending on your genes

    Diet and exercise will keep your brain young – depending on your genes

    Following a nutritious diet or exercising might affect how your brain ages, however the results on cognitive abilities later in life rely on particular gene variants that not everybody has
    Diet and exercise will keep your brain young – depending on your genes
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  • Nigerian Government Begins Distribution of N20,000 Relief Fund To Vulnerable Households

    Nigerian Government Begins Distribution of N20,000 Relief Fund To Vulnerable Households

    Nigerian Government Begins Distribution of N20,000 Relief Fund To Vulnerable Households 7

    Nigerian Government Begins Distribution of N20,000 Relief Fund To Vulnerable Households 8

    Nigerian Government Begins Distribution of N20,000 Relief Fund To Vulnerable Households 9


    The Nigerian Government on Wednesday commenced the distribution of N20,000 relief fund to vulnerable households in Kwali Area Council of the Federal Capital Territory.

    Minister of Humanitarian Affairs, Disaster Management and Social Development, Sadia Umar-Farouk, said exercise would continue for the next four months.

    She added that the relief fund was being distributed in line with the announcement made by President Muhammadu Buhari during his nationwide broadcast on Sunday. 

    Nigerian Government Begins Distribution of N20,000 Relief Fund To Vulnerable Households 10


    Farouq disclosed that the N20,000 would be given to each person in vulnerable households as palliative to mitigate the effect of lockdown. 

    She said, “Because of this COVID-19, the vulnerable groups have to expand because we are aware that there are people who live on daily wage.

    “So, we are also going to look at those groups of people to see how we can get food relief intervention to them in this period.”

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  • Legal Issues Arising From Management Of Covid-19 Patients By Ahmed Adetola-Kazeem

    Legal Issues Arising From Management Of Covid-19 Patients By Ahmed Adetola-Kazeem

    Legal Issues Arising From Management Of Covid-19 Patients By Ahmed Adetola-Kazeem 11

    Legal Issues Arising From Management Of Covid-19 Patients By Ahmed Adetola-Kazeem 12


    A lot of legal issues are bound to arise as an aftermath of the outbreak of Coronavirus otherwise referred to as COVID-19.  There is therefore a need to shed light on some of the issues that may arise and how to navigate them. This article will x-ray the rights of patients, the rights of health workers and the basic minimum obligations of the government.

    The Code of Medical Ethics in Nigeria 2008 lists acts that constitute professional negligence. Rule 29.4 of the Code outlines some of these acts as follows:-

    a)      Failure to attend promptly to a patient requiring urgent attention when the practitioner was in a position to do so;

    b)     Manifesting incompetence in the assessment of a patient;

    c)      Making an incorrect diagnosis particularly when the clinical features were so glaring that no reasonable skillful practitioner could have failed to notice them; 

    d)     Failure to advise, or proffering wrong advice to  a patient on the risk involved in a particular operation or course of treatment, especially if such an operation or course of treatment is likely to result in serious side effects like deformity or loss of organ, or function;

    e)      Failure to obtain the informed consent of the patient before proceeding on any surgical procedure or course of treatment when such consent was necessary; 

    f)       Making a mistake in treatment e.g. amputation of the wrong limb, carelessness that results in the termination of a pregnancy, prescribing the wrong drug, or dosage in error for a correctly diagnosed ailment, etc;

    g)     Failure to refer, or transfer a patient in good time, when such a referral or transfer was necessary;

    h)     Failure to do anything that ought reasonably to have been done under any circumstance for the good of the patient;

    i)       Failure to see a patient as often as his medical condition warrants or to make appropriate comments in the case notes of the practitioner’s observations and prescribed treatment during such visits. It also includes failure to communicate with the patient or with his relatives as may be necessary with regards to any developments, progress or prognosis in the patient’s condition.

     

    Rule 11.2 of the 2008 Code of Medical Ethics in Nigeria provides that, “A physician shall preserve absolute confidentiality on all he knows about his patient even after the patient has died.”

                 Rule 44 of the Code of Medical Ethics has extensive provisions on Confidentiality and when disclosure of information can be made. The Rule provides in part that:

    “Disclosure of information on the patient by the doctor can only be made following an informed consent of the patient in writing. It is clear that the ethic covers even such information as induced abortion, venereal disease, attempted suicide, concealed birth and drug dependence but would exclude situations in which a discretionary breach of confidentiality is necessary to protect the patient or the community from danger and this must be made clear to the patient at the time of the confidential disclosure. Where statutory notification of disease is involved, the consent of the patient is not required.”            

                Confidentiality: To Disclose Identity Of Covid-19 Patients Or Not To Disclose?

    COVID-19 is an infectious disease caused by a newly discovered coronavirus. Most people infected with the COVID-19 will experience mild to moderate respiratory illness and recover without requiring special treatment.  Older people, and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to develop serious illness.[1]

    The Federal Ministry of Health confirmed the first case of COVID-19 in Nigeria on the 27th of February 2020. It is the case of an Italian citizen who works in Nigeria and returned from Milan, Italy to Lagos, Nigeria on the 25th of February 2020. In reaction to the report, the social was divided between those who want the name of the Italian disclosed and those that preferred it remains confidential. The outcry was even more when the Chief of Staff to the President tested positive according to reports from various media houses[2], but the Minister of Health decided to keep mute on the identity of the President’s aide who contacted the virus, citing confidentiality.

    It will ordinarily be wrong to disclose the medical status of someone infected with COVID-19, for instancethe case of the Italian who was the index case. However in view of the proviso to Rule 44 of the Code of Medical Ethics 2008 which provides that a discretionary breach of confidentiality is necessary in order to protect the community from danger, I am of the view that the test results of popular figures who hold strategic offices like the Chief of Staff to the President or a Governor must be disclosed to guaranty public safety. This is necessary in view of the countless number of people from all works of life they come in contact with on a daily basis.  It will be correct to have made their status public in the overriding interest of the public, since it will enable those who have come in contact with them isolate, just like we have seen in the cases of the British Prime Minister, the Bauchi State Govenor, Prince Charles, the First Lady of Canada and many more. We must commend those who announced their status in public themselves-it is the best thing to do in the interest of humanity

    The World Health Organization (WHO) provides additional guidelines for the management of coronavirus patients specifically.[3]

    Health workers should:

    •follow established occupational safety and health procedures, avoid exposing others to health and safety risks and participate in employer-provided occupational safety and health training; 

    •use provided protocols to assess, triage and treat patients; 

    •treat patients with respect, compassion and dignity; 

    •maintain patient confidentiality; 

    •swiftly follow established public health reporting procedures of suspect and confirmed cases; 

    •provide or reinforce accurate infection prevention and control and public health information, including to concerned people who have neither symptoms nor risk;

    •put on, use, take off and dispose of personal protective equipment properly;

    •self-monitor for signs of illness and self-isolate or report illness to managers, if it occurs; 

    •advise management if they are experiencing signs of undue stress or mental health challenges that require support interventions; and 

    •report  to  their  immediate  supervisor  any  situation  which  they  have  reasonable  justification  to  believe presents an imminent and serious danger to life or health.

     

    Doctors and health workers in Nigeria must endeavor to digest the guidelines in the Code of Medical Ethics as well as the WHO Guidelines for management of Coronavirus victims and ensure they work strictly by their provisions. A breach of these duties have dire consequences. 

    Options Available To Covid-19 Patients Who Are Victims Of Medical Negligence

    A Coronavirus patient who has suffered medical negligence has a number of options:

    1. He could file a complaint with the regulatory body (e.g. the Medical and Dental Council of Nigeria, in the cases involving a Doctor). The Doctor will in the first instance be investigated by the Medical and Dental Practitioners Investigation Panel, after which he will be tried by the Medical and Dental Practitioners Disciplinary Tribunal. If found culpable,  the Doctor may be warned, suspended from practicing for a period not exceeding 6 months or in very serious cases, have his name can be removed from the Register of Medical Practitioners. The Medical and Dental Practitioners’ Disciplinary Tribunal does not award monetary damages.

    2. A suit can be filed against the Medical Doctor, the Hospital, Agency or Government in the High Court for Medical Negligence and monetary damages will be awarded if the Defendant(s) are found culpable.

          3.  If there is an element of Crime, a report could be made to the Police who would conduct Criminal Investigation and where the investigation reveals gross negligence, recklessness or wanton disregard for life of the victim, the police can prosecute or forward the case file to the office of the Attorney General of the State for possible prosecution in deserving cases.  

    A Need To Do More For Doctors And Other Professionals In The Health Sector

    Health workers are at the front line of any outbreak response and as such are exposed to hazards that put them at risk of infection with an outbreak pathogen (in this case COVID-19). Hazards include pathogen exposure, long working  hours,  psychological  distress,  fatigue,  occupational  burnout,  stigma,  and  physical  and  psychological violence. 

    During the outbreak of Ebola more than 500 health care workers died in Guinea, Liberia and Sierra-Leone alone. We also lost some of our finest doctors and health workers to the disease in Nigeria, the most prominent being Dr. Stella Adadevoh, who is credited with having curbed a wider spread of the Ebola virus in Nigeria by placing the index patient, Patrick Sawyer, in quarantine despite pressures from the Liberian  government. As we speak, The coronavirus is waging a war of attrition against health care workers throughout the world, but nowhere is it winning more battles at the moment than in Italy and in Spain, where protective equipment and tests have been in severely short supply for weeks. In Spain 13.6% (6500) of those affected with the coronavirus are health workers and in Italy 10% (7400) of those affected with the virus are health workers. [4] In New York dozens of health workers have been affected with the virus, while hundreds are in quarantine.[5] According to reports filtering in as the time of concluding this article, three health workers have been infected with COVID-19 in Abuja, Nigeria.[6]

    Human Rights Watch research into health system collapse in Hungary and Venezuela suggests the nations’ mismanaged, underfunded, and understaffed public healthcare system is poorly equipped to handle a COVID-19 outbreak. Patients and medical experts described a lack of basic hygiene protocol, lack of isolation rooms, and a shortage of health professionals, doctors and nurses, and medical supplies in general.

    The situation is not too different in Nigeria at the moment and except something drastic is done we might be witnessing a devastating effect of the pandemic. Nigeria’s, public health capacity has been diminished by large scale public sector corruption. Medical personnel lack surgical masks and local supplies have been diverted and shipped to other markets partly due to corruption. Many states are ill-prepared to combat the impeding surge in patients. A senior health worker with a government hospital in Abuja, in an interview with Sahara Reporters, lamented the lack of quality Personal Protective Equipment for them, adding that government must invest in the protection of health workers at the frontline of the battle against the virus. He said, “The unfortunate thing is that the government is not providing us with what to work with. It is sad that our PPE are not up to the world standard and can be penetrated by viruses. Some of us (health workers) have to use our personal funds to purchase gloves as we do not trust the ones government supplied. Nigerians should please remember us in their prayers and government should provide us with what we really need to work.” [7]

    There was report that in Bauchi State a Coronavirus patient rejected the isolation centre at the Bauchi Specialist Hospital and went back home while describing it as “too dirty”.[8]  

    It is disappointing to hear that the hazard allowance for doctors and health workers is N5,000 per month in Nigeria. The amount is very paltry compared to the risks and the attendant emotional and psychological stress suffered by the health-care workers (HWCs) particularly during monumental outbreaks like this. Unfortunately, when a patient is mismanaged, these doctors and health workers bear the burden of paying huge compensation and sometimes losing their jobs. More importantly, the brain-drain in the health sector is monumental, almost all my friends who are doctors, work abroad. Unfortunately, there are concerted efforts by the US Government to engage foreign Doctors to further fortify its health work force as COVID-19 ravages. Many young Nigerian doctors are already considering the offers because the Nigerian government has paid little attention to their welfare and the welfare of the general health workforce. To stop the exodus of our doctors, who are already in short supply, the government must act fast by improving their welfare packages in line with acceptable international standards.

    The psychological needs of doctors and health workers are also often ignored. Unsafe working conditions contribute to health worker attrition in many countries due to work-related illness and injury and the resulting fear of health workers of occupational infection, including from HIV and Tuberculosis. The 2006 World Health Report – Working Together for Health reported on a severe health workforce crisis in fifty-seven countries, most of them in Africa and Asia. [9]

    Protecting the occupational health of health workers is critical to having an adequate workforce of trained and healthy health personnel. Governments at the Federal and State levels are urged to do more by complying fully with the World Health Organization’s guidelines regarding the Rights of Health Workers while combating COVID-19. Some of the rights are:

    ·         assume overall responsibility to ensure that all necessary preventive and protective measures are taken to minimize occupational safety and health risks;

    ·         provide information, instruction and training on occupational safety and health, including; Refresher training on infection prevention and control(IPC); and Use, putting on, taking off and disposal of personal protective equipment(PPE);

    ·         provide adequate IPC and PPE supplies (masks, gloves, goggles, gowns, hand sanitizer, soap and water, cleaning supplies) in sufficient quantity to healthcare or other staff caring for suspected or confirmed COVID-19 patients, such that workers do not incur expenses for occupational safety and health requirements;

    ·         not be required to return to a work situation where there is continuing orserious danger to life or health, until the employer has taken any necessary remedial action;

    ·         allow workers to exercise the right to remove themselves from a work situation that they have reasonable justification to believe presents an imminent and serious danger to their life or health. When a health worker exercises this right, they shall be protected from any undue consequences; 

    ·         honour the right to compensation, rehabilitation and curative services if infected with COVID-19 following exposure in the workplace. This would be considered occupational exposure and resulting illness would be considered an occupational disease,

    ·         provide access to mental health and counselling resources; and 

    ·         enable co-operation between management and workers and/or their representatives. Etc.

    In conclusion, professional care givers for COVID-19 patients should uphold four basic principles formulated by Beauchamp and Childress in their book ‘Principles of Biomedical Ethics’ in order to protect themselves from liability for negligence. The four basic principles are autonomy, beneficence, non-maleficence and justice.

    Autonomy: People have the right to control what happens to their bodies. This principle simply means that an informed, competent adult patient can refuse or accept treatments, drugs, and surgeries according to their wishes. People have the right to control what happens to their bodies because they are free and rational. And these decisions must be respected by everyone, even if those decisions aren’t in the best interest of the patient.

    Beneficence: All healthcare providers must strive to improve their patient’s health, to do the most good for the patient in every situation. But what is good for one patient may not be good for another, so each situation should be considered individually. And other values that might conflict with beneficence may need to be considered.

    Non-maleficence: “First, do no harm” is the bedrock of medical ethics. In every situation, healthcare providers should avoid causing harm to their patients. You should also be aware of the doctrine of double effect, where a treatment intended for good unintentionally causes harm. This doctrine helps you make difficult decisions about whether actions with double effects can be undertaken.

    Justice: The fourth principle demands that you should try to be as fair as possible when offering treatments to patients and allocating scarce medical resources. You should be able to justify your actions in every situation. For instance, it will amount to a professional misconduct for a Health-care Worker to remove a poor man from the ventilator because a Senator was rushed in. 

    Ahmed Adetola-Kazeem is a partner in Adetola-Kazeem Legal Practice and specializes in Medical and Health Law

    Email: aadetolakazeem@gmail.com;aadetolakazeem@gaklp.com

    [1] https://www.who.int/health-topics/coronavirus#tab=tab_1(Accessed on the 28th of March 2020)

    [2] https://businessday.ng/coronavirus/article/abba-kyari-tests-positive-for-coronavirus-buhari-negative/

    https://www.channelstv.com/2020/03/24/buharis-chief-of-staff-abba-kyari-reportedly-tests-positive-for-coronavirus/ (Accessed on the 28th of March 2020)

    [3] Coronavirus Disease (Covid-19) Outbreak: Rights, Roles and Responsibilities Of Health workers, Including Key Considerations For Occupational Safety And Health”. https://www.who.int/docs/default-source/coronaviruse/who-rights-roles-respon-hw-covid-19.pdf?sfvrsn=bcabd401_0   (Accessed on the 26th of March 2020)

    [4] https://abcnews.go.com/Health/wireStory/collapsing-virus-pummels-medics-spain-italy-69789413 (Accessed on 26th March 2020)

    [5] https://www.washingtonpost.com/health/covid-19-hits-doctors-nurses-emts-threatening-health-system/2020/03/17/f21147e8-67aa-11ea-b313-df458622c2cc_story.html (Accessed on 28th of March 2020)

    [6] http://saharareporters.com/2020/03/28/exclusive-two-nurses-one-doctor-infected-coronavirus-abuja-hospital

    [7] Supra

    [8] https://www.dailytrust.com.ng/coronavirus-patient-rejects-bauchi-isolation-centre-returns-home.html (Accessed on 28th March 2020)

    [9] https://www.who.int/occupational_health/topics/hcworkers/en/(Accessed on 26th March 2020)

     

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