NEWS AGENCY OF NIGERIA

Suspected Meningitis outbreak kills 38 in Jigawa

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By Muhammad Nasir Bashir

 No fewer than 38 persons have died of suspected Cerebrospinal Meningitis (CSM) in Jigawa, an official, have confirmed.

Dr Salisu Muazu, the Permanent Secretary, Ministry of Health, told newsmen in Dutse on Thursday that the state recorded a total of 398 suspected cases  between October 2022 to date.

Muazu said the disease was detected in 56 political wards across seven local government areas of the state that boarder Niger Republic.

He said the outbreak was initially from the neighbouring Niger Republic, and later spread to the border communities in the state, through trans border activities.

The permanent secretary listed the affected areas to include Babura, Maigatari, Suletankarkar, Birniwa, Gumel, Gwiwa and Yankwashi.

“This is in spite of the fact that last year, we conducted immunisation against this disease across the state.

“But after getting the report of the outbreak, we took the samples for test in the laboratory, and we discovered it was a strange disease.

“It is not a normal CSM disease that we commonly know which is the type A, this one, we discovered that it is bacteria, known as type B.

“And immediately after results were obtained, the state government, through the ministry, swung into action, by offering free treatment, control and prevention measures in the affected areas,” he said

Muazu further stated that the ministry had established an isolation centre at Gumel General Hospital, to which affected persons are being referred to for treatment and observation.

He, however, stressed that the situation had been brought under control, as cases are being sporadically recorded.

“As of now, we record only one to two cases per day. In fact there are some days that passed without recording a single case, as the last was recorded on Saturday,” he said.

The permanent secretary commended the UNICEF, WHO and NCDC for thier support to the ministry in tackling the outbreak. (NAN) (www.nannews.ng)

Edited by Idowu Ariwodola/Rabiu Sani-Ali

COVID-19 survivor offers respite in “Work in Progress”

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By Nathan Nwakamma

Mr Sam Enudi, a New York based Nigerian, says his book “Work in Progress” provided a multidimensional approach to solving everyday life struggles.

Enudi told the News Agency of Nigeria (NAN) in an interview in Yenagoa, that his interest in seeking a way out of troubles and life challenges culminated into writing the book.

He said the intention was to offer solution to the numerous challenges faced by humanity in the quest for survival across multiple health scenarios especially the COVID-19 pandemic.

Enudi, a Social Crusader from Delta, holds a degree in Psychology and Business Administration.

He said that the book was available on Amazon’s book platform ‘Kindle’ on Feb. 15.

According to him, it covers different aspects of human struggles such as mental health, social expectations, and financial disparity.

“This book extensively discusses self-growth and development in the context of physical, emotional, financial, and mental struggles and provides a viable panacea to overcoming them.

“Work in Progress is a thought-provoking lone hope in the struggle for peaceful human existence, guiding the reader towards a fulfilled lifestyle through minor attitude adjustments.

“I witnessed the massive loss of human lives and its attendant challenges during the pandemic.

“As one of the survivors, I was motivated to come up with an encouraging and healing outlook on life to enable the society to find strength in life challenges.

“The book will help people work on their self-development and self-growth for a self-healing journey,” Enudi said. (NAN) (www.nannews.ng)

 

Edited by Chidi Opara/Isaac Aregbesola

COVID-19 hindered development of children, young people- World Bank

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By Okeoghene Akubuike

The World Bank says the COVID-19 pandemic caused a collapse in human capital hindering development of millions of children and young people in low- and middle-income countries.

This is according to the new World Bank report: “Collapse and Recovery: How COVID-19 Eroded Human Capital and What to Do About It’’.

A statement issued by the World Bank on Thursday obtained by the News Agency of Nigeria (NAN) in Abuja said the report analysed global data on the pandemic’s impacts on young people at key developmental stages.

It said the stages were early childhood (0-5 years), school age (6-14 years), and youth (15-24 years).

“The report found that today’s students could lose up to 10 per cent of their future earnings due to COVID-19-induced education shocks.

“Also that the cognitive deficit in today’s toddlers could translate into a 25 per cent decline in earnings when these children are adults.’’

The statement quoted World Bank Group President, David Malpass as saying, “the pandemic and school closures threatened to wipe out decades of progress in building human capital.

“Targeted policies to reverse the losses in foundational learning, health, and skills are critical to avoid jeopardising the development of multiple generations.

“Countries need to chart a new course for greater human capital investments to help citizens become more resilient to the overlapping threats of health shocks, conflicts, slow growth and climate change.’’

Malpass said countries also need to lay a solid foundation for faster and more inclusive growth.

The statement said due to the pandemic, preschool-age children in multiple countries had lost more than 34 per cent of learning in early language and literacy.

It said the preschool children had also lost more than 29 per cent of learning in maths, compared to pre-pandemic cohorts.

It said even after schools had reopened in many countries, preschool enrollment had not recovered by the end of 2021.

“It was down by more than 10 percentage points in multiple countries. Children also faced greater food insecurity during the pandemic.’’

The report showed that among school-age children, on average, for every 30 days of school closures, students lost about 32 days of learning.

“This is because school closures and ineffective remote learning measures caused students to miss out on learning and also forget what they had already learned.’’

The statement said in low- and middle-income countries, nearly one billion children missed out on at least a full year of in-person schooling due to school closures.

It also said that more than 700 million children missed one and a half years of in-person schooling in low- and middle-income countries.

“As a result, learning poverty which was already 57 per cent before the pandemic has increased further in these countries, with an estimated 70 per cent of 10-year-olds unable to understand a basic written text.’’

The statement said COVID-19 dealt a heavy blow to youth employment.

It said 40 million who would have had a job in the absence of the pandemic did not have one at the end of 2021, worsening youth unemployment trends.

“Youth earnings contracted by 15 per cent in 2020 and 12 per cent in 2021.

“New entrants with lower education will have 13 per cent less earnings during their first decade in the labour market.

It said evidence from Brazil, Ethiopia, Mexico, Pakistan, South Africa, and Vietnam showed that 25 per cent of all young people were neither in education, employment nor training in 2021.

The statement said the report highlighted evidence-based policy options to recover from current losses and forestall future ones.

It said in the short term, for young children, countries should support targeted campaigns for vaccinations and nutritional supplementation.

The statement said countries should also increase access to pre-primary education and expand coverage of cash transfers for vulnerable families.

It said for school-age children, governments need to keep schools open and increase instructional time, assess learning and match instruction to students’ learning levels.

“Government should also streamline the curriculum to focus on foundational learning.’’

The statement said for youths, support for adapted training, job intermediation, entrepreneurship programmes, and new workforce-oriented initiatives were crucial.

It said in the longer term, countries need to build agile, resilient, and adaptive health, education, and social protection systems that could better prepare for and respond to current and future shocks.

The statement quoted Norbert Schady, Chief Economist for Human Development, World Bank and a lead author of the report as saying:

“People under the age of 25 today, that is, those most affected by the erosion of human capital will make up more than 90 per cent of the prime-age workforce in 2050.

“Reversing the pandemic’s impact on them and investing in their future should be a top priority for governments.

“Otherwise, these cohorts will represent not just a lost generation but rather multiple lost generations.”

The statement said the World Bank Group was working closely with governments to protect and invest in people as they cope with and recover from the pandemic.

It said the bank’s pandemic response financing reached 72.8 billion dollars between April 2020 and June 2022, including 37.6 billion dollars and 35.1 billion dollars in IBRD and IDA commitments.

“During the same period, the bank’s financing in human development reached 47.5 billion dollars, supporting 300 projects in low- and middle-income countries.’’ (NAN) (www.nannews.ng)

 

Edited by Ese E. Eniola Williams

Leprosy Mission scale-up intervention to ensure inclusion of children with disability

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By Lizzy Okoji

The Leprosy Mission Nigeria (TLMN) has scaled up its intervention for 2023 in the country.

This is to ensure that children and young Persons With Disabilities (PWDs) were fully included in the society without any form of discrimination.

Mrs Jika Amah-Baruwa, the Senior Programme Officer, TLMN, made this known at the opening of the Mission’s 2023 Partners Inception meeting on Thursday in Abuja.

Amah-Baruwa noted that inclusion of children and young PWDs must go beyond paper work to implementation.

She said that adopting the Rights Based Approaches would enable PWDs (including children, their caregivers & families) to build resilience and actively participate in the socio-economic aspect.

Amah-Baruwa told newsmen that TLMN was determined to achieve through a cluster of 22 local partners across all geographic zones of the country, an increase from 17 individual local partners in 2022.

“This inception meeting kick-starts the process to further engage the government around disability issues.

“We say again and again that it must be an inclusive society not just on paper but that everybody matters.

“We want to see a Nigeria where PWDs have access to quality education and support services, such that our classrooms have supplies that will enable children with disability read and write unhindered.

“Afterall, PWDs pay tax, so also when it comes to development and issues in Nigeria, why are they not participating.

“It is for strategic reasons that we adopted the cluster approach and not just a single partner working independently, because we wanted a situation where we can have clusters of organisation working as a stronger component to be able to address issues.

“Though 22 partner organisations, it is a crushed component of network of partners who will be working as 16 organisations,” Amah-Baruwa said.

Meanwhile, Dr Nasir Gwarzo, the Permanent Secretary, Ministry of Humanitarian Affairs, Disaster Management and Social Development, has reiterated the Federal Government’s support to the Leprosy Mission in achieving its mandate.

Gwarzo, represented by Mr Chidera Ahauotu, Assistant Chief Social Welfare, said the ministry would work with TLMN towards actualising its 2023 objectives, aimed at inclusion and empowering the physically challenged, people affected by leprosy and tropical diseases.

“The Federal Ministry of Humanitarian Affairs have the mandate for disability matters in Nigeria.

“And that is one of the key areas the leprosy mission has focused on in order to promote an inclusiveness in all spheres of life in the society.

“So, we encourage the leprosy mission in whichever way they come to us, financially, morally and where we can.

“They help us in designing some of the programmes that will assist the disability community and we continue to exchange ideas on how to enhance the disability community.

“And all other persons affected by leprosy and other neglected tropical diseases in Nigeria,” Gwarzo said.

Similarly, Mr Afolabi Fajemilo, the Executive Director, Festus Fajemilo Foundation, one of TLMN’s partner organisations, said that they would continue to do more to meet the needs of persons with disabilities and those infected with leprosy.

“We have been reaching out to persons with disabilities, especially children, in critical areas including health education, livelihood.

“So this year, we intend to reach out more to target beneficiaries bearing in mind the effect of COVID-19 still in place, the recent crises in the country regarding currency crunch.

“So we intend to deepen our programmes in terms of education, livelihood to provide succour for our target beneficiaries, their parents and caregivers.

“It will be our desire to have more funding, support from Lilianne Foundation via the Leprosy Mission so that we can achieve more,” Fajemilo said.

The News Agency of Nigeria (NAN) reports that TLMN SPO-PO meeting seeks to bring partner organisations together at its instance as the strategic partners organisation to synchronise work plan for the year and the budgeting. (NAN) (www.nannews.ng)

Edited by Deborah Coker/Muhammad Suleiman Tola

Group seeks measures to kick out leprosy from Nigeria

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By Angela Atabo

Stakeholders in the health sector on Wednesday have called for deliberate measures to kick out leprosy from Nigeria.

They made the call at a one-day Symposium on World Leprosy Day with the theme: “The Multi-Dimensional Impact of Leprosy on the Sufferers: The Need to have the Conversation Now” in Abuja”.

The News Agency of Nigeria (NAN) reports that leprosy is a curable infectious disease mainly causing skin lesions and nerve damage.

Dr Chukwuma Anyaike, National Coordinator, National Tuberculosis, Buruli Ulcer and Leprosy Control Programme said there was need for Nigeria to join the global community to kick out leprosy from the country.

This, he said, it was because of its effects not just on adults but also on children.

Anyaike said: ‘”This is very embarrassing; whenever you see an infection or a disease affecting the children that means that there is an active spread of the disease.

“People tend to run away from leprosy and it comes with a lot of misinformation some say that it is due to punishment from God or due to voodoo.

“So, there is so much stigma and discrimination attached to it and our priority is to engage the communities that is the sure way of getting the right information and reduce stigma and discrimination.

“There are several things attached to stigma and discrimination: First on the list is social exclusion, it comes with poverty and all because they don’t come out among people.”

Anyaike said that the group strongly believed that if leprosy was kicked out it would contribute majorly towards achieving sustainable development goals as a country.

Dr Sunday Udo, National Director of Leprosy Mission in Nigeria, said, “leprosy is really not getting much attention in Nigeria like other diseases probably because it affects the poorest of the poor.”

Udo said the symposium was put together to mark the World Leprosy Day was aimed at creating awareness on the disease and know how far the country had fared and the way forward.

“That is why TLM and other lead agencies are really poised to ensure that we don’t neglect or leave them, we support them and work with them to improve their lives and ultimately defeat leprosy.

“We have a drug called prophylaxis. It is a drug that we can give to anybody who comes in contact with leprosy and then within two years, you are protected.

“So, every two years, you get a pill that will protect you from catching the disease.

“Now, we want the government to be able to pick up this particular intervention and make it national,” he said .

Mrs Nella Andem-Rabana, SAN, Board Chairperson TLMN, said leprosy was curable, adding, “but because it is not known on time, it leaves indelible marks on people.

“The popular belief that leprosy is caused because of people’s sins or as a result of curse is false .

“It is peripheral, it’s on the skin around the nose region itbis curable but if you live it too long, they can really deform you then people will begin to segregate .”

Andem-Rabana advised people to stop living by speculation and build their knowledge on how to tackle the disease so as to help themselves and those around them.

“If the rest of the world has eradicated leprosy, we can do it too and I think we should do it now,”she said

The National Leprosy Goodwill Ambassador, Chief Chika Okpala also known as Chief Zebrudaya called for the need to intensify sensitisation on the disease .

Okpala said:”If people are properly educated on the disease , then it would stop this stigmatisation that is rampant in Nigeria.”

He said that there was need for the government to take deliberate steps to tackle the disease, adding a lot needed to be done to eradicate the misconceptions around the disease.(NAN)(www.nannews.ng)

Edited by Bashir Rabe Mani

Adeleke inaugurates free healthcare for 18,000 indigents

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By Victor Adeoti

Gov. Ademola Adeleke of Osun, on Wednesday, inaugurated free medical and surgical outreach for 18,000 indigents in the state, to mark his 100 days in office.

Adeleke, while inaugurating the medical outreach tagged: “Imole free medical and surgical outreach, organised by Osun State University Teaching Hospital, in Iwo town, reiterated his commitment to quality healthcare delivery in the state.

The governor said that 18,000 indigents spread across the nine federal constituencies in the state would benefit from the first phase of the exercise.

Adeleke, who expressed readiness to develop the state and make it better than he met it, assured that his administration would develop all the healthcare centres in the state with a view to ensuring healthy living.

He said that his administration would focus on the welfare of the masses, especially health care delivery, road rehabilitation, construction and infrastructural development.

The governor, who decried the failing health condition of some aged people in the state, said that the free medical and health services would be a routine exercise for their sake.

In his remarks, the Oluwo of Iwo, Oba Adewale Akanbi, commended the governor for the free medical outreach.

Oba Akanbi said the free medical outreach would give hope to the sick, who had lost hope for better health care due to lack of money.

Also, the Chief Medical Director of the hospital, Prof. Peter Olaitan, said the essence of the medical outreach was to cater for the medical needs of the downtrodden in the state.

Olaitan said that proper arrangements had been made for adequate care of all the patients.

He said that medical personnel were drawn from the teaching hospital and other neighboring teaching hospitals, especially the Obafemi Awolowo University Teaching Hospital, Ile-Ife for the exercise. (NAN)(www.nannews.ng)

Edited by Remi Koleoso/Chinyere Joel-Nwokeoma

Stakeholders underscore importance of establishing National Mine Action Centre

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By Ahmed Ubandoma

Stakeholders in the Humanitarian sector have underscored the importance of establishing a National Mine Action Centre aimed at identifying and supporting persons affected by the devastating impact of mine action.

The stakeholders made this known at the inaugural meeting of Humanitarian Mine Action organised by the Federal Ministry of Humanitarian Affairs, Disaster Management and Social Development and other development partners on Wednesday in Abuja.

They said that the centre would provide the necessary psycho-social support to victims of mine action in the country.

The Permanent Secretary of the ministry,  Dr. Nasir Sani Gwarzo expressed optimism that the National Mine Action Centre, when established, would cater to the humanitarian needs of  victims.

Gwarzo said the initial reason for the creation of the National Humanitarian Mine Action Committee, was to identify and support persons affected by the devastating impact of mine action.

“ That’s why we established the committee; this committee will coordinate all the necessary preparation that will eventually lead to the establishment of the centre.

“The  ministry had earlier concentrated on social support through the welfare, and poverty alleviation of the vulnerable populace.

“ Now, the ministry has widened its scope after three years, all these programmes have been well achieved and even institutionalised.

“ What remains now is to look at other activities that also need attention and one of those clear activities is that of Humanitarian Mine Action.

“Nigeria is plagued with so many epicentres of mine activities and it’s at the rate of almost one per week, you get a mine explosion somewhere, especially in the places that have experienced some social unrest.

“The initial letters that we have written to so many stakeholders and partners and the responses were overwhelming and very encouraging.

“ I believe that in the near future, Nigeria will be at a very comfortable stage of implementing this mine action“ he said.

A retired Group Captain , Sadeeq Shehu, who is the coordinator of the humanitarian mine action committee, expressed his commitment towards supporting the actualisation of the centre.

In his presentation,  the Director, Anti-Personnel Mine Ban Convention, Mr Jaun Carlos Ruan,  reiterated the need for stakeholders to ensure multi-sectoral approach to strenthen Nigeria’s efforts to tackle cases associated with mine action.

Other stakeholders, who spoke at the event were unanimous on need for government to provide effective legal framework and a support action that would ensure full implementation of the humanitarian mine action for the benefit of all victims.

They also agreed that the establishment National Mine Action Centre would support victims affected by the devastating impact of mine action, especially in war-torn areas. 
(NAN).(www.nannews)

Edited by Grace Yussuf

Myths around blood donation wrong, outdated– Nurse

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By Olanrewaju Akojede

The Chief Nursing Officer, Lagos University Teaching Hospital (LUTH), Idi Araba, Mrs Fatimah Adebisi, on Tuesday said that the myths created around voluntary blood donation were wrong and outdated.

Adebisi made this known in an interview with the News Agency of Nigeria (NAN) on the sidelines of the Valentine’s Day Blood Donation Drive held in Lagos.

NAN reports that the voluntary blood donation, the 6th edition of the exercise, was convened by a Non-governmental Organisation (NGO), Timilehin Leukemia Foundation.

Adebisi also told NAN that given the population of Lagos State, there was a need to have more blood banks to cater for patients in need.

“Blood donors need to realise that the myths that have been created around voluntary blood donation are wrong unacceptable and outdated.

“Some of the myth that donors might get sick after donating or that, there may not be enough blood in the system after the exercise, are all wrong uninformed narratives.

“There are standard procedures before anyone can be allowed to donate blood. We have strict processes before the exercise; not that blood donation is stressful, but we want to know the status of the donor.

“`A healthy man will have enough blood to spare in the body and it will also help the donor to know his health status as well, and that is the reason for health check before the exercise.

“Blood donation is highly beneficial and recommendable for all, because aside of the fact that it saves the lives of many, the donor himself has a lot to gain than what he thinks he has lost,” she said.

Adebisi added that the state of the blood bank in relation to the needs of the state showed that the blood bank needed adequate supply to cater for any emergency or treatment of patients.

“The population of Lagos is always increasing with many people migrating daily. So we need to be conscious of our need medically as well. It is however true that more people are getting the right awareness now.

“The benefits of blood donation are many without any side effect; blood donation can lower harmful iron stores in the body and also lower the risk of heart attack.

“Blood donation can also help to reveal potential health problems, help the mental state, burn some calories, increase the production of new blood cells and gives joy,” she said.

The convener of the Valentine’s Day Blood Donation Drive and the Chief Executive Officer of Timilehin Leukemia Foundation, Mrs Oyedele, tasked the government to ensure that the problems in the health sector were fixed.

“Government needs to fix the problems in the health sector because it is critical to the wellness of the people. We need to take this sector seriously.

“The high influx of our medical personnel out of the country which is being tagged as medical brain drain is worrisome, infact the health sector itself is bleeding right now.
“The citizens who cannot afford the medical bills outside Nigeria will be the one to suffer for this problem, so we need to do something about it before it gets out of hand.

“We have seen some improvement in the appreciation for blood donation, but we need more of this at least we should have a blood bank in each of the Local Government Area in Lagos State,” she said.

 

NAN reports that no fewer than 60 people participated in the voluntary blood donation held at the Textile Labour House, Acme Road and Mechanic Village Ogba. (NAN)(www.nannews.ng)

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Edited by Dianabasi Effiong/Vivian Ihechu

IMAN offers medical care to 874 orphans, indigents in Yobe

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By Nabilu Balarabe

Yobe Chapter of the Islamic Medical Association of Nigeria (IMAN), has spent over N2 million on providing free healthcare services to 874 orphans and indigents in the state from January to December 2022.

The Secretary of the chapter, Mohammad Bularafa stated this during a congress and welcoming of new members held in Damaturu on Wednesday.

He listed the services rendered to include blood transfusion, blood drive, surgery, transportation, investigation, provision of drugs, clothing, feeding, among others.

Mohammed said funds for the services were sourced from members’ monthly contributions and donations from philanthropists, agencies and the general public.

The chairman said the services were carried out in three health centres, namely Specialists Hospital, Yobe State University Teaching Hospital and Women and Children Hospital, all in Damaturu.

He identified paucity of funds, inter-professional conflicts, inadequate awareness of IMAN’s objectives and low level of membership as some of the challenges of the association.

Mohammed commended Save One Million Lives (SOML) project and other partners for supporting the association with 100 bags of blood and screening materials.

The chairman called on Muslims to donate in helping the needy, noting that such charity would continue to benefit the giver even after he/she dies.

Also, Alhaji Bukar Adamu, Chairman, Damaturu Local Government Council, commended IMAN for rendering humanitarian services to the people of the state.

He reiterated his willingness to partner with the association in any project or programme that would assist the people. (NAN) (www.nannews.ng)

Edited by Vincent Obi

UBTH conducts first open heart surgery

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By Joy Odigie

The Chief Medical Director (CMD) of University of Benin Teaching Hospital (UBTH), Prof. Darlington Obaseki, says the hospital conducted its first open heart surgery in January 2023.

Obaseki said this on Tuesday in Benin at the 50 per cent subsidised specialised surgeries’ inauguration as part of activities for the 50th anniversary of the hospital holding in May.

The CMD said the medical bill of one of the three patients for the open heart surgery was subsided by the Deputy Governor of Edo, Mr Phillip Shaibu.

He commended the deputy governor for being a pillar of support to UBTH and for also supporting the 50 per cent subsidised specialised surgeries.

Obaseki said the 50 per cent subsidy on speculised procedures such as Endoscopic and Laparoscopic surgeries, Colonoscopy, Optical Coherence Tomography (OCT) among others would be done till the end of February.

”We started since the beginning of this month. As of today, we have 115 patients for surgeries, anybody screened and certified free to undergo surgery would benefit from the programme,” he said.

The CMD said that although Nigeria could take care of its citizens’ health needs, medical tourism situation was responsible for citizens’ inability to place value on what it had.

”We need to advertise ourselves because the general society don’t seem to reckon on the medical professionals in Nigeria, we are up to the task, not until we travel,” he said.

According to him, the country is losing so much money to medical tourism when there are qualified medical personnel in Nigeria.

”There is a new report on the health market in Nigeria commissioned by Pharmaset Foundation which indicated that Nigeria is losing huge money to medical tourism.

”As at 2021, the value of the medical tourism market, the amount of Money Nigerians spend going to seek healthcare abroad is 1.9 billion dollars annually’’.

”Every month, 9,000 Nigerians seek medical care outside Nigeria and majority of them go to India.

”The question is why do they go out to seek for care? Some of the things they go out for are the things we are doing here.”

He said that Nigerians must learn to contribute cheerfully to the health sector, adding that a true philanthropist was the one who contributed to the health needs of his people.

Also speaking, the deputy governor, Shaibu commended the CMD for breaking new grounds in the health sector and for making the hospital a centre of excellence.

He said that the state government had always leveraged on the facilities, expertise of the personnel and technological advancements of the hospital to drive health reform in the state.

The News Agency of Nigeria (NAN) reports that Shaibu also called on Nigerians to show love by contributing their quota to the development of the health sector.

Mr Lucky Adubi, one of the patients, who benefitted from the subsidised specialised surgeries, commended the hospital for making him to see the light at the end of the tunnel.

He sought for sustainability of the subsidised surgeries so as to give succour to the poor. (NAN) (www.nannews.ng)

 

Edited by Dianabasi Effiong/Ese E. Eniola Williams

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