Don Decries High Neonatal Mortality Rate, Attributes It To Shortage Of Workforce

Professor Lukman Olajide Abdur-Raheem, the University of Ilorin Paediatric Surgeon,
has observed that Neonatal Mortality Rate (NMR) is still high at 26.6 per cent, attributing this factor to lack of access to surgery which includes the significant shortage workforce.

Abdur-Raheem made the observation while giving account of his contribution to knowledge and the medical field at the university’s 222nd Inaugural lecture which he delivered with the title “Shades of Joy and Cry: Intricacies of Children’s Surgery for Restoring Smile and Hope for the Future”.

He said globally, 1.7 billion children do not have access to safe, affordable and timely surgical care, with the sub-Saharan Africa bearing the largest burden because up to 50 per cent of the population are children, he revealed.

The Paediatrician advised the Federal Government to step up paediatric surgical care awareness at the primary health care level, so that the conditions are identified early and appropriate counsel are provided to caregivers.

“All existing children hospital should be upgraded to have complimentary well equipped and staffed Paediatric surgical services at the state and federal levels,”

He particularly appealed to all tiers of government to make Laparoscopy, known as keyhole surgery, accessible and affordable to indigent Nigerians.

He described Laparoscopy as a type of surgical procedure that allows a surgeon to access the inside of the abdomen and pelvis without having to make large incisions on the skin.

According to him, the benefits of this technique have been enjoyed by the elites and NHIS enrollees because of the higher cost which might be catastrophic for families who pay out of pocket.

Abdur-Rahman, who teaches in the Faculty of Clinical Sciences, College of Health Sciences of the University, said “if this surgical procedure is made accessible and affordable to poor families, it will guarantee adequate exposure and training of many colleagues”.

He stated that he had propagated the use of the procedure at the University of Ilorin Teaching Hospital (UITH) by training colleagues, surgical residents and allied health staffs, among others.

“We have maximised these benefits in our practice in providing diagnostic and therapeutic management of non palpable undescended testes, disorders of sexual differentiations and complicated appendicitis,”

He said there is a need to provide dedicated Laparoscopy suite with complementary endoscopes to assure seamless service delivery and equipment protection and maintenance.

He also advised on the need for focus on collaboration between basic medical and clinical sciences to establish paediatric gastrointestinal surgical clinical trials, antenatal diagnosis, neonatal screening and early postnatal surgical intervention using comprehensive outcome measures.

Professor Abdur-Raheem, who made waves as head of a 60-man team who successfully separated a conjoined twins in January 2021 at the institution’s Teaching Hospital facilities also announced the death of one of the twins, which he said resulted from adhesive intestinal obstruction, barely two weeks to her second birthday.

The twin sister, who he reported as healthy to date, was among the crowd, with her mother, as audience at the university Auditorium, venue of the lecture.

The University of Ilorin Teaching Hospital (UITH), on January 14, 2021 had presented the set of female twins, alive, to the public after doctors successfully separated them.

It was reported at the time that the feat was despite the dearth of equipment at the hospital.

The Chief Medical Director (CMD) of UITH, Prof. Abdullah Dasilva Yussuf, who briefed the press on the occasion attributed the accomplishment to the commitment and determination of the team.

Explaining the complexity of congenital joining of babies, the inaugural lecturer explained that conjoined twins are rare anomalies resulting from an abnormal division of fertilised ovum during the process of twinning.

Conjoined twins, he said, have intricate parts that are shared in unique manner from the head to the toes and require thorough investigations to determine anatomic and physiologic implications of separation of the shared parts.

According to the don, about 19 pairs of conjoined twins were reported to have been born alive or dead in Nigeria in the last nine decades, from which the UITH, Ilorin had managed three pairs between 2005 to 2015, even under fragile conditions.

“In our setting, we adopted adult investigative and therapeutic equipment for optimal outcomes since many children equipment are not available.

The success with the celebrated first successful separation of conjoined twins in llorin in January 2021, according to him, resulted from the cohesive 66-man multi-disciplinary collaborative team under his leadership.

The application of simulation skills in the clinical scenarios, he said, was presented and highly commended at the 2021 Bethune Round Table conference in Canada.

The Inaugural lecturer, who reeled out the burden of paediatry surgical diseases, including birth defects, neonatal surgery, congenital anomalies and their effects on the physical, mental, financial and social status of children and parents asserts that in Nigeria, the estimated incidence of birth defects varies between 2.5 and 11.5 per 1,000 live births in the six geopolitical zones of the country.

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