Govt is planning to build traditional medical centres in hospitals

Minister of State for Health, Senator Olorunnibe Mamora, in this interview with FRIDAY OLOKOR, explains the Federal Government’s efforts to fight the COVID-19 pandemic

You once said that since vaccines for the treatment of coronavirus would not be ready till 2021, there was a need to encourage traditional remedies. What informed that decision?

The information out there is that we may not be able to have a vaccine until 2021. So, what do we do in this circumstance? Do we just fold our arms, particularly in terms of what we can do within the country? Do we opt for home-grown solutions? I did say that there were no shortcuts about this thing and I then gave a background in terms of the efforts we were making as a country, where the herbal practitioners and the traditional healers were coming up with some remedies. We had a virtual meeting with 19 of them; those who had submitted proposals or remedies that they wanted us to look into.

There is no shortcut to the process of the validation of the efficacy of a remedy. It is a long process and the starting point is at the level of the National Agency for Food and Drugs Administration and Control, where they will have to determine the suitability of the remedy for human consumption. They will look at the chemical composition. Then it goes on to the National Institute of Pharmaceutical Research and Development and of course, the Nigerian Institute of Medical Research. They will look at this and then they can do animal studies and then you go on to the real clinical trial. That is where you now administer this remedy on patients. You cannot just go on and do that. You have to source for volunteers.

There have to be volunteers and they would have been told what the implications are. Then, it will be administered and they will be monitored as to what effects this remedy may have on them as regards the reduction in the period of hospitalisation, reduction in symptoms and then you monitor the side effects.

In the administration of a particular remedy or a drug, you are not just looking at the side effects, the side effects may be little, but what you look at are whether the therapeutic advantages outweigh the side effects, because every drug is a potential poison. It depends on who is getting it and under what circumstances. If the therapeutic advantages outweigh the side effects, then you will still go ahead and you will have to do this over a period of time, because some of the side effects may not manifest immediately. It may be after a long time and that is why it takes years.

You heard the Director-General of the Nigeria Centre for Disease Control saying that on the average, it may take about 10 years from the submission to when it becomes available commercially. So, those were the kinds of things I was trying to explain. As it is now, the submissions we have from these traditional practitioners have been submitted to NAFDAC and what NAFDAC has done is to do its own basic tests on them.

Are you saying that if this sails through, the government is going to give recognition to traditional medical practitioners?

The recognition has always been there. In fact, we already have the Traditional Complementary and Alternative Medicine Bill, which is undergoing fine-tuning right now in the ministry and thereafter, of course, it will have to go through the Federal Executive Council and finally, we will submit it to the National Assembly for processing before it becomes a law. Of course, we are trying to be in tune with global best practices in terms of the processes, and of course, part of what we are trying to do is to establish the Traditional Complementary and Alternative Medicine Hospital.

Two, we are looking at establishing the Institute of Traditional, Complementary and Alternative Medicine. The third thing is that we are looking at the possibility of allowing the traditional medicine ward to exist alongside western medicine ward so that within the same setting of a building you can have them co-exist as it is being done in some countries, even in Ghana. So, those are the kinds of things we are looking at and we can then begin to reap the benefits of our own home-grown remedies.

When coronavirus pandemic came up, some researchers, including a former Chairman of the Independent National Electoral Commission and renowned pharmacologist, Prof Maurice Iwu, claimed that they had cures for it. What are you doing to encourage indigenous production of drugs?

I have just told you that we are trying to have an Act in place, an enabling law that will guide the practice, the TCAM Bill. We are making contacts with China, India and some of these countries that have done so well in terms of traditional medicine practice and they are willing to assist us to support us in establishing what we call the TCAM Hospital. We are also looking at how we can also make it co-exist with regular hospitals. We are looking at how we can also help to fast-track as much as possible because in the Zoom interactions we had with them, one of the things we asked was the challenges being faced by these people.

One of such challenges we are to address is the issue of what we call intellectual property right. A situation where they will be sure that whatever we have will be protected, not something that someone will go behind through the backdoor and and claim its ownership. That is very critical. And the issue of funding is also there.

The rainy season is here and people say that this is Nigeria’s own flu season. Should this be considered good or bad news vis-à-vis the current pandemic?

It will be difficult to say yes; because this is the first experience we are having with coronavirus. We have never had it before. This is the first wet season we are having since the pandemic started. , my attitude is let’s wait and see. Individuals, like we have always said, should take responsibility for their own health. If there is tendency for increase in flu, then with the pandemic in place, we have to pay double attention to our health.

So, my own advice is for our citizens to be extra careful at this point in time. Do not take anything for granted and the advisories issued and the regulations should be followed. Non-pharmaceutical interventions such as keeping social distancing and use of face masks should also be taken very seriously.

There are several instances where people died as a result of the fear that every illness is COVID-19 and therefore they could not get assistance. Would you say that the government did enough through the National Orientation Agency as regards sensitisation of the public?

The death of a human being is painful, no doubt about that. The first duty imposed on us as medical practitioners is to save lives and so where that life is lost, one will feel terrible about it. In human nature, there is always this fear factor, which is a natural thing. At a period like this, a period of COVID-19 pandemic, the fear factor is on both sides. The patient visiting the hospital, particularly in terms of routine ailments like diabetes, hypertension, heart diseases, renal diseases or liver diseases, even a patient that has malaria, the fear factor of ‘I hope I am not going to pick COVID-19 in that place’ is always there.

Then, the totality of the period in which we find ourselves is a kind of a period of emergency, where things are in ‘abnormal’ situation. The questions are, ‘How do I even get transport to get me to the hospital?’, ‘What am I going to meet there?’, ‘Am I not going to get exposed?’, ‘How much risk am I subjecting myself to out there?’ So, those are factors that will ordinarily affect that patient.

The other side is those at the other end – that is doctors, nurses and other caregivers. Again they are also human beings and they will have their own fear factor too, particularly under a circumstance if they don’t feel adequately protected and that is why we are talking of personal protective equipment; basic PPE like face mask and gloves. These are basic things, particularly for someone working at the accident and emergency ward or room. So, if those things are not readily available, again the tendency is that fear may limit the extent of interaction. But we have over and over again appealed to doctors and nurses to please not allow such to deter them from rendering the services.

That is why some of us again advocate that we may start to consider the need for the rapid diagnostic test kits. We know that there are so many rapid diagnostic test kits in the market and some, if not most of them, are not reliable. They don’t have that level of specificity and sensitivity. But these things are being refined over time and we are probably beginning to have some now that can have sensitivity, specificity and reliability of as high as up to 90 per cent. So, I am saying is that if we have such, then we can now use that as an emergency measure. That is when a patient comes, you use it to quickly determine the state of the patient. If that patient is negative then, that will give you the confidence to attend to that patient.

The issue of rape appears to have defied solutions. Some have suggested that rape victims should not have their bath before going to hospital in order to preserve evidence. Is there a medical interpretation to that and is this the thinking of the government?

The thinking of government can only be put within the perspective of law. My reaction to your statement is that I once listened to a police officer, who said it was difficult to establish rape and probably talking along the line that you have just mentioned. That is what can be called the telltale signs are no longer there. The first thing in rape is probably evidence of physical aggression on the victim, which may show in so many ways, starting from the tearing of the dress of the victim. It can go on to more terrifying situations like bruises, which can be from nails, objects that the rapist used to overwhelm the victim and those telltale signs.

Of course, now looking at the private parts, what evidence is there, maybe sign of forceful entry, which could be vagina tear; it could be bruises around the vagina and all that. And like you said, if such a victim has already taken her bath before reporting, those things may no longer be evident and so they may not appear fresh.

As a doctor attending to such a patient, those are the kind of things one will look out for, apart from the history, which you will take. History is always a patient management asking what happened, how it happened, under what circumstances and all that. Then you now move on to the patient’s examination, which starts from just looking at the patient before you. When you see somebody, who is obviously depressed, you can just say it and then before you even touch in terms of physical examination and all that, from the head to the toe, there are things you look out for that will be meaningful to you as a medical practitioner; then you now focus on the private parts, the vagina, both externally and internally, and all that. You look for bruises internally, and of course lacerations, and what have you, bleeding and all that, you look for all these things.

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