Nigeria is one of the countries yet to implement multi-month refill policies for HIV (Human Immunodeficiency Virus) medicines, which allows dispensing longer prescriptions to People Living With HIV/AIDS(PLWHA) for at least for 90 days rather than the usual 30 days.
The non-implementation of a multi-month policy, even in an era of major restrictions on physical movements and travels which the COVID-19 pandemic has birthed, may adversely affect the country’s response to ending the global epidemic.
COVID-19 and its numerous challenges, as well as rife stigmatisation and discrimination against PLWHA, may knock Nigeria off track to end the AIDS epidemic by 2030. Many young HIV positive Nigerians in dire need of drugs, having run out of supplies because they cannot go to their treatment centres, confided in TOBORE OVUORIE that they have never disclosed their statuses to their parents or any family member and will never do so; even in this critical COVID-19 era.
11 of those affected: Opeyemi, Bimpe, Tokunboh, Chiedu, Lawrence, Olamide, Adaobi, Michael, Osas, Beauty and Abdul spoke with me. All are undergraduates in higher institutions between 17-22 years. They are from diverse backgrounds with different orientations and worldviews. Some know each other. Most don’t. But they share two things in common: top secrets, now well-kept with me. I can only share some of their experiences in this three-part series but must keep their identities top secrets, too.
Here are their stories.
APRIL 7TH, 2020 1.34PM
“Haa! It is not possible, ma. My parents will kill me.”
“This is a dicey one. Your parents won’t allow you leave Lagos for Benin without very good reasons since schools are not in session. Ope, see, your parents cannot kill you. Will they be shocked? Yes. But they will get over it and be involved with your accessing care; at least, for your refill and viral load checks.” I was not done with what I wanted to tell Opeyemi before he interrupted my flow. “Not that kinda kill. They will disown me, stop my education and I will become the topic for sermons in church and painted as evil.”
“Your parents are pastors?”
“My dad is. MFM (Mountain of Fire and Miracles).”
“Now you understand why I can’t and must never tell my parents or anyone in my family that I am HIV positive.”
REWIND THE GENESIS
It all began on Tuesday March 31 after the Federal Government directed all tertiary institutions of learning be shut down to curb the community spread of COVID-19 in Nigeria.
I vividly remember Steven, popularly known as Odogwu Dollars, amongst our peers, started phoning me at exactly 2.54am that day. I ignored his calls and continued with the video editing script I was writing for the first phase of my three-part investigative series on illegal migration for publication on July 30. Odogwu only remembers me whenever he needs assistance. I was forced to answer his call at about 3.10am when it dawned on me he will run my phone’s battery down with his usual but annoying speed-dial.
I wasn’t wrong.
Odogwu needed at least a bottle of antiretroviral. Not for him. It is for Beauty, a 20-year-old third year student of the University of Lagos (UNILAG).
Antiretroviral, also known as ARV, is the medicine People Living With HIV (Human Immunodeficiency Virus) take every day to fight and stop the damages the virus carries out in the body. The World Health Organization (WHO) says the infection attacks the body’s immune system, particularly the white blood cells called CD4 cells.
When affected persons don’t take their antiretroviral medications and consistently, their immunity against infections become weakened because the virus destroys their CD4 cells. This can result in Acquired Immunodeficiency Syndrome (AIDS), which can lead to serious illness and death.
While hurrying to pack and leave her hall of residence, as insufficient notice was given to them to exit the hostel, Beauty mistakenly placed her antiretroviral in the wrong box which she had decided to leave behind in school thinking academic session won’t be interrupted for long. She was already at home with her family in Benin, Edo state, when she discovered the grievous error.
“ARVs are not hawked on the streets of Lagos. Neither are they dispensed easily and cheaply like paracetamol in hospitals. But let’s see what happens,” I told Odogwu. I made no promises but was shocked when Beauty phoned me later in the morning same day.
MARCH 31st, 2020 10.05AM
“Please ma, help me. I have missed eleven days already,” Beauty sounded like she would burst into tears.
“It’s not as easy as you think. First, I don’t work in a hospital. Abi did Odogwu tell you I’m a doctor?”
“E-hen. So, a doctor friend is the one to help out with the drugs if he can. And, he could lose his job if it’s discovered he gave antiretrovirals to someone who is not the centre’s registered and physically present patient.” Beauty interrupted me.
Her voice louder than before and ladened with sobs. “Ma, please, help me ma. My viral load is not yet good.”
“Secondly, we must look for exactly that which you are taking or something in the same family with it.” She cut me short again but already in tears. “Please ma, or can you help me go to my hostel in school? My roommate and friend has the key to where it is. I will call her to follow you to the hostel.”
“UNILAG is empty. There would be no one in the hostel. You live in Moremi Hall, not so?”
“I was in Moremi Hall on 20th of March when the announcement was made that everyone should vacate the hostel due to coronavirus. Even if we meet someone at the hostel, the hall porters won’t allow us in. What about you simply tell your parents so that they will allow you come to Lagos easily for your ARV, CD4 Count and any other stuff?”
“Haaa. Aunty, it’s not possible! Nobody in my family even knows I have HIV.”
“Why? Your parents will support you if you tell them.”
“Haaaa, Aunty. It’s not possible o. My people don’t believe in girls going to university. In my family, once you have written your first WAEC, that’s it o! You pass, you don’t pass, means nothing to them. They wanted me to learn hairdressing then travel to Spain, Holland or Italy. I hustled for money to write JAMB, passed very well and entered UNILAG without knowing anybody there. Is it people who tell me my going to university is a waste of time that will now support me when they hear I now have HIV?”
I tried to say something but she cut me short again.
“Ordinary to pay only school fees o, they abuse hell out of me that my mates are already in Europe controlling money home to Benin from jand. Aunty, na big excuse for dem nor to pay my school fees be dat o. In short, dem go pursue me comot from house join sef!” Beauty’s pitch was several decibels higher. Her impeccable English thoroughly mixed with pidgin English popularly known as Waffi- in Nigeria.
HIV PHENOMENON IN NIGERIA
Opeyemi and Beauty are two out of the estimated 1.9 million persons living with HIV in Nigeria. A 2019 national survey partnership conducted by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the National Agency for the Control of AIDS (NACA) titled: ‘Nigeria National HIV/AIDS Indicator and Impact Survey (NAIIS),’ indicates the national HIV prevalence has reduced to 1.4 percent among adults aged 15-49 years when compared to the previous 2.8 percent, estimate.
The survey states that girls and women between the ages 15-49 are more than twice as likely to be living with the virus than men. A differential ratio of 1.9 versus 0.9 percent is stipulated for both genders, respectively.
However, the difference in HIV prevalence between women and men is greater among younger adults, with young women aged 20-24 years more than three times as likely to be living with HIV compared to men in the same age group. At the national level, viral suppression among people living with HIV aged 15–49 years stands at 42.3 percent. That is, 45.3 percent among women and 34.5 percent among men.
According to the 2019 national data, Nigeria’s South-South zone has the highest HIV prevalence at 3.1 percent among adults aged 15-49 years. The North-Central zone has a prevalence rate of 2.0 percent while the South-East has a 1.9 percent rate.
The survey indicates South-West has a lower HIV prevalence at 1.1 percent while the North-East and North-West Zones follow in same stride with 1.1 percent and 0.6 percent, respectively.
The HIV/AIDS virus remains one of humankind’s greatest global health challenges as it has spread across all countries. The spread is on the increase among heterosexuals and bisexual males but predominantly among young persons in African countries like Nigeria. The rapid growth of HIV positive cases in the last few years globally and in Africa indicates majority of Nigerians infected with the virus are the youths. The UNAIDS says the virus is predominant among young people in Africa because they constitute larger percent of the society.
In November 2016, the National Population Commission put Nigeria’s populations at 182 million people with a widening youth bulge because more than half of these persons were under 30 years of age. However, by Friday June 26th, 2020 at 9.44am, Worldometer elaboration of the latest United Nations data indicates the current population of Nigeria is 206,018,277.
Nigeria has shown steady progress on increasing access to treatment for PLWHA with the adoption of a test- and- treat policy in 2016. This measure has further accelerated referrals to treatment facilities for people who test positive for the virus.
From 2010 to 2017, the country almost tripled the number of PLWHA having access to antiretroviral therapy moved up from 360, 000 in 2010 to more than 1 million in 2018. However, the NAISS indicates that more than half of people living with HIV still do not have suppressed viral loads.
The COVID-19 and its consequent restrictions and challenges may cause a spike in the number of persons without suppressed viral loads, such as young persons who are hiding their status from their parents, guardians and families.
YOUNG NIGERIAN STUDENTS’ HIV PERSPECTIVE
In the last five years, there has been a significant expansion in the country’s response to HIV. The number of hubs providing treatment has tripled with over 201 centres unlike previous years. For instance, the number of centres providing services to prevent mother-to-child transmission of HIV have increased eightfold and the number of HIV counseling and testing sites has increased fourfold. A total of 11.3 million adults were counseled and tested for HIV in 2016, four times as many as in 2012.
But the country is still lagging behind in provision of counseling, test and treatment centres strictly for young persons. Nigeria has not prioritised tailor-made policy for HIV control for young persons of institutions of higher education.
Undergraduates, who spoke with me for this story, said they were yet to test for HIV because when they walked into some of the centres, they didn’t see anyone in their age group there. So, they walked out, never to return. Some said they didn’t like the way the adults in the place looked at them so they left, while others feared an adult there may know one or both of their parents.
The prize for rendering assistance is more requests for assistance; not thank you. After I successfully got multi-month refill of HIV medicines which would last Beauty for 90 days/three months, my phone started buzzing with calls from students of various higher institutions of learning in dire need of ARVs.
I don’t know who has been sharing my phone number around telling these young undergraduates that I can help them with free ARVs during this period that they are home and still hide their identities and HIV status. Beauty denies sharing my number with other persons. Odogwu, too. But I suspect Odogwu is the culprit. Well, that is how I got to meet Bimpe and other young persons who are hiding their HIV statuses from their families.
Bimpe, 19, a second year student at the Yaba College of Technology, Lagos, would have submitted herself to be tested for HIV since last year. “When I walked into where I was to wait at NIMR (Nigerian Institute of Medical Research), I didn’t see my mates there,” she stated.
“You mean, not even one young person like you there?”
“That day, I didn’t see o. They were all looking one kind. As I entered and sat down, some were even looking at me like television. I became afraid that they possibly know my mom that’s why they were staring at me. See, they were actually gazing, not staring.”
“Why were you afraid they possibly knew your mother?”
“Haa. Ma, you will understand if ever you meet my mom. She is fire!”
“Yes, fire. Aunty, maami kii n s’eran riro. My mom is tough. Very tough.” I guess she interpreted the Yoruba statement thinking I don’t understand the language. She was wrong.
“So, she will kill you?”
“Aunty, she is unpredictable. But I know everything bad will happen if she hears I am HIV positive.”
“Everything bad, like what?”
“See, my mom refused me accepting admission at UNILAG because she thinks girls that go to universities, especially UNILAG will become corrupt. I passed and my name appeared on UNILAG admission list but my mom refused me going o.”
“Yes. She believes boys can attend universities and girls should not. My mom thinks girls who attend polytechnics are better behaved and won’t get corrupt. That’s how I ended up in Yabatech o.”
My attempt at not roaring with laughter was successful. It was my first time of hearing such. And, I found it highly ludicrous.
Curiosity to get checked for HIV because of some tweets about HIV she had seen made her return to NIMR, Yaba at about past 4pm sometime in November last year. But, the person to administer the test on her was closed for the day. That ended her curiosity to be tested for HIV until January 2020 when the doctor who had been treating her for malaria and excessive weight loss for over four months, recommended XYZ test.
She checked online and discovered it meant HIV test. She left her school environment to the Lagos State University Teaching Hospital (LASUTH), Ikeja to get tested because she felt better protected testing somewhere far from school and home.
Bimpe tested positive.
She was later told her viral load was at an abysmal level, immediately placed on ARV and commenced regular check-up appointments at a treatment facility in Lagos (name deliberately withheld). She was already adapting to the new and healthier lifestyle until COVID-19 and its restrictions arrived.
MORAL POLICING AND COMMODITIZATION OF GIRLS AND WOMEN
Bimpe never expected to test positive. Her (now ex) boyfriend was the only person she was seeing. They had been together since the second month of her resumption at Yabatech. And, she never had vaginal sex. So, she found her test result shocking. She went to two other places to retest. The results never changed.
“When you say you have never had vaginal sex, how do you mean?”
“We were doing it from behind.”
“Yes.” I noticed Bimpe’s voice level had dropped, her countenance changed, her light skin turning red, her head bowed down. Relieving embarrassing, painful and regretful memories, I thought.
“One can contract HIV through anal sex.”
“I never knew until then.”
“I’m sorry to ask, why anal? Please, I’m not judging you; just curious.”
“That’s the only way to make my mom feel I’m still a virgin.”
“I don’t understand.”
“She monitors and checks if my hymen is still intact.” Bimpe paused while I stared at her trying to mask my being shocked. She continued “She wants us to keep the bed undefiled until our wedding nights.”
“How do you mean by US?”
“My sisters and I”
“How many are they?”
“We are three girls.”
“Is your father aware of this?”
“He is dead.”
“I’m sorry to hear about this.”
“It’s ok ma. Mom has been the only one fending for my sisters and I.”
“She didn’t remarry?”
“No. She never did notwithstanding she was young when my daddy died.
“Please, how long ago is this?”
“He died three months before I was born.”
“I’m so sorry for your loss.”
I noticed she was already sniffling, so ended the session with her.
Two days later, I got her three bottles of Tenofovir Disoproxil Fumarate PDM Schedule 2; the exact antiretroviral she is on. They will last her for 90 days. I have been on the lookout for when schools would resume so she wouldn’t be under her mother’s lock and key while I can urge and monitor her going for the proper HIV treatment regimen.
COVID-19: IMPACT ON YOUNG PERSONS’ VIRAL SUPPRESSION
Studies so far indicate when PLWHAs are virally suppressed, they remain healthy and transmission of the virus is prevented. This can be achieved through consistent treatment / taking their antiretroviral medication daily and at the exact time recommended. Unfortunately, the COVID-19 and subsequent restrictions are making this almost impossible for many young persons, such as Adaobi because schools are not in session while their parents are in the dark about their HIV status.
In 2018, Adaobi, 21, now a 400 level engineering student at the Federal University of Technology Akure (FUTA), was in Lagos shopping for clothes she planned to sell on campus when representatives of a nonprofit organization came to inform her about an ongoing free HIV test session. The screening point was a walking distance from her. She was reluctant but eventually agreed to get tested.
Adaobi fainted on seeing her result.
She comes to Lagos every month for monthly refills of her HIV medicine and CD4 count check. This is the test through which her viral load is monitored and has been doing this for the past two years. She chose Lagos because it is far from school and home, so reduces the possibility of a school mate seeing her in a facility for persons living with HIV.
Adaobi has been able to manage her schedule between school in Akure, Ondo state, treatment in Lagos and being with her family in Onitsha. She still finds it hard to believe that “just a mere disease” (COVID-19), can mess her plans and wants to ruin her “little secret.” Her exact words.
Running out of her medication is not her only challenge. Being able to consistently take the ARV at exactly 8.30pm while with her family has been a huge challenge.
PLWHAs are advised to take their HIV medicines not only daily but at the exact time they took it for the first time. If, for instance, a person took the ARV for the first time at 9pm, he or she must always take it at that time. Not even a minute late. Adaobi has been faithful with taking her medicine until the compulsory long stay with her family in Onitsha due to COVID-19 restrictions.
“I take my antiretroviral at exactly 8.30pm. No matter what I am doing, I leave it and sleep for the day. But it’s been difficult since my being with my people.”
“Always, we start preparing night food at past seven in the night. So, the time I should have eaten and take my medicine is affected. At some point, I found a way to eat early and take my medicine, but when I’m already drowsy and sleeping is when my mom will wake me to come and make soup, serve my father his food, run some errands or join everybody for night prayers. And, prayers are always very long.”
“How do you intend to manage this if I’m able to send you the medicine you need?”
“I don’t know. My father has started complaining that I sleep like a chicken. My mom asks questions anytime she sees me taking the medicine. I tell her its multivitamin supplement for my eyes. I have been having problems with my eyes so she believes me.”
“Believes you? Even with what is written on the bottle of the ARV?”
“No o. I always put the medicine inside a multivitamin supplement bottle. That way, no one knows its HIV medicine.”
Beauty’s fears that her parents will end her education if her HIV positive status is uncovered turns out to be true. June 20th, 2020, I contacted her father on phone claiming I am a regular customer at his food store situated near one of the higher institutions of education in Edo state.
I then subsequently sent a two-question survey to him via WhatsApp wanting to know what he will do should his child who left home for the university with a HIV negative status subsequently tests positive to the virus after settling on campus.
“If my daughter who left my house HIV negative when going to university for the first time, returns home with HIV, then she should not bother going back to school. I won’t allow her waste my money. Na book I send her go read. I no send her go flex. And, if she thinks say she fit flex so tey she rock HIV join sef, na red card be that for her.”
“Sir, but HIV doesn’t affect learning. She can still live a normal life, don’t you think so?”
“Which yeye normal life? Which man go free marry woman wey don catch HIV?
“They do o. I know of HIV negative men who are married to HIV positive women.”
“E no possible. Stop lying to yourself.”
“I’m not lying sir. They are people well known to me.”
“That’s the problem with you girls wey too read book. Una think say una fit yarn dust and everybody must believe you. I dey always talk am, secondary school (education) don do for woman. When dem go university, dem go become know-know, waka-waka and catching HIV go be the certificate dem go bring come house.”
Mr. Obatunde Oladapo, Executive Director, PLAN Health Advocacy and Development Foundation, Oyo state, says persons who believe that HIV is contracted only through sexual intercourse are still living in stark ignorance about the basics of how people get infected and the risk factors. He questions the quality of parenting of the young PLWHAs featured in this story.
“If your child cannot confide in you, then, there is a problem. Parents should also always realise that they have responsibility over their children. If your child is not doing things right, at a point in time, there must be somewhere that you have lost it,” he said.
A day before sending the two-question survey to Opeyemi’s father, I phoned him to say hello introducing myself as one of the students he ministered to at the University of Ibadan two semesters ago. Opeyemi was 100 percent correct about what would become of him should his parents, particularly his dad, be told about his being HIV Positive.
“God forbid! No child of mine will have HIV in Jesus name.”
“Sir, it’s only an assumption for research purpose”
“I will not answer such demonic question. Are you really sure you are born-again?”
“I am, sir. And spirit filled.”
“I doubt it. No spirit filled person will imagine and ask such about another child of God. My children are purified and anointed for supernatural exploits. They will never end up with such evil result. Only carnal people end up with HIV.”
“Sir, it’s only a survey.”
“That is not a question to be asked. I refuse to partake in such demonic survey. I consider this conversation over.”
According to Oladapo, the parents of young persons featured in this story need help because they are the problem. He said in the long run, it is an opportunity for parents such as Opeyemi’s father to realise that he has been fooling himself and come down from his high horse to face the reality of life.
“It is not a matter of faith. It’s not a matter of being holy. It’s not a matter of being religious. It’s a matter of life and HIV is a biological thing, it is not a spiritual thing. He does not understand it. He (Opeyemi’s father) does not understand it.”
According to him, PLWHAs being consistent with their treatments is what is needed, not praying the virus away.
“There are things that are within the control of man (human beings) that we don’t have to put before God… For God sake, one tests positive, and he is talking about being carnal?
“Don’t we have pastors that are HIV positive? At least, I know two medical doctors that are HIV positive, as we speak. I know two ex-Governors, apart from slapping Senator that everybody knows. I know other Senators that are positive and ex-Senators, too. And, Pastors, too. So, what’s the point!? Does HIV care about anybody’s status? It’s a biological thing,” he added.
He said the church is grossly uninformed about HIV. The faith- based response is very weak and uninformed. He said for the faith- based response to be effective, there should be a clear line of delineation from the science of HIV and the religious and spiritual aspect of caring for a person and being able to help young persons with information to prevent themselves from being infected.
“…MY MOTHER DOESNT KNOW I HAVE BEEN HIV POSITIVE FOR OVER 10 YEARS!”
Many factors make Nigeria’s population, especially young people vulnerable to contracting HIV. These include Nigeria’s low income socio-economic status, illiteracy, hypocritical, contradictory and negative cultural beliefs about sex, unemployment and large population living mostly in rural parts of the country.
There are over 45.5 million young persons in Nigeria. This is more than half the population of all West African countries. Nigeria has the largest population in Africa. This is why young persons are at the centres of the HIV/AIDS challenge in Nigeria and several others.
Researches indicate persons age15-24 years are the most affected age group. Female undergraduate students are highly vulnerable to contracting the virus and other sexually transmitted diseases (STDs) mainly because poor access to sexual and reproductive health education and commodities have resulted in low condom use during sexual intercourse.
However, studies repeatedly indicate Nigerians discriminate against, reject and stigmatise persons living with HIV. Such is very common even within families. Reason many persons living with the virus such as Grace, keep their statuses secrets from their families, though they all live under the same roof, eat and laugh together.
Grace, who will be 28 later this year, has been living with HIV for over 10 years. And, her mother is in the dark while Grace has no plan of informing her. “Because my mother will stigmatise me if she knows my status,” she tells me in this video interview she granted but with her identity protected.
Unfortunately, due to stigmatisation and lack of youth friendly testing centres, most of the young persons I interviewed for this story are unwilling to subject themselves for HIV tests.
THEATRICS AND FEMINISATION OF HIV
“If my child is having HIV, there is no need of attending school. I will have to withdraw the child from the school….”
This was the reaction of Mr. Ehigiator Nosakhare, a taxi driver in Benin city, Edo state. He wasn’t talking about his son. He thinks letting “her” go to school with the virus residing in her is risky. Though no specific gender was referred to in the question posed to him, he automatically felt only a girl-child will test positive to HIV. He would protect others- the school community, by keeping her at home. Questioned about her right to education, he said she will school at home. He would get her a home teacher.
Nosakhare is not the only father with this mindset. Some parents out of the numerous whose thoughts and ideas about HIV I have sampled, share same sentiment.
He described himself simple as Osayimwense, a business man. To him, HIV will not spread in schools if girls living with the virus don’t prostitute themselves. “When she knows fully well that she is such a person, if she can keep herself, she cannot spread it,” were a part of his words.
“… if that child is a female child, if she continues prostituting, she can spread it. When she knows fully well that she is such a person, if she can keep herself, she cannot spread it.”
“NO SCHOOL FOR OUR CHILDREN WHO TEST POSITIVE TO HIV!”
Mr. Gentle is an automobile repairer at Jakpa, in Warri, Delta state. He says should his younger brother tests positive for HIV, he wouldn’t give a damn. But he fears contracting the virus from him. He however says he will inform the school about the brother’s HIV status only after he has been withdrawn from school. That way, according to him, the school can check other students.
Mr. Gentle believes withdrawing his brother from school is the only way to prevent spread of the virus in the school community.
“People living with HIV do not live long,” he says. He doesn’t know there is a medication- antiretroviral, for HIV. Though he has been seeing it on TV, he doesn’t know it is real.
Many parents interviewed in Lagos, Ogun, Edo and Delta states respectively as well as the Federal Capital Territory (FCT), Abuja, feel ending a child’s education is the only way to curb the spread of HIV. Mary, a trader at the Sapele, joined other parents in saying she would withdraw her child from school for testing positive to HIV.
“BOYS DON’T PROSTITUTE THEMSELVES LIKE GIRLS DO!”
“I won’t allow her go to school if she tests positive for HIV. She will be at home. If contracting it was not of her making (through sex), I will look for solution for her. I am sure there are herbs that will help her. It would be combined with whatever we are given at the hospital,” Baba Tosin, a plumber based in Ekpoma, the part of Edo state, which hosts the Ambrose Alli University, said.
Baba Tosin says if the daughter contracts it through sex, he will abandon her for sometimes after being withdrawn from school. This is to teach her a lesson. Then, “will look for solution for her.” His belief? A combination of herbs and visits to the hospital, he thinks, is the surest way to keep the daughter alive.
“When she is alright, I will enroll her as an apprentice to a tailor. That is the price to be paid for being wayward and contracting HIV in the process. At least, there’s good money in sewing business,” he says in a combination of stammering English, fluent Yoruba and pidgin.
Asked if it were his son who tests positive, what will he do? “It is mostly females who contract it,” he retorts. “Boys don’t prostitute like girls do.”
NIGERIA’S VERY WEAK MEDICAL REFERRAL SYSTEM AND UNCONNECTED HIV TREAMENT CENTERS
The investigations carried out so far amongst several young People Living With HIV, and majority of them being students studying in 16 different higher institutions of education in the country, reveal Nigeria has a huge gap and challenge of medical referrals in her HIV treatment programme.
In countries where there is a good medical referrals system, patients simply go to centres at the new place where they located or wherever they are stranded, and the centers where they are coming from are contacted for verification, then medications are dispensed to them at their new locations.
This is made possible because, for instance, in more advanced countries, all the clinics are connected and patients’ medical information are rigorously defended. But investigations for this story reveal that in Nigeria there is no system of referral, whether electronically held, or in hard copies.
Findings so far in the course of this investigative series reveal patients on treatment programmes for ailments such as HIV and Tuberculosis, which need monitoring, do not have reference numbers on anonymous cards which shouldn’t indicate them being for HIV clinics; so that whenever they change locations, especially if suddenly as caused by the COVID-19 outbreak, they can still have access to treatments and medications at facilities closest to them in their new locations.
The plights of these young persons in this story exposes gaps in Nigeria’s treatment programme as the referral system is weak, and the treatment centers are not connected.
Oladapo said the solutions to these problems during and post COVID-19 era is delivery of HIV services and treatment through taking the HIV medicines to the doorsteps of persons living with the virus, if possible. Or, close to them, if they do not want the medicines brought to their homes.
He also recommended Nigeria should adopt mobile phlebotomy services during and post COVID-19 era. This involves taking the samples of People Living with HIV for viral load or CD4 monitoring and this can be done without people around knowing. It can be done through getting the person living with HIV to sit at the back of the car, as if the tester and the person are chatting, take his or her sample and the person goes back home.
He urged the Nigerian government to ensure HIV medicines and treatments get to persons living with HIV irrespective of the restrictions caused by the COVID-19.
One of the respondents whose opinions was surveyed for this story, a student of Babcock university, Ilishan, Remo, Ogun state, who simply described herself as Nehi, suggests that schools or the government should introduce HIV e-learning through academic libraries which will enable young persons like her to learn about HIV/AIDS at their own pace and “away from prying nosey adults.”
She says there is the need for the provision of health information services through libraries to high-risk population such as young persons in Nigeria’s higher institutions of learning because they are increasingly vulnerable to HIV/AIDS through alcohol and drug abuse, peer pressure, unprotected and risky sexual behaviour. Neri also suggests awareness campaigns on campuses should address the intense social stigma attached to the disease.
Mr. Oladapo suggests biometric registration of persons living with HIV as a solution to ensure medical doctors and key health personnels at other treatment centers are able to access a patient’s records, though registered and receiving treatment at a different facility. He said protocols should be put in place to guard against the information falling into wrong hands. In addition to this, unique numbers should be given to various persons living with the virus at their treatment facilities; that way, they can receive their medications and treatments at other facilities and states.
The former Executive Director of UNAIDS, Michel Sidibe says Nigeria should not let her guard down. He called for better focus on delivery of HIV prevention, treatment and care services to those in direst need of them. That, way, Nigeria will be on the path to ending AIDS in the country by 2030.
Ms. Winnie Byanyima, current UNAIDS Executive Director calls on everyone globally to get involved in the HIV/COVID-19 response and recovery. She urges “All African leaders and citizens to join hands with others and advocate that a global problem finds a global solution.”
Rotimi Sankore Development Journalist, Rights Advocate and formerly Coordinator of the Africa Public Health Alliance and 15%+ Campaign elaborated that “The problems faced by these youth reflect the lack of a well organised health referral management system in Nigeria which can help all patients moving from one location to another maintain treatment.
“When we launched the Africa 15%+ Health Financing Campaign with Nobel Laureate Arch Bishop Desmond Tutu as Chair, one of our demands was that governments introduce referral systems as a way of reducing inefficiency and ensuring anyone requiring continued treatment for TB or HIV due to re-location can do so. Aside from unnecessary stress and inefficiency, one of the risks of interrupted treatment is development of drug resistant variants of diseases which is making Africa’s disease burden even heavier and more expensive.
“It’s a real shame that 19 years after the Abuja AU Heads of State Health Financing Summit, COVID19 has again exposed the lack of a basic referral system in Nigeria. This problem has to be fixed to strengthen Nigeria’s health systems from Primary to Tertiary levels. We have an estimated 15.8 million young people in Tertiary institutions. Imagine just 10 percent of them needing to continue with any treatment outside school and finding out they cannot.”
The names of the students living with HIV featured in this report were changed for their privacy in accordance with HIV reporting ethics. It is unethical for parents/guardians to learn about their children/wards’ HIV status through this story.
This report was facilitated by the Wole Soyinka Centre for Investigative Journalism (WSCIJ) under its COVID-19 Reality Check Project.
Source: The Nation
JUST IN: Lagos LG boss dies of COVID-19
The Chairman of Onigbongbo Local Council Development Area of Lagos State, Mr Babatunde Oke, has died from COVID-19 complications.
Before his death, Oke was spending his second term as the council chairman and was a strong member of the All Progressives Congress (APC).
Babatunde Oke died early Wednesday, 12 August 2020 from complications arising from Coronavirus Infection.
Sources said that Oke, a chieftain of the All Progressives Congress (APC) has been sick for some time but recovered, only for the sickness to relapsed late last week due to the stress he went through during the last Sallah break where he was reported to have exposed himself again.
According to a post on his Facebook page, Oke died today at St. Nicholas Hospital on Lagos Island, where he was moved when his illness became critical.
He did a lot of awareness on COVID-19 in the council during his lifetime, according to residents in the council.
He was the second council boss to die of COVID-19.
In June, Augustine Adeoye Arogundade, chairman of Agbado/Oke-Odo LCDA also succumbed to COVID-19.
Kwara records eight new cases of COVID-19
Kwara has recorded eight new cases of the coronavirus (COVID-19) pandemic as at 11.45p.m on Monday, Aug 10.
The state now has a total of 865 confirmed cases of the virus, while one patient was discharged.
Mr Rafiu Ajakaye, the Chief Press Secretary to the Governor and Spokesman of the Technical Committee on COVID-19, made this known in a statement on Tuesday day in Ilorin.
According to him, out of the 865 confirmed cases, 516 patients were discharged leaving 330 active cases in the state.
Ajakaye said 19 deaths have been recorded out of the 3, 853 people tested for the virus.
He added that 2, 922 tested negative for coronavirus with 66 tests being awaited.
US gifts Nigeria 200 ventilators [Photos]
The United States has handed over 200 ventilators to Nigeria in fulfilment of the promise made by US President Donald Trump during a telephone conversation with the President, Maj Gen Muhammadu Buhari (retd.), in April 2020.
The medical equipment were handed over to the Minister of Health, Dr. Osagie Ehanire, by the US Ambassador to Nigeria, Mary Leonard at a ceremony in Abuja this morning.
President Trump while making the promise said the US would support Nigeria during the pandemic.
Speaking while accepting the ventilators, Ehanire said
“We shall be taking delivery these ventilators to shore up our intensive care response capability courtesy of the President of the United States and the US people.
“It is my pleasure to be here at the Premier Medical Warehouse Abuja at the invitation of USAID Nigeria on behalf of the
USA government to receive valuable medical equipment that will support the Nigerian government in their fight against the COVID19 pandemic.”
“This donation consists of 200 ventilators which are critical components of the response strategy that will help to save the lives of persons who have been severely impacted by #COVID19. These ventilators will be of great benefit to the people of Nigeria.”
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