Prostate cancer which occurs in the prostate is one of the most common types of cancer. It has become a health concern affecting men.
While men at the age of 50 and above are said to be at risk of suffering from such cancer, Cancer Research – the world’s largest independent cancer research organisation revealed that “most prostate cancers start in the outer gland cells of the prostate and are known as acinar adenocarcinomas. Many of these cancers grow extremely slowly and are not likely to spread. But some can grow more quickly.”
– What is the prostate? –
The prostate, a small gland in men, forms a crucial part of the male reproductive system. Resembling the size and form of a walnut, it is situated in the lower pelvis, positioned below the bladder and situated just ahead of the rectum.
One of its primary functions is contributing to the production of semen, the whitish fluid responsible for transporting sperm from the testicles via the penis during ejaculation. Additionally, the prostate encircles a portion of the urethra, a tube responsible for conveying urine from the bladder
– Symptoms –
Symptoms of prostate cancer can include difficulty/pain in urination, weak or interrupted flow of urine; urinating often, especially at night; and trouble getting an erection (erectile dysfunction or ED). Others include blood in urine; inability to hold or delay urination; and pain in the hips, back (spine), chest (ribs), or other areas.
A report by PUNCH Healthwise in February 2023 suggests regular test/medical checkups, especially for men aged 50 and above.
Former Chairman of the Society of Gynaecology and Obstetrics of Nigeria, Akinsola Akinde, made this known saying, “All men are at risk to have prostate cancer. If you get to the age of 50 years, you should do a routine screening. There is a test that can be done that will help to pick up the diseases at an early stage. The thing about cancer is that it is usually in different stages, and if you can pick up cancer at stage one, you can more or less cure it.”
– Risk factors –
As earlier mentioned, men who are at the age of 50 and above are at higher risk of prostate cancer. Also, African-American men develop a high risk of prostate cancer.
Other factors include family background, diet, lifestyle, race, lack of regular physical activity, amongst others.
In an interview with The PUNCH, an Assistant Professor in Clinical and Administrative Sciences, Department of Pharmacy, University of Oklahoma Health Sciences Centre, Stephenson Cancer Centre in Oklahoma, Dr Motolani Ogunsanya, in July 2023 reports prostate cancer can lead to a range of complications, which can vary based on factors such as the stage of the cancer, the individual’s overall health, and the effectiveness of treatment.
“Prostate cancer can give rise to various complications that encompass physical, emotional, social, and functional aspects. The nature and severity of these complications can vary depending on several factors, including the patient’s age, the stage of cancer at diagnosis and the type of treatment received. For example, physical complications may involve urinary issues such as urinary incontinence (inability to control urine flow) or urinary obstruction (difficulty urinating). Sexual problems like erectile dysfunction or a decrease in libido can also occur,” Dr. Ogunsanya said.
The migration of doctors and other health workers to other countries is taking a toll on hospitals across the country as the institutions have reduced the number of their outpatients and surgeries due to a shortage of manpower.
Almost all the health institutions were battling with the shortage as they could not cope with the high number of patients who thronged the government hospitals, which were affordable compared with the private ones.
The Chairman of the House of Representatives Committee on Health had on Wednesday raised the alarm that not less than five wards with about 150 beds, had been closed down at the Lagos University Teaching Hospital, Idi-Araba, due to a shortage of health workers.
The Chairman of the Committee, Dr Amos Mogaji, said the five wards had to be shut because there were no workers to operate them despite the large number of patients received at the institutions daily.
Findings showed that LUTH was not the only hospital battling with the problem as health workers lamented the heavy workload because their counterparts had left the country.
Although the Nigerian Medical Association and the Nigerian Association of Resident Doctors could on Sunday not give the exact number of medical doctors that had left the country, the NMA had a few years ago said 2,000 health workers were leaving yearly.
Also, the NARD had in January 2023 stated that a survey it conducted indicated that more than 2,000 of its members left the country in 2022.
However, the harsh economic conditions in the country have been pushing many doctors to leave the country as 1,197 doctors had moved to the United Kingdom since May 29, 2023.
With health institutions including the Lagos University Teaching Hospital, the Federal Medical Centre, Abeokuta; Aminu Kano University Teaching Hospital, Kano and the Obafemi Awolowo University Teaching Hospital, Ile-Ife losing close to 1,000 doctors to japa in the last two years, there are strong indications that over 4,000 doctors might have left the country in the last two years.
In the FMC, no fewer than 200 doctors, including 50 medical consultants have left the country for greener pastures abroad.
Because of the shortage of doctors, it was gathered that the hospital was forced to reduce the number of its outpatients attended to and elective surgeries.
According to veryhealth.com, an “elective surgery” is the term used for a procedure that can be safely delayed without great risk to a patient’s health, such as cataract surgery. A nonelective (or emergency) surgery is a procedure that must be performed immediately for lifesaving or damage-preventing reasons.’’
In Kano State, The PUNCH gathered that no fewer than 789 nurses and 162 doctors had left the state, while about 50 doctors had left hospitals in Benue State.
One of our correspondents gathered that as many as 65 doctors left the OAUTH, Ile-Ife, in the last year, while about three wards had stopped admitting patients over inadequate manpower in the hospital.
File: A hospital ward in Nigeria
An official of the NARD in the hospital, who spoke on the condition of anonymity, said, “65 doctors left OAUTH last year. 45 of them completed their training and left, while 20 abandoned their training and left for other countries.”
He also said about three wards in the hospital had stopped admitting patients due to inadequate manpower.
“Out of three units we have in the emergency section, only one is admitting patients. Two other units in the emergency ward are not admitting patients due to inadequate staff.
“Also, the psychiatric unit is not admitting new patients because we don’t have enough nurses. The Paediatric Unit is seriously understaffed. Generally, we don’t have enough staff in the hospital. Some people are available to work, but they are not employed,” he said.
OAUTH management could not be reached for reaction to the claim, as calls to Kemi Fasooto, the hospital Public Relations Officer, rang out and she has not responded to a text message sent to her by our correspondent, as at the time of filing this report.
At the FMC, Abeokuta, the Chairman of the Medical and Dental Consultant Association of Nigeria, Dr Jimoh Saheed, stated that in the last four years, the hospital had lost about 50 consultants and 150 resident doctors to the japa syndrome.
He said, “The japa syndrome has really affected and is still affecting the healthcare system in Nigeria. About 50 medical and dental consultants left FMC Abeokuta alone in the last four years. The number of resident doctors who left for greener pastures should be times three the above number.
“Therefore, the implication is that there is a severe shortage of manpower in the hospital, which has hampered the service delivery and care of patients. We have had to reduce the number of patients seen per clinic and also, and the elective theatre cases per day also dropped.
“As it stands, some segments of our emergencies had to be collapsed for the unit to work efficiently. The implication of all these will mean that we can’t function optimally and the japa wave has affected service delivery, training of medical specialists as well as research.”
Jimoh said the way forward was for the government to declare a state of emergency in the health sector, which would include massive recruitment of various health personnel, and equipping the hospitals to international standards, among others.
Similarly, the Chairman of the National Association of Nigeria Nurses and Midwives, Ogun State Hospital Unit, Ijaye, Abeokuta, Mrs Lola Idowu, said nurses that had left the hospital in the last three years could not be less than 40, including those who had retired.
The Benue State chapter of the NMA confirmed that more than half of the number of medical doctors working in the state Health Management Board had left the country to search for jobs in better locations.
The NMA Chairman, Dr Usha Anenga, described the situation as pathetic.
Anenga said, “We used to have over 100 doctors at the Health Management Board but now there are less than 50 left. We used to have a consultant and epidemiologist at the Federal Medical Centre but they have left. The gynecologist at the University Teaching Hospital has also left.”
At the University of Jos Teaching Hospital, Plateau State, about 100 resident doctors have left the facility as the remaining ones at the hospital lament the shortage of manpower in the health institution.
The President of the ARD in JUTH, Dr Ishishen Artu, stated that last year, more than 70 resident doctors had left the hospital.
“What is happening across the country about japa syndrome is not different from the situation here in JUTH. When I came on board as ARD president about 11 months ago, we had 410 members.
“But during our last nominal roll from the accounting department, we were about 340. So that is to tell you how doctors have been moving away from the hospital,” Artu stated.
He blamed the manpower shortage on poor welfare packages, insecurity, and inadequate equipment, and called on the government to intervene to avoid an imminent collapse of the health system across the country.
He added, “Some of us who are still around are not finding it easy. Many of our mates outside the country including Ghana, and South Africa are receiving three to five times what we are receiving in Nigeria.
“They want to come home to practice but they can’t come under the present situation. That is why the government has to look at the issues holistically to address them so that the health sector will not break down completely in the country.”
Kano hospitals hit
Over 789 nurses and 162 doctors have relocated outside Nigeria from Kano State alone, according to the NMA in the state.
Similarly, over 162 medical doctors relocated to other countries across the world within the same period under review.
The Chairman of the Kano State Chapter of the Nigerian Medical Association, Dr. Abdullahi Sulaiman, disclosed this in a telephone interview with The PUNCH on Saturday.
“Many medical doctors and other categories of healthcare workers are exiting the state in droves. So, I cannot tell you the exact number of doctors and nurses that have left the country. I can only give you an estimate.
“It is a bad situation and this is across almost all healthcare workers, not only doctors. They are leaving for Gambia, Somalia, Rwanda, Saudi Arabia, and many others every week,” he said.
According to him, the shortage of such personnel was causing a lot of problems, as those left behind were forced to bear the brunt in the form of overwork, exhaustion, and burnout in a non-conducive working environment.
“About two years back, we wanted to open some wards that were constructed and donated by some wealthy individuals at the Aminu Kano Teaching Hospital, but because there were no healthcare workers to man the places, we had to suspend the opening until later,” Sulaiman stated.
He stated that recently, five anesthetic doctors were employed by the AKTH but three had since abandoned the work and relocated abroad.
“We have been talking about the issue but the government is not taking deliberate steps to address the problem.
“To prevent doctors and other categories of health workers from going out of the country, the government must take deliberate action to address the issue,” he added.
1,197 doctors move
Findings showed that approximately 1,197 Nigerian-trained doctors moved to the United Kingdom since May 29, 2023, to date.
At the moment, Nigeria is set to overtake Pakistan and become the country with the second-highest number of foreign-trained doctors in the UK. Currently, India remains the country with the highest number of foreign-trained doctors in the UK.
This is according to the register of the General Medical Council of the UK. The GMC is a public body that maintains the official register of medical practitioners within the UK.
Though about 1,197 Nigerian-trained doctors were licensed between May 29, 2023 and December 1, 2023, the total number of Nigerian doctors licensed to practice in the UK is now 12,198.
This figure, however, excludes Nigerian doctors who were trained in other countries.
Presently, there are 73 Nigerian-trained doctors in the field of anaesthetics and Intensive Care Medicine, 61 in the field of emergency medicine, 241 for general medicine, 207 for obstetrics and gynecology, 17 for occupational medicine, 16 for ophthalmology, pediatrics field with 164, and 50 for pathology.
There are 35 of them for public health, 357 for psychiatry, 29 for psychiatry and 135 for surgery.
The rate of migration of medical doctors has recently become a matter of concern. The Nigerian Medical Association, while lamenting the high rate of medical brain drain, had said Nigeria might import doctors in the future.
In 2015, only 233 Nigerian doctors moved to the UK. The number increased to 279 in 2016, while the figure was 475 in 2017. In 2018, the figure rose to 852, while it further increased to 1,347 in 2019.
In 2020, the figure was 833 even though the GMC closed operations during the COVID-19 pandemic. The figure for 2021 was put at 932.
The Chairman of the Committee of Chief Medical Directors of Federal Tertiary Hospitals, Prof. Emem Bassey, commenting on the brain drain said, “Some African countries are also beginning to poach from Nigeria.
“The West Coast is looking for our specialists. So many people are now going to places like Sierra Leone and Gambia and the wages they earn $3000 to $ 4000. It is about three to four times what they earn back home. So we are beginning to see that people are leaving for other African countries too.
“The health sector is currently undergoing a major crisis in terms of manpower. What we are seeing is that medical specialists, not just doctors, even nurses even more nurses are leaving. Doctors, nurses, laboratory scientists, physiotherapists, radiographers, and all manner of health professionals are leaving the country in droves.” ( PUNCH)
The Anambra State Aids Control Agency (ANSACA) says no fewer than 98,960 people in the state are living with HIV/AIDS in Anambra.
Dr Afam Obidike, Commissioner for Health gave the statistics on Thursday in Awka during a media briefing ahead of 2023 World AIDS Day observed every Dec. 1, since 1988.
World AIDS Day is commemorated globally to raise awareness about HIV and AIDS and honor the lives affected by the epidemic.
This year’s commemoration had the global theme ‘Let Communities Lead” and domesticated in Nigeria as ‘Communities’ Leadership to end AIDS by 2030′.
Obidike said: “With the national prevalence of 1.4 per cent, our state HIV prevalence is ranked 5th highest in the country and the highest in the South East.
“It is estimated that 98,960 residents are living with HIV out of which 58 per cent know their status and 44,808 are currently on treatment.
The state is making the needed progress towards attainment of the Global 95-95-95 targets of which we are at 65:81:93.
“And worthy of note is the gradual decline in new infections which is at 46 per cent between 2021 and 2023 and AIDS related death which is at 32 per cent between 2021 and 2023.
“We are scaling up Prevention of Mother-to-child Transmission services to ensure no woman transmits this infection to her baby. The good news is that with the advent of Anti Retro-viral Therapy (ART), HIV is no longer a death sentence,” he said.
The Commissioner said the state was also scaling up access to HIV self- testing to tackle stigma and discrimination.
Also speaking, Dr Afam Anaeme, Director Public Health, described HIV/AIDS as one of the diseases of public health importance.
Anaeme said the disease is transmitted from person to person through body fluids during sexual activities, mother to child during pregnancy, labour and delivery, breast feeding, blood transfusion and risky sexual behaviours.
He said there was need for community involvement in planning, implementation and monitoring of HIV programmes as well as access to relevant prevention, treatment and care services.
“Communities are people living with, at risk of, or affected by HIV and they need to lead the frontline of progress in the HIV response.
“With the participation of everyone, we can reduce the prevalence of HIV/AIDS in Anambra, ” he said.
In his remarks, Executive Director of ANSACA, Mr Johnbosco Ementa, urged residents to take advantage of the free testing centres across the state to know their status.
He said that the state government
increased the number of HIV treatment sites from 104 to 1,182, with the collaboration of implementing partners.
“We also deployed mobile testing units, home-based testing, and community outreaches, to significantly improve HIV testing coverage and accessibility.
“We appreciate our partners – Achieving Health Nigeria Initiative, AIDS Health-care Foundation, UNAIDS, CHAI and Global Fund for their support,” he said
The Pharmaceutical Society of Nigeria has called on the Federal Government to probe alleged corrupt cases made against some of the Chief Executive Officers of the Federal Health Institutions.
A communique of the 96th annual national conference of the PSN, titled, ‘Jewel City 2023,’ also raised alarm over the unregistered two million drug sellers in the country.
The communique, signed by the President, PSN, Prof. Cyril Usifoh, and National Secretary, Mr. Garfa Madehin, noted that the conference was held between October 30 and November 4 at Gombe International Conference Centre, Bauchi Road, Gombe State, Nigeria.
“The conference called for the probe of corruption against some of the CEOs of the FHIs, whom empirical data confirms, indulge in the procurement of drugs through their proxies in addition to diverting Drug Revolving Funds accruable to identifiable bank accounts that are not official accounts in their institutions.
“The conference called for a special retreat to resuscitate GRF by bringing together the HODs of Pharmacy and the CEOs of all the FHIs with a caveat to mandate the PSN National Executive Council to sponsor the same if the Federal Ministry of Health is interested in such collaboration,” the communique read.
The PSN also warned that the mortality rate in the health system would surpass the all-time high of 10.8 per cent recorded in 1998 if the funding of the Pharmacy Council of Nigeria was neglected.
It read, “The conference highlighted the unfavourable status quo of over two million unregistered drug sellers, 35 open markets, fake drug syndrome with a high incidence rate of 16 per cent to 48 per cent based on various national and international studies in the last 25 years, the unacceptably high rate of drug abuse involving the use of narcotics and controlled drugs even when the government embarks on what has always been described as insufficient funding of agencies involved with drug distribution in Nigeria.”
The PSN, in the communique, called for proactiveness in dealing with emerging diseases and also appealed to the Federal Government to fund research-based pharmacists in pharmaceutical institutions.
“The conference called for proactiveness in dealing with emerging diseases, including Lassa fever, Ebola, coronavirus, Monkeypox, Buruli ulcer, diphtheria, and other related diseases.
“The conference encouraged government at all levels to make funds available to research-based pharmacists in research institutes, drug research and production units, centre for drug discovery and the pharmacy schools to identify, research, and produce drugs of choice for use in our peculiar environment. This is the only way to actualise the concept of universal health coverage with pharmacists as the pivotal point persons,” it added. (The PUNCH)