Category Archives: government

Physician Heal Thyself

Yet another doctor has committed suicide recently. The 3rd in the past year in the UK that I know about. There are probably more. It is so sad. On the face of it, many people might think what do doctors have to be so depressed about? The public still imagine that being a doctor comes with a good job, good income and the respect of the population in general. Those of us in the profession and our loved ones know better. For most doctors, the work is relentless. The NHS is no longer fit for purpose. There are too many patients with less resources to care for them. There is more and more paperwork borne out of the NHS having too many ‘managers’ who analyse medical errors and harm and feel that creating another form to fill in will prevent future incidents. They fail to realise that what is needed is more funding to employ enough staff for the numbers of patients we treat. They fail to realise that they need to invest in their staff and make them feel appreciated and valued for their hard work and for doing more than they are contracted to do. They need to examine the levels of sickness and absenteeism and realise that burnout is real and so is depression. Above all, they need to realise that without preventative measures, doctors will continue to work themselves until they simply can’t.

Although the UK rates highly in a lot of economic and living standards indices, being a rich developed 1st world nation, it doesn’t do so well with mental illness. The positive news is that the UK had made it into the top 20 of the world’s happiest countries in 2017 (it was previously 23rd and is now 19th) for the first time since 2012 when the world happiness report started being published annually.

In March 2017, the Mental Health Foundation commissioned a survey to look into prevalence of mental health in the UK and to identify the factors about individual that make them vulnerable to suffering from a mental illness. It found that 7 out of 10 women, those aged 18-34 and those living alone had a mental illness. Only 1 in 10 of the whole population are happy most of the time. Women are 3 times as likely as men to suffer a mental illness. Stress is a growing problem. Majority of people suffer from either a generalised anxiety disorder, depression or phobia. Self-harm and suicide are not classed as mental disorders but are a response to mental distress usually cause by mental illness that has not been recognised and treated.

With these statistics in mind, it is easy to see why young female doctors are at risk of mental illness. Couple that with the fact that medicine attracts people with a type A personality who are high achievers and do not like to admit they have a ‘weakness’ or that they need help. I have already described working conditions in today’s NHS. No wonder so many young female doctors are struggling and every year, we lose a few to suicide. What I find particularly difficult with this is that when colleagues pay tribute to those who have died, there is always a huge sense of shock. Unfortunately, these women hide their illness so well that often even their closest confidants have no idea how much despair they are in. Their friends often describe them as ‘superwoman’, someone who ‘has it all’, always helping others, taking on incredible amounts and managing to ‘juggle it all’ somehow. They give so much to others that they forget to give their selves.

Caring. Freedom. Generosity. Honesty. Health. Income. Good governance. These are the things that increase happiness and promote mental well-being according to the Mental Health Organisation. I would sum it up as friendship. I think human beings are social creatures (yes, even the introverts) and need to have at least one good nurturing relationship. This is intrinsically linked to self-worth. Many people who have attempted suicide and lived to tell their story say that depression and anxiety eroded their self-worth to such an extent that they felt useless and that the world would be better without them in it. Depression interferes with rational ordered thinking. When it is severe, it is like being in a deep dark hole, full of doubts and lacking in any hope. Far from being selfish, I believe people who contemplate suicide are (in their warped thinking) being selfless and believe in that moment that they are un-burdening those around them.

So is there anything we can do to turn the tide? Most experts agree that by the time a person has planned to commit suicide, it is probably too late to do anything. The depression has taken over and has them fully in its grasp. Where we can make a difference is at a much earlier stage. We need to prevent people with low mood going on to develop depression. We need to be that friend who validates their self-worth. The one who lets them know in words and action that their presence is very much appreciated in your life. We need to talk about mental health more so that someone at the early stages of depression feels able to confide in someone and seek help. If mental illness is so prevalent, why do we not talk about it more? Why are we ashamed to say, ‘I am depressed, I need time off work to get treatment/rest to get better’? Would any of us feel ashamed to call in sick at work if we developed appendicitis, had to have surgery and needed a few days to recover? Just because mental illness is invisible doesn’t make it less valid. I think this ultimately is what will turn the tide. Talking about it, admitting we have a problem and asking for help early, taking time out now to prevent getting to the point where all hope is lost and we feel like we have no other option other than suicide.

If you are reading this post and can identify with the desperation that mental illness can induce, please reach out to somebody. Ask for help and support. If you are in the UK, there are some very good resources. Your GP should be your first port of call. If you are feeling suicidal, call the Samaritans on the free phone 116 123. Mind has help pages online that can be accessed at https://www.mind.org.uk/information-support/types-of-mental-health-problems/suicidal-feelings/helping-yourself-now/#.WX8lFojyvIU as does Turn2Me at https://turn2me.org/?gclid=EAIaIQobChMIvKCtr8Sz1QIVT5PtCh2D7QnCEAAYAiAAEgKyyPD_BwE. The Mental Health Foundation has some great guides for promoting mental wellbeing which can be accessed on https://www.mentalhealth.org.uk/your-mental-health . The app Headspace comes very well recommended for dealing with stress, anxiety and depression.

If you are a medic, there is a wonderful Facebook group called Tea & Empathy for peer support for all those working in healthcare. It was founded after we lost another one of our young doctor colleagues a couple of years ago and is a brilliant space full of supportive caring people. The Wales Deanery has published a booklet specifically aimed at helping medics cope with the stress of the job. You can access it here: https://www.walesdeanery.org/sites/default/files/bakers_dozen_toolkit.pdf.

Finally, I want to say to you all: You matter. You are loved. You are not alone. Be kind to yourself x

 

Champion the Truth

If you don’t live in the UK, you may have missed the junior doctor contract row that has been brewing for a few years but has escalated over the last couple of months. If you live in the UK and rely on major media outlets to keep you informed, you may think the dispute is about junior doctors asking for more money. I would suggest you turn to social media for more accurate information from doctors, other NHS staff and more importantly their families. Long and short of it is that the dispute is about our Government deciding we junior doctors need to work longer hours whilst our pay is cut and refusing to do the simple arithmetic that would show that if you want more junior doctors working around the clock, you need to recruit more of them because we are already working long hours and we absolutely will not do me as it would put our lives and the lives of patients that we hold so importantly at risk. I mean, how is it fair that the Government has voted to pay its MPs more and they can still claim vast amounts on expenses yet the very same Government says we have no money in the coffers to pay for more junior doctors? Isn’t that ridiculous???

I digress, please read up on Facebook, twitter and blogs writing on the issue. Plenty of truth out there is you care. The baseline is that at least half of the junior doctors who have voiced their opinions have stated either that they have made up their minds to quit the NHS or are at the very least, looking into alternate careers or going abroad. The simple truth is we as a group of junior doctors think the bottom line is that the Tories have vested interest to tear down the NHS and privatise our healthcare and hence line their pockets. There is also strong evidence out there that the current fool we call our Health Secretary has been a champion of NHS privatisation for many years and probably owns share in private health insurance conglomerates like Virgin Health.

This blog is actually about the one good thing that has come from this attack on junior doctors. We now have an online Facebook forum called Junior Doctors Forum which is by invitation only. It has 63,000 members and counting. Not all of them are junior doctors. We have consultants, medical students, nurses, midwives, paramedics and other allied healthcare professionals plus a few lawyers, journalists and even politicians about the forum. What I want to do is big up the passion of those on the forum and champion them sticking to their guns and being honest about how they feel and what this is doing to us as a group. Never has there been so much unity within the profession. Medicine is a very hierarchical and competitive profession and although we all start as one, we generally sub-divide as we become more senior and choose specialisation programmes. Our world then shrinks even further so all we know is related to the one field eventually. Our only contact with the outside specialities is if they are part of the multi-disciplinary team that we need to make sure each patient’s care is optimal with the inclusion of all relevant expertise.

So it is all good news though? No. Unfortunately when you get 63,000 opinionated voices with the top 1% in terms of IQ and ability to rationalise, debate and analyse, you get varying opinions. I am all for freedom of speech and embracing our differences. However, as with all other aspects of life, some are excessively worried about how other people interpret our opinions. An article was published based around a discussion we had on the forum and people are getting all uppity about all coming across professional and un-emotional. Why? If this was about professionalism only, we would all continue our stony silence whilst we get attacked as we give our all for the greater good. This time, we have stood up and shouted NO because not only have they attacked us (we have thick skin because of the nature of being medics who take enormous responsibilities day in, day out) but they are threatening the very fabric of the health of our nation. Their proposals are not only ensuring that many of us want to leave because we choose life and living than putting ourselves in danger from physical and mental exhaustion, they are also meaning that we are now less willing to carry on doing extra unpaid hours for no thanks.

The NHS has been running on the goodwill of its junior doctors for a very long time and things have been in a steady decline for the past decade yet this is the first year that doctors have threatened to strike. We love the NHS and have been carrying its weight to the detriment of our mental, physical and psychosocial health for far too long. This is the straw that will break the camel’s veritable back. It is because we are passionate that we are fighting the proposed changes which may start with junior doctors but we all know will extend to the rest of the hardworking staff the NHS is lucky to have as its employees. How then can anyone ask that we lie about how angry and betrayed we feel? How upset we are that we are being made to reconsider our futures? Whether we can afford to have children and continue to be there for our patients? How the lies of Hunt et al are demoralising us? How we don’t feel it is worth it anymore to carry on in the NHS when all we get for breaking our backs for a pittance (£11/hr 6 years after graduating for me compared to a plumber who can earn up to £50/hr) is abuse and an Etonian ignoramus vilifying us for caring.

Well, I am here to say that no. I will not be unemotional. If I didn’t care for the NHS, I would have quit after my first foundation year when I became a fully licenced medical practitioner. If all I care for was the money, I would be abroad today with a private clinic, dictating my hours and pay. If I didn’t care, I would not be attending protests and spending what little I have left over after my living expenses and medicolegal expenses on supportive merchandise. I care and I am not afraid to show it.

Hunt is only the face of the Tory campaign to break the NHS and leave privatisation as its only viable option. The Tory Government is libellous, dishonest, spineless and un-democratic. If the general public continues to buy the bullshit the Government is peddling, it will be the British public who will pay the price in the next few years. So unless you are all dying with something that will kill you with certainty in the next couple of years, wake up and realise facts. Fact is the NHS as we know it will be no more unless the whole of the British public fights this. Just google how much it’d cost you to pay for your health insurance in the US and imagine the UK going the same. Doctors are in hot demand the world over. We can and will be forced to leave the UK and the NHS is this horror continues and we will be fine. I assure you. So the fact that I am getting emotional is not because I am a greedy lazy overpaid privileged posh kid as Hunt and co would have you believe. It is because I care and I am not afraid to show it. Fact!

Open Letter to David Cameron – Our Silent PM

This was written by the father of a UK doctor. He lives in Sweden but is speaking out to save our NHS. If you share his sentiments. Reblog or share my link. Please.

Sir,
Your silence in the matter of the NHS and Junior doctors is conspicuous and indicates your silent approval of the Health Secretary and his policies.

This is not a matter only between Mr. Jeremy Hunt, the NHS, and junior doctors. In fact, this concerns everyone, from a child yet to be born to the elderly person counting the last breath and every one in between. Therefore your intervention is of vital importance to the national interest.

It is also very painful to see how ruthlessly and insensitively you treat the elite youth of your society. The youth who have chosen to indulge in the service of people of your nation, day and night, ignoring their own comfort and social life. They are the foundation of health and wellbeing of your nation of which, I am sure, you are proud of.

I have seen the plight of junior doctors. They are working day and night, have no control over their week-ends or holidays, when on call they have to be available for up to 48 hours. They cannot think of taking leave irrespective of personal urgency. In spite of all this they are single-mindedly devoted to their duties and responsibilities and have never asked for a pay rise. They are just short of being slave driven. To add ridicule and insult to their calibre, Mr. Jeremy Hunt wants to reduce their pay and increase their working hours (while informing the public he is doing the opposite). All the while he has been projecting them as greedy and an unwilling work-force. You are watching all this silently.

The fact is that junior doctors are tired, fatigued, exhausted, demoralised and yet they stand erect and defend the health system of your nation.

I will spare myself the energy and assume that you know more than I can ever explain. You will be well versed on the internal workings of your own government, therefore, I will draw your attention to a few things which might have escaped your attention. I do not think that this has escaped the attention of Jeremy Hunt because it appears his is a well calculated mission.

First, all signs suggest that you want to privatize the NHS. If that is so, you should come out boldly and declare to the public that you want to do so. Firing the gun from the shoulders of the junior doctors and blaming them is not graceful nor is it worthy of a strong Government. The public who have placed you in the high office have the right to know your plans rather than manipulations. If your Government succeeds, cutting the pay of junior doctors and increasing their working hours, junior doctors will survive in one way or another. However, the entire population of your country will suffer. I do not think that they will forget nor forgive. Therefore, before you dismantle the NHS, it is imperative that you rethink your plans because the health and wellbeing of your country depends on it, and for this, you are directly answerable – even in the future.

Second, the Health Secretary has succeeded in downgrading and vilifying the medical profession as much as possible. Once again, you are a silent witness to this. He has taken away all the motivation and incentive from bright and elite students of your schools and colleges to choose the medical profession. If he is allowed to succeed further, you might find medical colleges left wanting for students. That would create an enormous shortage of qualified and quality doctors in the long run and an ever increasing burden on the health service.

Thirdly, if you and Mr. Jeremy Hunt succeed in privatising the NHS – I can see how this could be the interest of Mr. Jeremy Hunt. Your previous health secretary Mr. Lansley, has recently take a role in a company who is promoting privatisation of The NHS.

If The NHS is short of funds (and we know it is, through systematic underfunding by the government), it is not the fault of junior doctors. On the contrary they have to work even harder without adequate machines, equipment and staff. It is a simple case of mismanagement of finances and mismanagement of administration. Instead of pointing the gun toward the junior doctors – who are the weakest link in the chain of NHS hierarchy – aim your guns at cleaning and pruning the financial management of NHS. Look deeply into it as to why The NHS is in this position.

There are 53000 junior doctors. They are working for at least double that number. Each doctor is giving you output for at least two doctors. Instead of motivating them, patting them on the back, and incentivising them, you want to pull the carpet from under their feet so that all of them tumble down. More worryingly, you are willing to do this on the whims of a few people who may not think beyond their own interests at the cost of the health of your entire nation.

Your junior doctors are dedicated, hardworking and responsible. They are the future specialists, researchers and innovators. They are the backbone of the health system of your country. Give them the respect they deserve. Give them the motivation and sense of worth. Applaud them for having chosen the medical profession.

I have seen them working with dedication and without complaining in spite of all the hardships they face as my son is one of 53000 junior doctors.

This letter is the voice of 106000 parents who are proud of their children and their devotion to the service of people.

Best regards,
Anil Bhatnagar

What does a Junior Doctor Do Exactly?

A letter written to Jeremy Hunt by a consultant currently working in England.
An excellent illustration of how indispensible ‘junior’ doctors are to the NHS and the public as a whole. I couldn’t have put it better myself so I haven’t tried to 😀

…………………………..

Dear Mr Hunt,

My name is Philip, and I am a consultant physician. Not so long ago, I was a junior doctor and like many others I am outraged and angry about what you propose to do with ‪#‎juniordoctors‬ and their ‪#‎juniorcontracts‬.

I thought that maybe, given you have not worked in healthcare, you might not understand what it is that doctors do (much like if I was made, say, head of Network Rail) so I thought maybe I can help you by shining a light on what I used to a few years ago as a medical registrar.

The medical registrar is the most senior medical doctor in the hospital out of hours. In explaining to my friends what we do, I tell them everyone who doesn’t need an operation right away, or doesn’t have a baby falling out of them, above the age of 16, is our business (and often we have to look after those too). We were the ubiquitous shirehorses that carried the hospitals medical workload day and night. And here’s a typical night shift I did at a general hospital. (all details changed and adapted from real cases to protect patient confidentiality).

I arrive at 8:50 PM for a 9:00 PM handover. It’s been a busy day and the emergency department is full. The outgoing medical registrar tells me there are no beds in the hospital. There are 10 patients waiting in A&E for the medical team, and a lot of patients need reviewing on the wards. He’s already admitted 36 patients during the day, and the consultant is still there seeing some of them with the daytime doctors. I wave hello at her as I head into the fray. I know the consultant and she’s not seen her kids since her on call week started. She waves back wearily.

My first patient for review was a young man with abdominal pain. My first thought as I walked into his cubicle, he looks sick. This is a skill you develop after years of training, when you look at someone and know that they are minutes from death. He’s grey, clammy and shocked. I immediately set about treating his shock and assessing why this has happened. Does he have a bad infection? Is he bleeding? Does he have a blood clot on his lungs? A quick bedside test confirms he’s bleeding badly, likely internally, and my surgical colleague (another junior doctor) and I urgently arrange for an operation. He hurriedly talks to his parents and completes a inacapacitated patient consent form as his condition deteriorates. I leave him in theatres with the anesthetists and surgeons as I have other patients to see.

The next patient was an elderly woman who has fallen. Although she has no hip fracture, she’s unable to walk and needs admission for painkillers and rehabilitation. I reassure her as best I can and stop many of her medicines potentially making her fall. There are no beds for her on the assessment unit or the elderly care ward, so the A&E sister arranges for a pressure support mattress and bed for her in the department overnight. She was lonely and depressed, and I spend some time talking to her about her worries and fears but after a while I needed to move on. She squeezes my hand and smiles, thanks me and settles for the night.

Next is a resus patient with an asthma attack. He is drunk and abusive verbally, though he’s too breathless to be too abusive. A blood test show his attack is life threatening and he he fights off attempts to treat him by myself and the A&E team, pulling off his nebuliser mask and oxygen. As I read out the blood test result to the intensive care registrar (another junior doctor) the man goes blue in the face, gasps and stops breathing. I drop the phone, run over and take over his breathing with a manual ventilator. He has had a respiratory arrest. Alarms blare, help comes running, we inject him with various medicines to help relax his airways and the intensive care doctor slips a tube into his windpipe to help him breathe. The consultant physician, still there, helps with what she could, running blood tests and helping to scribe in the notes. After a nervous period, he stabilises and we take him to intensive care.

It’s now midnight.

In the meantime I have reviewed five more patients, seen by the twilight team, and also my night SHO has discussed some patients with me. The consultant finally got home around 11PM. I’m now on the wards, a liver patient with severe cirrhosis is unrousable. I read through the notes. He has cirrhosis and is not suitable for a transplant. The team has tried everything. I sit and talk with his family, telling them I’m very sorry but there’s nothing more to be done. They cry, one of them screams at me that I’ve killed him, but I accept this as part of my job. With more assurance they’re calmer and I reassure them he’ll be kept comfortable.

My bleep goes off as I write in the notes. Is that the medical reg? The hospital is now totally full, can you please choose some patients to send to our sister hospital down the road? I groan, although I understand the necessity patients understandably hate it. I pick four stable patients and liaise with the registrar down the road.

2AM. I send my SHO off for a quick break as I review some more patients. A confused elderly man who might have a urine infection, a young man with severe headache, a diabetic patient with a very high blood sugar, a lady withdrawing from alcohol and hallucinating. The A&E sister makes me a coffee, lots of milk, lots of sugar.

3AM. I’m with a man in resus again, he is vomiting bright red blood in large volumes. He is jaundiced and looks unwell, very unwell. As the A&E team arranges for a massive transfusion to be set up, I ring the intensive care doctors and the gastroenterology consultant. He listens and says “I’ll be coming in”. I then slip a line into his neck under local anaesthetic, a practiced skill that’s hard at 3AM when you’re tired, but fortunately successful. We pour blood, clotting products, medications and antibiotics into him to halt the bleeding. The gastro consultant arrives at 3:40 and he’s taken to theatres where he performs a life saving procedure. The patient goes to ITU.

4AM. A brief moment to sit down for a quick break. I have reviewed three more of the SHO’s patients. This is the first time we’ve had a chance to sit down together, a quick chat and a cup of tea was interrupted by a cardiac arrest bleep. We run to the cardiac ward. A 54 year old gentleman admitted with chest pain by the day team has had a sudden cardiac arrest. The excellent CCU nurses are doing CPR and attaching a monitor. I ask them to stop as it’s attached, the rhythm is ventricular fibrillation.

“Back on the chest please, charge defib to 150, charging. OK, off the chest, stand clear, top middle bottom myself, oxygen away, SHOCKING.” The patient jolts. “Back on the chest please.” I heard myself say.

Two minutes later he has a pulse. We repeat an ECG, he’s had a full heart attack. I call the cardiologist at the heart attack centre 10 miles away. He’s accepted and an ambulance crew transfers him for an emergency angioplasty. I send my SHO back to A&E as I write a transfer note.

5AM. The resus doors burst open. Another patient, an elderly woman with breathlessness. The A&E F2 listens to the chest, pulmonary oedema. She’s given the emergency treatment but it’s not working. I decide to start her on positive pressure oxygen. Strapped to her face was a tight mask blowing oxygen to inflate her lungs, buying time for the medicines to work. The plan works and pints of dilute urine fills her catheter bag, her breathing improves and she says thank you through the mask. Despite the fatigue I smile and give the F2 a fist bump for a job well done.

7AM. Four more reviews. a patient with kidney failure due to medications, a depressed young man who took an overdose, an elderly nursing home resident with pneumonia, and an elderly man with a broken hip whom I assess with the orthopaedic surgeon. I start to round up the patients for the ward round. 18 patients overnight, five transfers out, one death. A relatively quiet night. I check with the clinical site manager and SHO that we’ve not missed anyone and click save on the list. No one is waiting to be seen, a good feeling.

8AM. The consultant from last night arrives, she looks tired but asks us how we’re doing. OK we said. We start in A&E as most of our patients are still there, the site manager is worried as some of the patients from last night are coming up to 12 hours in A&E. We review each patient’s story and tests, and talk to them about their condition. We visit ITU for the two new transfers there.

11AM. The ward round of the night patients are done, and I have completed a death certificate for a patient overnight. I climb into my car and listen to the breakfast show as I drive home, an hour away. I’ll be in bed by 1PM , and back for the night shift after 6 hours sleep. A relative luxury from a relatively quiet night.

This would be a relatively quiet night for a junior doctor and I am sure many registrars would laugh at how easy I’ve had it! But the people doing this work are junior doctors, who show dedication, commitment and goodwill beyond belief. They do lifesaving work up and down the country, working hard without complaining and sacrificing time with their families.

Please, I beseech you, treat them fairly and with the compassion they treat others daily. The new contract is not fair, and the extended hours it’ll cause is not safe. ‪#‎notfairnotsafe‬

I hope this little story will give you some insight into the vital work junior doctors and the NHS do. If you like, please come and spend a night at our hospital, I’ll come in with you and show you around. Please talk to my junior colleagues and listen to them, you may be surprised what you’ll learn.

Best wishes,

Dr Philip Lee

Save Our NHS!

Sharing this from a doctor’s facebook wall with permission because she says it better than I could express through the mounting frustration and despair I feel.

“I would like to tell you what the NHS means to me. It means that as a doctor. I get to think about what my patients need, and what is best for them. I get to think about that, above all else. Because my patients are someone’s daughter, someone’s wife, someone’s mother, someone’s mentor, someone’s shoulder to cry on, someone’s friend. I get to value their life over all else.

I love that. I love that when I’m driving down a busy street at rush hour, and an ambulance with blue lights and sirens wailing, presents itself to this mass of people on the road – people with jobs to get to, meetings to attend, events to arrive at, exams to sit – not one of them stops in the middle of the road and refuses to let the ambulance pass.
Not one of them thinks their schedule is more important than the stranger in the back of the ambulance, fighting for their life. They, the general public, the person on the street, the people of Britain, value a stranger’s life above everything else at that moment. I love that. I love the humanity.

Jeremy Hunt says, he wants us to provide a 24 hour NHS. I think thats fantastic. I am pretty sure I have already worked every hour of every conceivable day to make up the 24/7 ideal. I work bank holidays and public holidays and religious holidays. I work often right up until I need to leave to catch a train to a graduation or a wedding. Sometimes I have an Emergnecy and I work past that. And I send my apologies and I lose my tickets. Because the person I am working on matters. Because I value their life over all else at that moment in time.

I think a 24/7 service is wonderful. It’s the dream. It’s like dubai at night. Or New York always. The service that never sleeps. I mean. I never sleep. Not on call. But, yes, sure, things can be delayed. It takes longer for one doctor to see 80 patients at night, than it does for a team of 4 to see them during the day. It takes longer for one lab technician to process 80 blood samples vs a team of 5 during the day. It takes longer for one radiographer to image 80 patients overnight than a team of 3 during the day.

The hospital is not just made up of doctors. We cannot work without our colleagues. Nurses, phlebotomists, pharmacists, radiographers, porters, health care assistants, scrub nurses, physicians assistants, and anaesthetics techs.
We all work together as a team. At all hours of the day and night. Because we value the life of the person we are seeing.
We would love a 24/7 service. But you cannot achieve it by taking the same doctor, spreading him or her thinner to cover the gaps they are already covering regularly – and then tell them that’s what they ought to have been doing all along so let’s slash your meagre pay by 1/3 for good measure.

To achieve the sort of dreamlike 24/7 service Mr hunt is selling and we all want to buy. The answer is simple. Create more training posts. Hire more doctors. Twice the current amount. Hire more nurses. I’m tired just watching them scramble night after night, running between rooms taking care of double their normal case load. Hire more ancillary workers. If you really wanted a fully functioning service, where 3am on a Sunday looks the same as 10am on a Tuesday, that’s the solution.
Don’t fillet and tenderise your already overstretched team to plug the gaps. And don’t turn the public against them because they have said that it’s not right.

What happens to our value as human beings? As care givers? As people who place others first? Where is the logic, in destroying one of the greatest legacies of modern history? In order to reappropriate the money as bonuses for management consultants who “told us what was wrong”.

I never finished my story about what the NHS means to me. When I’m done with my job. And that isn’t dictated by the clock but by when my patients are all stable. When I’m done I go home to my mother, who is terminally ill. Sometimes she is very unwell. And at those times I return to the hospital. This time not as a doctor, but as patient and family. I cannot begin to explain the relief in knowing that our arrival isn’t heralded by piles of paperwork to determine how much money we have to pay for treatment. They wouldn’t find much. I’m always overdrawn. I once laughed when I lost my wallet, because there wasn’t any point in cancelling my bank cards. They would find nothing in the account. I am 34 years old and a “junior” doctor that has been working for 10 years. But I have nothing worth stealing. That’s because I usually just get paid enough to cover my rent and bills. And when I need to do exams or get a wedding gift or live without relying on a credit card I would pick up extra shifts, working even more weekends and holidays than I normally would, which was already a lot.

Then, like a lot of my colleagues. I volunteer. I volunteer my services to local communities. I voluntarily sit on charitable boards where I help develop plans to help the most vulnerable in society. I travel to refugee camps to help those that unlike me, cannot make ends meet, have been forced out of their homes through no fault of their own, and now have no one to care for them. Very few people value them at all, these proud, resilient, insightful people in camps and on journeys – let alone above all else.

So I am grateful for the NHS. Because as a terminal cancer patient. My mum and I show up at our A&e a lot. And often at the most inconvenient times. 3am. 7pm. Weeknight. Weekday. The tumor doesn’t care. But you know who does? NHS staff. They care. They value her life over all else when she walks through the door – even if she may not have very much life left to live. They always smile. They always listen. They are always patient and kind. They are cheerful most of the time, even as their pagers bleep mercilessly through every conversation they have, alerting them to another patient in need of being valued.

They trundle away regardless of the time, tucking my mum into bed, helping her to the bathroom, taking her blood despite the fact that her veins disappeared under the influence of chemotherapy long ago. Patiently searching for those life giving green threads in her hands and arms. Listening to her chest. Poring over her substantial medical history to make sure they understand everything. Discussing the minutiae that may unveil what the cancer is doing this time and how they can best hold it at bay. There are no shortcuts even at 3am. They value their patients and the families above all else. And I love them for that.

That’s what the NHS means to me. Service that comes full circle.

I treated someone’s mum like they were the only person in the world that mattered right then. And later on that night, some other kindly fatigued uniformed intelligent gentle soul did the same for my mum. And sometime during those 24 hours someone was late to pick their kids up from school or collect their dry cleaning – because an ambulance with the most valuable person to someone else, closed off the road they were on as it whizzed past.
That. is Healthcare delivered as a right, not a privilege. That is humanity. So the only question, Mr. Hunt. (And anyone else who backs the sham of making an understaffed workforce doing the best it can to work twice as long for two thirds of the pay, and ensuring that women who have families and researchers who seek to cure terminal conditions like my mother’s can’t do their job, which is what they value – ) the only question is – What do you value above all else? Money? The bottom line? The shareholders? Your mates who run companies that want private contracts? A shot at being PM?

None of that will matter to you when you are ill, Mr. Hunt. I promise you. At that moment in time. You will value your health above all else.

More than that, you will want a team of dedicated well trained NHS employees to value you above all else.
Value.your.health.service.”

Is the UK really a democracy or is it a dictatorship in cloaks?

no to war

Do you all remember when Tony Blair announced that Afghanistan was a direct threat to us UK citizens and that we would be sending in troops with America to fight the Taliban? That was in 2001. I was only 16 years old. Yet I saw straight through that lie. What a whopper! America was out for blood after September 11th and wanted one man in particular Osama Bin Laden. Majority of the UK population knew this. The marches in protest against sending in troops were the biggest ever in British history. Numbers quoted for those marches were around the 30,000 mark (police say 20,000, some sources say up to twice that number). I was one of those thousands of face. I might have been once of the few ‘children’ there but I can tell you, there were people from all works of life. Some poor, many middle class, few clearly wealthy. Some young adults, some elderly with walking aids, even the odd scooter here or there. There were Caucasians, Asians, middle Easteners and Africans like me. There were atheists, agnostics, muslims, christians, hindus, buddhists and more. Many came from all corners of the UK to join those of us who lived in London. We all marched for hours across London. We made it clear that we did not agree with the premise of the war and did not want our taxes paying for the illegal invasion of a foreign land. We signed petitions. The media talked about it for weeks on end.

The outcome? Tony Blair and his Government went ahead to approve the war and committed us to over 10 years of conflict. Our taxes paid for more than an estimated £37 billion. 454 of our armed forces died in that war. An estimated 21,000 innocent civilians living in Afghanistan, already terrorised by their Government and the Taliban, lost their lives. All because America lost 2996 people in the September 11 twin towers bombings. Sure that is a big number but what does it have to do with the UK really? Is the US not big enough to fight its own battles? Where is the proof that it was actually Bin Laden that carried out the bombings? Or maybe it was the Taliban. If there had been proof, the Afghanistan Government was willing to extradite those responsible. No such proof was forthcoming. Instead, the innocent were slaughtered.

Now their blood is on our hands. Despite the fact we stood up and said no. So I ask you: how is this a democracy when a significant proportion of your electorate says  we do not want it and you don’t even dignify them with a proper answer. No appropriate justification or apology for the cost of the war which we all could predict but not the government that is supposed to be looking after us. Can you imagine what we could have done with that £37 billion pounds instead? That is over £2.8 billion a year. That could have paid for 95,000 junior doctors, 113,000 band 5 nurses or 98, 000 high school teachers. We could have paid for most of the proposed high speed rail project (estimated £46 billion) or paid for an upgrade of our main railways and motorways. Which would you rather invest your money in?

Personally, as a taxpayer I would have been happy for the money to be spent on any of the aforementioned worthy projects which would improve our lives. I resent that I involuntarily paid for the slaughter of thousands of innocent Afghanis. Similarly, we invaded Iraq and the costs are still adding up. Because our murdering politicians (Tony Blair and his parliament) decided like a bunch of dictators to pursue an agenda not in the interest if their population. Not only are we still paying the financial cost, we now face bigger threats from groups like Islamic State who have evolved directly from the Afghani/Iraq conflict and our role in it. So shame on you Tony Blair and whoever was in a position to stop this and chose not to. Shame on you, You murderers of innocent children and women and unarmed men. Shame on you politicians pretending to be democratic when clearly you are the worst kind of dictators. Who else wants to declare war on these criminals and invade them, capture them and extradite them to Afghanistan and Iraq so that they can be punished for their war crimes? Anyone?

The Greatest Heist

When people talk about the Palestinian-Israeli conflict, I want to shut my ears and not have to listen about who started what and whose fault it was. Initially (I’m talking about the most recent spate of killing this summer), the UK media was all pro-Israel and blaming it all on Hamas and Islamist militants. Of course this is the currently flavour of the new millennium so I don’t expect any different. However, I do wonder why we have got to the point that legitimises Israel enough that we question who started what.

I know history isn’t my strong point…indeed I dropped the subject as soon as I was allowed to in school because the lessons were so boring for me, I felt like I was having a mini-stroke each time I had to endure one. But these days with the internet and good writers, I am loving my history. So let’s look at the facts about Palestine and those who came in to steal their land.

Palestinians (comprised of mostly Muslim and Christian Arabs and a minority of Jews) were living peacefully in the South-western corner of the Middle East. In the years around 1948, Europeans of Jewish descent (mostly Russian, German, Polish and Romanian) mobilised and en-masse emigrated to the ‘Promised land’. They were led by a group of political extremists who called themselves Zionists who wanted their own State. Unfortunately, it was already occupied by the Palestinians. These Palestinians were home and had no intention of letting someone else move into their land and displace them. So they didn’t quietly give up their land. They fought to protect their homes. The emigrants decided that if the occupants would not create a space for them, they would force them to. So they killed nearly 1 million Palestinians and they moved in. In 1948, after a lot of bloodshed, the Zionists lay claim to over 50% of the land occupied by the Palestinians.

The UN did a lot of hand-wringing and said the occupation was illegal but their voices were quiet because politically and economically, the Zionists were powerful and for the UN big players (the US and UK especially), the Zionist money trumped the human rights of the people of Palestine. So the UN threw up its hands and turned away without any real admonition to these land-grabbing killers. Over the next 60+ years, the Zionists grabbed more and more land for their new territory (Israel), all the while killing thousands of innocent Palestinians and generally making life for the majority of Palestinians intolerable.

Today, Israel with its approximately 7.5 million population occupies a territory of just under 22,000 square km compared to Palestine’s 3.5 million population who occupy less than 6,000 square km. From all accounts, the Jews only owned 7% of the land to begin with. So they owned less than 2000 square km and that has somehow grown to 11 times its size (now occupying 78% of the area). Israel has built walls effectively imprisoning those within them and controls movement of the Palestinians. It controls the movement of food and other commodities needed in daily lives. Palestine which existed hundreds or even thousands of years (as there are historical texts that talk about Palestine from around 600AD) is not a UN-recognised country but Israel which was created within a lifespan and who illegally grabbed land has a seat on the UN council.

Am I missing something here? Put yourself in the shoes of the Palestinians. Whoever you may be and wherever you may belong. I try to imagine what I would do. This is how I imagine this. My husband and I have a house (not imagination). It has a few bedrooms and a few bathrooms, a kitchen and a living room, a garden and a garage. It belongs to us. It is newly built so it never belonged to anyone else. We have papers of ownership. The records all show the deed are in our name. My husband and I live in it. We are chilling at home one weekend when someone knocks on my door. It is a family of 4 from neighbouring Coventry. They are from out of town and they have no place to spend the night but they have a tent. Can they camp out in our back garden until they are rested? We let them have our garden. One day, we come home from work and they have moved into our garage. Sorry, they say, it was raining so hard that we just needed to get some more concrete shelter. Okay I say, being kind-hearted. Days roll into weeks and I say to my husband it would be nice to have access to the garage again but we decide to just let them be because they are not causing undue inconvenience. One day, both my husband and I work late and come to find the family has moved into the house and occupied 2 out of 3 bedrooms. There are only 2 of you, they reason, and you really don’t need more than the master bedroom and your bathroom. My husband and I are not happy. It is our property after all and we paid for it. We contact the police who says it is your home but our hands are tied if they say you invited them in. As we try to think of a solution, we come home one day to find our things have been moved into the garage and the locks to the doors to the house have been changed so the only room we have access to is the garage. We knock on the door angrily and are told through the letterbox to leave or else.

What would you do? Of course, we would try to get the Police to evict them and restore our property to us. We might involve the local media and social media in an effort to get some support. However, if everyone sat on their hands and were not interested in our story would we just leave it at that? The truth is we would try anything to get them out. We would break down the door and throw their things out and move our things back in. We would drag them kicking and screaming out onto the street outside if we were strong enough to do so. Or we would mobilise our neighbours and friends to get them out.

This is what Palestinians have done as far as I can see. They fought not to leave their land. They were forced out. Many tried to appeal to the world for help to restore what was legally their land. Then a small fraction of the population got angry enough to pick up arms and resort to violence. Hamas and other political groups were born and as they gain more support, their weaponry gets more sophisticated. However, the moneyed Zionists have far superior weapons and superior defences so again, it is the whole population of Palestine that suffers. But Hamas and their ilk do not stop to consider that and neither does Israel. The innocents of Palestine (mostly unarmed young men, children and women) continue to die as they are caught in the crossfires.

Now picture that Palestine is located in Europe. Imagine that England was Promised to a group of people in their Holy text a couple of millennia ago. And these people decided to mobilise in 2015 to collectively travel to England. Then imagine that they initially claim asylum and stay with people of same ancestry. And over months, they move into neighbouring lands until the neighbours protest and resist. The invaders then mount violent assault on the people occupying England, pushing all those people North and across in Wales and Scotland. Imagine them killing more than 10% of the people currently living in England and then declaring England is no longer to be called England…that they have renamed it ‘Promised Land’ and the English are no longer citizens of a known legitimate state. Imagine…

What a dire situation those people live in! What kind of a world sits back and watches the conflict deepen and life become more and more inhumane for millions? What kind of world rewards criminality with legitimacy? I feel desperately sorry for those who are living under this tyrannical rule and feel they have no choice but to put up with because it is their home. Obviously I know that the issue of humans and their attachment to land is complex and people have always valued land more than most things including significantly their lives. And there is the small issue of the walls around Palestine so many cannot merely leave and move onto greener pastures. What a hot mess!

Nigerian Converts

The Glasgow Commonwealth Games have occupied many of my waking hours in the past 3 months (yes I recorded it all and have savoured the many hours slowly over 3 months instead of 2 weeks). The competition has been great viewing and I find myself from time to time wishing I had tickets for Glasgow. To be honest, I am puzzled about that still because I am sure if I had known when they were on sale, I would have tried to get tickets for some of it but that opportunity completely passed me by. Sadly.

Although I am a bit competition-mad and will watch most TV programmes with even a hint of competition and a chance to be awed by talent, as an amateur athlete myself back in the day I have a special love for the athletics. And these Games were very special for me for a puzzling reason. We Nigerians are pretty good at the sprints so we tend to feature throughout the rounds. The first heats were men’s 400m I think and when the Nigerian fellow was announced, I sat up in surprise. First his name was very ‘black American’ sounding (most Nigerians have at least one traditional name somewhere in their full name). Then, the commentators went on to say he was ‘one of the many Nigerian converts’. I was puzzled. I had never heard of a person converting to a country before. I mean I know people change nationalities for example but I have never heard it phrased as ‘converting to British’ for example. Odd choice of phrase but I was even more puzzled as to who these people were and why they were converting to Nigeria.

Turns out that these athletes are former American (plus 1 former GB) athletes who have swapped alliances to Nigeria. Now as a Nigerian, I have never been surprised to see a Nigerian name in a British, American, Dutch or even Qatar vest. Truth of the matter is, with the corruption in the Nigerian Government, there is practically no investment in Sport these days and our long-suffering patriotic athletes are forced to abandon ship for greener pastures. And I don’t blame them. If as an athlete for Nigeria I would have to work a horrible job to keep the roof over my head and food in my belly and juggle all that with training, I too would choose to go another team who would not only sponsor me so I can focus on my sport but also give me support in terms of coaching, psychology and physiotherapy. Rather, I was very surprised to see the movement was in the other direction. People actually joining Team Nigeria from other countries. So I investigated.

Apparently our Government has actually made real effort in ‘recruiting’ these former US/UK athletes in the hope of boosting our medal chances. I also discovered that the reason why these athletes’ names are suspiciously not-Nigerian is because many of them are many Generations American/British but according to the news on the internet, they are all bona fide Nigerian – by which I deduce that maybe some of them are 25% Nigerian but they were born and bred abroad and probably did not even have a Nigerian passport/citizenship until they were ‘recruited’. Rumours are that some of these athletes should not be representing Nigerian because their claim to citizenship is tenuous to say the least (I read about a girl who is Nigerian because her American uncle married a Nigerian, thus becoming Nigerian himself and somehow that qualified his niece as a Nigerian?). Dodgy if you ask me.

It is all well and good that our Government has finally sat up and taken note that we have been haemorrhaging all our talent to the West in the last 2 decades (at least) and is making an effort to correct things. However, I concur with their detractors on the internet who point out that allowing these ‘Nigerian’ converts to come in and out-compete our less experienced home grown talents and then for them not to win the expected medals is probably more of a con than a pro. What our Government should be doing is recruiting our budding athletes in schools and universities and creating a training programme with good support to allow our talented young people to hone their skills and become the elite athletes they have the potential to be. We should be investing in our athletes like the great sporting nations do so that we have professional athletes whose focus is all on their sport whilst they are in their prime. We should be there for our athletes so that they don’t have to go on strike before major sporting meets to get their just dues. We should go back to the 90s when we were all so proud of our sports men and women and we treated them like the superstars they were.

Nigeria with our huge population has plenty of potential. We really don’t need to leave our shores to recruit people in. All we need to do is invest time and money in those already there and I am sure in the years to come, we will be up there with the US, Jamaica and GB teams. Long live athletics. Long live our talented children. Long live Nigeria.

My Legendary Granddad

We all call him Baba. He is 84½ years old and still going strong. He was born in Girei, a small town not far from Yola. He went to the famous Barewa College back in the day and he has lived in many many places over the years. Many Nigerians know him or of him because he was around when Nigeria got Independence from the UK and back then he was a Permanent Secretary for Education to the Federal Government of Nigeria and was involved in a lot of the well done legislative processes related with forming a new Government structure. Unfortunately, a lot of the good work done then has been unravelled by our unscrupulous Governments but enough said on that one!

Nowadays, he is just a farmer. I say just because all my life, he has been a farmer but he was also working full-time in Civil Service and an active board member of several companies and institutions. His farm is massive. It’s many hectares of prime land in Fufore…I used to think it was as big as Yola but maybe not. It stretches from the main road to Fufore from Yola to the mountains in the horizon. Within it are a lake and a large pond. There is the round house, the abattoir, the horse stables, the building that houses the tractors and other large machinery, the barns for the cows, the clusters of huts and bungalows housing all the farm staff. As a Fulani man, his main focus is the cattle. Of course. He has cows for beef but his love is dairy cows and he cross-breeds cows from all over the globe to make them better milk-producers. He is also big on his fish farming these days so has 3 other farms with fish ponds etc. Over the years, he has kept horses, rabbits, chicken for eggs, sheep, goats and more. To feed his large herds, grass is obviously a necessity so a lot of the land is given to planting of grass and making hay. He also routinely plants rice, maize and beans. The beauty of it is that a lot of our food at home is fresh from the farm. We have fresh milk which we make into yoghurt every evening at home. We have fresh meat and fish whenever my granddad decides we are due some. We get large sacks of maize, rice and beans every year so we never have to buy some things.

One thing that stands out about Baba is his discipline and strong will. I found out that he used to be a heavy smoker until he was in his 40s. I was stunned to find that out because as far as I knew he was too strong to be addicted to anything. I am told that he woke up one day and decided he did not want to be a smoker anymore. He went into his room, got his stash of duty-free cigarettes and gave it to one of the house staff and told them to take it away. He never, to our knowledge, smoked another cigarette. Now that is how you go cold turkey. He also used to drink strong black coffee every afternoon at 4pm on the dot. I would have sworn then that he was addicted to his coffee but apparently not so because nowadays, he can do without any coffee for days.

Back in the day, his Yola daily timetable was almost military. He would wake up and leave for the farm at 6am every morning. He would come home for 8am in time for breakfast which he expected to have on the table at 08:00. After breakfast, he was a little flexible and would go out to visit people, have meeting, work in his home office etc. Lunch was at 1pm followed by a siesta which ended around 3:30pm. He would wake up and play solitaire on his bed (back then using real cards) until about 3:45 to 3:50pm when he would get dressed and go into the living room to await his 4pm coffee. He was in the car for the farm at 4:15pm and then back at 6:00pm. So basically, it was a strict timetable from 6am to 6pm daily.

His military tendencies also extend to punctuality. If you say to Baba I will see you at 7pm, he will call at 07:05pm to check why you haven’t yet turned up. If he asks when to expect you and you say between 7pm and 7:30pm, he is a little better but again, he will be on the phone or go out at 7:35pm because he will get impatient at your ‘lateness’. Travelling by road with him can be a hard trial too. Even if the journey is for a holiday somewhere 4 hours away, he will insist that you set off at 6am in the morning and woe on you if you are more than 5 minutes late getting to the car. He once invited a young woman friend of his to join him on a trip to Gembu in the Mambilla which is one of his favourite places to go in Nigeria. He asked her to meet us at home at 6am to set off. He never mentioned to us that he was expecting a guest so no one knew anything about her. Off we went to Gembu that morning and we were there at around 1pm. He decided he wanted to go check out his farm and see the cows in an hour. Now, my sister and foster sister were there too and we were sharing our room and bathroom. We also had to use a kettle to boil some hot water for our baths because there was no working heater. Suffice it to say, Charo (my sister) and Bilky (my foster sister) managed to have their baths and I was last so at 2pm, I was just about to step into the bath when my granddad gave the order for the troops to assemble for departure. Knowing my granddad, I said to the girls ‘you go without me’ and took my time freshening up. I was mooching in the kitchen trying to find some food when there was a knock on the door. I hesitated for a second and then went to investigate. There was a strange woman at the door with a guy. Apparently, they had driven down from Abuja to join us on the Mambilla trip and they had turned up at the house in Yola 30 minutes late and found we were gone. It took them 2 extra hours because they kept getting lost (no sign-posting and no satnav then) but here they were. I shook my head and took them out with me to find lunch. LOL.

Baba decided when I was in Primary school that because I had an aptitude for mathematics, I should be an Economist. He didn’t share his brilliant ‘plan’ though until I got to midway through secondary school when I had to make choices on subjects. One of the many choices was Economics which I opted not to do because I was into my sciences, biology and agriculture in particular. When he found out over dinner one evening that I was not going to be studying Economics, he wasn’t impressed. I was like ‘why do you care?’ Then I found out he thought I would make a brilliant economist. Sadly for him, I am a girl who knows what I want and I knew from the age of 4 that I was going to be a doctor. He is still somewhat sad that I chose to become a doctor and not an economist.

Baba is a type 2 diabetic and has been since he was in his 40s. He was so good with his lifestyle modification regime that he did not need any medication for decades and he has only in the last 3 years or so started using insulin. However, about 2 years ago, he became naughty with his diet. I went to Yola for 6 months in 2012 and one day, I came to the kitchen and found bottle of diet coke in the fridge. Now there are never pop/fizzy drinks in our home unless there is a dinner party or a wedding or something so this was highly unusual. I questioned the cook and found out that Baba had taken to sending the boys out for bottle of coke after I had gone to work when I was on-call or after I had retired to Mammie’s side of the house for the night after work. I was shocked. Why would he after 40 years of being good suddenly opt to start drinking probably the unhealthiest drink on earth? Of course, I took all the coke bottles out of the fridge and gave it away and I never allowed him to store any in the fridge. I am not sure whether he snuck some past me into his bedroom and drank it hot but I know there was no way I was going to let him kill himself slowly through high blood sugars and the attendant miserable complications. Oh dear!

Another stand-out thing about Baba is his vigour. By that I mean his physical stamina and strength. As I have described, he would spend hours every day on the farm and still does when he is Yola (he is not in Yola most of the time these day). He used to walk at such a speed that we had to trot alongside him to keep up with him when we were younger. My grandmother Mammie had tiny size 3.5 feet and walked quiet slowly (don’t know whether it was because of her baby sized feet or just that she was such a dignified lady that she never rushed). We found it quite comical this contrast between Mammie and Baba. I remember once bumping to them on Oxford Street in London. Well, I say bumping into them loosely. We bumped into Baba as he hurried down the street and asked where he had left Mammie. ‘Oh she is back there somewhere’ he said, pointing vaguely in the direction he was coming from. So we had a brief chat and he moved on whilst we went searching for Mammie. We found her about 300m away, calmly walking and window-shopping as though she wasn’t supposed to be with her husband. When we teased her, she shrugged and said ‘you know what he was like’. Yes we do.

He was on his way out in his home in Abuja about 4 years ago when he slipped and fell down the marble staircase. My mother found him unable to put his weight on his leg and when examined, they found he had an open fracture of both his tibia and fibula (the 2 lower leg bones). He was flown to London for surgical repair and then had to learn how to walk again. He went stir-crazy and sent my poor mother up the wall by refusing to do anything. He must have been depressed and scared because he refused to co-operate with physiotherapy for many days and just wanted to be left alone despite claiming he had never felt any pain except at the moment he broke the leg. When he finally made it out of bed and was confident enough on crutches, he was sent home with the plan to use the crutches for 6 weeks until the wound was fully healed. He called me 2 weeks later to ask permission as a doctor to ditch the crutches. I asked what the Consultant Orthopaedic Surgeon had instructed and he brushed off my question and insisted he was fine to walk. I refused to give him the go ahead to go crutch-free so soon. It didn’t make the slightest difference. To my mama’s misery, he threw out his crutches and was back to walking in no time. He is now almost back to pre-fracture vigour and only if you look closely will you notice that when he has to step down when walking, he hesitates ever so briefly as the memory of his accident comes back to him.

As I already mentioned in another blog, I inherited my facial features mostly from my grandmother Mammie. I did however inherit some things from my grandfather. His toes which my mum has and I have too with the funny 4th toe. Also the vein-iness of our hands and feet. All of us (my mum, sister and I) have a funny patch 2/3rd of the way of one of our eyebrows which has coarser longer haywire hairs that like to stick out rather comically. Mama studiously ignores her eyebrows and bats our hands away when we try to smooth the funny patch down. My sister gave in to the eyebrow shaping. I am resisting shaping my eyebrows and usually brush them into order but these days, there are usually 1 or 2 really stubborn long pointing hairs that I have to pluck out. A big thing I have inherited from Baba is my stubbornness. I prefer to call it tenacity, determination, decisiveness or ‘knowing what I want’. Most of the Joda grandchildren exhibit the same characteristic to one degree or the other. I have been called hard-headed a few times in my life. I never back down from an argument if I know I am right. I will do things the right way even if it will make my life awkward as long as it is right to do it that way. I would face the scariest person down if they lie about me rather than be quiet for an easy life. I will plan and work hard for years to achieve a goal or dream.

The last thing I have inherited from Baba is his principled ways. As you probably know, for anything to work in Nigeria, you need money and the more money, the better. That is why corruption is so rife. People want to get things done for personal gain and the more they want, the more money they need to accumulate to pay for it all. Sadly, many of these people are the people governing Nigeria so a vast chunk of all of our wealth (and it is vast being one of the largest oil-producing countries) is diverted into personal accounts and safes in homes and spirited away to offshore accounts in Switzerland, the Caribbean Islands and Asia where it can be kept private from inquisitive eyes. Baba is often accused of being a ‘bature’ because he will not make a penny more from a job than the contracted amount. A ‘bature’ means a white person which in the Nigerian context means the colonising Brits. So when you are accused of being a bature, they are suggesting that you follow the white man’s laws and are transparent in a way that is not natural in the Nigerian tradition. 3 out of 4 of his children are just as principled when it comes to earning their way the honest way and I strive to be like them. To me, money is nice to have and necessary to provide the basics of life but my ambition has never been to be rich. I just want to be comfortable. Baba is also straight-talking. If you want to know something, you ask him a direct question and you get a direct answer. Unless he doesn’t know, in which case he will say so. I too am a straight-talker…although people have called me precocious, abrupt and even rude because of it on occasion. To be honest I don’t really care what people say about me unless they misconstrue what I say and get mad. And fair enough, rarely I am intentionally rude because someone is being mean, unhelpful, unfair or verbally abusive at work.

Anyway, I digress again! I will finish by saying that I know Baba is lonely these days because at nearly 85 years, his friends and all of his friends have died. Most of his brothers and sisters are gone too so he feels alone a lot of the time as his children and grandchildren are busy leaving their lives and many of us are not even in the same town as he is. He had diabetes and hypertension and several other organs are beginning to show signs of old age. He keeps losing interest in all of his old interests and every day, he has a new project that gets abandoned when he dreams up something else. Despite all that, I pray that he stays with us until we can have an even bigger party on his 90th birthday compared to his 80th. Because I want to have children and for him to meet them and look at them with the wonder with which he looks at my nephew, his first great-grandchild.

Freedom

Freedom comes in many forms. As does oppression. Before I launch into my tirade against hard-headed hard-line judgmental people and narrow-minded stereotypes, I have a confession for you. I am a feminist. And I am proud to be one. My mother is a feminist, the first in my family and I am proud to say I will carry on that tradition and pass it on as far as wide as I am capable. Feminism for me is all about freedom. People who know nothing or small bits about feminism immediately think a feminist is a woman who hates men, wants them all to suffer and is probably lesbian or at best bisexual. I am writing this to set those people straight of their misconceptions.

First of all, I know of feminist men. Misconception number 1 banished. 2nd misconception is that feminists hate men. The ones I know don’t. We all have things we don’t like about people, be they men or women or even children. We even have the odd people we hate like the wife-beaters and child rapists. Yes most of those are men but there are evil women too and we feminists hate them with as much passion as we hate the men. 3rd misconception is that we want men to suffer. That one is easy – if you read anything about feminism proper, you’ll know that what feminists actually want is for women NOT to suffer because of the things men do to them. Last misconception is that feminists are lesbians. Well, I am married and I love my husband. And I can tell you that when I go to bed with my husband, I am not looking to fondle breasts or play with his hair. My mama, despite the 1st disastrous outing with my biological father, remarried and I know it wasn’t all chat. So there. Feminists are not all women, we do not hate all men, we do not wish to harm all men and we are not all lesbian.

I was born into feminism. Like I said, my mother is a feminist so from infancy, I was exposed to a lot of grown up things. Things that she tried to shield me from but as I said in another blog, I loved to sit with my mum and would often refuse to leave or would hang around even when they wanted privacy so I heard a lot. And part of my contradictions as a child was that I listened and never forgot anything I heard. I would always come back to my mama at a later date having thought about what I heard and ask her to explain the whys and the whats. To her credit, incredible woman that she is, she would patiently explain and give me leaflets and books to read to help me understand.

One of the first things I learnt from my mama is that in a Yola marriage, a woman has to put up with a lot of crap. A lot of that is linked to the fact that in Yola when I was growing up, most women were housewives (two-thirds I would guess). Which meant that women were dependent on their husbands for all their material needs. This gave many men the license to use and abuse their wives. Women in Yola are strong, by Yola women I mean the Fulani women. They are so strong that they think crying/complaining of pain whilst in labour is a sign of weakness (rightly or wrongly). I know this for a fact because I worked in FMC Yola for nearly 5 months a few years ago and as a paediatrician, I was in the children’s wards which were right next to the maternity wards and I swear I probably only heard labour ‘sounds’ 5 times in the whole time I was there. And those women were probably not Fulani and had complicated births. I digress but you get the point. That is why I know how badly they must have been treated. Because they came crying. Weeping like they had lost a child or a parent. My mama was like the agony aunt with legal and financial aid at her NGO.

I also learnt that although the Yola community, like many others, hides behind religion and tradition, the religious and traditional leaders know what the truth is and if forced to will admit it. For example, a lot of muslim Yola women are/were under the impression that divorce was the domain of the husband and the wife was basically under lock and key unless he decided she could leave. Actually Islamically the wife has as much of a right to divorce her husband as he does her but tradition meant that the husbands were better educated which then meant 2 things: 1. The husband could write a divorce script and the wife being illiterate could not and 2. The ‘law enforcers’ in customary and Islamic courts were men so unless faced by someone in the know, feminists generally like my mama, they would rule in favour of the men. My mother asked her lawyer friends for guidance and her belief that the wife had a right to divorce as long as she had valid grounds was correct. Then we found out through her NGO’s work that a few Yola women despite being uneducated had realised this a while back and they had successfully filed for divorce. Guess the commonest reason they cited for wanting a divorce: my husband is impotent. And you know why that is? Because the husband was too ashamed to face any questions on his virility that he granted the divorce asap. Good on those women who discovered and shared the secret!

One of my mama’s NGO’s main focus is empowering the girl child and preventing child marriage. Unfortunately, there is still a huge discrepancy in the achievements (economical and educational) of boys and girls in most of the world. But feminists have made huge inroads into improving the situation. I have seen dozens of girls brought to my mama and not one appeal for help was turned down. My mama and her team fought tooth and nail to emancipate every child forced into a marriage. They then tried to provide them with long-term prospects either by sponsoring them to go to school or learn a trade. Many of them have been employed by my mama at one point or the other. Many of them are now fully grown women with careers or atleast a means of making some money so they can retain some independence and support their children should their husbands fail to provide. Many of them become one of my mother’s many children and one of my many sisters and the occasional brothers (through their sisters).

One thing about being feminist is about knowing and appreciating the fact that women and men are physically and mentally different. We do not want to be like men. Most of us do not want to take over the traditional male roles that have evolved into male roles because of the physicality. That is not to say that a woman cannot do the same job but it might take longer or she might need another pair of hands and sometimes it is easier for a man to do. Just as we know that there are men who are very paternal and are very capable of nurturing and looking after a baby’s needs BUT physically it is impossible for them to be as good as the mum because they have not got a uterus to carry the developing foetus for 9 months and they have not breasts to breastfeed with. Just as we know that a woman matures mentally in her 20s to her 30s whereas many men do not get to that level of maturity until they are in their late 30s and 40s. And we know being a mother brings out the tiger in every woman so that when their babies are in danger, they are capable of superhuman feats to save them. Men in general do not have those same instincts however it is well known how protective men can be of their daughters especially. So although feminists want women to have equal (human) rights with men, we recognise and even appreciate the differences in how we are built.

The biggest thing about being a feminist is the issue of how to dress. As a feminist I believe that every woman should be able to dress as she pleases. To please herself that is. Because people accuse feminists of hypocrisy if they are dressed to impress or sexily. The point is feminists believe that the woman’s body is hers to do with as she pleases. If she wants to cover herself head-to-toe in a black Arab gown and gloves and socks, then we are happy with it as long as it is her choice. If the same woman decides that today, she would rather be in a miniskirt and vest top, then that is okay too because it is what she wants. Not what her father or brother or husband or even mother wants. It’s all about the right to choose for yourself as an adult woman. But our people are obsessed with the issue of how a woman dresses so the disagreement continues. Tragically, many uneducated people still subscribe to the fallacy that the way a woman dresses is partly to blame for them becoming a victim of rape. To that I say, why is it that a man can walk around in shorts or topless in the heat and in general no woman tries to rape the man but when the roles are reversed the rapist points a finger at his victim for enticing him? Nothing justifies that barbaric act and its almost laughable that anyone would buy that as an excuse in this day and age. Thank goodness for the Nigerian Constitution stipulating a custodial sentence for all rape and for the NGOs providing the legal aid to ensure more men are convicted of this heinous crime.

Above all to me feminism represents love and freedom. Love because we stand up for those girls and women who haven’t a voice to say no when things are being done to them that they absolutely do not want or consent to. Freedom because that is what we promote no matter what the problem a girl or woman is faced with. Freedom to be born (and not killed solely for being female), freedom to go to school (and not be kept at home to learn to be a domestic goddess whilst your brother goes to school), freedom to have a childhood (and not be raped or married off too young), freedom to learn a craft or study for a degree, freedom to marry or not, freedom to choose who you share your bed and home with, freedom to decide how many children you bear in your own womb and breastfeed and nurture for the rest of their lives, freedom not to be violated or abused, freedom to leave a bad relationship. One day the whole world will realise that feminists are not against men but they are for men and women. That what we want is the world is to be happier and for all groups to be free to live a happy life. What we want is for the world to show some love to each other regardless of faith, tradition, ethnic group, education, class, age and most importantly gender. Peace!