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This was definitely worth another post this week.

Maybe by now, some of you have figured out beyond my penchant Nollywood, the mindless sputterings (made-up word, I think) of old Igbo men - such as this one and oh man, this one - I also have some interest in chronic disease management outside of the West (it's a budding interest, but an interest, no less). Even diseases traditionally thought of as acute (meaning you either get over it or die really quickly) are increasingly requiring a paradigm shift towards long-term care (namely, AIDS). Unfortunately, poor health infrastructure means that it is next to impossible to address such chronic disease care issues in the developing world (I know, I hate generalizations too, but bear with me)...I mean, seriously, check out the case of this guy...who happens to be the (former?) President of the the largest African nation, but has recently been relegated to receiving health care services at a glorified car park.

Developing nations find themselves in double jeopardy - battling acute infectious diseases while remaining horribly unprepared to face the rising threats of "first-world" health issues such as cardiovascular disease, cancer, motor vehicle accidents, mental illness, etc. Large-scale disease-centric interventions, at times serves to weaken overall health infrastructure, placing focus (and funding) on one or two diseases to the neglect of others - most oftentimes non-communicable or chronic diseases (NCDs). Consider NCDs as the latest addition to the category of Neglected Tropical Diseases (NTDs).

A recent study published in the the journal PLoS medicine (H/T Kaiser Daily Global Health Policy Report) found that high NCD burden served as a major barrier to achieving the UN's Millennium Development Goals (MDGs), which excludes NCDs among its list of health priorities, but includes HIV, tuberculosis, infant and maternal mortality. In regards to progress towards MDGs, reduction in NCD burden by 10% was nearly the equivalent to a 40% rise in GDP (or at least five years of economic growth in developing countries). The study highlighted the fact that NCDs plays an important role in the complicated relationship between poverty and health and as a result, greater emphasis should not only be placed on addressing NCDs, but health systems as a whole.

Our findings suggest that achievement of feasible reductions in the impact of these chronic diseases on poor households could greatly enhance progress towards existing health MDGs. If not adequately addressed, high rates of NCDs in low-income countries may further impede progress towards the health MDGs.

To bring it closer to home, the World Health Organization estimates that Nigeria loses about 400 million dollars a year in national income from premature deaths from heart disease, diabetes, and stroke. I wonder, if that figure includes revenue lost from exporting the healthcare of our presidents to other countries...

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Faith-based organizations recently received some good press over the weekend with the publication of Nicholas Kristof's New York Times op-ed piece - Learning from the Sin of Sodom. In it, Kristof chastises liberal do-gooders for their "snootiness" towards Evangelicals and sings the praises Christian NGOs and churches for engaging in the thankless task of battling the "common enemies of humanity" such as poverty and exploitation. Considering the complicated past of foreign missionary work during colonial times and the recent Haitian adoption scandal by American missionaries, I am sure that religious communities everywhere are grateful for the article. Indeed, the church has been responsible for bringing about some good to the communities they serve in the developing world. When working in a long-term capacity, churches and other faith-based organizations have established schools, hospitals, and other needed infrastructure that rivals that of some secular organizations and local governments.

While I commend the efforts of Christians to live out the tenets of our faith through service, I find problematic some of the more recent trends I have personally witnessed amongst churches and individuals - primarily the interest in short-term international missions projects. One to three weeks long, such short-term projects are typically glorified (or should I say, church-ified) versions of slum tours. Merely donating to an established local entity is not enough. Rather, some feel the need to "experience first-hand" the raw poverty and pestilence that plagues the non-western world. No real training or skills are needed other than a heart for down-trodden people (or an eye for poverty p*rn). The emphasis is thus taken away from selfless Christ-like service, and is rather placed on fulfilling the short-term missionaries' desire to be needed.

In providing the lay person with this short-term experience, oftentimes, no thought is given to long-term implications of the excursion. In the case of short-term medical missions projects, which are sometimes conducted independently of local hospitals and resources, thousands of patients are attended to but little consideration is given to follow-up care. The goal is to reach the greatest number of people in an allotted time frame. More than 70% of patients with chronic, non-communicable diseases live in the developing world; and therefore long-term management of such patients is required. To say that short-term medical missions is like putting a bandage on a festering wound would be an understatement. I guess it's more like saying to a brother or sister without clothes or food, "Go, I wish you well..." without doing anything for their physical needs.

I also find that with short-term missions projects, there exists little discussion on evaluation or assessment of their interventions. In order to meet fundraising goals, emphasis is placed on the wow factor a project can evoke - "we saw x amount of patients," "we donated x number of y," etc. And because record-keeping remains virtually non-existent, no one can definitely measure the long-term impact of such excursions on target populations. Such projects are only answerable to their congregations, who may not be terribly familiar with the nuances of outcomes measurement.

Admittedly, the aforementioned also applies to secular non-profits and organizations. However, I feel as if some of these issues are particularly aggravated in the Christian community, where motive trumps means or outcome. The attempt to shuttle scores of Haitian "orphans" to the Domincan Republic by a church group, highlights such pervasive attitudes. It seems as if faith has provided us with the license to embark upon hastily organized projects and missions, because regardless the means or outcome, our intentions are sanctioned by God. While Christian organizations such as World Vision, highlighted in the Kristof's oped piece, should be commended, I do think that for a vast number of faith-based organizations and initiatives, our strategies need to be re-evaluated.

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First, I apologize for the silence...schedule a bit crowded these days. A belated Happy New Year to all.
I tend to find it most difficult to fall asleep when I am busiest for some reason, and have taken to sneaking in a few pages of fiction as a new nighttime/early morning ritual. For the longest time I have been meaning to read Uwem Akpan's collection of short stories, "Say You're One of Them."
As a matter of personal principle, I try to stay away from reviews, particularly critical ones, until after I finish reading a novel. However, after delving into the first few pages I had to confirm my suspicion that I was in possession of 300plus pages of unadulterated poverty p*rn (sorry for the asterisk, trying to avoid the onslaught of strange comments I receive when I use such terms...such as in this post.) I was so naive....for only stories of child prostitutes and wonton African poverty would titillate the Oprah Book Club following.
While I have less patience for such genres, writer and blogger, Alligator Legs, takes a more balanced view (while confirming my initial gut reaction) and reviews his most recent contribution to the The New Yorker.

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...May become all the more common in the future. My initial reactions to the foiled terrorist attack on Christmas day can be found at NigeriansTalk.org.

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You should check out my mom's (yes, as in my own mother's) blog - Akuko Ifo (honestly, it is too late in the day for me to start searching for o's and u's with dots under them...and yeah, you're right - in the time it took me to write this, I could have spelled out "Akuko Ifo" properly.) My mom recently started a blog to share some of the folktales she told my brothers and I when we were younger. Please feel free to widely circulate this message to your children and friends with young children. Right now, all she has up is an intro post, but she hopes to have a fresh story up after the Christmas holiday.

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I thought I was the only one who could not sit through the completion of Adichie's TED talk, "Danger of a Single Story." Honestly, I think my self-declared fast from Facebook was largely spurned by the inundation of my mailbox and Newsfeed with links to this talk.

First let me admit that I literally swallowed Half a Yellow Sun after dinner one night, and nearly felt somewhat depressed when I started inching towards the final pages of the novel because I so desired the book to go on, and on, and on. To say that Adichie is an amazing storyteller, would be quite the understatement. I have not yet had the chance to pick up her collection of short stories, The Thing Around Your Neck (Christmas gift, anyone?).

Yes, call me a hater, but I felt that at least the first few minutes that I did happen to slug through were somewhat tiresome. Literally, it was the "single story" that I have heard countless numbers of Nigerian, Ghanaian, Jamaican immigrants tell over again, but this time, more eloquently and on a more public stage...

Young person fetishizes the West...person grows up and travels to this West...person becomes increasingly jaded with the West and its apparent love affair with itself (to the ignorance of other non-Western countries)...person becomes more aware of the beauty and diversity of his/her African identity (primarily through Western outlets which were hitherto thought of as inaccessible in home country)...person shuns western dress and takes interest in rocking dashikis and African headwraps...

And true, as someone has mentioned to me in the past, Adichie's loudest critics happen to be men - see here and here - which was why I was initially hesitant to bring attention to yet another male who just doesn't get our collective love affair with Adichie. Beyond calling attention to the fact that several Nigerian stories were well-established around the time of Adichie's birth, Nnorum Azuonye also points out the apparent contradiction behind Adichie's talk...

The jaundice in The Danger of a Single Story is that Ms Adichie was in fact perpetuating stereotypes. Anyone who does not know better who watches that presentation would conclude that all Westerners refer to Africa as a country. We know this is not true. There is a lot of it going on, but it is not standard by any stretch of the imagination. Never mind that Africans, especially Nigerians are guilty of insinuating that Africa is a country. Many times in the United Kingdom, you ask a Nigerian where he comes from. Afraid of admitting to being a Nigerian and being consigned to the heap of criminals...he would say he comes from Africa. He would only admit the Nigerian connection if the person asking knows Africa is a continent and questions further, ‘what part of Africa do you come from?’ Interestingly, some would respond to this more specific question with a neither here nor there answer; ‘my Dad originally comes from Lagos, and my mother is from Benin.’ If pushed further, he will say, ‘Make it Lagos. I come from Lagos.’

Azuonye forgot to add that yes, while some Westerners find Africa as the bastion of poverty and disease, several of our compatriots have also made careers off of such saving some nebulous creature called Africa. I would suggest taking a peek at the essay yourself...and if Azuonye also sounds tiresome, by all means, change the page in search of yet another single story.

H/T Aloofar for the link

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Have been a little slow with social media updates since the holidays so forgive me if I wasn't aware of this earlier.

Texas in Africa describes the recent partnership between Twitter and (RED) to celebrate World AIDS Day as a "failure." I wholeheartedly agree. December 1, a day when the entire world promotes AIDS awareness, Twitter has decided to highlight all tweets with the word Africa in red thereby reinforcing an inextricable link between Africa and AIDS.

Seriously, why? Was not aware that today was Africa AIDS day....missed the memo.