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Strong PHCs yield healthier society –Saraki



Toyin Ojora Saraki is the wife of the Senate President and Founder/ President of the Wellbeing Foundation Africa, an organisation with focus on maternal, newborn and child health. In this interview with DEBORAH OCHENI, Saraki highlights the need to strengthen Primary Health Care facilities and midwives as measures to keep mothers and babies safe



As the founder of Wellbeing Foundation Africa, how will you rate the achievements of the foundation so far?

I have been privileged to lead our home-grown wellbeing Foundation Africa (WBFA) for over twelve years and in all our advocacy, healthcare and health promotion interventions, we have prioritised the importance of impact at the most basic level which is the community.

Our clients held personal health records (PHR) were developed in collaboration with the World Health Organisation, WHO, the Federal Ministry of Health, FMOH and other partners.

This booklet was influential in the roll out of midwives service scheme (MSS) many years ago reaching primary healthcare centers across Nigeria and placing the skilled midwives whose unique capacities I have committed to champion as a global ambassador for the public health solutions for reproductive, maternal, newborn, child, adolescent health and nutrition through advocating for adoption of ICM’s Midwifery Service Framework.

What measures are the Foundation taking to keep mother and baby safe?

Our safe delivery kits, the now ubiquitous ‘mamakit’ helps to provide the essential tools to take a delivery, keeping mother and baby safe and healthy. Recently, we have deplored the ‘MamaCare’ Antenatal and postnatal programmes that helps health care facilities with health promotions and educational classes supporting expectant and new mothers through the life-changing experience of pregnancy and childbirth.

Through midwives, we ensure that our women are well informed and prepared and the programme has reached over 200,000 women across Nigeria in less than 18 months.

As we progress with hard work and all our collaborative efforts, we must ensure that midwives are central to our healthcare systems and that they are respected and given the correct salary and training; they must deserve the highest form of gratitude.

We must also strengthen our PHC system and reach our health budget goals in line with the Abuja declaration of 2001 which recommends at least 15 per cent of national budgets for health and the recent Addis Ababa Declaration. A stronger PHC and smarter budget spending will lead to a stronger, fairer and healthier society.

Recently, the World Bank and WHO endorsed the Wellbeing Foundation. What is the foundation doing to sustain the height in today’s changing world?

The World Bank and the WHO endorsed the Wellbeing Foundation Africa’s Personal Health Records at the measurement and accountability for health summit in Washington DC including it in the roadmap document. We have gone further to develop other health stationary and digital tools for use in healthcare facilities.

As the chairperson of the 8th National Assembly’s Primary Health care Revitalisation Support Group, what is the progress so far in ensuring that the 2017 health budget works?

With regard to the advocacy to ensure that Nigeria’s health budgets function efficiently to deliver universal health coverage, UHC, the progress of the 8th National Assembly’s Primary Health Care Revitalisation Support Group (PHCRSG) as mandated by over 72 civil society organisations, CSOs and non-government organisations, NGO’s which I am very humbled and grateful to serve as chairperson and champion with Dr. Benjamin Anyene as Co-Chair, the membership of which in cludes the ‘ONE Campaign’ and many other highly respected organisation.

The PHCRSG group followed quickly after a public hearing convened by the National Assembly House of Representatives through its committee on health care service for the revitalisation of primary healthcare in Nigeria to avert the disaster in the health care sector of our dear country.

It is a task I take very seriously and I must commend every individual and cooperate support rendered so far. We have had several meetings and consultations with local and global stakeholders and development partners.

Why do you emphasise the need for strong PHCs in most of your campaigns?

One can’t help but reiterate the importance of PHCs in the delivery of health outcomes for our people, including strengthening health and health related systems.

We know that an efficient and effective PHC system is one that can cater to between 70 to 80 per cent of healthcare need of our people. Similarly, these PHCs will be close to the people’s living and working places in terms of locations.

We know that the battle to deliver UHC with quality, efficient care to keep our citizens well and strengthen largely absent referral systems to higher tiers when they are unwell, will be won or lost at the PHC level which is closest to the people.

How would you describe the activities of MamaYe since its inception in 2013?

I have been continuously inspired and moved by the progress that the ‘mamaYe’ campaign has made in reproductive, maternal, newborn, child and adolescent health (RMNCAH) cross Africa and I will like to implore us all draw upon the past successes to look confidently upon our future goals and aspirations with the most notable and pressing being improving the allocation, efficiency and accountability of health budget commitments and processes in Nigeria.

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Health benefits of cucumber (3)



Cucumber is a creeping vine that roots in the ground and grows up trailing or other supporting frames, wrapping around supports with thin, spiraling tendrils. The plant has large leaves that form a canopy over the fruit. Face Mask: For oily skin – grate 1/2 cucumber into a bowl and add one tablespoon of honey.

Apply to the T-Zone, which is the forehead, nose and chin. To reduce pores and tighten skin – apply the mixture all over the face including under the eyes and eyelids. Leave on for 15 minutes and rinse with warm water, Pat dry with a clean towel.


Fighting cancers: Cucumber is known to contain lariciresinol, pinoresinol, and secoisolariciresinol which are linked to a reduced risk of several types of cancer. Controlling blood pressure: Cucumber juice contains a lot of potassium, magnesium, fiber, and phytonutrients that work effectively for regulating blood pressure.


Aiding digestion: Their high water and dietary fiber are very effective in driving away the toxins from the digestive system. Daily consumption of cucumbers can be regarded as a remedy for chronic constipation. Relieving gout and arthritis pain: Cucumbers are rich in vitamin A, B1, B6, C & D, Folate, Calcium, Magnesium, and Potassium.


When mixed with carrot juice, they can relieve gout and arthritis pain by lowering uric acid levels. Cucumbers also contain a substance needed by the cells of the pancreas for producing insulin. Researchers have found that sterols in cucumbers help reduce cholesterol levels. It is one of the very low calorie vegetables. It contains no saturated fats or cholesterol.


Cucumber peel is a good source of dietary fiber that helps reduce constipation, and offers some protection against colon cancers by eliminating toxic compounds from the gut. It is a very good source of  potassium, an important intracellular electrolyte.


Potassium is a heart friendly electrolyte that helps bring a reduction in total blood pressure and heart rates by countering effects of sodium. Cucumbers contain unique antioxidants in moderate ratios such as ß-carotene and a- carotene, Vitamin- C, vitamin-A, zea-xanthin and lutein.


These compounds help act as protective scavengers against oxygen derived free radicals and reactive oxygen species (ROS) that play a role in aging and various disease processes. Cucumbers have mild diuretic property, which perhaps attributed to their free-water, and potassium and low sodium content.


This helps in checking weight gain and high blood pressure. Ongoing research indicates that Cucumbers play a key role in the treatment of Alzheimer’s disease patients by limiting neuronal damage in their brain.

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Heavy drinking increases risk of dementia



Scientists yesterday said people who drink enough to be hospitalised were at serious risk of dementia and Alzheimer’s disease.


According to findings published in the ‘Lancet Public Health’ journal, more than a third, 38 per cent of the 57,000 cases of early-onset; dementia were directly alcohol-related and 18 per cent had an additional diagnosis of alcohol use disorders. Overall, alcohol use disorders were associated with a three times greater risk of all types of dementia, the research showed.


To this end, lead author in the study, Dr. Michaël Schwarzinger, of the Translational Health Economics Network in France, said; “A variety of measures are needed, such as reducing availability, increasing taxation, and banning advertising and marketing of alcohol, alongside early detection and treatment of alcohol use disorders.”


Dementia, which is not  a specific disease, is an overall term that describes a wide range of symptoms associated with a decline in memory or other thinking skills severe enough to reduce a person’s ability to perform everyday activities. Alzheimer’s disease accounts for 60 to 80 per cent of cases.


Previous studies consistently showed that, overall, heavy alcohol consumption was detrimental to health and was a leading preventable cause of death. When the body takes in more alcohol than it can metabolise, the excess builds up in the bloodstream.


The heart circulates the blood alcohol throughout the body, leading to changes in chemistry and normal body functions. It had been shown that even a single bingedrinking episode can result in significant bodily impairment, damage, or death. Over time, excessive alcohol use can lead to the development of many chronic diseases and other serious health problems.


However, the new study, which used the French National Hospital Discharge database, looked at more than a million people diagnosed with dementia between 2008 and 2013.


Although, the study was not conducted to look at the effects of moderate drinking on people’s dementia risk, Schwarzinger warned that the research showed damage done to the brain by alcohol was never repaired.

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Lifestyle, screening key to tackle colon cancer



About 80 per cent of Nigerians who are diagnosed with colon cancer die from it, even though the disease is preventable. Experts said rectal bleeding, fresh blood in the stool, unexplained constipation, diarrhoea alternating with constipation are among the indicators of colon cancer. APPOLONI A ADEYEMI reports


News about the death of the Zimbabwean opposition leader Morgan Tsvangirai who died from colon cancer at the age of 65, is another indication of how late stage cancers could increase mortality.


Reports showed that Tsvangirai who was the president of the Movement for Democratic Change in Zimbabwe, had been suffering from colon cancer for at least two years, but his condition deteriorated rapidly shortly before his death, despite treatment in neighbouring South Africa.


The death of Tsvangirai on February 14 may have brought colon cancer death to the consciousness of Nigerians; sensitisation about this condition has been in the front burner. As far back as 2016, the Society for Gastroenterology and Hepatology in Nigeria (SOGHIN), had raised the alarm that Nigeria was contending with heavy burden of colon cancer. According to SOGHIN, “More Nigerians above 40 were coming down with colon cancer, which is also known as colorectal cancer and bowel cancer.”


In spite of this background, most Nigerians may not be aware of colon cancer; yet it is one of the most common cancers, globally. Colon cancer is the third most common cancer in Nigerian men, after prostate and liver cancer and the fourth most common cancer in Nigerian women, after breast, cervical and liver cancer. Colon cancer is the development of cancer from the colon or rectum (parts of the large intestine).

The human colon, or large intestine, is a muscular, tube-shaped organ measuring about four feet long. It extends from the end of the small bowel to the rectum.


Its functions include to digest and absorb nutrients from food, to concentrate fecal material by absorbing fluid (and dissolved salts, also called electrolytes) from it, and to store and control evacuation of fecal material. Most colon cancers develop slowly, over ten (10) to fifteen (15) years. It usually begins as a small non-cancerous growth, called polyp on the inner lining of the colon or rectum.


The World Health Organisation (WHO) estimates that every two hours a Nigerian is diagnosed of colon cancer.


The Chairman, National Consultative Committee on Cancer Control in Nigeria, Prof. Francis Abayomi Durosinmi-Etti told the New Telegraph that more Nigerians were coming down with colon cancer. “We are noticing an unusual increase in the incidence of colon cancer. “This last week alone, I saw three colon cancer patients at the clinic at the Lagos University Teaching Hospital (LUTH).”



“On what his clinical experience has been like Durosinmi-Etti said from the rate at which affected persons turn up in the clinics, we can conveniently say colon cancer ranks among the first five common cancers in both men and women in the country presently.”


Nigeria records an estimated 102,000 new cancer cases including colon cancer annually, according to data from the Federal Ministry of Health (FMOH). Similarly, cancer is responsible for 72,000 deaths in Nigeria every year.


Sadly about 80 per cent of all Nigerians who are diagnosed of colon cancer die from it, said Dr. Abia Nzelu, a fellow and consultant of the West African College of Surgeons and the National Postgraduate Medical College of Nigeria.


Nzelu who is also the Executive Secretary, Committee Encouraging Corporate Philanthropy (CECP-Nigeria), said, “This is very unfortunate given the fact that colon cancer is one of the cancers that is virtually 100 per cent preventable.” Examples of personalities that survived colon cancers are Justice Ruth Joan Ginsburg, the oldest and only female Justice of US Supreme Court who marked her 82nd birthday on March 15, 2015.


She developed colon cancer in 1999. During the treatment, she did not miss a day on the bench. In 2009, she again had successful treatment for pancreatic cancer and did not miss any oral arguments in court. Similarly, Queen Elizabeth the Queen mother, survived colon cancer and breast cancer at ages of 66 and 83 years respectively.



She died cancer-free at the age of 101. Furthermore, Pope John Paul II, the second longest serving pope in history, survived colon cancer and later became a patron of the Global Campaign for Prevention of Digestive Cancers.


These success stories are a result of availability of infrastructure for screening and treatment of cancer in the respective countries of the survivors. Symptoms On factors that indicate the existence of colon cancer in a person, Durosinmi-Etti said people who experience rectal bleeding must see the medical doctor urgently.


“If you see any sign of fresh blood in your stool you need to see a doctor,” he said, adding that it was important to have such fresh blood checked by the medical team to ensure that was not colon cancer.


He advised people that experience unexplained constipation, stooling that is excreted in very small, narrow form, rather than being excreted in bulk, unexplained weight loss or weight gain, to see the doctor urgently, adding “These are all indicators of colon cancer.”


Durosinmi-Etti asserted that experiencing all these does not necessarily mean that the one has colon cancer, but advised affected persons to see the doctor that would recommend necessary tests to determine the health status of the patient visà- vis colon cancer.


Other symptoms of colon cancer include change in bowel habit such as diarrhoea, constipation, or diarrhoea alternating with constipation that lasts for more than a few days, a feeling that one needs to pass stool that is not relieved by doing so (tenesmus).


Tenesmus is a continual or recurrent inclination to evacuate the bowels, caused by disorder of the rectum or other illness. Other symptoms are blood in the stool, cramping or belly pain, weakness and fatigue.


“It is noteworthy that colon cancer may not have obvious signs and symptoms in the early stages. So, people should not wait for symptoms,” Nzelu advised. Risk factors Factors that can affect a person’s risk for developing colon cancer include several modifiable lifestyle habits such as diet, weight, exercise, smoking and heavy alcohol intake as well as non-modifiable factors like age, family history of colon cancer or polyp; type 2 diabetes.


Race and ethnicity also play a role. For example, in the United States (US), of all racial groups, African Americans have the highest incidence and mortality rates of colon cancer.


Of these risk factors, the link between diet, weight and exercise and colon cancer risk are some of the strongest for any other type of cancer. Prevention According to Nzelu, with lifestyle modification (including regular medical screening) most cases of colon cancer can be prevented.


The recommended measures include the intake of diet high in fibre such as fruits, vegetables and whole grains, diet low in red meat (such as beef, pork, lamb or liver) and processed meat (such as hot dogs and sausage) as well as liberal intake of water. She said, “It is important to note that fibre supplements have not been shown to be helpful in reducing risk of colon cancers. “Rather, the emphasis should be on dietary sources of fibre, such as oat bran, wheat bran, legumes (beans), green leafy vegetables, carrots, oranges, bananas and other fruits and vegetables.


“Avoidance of excessive weight, smoking and excessive alcohol intake while increasing the intensity and amount of physical activity, also helps to reduce colon cancer risk.”


Above all, eligible individuals, people who are 40 years and above, should undergo screening as recommended. Nzelu said regular colon screening is one of the most powerful weapons for preventing the cancer.


“This can in many cases, prevent colon cancer, altogether. This is because, with regular screening, most polyps can be found and removed before they become cancers.


Screening can also result in finding colon cancer early, when it is highly curable.” Available tests Screening tests for colon cancer include stool test, endoscopy (sigmoidoscopy, colonoscopy), as well as x-ray (double contrast barium enema and CT colonography).


According to Nzelu, an important advantage of colonoscopy is that polyps that are found during the procedure could be clipped off on the spot.


In addition, it only needs to be repeated every ten (10) years if the result was normal. “The recommended age for commencement of screening in the western world is 50 years.


However, anecdotal evidence shows that the peak age of diagnosis of colon cancer in Nigerians is about 44 years.


“This is highlighted by the relative youthfulness of some prominent Nigerians that have fallen victim to colon cancer, according to recent media reports.


For this reason, Nigerians should commence screening from the age of 40.” Those with a family history should commence screening ten (10) years before that age at which the affected family member was diagnosed.


On his part, Durosinmi- Etti said most of the patients diagnosed with this condition in the country presently were persons living sedentary lifestyles, for example people in jobs requiring them to sit down all day long.


“What is also significant, according to Durosinmi- Etti is that now there’s more non-governmental organisations involved in raising awareness about colon cancer as well as providing free screening for Nigerians. “This development paves way for more persons afflicted with the disease to be picked up early for medical attention,” he added.

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