Nobody Knows Why Nigerians Die

Death is an inevitable consequence of life. Knowing the causes of morbidity and mortality in a given population is important for seeing public health goals and monitoring progress. Globally, the Global Burden of Disease is measured by the Institite For Health Metrics and Evaluation (IHME), an objective project that calculates and monitors trends in mortality and morbidity in different countries over the years.

A glance at Nigeria’s data will show the leading causes of death for Nigerians to be:

1. Lower respiratory infections
2. Neonatal disorders
3. HIV/AIDS
4. Malaria
5. Diarrheal Disease
6. Tuberculosis
7. Meningitis
8. Ischemic heart disease
9. Stroke
10. Cirrhosis

But there is a problem: The data used for these rankings is incomplete and these are just best guess estimates and projections from incomplete records.

Nobody knows for sure why Nigerians die.

One challenge the program has faced is inadequate and outdated data for most countries. To combat this problem they use sophisticated data modelling and projections to arrive at working figures. This works but it is not as accurate as actual data, collected in real time.

A cursory online search for causes of mortality in Nigeria reveals the paucity of data. About three studies are seen at first glance. All of them small facility based studies or compilation of archives. A truly representative data set would involve a record of all deaths in Nigeria. For every death there should be a documented cause and the data should be gathered, aggregated and made publicly available.

This is not the case.

Although the Nigerian Populatiom Commiom Act of 1992 stipulates that all deaths should be registered by the commissioner and duly recorded.

“The death of every person dying in Nigeria and the cause thereof shall as from the commencement of this Act be registered by the registrar of births and deaths for that area in which the death occurred by entering in a register kept for that area particulars concerning the death as may be prescribed.”

Indeed, if this law has been enforced there would be robust data about the number of deaths in Nigeria and their causes.

Alas, there has been very little compliance.

An article by the Canasian Immigration and Redugee Board, published in March 2011, the authors clearly records the frustrations of anyone trying to obtain a death certificate and the laissez faire attitude of those tasked with issuing them.

A counsellor at the Deputy High Commision of Canada to Nigeria in Lagos is said to have indicated in writing to with the Research Directorate that “it is not common for the NPC to issue death certificates because most people do not see the need to do so (Canada 25 Feb 2011).

The question is why?

A few explanations lend themselves readily:

1. The law stipulated that these deaths should be recorded free of charge.

This provision which was probably made to improve access however it has also reduced any incentives for the commission to invest time and money in death registration. Data collection is an arduous task , so without any financial incentive, it serves as an increased burden on the commison without any apparent gains.

The second issue is one of demand and supply. Most Nigerians are not concerned about causes of death or their records. Autopsies are hardly done. This lack of interest also fuels political disinterest. For the average Nigerian, a record of deaths and their causes is of little or no concern.

But this ought not to be.

Studies of morality and morbidity are of great public and global health interest. They help researchers to monitor trends and design program that can impotent life expectancy.

Today, the average life expectancy for Nigerians is 56 years, far below the international average of 72 years (source: WHO).

Accurate data on causes of death can highlight the greatest causes of death and lead to a focus on their prevention.

If the attitudes towards the collection of data change, the next thing would be to change the process.

First registering deaths should be made compulsory. The data should be collected by the communities through their leaders and the disease and notification officer a for each local government should be notified. And the collection should be the responsibility of the local governments.

A part of the budgets, both of the commission and of the local governments should be dedicated to death registrations. Families of the bereaved should be made to pay a token amount which should be waived for indigent families or people with peculiar circumstances.

Collected data should be collated by state and nationally. The figures should be updated monthly to a national database such as the DHIS. The data should be blockchain protected to avoid tampering and falsification.

If these measures are in place they would change the way data about Nigeria is reported. For the first time we would have truly representative data and be able to make better decisions. Instead of models and educated gusees, we would know for sure why Nigerian are dying and we would be able to tackle it, making it possible for Nigerian to love longer, healthier, more productive lives.

Tribute To A Trailblazer

We were united by the web across time and space
we had the pleasure of your company, your thoughts, your generosity,
You lived for decorum
even in difference, in disagreement,
in jest,
the world is duller without you,
no one can take your place in our hearts,
no one can wear your colours, we bid you adieu,
may your life continue to inspire others, may your candle shine in the darkness, may we meet again someday,
Adieu Chivaneze.

***

This tribute marks the passing away of a friend, brother, son, follower @chivaneze

May we learn to live for eternity.

Good People Don’t Die

I come to mourn you
To bathe my mind with
The pain of losing you,
The soak my thoughts
In things that now can not be.

My heart
Dangles in my chest
Like a bag of rubble,
Regret echoes
Pepper on my pain.

Then I hear a whisper–

“Good people don’t die.

They are not stopped by an idiot’s bullet,
They are not cowed by cancer’s cowardice,
They are not bent by a madman’s machete,
They are not silenced by the hangman’s noose.

They live on,
In the immortal words of their wisdom
They thrive in the permanence of deeds done,
They flourish in the hearts of those that love them.

Good people don’t die
They live
In me and you.”

I Want My Flowers Now

I want my flowers now,
While I have hands to hold them,
I want my praise songs too
Whilst my feet can move to their tunes
I care less for
Posthumous garlands
Or gardens full of roses,
Nor for
Eloquent dedications
Sang as obituary dirges.

For some it may be too late
To tell them how much
They blessed you,
But for us,
The day is still young,
So let’s get busy saying
Our “I love you”s
“Your life was a blessing to me”
“I couldn’t be who I am today without you”
” You brought such joy, laughter, wit, wisdom, insight, blessing, growth and fortune my way.”

Quickly, before the Grim Reaper calls again,
Let’s hurry,
Let’s say.

Love, Death &Ebola

Belinda watched Womako trudge into the makeshift bathroom behind their home.

“Woman! Where is my hot water!”

Belinda didn’t have the strength to remind him that their power had been cut–a souvenir for owing 3 months of bills, nor the patience to explain that she had to conserve fuel for meals.

She sighed instead and said “I’m sorry Woma, please just manage it.”

She heard the clash of metal and stone amidst her husband’s grumbling. They had been a reasonably happy couple before but the disease outbreak had changed things. Woma had to work longer shifts, coming home exhausted and irritable. She couldn’t remember the last time he played with her or the last time she felt him on her thighs.

Now her days were a cycle of watching him rush of to work, grouchy welcomes and loveless nights. Her fledgling bush-meat business was on hold and Woma hadn’t been paid in two months. The government had promised to pay more as hazard allowances to workers in the health facilities affected by the disease. Nothing had been done about that yet.

Woma walked past her into the house. He had hoped to change the thatch and mud hut to a proper house, but now, such talk was fantasy.

She waited a while then joined him in the room. The plate of rice and soup was untouched. The jug of water was empty though and Womako was not in the room.

“Bella”

“Yes”

“Come.”

She flicked aside the curtain to see him prostate on a mat in the adjoining room. They hoped it would be their children’s room, someday, but now it housed the occasional cousin from the village and Womako’s old books.

“Woma, what is it? Are you well?”

“Wait. Don’t come closer. I started feeling unwell on my way back and I don’t know. I have called Willie to come and take me back to the hospital. But that will be after he takes you to the motor park and puts you on a bus to the border. Under the mattress, you will find $300, I want you to take the money and travel to Ghana. Stay with your sister there and get tested if you feel any illness.”

“Woma what are you saying? How can I leave you now?”

“You must Bella. You have suffered enough drinking every potion and pill trying to get pregnant for the past three years. Visited every healer, seer and saviour, what they didn’t tell you was that you were fine. I am the one that can’t fill your field. I am the one without seed.

Now, there is no need for me to make bad worse. Do as I say. May God keep you and may He forgive me.”

“But what about the house? What about our plans for the new plot of land?” Bella asked in a tear choked whisper.

“Land and houses are for the living Bella. If I live, we will see. But now, I want you to pack, Willie is coming.”

Belinda packed.

Willie came and took her to the park. She got to Ghana safely. A week later she was told Womako’s ashes were buried in their backyard.

She waited for her own illness to begin. It never did. Instead she put on weight and lost two shades of tan. And many nights she would lay awake thinking. She would imagine herself a judge and Womako an accused. Should she hate him for the three years of lies? Should she acquit him for an act of uncommon courage? The arguments would rage for and against before sleep would whisk her away, to awake again to the toils and troubles of another day.

Splinters Of Glass In A Bleeding Heart.

Hmmmmggh!

Where do I begin? With an apology, I haven’t posted as often as I should. I have a bag of excuses for this:

  • 1. The Westgate attacks shocked my fingers to stone.

    2. Prof Kofi Awoonor’s Death shot me into mourning.

    3. My Samsung Tab has gone into coma (read possible death).

    4. I missed another set of deadlines (Again?! Yes. Again).

    5. Unforeseen emergencies arrived and scrambled my budget.

    6. I have been scouting for 1M votes for my clients.

    7. I lost an election.

    8. I lost a friend.

    So there, it hasn’t been as easy as it usually is. It has been rough and tough and challenging. But all through you have been on my mind. And I know that often it is grief, not glee that brings out the best in us.

    I hope I’ll get to write about all these things, one after the other, and share my writing with you.

    In any case, I thank God for being there for me through it all.

    I thank Him for

    1. The hostages that made it out alive and. Eliot Prior the brave four year old boy that stood up to a bad man with a gun. He got a bar of chocolate and freedom.

    2. Afetsi Awoonor, that he is hurt but alive and recovering. My prayers are with you.

    3. My new laptop, Sam. (Though I can’t quite remember how to type on a keyboard and sometimes I touch and tap the screen. (x_x)

    4. The new opportunities emerging everyday and the painful lesson learnt.

    5. That I could give towards the emergency, and I have gotten a third of the money back already. *Azonto*

    6. I am just doing the vote scouting once, some people do thing for a living. Phew!

    7. I learnt never to jump into a tging unprepared.

    8. I have gained many new friends and followers and fans.

    9. I am still here; and where there is life, there is hope. Hallelu!

    Going forward, I hope to be more faithful, +/- return to the 3 posts a week thing. I don’t know for certain, yet. What I do know is that I truly appreciate you and you are the best blog readers in the galaxy. Thank you for choosing to read me.

    ^

    ^

    ^
    🙂 How have you been? What has been on your mind? Please share with us in the comments (or privately email/Twitter).

    And please share this as widely as you can. Thank you. God bless you.

  • Splinters Of Glass In A Bleeding Heart.

    Hmmmmggh!

    Where do I begin? With an apology, I haven’t posted as often as I should. I have a bag of excuses for this:

  • 1. The Westgate attacks shocked my fingers to stone.

    2. Prof Kofi Awoonor’s Death shot me into mourning.

    3. My Samsung Tab has gone into coma (read possible death).

    4. I missed another set of deadlines (Again?! Yes. Again).

    5. Unforeseen emergencies arrived and scrambled my budget.

    6. I have been scouting for 1M votes for my clients.

    7. I lost an election.

    8. I lost a friend.

    So there, it hasn’t been as easy as it usually is. It has been rough and tough and challenging. But all through you have been on my mind. And I know that often it is grief, not glee that brings out the best in us.

    I hope I’ll get to write about all these things, one after the other, and share my writing with you.

    In any case, I thank God for being there for me through it all.

    I thank Him for

    1. The hostages that made it out alive and. Eliot Prior the brave four year old boy that stood up to a bad man with a gun. He got a bar of chocolate and was let go .

    2. Afetsi Awoonor, that he is hurt but alive and recovering. My prayers are with you.

    3. My new laptop, Sam. (Though I can’t quite remember how to type on a keyboard and sometimes I touch and tap the screen. (x_x)

    4. The new opportunities emerging everyday and the painful lesson learnt.

    5. That I could give towards the emergency, and I have gotten a third of the money back already. *Azonto*

    6. I am just doing the vote scouting once, some people do thing for a living. Phew!

    7. I learnt never to jump into a tging unprepared.

    8. I have gained many new friends and followers and fans.

    9. I am still here; and where there is life, there is hope. Hallelu!

    Going forward, I hope to be more faithful, +/- return to the 3 posts a week thing. I don’t know for certain, yet. What I do know is that I truly appreciate you and you are the best blog readers in the galaxy. Thank you for choosing to read me.

    ^

    ^

    ^
    🙂 How have you been? What has been on your mind? Please share with us in the comments (or privately email/Twitter).

    And please share this as widely as you can. Thank you. God bless you.