Rising cases of sudden death reinforce need for regular medical checks

Pastor Sam, 39, showed no physical sign of abnormality that Sunday as he stood before the congregation in his local church in the Okota area of Lagos disseminating the word of God. He was his usual vibrant self, moving from end to end and gesticulating as he preached, intermittently making the congregation reel in laughter with his witty jokes.

So when the news of his death broke barely an hour and a half after the service, no one believed it. The question on everyone’s lips was, “How come?”

“We just returned from service and as we sat at table, he complained of a slight ache around his chest region. Then as we ate, he suddenly held his chest, like someone who was having a seizure, then slumped. He died before we could get to the hospital,” his wife Rose explained.

Pastor Sam’s kind of story is becoming an all too familiar one around us these days. Cases of sudden death are on the rise, leading medical experts to emphasise the need for regular medical check-up. The medical experts who spoke to BDSUNDAY said regular proactive checks go a long way to avert avoidable health problems, leading ultimately to higher life expectancy and lower morbidity.

The experts also stressed the need to maintain sound health through healthy lifestyles, such as intake of proper diet, regular exercise, weight control, and so on, while also calling for expansion of the National Health Insurance Scheme (NHIS) in order to improve access to health care for the greater majority of Nigerians. Malachy Okpe, a chief pharmacist at the University of Nigeria Teaching Hospital (UNTH), Enugu, who confirms that cases of sudden death are indeed on the rise, says most of these deaths are a result of cardiovascular conditions which are not known to the sufferers, adding that they could also be neurological, such as in cases of epilepsy.

“Earlier in March, a nurse drove herself from work in UNTH Enugu to their gate at Independence Layout, Enugu. Her husband came to open the gates for his wife and met her slumped on the steering wheel. She died before getting to a nearby clinic. She died of coronary aneurysm, yet she was not a known cardiac patient. Another young medical lab technician (UNTH staff) who went for a course in the USA slumped in a taxi taking her to the airport to board her homebound flight. That was in January,” Okpe says.

“In February, I was shocked to see comments on my friend’s Facebook wall, such as ‘RIP Onwa’, ‘Goodbye Onwa’, etc. I called another friend who confirmed that my friend and classmate Onwa slept and didn’t wake up. He was a practicing pharmacist in Lagos. April last year my cousin Ejike who chatted with me on Facebook the day before died in his sleep in Ghana. It was after 48 hours that people got to know and forced his door open. He was an apprentice for his Oga who had travelled to Togo at the time died. My village people nearly lynched his Oga, claiming he used Ejike for money ritual. And the list goes on,” he adds.

Doyin Odubanjo, a public health expert and chairman, Association of Public Health Physicians of Nigeria, Lagos chapter, says there is a general rise in non-infective diseases, adding that many of the sudden deaths are caused by cardiac arrest.

“Generally speaking, there’s an increase in non-infective diseases in general, including those that may cause sudden death. Many such deaths are caused by cardiac arrest/heart attack,” says Odubanjo.

He adds that the best way to check the development is by lifestyle changes – proper diet, exercise, weight control, among others.

Philip Anukwam, director, De-Lord’s Medical Laboratories, Satellite Town, Lagos, says the major cause of these sudden deaths is people’s refusal to go for medical check-up until their condition has reached an advanced stage, adding that the deaths could have been prevented if the conditions had been diagnosed early enough.

“People may look very healthy outwardly but inside they are very close to death. That is why it is necessary to go for regular medical check-up, not when it happens we begin to blame evil people and witches and wizards, but we have not taken basic precautions,” Anukwam says.

He adds that people should do comprehensive medical checks regularly, preferably quarterly or every six months, or based on their body system.

“For instance, even if you did a check-up last month, once you notice something irregular in your body system, you should just go back and check again. The body can change anytime, with the fumes we inhale every day, the pollution from the environment, the generator noise,” Anukwam says.

“It is necessary to check the organs regularly, such as the heart, kidney, liver, etc. People should also check their blood pressure, sugar level, cholesterol level, etc as often as possible. Such checks will reveal any inherent danger in the body system which can then be handled easily to avert sudden death,” he says.

Speaking further, Okpe says to avoid these slump-and-die cases, people should go for medical checks as frequently as necessary. According to him, routine checks like eye, dental, cholesterol, sugar, and so on, as well as specific ones that are peculiar to sufferers and/or gender, like prostate check, breast exam, etc, should be taken very seriously.

“Every man or woman who is healthy should go for routine medical check-up according to the prescribed frequency for each check. For example, eye checks should be once a year, dental checks twice a year, blood pressure once a month, prostate check once a year for men above 40,” he says.

“All these checks go a long way to avert health problems most of which are avoidable. The overall result of these proactive checks is higher life expectancy and lower morbidity. The cliché ‘prevention is better than cure’ is not yet outdated. The same goes for ‘a stitch in time saves nine’,” he adds.

Many Nigerians who spoke to BDSUNDAY cited cost as a reason for their reluctance to go for regular checks. Anukwam agrees that some of the checks may be quite expensive and calls for the expansion of the NHIS to accommodate more Nigerians.

“People on the NHIS do not bother so much about bills. Even though the scheme may not cover all categories of ailments or laboratory investigations, it still goes a long way. So all organisations should ensure they enrol with Health Maintenance Organisations (HMOs) to avail their staff of this opportunity. Again, the scheme should be expanded somehow to also accommodate those in the informal sector because that is where you really find the bulk of Nigerians,” he says.

Odubanjo adds that NHIS should improve access to health care by ensuring that people can access care when needed without being hampered by cost.

“We definitely will benefit more as the coverage expands. However, there is need to work on redesigning the NHIS to achieve quality health care provision,” he says.

But for Okpe, the reason people in developing nations like Nigeria do not go for preventive health care goes beyond poverty.

“So many researchers attribute it to poverty. In my own opinion, poverty is not the only culprit as wealthy folks have been diagnosed in emergency units of conditions insidiously in their systems for years. I think the problem we have is cultural or religious. In my years of practice I have observed this kind of ‘it is not my portion’ belief. Even though medical science has advanced to accurately diagnose many diseases at early stage, so many Nigerians reject asthma, diabetes, cancer, etc even in the presence of their medical consultants,” Okpe says.

“Another reason why people do not go for medical checks when they feel well is because most times we are good in diagnosis but not good in treatment or management. An average Nigerian cannot afford treatment in India, for instance. So we ‘reject’ these ‘portions’ instead of accepting it and dying helplessly in it,” he adds.

CHUKS OLUIGBO