I was in clinic sometime in July, and this woman walked in with great difficulty from a chronic pelvic pain. But that wasn't her major problem though.
She had not been experiencing her periods for close to a year, and as a result, had not been able to conceive. She was just 28 years old, 5 years into her marriage, and had only a kid.

It was definitely a case of secondary infertility. That was the simple part. The burning question was why was she not able to conceive; why wasn't she seeing her periods?

As I was exploring the ovarian causes of infertility, a wild thought strayed into my head, and I decided to pursue the possibility of premature ovarian failure. To my chagrin, everything was checking out: hot flushes, insomnia, anxiety, palpitations, vaginal dryness – all pointing towards MENOPAUSE, especially in the absence of a thyroid swelling. But she was just 28 for Pete's sake, and about 12 to 17 years away from menopause!
Then she mentioned that the symptoms had started shortly after an abdominal surgery done by a Theatre Attendant [people who undergo a three year training to be able to assist in the theatre, set up the theatre for surgery, sterilize instruments after surgeries, and to be able to suture and dress minor wounds], and my heart sank. When she said that the indication for the surgery was an ultrasound diagnosis of "ovarian cysts," my heart sank further.

Holding my breath, I asked if they have a picture of the "cysts" removed during the surgery. The husband swiped through his phone, and showed me the "cysts." But they were no cysts; my eyes popped as I recognized her ovaries – two of them, lying neatly inside a kidney dish.
When I saw the ultrasound report that led them to do the surgery, it was heartbreaking to realize that it was a functional cyst, a simple one measuring barely up to a centimeter in diameter. Ergo, it didn't need any treatment, let alone surgery. And she lost her two ovaries because of it!

She's just 28, and with only a kid, she's yet to complete her family, but she can no longer do that as she had been rendered sterile by a quack! And oh, the chronic pelvic pain that was making it difficult for her to walk was due to dense adhesions in the pelvis, a complication of the same surgery!

With the proliferation of Community Health Extension Workers [CHEW], Birth Attendants [BA], Clinic Attendants [CA], Theatre Attendants [TA], and alternative healthcare providers like Traditional Bone Setters [TBS], quackery is on the increase.

Just the other day, a child born with club foot developed gangrene after being mismanaged by a TBS, and had to have both legs amputated. That's just one, out of too many, that got to make it to the public.

The fact is that there are a lot more of such occurrences happening in clinics manned by CHEW’s and CA’s, maternities manned by ill trained BA’s, and "human abattoirs" [I wouldn't call those theatres] manned by TA’s; and if left unchecked, if these people are left unsupervised, it will only get worse.
Mind you, these programs are actually commendable government initiatives, recognized by the World Health Organization, meant to bridge the enormous gap between the conventional healthcare professionals and people in need of health care delivery in rural communities.

There charge is m-ainly to run primary health care in places where doctors, pharmacist, nurses and other conventional health care professionals are not readily available. They are meant to be engaged largely in preventive medicine, creating public health awareness, immunization, treating common ailments like uncomplicated malaria and upper respiratory tract infections [and in the case of TAs, suturing and dressing minor wounds];and recognizing serious cases early enough to refer for prompt and timely intervention.

In Nigeria, however, every good initiative somehow finds a way to be dragged to the mud, especially when people start doing more than they were trained for. The problem with Nigeria has always been people refusing to stay in their lanes. It happens not just in our roads, but also across professional divides!

Here in Benue state, these programs have been so bastardized that every CHEW, BA, CA, and TA have their own clinics, where as you may expect, they handle not just the primary health care cases they were trained for, but complicated cases, even ones that no doctor, but a specialist in the respective field, would dare near!
The funny thing is that the unsuspecting, uneducated masses don't know the difference; as far as they are concerned, we are all "Ortwers" [Doctors]. And the result? An alarming increase in death rate, as even the ones they eventually refer, they do so only at the point of death.

This article is a clarion call for all stakeholders concerned to get off their negligence and do something pretty fast, as this is a public health emergency!
And while we are waiting for them to do something, you – yes, you reading this – can do your own bit by helping to spread this message, to get people better educated, better aware of their environment, better informed as ignorance remains a component of the vicious triad that is the health Waterloo of the average African man.

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