Today, Thursday, was the day we looked back into history. The first instance was a look back a hundred years ago at the personalities involved in the case of Walter Noel Clement, who was the first case of sickle cell described in the western medical literature. Although Clemens’ case had been worked out by the intern at that hospital in Chicago, it was his boss, Thomas James Herrick that took the credit and got the fame. Nothing new about that, I hear you say. Clement returned to Granada eventually after qualifying, and set up practice in St George, the capital. Strangely, virtually nothing of him survives, except his signature. Not even a picture. So, although we know what his blood looked like, we have no idea about the man himself. We were taken to his graveside by the lecturer, though, who showed us tombstones before and after hurricane. We also went and raided the contents of a tomb that was 3200 years old. During the last year, researchers from Egypt and Europe were able to do detailed examinations of the mummified body of the boy-King Tutankhamun, after which, they concluded that the Boy King had died of malaria. This conclusion has been contested by other experts who now think that it was more likely that sickle cell anemia was the cause of death instead. This mater was brought up at the congress in the context of discussing how long sickle cell has been in African populations.
Sickle cell anemia is dominated by pain, and so a big chunk of today’s session was dedicated to pain and how to deal with it. The major point that was made was that caregivers need to understand the suffering that pain induces in sickle cell patients and to be ready to deal with it. Not treating pain adequately is one of the most serious complaints that sickle cell patients have about the way they are cared for. It seems that there is still a serious need for education among care givers and sickle cell patients deed to be on the frontline to make sure that the required lessons are taught.
You may be wondering what might have happened to me during the long silence since I last made a posting.
Well, the answer is simple. I had been so gripped by FIFA World Cup events in South Africa that just about everything else was blown out of orbit. And shortly afterwards, I followed that up with a real visit to Africa, this time to Accra in Ghana. However, this is not relaxation as watching the World Cup had been. Here there are no vuvuzellas to lift the spirit when faced with the repeated disappointment as time after time, the team one was supporting faced and suffered elimination. Interestingly though, even after three days, I can see no signs of Ghanaians pining over what might have been. They seem to have picked themselves right up and, judging by the choked streets of Accra, life has returned to business as usual. And usual business includes hosting major international conferences.
The conference I am attending is the First ever Global Congress on Sickle Cell Disease. As many of you might know, sickle cell disease is an inherited blood disorder that has a high prevalence among people of Africa descent. As some of you might also know, sickle cell disease is one of the so-called neglected tropical diseases and this congress was designed to raise awareness of the disease and to foster networks among people interested in improving the lot of patients affected by its devastating consequences. Interested persons include doctors, nurses, psychologists, social workers, sociologists and priests up to and including an archbishop. The year 2010 is also of signal importance in sickle cell disease, because it marks the centenary anniversary since the first case known to modern medicine was described in western medical literature. But it was also an occasion to reflect that this was a disease that had been known among African societies since time immemorial. This point was made by Dr Felix Konotey-Ahulu who, during the opening ceremonies, was presented with a distinguished service award for his outstanding contributions to sickle cell disease patient care, research and education.
Today is the first full day of the conference and many important presentations were made about different aspects of sickle cell disease. Although sickle cell anemia has until recently been generally considered to be incurable, new therapies have been rolled out in recent years. The most important of these is treatment for what is one of the most distressing features of the disease, namely intermittent, recurrent attacks of excruciating pain affecting most areas of the body. This treatment consists of daily oral intake of a drug called Hydroxyurea. Many patients taking this drug have enjoyed a marked reduction in the frequency of their pain attacks and have been able to stay away from hospital emergency rooms and hospital admissions. Also, there was increased optimism among patients and caregivers when a researcher from New York reported that patients given a radical treatment consisting of bone marrow transplantation from a matched sibling donor had a greater than 85-90% chance of being completely cured of sickle cell disease.
Good news indeed and there is bound to be more which I will tell you about in my next posting.
Some weeks ago I, among others, was cock-a-hoop about the prospect of oil in the waters of Sierra Leone. Now, here was a resource, we were thinking, wells from which we were, in time, to drink deep and long to refresh our impoverished souls. We had a sense that things were about to get better, much better, for the country. Wherever the price of crude went, it was going to take us to places we hadn’t been before, and we would be glad. But in the midst of all that celebratory back- and thigh-slapping, there was an undercurrent of unease that there was a possibility, ever so slight, that we were being handed a poisoned chalice. We look fearfully down the coast at the experience of our neighbor and big brother, Nigeria, and mutter invocations that please, God, let not our case be like theirs.
The great expectations that Big Brov, Naija, anticipated from its considerable resources of light sweet have not been altogether unalloyed. Apart from everything else, there has been an ugly civil war sparked by the former Eastern Region’s decision to secede from the union because it perceived that the oil revenues from its ground and deltas were going disproportionately elsewhere in the Federation. (That, as it happens, is a road we, too, have trod before. Never again!)
But although, in the end, the Nigerian federation prevailed and has survived in a new incarnation, there remains a simmering resentment among the peoples of the Delta region who feel that they are still not getting their due, whilst the environment is being re-shaped into a brutal wasteland, with no relief at all in sight for its peoples.
These environmental dangers are what are inducing me to step back a little from the rosy economic prospects that oil has brought to so many other countries, especially outside Africa: As one watches the heroic efforts of scientists, technicians, government departments that command vast resources of know-how and money, try to contain the oil now being spilled into the Gulf of Mexico, one cannot help but wonder how such a disaster could be handled in a poorly-resourced country like ours if such an incident were to occur in the waters and shoreline of southern Sierra Leone. We should wonder, for example, if such an incident (never an accident; these events are all too predictable) were to occur, what would be the logistics of shipping appropriate equipment across thousand of miles of ocean to deal with the uncontrolled gushing? Who would be responsible for clearing up the mess? Who would take responsibility for restoring those golden beaches to their legendary beauty? And who would pay for the loss and restoration of all the marine species devastated by toxic stuff pouring into the sea? The nascent tourism industry that is so much talked about these days would be dead in the water. The mind boggles.
These questions require answers before we give open-ended licenses to powerful international operators who give no second thought when they stamp their devices and desires on the powerless. We have the right to expect that those bearing the responsibility for protecting our interests must stand true to their national obligations even before serious drilling starts. The question is, can they put national interest first and resist the sweet talk of multi-national companies with deep pockets? One wonders.
One week ago, Britain’s Prime Minister, Gordon Brown, left his office at 10 Downing Street and drove down the road to Buckingham Palace to ask the Queen to dissolve the House of Commons, the lower house of Parliament.
Even though this event had been long anticipated, its announcement triggered wild excitement among the press which reacted as if it had just been handed a new toy to play with. All were now looking forward to four weeks of theatre that will culminate in a general election that everyone hopes will usher in a new government to guide the country over the uncertain terrain of the next few years.
The excitement has been such that, sooner or later, someone was bound to get him or herself into a whole heap of trouble, as each candidate strives to outshine his/her opponent in making the extreme promises and extravagant gestures that they hope will work the magic with an apathetic electorate.
And since this has been declared the first British general election in which campaigning finally entered the internet age, there is ample opportunity for candidates and cash-strapped parties to level an otherwise uneven playing field. But this age of opportunity also has its downside, and watchers have been sharpening their knives for the unwary who, out of an excess of fervor or a want of commonsense, inevitably trip themselves up.
The first notable casualty is a candidate in a Scottish constituency who was foolish enough to twit that the elderly are “coffin dodgers.” Moreover, in another set of 140 characters he went on to say that when it came to bananas, he preferred the slave-grown and chemically enhanced variety rather than the fair-trade, organically-grown kind that, in his view, tasted like shit. With such strong opinions, never mind what he twitted about his own party colleagues and those in the opposition, it was not surprising, least of all to himself, that he was quickly disowned by the party to which he belonged and told to seek his political fortunes elsewhere.
So far, there has been little to differentiate the main parties from each other apart from the usual bluster and name-calling. However, one item that has generated quite a bit of frosh is the governing Labour party’s avowed intent to increase national insurance tax for workers in employment. The proposal has been roundly condemned by the other main parties, led by the Conservatives, which look upon it as a tax on jobs, a view that legions of business bigwigs have been quick to endorse.
The major parties have now weighed in with their manifestos, slim volumes all, but containing material that the pundits have been quick to dissect and mock. But so far, there has been no hint of political murder or cries of potential electoral fraud. This is a great wonder, as those of us brought up on democratic processes in Africa look on with bated breath for the first signs of serious mayhem. Perhaps, the first ever TV debate between the three leading party contenders, which is to be held tomorrow night will see the first drops of blood being spilled. Metaphorically speaking, of course
I have recently returned from a long visit to Sierra Leone. Well, Freetown, if you want to be picky.
One of the things that bothered me while there was the appalling quality of the news reporting. My disappointment is against all sections of the news media, electronic as well as print. As for the latter, the least I say about it (for now), the better. I hope I shall find time to do a more comprehensive rant about it in the near future. For the electronic media, all that needs to be said can be distilled into a single lament: that even the BBC’s stringer in Sierra Leone’s second city, Bo, has been caught fabricating a story.
You might well wonder why I am starting a blog with a wail over the state of the press in Sierra Leone. In the best of circumstances anyone would have to have a whole bellyful of guts to take on the media. But I am not reckless. I feel forced to complain about it because of opportunities it so often loses in leading intelligent debate on issues of public importance. This time, the one that is being so badly managed is one affecting the public health; in particular, the government of Sierra Leone’s avowed intent to institute “free” health care for pregnant women, lactating mothers and children under the age of 5 come April 27 this year.
I am happy to state, however, that about the time when this initiative was beginning to cause serious difficulties for the government, a conference, addressing just this issue and others concerning why Sierra Leone has this terrible record on maternal and child health that has scarred the nation so these long years. The conference, organized by the Sierra Leone Health and Biomedical Research Group, brought together a number of researchers over a two day period at the Taia Resort Hotel, pleasantly situated along the sandy shores of the famed Lumley Beach, just outside Freetown.
Not distracted by the seductions of the blue waters and golden sands, the researchers, coming from places as widely dispersed as the United States National Institutes of Health, Tulane University, New Orleans, Louisiana, the University of Illinois at Urbana-Champaign and the United Kingdom as well as Sierra Leone itself, tackled matters such as maternal and child health and other issues affecting women’s health. Other public Health issues that were discussed included cancers, malaria, epilepsy and some of the so-called neglected tropical diseases such as helminthic infestations, sickle cell and Lassa fever.
The most significant theme that ran through the symposium was a sense that an evidence-based methodology was essential for a rational approach to solving the myriad public health problems that face Sierra Leone, and that this was most likely to be achieved if research was conducted on a cooperative platform.
Many young students were present at the meeting and it was gratifying to note that their number included not only medical and natural science graduates and undergraduates, but also some in the social sciences as well. Perhaps a turning point may well have been reached for a multi-disciplinary approach that will incorporate the social sciences in the type of biomedical research that is going to be pivotal in solving our problems.
It has been a funny old military-type week in Africa. Even before that coup in Niger. This is the week when the UNICEF country representative, for unspecified sins, was expelled from The Gambia, with only 24 hours in which to pack her bags and leave. It was also the week in which the President of Sierra Leone, Ernest Bai Koroma announced that this year, Armed Forces Day, Thursday, the 18th February, was to be celebrated with a public holiday.
Here was a contrast in political culture. Whilst, in The Gambia, its quasi-military government peremptorily gave a member of the UN “family” her marching orders, in Sierra Leone, the head of the UN was audacious enough to tell the President that the declaration of a public holiday was not convenient for the UN. They already had their plans and schedules, you see, and it would have been too disruptive for them to re-schedule their grand designs to another day.
Now, up to the time of writing, the government has been publicly silent in expressing surprise, at least (a diplomatic way of indicating annoyance), that the UN had been too engrossed in its exertions to help the country out of its misery, that it could not find the time to observe some minimal courtesies.
I am not one to advocate hither and thither expulsions, but my disquiet became even more profound when I observed the head of the UN in Salone leave his compound that same February 18 day in his convoy of white-painted four-wheel drive Toyota Landcruisers, with UN soldiers stopping the main flow of traffic to ease his exit. And this was not the first time that I had caught the UN head behaving in a manner beloved of despotic African heads of state. Less than a week ago, we had had to endure the interruption of traffic flow, as he sped by in another white-painted convoy, escorted by motor cycle out-riders to boot.
There has been an outcry in the local press, especially on the airwaves, where callers have called for strong action to be taken, but I suspect that nothing will be done, because we are beholden to external donors who provide considerable budget support for the government. The solution to this dependency predicament is simple: send all the vast numbers of NGO’s packing and try to live within our means. God knows, we have considerable means of our own, too many to be enumerated here. And then, we will become, in the words of Quebecoise nationalists in those heady days of not so long ago, “Maitre chez nous,” Masters in our own house.
Just over a week ago, on Christmas Day, a passenger allegedly attempted to ignite a device on board a Delta Airlines flight, just as it began its final approach to Detroit’s international airport. The flight had originated at Amsterdam’s Schiphol, but the passenger in question, Umar Farouk Abdulmutallab, had started his travels in West Africa, from Accra in Ghana, to Lagos and then on to Amsterdam.
This news set bells of recognition clanging in my head, as I recalled our transit through another West African Airport just a few days earlier. Then it was Freetown’s Lungi International Airport, when our passage through security was no different from the many others we have had the misfortune to endure at that airport. It was lamentable. Firstly, to set the scene, there were no electronic scanning devices to monitor check-in baggage so that, as a result, checking had to be done by hand.
In order for a hand search of check-in baggage to be conducted, you have to present your travel documents and stand face-to-face with the security agents, whose body language was more than eloquent in conveying the terms under which the imminent transaction was to take place. By winks and nudges, the two officials communicated that our bags need not be subjected to a search if we played our part in this sordid drama. There was nothing left to the imagination for a misunderstanding of what exactly we had to do to avoid a legally required safety measure. And, looking at us directly in the eye, they made a show of not opening and examining our bags, adding that we were respectable, mature citizens that should not be subjected to the indignity of a search. And, as we moved on, the final verbal appeal came: “You borbor den dey naya, oh. Dis na Chrismess,” meaning, “Your lads are here. This is Christmas.”
One can take whatever message from this, ranging from a benign effusion of seasonal goodwill to the malign solicitation for improper conduct. However, the expression, “You borbor den day nay oh ” is a well-recognized code, applicable in all seasons, requesting a bribe or tip for services rendered. In this case, it was obviously the latter, an outrageous attempt to receive money for services purportedly delivered, or more accurately, for a dereliction of duty.
That was our progress through check-in baggage security. Checking of hand luggage was equally unsatisfactory. Electronic metal detectors stood as silent monuments to the absence of a maintenance culture and so manual checking was again, mandatory. Here, as before, the body language spoke volumes. Anticipating that we would understand what was being said, the examination of our hand baggage was token, if that. I had a laptop as well as other minor electronic gadgetry, which remained undisturbed in their sections in my bag. What was done, at least in my case, was a patting down to ensure that I had not secreted any prohibited items on my person. That was good. And to give the devil its due, it seems likely that, if Umar Farouk Abdulmutallab had tried to get through, Lungi security, already dressed to kill, he would have been foiled at that point. Anyway, we declined to perform according to script and escaped into the pre-boarding lounge, feeling that we were in the hands of a capricious providence that could decide our fate in whatever way it felt disposed.
I know that there will be howls of protests about these observations with denials coming from all quarters. But if the authorities are ready to take their responsibilities seriously, they will take a close look into Lungi Airport security with the seriousness that this matter deserves. After all, this government is sworn to rooting out corrupt practices that impede progress in our country and that it will deny protection to sacred cows. And it would take only one unfortunate act of negligence to bring us again into the headlines. I can just see them with the old, tired mantras being trotted out again “Sierra Leone, just emerging from a brutal civil war, is a perfect breeding ground for terrorists schooled in the arts of limb hacking, etc, etc, blah, blah, blah.” Apart from the appalling loss of life that could result, our national pride cannot withstand any such further injury. As we say in Krio: “Lonta.” “You have been warned.”
