The University College Hospital (UCH), Ibadan, Oyo state, is the first teaching hospital in Nigeria, and it lacks a basic diagnostic machine: the magnetic resonance imaging (MRI) machine. This has put a strain on patients who require proper diagnosis and treatment.

Being a radiologist, one would expect getting an MRI investigation done to be a walk in the park. This is not the case for Ademola Joseph, a 37-year-old radiologist and father of two.

Joseph has a towering figure but is now slightly bending due to his knee injury during a football match last August. He walks with an uncomfortable limp, making occasional grimaces. He was visibly in pain as he interacted with the reporter.

“After the injury, my doctor recommended an MRI investigation before he could start treatment. The test is important for him to see clearly what might have gone wrong there,” he said, pointing to the affected knee.

After the injury, his work and personal engagements suffered remarkably, just like his knee.

Entrance to the MRI centre, but patients can no longer access its services.

“The MRI machine in this hospital (UCH) has been out of use for several years; so, the only alternative I have is to get the test done in a private facility. But it is so expensive that it would require me to take a loan. Before now, it was a matter of simply walking in and having the test done at UCH,” he said.

Joseph has been a radiologist for almost a decade. He feels betrayed by the healthcare system, which cannot take care of his medical needs despite his diligent service.

An MRI machine is critical in the diagnosis of certain conditions, such as injuries, tumours, cysts, certain heart problems, and more.

It uses strong magnetic fields and radio waves to create detailed and clear images of the organs and tissues within the body.

“It is one of the most advanced forms of medical investigation,” says Godwin Ogbole, a professor and head of the radiology department at UCH.

THE PREMIER HOSPITAL

The University College Hospital, a foremost tertiary health institution in Nigeria, was established in August 1952. The hospital was launched to close the training gap of medical healthcare professionals in Nigeria and Sub-Saharan Africa.

The MRI centre, located in the south-east wing of the hospital, was inaugurated by former President Olusegun Obasanjo in 2005. But it only worked for eight years.

In 2014, another MRI machine was inaugurated by Temitope Alonge, the serving chief medical director. It was a private-public partnership between ERS Nigeria Limited, a Lagos-based medical supplier, and the UCH.

It stopped working in 2019.

While there are more advanced MRI machines depending on power, the machine in UCH is 0.2T (Tesla is the standard for measuring the magnetic field strength of a machine).

Globally, a basic MRI scanner costs $150,000 but can exceed several million dollars. Research showed that Japan has the most MRI scanners per capita, with 48 machines for every 100,000 people.

“Currently, about 80% of Africa’s population does not have access to MRI. Even if they can afford it, the service is not available,” Ogbole said.

He noted that over 10 countries in Africa do not have a single MRI and the 1.5 Tesla MRI machines in Nigeria are concentrated mostly among the top 5% of the population who live in urban areas like Lagos, Abuja, and Port Harcourt.

Patients now have to look for means to carry out MRI investigations in private facilities, which are usually more expensive than similar services offered at UCH when the machines were active. For others who cannot afford private services, they are forced to live with their conditions.

Adeola Adebisi had to suspend her compulsory national youth service for over six months. She has been battling with back pain for five years. She was diagnosed with scoliosis, a condition where some parts of the spine are curved; however, most recent investigations showed other concerns. In 2020, she was told to do an MRI for a more comprehensive evaluation.

“My sister and I walked into the MRI centre with a request letter from the doctor. We met the doors open and the lights on, but the MRI machine was not working,” she told TheCable.

Adebisi said that although there is a building dedicated to MRI scans on the hospital premises, the machine is out of service.

“I was told that it had been faulty for a long time, so we were told to find another facility for the scan,” she said.

“Then I was informed that the only place in Ibadan with a functional MRI machine was at a private diagnostic centre.”

Adebisi said she visited the centre but couldn’t afford the scan as she had already spent a lot on the other tests.

“The scan had to be put on hold for about three years. With the help of my family, the money was eventually raised, and I went back to the centre to find out that the price had ballooned,” Adebisi lamented.

“I spent almost N200,000 ($187) on the test. It was really painful because the delay went on for too long, and I had to live with the pain through the years.

“Every time I went for my appointments at UCH, I used to see different patients with their MRI results from private labs or even some from other states.

“People would make jokes about why they have to spend that much money on MRIs when they don’t even have enough for food.”

Emmanuel Abiodun sustained an injury in 2018. He had an x-ray done as he was feeling some discomfort in his right knee.

His X-ray result pointed to an abnormality in the patella region, which needed an MRI for confirmation.

“It happened at the time the machine was down. I was forced to start using other forms of treatment like exercise and therapy to reduce pain,” he said.

“An MRI scan is an important clinical procedure, and it would have been nice for me to get it done then to know what the problem was and if surgery was needed.”

THE NEED FOR URGENT SOLUTIONS

“From my experiences as a medical student and now a doctor, I’ll say we are making progress,” says Babatunde Odunsi, a medical doctor at Lagos State University Teaching Hospital.

“Modern techniques of treatment and diagnosis have improved; but on the accessibility front, we are several steps behind.”

Odunsi said the lack of essential imaging or diagnostic aid in teaching hospitals points to poor management policy and governance.

“These are not exceptional or specialised tools; they are basic,” he said.

He noted that public-private partnerships increase accessibility and efficiency. He added that he expects such arrangements to work out at UCH and other teaching hospitals.

“We do not have local expertise. We do not have standard schools that train people to use these machines,” Ogbole, who is also an African Oxford (AfOx ) visiting fellow at Oxford University, said.

He told TheCable that most people who can afford to buy an MRI machine in Nigeria use it primarily for business.

“This is replicated across most African countries. Also, the few people who are trained to operate these machines have been compelled to relocate,” the professor said.

He, however, said plans are ongoing for the UCH to get a new MRI machine.

“There is an arrangement with the federal government to get the hospital a new MRI. Possibly in the next couple of years, we will get a 1.5 MRI,” Ogbole noted.

“It’s not in my purview to determine the cost of an MRI, as the new machine we are expecting is a form of public-private partnership and will also provide the technical capacity.”

Ogbole, who is a part of the leadership at the Consortium for the Advancement of MRI Education and Research in Africa (CAMERA), also recommended the use of a smaller, low-field MRI, which is easier to operate and maintain. He lamented the exodus of medical personnel from the country and the inadequate power supply in Nigeria. The low-field MRI, he said, is compliant with the uniqueness of Nigeria’s challenges and can also be used in rural communities.

“It looks like an ultrasound machine and can be used to scan a patient by the bedside in the Intensive Care Unit. The low-field MRI requires very little energy as it is battery-powered and cost-efficient,” he said.

Ogbole noted that while the downside of the machine is its low image quality, there is, however, diagnostic information that can be used for emergencies and to plan treatment.

“Investigations carried out in rural areas can be transmitted to any doctor anywhere in the world. We can begin to present these kinds of MRIs to peripheral hospitals for early diagnosis of conditions like stroke and trauma,” he added.

“A coolant is required. To keep it at a stable temperature, you need uninterrupted electricity. With the power situation in Nigeria, three or four generators are needed as they have to be switched on all year round. It also requires a lot of human capacity and trained personnel. Having the quality of trained people to manage MRIs in our environment is a challenge.”

He said biomedical engineers and the experts who operate the machines are in short supply.

Ogbole said the International Society of Magnetic Resonance in Medicine aims to democratise MRI, especially in Africa.

“Some of them are outdated already. Some of the machines that we have now are more than 20 years old,” he said.

Ogbole said the MRI machine in the UCH has reached its “logical end of life”.

THE DOCTOR’S FLIGHT AND THE PATIENT’S PLIGHT

Olushina Ajidahun, a resident doctor, said the healthcare situation in Nigeria is on the verge of collapse. He attributed this to a lack of adequate healthcare facilities and a poor reward and welfare system for health workers.

“It is embarrassing for one of the biggest government hospitals in Nigeria not to have a functional MRI. It should not be taken with levity. For example, you know that an MRI has a lot of applications and it is one of the modalities of medical investigation,” Ajidahun said.

“It hinders the doctors and the managing team as the level of their diagnosis is affected. I think that is very bad.

“It will lead to delay and inaccurate diagnosis because, without MRI, the doctors can only make guesses and could be treating the wrong ailment. This, in turn, impedes treatment planning and monitoring of patient’s progress and may lead to untimely deaths.

“Some procedures can only be done with assistance from an MRI. The machine can guide some surgical procedures, but when the machine is not functioning, then we cannot have those surgeries.”

Ajidahun said this results in patients consulting quacks because they don’t have money to do private investigations.

He noted that it is also going to impact the training of resident doctors because it is the only way they get professional experience. He advised the government to prioritise healthcare funding and rework the entire remuneration of healthcare workers.

“It would lead to a reduction of internally generated revenue in the hospital because patients have to be referred to private facilities. If you have a functioning MRI in a hospital, that’s more money for the government at subsidised rates for the government. That’s more IGR for the country,” he said.

“I think if this is done, you’ll notice that many healthcare workers would stay and try to help things get better. One MRI machine can save thousands of lives.”

Doctour is one of the healthcare professionals who left the country for greener pasture

Doctour, who goes by the pseudonym “Wakawaka Doctor” on X, formerly Twitter, told TheCable that he left Nigeria to practise elsewhere because he was overworked and underpaid.

“At the time, we’d see an average of 100–200 patients per day, and the salary was less than $100/ month,” he said.

“It’s disappointing that a big institution, a premier one like UCH, lacks access to a functioning MRI.”

“Neuroimaging in conjunction with physical examination is a valuable resource, and MRI is one of the biggest imaging techniques.”

For patients, the lack of access to MRI scans could result in delayed treatment and potentially worsened health outcomes. It may also lead to increased financial burden as patients may need to seek alternative, often more expensive, diagnostic methods.

kowalsky:

nce and lack of experienced supervision (what you get in teaching hospitals) of younger doctors.

melow666:
Where do i start..
I am my parents only child, i honestly have lived a very controlled and careful life. I first had intercourse at the age of 27 with a lady i was planning to marry but it didn't click because of certain issues. I wont consider myself a good Christian as i only remember God when i am in serious issues. But anyway, i have been careful all my life. A lot of my friends experimented with drugs, women etc, but i persisted with a clean and honest living. i graduated university at the age of 20, got a job, relatively good job, whilst still serving, so my life so far, had been comfortable. I have never struggled with anything in my life. My parents, both are teachers, would always remind of with a proverb in my place ' A single palm fruit does not get lost in the fire whilst been roasted', literally meaning, if you have a single palm fruit roasting in the fire, you have to carefully monitor it, unlike when you have a lot roasting. Figuratively, i was their only child.
Well in march 3rd on the eve of the lagos state gubernatorial election, i met a girl. I had known her from her workplace, although we did not have sexual intercourse, We somehow touched each other. Unfortunately for me, earlier that day, i had injured myself, just a pin prick on my thumb. Whilst touching this lady, there might have been bodily fluid being mixed. Immediately after this incident, when my senses have become less overwhelmed by my sexual desires, i noticed the injury. Instead of going to the hospital for prep, i simply asked God for forgiveness and forgot about it. I got to understand, that actions begot consequences.

In late march, i went on vacation to the UK, i had a lot of alcohol, i came back to work and since then, my life had been miserable, one health issue or the other.

First came, heart pain(Angina), jaw, shoulder and left had pain, i shrugged it off and started exercising, then came Neuropathy, i felt pain in my legs most especially whilst lying down, well, i increase my dosage of exercise. After all, i was young.

There was silence, my health issues were over, i thought, but then at the turn came stomach issues, i had severe diarrhea, bloating, nausea. I shrugged it off, it must be a stomach bug or something i ate whilst on vacation. I ate things that i knew would not sit right in stomach literally.

Whilst i was battling with the questions of my stomach biome, came fever, it was terrible, it wrecked me. I had never been this sick in life. I had malaria before now and knew all the symptoms that came with malaria, but this time around, it was malaria plus something i could not put my hand into. I never had headache and heart pain with malaria, but this time, i had meningitic headache, the centre of my skull was soft, i could push it in and my heart was racing and pacing as if i ran, even while sleeping. My Resting heart rate which i always monitored before now as sometimes above 100 while sleeping. I went to the hospital and after several test, they claimed i had malaria and typhoid. l started treating the malaria first but it was not getting better, i then took amoxillin, the headache seized but my symptoms doubled. I still had malaise, deep within me even though i was feeling better because the pain and headache had stopped, i still felt sick and my heart raced on.
Other symptoms speedily appeared, my lymph nodes got swollen on my groin, my neck had multiple swollen lymph nodes, my head also had swollen lymph nodes which were painful. Also i noticed i had severe oral candida, my nightmares began, i had very stupid and weird dreams.

I visited a nurse who did a full blood count and noticed that my lymphocytes were quite high, 58% of my WBC, i was also anemic and speculated that this would most likely be a viral infection. I am not very versed with virology, so first thing i concluded was maybe HIV. I knew my life had changed forever. I delayed the testing because i was afraid, i was due marriage, the pressure was coming from my parents, i also had plans of futhering my studies and relocating abroad, with this virus, these might come to naught, but instead of testing, i festered the thought, i carried this secret alone, i could not tell anybody my fears.

More symtoms then came, my tongue not just went white with candida but terrible cancre sores developed on my tongue, these sores would go and new and more numerous sores would emerge. Also i developed rashes on my laps due to anemia, i took supplements, i visited different hospital praying for a different diagnosis apart from HIV, i literally prayed, God give cancer instead of HIV, i joined various HIV groups on reddit, i spent so much of my salary in the hospital that i had to go back borrowing from my parents, but i couldnt tell them why i suddenly started borrowing.

More symptoms came, my hair started thining, i was going bald, went i comb my hair, clumps of hair just fell off, i felt terrible, every morning, i spent so much time in bed reading peoples experience with the symptoms of HIV, and guess what, i had all the symptoms even HIV Neuropathy, instead of going to work, i spent a lot of times on blogs reading people first symptoms of HIV that i was always late for work. The candida was not going any where.

More symptoms came, i developed a pain at my left back, went for various xrays and ultra sound and they found nothing, i did a kidney function test and it was okay, i did a UTI test and it came back okay, then i did an urethra swab and they found i had staph which like candida is a disease that affects people with poor immune function or immunocompromised people, also i found out, that i suddenly developed ulcer.

More symptoms, because of the heart issues, symptoms and stress of the sickness and the whole mental turbulence i found myself in, i became hypertensive, my blood pressure rose from 128/78 to 167/88, i had random headaches and eye pain, i started burping more tha 70 times in a day.

One day, i woke up after year of this mental torment, i something from a novel i had read in the past hit me, although contained in the bible, but the novel had exposed the true meaning of this to me, "THE TRUTH SHALL SET YOU FREE". On my way to the office, i bought a HIV unigold test kit, i also ordered a oraquick from Jumia,

This experience had a good aspect, as i drew me nearer to God, before now, i always thought the power to succeed depended on one's hard work, i would always quote Achebe "no god makes a man prosperous but the strength of his hands and diligence", will your hard work count if you have been bedridden by sickness, i think not.

I prayed like never before, i cried before God and begged everyday for a second chance. I would be better, i will be nicer to my parents and people around me, after all to love another person is to see the face of God. My health further worsened, my skin became sensitive to touch and i would cry out in pain if someone lightly touched my skin.

The French mathematician philosophy called Pascals wager is simple, the benefits of believing in God outweighs the so benefits of not believing in God, simply explained, let say you die and there is no God, what did you lose by keeping his commandments, maybe the luxury and things of the world, but that is little compared to the pain and anguish you would go through in the torments of hell, if God exist and you fail to believe.

John Lennox also points something rational to believing in God, his argument goes like this 'lets say an atheist losses a child, well you can only tell the atheist condolences, nothing more, but a Christian, you would remind that the child would of course be in eternal rest in the bossom of Christ. Thus Christianity is even more humane as it provides hope and faith for the loses we suffer here on earth, and for the evil that happens in the world, where real justice can be perverted, we are reminded that Christ is the true judge and we will get justice at the end of our life, thus as Christ whilst on earth, went through suffering, we might suffer, have faith that we will rise with him and get our reward, So Christianity is even more rational than atheism'.

I also reminded myself that even in the situation that i HIV that God also presents me with a second chance to make a difference by getting treated early since HIV is no longer a death sentence but a chronic illness not worse than diabetes.

I got tested, first using the UNIGOLD blood prick in the office, my heart raced preparing myself for the worst, but hoping for a second change.

It fortunately for me was non reactive to the virus, did another test with the Oraquick device, also non reactive and went to the hospital to confirm, still non reactive.

I still have some of the symptoms and hoping on God to make my healing complete. If you will, give your life to Jesus, he is a better driver than you are and he will take care of you. Just remind him of his words, keep a personal relationship with him, speak to him as you would a friend, if you sin, he will never deny or reject you. Remember, this is another chance for you as you have heard this words a thousand times, i pray that the holy spirit to would speak to you, as i have done my best, he is the great comforter and pray that this would not stand against you on that last day.

In everything, I give glory God.

iykbethany:
On July 18, 2023 this Youtube star Annabelle Ham died at the age of 22😢. She was young, healthy and attended a bachelorette party so I started researching why she died at such a young age.

Then I discovered that she died from an Epileptic event known as SUDEP (Sudden Unexpected Death in Epilepsy).

Doctors say patients with uncontrolled seizures are at greatest risk for SUDEP.

So today I would like us to talk about EPILEPSY.

Epilepsy is a disorder in which the nerve cell activity in the brain is disturbed, causing seizures.

Epilepsy is also known as: seizure disorder.

Epilepsy may occur as a result of a genetic disorder or an acquired brain injury, such as a trauma or stroke.

In all you do brother's and sister's, please avoid head injury. I know someone who had serious head inquiry almost 20 years ago, he just started having seizures since 4 years now.

Epilepsy Causes
In most cases, epilepsies are caused by genetic factors, traumatic brain injury (TBI), developmental brain abnormalities, infection, stroke, brain tumors etc.

Growing up in Nigeria, I noticed that once someone is having a seizure people would put spoon in their mouth and everyone would be shouting "pour am water" lol.

So how do you help someone epileptic?

1. DON'T put anything in the mouth of anyone having a seizure
2. Don't try to hold them down
3. Don't spray or pour them water
4. Place a soft cloth or pillow under their heads to minimise injuries.
5. Lay them on their left side to avoid spit or vomit entering their lungs
6. Remove tight clothing or belts
7. Take away any dangerous objects around them, eg wires, sharps etc
8. Time the episode, if it lasts longer than 5 minutes, take them to a hospital
9. The person has another seizure soon after the first one, take them to the hospital.

If you enjoyed this post please consider sharing it to educate others..

1vid:
VOMITING IN INFANTS AND CHILDREN

Vomiting in Infants and Children:
Vomiting is the uncomfortable, involuntary, forceful throwing up of food. In infants, vomiting must be distinguished from spitting up. Infants often spit up small amounts while being fed or shortly afterward—typically while being burped. Spitting up may occur because infants feed rapidly, swallow air, or are overfed, but it may occur for no apparent reason. Vomiting is typically caused by a disorder. Experienced parents can usually tell the difference between spitting up and vomiting, but first-time parents may need to talk to a doctor or nurse.

Vomiting can cause dehydration because fluid is lost. Sometimes children cannot drink enough to make up for lost fluid—either because they are continuing to vomit or because they do not want to drink. Children who are vomiting usually do not want to eat, but this lack of appetite rarely causes a problem.

CAUSES OF VOMITING IN INFANTS AND CHILDREN:
Vomiting can be beneficial by getting rid of toxic substances that have been swallowed. However, vomiting is most often caused by a disorder. Usually, the disorder is relatively harmless, but occasionally vomiting is a sign of a serious problem, such as a blockage in the stomach or intestine or increased pressure within the skull (intracranial hypertension).

COMMON CAUSES:
Likely causes of vomiting depend on the child’s age.

In newborns and infants, the most common causes of vomiting include

Gastroenteritis (infection of the digestive tract) due to a virus
Gastroesophageal reflux disease
In older children, the most common cause is

Gastroenteritis due to a virus
Less common causes
In newborns and infants, some causes, although less common, are important because they may be life threatening:

Narrowing or blockage of the passage out of the stomach (pyloric stenosis) in infants aged 3 to 6 weeks
A blockage of the intestine caused by birth defects, such as twisting (volvulus) or narrowing (stenosis) of the intestine
Sliding of one segment of intestine into another (intussusception) in infants aged 3 to 36 months
Food intolerance, allergy to cow's milk protein, and certain uncommon hereditary metabolic disorders may also cause vomiting in newborns and infants.

For More Detail Visit: https://www.potentialeffects.com/stomach-virus-in-infants/


In older children and adolescents, rare causes include serious infections (such as a kidney infection or meningitis), acute appendicitis, or a disorder that increases pressure within the skull (such as a brain tumor or a serious head injury). In adolescents, causes also include gastroesophageal reflux disease or peptic ulcer disease, food allergies, cyclic vomiting, a slowly emptying stomach (gastroparesis), pregnancy, eating disorders, and ingestion of a toxic substance (such as large amounts of acetaminophen, iron, or alcohol).

EVALUATION OF VOMITING IN INFANTS AND CHILDREN:
For doctors, the first goal is to determine whether children are dehydrated and whether the vomiting is caused by a life-threatening disorder.

WARNING SIGNS:
The following symptoms and characteristics are cause for concern:

LETHARGY AND LISTLESSNESS;
In infants, inconsolability or irritability and bulging of the soft spots (fontanelles) between the skull bones
In older children, a severe headache, stiff neck that makes lowering the chin to the chest difficult, sensitivity to light, and fever.

Abdominal pain, swelling, or both
Persistent vomiting in infants who have not been growing or developing as expected.

Bloody stools
When to see a doctor
Children with warning signs should be immediately evaluated by a doctor, as should all newborns; children whose vomit is bloody, resembles coffee grounds, or is bright green; and children with a recent (within a week) head injury. Not every tummy ache counts as abdominal pain (the warning sign). However, if children appear uncomfortable even when not vomiting and their discomfort lasts more than a few hours, they should probably be evaluated by a doctor.

For other children, signs of dehydration, particularly decreased urination, and the amount they are drinking help determine how quickly they need to be seen. The urgency varies somewhat by age because infants and young children can become dehydrated more quickly than older children. Generally, infants and young children who have not urinated for more than 8 hours or who have been unwilling to drink for more than 8 hours should be seen by a doctor.

The doctor should be called if children have more than 6 to 8 episodes of vomiting, if the vomiting continues more than 24 to 48 hours, or if other symptoms (such as cough, fever, or rash) are present.

Children who have had only a few episodes of vomiting (with or without diarrhea), who are drinking at least some fluids, and who otherwise do not appear very ill rarely require a doctor’s visit.

What the doctor does
Doctors first ask questions about the child's symptoms and medical history. Doctors then do a physical examination. A description of the child's symptoms and a thorough examination usually enable doctors to identify the cause of vomiting (see Table: Some Causes and Features of Vomiting in Infants, Children, and Adolescents).

Doctors ask

When the vomiting started

How often it occurs
What the vomit looks like (including its color)
Whether it is forceful (projectile)

How much is vomited
Determining whether there is a pattern—occurring at certain times of the day or after eating certain foods—can help doctors identify possible causes. Information about other symptoms (such as fever and abdominal pain), bowel movements (frequency and consistency), and urination can also help doctors identify a cause.

For More Detail Visit: https://www.potentialeffects.com/stomach-virus-in-infants/

Doctors also ask about recent travel, injuries, and, for sexually active adolescent girls, use of birth control.

A physical examination is done to check for clues to possible causes. Doctors note whether children are growing and developing as expected.

sammiewrite:
This same LASUTH is where my uncle was admitted in 2016 for a head injury related case and till date the management of the hospital can not account for his disappearance. Only thing my cousin got out of it were death threats from strange numbers. It's unfortunate the family of this boy will never get justice. An organ cartel is being run in that health facility.

pandax:


Please are they attending to this your child at a tertiary hospital - teaching hospital or FMC?

Any traumatic injury to the head before now?

Has your child had a prior nasal surgery?

How long has your child been having these enumerated symptoms?

A CT Scan of the PNS may be required to ACCURATELY diagnose nasal obstructions and its extent if any

Whether the CSF Leak is secondary to traumatic head injury, prior nasal surgery or any other cause, this case is an emergency

Rita30:





Yes I will talk to the doctors about it. Thank you very much

But what about the nose issue, please is there any obstructions in the nasal passage in that x-ray