Poor lifestyles patterns, poverty and urbanisation are contributing to a massive rise in health challenges for Nigerians as many grapple with what are commonly known as lifestyle diseases.
As deadly and debilitating as these diseases are, BusinessDay found that not only are the poorest Nigerians at risk, but even the middle-income class faces jeopardy.
Two weeks ago, an accountant was referred to Eugene Nwosu, an interventional cardiologist.
The patient could not walk short distance without losing strength. He had suffered episodes of dizziness, fatigue, breathlessness and somehow was close to collapsing. Nwosu’s investigations confirmed the patient had a complete heart block and heart rate at 33.
The patient’s trouble began a year earlier. He had been diagnosed at an Ikoyi-Lagos cardiology hospital where his medical report recommended he needed a pacemaker. The small device placed in the chest or abdomen to help control abnormal heart rhythms costs about N1.5 million and the whole procedure costs an average of N2 million. The patient left Ikoyi and headed for Lagos State University Teaching Hospital (LASUTH). There, he repeated some tests at cheaper rate but again, the submission was that he needed a pacemaker. He left, hinging his health on fate.
Nwosu thought he could make a difference in the management of cardiovascular diseases when he returned to Nigeria two years ago, after 33 years of postgraduate medical training and cardiology practice in the United States.
His pride in his dexterity was hurt in the face of multidimensional poverty that leaves an accountant, who earns much above the minimum wage, unable to foot his bill. Nwosu’s shock was worsened by the fact that his patient is not the regular Nigerian low-income earner trading in the informal sector.
“He was in search of a pill for a cure. I told him there is no cure for this,” Nwosu explained. “If this was in the United States, that same day or next day, he would have had a pacemaker but here he has been like that for one year. The healthcare in this country is a failure.”
BusinessDay found out that death tolls may be on the rise, chiefly as a result of poverty, low awareness, fear of stigmatisation and perhaps, religious belief.
Over the last three years Damilola Awoshina, a 46-year-old female petty trader with high blood pressure and diabetes, has been treating the diseases.
Without any health insurance to access care, Awoshina battles with an unhealed sore on her right leg and yet, struggles to provide for her family at the same time.
Unknown to her, the health challenges started with poor diet and were compounded by her ignorance.
Lifestyle and poverty are a combination that worsens the health challenges of many Nigerians, paving way for several avoidable untimely deaths. Conditioned by unemployment and lean wallets, many neither live nor feed right. People consume poor diets in a bid to simply fill their bellies, contributing to shortened life expectancy.
“Lifestyle and poverty contribute significantly to poor health indices. For many patients we see, their pocket determines the kind of test they can get,” said Oluwasanmi Ogunkilede, principal medical officer of Randle General Hospital, Surulere, Lagos.
Ogunkilede explained that majority of patients don’t approach good hospitals, rather they go to quacks that compound the problems before they go for proper check-up.
Currently, Nigeria is the poverty capital of the world, with 98 million living in multidimensional or extreme poverty, according to the World Poverty Index.
Extreme poverty occurs when a person lives below $1.90 (N684) daily. Unemployment is 23.1 percent.
These numbers are indications that over half of the Nigerian population cannot pay their medical bills.
“Healthcare in Nigeria is not largely publicly funded, and there are out-of-pocket costs associated with diagnosis, treatment, and survival,” said Lanre Yusuf, a Lagos-based medical practitioner.
‘This has worsened the level of poverty because too many Nigerians have died due to lack of funds for medical treatment,” Yusuf said.
Similarily, Adesimbo Ukiri, chief executive officer, Avon HMO, said when the economy suffers, people’s health gets worse because there is almost no aliment that stress and worrying do not contribute to.
“When the body is under stress and people are not sleeping well, their immunity system does not work as well and they fall ill more frequently and much more easily,” Ukiri said.
“I keep on saying that you cannot separate economic growth from health. When you have a healthy workforce, then they are more productive, are able to think creatively, are more innovative and able to come up with solutions to problems plaguing the society,” she said.
Experts raise concerns on lifestyle
Experts say unhealthy diet has caused millions of Nigerians diseases such as high blood pressure, obesity, respiratory diseases, and high cholesterol level. It is a huge burden where malaria, HIV/AIDS, tuberculosis and other communicable disease are present.
Lifestyle change involves changing long-term habits, typically of eating or physical activity, and maintaining the new behaviour for months or years.
“Whether rich or poor, lifestyle pattern matters a lot and regular health checks are important. Nigerians in the bid to make money to live well don’t have time for rest, recreation or vacation,” Ogunkilede cautioned.
Ojo Sikiru, a medical practitioner based in Lagos, said significantly increasing awareness of health issues will reduce stigmatising conversations around diseases, while empowering families with important information about lifestyle modification which research has shown can play a role in reducing the risk of health issues or improving outcomes for wellbeing.
“Awareness is key to survival; we have to be in this together, as we do not know where the prevalence of diseases without cure is going to come from,” said Sikiru.
Richard Adebayo, a consultant psychiatrist/clinical psychologist at Federal Neuropsychiatric Hospital Yaba, Lagos, said the frustration from the economy could lead to the consumption of alcohol and smoking that also trigger some lifestyle disease.
“You do not have to wait until you present with diseases like diabetes and hypertension before adjusting your lifestyle. Avoid junk foods and key into natural fruits and food items with high fibres, vegetables, dieting, meditation, regular exercise, nutrition and especially finding time to rest,” Adebayo said.
The expert, however, explained that an individual who is sleeping poorly may also lose appetite because those who are stressed up find it difficult to eat.
“Some people use wrong coping strategy. When they are stressed up, they think the best is to smoke cigarettes or take alcohol,” he said.
Experts say investing in Nigeria’s health system is an opportunity to accelerate economic development and growth, contribute to saving millions of lives and moving the country closer to achieving objectives of national poverty reduction strategies.
“Providing health services without guaranteeing a minimum level of quality is ineffective, wasteful and unethical,” said Muhammad Pate, chief executive, Big Win Philanthropy and Nigeria’s former minister of state for health.
ANTHONIA OBOKOH & TEMITAYO AYETOTO
