Placed on a hospital cupboard about two meters from the ground, the little box glows with a brilliant blue light, beautiful in the dark. Unlike the normal incubator used in Paediatric Intensive Care Units (PICU), the box measures approximately about 1m x 0.5m x1m (3ft x 2ft x 2ft) and weighs a little above 5 kilograms (11 pounds) . This box has saved the lives of many babies since a young mother and her team first produced it, three years ago.
Originally conceived, designed, tested and launched in Yenagoa, Bayelsa State, the box now sits in the paediatric units of various hospitals in the Federal Capital Territory (FCT), including Maitama, Wuse and Asokoro District Hospitals.
Named Crib A’Glow, it is a low-cost phototherapy solution to treat newborn babies with neonatal jaundice. It was developed by a young mum and professional graphic designer, Virtue Oboro, after her son’s experience with jaundice. With a group of medical professionals and biomedical engineers, she built a prototype, but it took four failed attempts and several trials before the product worked and she started her company, Tiny Hearts Technologies.
Addressing a Silent Child Killer
Data from the World Health Organization’s Global Health Observatory shows that in 2017, newborn deaths accounted for 47% of deaths among children under five, and in 2016, 1 million children died as a result of complications arising from premature births. While jaundice occurs in about 50% of babies reaching full term, it occurs in 80% of preterm babies. A paediatric specialist at the Asokoro District Hospital in the FCT estimates that 8 out of every 10 premature births in their unit have the condition.
Image credit: Nigeria Health Watch
Jaundice is usually caused by an excessive build-up of bilirubin, a substance made when the body routinely breaks down red blood cells. However, a newborn’s still-developing liver often cannot remove bilirubin quickly enough, causing an excess. Another predisposing factor is Rhesus (Rh) incompatibility between a mother and her baby. Although a small number of babies have different rhesus blood types from their mothers, these mismatches can lead to jaundice. Occurring in the first few days of life, the most notable symptom is a yellow colouration of the skin, which with time, is also observed in the whites of the eyes. While many mild cases do not require treatment, the common treatment for severe jaundice is phototherapy which involves placing the baby under a special type of light that helps break down the excess bilirubin.
A harrowing experience with jaundice
If the bilirubin isn’t broken down quickly enough, it can lead to death or severe disability. Early detection is therefore very important because the symptoms can be missed by new mothers. In the case of Oboro, she thought her son, Tonbra, “just had a fair complexion.” Oboro was discharged from the hospital about 48 hours after delivery, and it wasn’t until her mum, a nurse, came visiting that she realised the yellowish colour was unusual. Once they returned to the hospital, little Tonbra was diagnosed with jaundice. Oboro described the experience that followed the diagnosis as “harrowing“, as the excitement of the birth of her first son was replaced with fear and uncertainty, especially when she learned of the possibility of brain damage if the diagnosis was not properly handled.
With all phototherapy treatment units in use at the PICU of the hospital where Tonbra was admitted, a mother whose baby had almost recovered asked that her baby be discharged to give baby Tonbra a chance. Almost immediately, he was placed inside the phototherapy unit, but then, there was a power outage and other alternative sources of power in the hospital failed. The doctors performed an emergency blood transfusion which sustained him until he was able to access a phototherapy unit. After about a week, Oboro returned home with her baby but the experience was not to leave her for weeks.
Nurses at Wuse General Hospital search for space to place the Crib A’Glow phototherapy unit. Photo source: Tiny Hearts
Necessity usually leads to invention but for Oboro, it was a combination of the near-death experience of her son, curiosity, a passion for problem-solving and empathy for other babies who might face similar situations, that led to the development of Crib A’Glow.
Once she and her son had recovered from the experience, she set out to learn more about jaundice and possible ways for other parents and healthcare providers to overcome the challenges they had faced. The main problems turned out to be lack of quick access to treatment and unstable power supply.
After extensive research, Oboro and her team came up with Crib A’Glow, a simple solar-powered phototherapy system that can be easily moved around to locations where it is needed.
Powered by the sun, the unit solves the problem of unreliable power supply. It also improves ease of access as the equipment can be easily disassembled and moved from one location to another where it is needed urgently.
As a social enterprise, the company is sustained by selling and hiring out the Crib A’Glow phototherapy units. A unit sells for N150,000 and can be rented at the rate of N3000 for 24 hours. Tiny Hearts Technologies also produces disposable phototherapy blindfolds, conducts training programs and recently launched a sensitisation initiative called Yellow Alert to help raise awareness about neonatal jaundice among pregnant women.
Medical staff at the neonatal and pediatric unit in Asokoro District Hospital watch a demonstration of the Crib A’Glow phototherapy unit. Photo source: Tiny Hearts
Beyond Bayelsa: Scaling up a home-made solution
Since the inception of Tiny Heart Technologies in 2016, over 1250 babies have benefitted from their initiative, says Oboro. For her, the task of pitching their services to hospitals is a difficult process because most times, they are met with scepticism. “They usually prefer big equipment from big companies outside Nigeria and usually don’t want to try homemade solutions,” Oboro said. However, they continue inventing strategies to win them over. She recounted how such efforts saved a baby’s life and led to bringing the Crib A’Glow unit to three hospitals in the FCT.
In February 2018, Oboro walked into the paediatric intensive care unit of the Niger Delta University Teaching Hospital (NDUTH) in Yenagoa, Bayelsa state capital. Her mission was to retrieve the phototherapy unit she had rented to the hospital for use. An attending paediatrician told her that a baby was to start treatment with the unit, but the parents were unable to afford it. After hearing the story and with a plea from the doctor to assist, she decided to see the baby.
Medical staff at Wuse General Hospital receive a free unit of the Crib A’Glow phototherapy equipment from Tiny hearts technologies. Photo source: Tiny Hearts
Baby Ndukwe, as he was called, had jaundice but presented at the hospital when complications had set in. His parents had turned to herbal remedies when they first noticed he was sick. On seeing the state of the baby, Oboro decided to assist by starting a fundraiser for him even though it was out of their line of business. She got consent from the parents, took baby Ndukwe’s picture and asked for financial help through her WhatsApp network. Within 24 hours, over N70,000 was raised. This helped offset his medical bills, rent the phototherapy unit for the duration of his treatment and even covered the next baby in need of treatment.
Someone who donated to the fundraiser for baby Ndukwe bought three units of the phototherapy unit and anonymously donated them to three hospitals in Abuja. Oboro said the donor’s motivation was simple. “She said since the Crib A’Glow helped save the life of one baby, she wanted to extend that opportunity to other babies who might need it,” she said.
Twin babies placed inside a Crib A’Glow phototherapy unit in a private hospital in Bayelsa. Photo source: Tiny Hearts
Can Nigeria sustain innovative homegrown start ups?
The challenges with the Crib A’Glow solution are not different from other Nigerian start-ups and largely revolve around the cost of running a business, hiring and retaining talent, government support and regulations. But as a Nigerian medical equipment and device start-up, Tiny Hearts Technologies has its unique set of challenges too, one of which is the inherent preference for imported products. Oboro said this is one of their biggest challenges because it’s difficult to convince hospital executives to adopt their solution.
The cost of using the equipment is another challenge. Hospitals that rent the units need to make profit because they are running a business. This is likely to increase the cost for patients’ relatives and introduce a barrier to access. This can be overcome if there is an effective health insurance system that covers citizens in the formal and informal sectors.
The Crib A’Glow phototherapy unit was donated to Maitama District hospital by an anonymous donor after it saved a baby’s life in Bayelsa. Photo source: Tiny Hearts
A challenge which raises an important question is the issue of patents and protecting intellectual properties. How well are these innovations protected especially in a highly competitive market like Nigeria? Oboro says she has a patent right which offers protection for her design. The legal framework for patents is enshrined in the Patents and Designs Act of 1971. In place for nearly five decades now, is the Act still in tune with current realities, and able to protect young inventors?
Globally, there is a need for affordable technologies to tackle neonatal jaundice. The Crib A’Glow is one of such but for it to thrive, we must develop a culture of adopting and supporting Nigerian-made solutions once they are proven to be effective. The team has plans of expanding to other African countries but charity, they say, begins at home. Let us adopt and use our own, so that other babies like Tonbra and Ndukwe can be given a fighting chance.
By Chibuike Alagboso (Lead Writer)
Providing Affordable Healthcare in Nigeria Should Be Everyone’s Business
“It is my greatest desire that we improve the healthcare system in Nigeria and provide affordable healthcare for local communities at the grassroots so that people can have access to the care they need, when they need it, in ways that are user-friendly” – Adaku Efuribe
The 74th UN General Assembly took place in New York last September; high level meetings were held and Universal Health Coverage (UHC) was a hot topic for the week. As expected, Nigeria had a delegation of Government representatives, NGO’s and individual advocates who are working towards achieving SDG3 and UHC in attendance. So how do we implement new policies and what are the key drivers to providing UHC for all in Nigeria?
As an advocate for UHC/SDGs, I have been lending my voice over the years calling the Nigerian Government to action towards implementing UN SDGs agenda and achieving UHC.I have studied and participated in primary healthcare provision in developed economies and can say for sure healthcare provision is very expensive, but I believe we can up our game towards providing primary health care for everyone at the point of need.
Some developed economies have used the tax system to ensure their national health service does not run out of funds, a percentage of all earnings is taxed and put aside in a ‘pot’ to supplement the health budget. From a lay man’s point of view, just like the banking system, we all bank our money at different times and we withdraw money at different times, so for a contributory healthcare system, everyone will not fall sick at the same time, some will experience life threatening sickness at some point in their life, some would have long term conditions like CVDs, Diabetes, etc., while others would only go through emergencies or minor ailments/major diseases.
In Nigeria for instance, we have a few HMO schemes covering the organised private and public sector. The ‘common man’ on the street does not have any sort of health insurance whatsoever, which leaves them at the mercy of chance. In an unfortunate event of serious illness like cancer or organ failure, they find themselves in a situation where they cannot pay for medical services hence resorting to luck to stay alive. A lot of unavoidable deaths have occurred due to lack of funds to pay for medical treatment.
The public primary care providers are underfunded and the issue of corruption has eaten deep into the fabric of the healthcare system where funds allocated for medical equipment’s, pharmaceuticals etc. are diverted for personal use.
What plans does the present Government in Nigeria have to provide Universal Health Coverage and in so doing, contribute to the economic growth of the Country?
Sustainability can be defined as meeting the needs of today without compromising the needs of tomorrow.
‘As articulated in SDG 3, health is crucial for sustainable human development, both as an inalienable human right and an essential contributor to the economic growth of society. Health contributes to national development through productive employment, reduced expenditure on illness care and greater social cohesion.
We believe that universal health coverage (UHC), delivered through an adequately-resourced and well-governed health system, will be capable of addressing these and other health challenges. Universal health coverage must ensure equitable access to affordable, accountable, appropriate health services of assured quality to all people.
These must include promotive, preventive, curative, palliative and rehabilitative services. UHC must be supported by policies and services addressing the wider social and environmental determinants of health for individuals and populations’. Sustainable Developments solutions network
Key words for providing health systems that works!
- Well Governed Systems- Are there systems and policies in place that can be retained and continued
- Promotive- Do we have health promotion strategies in place to promote good health and wellbeing
- Preventative- Are we taking preventative measures seriously, screening, vaccination, reducing CVD risk through lifestyle management?
- Curative- When we fall ill or in times of emergency, do we have access to affordable healthcare, or does sickness lead to poverty?
- Palliative and rehabilitative services- For terminally ill patients, do we have plans for social prescribing and support? For people engaged in substance misuse, do we have plans for treatment, rehabilitation and integration back into the society
WHO uses 16 essential health services in 4 categories as indicators of the level and equity of coverage in countries: Where does Nigeria rank in the indicators?
Reproductive, maternal, newborn and child health:
- Family planning
- Antenatal and delivery care
- Full child immunization
- Health-seeking behaviour for pneumonia
- Tuberculosis treatment
- HIV antiretroviral treatment
- Hepatitis treatment
- Use of insecticide-treated bed nets for malaria prevention
- Adequate sanitation.
- Prevention and treatment of raised blood pressure
- Prevention and treatment of raised blood glucose
- Cervical cancer screening
- Tobacco (non-)smoking.
Service capacity and access:
- Basic hospital access
- Health worker density
- Access to essential medicines
- Health security: compliance with the International Health Regulations.
The Nigerian Government can do more to improve health outcomes and tackle poverty, by increasing coverage of health services, and by reducing the impoverishment associated with payment for health services. We can subsidise the payment for health services and provide emergency health care at the point of need by ensuring we are constantly reviewing our health policies and implementing proven international strategies. The Health budget does not in any way reflect the health needs of Nigerians, this needs to be reviewed.
As Individuals, if we take health promotion seriously, and change our lifestyle habits, then we can make changes that would reduce the cost of health as well.
Adaku Efuribe is an SDGs/UHC Advocate & Clinical Pharmacist with expertise in medicines management, integrated healthcare and health promotion.
GE Healthcare Launches Versana Ultrasound Machines to Drive Access to Affordable and Quality Healthcare in Uganda
GE Healthcare team displaying the Versana Premier and Versana Essential Ultrasound machines during the Uganda Society for Advancement of Radiology and Imaging Conference (USOFARI).
This innovative system is well suited for general practice clinics, physical check-up centers, community health clinics, and other facilities offering basic medical care
KAMPALA, Uganda, November 11, 2019- GE Healthcare has announced the launch of Versana Premier and Versana Essential for the first time in Uganda. The launch was announced during the Uganda Society for Advancement of Radiology and Imaging Conference (USOFARI).
Versana Premier is a world-class ultrasound designed for peace of mind, easy to use and easy to own. The Versana Premier ultrasound system can help deliver high-quality, personalized care, patient after patient, day after busy day. This innovative system is well suited for general practice clinics, physical check-up centers, community health clinics, and other facilities offering basic medical care. It also comes with local product and clinical training to help healthcare professionals gain comfort and proficiency with the system to enhance patient care.
Versana Essential is a complete ultrasound solution that healthcare professionals can learn to use quickly and productively. It enables confident clinical decision making for quick referrals and immediate clinical correlation to help scan a wide range of patients. The machine is designed with the growing medical center in mind, to provide the clinical capability and support they want without compromising the quality, reliability, and affordability needed.
Both Versana Premier and Versana Essential are part of the Versana ultrasound family, which comprises of solutions that help to empower care without compromise, balancing capability, affordability, and reliability. These innovative systems found within the GE Healthcare Primary Care Ultrasound Segment are well suited for general practice clinics, physical check-up centers, community health clinics, and other facilities offering basic medical care.
“We are excited to participate in this year’s USOFARI conference together with other private and public partners in an effort to continue providing the latest imaging solutions to enhance early detection of diseases and ultimately the most appropriate treatment for patients,” said Andrew Waititu, General Manager, GE Healthcare East Africa. “The launch of Versana Premier and Versana Essential is a testament of our continuous investment in innovations that help to drive access to affordable and quality healthcare for all across Uganda.”
Also Read Meet Mariatheresa S. Kadushi, Founder of M-afya, A Mobile App Providing Health Information In Native Languages In Africa
Universal Health Coverage (UHC) is part of the United Nations sustainable development goals, to ensure that every person, everywhere, should have access to quality healthcare. As part of its vision 2040 and the health sector development plan, Uganda seeks to accelerate movement towards UHC with among others, essential health and related services needed for promotion of a healthy and productive life.
Understanding Nutrition History For A Healthier Life
Pounded yam with vegetable soup (Image: Simplinatural)
“We are less healthy today than our ancestors. By disregarding traditions, we’ve predisposed ourselves to genetic damage.” Catherine Shanahan M.D author of Deep Nutrition.
It’s the 21st century and the machines, computers, social media and tech drivers are here. Giant strides in medical science, engineering, technology has made life better and easier for us. We were supposed to be a very healthy and wealthy generation but instead we started to get sicker and unhealthier. Over the last 50 years cardiovascular related health issues is the number one killer of men and women worldwide according to a WHO report.
Our diets changed and so did our bodies and health. We deciphered so many hypotheses of what could be the problem. We thought it was inadequate exercise, so we exercised more but nothing changed. Whenever we thought we knew the answer to what was happening to our health decline, we realised we were right back where we started from. We continued to grapple with modern diseases medical science seems unable to mitigate.
What does history have to do with our health?
The year is 1901 and my maternal Grandmother is preparing dinner of Amala and ewedu soup (Yam flour and a vegetable). She prepares the dinner just before sun down and gives her large family to eat. Three times in a week, she prepares the same type of meal. However, unknown to my grandmother was the fact that the fermentation process during yam flour processing had converted the starch present in the yam into more complex nutrients like minerals and vitamins by the help of a bacteria called lactobacilli.
Fermentation converts starch(sugar) to lactic acid leaving by-products like beneficial minerals, vitamins that the gut uses to produce important neurotransmitters like serotonin. Serotonin is responsible for regulating sleep, appetite, moods and pain inhibition in the brain but its production is influenced by the billions of friendly bacteria like lactobacilli in the gut. She knows nothing about the science behind what she prepares for her family but from observation over time along with thousands of other women, she knows that a good meal of amala was easily digestible, filling and kept everyone happy.
It’s the 21st century and we no longer sprout our grains for their beneficial vitamins and minerals but cart them off for processing and our diet high in refined sugar and processed oils have now started to harm our brain. Our cells are weak from oxidative stress and inflammation but we continue to eat these modern diets.
We see a spike in suicide rates and depression amongst young people all over the world with no end in sight. Maybe this is the right time to begin to study nutrition history. What worked in the past? What did our ancestors eat that made them strong and healthy? More evidence in nutritional psychiatry are starting to show a connection between what we eat and how we feel.
A critical look into traditional African diets show a rich healthy source of nutrition based on what is now known as the four pillars of the human diet according to Catherine Shanahan author of best-selling book, Deep Nutrition. What is fascinating is how African dishes combine every aspect of the four pillars of the human nutrition making it one of the most nutritious and earlier diet in the world.
Fermented food: delicacies like kunu (fermented millet drink) masa (fermented rice fried in oil) beautifully incorporate food techniques like fermentation ensuring adequate gut health and microbial balance in the body.
Organ meat: Organ meat known to contain vital vitamins are extensively used in preparing soups broth popularly known as pepper soup in southern Nigeria. It is also eaten with other delicious dishes.
Meat on the bone: dishes with meat containing bones are known to provide collagen and body building nutrient and a Nigerian dish that incorporates this is miyankuka dish(a favourite) from northern Nigeria.
Sprouted foods: sprouting known to convert carbohydrate in grains to complex nutrients like vitamins and mineral was on e of the ways our ancestors could successfully grind their grains to powdery usable forms. A traditional African dish that incorporate the technique is Eyin drink from the north central part of Nigeria.
Healthy nutritious diet is delicious, natural and better. Our generation advanced in technology, science and knowledge but needs to pay attention to a vital part of history- our nutritional history. History tell us what’s worked in the past and what’s not working now. It’s time we change the trend once again and return to our roots.
Deborah Ogwuche is the creative director and founder of Food Channel Africa, a 24-hour television channel dedicated to showcasing African cuisines. She is a published author, a food blogger and a healthy food advocate.
Email: [email protected]
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