UZOKWE'S SEARCHLIGHT

Monday, June 29, 2020
obiuzokwe@comcast.net
Harrisburg, PA, USA
DIABETES: NIGERIANS BEWARE OF THIS SILENT KILLER IN THE ERA OF CORONAVIRUS (PART 1 OF 2)

am partially reprising an article I wrote many years ago about diabetes. My decision to update and republish it, is informed by the fact that every time one hears about an untimely death in Nigeria, it seems like there is always a diabetes angle to it, directly or indirectly. The ailment is so commonplace in Nigeria now that when some folks want to refer to a diabetic patient, they simply say, “he or she has sugar problems!

The ubiquity of the ailment is also matched by its deadliness as confirmed in a scholarly article titled , “Diabetes Care in Nigeria”, authored by Olufemi Adetola Fasanmade of University of Lagos and Samuel Dagogo-Jack of the University of Tennessee Health Science Center in 2016. There is no gainsaying the seriousness of the following statement from the article: “Diabetes undoubtedly has changed the landscape of health care in Nigeria over the decades. Diabetes has been associated with the resurgence of tuberculosis and with the rising prevalence of end-stage kidney disease, erectile dysfunction, and stroke. Diabetes has also led to higher numbers and the majority of cases of lower extremity amputation (LEA) in Nigeria. On medical wards, patients with diabetes have the longest hospital stay and highest medical bills with diverse complications, such as stroke, heart failure, and LEA from foot gangrene. …Diabetes is observed in a quarter to a third of all admissions in Nigerian medical (nonsurgical) wards and is one of the leading predisposing factors to operative obstetric delivery, premature births, and neonatal mortality”.

The question is, are Nigerians aware of all the diabetes complications and predispositions outlined above? In this COVID-19 era, when you add all these complications to the fact that medical experts tell us that those with underlying ailments, like diabetes, are more likely to lose their lives to COVID-19 if contracted, makes diabetes even deadlier! Medical experts use the word “comorbidity” to describe the “simultaneous presence of two chronic diseases or conditions in a patient” [LEXICO] as in coronavirus and diabetes. Nigerians need to watch out!

I remember feeling saddened, some years back, when I learnt about the passing of Debe Ojukwu, the son of late Dim Emeka Odumegwu Ojukwu. It was reported that diabetes had a hand in his death.

The ubiquity and deadliness of this ailment, in Nigeria, not only astounds me, but continues to highlight the gaping chasm between the healthcare delivery system in Nigeria and a place like the United States. I say this because even though diabetes is also present, substantially, in the United States, health education, constant screening, more targeted healthcare delivery system and lifestyle changes make the ailment less debilitating for sufferers. Here, during yearly physical exams, people are screened for diabetes either using the general blood glucose level test or the A1c test. As a result, in many cases, the disease is caught at the early stages of onset and hence treated or managed very well. It does not present opportunistic ailments like retinopathy or neuropathy or disrupt lives. Diabetic retinopathy is “damage to the blood vessels in the back of the eyes that could lead to blindness”[Facty Health.com]. Diabetic neuropathy is a type of nerve damage that affects legs and feet.

My question is simple: What special effort is the government of Nigeria making to curb this killer disease and its concomitant effects? In this pandemic era, are sufferers getting sufficient education to be able to safeguard themselves from the pandemic? Are they taking the necessary safety measures of hand washing, mask-wearing, social distancing and the likes to avoid contracting coronavirus in the first place?

If the reader wonders why diabetes is a source of concern to me, then I will tell you. I know people who live with this awful ailment in Nigeria. I know what they go through every single day. I also know people who have lost their lives to this awful ailment in Nigeria. I have told the following story before in my writings but it bears repeating here. Some years ago, a distant relative suddenly passed away. He died sometime in April or June of that year but I had seen him the previous Christmas season when I visited the country. We even sat down several times for conversations about general issues. He looked hale and hearty. The reader can imagine how shocked one was, a few months later, to hear that he had passed away because of diabetic complications!

Now, what does the reader make of this heartbreaking story which I have also told somewhere in my writings? One night some years ago, I was woken from sleep by a phone call. As soon as I saw the time, I could tell that the call was not an ordinary one. No one would be calling at that ungodly hour if there was no emergency. I was right. It was a relative calling to inform me that diabetes had caused the limb amputation of someone we know. To protect the person’s identity, I will use the name – Emenike. The amputation was the result of diabetic neuropathy. I last saw Emenike the previous December. It was after the news of the amputation that I became aware of the fact that he had been diagnosed with the disease sometime back. Typical of the progression of the ailment, he started having a tingling sensation in one foot. The tingling sensation quickly progressed to loss of feeling on that foot.

Emenike dutifully went to the doctors in one of the respected University Teaching hospitals and got treatment. When the symptoms did not improve, one of the doctors referred him to what they call "icha oku"- heat or thermal treatment. This is where the patient's leg is placed inside an enclosed heat source for a period of time each day. The rationale is that since the loss of feeling is the result of blockage of the blood vessels going to the foot, the heat treatment would help "dissolve" the congealed blood and allow flow again.

While he was undergoing this unconventional treatment, unbeknownst to him, he was losing valuable time that could have been used to save his leg. After several of the heat treatments, when it became clear that the condition was not improving, Emenike was airlifted to India. There, his case was declared critical. The so-called heat treatment had damaged more nerves and any remaining living tissues and quickly progressed to gangrene. The doctors had no choice than to amputate the leg. Update! - Emenike has since passed away from the ailment after many years of suffering other complications that included stroke.

From what I read and see, treatment and control of diabetes depends largely on whether the patient is educated enough about the disease and how to manage it through lifestyle changes and nutrition. It also depends on whether the doctor in charge prescribes the right course of action regarding drugs to take, how to takes them and in what doses.

Author of the books- 1. Nigeria: Contemporary Commentaries and Essays

2. Surviving in Biafra: The Story of the Nigerian Civil War

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