By Chioma Obinna

Why should Nigerians suffer needlessly from preventable diseases? After 51 years of independence, why should we not have access to adequate and universal healthcare? What steps are being taken to address the situation? These are just some of the plethora of questions posed by Denrele Animasaun – a London-based registered nurse and health promotion specialist.

Denrele, an experienced and active healthcare provider based in the United Kingdom, is a firm believer in the tenets of providing the right information and education to people in the interest of ensuring qualitative healthcare.

Bringing home her wealth of experience in healthcare management, she asserts that Nigerians need not die in silence if they are adequately informed and educated about their own health issues. In this encounter with Bashir Adefaka, she gives insight into a unique initiative that would ensure prioritisation of the health of the average Nigerian:  Excerpts:

The silent killer diseases

Silent killer is often a term used for diseases  that produce minimum or no symptoms and is capable of causing death if not treated.  Major silent killer diseases   are; heart diseases, hypertension   and diabetes.  As  well  as  are other lesser known  silent  killer diseases  such  as  breast   cancer,  prostate  cancer, renal cell cancer , pancreatic cancer, hepatitis B or C infection to name a few.

Our health should be top priority and not an option.  I  have  found  over  the years  of   working   with  the  black   community  that  we do not  place high  priority  on  our  health  as  we  do  in  other  areas  of  our  lives.    We   should,   because if   we  are healthy  we  can  do  a  lot  of  things   including  being around   for  our  loved  ones   for  much  longer and  contribute  the   social  and  economic  of  our   country.

Why is this problematic? There is  a delay  to  act  within the black  communities  in terms  of   these   silent   killers,  as if  to   play  a  wait  and  see   game  ,or  that  there  will   be  some   divine  intervention .   This  is   quite  concerning  as  hypertension and  diabetes  which are   quite  endemic in our  community  amongst    others  such as   malaria, sickle  cell, asthma, prostrate  and  breast  cancers.

Black men are three times more likely to develop prostate cancer that their white counterparts.  As with  breast  cancers,  our females   are    sometimes  have the very  aggressive  ones   that  can  benefit   from  early  presentation  rather than   wait   until  it  becomes  terminal .It is important   to raise the awareness of this hidden cancers.

Most  of these  diseases  run  in families  and  based  on  our  lifestyles, stress, poverty, and  lack  of  awareness  so  we  could  make  the  shift  if  we   are  aware  of  our  health   history  and  lifestyles. In  the  case   of  heart  disease , the  risk  is increase  if  you  have a male relative  with  coronary  heart disease  under  55 or a female relative under 65 and  or  you  are  obese , overweight high cholesterol  diets, you eat too much salt; you don’t eat enough fruit and vegetables; you are not active enough; you are overweight; or you drink too much alcohol.

Primary steps

We need  to  make  health   education   more  accessible,  interactive  and participatory  and  let   people  know  that   they  have  to take   control of  their   health   by  raising  awareness  making  it   more  vivid ,innovative  to clearly  understand   what  the   main  causes  of   diseases  that   affects  us  as   members   of the community.

It   is important that   you know your   blood pressure; the normal range for blood pressure readings is 120/80 to 140/90, although many healthy people have a lower blood pressure than 120/80. If it is higher than 140/90 seek medical help, look at your lifestyles and make changes. If yours is consistently high, you have a greater risk of developing coronary heart disease and having a stroke. Ask your doctor to check your blood pressure.

For a few people, friendly eating habits may help them to avoid medicines altogether.

For healthy weight, it is good to lose weight and watch what you eat and drink – the healthier your eating habits are, the lower your blood pressure will be.

Need to set up

I  subscribe to  the  maxim   that  charity   begins at  home,  since   I  have  worked  in  the   health  field   for  close  to  two  decades  in  the  United Kingdom.  Now seems   to be the right   time   to bring it home. One of  the most  disturbing  statistics  indicate  that   people   from   the  black community  are  less likely   to  access health  care  and  more likely   to  suffer   from  high  blood pressure, diabetes, sickle cell , mental health  problems, breast  and  prostate  cancers.

Health programme for the Nigerian community

“Improving the health of our communities” is an innovative health programme designed to encourage local people to seek help for their health concerns. It  is  based   on  the successful main stream  community  health  programme  in the United Kingdom  called “Cares of  life  service.”

The service set up the barbers and hairdressers Network in South East London.  We  know everybody   goes to their barbers and hairdressers regularly. It is  aimed  at  making   use   of  long  established , non – medical support system  alongside  social ,community networks   such  as  the   Faith  groups,   churches,  mosques ,market people  and  actively  involve  them   in  health promotion  campaigns .

At  the  barbers’ and  hairdressers’, it  is more  than  a  place  for  grooming, it is news  room, advice centre, and more  goes  on  in  these places  that   it  was important  to  harness   this,  after all   everybody  talks   to  their  barbers   don’t they? Barbers and hairdressers can then provide free signposting service and advice   to their   customers.  Health  social  issues  that  can  be  addressed include domestic   abuse,  diabetes,  high blood  pressure, sickle  cell,  glaucoma, breast and   prostate  cancers and  many  other social  and  health  issues.

Aims and objectives

The  aim of  this  new  health  initiative  will  be to   focus   mainly  on six aspects  of   health  and social  concerns prevalent  in  the  local  communities: Diabetes, high blood pressure, Sickle cell, prostrate and  breast  cancers, domestic violence  and  high  maternal mortality  rate.  We will train and recruit a pool of workers which would include volunteers, faith groups, barbers and   hairdressers trained and supported by professional health care workers.

It  is an  established  fact   that  black  people  are culturally  and  generally   unlikely  or  hesitant   to  access   health services. It  is  imperative  that we  need  to  tackle   ill  health at  an  earlier   stage and work  with  younger people so  that the  health seeking  behaviour  changes   for  the  better  and over  time  with  a  sound and  robust health  care  programme.

Lay   workers   will   be   trained  to   identify  signs  and  symptoms   of   basic  health  and  social  concerns  and  sign post  people  needing  specialist  help  to  appropriate  and  participating agencies.

Target audience

We  aim to signpost   local  people especially   from  the   socially  deprived  area needing  health care  and  social  support  to local and appropriate  health professionals. It   will  be    free   at  point  of  access,   for  adults 18 -65  years  old  and  in time  it  can  be   open  to all  if  need  be,   for instance,  in  the   case of   health  promotion and social   information  in  schools or  in  case  of   domestic  violence,  which   can  be  made  accessible  to  all  and  in  different setting.

With  the  assistance  of  the  state  commissioner,  health  and  information  departments, we  will  map out local   community  zones; doctor  surgeries,  hospitals and medical centres.

Health  professional   can  harness  these  resource and    provide  free screening  and   early  intervention   and in time   will  result  in   reduction  and  better  prognosis.

Barriers

I  have  been told  that  things  take  time  in Nigeria,  to  take  root  especially   non  profit  programme  such  as  this,  I  believe  where  there  is  a  will  there  will be a  way.

I  strongly believe  that  health  is not an option  it  is  a  priority, and more  so,  if we  are   to have  a strong  economy . This  would  not  be  the  case  if  the  young,  economically   viable  people  are  dying  needlessly, it is   about time that   we  realise that  we   are  economically  haemorrhaging  manpower  and  potential  earnings  at  its  prime  and   it   will ultimately affect the  social  and  economic  fibre   of   our  society.

·That politics will play a part in it   and may hinder its progress. The programme is   for the people and that it is bigger than any   political partisanship.  In fact  I  welcome  any  Governor  or  Ministry  of  Health   who  want us   to  roll   out  the  programme   to  get  in touch  with  us  we  will  be happy   to  do  so.

·    -That seeking set up capital will be a problem.   Other   than  initial  set  up  capital this is  a  health  programme   will  pay  dividend  and   cheaper  in  the  long   run  and  it  can  form  part of  an  established   health programme.

·What’s  in  it   for   me  culture may   railroad  or  stall   the  programme , this  programme is   run  a  an altruistic  principle: it  is  our  collective  responsibility  that  it  works  the more   we  work  towards  a collective   goal  the   better  for  all  us.

Cost implication

Initial  set up  running  costs   though  can   cut   down   costs when  it  forms   part  of  the  established community frame work   and we  can   plug  in  the  NYSC  programme  so  gain access to established  resources  and  manpower –National   Youth  service Corps, Nursing   students  and  other    health  allied professionals.

All data collated are fed back and shared with numerous strategic bodies within the Health department and Primary health care. It can be used to form   future health programmes and identify health   issues and   distribution of resources.

About Cares of Life service

It is a mainstream community health promotion service that works to improve the health service provision for the black community living in the Borough of Southwark, London.  It is an award winning service, it won the British diversity award 2003, 2004, the charitable foundation award for innovation 2005; in 2009 won the certificate of recognition for preparing young people for adult life by the Lewisham business education Forum.

The   service   has  been  a  standard  bearer  and  has   been  used  as  an  example   of   good  practice. .  The  service  has  received visits   from   New Zealand,  Denmark   and  South  Korea  by  health  service experts  keen  on  learning    more and with  the  view  of  setting  up  similar  services  .

The  service   has   featured  in  BBC   health   programme  and  Channel  4  as   well as   the  national  service  journals and  cited  in   many  others  locally, nationally   and  internationally. The service uses its extensive local knowledge to build capacity within the local community and the health services. We have  an ongoing  working  partnership  with  Kings College Hospital breast cancer  care team  the Renal  research  UK , Diabetes UK, the Lupus UK,  the British Heart  foundation, Prostrate Cancer , the Sickle cell  society and  the Glaucoma campaign.

The  disproportionate  gap between  the  white  and the black  community  was   a  singular drive  that  led  me  to  work at  Cares  of  Life  service.   The Service was   set up   Dr Dele Olajide a renowned consultant psychiatrist and an expert.  The  Service is  a  trail blazer, very  innovative , harnessing grassroots  support  and  enable  the  local   community   to  help  themselves.

Its   unique  selling  point  is the  way   it  provides  health intervention  with  culturally  appropriate services,  projects and  training  to  health  professionals, carers, voluntary  services and statutory personnel and  connecting  health  care services  with  local BME  communities  and  meeting  in   an  effective  and  targeted mental   health needs . Using innovative and creative tried and tested methods to deliver an effective and efficient health programmes to local population or target groups.