South African Hospitals Brace For Coronavirus Surge

A queue of cars are seen at the Maseru Bridge border post between Lesotho and South Africa on March 24, 2020. Molise Molise / AFP.

 

Staff at Johannesburg’s Charlotte Maxeke hospital were swamped last month when hundreds of panicked locals rushed in for testing after South Africa reported its first coronavirus case.

A handful of infections had snowballed to dozens in three days, catching hospitals off guard and exposing a glaring lack of preparedness.

Coronavirus has steadily spread across South Africa over the past two months, with 4,793 cases — the highest in the continent — and 90 deaths.

Almost five weeks of strict lockdown have slowed the increase, buying precious time for hospitals to prepare for an expected surge in infections.

“The lockdown has given us a chance to stock up on PPE (personal protective equipment), organise our wards and make sure our staff has been trained,” said Dr. Feroza Motara, emergency department head at Charlotte Maxeke.

Epidemiologists say imposing the lockdown when cases were relatively few helped to temporarily flatten the curve.

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They, however, warn of an exponential increase once restrictions are lifted — a move scheduled to begin gradually from May 1.

“We needed a bit of time to get prepared,” said the government’s chief COVID-19 advisor Salim Abdool Karim. “The key is going to be the extent to which we can prepare hospitals.”

At Charlotte Maxeke, a public facility, suspected patients are now swiftly directed to green tents put up outside and swabbed on the spot by nurses.

– System might not cope –

Karim predicted a peak of infections in July and feared the health system might not cope.

South Africa’s Health Minister Zweli Mkhize said at least 87,000 beds had been freed up for coronavirus patients at public institutions.

Field hospitals are being set up as triage facilities to avoid overburdening emergency rooms.

This week, the minister told parliament that 288 quarantine sites with 23,604 beds would be opened across the country.

“If people are not sick at the same time we can actually go quite a long way with those numbers (of beds),” Mkhize said.

Quarantine sites will mainly host mild or asymptomatic patients who cannot self-isolate — an issue for many dwellers living crammed in townships.

“We have quite a number who are in hospital not really because they are sick but simply because… they cannot self-isolate at home due to social conditions,” said Nosipho Dlamini, who manages Charlotte Maxeke’s emergency nursing staff.

– 80% without health insurance –

President Cyril Ramaphosa has announced an additional 20 billion rand ($106 million) to adequately equip hospitals.

“(Coronavirus) can overwhelm even the best-resourced health system within a matter of weeks,” Ramaphosa said. “It is precisely… what we have gone to great lengths to prevent.”

Over 80 percent of South Africa’s 57 million inhabitants have no health insurance and rely on public hospitals.

Public facilities had less than 18 beds per 10,000 insured patients last year, said a report by the South African non-profit Health Systems Trust.

“We had to extend the casualty to the tents outside,” said nurse Dlamini, adding that both the pediatrics and gynaecology casualties had been moved.

Meanwhile, private healthcare providers have also been gearing up.

Anchen Laubscher, director of private hospital chain Netcare, told AFP the group had invested $8 million to “enhance the readiness” of its 1,200 ICUs and $16 million on protective equipment.

– Protecting medics –

Staff at Charlotte Maxeke have relied on a mix of public funding, company and community donations to pull together a decent stock of PPE.

“There have been shortages of PPE around the entire world,” said ICU specialist Abdullah Laher. “It is always a concern for us.”

Keeping staff healthy will be key in South Africa, where hospitals were understaffed even before the pandemic.

Motara’s “big worry” was whether her colleagues would be safe, exhausted or suffer emotional trauma.

“Then of course there is the bigger picture,” she added. “Are we going to have enough PPE? Medication? Ventilators?”

Health expert Mosa Moshabela warned that some hospital workers were not being adequately prepared for the challenge ahead.

“What is really important is that health workers themselves learn to behave differently,” said Moshabela, public health dean at the University of KwaZulu-Natal.

“We have not taken enough time to teach them the extra skills and practices that will help them prevent infection.”

Nurse Dlamini took matters into her own hands and started weekly training sessions after some staff panicked and stopped coming to work.

Emergency specialist Jana du Plessis is also training and preparing.

“I think we are all worried at this point,” she said, adding: “But we have a job to do. This is what we signed up for.”

AFP

Establish One General Hospital In Each LG, FG Tells States

Osagie Ehanire, Health, Industrial Action, Minister

 

The Federal Government has asked state governments across the country to build general hospitals for the easy accessibility of healthcare delivery.

Minister of Health, Dr. Osagie Ehanire made the call on Monday while on a working visit to Jigawa State to assess existing health facilities for the establishment of a teaching hospital for the Federal University in Dutse.

“ For the 774 local governments of Nigeria, we are expecting to see several functional general hospitals to improve primary and tertiary healthcare,” he stated.

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According to him, the President Muhammadu Buhari administration’s approach to healthcare is bottom to top, as such the need to provide excellent health services from the grass root.

Speaking also, the Deputy Governor, Mr Umar Namadi who had earlier received the minister in his office said the state government is already establishing two new specialists’ hospitals in the state.

Meanwhile, the Vice-Chancellor of the Federal University, Dutse, Professor Batul Muktar said the university hopes to begin clinical studies if approved by the Federal Government.

Senate Moves To Ensure Quality Healthcare For ‘Poor’ Nigerians

File Photo: The Institute of Maternal and Child Health (Ayinke House) with facilities at LASUTH, Ikeja.

 

The Senate on Thursday began moves to regulate Health Insurance in the country in a way that would allow poor Nigerians access to quality healthcare.

According to the upper chamber, this can be realised by seeking the establishment of the National Health Insurance Commission.

The Upper Chamber while considering a bill For an Act to repeal the National Health Insurance Scheme Act, 2004, said the passage of the National Health Insurance Commission bill, 2019 under consideration by the National Assembly would guarantee the effective implementation of the country’s health insurance policy.

According to Senator Ibrahim Yahaya Oloriegbe (APC, Kwara Central), the bill “is about every family in Nigeria as it is manifestly clear that it is poised to positively affect all Nigerian families.”

He added that amongst other things, the bill seeks to boost healthcare delivery in Nigeria, provide robust, affordable and sustainable financial mechanisms for health, and reduce the high mortality rate across the country.

Oloriegbe further stated that the NHIS Commission bill, when passed into law, will strengthen the implementation of the Basic Health Care Provision Fund provided for in the National Health Act 2014, and enacted by the Seventh National Assembly under the leadership of Senator David Mark.

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“Nigeria’s healthcare system is in urgent need of reform – the system must refocus to ensure it meets its laudable objectives and global best practices,” he said.

“It is time to provide the legal framework for a new policy shift in order to help poor and vulnerable Nigerians access to quality healthcare without any financial impediment.

“The bill as proposed, if enacted and properly implemented in the form envisaged, will make health insurance compulsory, boost the nation’s health indicators, improve productivity and economic well-being of citizens and enable the attainment of Sustainable Development Goals.

The Senate President, Ahmad Lawan, after consideration of the bill, referred same to the Committee on Health for further legislative work.

Meanwhile, the Senate also urged the private sector not to leave funding of Nigeria’s health sector to the government alone if the attainment of universal health coverage by 2030 must be realised.

It also urged States in the federation that have not enacted laws on National Health Insurance to do so without further delay.

The resolutions were reached sequel to the consideration of a motion on “The 2019 International Universal Health Coverage Day”, sponsored by Senator Chukwuka Utazi (PDP, Enugu North).

Coming under Order 42 and 52 of the Senate Standing Rules, the lawmaker stated that the United Nations General Assembly on December 12, 2012, endorsed a resolution urging countries to accelerate progress towards Universal Health Coverage (UHC) with emphasis that everyone should have access to quality and affordable healthcare.

He said that the goal of the UHC is to ensure that all people, no matter who they are or where they live, should be able to obtain health services they need without suffering financial hardship when paying for them.

Four Killed As Syrian Air Strikes Hit Hospitals

 

Regime airstrikes Thursday on an anti-government bastion in northwest Syria killed four civilians, two of them children, and hit three hospitals already damaged in previous raids, a monitor said.

A fifth person, another child, was killed in a separate air raid by regime ally Russia also in the Idlib region, the Britain-based Syrian Observatory for Human Rights war monitor said.

The Idlib region is supposed to be protected from a massive regime assault by a September buffer zone deal, but the area housing three million people have come under the increased regime and Russian fire since April.

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The region is administered by Syria’s former Al-Qaeda affiliate Hayat Tahrir al-Sham, but other jihadist and opposition factions are also present.

“Regime warplanes again targeted three hospitals in the south of Idlib,” which had been hit and damaged in raids in previous weeks, the Observatory said.

There were no casualties in these raids on the village of Hass and the town of Kafr Nabl, it added.

Obeida Dandouch, who heads a rescue group in the area, said the strike in Kafr Nabl damaged a large part of what was still standing at the local hospital.

In May, Amnesty International accused the Syrian regime and Russia of launching “deliberate and systematic” assaults on hospitals in the northwest.

At least 25 hospitals and clinics have been destroyed or damaged by air strikes and shelling since the end of April, according to the United Nations.

Five rescuers were also killed in the last two weeks of June in an air strike on the Idlib region.

Thursday’s strikes killed four civilians, two of them children, in Kafr Nabl, Hass and the town of Khan Sheikhun in Idlib region, the Observatory said.

A Russian air strike near Al-Bara village killed a little girl and wounded several people, it added.

Syria’s war, which started in 2011 with the brutal repression of anti-government demonstrations, has killed more than 370,000 people and displaced millions.

AFP

Yobe Govt Approves N679m To Equip Three Hospitals

Yobe Govt Approves N679m To Equip Three Hospitals
File photo

The Yobe State government has approved N679m for the supply and installation of state of the art medical equipment for three major hospitals.

The three hospitals, located in Potiskum, Gashua and Geidam, were recently upgraded and renewed to provide improved healthcare services for the downtrodden people of the state.

Commissioner of Home Affairs, Information and Culture, Mala Musti, told reporters on Thursday that the fund was approved at the State Executive Council meeting which held at the Government House in Damaturu, the state capital.

He said, “The state government had, in June 2016, spent N1.8 billion for the total rehabilitation and expansion of the three hospitals.

“Today, the council approved N679,380,000 for the supply, installation and user training of assorted medical equipment to the three hospitals”.

The approval, according to him, was in line with the resolve of Governor Ibrahim Gaidam’s administration to make quality healthcare services available and accessible throughout the state”

Musti added that N97,703,650 was also approved for the purchase of science laboratory equipment, tools and reagents amongst others for the five secondary schools that were also rehabilitated and expanded by the Gaidam administration.

He listed the schools to include; GSS Fika, GSS Yunusari, GSS Nangere, GSS Gwio-Kura and GGSS Nguru.

The commissioner explained that the laboratory equipment are intended to boost the study of science subjects such as mathematics, biology, physics and chemistry.

Earlier, Governor Gaidam said that his administration would continue to sponsor indigenes to study in higher institutions of learning both within and outside the country.

He made the promise when he received an award of excellence which was conferred on him by the National Union of Yobe State Students (NUYOSS) for his immense contribution to the development of education.

The governor reiterated the commitment of his administration to improving the sector through regular payment of scholarship allowances among other incentives encourage teaching and learning in the state.

Obiano Distributes N258.5m To Faith-Based Hospitals

Willie Obiano
File photo: Willie Obiano

Anambra State Governor Willie Obiano says his administration is committed to improving healthcare delivery across the state to provide affordable and accessible service for all.

In the light of this, the governor donated N258.5m to faith-based hospitals in the state as intervention funds to run proper healthcare system.

Presenting the cheques to the mission representatives on Tuesday at the Professor Dora Akunyili Women Development Center in Awka, he said the disbursement was part of efforts to support the mission as major players in the ongoing health revolution in the state.

Obiano also explained that the monies were distributed according to the number of hospitals owned by various denominations as the law gazettes, as well as their capacities as worked out in the state 2017 budget.

He said the development was aimed at structuring health approach in the state in three critical areas that include the provision of infrastructure, ensuring the comfort of patients as well as training and retraining of health workers.

On his part, the Commissioner for Health, Dr. Joe Akabuike, disclosed that the government has introduced total health reforms that have guaranteed coordination and greater efficiency in the state’s health sector.

He noted that some major breakthroughs of the administration – which include the introduction of Universal Health Insurance Scheme; strengthening of the state primary healthcare system and the setting up of the State Integrated Emergency Management System – were helpful during the Ozubulu shooting incident.

The Special Adviser to the governor on Agriculture, Tourism, Training, Methodology and state Emergency, Amaechi Okwuosa, commended the governor for the fund distribution.

Okwuosa described Obiano as the most mission-friendly governor in Nigeria, saying the cordial relationship he has with the church was without bias.

The Roman Catholic Mission received a cheque of N159.5m, the Anglican got N84m while the Pentecostal mission received the sum of N15m.

Other faith-based hospitals that were not included in the disbursement were asked to forward their details for inclusion in the 2018 budget of the state.

Nigeria Is Committed To Tackling Climate Change – Min. Of Environment

Amina-Mohammed-Minister-of-environmentThe Nigerian government says concerted efforts are being harnessed among all major stakeholders to begin an expansive programme to protect and sustain the environment as intense talks continue globally on tackling and managing climate change successfully.

The Minister of Environment, Amina Mohammed gave this indication during a 2-day facility tour of Forestry Research Institute of Nigeria (FRIN), Jericho, Ibadan.

Mrs. Mohammed hinted that President Muhammadu Buhari is focused on investing heavily in research institutes across the length and breadth of Nigeria and FRIN is a critical partner to the country in environmental preservation and controlling the ills of climate change.

She said that the era of Federal Government just awarding contracts for various projects at research institutes is gone and replaced with sincere determination to ensure that the research facilities in Nigeria not only live up to expectation, but also provide jobs for the teeming youths of the country.

The Minister, who was led into the over four hours facility visits of various departments and sections of the agency by the Executive Director, FRIN, Dr Adeshola Adepoju, described the agency as an asset and a platform for evidence based research in Nigeria.

She noted climate change has eaten up some portions of the environment and research institutions like FRIN are needed to reclaim the environment.

The Minister said that the narrative among Nigerians on environmental protection must change with a carefully laid out plan to avoid wastage and turn existing ones to wealth.

She also assured Nigerians that the Buhari-led administration would end the era of plastic waste on Nigerian roads and open defecation, to safeguard the natural environment and as well provide job opportunities for the citizens.

“By 2019, we will end an area of plastic bags, pure water sachets and bottled water as waste on the streets. We’re not banning it because we cannot ban it, but getting the plastic companies to collect it, pay for it and we turn waste to wealth and they recycle it.

“The government plans to end open defecation in public places by 2019 through partnership with the private sector and erect toilets in public places like motor parks, markets, hospitals,and schools.”

She further reiterated the need to restore dignity in peoples’ lives and at the same time help provide jobs with the private sector and change the perception of the people with safety practices.

Lagos State Bans Public Smoking

The Lagos State House of Assembly in South-West  Nigeria on Monday passed a bill to prohibit smoking in designated places and vehicles in the state.

The bill which was sponsored by Gbolahan Yishawu, the lawmaker representing Eti-Osa Constituency 2 at the House, places a fine of N10, 000 or 3 months imprisonment, or both for first offenders.

The law prohibits residents of the state from smoking in public places such as schools, day-care centres, libraries, museums, hospitals, public transportation, restaurants, public toilets among others.

The law, which passed its third reading on Monday, also mandates owners of public places to place signs with the inscription; ‘No Smoking’ or symbols as part of enlightenment for smokers and would-be violators of the law.

Section 4 of the bill also states that “it shall be the duty of owners or occupiers of public places to ensure that approved signs are displayed conspicuously at each entrance, and in prominent locations throughout the premises.

The law also mandates such owners of public places to create areas far from the vicinity where people could smoke. Non-compliance by owners of public places, according to the law shall attract a fine of 100, 000 Naira or 6 months imprisonment, or other non-custodial punishment that the judge may deem fit.

In the case of a corporate organisation’s refusal to place a ‘No Smoking’ sign or symbol within its premises, any personnel in the management of the corporate body would be liable to a fine in the sum of 250, 000 Naira upon conviction. This may be a director or manager in the organisation.

According to the bill, anyone who repeatedly violates the provisions of the law, on conviction shall be liable to a fine of 50, 000 Naira or 6 months imprisonment or both. While anyone who smokes in the presence of a child shall be liable on conviction to a fine of 15, 000 Naira or 1 month imprisonment.

The law gives the state Environmental Protection Agency the powers to implement it while residents are allowed to report to the state Ministry of the Environment, any grievances against state officials who are saddled with the implementation of the law. It is however, an offence to obstruct duly authorized officers from carrying out their duties under the provision of this law.

More places may be designated by commissioners of the state, as non-smoking areas for the sake of effective implementation of the law.

Section 12 of the 16-section law that has been passed to the state Governor, Mr. Babatunde Fashola, for assent

Fewer Blood Pressure Screens May Be More Effective

Less may be more when it comes to blood pressure checks, according to a new study.

After analyzing five years’ worth of data for more than 400 patients, researchers conclude that the current practice of screening at every visit to the doctor’s office – up to several times a year – may result in more people mistakenly diagnosed and unnecessarily treated for high blood pressure than would simple yearly screening.

Blood pressure measurements are often taken without following proper procedure, according to lead study author Dr. Gregory Garrison, so the readings can be widely inaccurate and lead to some people being wrongly diagnosed with hypertension, while others who have the condition are written off as just “more false positives.”

“One, it results in unnecessary patient anxiety, repeated clinic visits, and laboratory testing,” Garrison, of the Mayo Clinic in Rochester, Minnesota, told Reuters Health by email. “Two, it often lulls physicians into writing off a positive result because so few are confirmed.”

Garrison and his colleagues found that taking fewer readings, while still sometimes inaccurate, would weed out almost half of the false positives.

The researchers looked at Mayo Clinic records for 68 patients diagnosed with high blood pressure and 372 patients without high blood pressure. Based on the readings from every doctor’s visit, all 68 high blood pressure cases were identified, but 110 people without high blood pressure would also potentially have been wrongly diagnosed because of a stray high measurement.

When the researchers analyzed the same data but only considered one measurement per patient per year, they identified 63 of the patients with high blood pressure – at or before the original date of their actual diagnosis – and got 67 false positives, according to the results published in the Annals of Family Medicine.

An office blood pressure measurement can be inaccurate if it is not performed with the patient seated, arm supported, after a five-minute period of rest. Otherwise, blood pressure can rise temporarily for a variety of reasons, including the mild stress of being tested by a doctor, known as the “white coat effect.”

“Blood pressure technique is not good at all, and does overestimate a lot of the time,” said Dr. William Cushman, chief of the Preventive Medicine section at the Veterans Affairs Medical Center in Memphis, Tennessee.

But he disagrees with the Mayo team’s conclusion. Overestimation results in unnecessary expense and anxiety, but doesn’t usually harm the patient, said Cushman, who was not involved in the new study.

If less frequent testing fails to identify a few positive cases, that could be a bigger problem, he told Reuters Health.

In the study, annual testing failed to identify five of the 68 cases of hypertension, or a little over seven percent, which was not statistically significant in that case. But it could become significant when applied to a larger population, according to Cushman.

“In populations, we don’t want to miss ten percent of people,” Cushman said.

High risk patients with high blood pressure can start to see the benefits of treatment after six months or a year, so waiting twelve months between tests could have consequences for some, he added.

For most people, hypertension is a slow moving disease, and a diagnosis delayed by a few months or a year is unlikely to have noticeable negative consequences, according to Garrison.

“However, we have a number of patients, perhaps as many as 30 percent, who have hypertension for years without diagnosis and proper treatment,” Garrison said. “This can result in heart disease, kidney disease, and many other complications.”

These people can have elevated readings for years that go unnoticed or undiagnosed because they are written off as false positives and attributed to pain, infection or some other cause, he explains.

Measuring blood pressure less often and taking each reading more seriously could help catch some of those undiagnosed cases, Garrison believes.

The United States Preventive Services Task Force, a government-backed advisory body, recommends blood pressure screening once every two years for people at low risk for the condition and once yearly for those at high risk.

Doctors continue to test at every visit partly because patients expect it, Cushman said, and partly because there are generally no organized efforts to ensure patients and doctors remember to screen every year or two.

Before doctors can start screening less, that kind of system of reminders needs to be in place to ensure no patient falls through the cracks, Cushman said.

Getting blood pressure taken is very important,” he added. “If an adult has not had their blood pressure taken in a year, or they don’t know what it was, then they should get it taken fairly soon, or ask for it,” he said.

SOURCE: bit.ly/Yp5jZD Annals of Family Medicine, March/April 2013.

Ipads used in the hospitals

Ipads are increasingly finding its use in the medical  and health field, with applications ranging from giving individuals instant access to a wealth of reference.

Educational and personal health information, to helping hospitals streamline their operations, reduce labor costs, improve efficiency, and helping health professionals with analysis and diagnosis.

For some doctors, the use of ipads can also be used to get fast access to information on the internet instead of caring your laptop all around.

For some hospitals, they have installed kiosks where patients, visitors and medical staff use the securely mounted touchscreen tablet to look up information.

iPads in Medical Education

At first it was just a tool that students use, now schools are now switching to ipads as a main platform for delivering the curriculum.

According to some medical students they say its cost effective for them and improves on their learning skills.
It also helps most students that travel a lot instead of carrying copies of paper, they can carry their Ipads.