14042019 - 144 Killed in nine days

SUNDAY VANGUARD, APRIL 14, 2019, PAGE 31
ease!’
hey prefer the male type
Stating that a female condom is a vital tool to protect
girls and women’s reproductive health as well as offer
them reproductive health choices, she lamented that
male condoms are more accepted than female.
“Women are not using it since it was introduced about
nine years ago in Nigeria. Not all women have seen or
heard about it. If you bring 10 women together, hardly
will you find two women out of the 10 that know about
it. Some women say they feel embarrassed using it. It
is good than male condom because a woman can insert
it for five hours before sex if it is well fixed. The
problem is low awareness about it. There is a need to
sensitize the woman about it. Unlike men that can enter
any shop and get condoms on the shelf, many women
cannot walk into a shop and demand for female
condoms. They prefer modern methods”, she said.
“While I was in public service as an immunization
officer for women and children, I will keep thousands
of male and female condoms. Women prefer to take a
male than a female condom.
“Most times, the female condoms expire in my hands.
Like in my facility, I will have about 500. If I managed
to distribute 200, it is a miracle but male condoms are
in thousands”.
Adekoya further recommended that female condoms
should be made available in all private and public
facilities and more awareness created on it.
How to use a female condom
Adding that few women who tried to use it were
discouraged due to the technicality associated with the
female condom, she said: “Before you open a female
condom, women should wash their hands very well as
the product is very oily. Check the expiry date and
that it appears in good condition. Take it carefully out
of the packet so as not to rip it and don’t use your teeth
or scissors, and be careful with sharp fingernails or
jewellery when you are opening it.
“You can sit, squat, lie or stand in a position you find
comfortable. It has two rings, squeeze the smaller ring
at the closed end of the condom and insert it into your
vagina as far as it will go, making sure that it doesn’t
twist. The large ring at the open end of the female
condom will cover the
area around the
vaginal opening. It
will stay outside the
body.
“When you have sex,
the penis should enter
into the female
condom. The woman
must always guide her
partner to ensure it
goes in the right place
and throughout the
intercourse.
“After sex, twist the
large ring to prevent
semen from leaking
out and gently pull the
female condom out. It
has its own
techniques; if not used
properly, it can result
in an unplanned
pregnancy”.
Adekoya said
although female
condom is a shortacting
barrier method
of family planning, if
used correctly, it is
highly effective.
Corroborating her
views, the National
President of
HealthCare Providers
Association of Nigeria,
HCPAN, Dr Adeyeye
Arigbabuwo,
confirmed that female
condoms are safe for
use. According him, it
is all about protection
against diseases and
u n w a n t e d
pregnancies.
Dr. Sakina Bello,
Senior Program
Advisor – Pathfinder
International in
Nigeria, on his part,
said female condom
empowers the woman/
girl to negotiate safer
sex as she can totally
control its use rather
than relying on the
man to provide and
wear his own condom.
“It is equally a
convenient method of
contraception as you
only need to use it
when you have sex.
Since it can be worn up
to eight hours before
sexual intercourse, it
gives the woman
enough time to
prepare for the act
ahead of time and
avoid any interruption
during sex. The
condom comes prelubricated
and wide,
with flexible rings that
heightens the pleasure
for both partners
during intercourse and eliminates
the possible discomfort often
complained with the male
condoms”, she said.
“On whether it is reliable, it is a
contraceptive with no serious side
effects. If used correctly and
consistently, the female condoms
are 95% effective against
unintended pregnancies and
sexually transmitted infections.
“There is generally a low level of
awareness about female condom
hence the need for increased public
education. According to NDHS
2013, less than 0.5% of the
population is aware of female
condom. However, there have
been pockets of programs led by
partners in a few states that have
increased the awareness to some
extent. Health providers have also
been trained, and some can
competently counsel their clients
on female condom.
“Interaction with female sex
workers also suggests that usage
among them is on the increase.
Although not as widely available
as the male condoms and often
more expensive, it is available in
all public facilities free and can be
obtained from major pharmacies or
super marts in Nigeria”.
Health watchers are of the view
that the female condom remains an
effective female-initiated method
that can make a major contribution
to prevention efforts globally and
enables women to exercise their
sexual and reproductive rights.
•Chris Bode
Inside the new LUTH,
57 years after, by Chris
Bode, CMD
By Chioma Obinna
Recently, the Chief Medical Director, Lagos University
Teaching Hospital, Prof. Chris Bode, was reappointed for
the next four years by President Muhammadu Buhari. Last
week, the CMD unveiled his plans to improve the 57-yearold
health institution. At the occasion, he said one of his
plans is to ensure that the hospital achieves 100 per cent
proficiency.
Excerpts:-
Challenges of the past
When I came on board four years ago, the system was
suffering. The greatest challenge was lack of confidence in
the system, both among workers and the people who come
here. Our various clients stopped believing in the system.
Now, with the co-operation and collaboration of others, that
narrative has changed. It’s humbling to know that the same
environment that was so hostile has gradually embraced change. We had stormy relationships,
stormy reception from trainees, from workers group, but I guess, through appealing to their good
side and showing by example from the leadership of the institution in the past four years, the
situation has improved appreciably. We have been able to change the mindset so that all workers at
LUTH now appreciate what we were established to do - render services to people. That is what
matters; any other thing will be excused. People are not interested in that, no matter what you do, if
you do it very well, people will come to you and if you don’t they will go elsewhere. And we don’t
want them to go elsewhere for many reasons because even our own livelihood depends on it and the
mandate given to us would be a failed mandate if we don’t fulfil it.
Repositioning hospital
There has been enormous support in the last four years from the
top management team, the nurses, the head of nurses and all heads
of department; they have been marvellous as they embraced the
experiment. The change we tried to implement has yielded very
good results, with all modesty. We must thank the Minister of Health
and his team. They have really risen to the challenge, done very well
for us and also the workers in LUTH have been marvellous. I must
say that our people know good things when they see it. I think that
is what has been driving us. The entire workforce is eager to reflect
the new order. The changes are manifest. For instance, our dental
school that was decertified last year because we didn’t have dented
chairs has now been re-certified. Through a joint effort between the
university, alumni and management, we have been able to put LUTH
back on the path to its former glory. Good things are happening,
that’s my message and we must do more. The greatest enemy of
progress is to be complacent, there is no resting here. We must
commend the management board led by Alhaji Isa Sali Bello and
his team for astutely leading the hospital at this time; we have been
able to accomplish a lot.
Changes
There is calm in the system now. I can recall that there was a year
we didn’t work for eight months; our salaries were paid by
government. At another time, we went on strike for five months. All
that had to stop. The healthcare sector can no longer afford such
disruption. So we had to start whittling that down with support from
members of the public, members of our staff and even government.
With time, the government started listening to what the agitations
were and the government was fulfilling them, promising and
fulfilling; coupled with delivering on low hanging, deliverables,
intermediate term and long term plans. All these have now started
bearing fruitful results and I like to add that it has really brought
LUTH to the fore again. A lot has been done during the past four
years. We now have a reliable power supply through our gas-fired
electricity, we now have a very good blood bank, good water supply;
our wards are beginning to be rehabilitated and other facilities as
•‘There was a year we didn’t work for eight
months and we got salaries. That has to stop’
We are a
government
institution, but
we must agree
that services are
not free. We
need to review
the concept of
health care
financing so
that there will be
universal
coverage
well including the acute stroke care centre. We are repositioning our radiology department. We are
putting up a new structure for the care of over 8,000 HIV patients and our advanced facility centre
has been up and running and is doing very well. Workers are going through further training and we
have crowned it with the $11 million NSIA-LUTH cancer centre which the President commissioned
in February.
Plans for the next four years
A lot more needs to be done, looking ahead. The reward for hard work is more work and, because
our facilities have been there for 57 years now, we need to carry out complete rehabilitation of our
wards, our out-patients department and many other structures. The out-patients facility is inadequate;
we want to build an extension so that patients can be seen more promptly rather than being given
long appointments. We are going to do the same thing for our operation theatre facilities and other
facilities that need to be upgraded and expanded.
We are appealing to all like-minded bodies to assist LUTH. The late Chief Isaac Olusola Dada
promised to build a renal dialysis centre for us before he passed away suddenly. It is going to cost
more than N200 million. It will have 36 dialysis machines and will be one of the largest in the
country for modern renal dialysis. The Lions Club and the family of Chief Dada will build and
furnish it on a PPP basis, experts in dialysis, institutions that supply equipment and consumables
can come and use it, we will make the services affordable to ensure that Nigerians come here rather
than go abroad. We are still going cap in hand. Already, we have immense support from the Sovereign
Wealth Fund; they have promised to sustain the cancer centre, so it will be a modern cancer centre
that render services and give meaningful returns to investors. It will serve as a beacon for publicprivate
collaboration in health care delivery. If they don’t see us as valuable, they won’t bring their
money to tie down. We are planning a hospital-wide information management system to reduce the
paperwork, improve efficiency and reduce the stress faced by patients. Another plan is to expand
operation theatres, intensive care unit and eye treatment unit. The ultimate goal is to make LUTH a
comprehensive and reliable hospital in one structure so that we don’t refer any patient. We want to
achieve 100% proficiency. If LUTH refers somebody to any other place, it’s like telling them to go
and die because we ought to have everything. Even if our accident and emergency ward are full, I
would rather you move patients straight to the ward and begin emergency care at the ward rather
than tell them there’s no bed. We would do all that we can to increase bed space. Even while doing
this we must appeal to all Nigerians, services in LUTH are highly subsidized between 30 and 80
per cent. Depending on the services, for an average operation, you may pay a million naira outside;
here you might pay just N200, 000.
Appeal
We are a government institution, but we must agree that services are not free. We need to review
the concept of health care financing so that there will be universal coverage. There should be a
safety net provided by the national institutional scheme for those who may easily fall through the
cracks. The elderly, children, pregnant women and accident victims should be taken care of under
a solid health insurance scheme. Public health institutions must continue to treat patients they are
not able to pay and we cannot reject anybody brought as an emergency. We found out that such
obligations are a big drain on the finance of tertiary institutions, not only at LUTH, it happens
everywhere. Maybe because this is a large hospital, we feel it a lot.