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What's up with Bill's home town?
7:45 AM Bill English wants to spend more time in this sleepy little Southland town. So what's it like?
Collins leadership bid
Judith Collins is going for it.
2 min ago Judith Collins has announced a bid to replace Bill English as leader of the National Party.
Fletcher's monopoly queried
6:42 AM Construction company says it's time to step in over key post-quake housing project.
Good in the UK, not in NZ
7:30 AM All the qualifications she should need can't get Catherine Barak the job she wants in NZ.
English out, now what?
7:54 AM OPINION: National's facing a huge step into the unknown. But first, the number crunching.
Live: Cyclone Gita
Gita spares Fiji devastation on the scale of Tonga, but it could strengthen again.
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Collins mounts leadership bid
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Fletcher Building losses mount
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Accreditation win for DHB
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The D4 back for more video
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Top 6: Sydney Mardi Gras events
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What to wear to Field Days?
editors' picks
'Do the maths' on retirement age
Cook Strait too strong for cables video
Lorde producer's 'dark side'
Parents stop school makeup class
NZ's 'frightening' poverty video
Missing boy's body identified
Pilots' error caused plane crash video
Plague of financial insecurity
Amy Adams has proven her worth on some tough portfolios, is well respected and might be deputy material.
National's leadership contest
Black Caps captain Kane Williamson celebrates running out England batsman James Vince.
Black Caps topple England
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'Do the maths, it's unaffordable': former chief economist returns to commentary
Recap: Black Caps v England T20 Tri-Series - match four
Teary and emotional, Bill English calls it quits - now what?
Cook Strait cable lifting in fierce currents - heftier ones needed
Fletcher Building 'suffered billions in wealth loss'
Auckland man jailed for 12 years for 'brutal' abuse of partner and children
'Face flies' leave US woman with worms in her eye in first human case of parasitic infection spread
Wellington intermediate school drops makeup class after complaints from parents
Live: Tropical Cyclone Gita tracks through Fijian waters as Tonga reels
National's leadership lineup - list of contenders to replace Bill English
05022018 Business Photo: SUPPLIED. Sir Edmund Hillary.
Quiz: Stuff's daily trivia challenge
The lions were "scattered by the sound of gunshots" but it was too late to save the man.
Lions eat man hunting them
Neither of us are into "ownership" but we have different ideas of what that means.
My lover wants to see other people
Bill English over the ages.
Bill English's style transformation
The Paratitahi tunnel, damaged during the November 2016 earthquake, will be increased in size as part of its repairs.
Taller tunnels for Kaikōura coast
Benny Castles, designer at World, believes it's all about finding your own look.
Men's work suit is dead
national crime politics stuff circuit science education
More rain in the north
Flooding in Kawakawa. Terry Strawbridge, the owner of Port Valley Engineering, sits outside his workshop, waiting for ...
7:41 AM Heavy rain on way again for top half of North Island, after downpours sparked flooding on Tuesday.
Kidnapping-accused 'sinister'
He was a hardworking RSA man. But in "the black of night", he turned into a prowler, court hears.
Address bungle: One dead
Killer's lament for the innocent
An Auckland man has been sent to prison for "unprecedented" abuse against his partner and six children (file photo).
Man's 'unprecedented' abuse
8:07 AM Auckland man half-blinded partner and threw son down stairs in long-running case of "sadistic" violence.
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Fletcher Building losses mount
And the building giant's chairman will step down.
TMO wrong on Anscombe try Was this a try to Wales in the Six Nations match against England?
Bill English quits. Now what? Bill English has big plans for the future.
Black Panther has sharpest claws The latest clip for Black Panther is a kick ass thrill ride that's as political as it is enjoyable.
Lorde producer's 'dark side' Lorde holding the six awards she won at the VMAS tonight.
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US kills '200' Russian fighters video
Secretary of Defence Jim Mattis said the bloodbath was "perplexing".
12 min ago "Perplexing" bloodbath could be deadliest clash between former foes since Cold War.
Workers 'offered aid for sex'
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Joyce denies misconduct claims
Zuma given 48 hours to quit
Queen Elizabeth II turns 92 in April.
Queen's successor debated
7:42 AM Commonwealth considers who should be rightful successor to Queen and NZ's next head of state.
business industries small business farming
Banks' record profit
The banks made a combined profit of more than $5 billion last year.
2017 was a good year for New Zealand's banks, raking in $5.19 billion.
How much privacy can you get?
OPINION: Politicians don't want you knowing about their love lives or cash, but privacy's an issue for all of us.
From garage to sharemarket
Retirement village revamp
About 125,000 New Zealand residents opted not to disclose where they were from on their departure cards.
Chart: Flight of the Kiwis
8:03 AM Aucklanders are taking full advantage of their international airport.
technology digital living gadgets social networking apps
The perfect phone is coming
The Essential Phone – the brainchild of Android co-founder Andy Rubin – was the first phone to feature a "notch".
12 min ago Manufacturers have had us drooling for years over the idea of a phone that's all screen, with no buttons.
Trade Me is watching you
Your Trade Me searches are about to get a whole lot more personal.
The changes coming to Android
Death by hacking almost reality
Finding somewhere to charge your phone at an airport can be difficult.
Travelling with tech troublesome
A smartphone is a traveller's best friend but despite being around for 10 years, airports, airlines and hotels haven't fully embraced them.
homed houses decor
Whisky and roses video
The fragrant Damask rose set Desiree Whitaker off on a new life path.
Meet a whisky maker who plans to produce pure rose perfume in New Zealand for the first time.
Live chat: Helping your garden grow
Gardening guru and author Lynda Hallinan is dropping in to answer your gardening questions.
Control back-to-school clutter
Buyer wanted for $1m air space
New couple TV presenter Erin Simpson and former Bachelor NZ star Zac Franich love art and a good cup of tea.
Things we love: Erin and Zac
TV presenter Erin Simpson and the Bachelor NZ's Zac Franich both love art and a good cup of tea.
life & style love & sex beauty fashion
What really is Chinese food?
Beijing's all about noodles, dumplings, bao and other wheat-based foods.
Sweet and sour in a polystyrene box is not real Chinese food.
'Contraception app' backlash video
One woman used the app for only a few months before discovering she was pregnant: "I cried for two weeks."
The dates we don't want to go on
The perfume everyone wants
Radius Elloughton Gardens residents William and Elizabeth Pitt have been married for 66 years.
Love tips from the golden age video
Combined, these Kiwi couples bring 176 years of relationship advice to the table.
well & good teach me motivate me inspire me
Why vapers go back to smoking
Some vapers are mixing electronic and real smoking.
Some smokers use vaping to help subsidise the costs of smoking.
Why thin doesn't mean healthy
Just because you can indulge in unhealthy foods without gaining weight doesn't mean you should.
Untold suffering faced by bird rescuers
Goop slammed for dangerous diet tip video
If you bleed during menopause, sex or pregnancy you need to visit a GP.
When bleeding isn't normal
If you bleed during menopause, sex or pregnancy, you need to visit a GP.
food & wine recipes
Say it with edible flowers
Apricots with blue cheese and borage flowers
This Valentine's Day, follow the old adages "the way to a person's heart is through their stomach" and "say it with flowers".
Easy chicken winner dinner
This affordable and tasty chicken dinner is from the new Bargain Box cookbook - Family Favourites.
Flat kitchens: what I wish I knew
World tequila shortage is coming video
nz farmer discovery digital editions
Science threat to red meat video
US company Impossible Foods is debuting its lab-grown "meat" burger in partnership with New York restaurant Nishi.
The time's approaching when farmed meat and 'clean meat' sit side by side.
Stock priority during drought
Farmers need to be making the right decisions on farms to recover from the drought.
Wetlands 'natural sponges'
Challenges for rural businesses
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Say no to Valentines here video
The Breaker Upperers is the story of two women who earn a living by breaking up unhappy couples for cash.
6:59 AM WATCH: Your first look at the Taika Waititi-produced comedy,The Breaker Uppers, written, directed by and starring Jackie van Beek and Madeleine Sami.
Best of the French Film Fest
6:52 AM Want to watch an icon of French cinema be mercilessly and hilariously skewered? Ecoute moi.
Robbie Williams' Kiwi birthday video
Miriama Kamo's write idea
Chadwick Boseman and Michael B. Jordan square-up in Black Panther.
Black Panther has sharp claws
7:50 AM REVIEW: This latest Marvel adventure kicks arse, wears its politics lightly but explicitly enough for anyone with the ears to hear it and the plot turns and twists enough to keep our attention engaged.
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Top 6: Sydney Mardi Gras events
Thousands of people will be in the parade.
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Take a break in Wairarapa stuff nation
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Tongan airport closed
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It's the hot new car colour
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White remains most popular colour for cars - but here comes grey.
Hurt drivers reach airbag deal
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Outback stands tall for Subaru
One in three don't stop video
Mercedes-Benz apologise to China for quoting Dalai Lama on social media.
Mercedes offends China
Mercedes-Benz apologises for upsetting Chinese consumers by quoting the Dalai Lama.
stuff nation quiz groups assignments
How to fill the NZ football void stuff nation
All Whites fans were out in full force (and song) at the World Cup play-off match against Peru in Wellington.
Rugby has the Bledisloe and cricket has the Chappell-Hadlee - so why is there no trans-Tasman football equivalent?
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Teddy aka 'Yoda' is a little dog with a lot of character.
A Finnish free lunch stuff nation
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Lola, the survivor stuff nation
Lola had a troubled and cruel start to life. But she's slowly on the mend.
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Lucky break sets up Williamson
Black Caps captain Kane Williamson is awarded the player of the match award at Westpac Stadium.
7:03 AM Black Caps captain looked certain to be run out first ball before his day turned dramatically.
TMO wrong on Anscombe try video
8:14 AM World Rugby rules Wales should've been awarded try in critical call in Six Nations loss to England.
No medal but locks of gold
Stokes returning to NZ video
Seta Tamanivalu holds the Super Rugby trophy after Crusaders beat the Lions in the final last August.
Crusaders buy into US team
17 min ago Crusaders and Canterbury Rugby Union take shares in new American professional team.
opinion cartoons
When Tinder leads to pregnancy
Catrina fell pregnant from a Tinder date who already had a girlfriend - but she says having a child helped turn her life ...
OPINION: "Just because I had decided to become a mother did not mean I could force fatherhood on him."
What was Sir Bob Jones satirising?
Sir Bob Jones says it should be clear his NBR column was a "piss take". (file photo)
OPINION: He says his Māori Gratitude Day column was satire. If only it was funny.
Why I love flying economy
Economy class: The older I get the more comfortable I am travelling this way.
OPINION: Walking onto the plane there's that strange class-conscious parade through the business cabin.
Don't accept if he asks you last
Why are we still committed to an outdated tradition that smacks of sexism?
OPINION: It's time to ditch the tradition of asking a dad for his daughter's hand in marriage.
special projects
NZ expands military role in Iraq
Harmeet Sooden
Our mission in Iraq has undergone a significant change, without the public being told.
The haunting of Evelyn Sen
The Haunting of Evelyn Sen: thumbnail
She believed her daughter was being tortured and couldn’t bear her suffering.
The last of the southern men
Donald Aubrey has farmed the 13,000 hectare Ben McLeod station for nearly 40 years.
Is the high country runholder an endangered species?
'A vast transfer of wealth'
Half a million hectares sold
Half a million hectares of publicly-owned land has been given up.
His addiction was no accident
Michael Demchy dropped more than one hundred thousand dollars in to pokies.
Michael resolved not to gamble. But something kept drawing him back.
What if you needed an organ?
Life out of death
Many of us say we're happy to donate, but very few do.
The Snowman and the Queen video
The Snowman and the Queen splash image chapter 1.
From his perch on a fifth-floor toilet, the sandy-haired Dunedin teen raises the gun: time to kill a royal.
good reads
Town where medieval meets modern
The site of the medieval Kilkenny Castle, set in lush parklands along the River Nore.
Kilkenny - full of history and pulsing with energy, this Irish town has two distinct sides.
Machine gun mafia football
Antony Golec comes off the pitch with Sheriff Tiraspol, Transnistria.
An A-League player wanted in on the Champions League. Buried in the fine print was relocation to a country that doesn't exist.
Novice sailors take on the Atlantic
Rohan and Abby reckon sailing is the ultimate way to travel.
When Kiwis Abby Sanford and Rohan Honson-Morris first took out their yacht, they didn't know how to turn on the engines.
Company thrives while mum grieves video
Selina Eruera with some of her son's forestry gear.
A couple who liquidated their company after a worker's death are doing fine. The worker's mum can't afford a headstone.
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$4.3m for touch rugby injuries
Touch players in Auckland made nearly 8000 injury claims to ACC during the past three summers.
Nearly 8000 injury claims were made to ACC over the past three Auckland summers.
When you have too many Havelocks
For more than a century, rumours have persisted that Havelock's historic post office was meant to be a church in ...
Did a church destined for Havelock North end up as a post office in Havelock?
Native lizards fitted with radios
The nagehere geckos have had tiny radio transmitters taped to their backs so they can be monitored.
The gecko's transmitters weigh less than a gram.
Terrible sketch helps catch suspect
Hung Phuoc Nguyen and the witness’ sketch of his likeness.
It looks like a strawberry wearing a cap and only has one ear, but unbelievably, it helped police.
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Most-liked Instagram post ever
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Lucas is America's cutest baby video
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Novice sailors take on the Atlantic
Rohan and Abby reckon sailing is the ultimate way to travel.
When Kiwis Abby Sanford and Rohan Honson-Morris first took out their yacht, they didn't know how to turn on the engines.
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Mount Rainier from the Skyline Trail in Washington state.
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Life on a French canal barge
In the vineyards.
Graeme and Claire Wood have cruised all over France on their floating home.
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Last year I finally made it to the iconic holiday destination of Santorini in Greece, made famous for its crisp white ...
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Olurotimi Seun:
Issues complexus et profundus. I hope the issues raised wouldn't just slide, this portends a lot for the future of medical practise in Nigeria.
It would also go a long way in stemming the brain drain of our doctors.
NMA and MDCAN have been sounding the alarm, while we await presidential intervention, let us be seen to put our house in order.
Good morning Hippocratic elders and brothers.
Olatunji Dr. Idowu:
I'm not sure there's any report of the co-racer being injured. The was report I'm sure of is that the President's son was trying to overtake the other when he crashed. That may not mean the other guy crashed too! My opinion!
Henry Ewunonu:
Perioperative patient outcomes in the African Surgical Outcomes Study: a 7-day prospective observational cohort study
Prof Bruce M Biccard, PhD Correspondence information about the author Prof Bruce M Biccard Email the author Prof Bruce M Biccard
,
Prof Thandinkosi E Madiba, PhD, Hyla-Louise Kluyts, MMed, Dolly M Munlemvo, MD, Farai D Madzimbamuto, FCA [ECSA], Apollo Basenero, MBChB, Christina S Gordon, DipNursing
, Prof Coulibaly Youssouf, MD, Sylvia R Rakotoarison, MD, Veekash Gobin, MD, Ahmadou L Samateh, FWACS, Chaibou M Sani, MD, Prof Akinyinka O Omigbodun, FWACS, Prof Simbo D Amanor-Boadu, FMCA, Janat T Tumukunde, MMed [Anaesthesia], Tonya M Esterhuizen, MSc, Yannick Le Manach, PhD
, Prof Patrice Forget, PhD, Abdulaziz M Elkhogia, FRCA, Prof Ryad M Mehyaoui, MD, Prof Eugene Zoumeno, PhD, Prof Gabriel Ndayisaba, MD, Henry Ndasi, FCS, Andrew K N Ndonga, FICS
, , ProfZipporah W W Ngumi, FFARCS, Ushmah P Patel, MMed [Anaesthesia], Prof Daniel Zemenfes Ashebir, MD, Akwasi A K Antwi-Kusi, FGCS, Bernard Mbwele, MSc, Hamza Doles Sama, PhD, Mahmoud Elfiky, MD, Prof Maher A Fawzy, MD, ProfRupert M Pearse, MD[Res], on behalf of the
African Surgical Outcomes Study (ASOS) investigators
Show all authors
Published: 03 January 2018
PlumX Metrics
DOI: http://dx.doi.org/10.1016/S0140-6736(18)30001-1
Summary
Background
There is a need to increase access to surgical treatments in African countries, but perioperative complications represent a major global health-care burden. There are few studies describing surgical outcomes in Africa.
Methods
We did a 7-day, international, prospective, observational cohort study of patients aged 18 years and older undergoing any inpatient surgery in 25 countries in Africa (the African Surgical Outcomes Study). We aimed to recruit as many hospitals as possible using a convenience sampling survey, and required data from at least ten hospitals per country (or half the surgical centres if there were fewer than ten hospitals) and data for at least 90% of eligible patients from each site. Each country selected one recruitment week between February and May, 2016. The primary outcome was in-hospital postoperative complications, assessed according to predefined criteria and graded as mild, moderate, or severe. Data were presented as median (IQR), mean (SD), or n (%), and compared using t tests. This study is registered on the South African National Health Research Database (KZ_2015RP7_22) and ClinicalTrials.gov (NCT03044899).
Findings
We recruited 11 422 patients (median 29 [IQR 10–70]) from 247 hospitals during the national cohort weeks. Hospitals served a median population of 810 000 people (IQR 200 000–2 000 000), with a combined number of specialist surgeons, obstetricians, and anaesthetists totalling 0·7 (0·2–1·9) per 100 000 population. Hospitals did a median of 212 (IQR 65–578) surgical procedures per 100 000 population each year. Patients were younger (mean age 38·5 years [SD 16·1]), with a lower risk profile (American Society of Anesthesiologists median score 1 [IQR 1–2]) than reported in high-income countries. 1253 (11%) patients were infected with HIV, 6504 procedures (57%) were urgent or emergent, and the most common procedure was caesarean delivery (3792 patients, 33%). Postoperative complications occurred in 1977 (18·2%, 95% CI 17·4–18·9]) of 10 885 patients. 239 (2·1%) of 11 193 patients died, 225 (94·1%) after the day of surgery. Infection was the most common complication (1156 [10·2%] of 10 970 patients), of whom 112 (9·7%) died.
Interpretation
Despite a low-risk profile and few postoperative complications, patients in Africa were twice as likely to die after surgery when compared with the global average for postoperative deaths. Initiatives to increase access to surgical treatments in Africa therefore should be coupled with improved surveillance for deteriorating physiology in patients who develop postoperative complications, and the resources necessary to achieve this objective.
Good evening All. I first learnt of this study on BBC Focus on Africa program few days ago when the it was pub;ished. I really think this sort of finding is worth interrotgatinmg further. Kudos to our own Dr. 'Yinka Omogbodun professor of Surgery who participated in the multi country study.
Chris Yilgwan:
A good start.
But it seems their methodology does not support the conclusions they are making.
The need to expand the scope and reach of the recruitment centers.
Henry Ewunonu:
Bro, how're you doing today sir?
Please read the full article.
There could be misleading assumptions in their sample selection and other methodology issues, but what hope do we have in Africa.
Can the Committee on Treatment Guidelines and Clinical Governance validate this study or prove it otherwise?
Chris Yilgwan:
Am fine.
We are far from getting there.
As chair of Specialties committee, I have tried to galvanize this kind of approach but it seems our people are used to working in their cocoons and don’t understand collaboration.
But from my experience with the global registry for Rheumatic heart disease, it is doable.
Irene AKHIDENO:
This study involved about 10 hospitals in Nigeria spread over the different geopolitical zones.
Prof Amanor-Boadu ,Foremost Anaesthesiologist.
Henry Ewunonu:
Great.
Can NMA stimulate an action that can make surgical outcomes more positive in Nigeria?
Irene AKHIDENO:
It was a snapshot type of study.
Good understanding of perioperative medicine by the surgeons is key.
This will ensure good anaesthetic review in which the recommendations by the Anaesthetists are taken into consideration by the surgeons as this will ultimately improve post operative outcome.
Henry Ewunonu:
I'm not a surgeon but my casual observation tend to suggest that immediate post-op care in Nigeria ia very sub-optimal. Patients hardly get the prescribed antibiotics and analgesics promptly either due to unavailability or human resource inefficiency/deficiency. They are also not reveiwed periodically unless thay start shouting and their relatives came up in arms drawn against the nurses and junior doctors on call. Again, since majority of the subjects studied were operated under emergent conditions, pre-op co-morbidities including poor nutritional statuses among others would definiety impact on survival.
Irene AKHIDENO:
Perioperative medicine involves pre,intra and post operative.
Elective cases are deferred if there are clinical issues that require optimisation.
With preanesthetic clinics(which Anaesthetists are clamoring for) cases are not deferred when patients have already being admitted for surgery
Emergencies do not have the luxury of optimisation with resultant increased morbidity and mortality
John Obafunwa, Prof.:
SINCE A LOT IS BEING SAID ABOUT THIS SUBJECT MATTER, PLEASE CAN SOMEBODY ADVISE ME IF THIS REPORT BY THE MEDIA IS TRUE OR FAKE? JUST SEEKING INFORMATION.
http://nigeriahealthonline.com/2018/02/10/report-that-nailed-nhis-boss-usman-yusuf.nho/
Clement Onwube:
NOTICE OF 2018 WORLD ORAL HEALTH DAY CELEBRATION.
Dear Dental Health Coordinators
This is to remind us that the 2018 World Oral Health Day Celebration is about Thirty eight (38) days from today, the precise date being Tuesday 20 March. The theme of this year's celebration is "SAY AHH! THINK MOUTH, THINK HEALTH"
Accordingly you are expected to identify an Oral Health Promotion tool such as ( Town Hall Meetings, Visits to Community Leaders, Schools, Prisons, IDP Camps, Market places, Motor Parks, Media Interactive Sessions, Using the Social Media, etc) that you may wish to adopt in creating dental health awareness in your state/FCT during the international day celebration. The above mentioned tools can be used singly or in combination depending on the resources available to you.
Therefore, you are expected to draft a proposal and forward same through your State Chairman to your State Officers Committee for vetting. A uniform template will be sent to you in due course following FDI World Dental Federation guidelines and format for 2018 celebration.
The National Dental Health Committee pleads with all NMA State/FCT Chapters to give their respective Dental Health Coordinators all the necessary support and assistance so that together we can pilot a successful WOHD Celebration with the needed impact.
Best wishes from,
Dr Clement Onwube JP
Chairman, NMA National Committee on Dental Health
Michael Idowu:
For our patients with VVF
Dear All,
Recruitment of patients for vesico vaginal fistula (VVF) repair is ongoing at the gynaecology department Wesley Guild Hospital, Ilesha for the forthcoming pooled effort. Treatment is free. For further information, contact Dr Fehintola (08037998247).
Let's save a life today
Wole Akinsulire:
Basic Surgical Skills course holds on 22-23rd February 2018 @Surgical Skills centre LUTH.
Kindly inform interested residents
Follow the link below for details👇🏼
https://www.facebook.com/events/802686413251935/?ti=as
Dr. Kennedy Obohwemu:
http://penkup.blogspot.com/2018/02/revealed-mysterious-snake-that-swalowed.html
Meshak:
Health sector dips as more Nigerian doctors move abroad
By Chukwuma Muanya, Assistant Editor
13 February 2018 |
More reasons have emerged on why no fewer than 5,405 Nigerian-trained doctors and nurses are currently working with the British National Health Service (NHS) in the United Kingdom (U.K.) and why many more will join the league.
The figure, released by the British government, means Nigerian medics constitute 3.9 per cent of the 137,000 foreign staff of 202 nationalities working alongside British doctors and nurses.
The Guardian investigation revealed that many more Nigerian doctors would join their colleagues soon because the U.K. has need for medics from Commonwealth countries, since some doctors in the European Union (E.U.) are already leaving because of Brexit.
It was also gathered that most of the Nigerian doctors and nurses are leaving for the U.K. because of better conditions of service. The migration has further worsened the physician-patient ratio in Nigeria from 1:4,000 to 1:5,000, contrary to the World Health Organisation’s (WHO) recommended 1:600. The physician-patient ratio in the U.K. is 1:300.
According to the WHO, countries with low physician-patient ratio have worse disease outcomes and life expectancy.
Figures from the Nigerian Medical Association (NMA) showed that about 45,000 doctors are currently practicing in Nigeria. This means that 12 per cent of 45,000 Nigerian doctors, that is 5,405, are practising in the U.K. and the country is now left with less than 40,000, excluding those practising in the U.S., South Africa, Saudi Arabia and others.
NMA President, Dr. Mike Ogirima, described the exodus of doctors as worrisome. He blamed the situation on poor remuneration for medical doctors, poor working environment and inadequate medical equipment and infrastructure.
He said the trend has worsened the doctor-patient ratio of 1:4,000, caused longer waiting time at hospitals, rise in fatal disease outcomes, and more frequent medical errors by over worked doctors.
Ogirima said: “Nigeria is using her resources to train doctors and professionals that will leave to work in foreign countries. What are those things attracting these professionals outside? Can we duplicate them here?”
“Government should provide adequate remuneration. We are not saying we should pay so much, but pay them for the job they are doing as and when due.”
Consultant Public Health Physician, Prof. Akin Osibogun, however, said the situation could be reversed if the Federal Government makes the National Insurance Scheme (NHIS) compulsory for all citizens. According to him, this would provide enough funds to improve the conditions of service and working environment for health professionals.
He said: “The few ones we have are leaving because of poor conditions of service, working environment and after service package. It means the physician-patient ratio has worsened, maybe from 1:3,000 to 1:5,000. When you compare, those countries that have better physician-patient ratio have better treatment outcomes.”
Osibogun, a former Chief Medical Director (CMD) of the Lagos University Teaching Hospital (LUTH), said Nigeria currently produces about 3,000 medical doctors every year and needs to increase the ratio by producing more, and developing plans on how to retain them.
He explained: “We need to make working conditions attractive. If they know they will have a house after 20 years of training, the lure to leave would be reduced. What are the benefits attached to the job? What are the provisions for the doctor’s family? What are the long-term prospects for the staff?
“We need to improve the work environment in terms of financing. Make it work-friendly, not crowding 10 persons in one office. Talk about electricity supply; you come to work and you are scheduled to do a surgery but there is no electricity.
“We need to be more drastic; re-organising the way we fund health service. There should be compulsory NHIS that will bring a pool of funds. We have to adopt a more holistic approach.”
But a consultant paediatric surgeon and c
urrent CMD of LUTH, Prof. Chris Bode, said the situation is not hopeless. He said the high migration of Nigerian doctors to the U.K. is because some doctors in E.U. countries are leaving because of Brexit and the NHS has opened its gates to doctors from Commonwealth countries.
Bode, however, said Nigeria needs proper planning to harness the opportunity the situation brings.
He said: “A medical degree is an international passport. Because of global competition, many doctors are moving to the U.S. and U.K. We lose because we trained them but we also learn from them by getting exposed to cutting-edge technologies. One day, if we harness them, they will come back to impact positively on the practice here.
“That is the method Japan, India and China used in adapting what they learnt in the U.S. and U.K. It is not a total loss. We are seeing a lot of movement of medical doctors abroad. It is not as if Nigerian medicine is dead. I had to spend a lot, $14,000, some years back on going to Israel to learn new skills. That has distinguished me and Nigerians are benefitting.
“Nigerian doctors are going to the U.K. because they have opened their gates. By the time the medical doctors come back, we will be better for it. It is not a hopeless situation. There is a lot we can do to harness the opportunity. We need proper planning.”
http://guardian.ng/features/health-sector-dips-as-more-nigerian-doctors-move-abroad/
Henry Ewunonu:
I'm thinking that every challenge presents an opportunity for addressing it and it's likes.
We have been talking about this medical manpower emigration even in the face of severe under/unemployment and the effects of the manpower shortages on the quality of health services in the country. It is amazing that these appear to have fallen on deaf ears. It has been so because solutions proferred have been allowed to just be another dust ridden file on the shelf. One of the ways to curb this emigration is to think and act the radical stuff.
Can we lobby for health to be in the EXCLUSIVE LIST even as several provisions of the 1999 Constitution are being amended?
State governors have messed up human resources for health across the different genre and cadres.
In some states, they have converted medicare as a relic of its glorious past.
There was a time when private medical prcatice was more illustrious and lucrative than public medical service.
That narrative has been changed due the enhancement of the pay packages of medical and health workers.
NARD recently held a national discuss on "Making our hospitals work better" in Abuja.
Several startegic Ideas were proferred. Governmnet was there.
Hospital administrators were there. Doctors were there.
Can we then raise that chorus to a crescendo by embarking on a campaign to make our working environments more condusive?
Should we keep on lamenting about the absence of soap and antiseptics for hand hygiene without letting our voices heared at the highest quarters in the land?
I will end here by reminding us of the famous saying of Frantz Fanon- “Each generation must, out of relative obscurity, discover its mission, fulfill it, or betray it.” Let's discover ours and fulfill it.
Michael Idowu:
FEATURE: Patients lament long waiting time at Nigerian hospitals as govt seeks solutions https://www.premiumtimesng.com/news/headlines/258454-feature-patients-lament-long-waiting-time-nigerian-hospitals-govt-seeks-solutions.html
Lassa fever: Doctors take sensitisation to markets as disease claims one in Osun https://www.premiumtimesng.com/regional/ssouth-west/258450-lassa-fever-doctors-take-sensitisation-markets-disease-claims-one-osun.html
Senator storms JAMB office with anti-snake venom, charmers over missing money https://www.premiumtimesng.com/news/top-news/258495-senator-storms-jamb-office-anti-snake-venom-charmers-missing-money.html
Abuse of Office: Court discharges ex-president Jonathan’s physician https://www.premiumtimesng.com/news/more-news/258518-abuse-office-court-discharges-ex-president-jonathans-physician.html
Senate moves to rescue Kanu Heart Foundation from AMCON take-over https://www.premiumtimesng.com/business/business-news/258523-senate-moves-rescue-kanu-heart-foundation-amcon-take.html
Dr Abdulkadir Bello Katagum:
Thank you for liking and sharing. Spread the word with us as we Celebrate this year's World Oral Health Day on the 20th March. #WOHD18 #SayAhh #ThinkMouthThinkHealth
Dr AB Katagum BDS, Dental Health C
Thank you for liking and sharing. Spread the word with us as we Celebrate this year's World Oral Health Day on the 20th March. #WOHD18 #SayAhh #ThinkMouthThinkHealth
Dr AB Katagum BDS, Dental Health Coordinator NMA FCT https://youtu.be/aFYvnZTTi_A
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Olurotimi Seun:
Issues complexus et profundus. I hope the issues raised wouldn't just slide, this portends a lot for the future of medical practise in Nigeria.
It would also go a long way in stemming the brain drain of our doctors.
NMA and MDCAN have been sounding the alarm, while we await presidential intervention, let us be seen to put our house in order.
Good morning Hippocratic elders and brothers.
Olatunji Dr. Idowu:
I'm not sure there's any report of the co-racer being injured. The was report I'm sure of is that the President's son was trying to overtake the other when he crashed. That may not mean the other guy crashed too! My opinion!
Henry Ewunonu:
Perioperative patient outcomes in the African Surgical Outcomes Study: a 7-day prospective observational cohort study
Prof Bruce M Biccard, PhD Correspondence information about the author Prof Bruce M Biccard Email the author Prof Bruce M Biccard
,
Prof Thandinkosi E Madiba, PhD, Hyla-Louise Kluyts, MMed, Dolly M Munlemvo, MD, Farai D Madzimbamuto, FCA [ECSA], Apollo Basenero, MBChB, Christina S Gordon, DipNursing
, Prof Coulibaly Youssouf, MD, Sylvia R Rakotoarison, MD, Veekash Gobin, MD, Ahmadou L Samateh, FWACS, Chaibou M Sani, MD, Prof Akinyinka O Omigbodun, FWACS, Prof Simbo D Amanor-Boadu, FMCA, Janat T Tumukunde, MMed [Anaesthesia], Tonya M Esterhuizen, MSc, Yannick Le Manach, PhD
, Prof Patrice Forget, PhD, Abdulaziz M Elkhogia, FRCA, Prof Ryad M Mehyaoui, MD, Prof Eugene Zoumeno, PhD, Prof Gabriel Ndayisaba, MD, Henry Ndasi, FCS, Andrew K N Ndonga, FICS
, , ProfZipporah W W Ngumi, FFARCS, Ushmah P Patel, MMed [Anaesthesia], Prof Daniel Zemenfes Ashebir, MD, Akwasi A K Antwi-Kusi, FGCS, Bernard Mbwele, MSc, Hamza Doles Sama, PhD, Mahmoud Elfiky, MD, Prof Maher A Fawzy, MD, ProfRupert M Pearse, MD[Res], on behalf of the
African Surgical Outcomes Study (ASOS) investigators
Show all authors
Published: 03 January 2018
PlumX Metrics
DOI: http://dx.doi.org/10.1016/S0140-6736(18)30001-1
Summary
Background
There is a need to increase access to surgical treatments in African countries, but perioperative complications represent a major global health-care burden. There are few studies describing surgical outcomes in Africa.
Methods
We did a 7-day, international, prospective, observational cohort study of patients aged 18 years and older undergoing any inpatient surgery in 25 countries in Africa (the African Surgical Outcomes Study). We aimed to recruit as many hospitals as possible using a convenience sampling survey, and required data from at least ten hospitals per country (or half the surgical centres if there were fewer than ten hospitals) and data for at least 90% of eligible patients from each site. Each country selected one recruitment week between February and May, 2016. The primary outcome was in-hospital postoperative complications, assessed according to predefined criteria and graded as mild, moderate, or severe. Data were presented as median (IQR), mean (SD), or n (%), and compared using t tests. This study is registered on the South African National Health Research Database (KZ_2015RP7_22) and ClinicalTrials.gov (NCT03044899).
Findings
We recruited 11 422 patients (median 29 [IQR 10–70]) from 247 hospitals during the national cohort weeks. Hospitals served a median population of 810 000 people (IQR 200 000–2 000 000), with a combined number of specialist surgeons, obstetricians, and anaesthetists totalling 0·7 (0·2–1·9) per 100 000 population. Hospitals did a median of 212 (IQR 65–578) surgical procedures per 100 000 population each year. Patients were younger (mean age 38·5 years [SD 16·1]), with a lower risk profile (American Society of Anesthesiologists median score 1 [IQR 1–2]) than reported in high-income countries. 1253 (11%) patients were infected with HIV, 6504 procedures (57%) were urgent or emergent, and the most common procedure was caesarean delivery (3792 patients, 33%). Postoperative complications occurred in 1977 (18·2%, 95% CI 17·4–18·9]) of 10 885 patients. 239 (2·1%) of 11 193 patients died, 225 (94·1%) after the day of surgery. Infection was the most common complication (1156 [10·2%] of 10 970 patients), of whom 112 (9·7%) died.
Interpretation
Despite a low-risk profile and few postoperative complications, patients in Africa were twice as likely to die after surgery when compared with the global average for postoperative deaths. Initiatives to increase access to surgical treatments in Africa therefore should be coupled with improved surveillance for deteriorating physiology in patients who develop postoperative complications, and the resources necessary to achieve this objective.
Good evening All. I first learnt of this study on BBC Focus on Africa program few days ago when the it was pub;ished. I really think this sort of finding is worth interrotgatinmg further. Kudos to our own Dr. 'Yinka Omogbodun professor of Surgery who participated in the multi country study.
Chris Yilgwan:
A good start.
But it seems their methodology does not support the conclusions they are making.
The need to expand the scope and reach of the recruitment centers.
Henry Ewunonu:
Bro, how're you doing today sir?
Please read the full article.
There could be misleading assumptions in their sample selection and other methodology issues, but what hope do we have in Africa.
Can the Committee on Treatment Guidelines and Clinical Governance validate this study or prove it otherwise?
Chris Yilgwan:
Am fine.
We are far from getting there.
As chair of Specialties committee, I have tried to galvanize this kind of approach but it seems our people are used to working in their cocoons and don’t understand collaboration.
But from my experience with the global registry for Rheumatic heart disease, it is doable.
Irene AKHIDENO:
This study involved about 10 hospitals in Nigeria spread over the different geopolitical zones.
Prof Amanor-Boadu ,Foremost Anaesthesiologist.
Henry Ewunonu:
Great.
Can NMA stimulate an action that can make surgical outcomes more positive in Nigeria?
Irene AKHIDENO:
It was a snapshot type of study.
Good understanding of perioperative medicine by the surgeons is key.
This will ensure good anaesthetic review in which the recommendations by the Anaesthetists are taken into consideration by the surgeons as this will ultimately improve post operative outcome.
Henry Ewunonu:
I'm not a surgeon but my casual observation tend to suggest that immediate post-op care in Nigeria ia very sub-optimal. Patients hardly get the prescribed antibiotics and analgesics promptly either due to unavailability or human resource inefficiency/deficiency. They are also not reveiwed periodically unless thay start shouting and their relatives came up in arms drawn against the nurses and junior doctors on call. Again, since majority of the subjects studied were operated under emergent conditions, pre-op co-morbidities including poor nutritional statuses among others would definiety impact on survival.
Irene AKHIDENO:
Perioperative medicine involves pre,intra and post operative.
Elective cases are deferred if there are clinical issues that require optimisation.
With preanesthetic clinics(which Anaesthetists are clamoring for) cases are not deferred when patients have already being admitted for surgery
Emergencies do not have the luxury of optimisation with resultant increased morbidity and mortality
John Obafunwa, Prof.:
SINCE A LOT IS BEING SAID ABOUT THIS SUBJECT MATTER, PLEASE CAN SOMEBODY ADVISE ME IF THIS REPORT BY THE MEDIA IS TRUE OR FAKE? JUST SEEKING INFORMATION.
http://nigeriahealthonline.com/2018/02/10/report-that-nailed-nhis-boss-usman-yusuf.nho/
Clement Onwube:
NOTICE OF 2018 WORLD ORAL HEALTH DAY CELEBRATION.
Dear Dental Health Coordinators
This is to remind us that the 2018 World Oral Health Day Celebration is about Thirty eight (38) days from today, the precise date being Tuesday 20 March. The theme of this year's celebration is "SAY AHH! THINK MOUTH, THINK HEALTH"
Accordingly you are expected to identify an Oral Health Promotion tool such as ( Town Hall Meetings, Visits to Community Leaders, Schools, Prisons, IDP Camps, Market places, Motor Parks, Media Interactive Sessions, Using the Social Media, etc) that you may wish to adopt in creating dental health awareness in your state/FCT during the international day celebration. The above mentioned tools can be used singly or in combination depending on the resources available to you.
Therefore, you are expected to draft a proposal and forward same through your State Chairman to your State Officers Committee for vetting. A uniform template will be sent to you in due course following FDI World Dental Federation guidelines and format for 2018 celebration.
The National Dental Health Committee pleads with all NMA State/FCT Chapters to give their respective Dental Health Coordinators all the necessary support and assistance so that together we can pilot a successful WOHD Celebration with the needed impact.
Best wishes from,
Dr Clement Onwube JP
Chairman, NMA National Committee on Dental Health
Michael Idowu:
For our patients with VVF
Dear All,
Recruitment of patients for vesico vaginal fistula (VVF) repair is ongoing at the gynaecology department Wesley Guild Hospital, Ilesha for the forthcoming pooled effort. Treatment is free. For further information, contact Dr Fehintola (08037998247).
Let's save a life today
Wole Akinsulire:
Basic Surgical Skills course holds on 22-23rd February 2018 @Surgical Skills centre LUTH.
Kindly inform interested residents
Follow the link below for details👇🏼
https://www.facebook.com/events/802686413251935/?ti=as
Dr. Kennedy Obohwemu:
http://penkup.blogspot.com/2018/02/revealed-mysterious-snake-that-swalowed.html
Meshak:
Health sector dips as more Nigerian doctors move abroad
By Chukwuma Muanya, Assistant Editor
13 February 2018 |
More reasons have emerged on why no fewer than 5,405 Nigerian-trained doctors and nurses are currently working with the British National Health Service (NHS) in the United Kingdom (U.K.) and why many more will join the league.
The figure, released by the British government, means Nigerian medics constitute 3.9 per cent of the 137,000 foreign staff of 202 nationalities working alongside British doctors and nurses.
The Guardian investigation revealed that many more Nigerian doctors would join their colleagues soon because the U.K. has need for medics from Commonwealth countries, since some doctors in the European Union (E.U.) are already leaving because of Brexit.
It was also gathered that most of the Nigerian doctors and nurses are leaving for the U.K. because of better conditions of service. The migration has further worsened the physician-patient ratio in Nigeria from 1:4,000 to 1:5,000, contrary to the World Health Organisation’s (WHO) recommended 1:600. The physician-patient ratio in the U.K. is 1:300.
According to the WHO, countries with low physician-patient ratio have worse disease outcomes and life expectancy.
Figures from the Nigerian Medical Association (NMA) showed that about 45,000 doctors are currently practicing in Nigeria. This means that 12 per cent of 45,000 Nigerian doctors, that is 5,405, are practising in the U.K. and the country is now left with less than 40,000, excluding those practising in the U.S., South Africa, Saudi Arabia and others.
NMA President, Dr. Mike Ogirima, described the exodus of doctors as worrisome. He blamed the situation on poor remuneration for medical doctors, poor working environment and inadequate medical equipment and infrastructure.
He said the trend has worsened the doctor-patient ratio of 1:4,000, caused longer waiting time at hospitals, rise in fatal disease outcomes, and more frequent medical errors by over worked doctors.
Ogirima said: “Nigeria is using her resources to train doctors and professionals that will leave to work in foreign countries. What are those things attracting these professionals outside? Can we duplicate them here?”
“Government should provide adequate remuneration. We are not saying we should pay so much, but pay them for the job they are doing as and when due.”
Consultant Public Health Physician, Prof. Akin Osibogun, however, said the situation could be reversed if the Federal Government makes the National Insurance Scheme (NHIS) compulsory for all citizens. According to him, this would provide enough funds to improve the conditions of service and working environment for health professionals.
He said: “The few ones we have are leaving because of poor conditions of service, working environment and after service package. It means the physician-patient ratio has worsened, maybe from 1:3,000 to 1:5,000. When you compare, those countries that have better physician-patient ratio have better treatment outcomes.”
Osibogun, a former Chief Medical Director (CMD) of the Lagos University Teaching Hospital (LUTH), said Nigeria currently produces about 3,000 medical doctors every year and needs to increase the ratio by producing more, and developing plans on how to retain them.
He explained: “We need to make working conditions attractive. If they know they will have a house after 20 years of training, the lure to leave would be reduced. What are the benefits attached to the job? What are the provisions for the doctor’s family? What are the long-term prospects for the staff?
“We need to improve the work environment in terms of financing. Make it work-friendly, not crowding 10 persons in one office. Talk about electricity supply; you come to work and you are scheduled to do a surgery but there is no electricity.
“We need to be more drastic; re-organising the way we fund health service. There should be compulsory NHIS that will bring a pool of funds. We have to adopt a more holistic approach.”
But a consultant paediatric surgeon and c
urrent CMD of LUTH, Prof. Chris Bode, said the situation is not hopeless. He said the high migration of Nigerian doctors to the U.K. is because some doctors in E.U. countries are leaving because of Brexit and the NHS has opened its gates to doctors from Commonwealth countries.
Bode, however, said Nigeria needs proper planning to harness the opportunity the situation brings.
He said: “A medical degree is an international passport. Because of global competition, many doctors are moving to the U.S. and U.K. We lose because we trained them but we also learn from them by getting exposed to cutting-edge technologies. One day, if we harness them, they will come back to impact positively on the practice here.
“That is the method Japan, India and China used in adapting what they learnt in the U.S. and U.K. It is not a total loss. We are seeing a lot of movement of medical doctors abroad. It is not as if Nigerian medicine is dead. I had to spend a lot, $14,000, some years back on going to Israel to learn new skills. That has distinguished me and Nigerians are benefitting.
“Nigerian doctors are going to the U.K. because they have opened their gates. By the time the medical doctors come back, we will be better for it. It is not a hopeless situation. There is a lot we can do to harness the opportunity. We need proper planning.”
http://guardian.ng/features/health-sector-dips-as-more-nigerian-doctors-move-abroad/
Henry Ewunonu:
I'm thinking that every challenge presents an opportunity for addressing it and it's likes.
We have been talking about this medical manpower emigration even in the face of severe under/unemployment and the effects of the manpower shortages on the quality of health services in the country. It is amazing that these appear to have fallen on deaf ears. It has been so because solutions proferred have been allowed to just be another dust ridden file on the shelf. One of the ways to curb this emigration is to think and act the radical stuff.
Can we lobby for health to be in the EXCLUSIVE LIST even as several provisions of the 1999 Constitution are being amended?
State governors have messed up human resources for health across the different genre and cadres.
In some states, they have converted medicare as a relic of its glorious past.
There was a time when private medical prcatice was more illustrious and lucrative than public medical service.
That narrative has been changed due the enhancement of the pay packages of medical and health workers.
NARD recently held a national discuss on "Making our hospitals work better" in Abuja.
Several startegic Ideas were proferred. Governmnet was there.
Hospital administrators were there. Doctors were there.
Can we then raise that chorus to a crescendo by embarking on a campaign to make our working environments more condusive?
Should we keep on lamenting about the absence of soap and antiseptics for hand hygiene without letting our voices heared at the highest quarters in the land?
I will end here by reminding us of the famous saying of Frantz Fanon- “Each generation must, out of relative obscurity, discover its mission, fulfill it, or betray it.” Let's discover ours and fulfill it.
Michael Idowu:
FEATURE: Patients lament long waiting time at Nigerian hospitals as govt seeks solutions https://www.premiumtimesng.com/news/headlines/258454-feature-patients-lament-long-waiting-time-nigerian-hospitals-govt-seeks-solutions.html
Lassa fever: Doctors take sensitisation to markets as disease claims one in Osun https://www.premiumtimesng.com/regional/ssouth-west/258450-lassa-fever-doctors-take-sensitisation-markets-disease-claims-one-osun.html
Senator storms JAMB office with anti-snake venom, charmers over missing money https://www.premiumtimesng.com/news/top-news/258495-senator-storms-jamb-office-anti-snake-venom-charmers-missing-money.html
Abuse of Office: Court discharges ex-president Jonathan’s physician https://www.premiumtimesng.com/news/more-news/258518-abuse-office-court-discharges-ex-president-jonathans-physician.html
Senate moves to rescue Kanu Heart Foundation from AMCON take-over https://www.premiumtimesng.com/business/business-news/258523-senate-moves-rescue-kanu-heart-foundation-amcon-take.html
Dr Abdulkadir Bello Katagum:
Thank you for liking and sharing. Spread the word with us as we Celebrate this year's World Oral Health Day on the 20th March. #WOHD18 #SayAhh #ThinkMouthThinkHealth
Dr AB Katagum BDS, Dental Health C
Thank you for liking and sharing. Spread the word with us as we Celebrate this year's World Oral Health Day on the 20th March. #WOHD18 #SayAhh #ThinkMouthThinkHealth
Dr AB Katagum BDS, Dental Health Coordinator NMA FCT https://youtu.be/aFYvnZTTi_A
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