elf-medication is another problem that continues to worsen the health status of Nigerians while sending some to untimely graves. This is a situation where people shun the services of trained health professionals when they take ill. They assume that they know what is ailing them and so, without prescription, they go to "chemists", procure and start taking the drug they feel would cure their sickness. The problem here is that they do not realize that two different ailments can sometimes have similar symptoms. It is not uncommon for people to self-diagnose hepatitis as malaria and start ingesting inordinate amounts of chloroquine until it is too late. In other instances, a deadly disease like cholera is diagnosed as mere diarrhea and so does not immediately get the targeted and aggressive treatment it deserves. Unfortunately, many have lost their lives because of such uninformed and misguided actions. There are even cases where opportunistic ailments that stem from diabetes like sores and sight problems are diagnosed as something else and treated accordingly; meanwhile, the main culprit, which is diabetes and which can be controlled through dieting and exercising, is ignored until it is too late. The list is endless.

This writer can understand why people sometimes resort to self-medicating. The high cost of medical services is one major culprit; people who cannot afford the services of hospitals sometimes resort to self-medicating. The other reason is that self-medicating is something many have practiced without qualms in Nigeria for a long time. It has become a habit difficult for them to break. Unfortunately, sometimes, this misguided action becomes the bane of the existence of some.

The other problem inherent in self-medicating involves the use of anti-biotics. Some people use it as a catchall for all ailments but as time progresses, their bodies slowly become resistant to the drugs and in real medical emergencies, they no longer work. It is not difficult to decipher what happens when a drug that is supposed to cure diseases that are sometimes fatal fail to work.

The solution to the problem of self-medicating and its attendant problems is to strictly regulate pharmacies so that certain medications like anti-biotics can only be dispensed on the orders of qualified doctors. Also, government must begin widespread education of the people, sensitizing them to the deadly consequences of this practice. It will also help if more modern and affordable medical clinics are put up..

The scourge of AIDS:
AIDS has now compounded the problem of premature deaths in Nigeria. The last available statistic projects that about 2.5 million Nigerians are walking around with Acquired Immune Deficiency Syndrome while thousands are dying yearly! Of course it is an ailment that mainly afflicts the young. Some money has now been earmarked for dealing with the epidemic but it still remains a mere drop in the bucket.

One must admit that the AIDS scourge is a difficult one to contain; the problem is compounded by the fact that the disease is sometimes seen as one that afflicts only promiscuous people and homosexuals. Because of that, people with the disease are stigmatized as social outcasts; sometimes, even their families try to distant themselves from them. In South Eastern Nigeria, the disease is referred to as "echi eteka" or "tomorrow is too far" and people who suddenly start losing inordinate amounts of weight are regarded with suspicion. The result of all this stigmatization is that some of those with the disease hide it from the public as well as their families. Also, many walk around with the virus without knowing it and continue to spread it to others inadvertently; they refuse to get tested because of the stigma attached to the disease.

If Nigeria must begin to make a tangible dent in the fight against AIDS with consequent reduction in the senseless death of our young, a multi-pronged and sustained approach must be adopted. First of all, education must be ratcheted up to unprecedented levels to reduce the stigma attached to the disease. Educational pamphlets that separate facts from fiction, about the ailment, must be massively printed and distributed. The government must also begin to enact and enforce policies aimed at preventing discrimination against those with the ailment. Of course, education about safe sex must follow aggressively. Preaching abstinence sounds great but is not realistic because the young may never stop experimenting. Hospitals should be equipped with the ability to offer education, prevention and treatment of the disease. Blood donation and transfusion must now be done under the watchful eyes of trained screeners so that the problems of blood contamination will be reduced to the barest minimum. Establishment of free testing centers that also provide those found to have the disease with some type of medical assistance, on a confidential basis, will make a very big difference. Finally, those who deliberately infect others with the virus must be made to suffer the fate of armed robbers because it is tantamount to homicide.

The loss of the most productive group in any society is not a good omen. AIDS is prematurely cutting down the young in Nigeria. Recent statistics project that by the year 2010, this disease would have set the population of the country backwards by 11.7 million! Some people with dark sense of humor say it is population control but population control should be by established birth control measures not through the death of the young in Nigeria. The government of General Olusegun Obasanjo must start acting fast.

Influence of diabolism and belief in juju
There is no gainsaying the fact that perpetual belief in diabolism is sending many Nigerians to untimely graves. Medical conditions that could easily be treated by qualified doctors are seen as engendered by "black magic" and so handled as such. The patients are sent to local herbalists who of course respond by administering concoctions that are sometimes toxic to the body. Delay in real treatment and the toxic effects of the concoctions, on the body, sometimes lead to senseless deaths. I recall the case of a Nigerian that was suffering from debilitating pains on both arms. The pain would start from the shoulder, radiate through the arms and then end up in the fingertips. Visits to doctors in Nigeria did not help because they all declared that they could not find anything. As this problem continued, people who professed to see the past and future prognosticated that the pain was instilled through "black magic" and was meant to eliminate the patient. Of course, the psychological impact of all this on the patient cannot be overemphasized especially considering the fact that the pain continued to increase by the day. On an overseas visit, the patient was taken to hospital where a specialist, after a battery of tests, diagnosed the problem as carpal tunnel syndrome and the patient was operated on both hands. This patient has been without pain for 8-years. In this instance, if the patient had accepted the prognostication at home and resorted to visiting herbalists, the probable next step would have been the ingestion of concoctions until the problem became late. It was a pity that doctors could not even detect the problem in Nigeria and this may be the result of absence of needed medical equipment. The lesson here is that belief in diabolism sometimes prevents Nigerians from seeking and getting proper medical attention and so end up in the hands of herbalists and soothsayers who, in the process of trying to prove the efficacy of their concoctions, send them to untimely graves.

The government needs a two-pronged approach to battle this problem - build modern health clinics and equip them with qualified professionals and requisite equipment. It is simply unacceptable that sometimes-deadly ailments cannot be diagnosed because of the absence of medical equipment. To break the stranglehold of diabolical beliefs on some Nigerians, distributing pamphlets that talk about symptoms of diseases could help people make better judgments about when to see qualified health professionals. This may help reduce dependence on herbalists and soothsayers.

Medical emergency system in disarray:
Each year, many Nigerians die at home as a result of ailments, like heart attack, that could be controlled if the emergency alert system were not in disarray. For starters, the phone system is not always reliable for use in emergencies. As a result, people are unable to get through to alert hospitals or ambulance services with the urgency the situation deserves. Even when one is able to get through to ambulance services, because of bad roads and traffic jams, they arrive the scenes of emergencies too late. It is common for injured people in accident scenes to bleed to death because help came too late.

It is important to note that sirens no longer give emergency vehicles any advantage because, even though it is supposed to be banned in Nigeria, so many private citizens use it with consequent loss of value and import. Because of all these, in emergencies, Nigerians tend to use their private vehicles to drive patients to the hospitals. The danger is that they are delayed because of bad roads and traffic jams. It is not uncommon to hear about people dying en route to the hospital in medical emergencies. Many lives could be saved if the emergency system is brought up to the level where it should be. The government must enforce the so-called ban on the use of sirens so that when medical emergency vehicles use them, motorists will respect them and get out of the way for them. The importance of rehabilitating our deplorable roads can never be overemphasized here.

Poverty and poor nutrition:
The saying that one is as good as what one eats is very relevant to this issue. Poverty has reduced many Nigerians, especially those in the lower rung of the economic ladder, to making do with poor nutrition. Some people get by with one meal a day while others eat the same carbohydrate-laden meal, three times a day. Any health professional would aver that poor nutrition leads to weakened immune system and susceptibility to opportunistic ailments. In the past, Nigerians took pride in subsistence farming. Then, most families produced the food they ate, including vegetables, fruits, nuts and other nutritious food items. Now, overdependence on oil has changed the dynamics of things and many are no longer interested in farming. The result is that common foodstuffs are priced way out of the reach of the poor and so they make do with what they can find. Poor nutrition leads to weakened immune systems, leading to all types of illnesses. With the type of poor medical facilities we have, these treatable ailments often lead to the untimely demise.

Nigerians must go back to basics. Farming should be encouraged and rural education program that would emphasize the need for good nutrition needs to be put in place. Those who engage in agriculture should be encouraged through grants to go mechanical so as to increase production.

Automobile accidents:
Automobile accidents claim the lives of young Nigerians at an alarming rate. During the 2003 road safety awareness meeting in Abuja, the Director General of NAFDAC disclosed that 21,940 people died through road accidents between 2001 and 2002. [Daily Trust, December 17, 2003] If this is not a staggering figure that should cause concern, I do not know what is. Some of the accidents are the result of reckless driving by drunk drivers; night driving is also a culprit because some drivers fall asleep on the wheels out of exhaustion. Some of the luxury buses that ply places like Onitsha-Lagos routes do so at night and we always read about accidents attributable to falling asleep on the wheels. The bulk of the accidents are the result of bad roads riddled with potholes.

The government must begin to do a series of things if this problem must be tamed. Sobriety checks, by honest law enforcement agents, should be instituted, especially for drivers of commercial buses that ply places like Onitsha -Lagos or Lagos-Ibadan and so on. These drivers should not be allowed to drive whilst under the influence of alcohol. The government must also begin to mandate speed limits for some of our roads. At lower speeds, drivers would be able to prevent accidents that would normally turn fatal at higher speed. Also, Nigerian roads are deplorable. It is time for the government to begin a massive reconstruction and rehabilitation of roads. It will of course cost money but will be money very well spent. Another problem is that drivers of commercial vehicles almost always overload the vehicles and sometimes the vehicles are so dilapidated that they are not even road worthy. Clamping down on drivers of these vehicles would help the situation

Death at the hands of armed robbers:
Many young Nigerians have died at the hands of armed robbers that now maraud our roads with abandon. Citizens have been promised all types of miracles with respect to dealing with armed robbery but so far it seems that nothing has worked. Corruption in the police force has made it difficult for any program to work. Radical measures that include community policing must be explored otherwise this will continue.

Environmental pollution:
Environmental pollution and eating of contaminated food and drinking of tainted water has not made matters better. In commercial centers like Lagos, you see people cooking next to open sewers and stagnant drainage channels where insects infest food and cause diseases like cholera and diarrhea. In the oil regions, oil spills contaminate fish and water and when locals eat the fish or use the water, they get sick and without proper medical attention die. Also, gas flaring in those regions result in air pollution that increase the rate of respiratory diseases.

Conclusion:
When will the government decide to tackle the epidemic of dying young head on and save the next generation of Nigerians from extermination? When would the government intervene so that the young can still dream dreams of fulfilling their destinies in life, seeing their own children grow, providing for them and living long enough to reap the fruit of their endeavors? In this New Year, Nigerians must become sufficiently mad about this bleak development to start asking serious questions. Something tangible must be done and fast.

Comments are welcome

HERE I STAND