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The Cycle of Life Part 3

I could write and write about the many lives I knew that were cut short in their prime but I will complete the cycle with this last blog about one of my oldest friends. His name was Nabil. We probably met as babies but the first meeting I remember was when I was 15 years old. We had moved to London the summer before and were getting settled in still. My mama came home one day and announced we had been invited to have dinner the Ibrahim’s on Saturday. Who were they? I asked. She explained that they were old family friends. The parents were my grandparents’ friends and although their children were younger than my mother and siblings, they knew them well as children. I am told one of the kids had even stayed periodically with my grandparents in Lagos when they were going to school there. She told me that the oldest daughter had 2 sons, one my age and I was going to meet them.

Although we both lived in North London, it was quite a trek as there was no direct tube route and we had to go on 2 (or was it 3?) buses. By the time we got there, my nose, fingers and toes were frozen and all I wanted to do was curl up into a ball and sleep by a fire. I needn’t have worried. As soon as we stepped into their house, I felt my frozen cells begin to stir. It was always tropical in that house. Mum and Baba (the grandparents) like it very warm so there was never any danger of being cold once you got in there. I was introduced to the many adults, face after smiling face. It was like a mini-Northern Nigeria. All the warmth, the noise, everyone speaking Hausa. The boys were called down, Nabil and his little brother. They were instructed to take me upstairs until it was time for dinner. Although Nabil was friendly, he was definitely the quiet one. His little brother made up for it. He was very chatty, still pre-adolescent and full of excitement about life. Back then, he was quite small too. Very cute!

Nabil played us some music and told me about how they had only been in London for a year so were new to town too. He explained who was who in the family and we made general chitchat with his little brother telling us his fantastical half made up tales. We were in the same year of school and I was older by 2 months. By the time we got called down to dinner, we were friends. Over the delicious dinner cooked by Mum (his grandmother) and his mum, we talked some more. We exchanged numbers when I left. We stayed good friends over the years. We went to visit every so often and they made the trip across North London a few times too. We text occasionally in between visits. The next year, we talked about finishing year 11 and applying for colleges. I told him I was doing all the sciences and Maths because I would be applying to do Medicine. He said he wasn’t sure yet what he wanted to be so he was still thinking about which subjects to choose. We talked about where to go and I must have been convincing because I suggested for him to join me in Barnet College and he promised to consider it. He wrote down his address on a teddy bear notepad I had so I could sent him information when I had a confirmed place.

Common sense prevailed and he went to a college more local whilst I went to Barnet College. We went to see movies together and we even ate out at this stage, being all grown up at the ripe old age of 17 and 18 years. Every time we went out, he would insist on paying for everything and I would argue him down so we went halves. His little brother had grown into pre-adolescence by then and would irritate Nabil endlessly. His patience was great and he would repeatedly ask him to butt out of our conversations. I didn’t mind. I had a sister too and as the younger sister, I knew what it was like to be the little one. When we applied through UCAS for universities, he finally had a plan. He was going to study Maths. I was shocked. I mean, I was a straight A student and I got my A in Mathematics, an A* even in AS. I was no slouch when it came to it but to do a whole degree in Maths? I was agog! Why would anyone in their right minds do such a thing? He took my teasing in his stride. He said he didn’t have a profession in mind like I did and he knew he could use his generic Maths degree to do a wide range of things. I accepted this but I still thought him mad. He gave me that calm smile of his. ‘You’ll see’, he said.

As is the norm, we saw each other less when we went off to different universities. I went to Birmingham and he stayed in London. We probably saw each other once a year but when we did, it was like no time had passed at all. Ours was a very easy friendship. He would tell me about his ‘crazy’ Maths course. He seemed happy. I would tell him about Medicine and how much of it there was. How I realised more and more that what I knew was only a small fraction of how much I needed to know. He was openly impressed by how well I coped with it. His support and belief in my abilities were unwavering. Just like his friendship. I knew he was there somewhere should I ever need a friend. We text and Facebooked more than we spoke face to face. I can count the number of times we spoke on the phone in all the years.

Over the years, I would tease him gently about his girlfriend, or lack of. As the Fulani girl, I should have been more embarrassed to talk about such things but he was so shy about it. It became part of our friendships. I would needle him about ‘her’ and he would counter by asking me about my many boyfriends. I wasn’t shy about it. I had very little in the way of boyfriends but I told him of every encounter and how I preferred not having a boyfriend. He never admitted to any love interests but his brother was a more open book and I know there was somebody special at some point. He graduated and started an online sales platform. Next thing, he was talking about going back to Nigeria for his NYSC (mandatory youth service). He settled in Lagos. I happened to go the Lagos route once in his time there so I got to see him. He looked way too skinny and I was worried. As a newly-qualified doctor, I saw ill-health everywhere and was concerned he wasn’t sharing. He reassured me that he was fine. I didn’t need to doctor him. I believed him because youth corpers do tend to look the worse for wear during their year’s tenure.

The last time I saw Nabil was in Life Camp, Abuja in 2011. He happened to be visiting Abuja whilst I was there on a 10-day holiday. He was staying with a friend who brought him over. Again, I thought he was too skinny and he laughed it off. ‘Maybe I was always meant to be skinny like you’, he said. We chatted for an hour and he had to go. As we hugged goodbye, I felt how bony he had become. Life in Lagos was a hard one for a young man trying to start a business. My parting words were ‘You need to eat more. You should look after yourself better.’ His reply was a laugh and a ‘Yes doc!’ I stood at the door and waved until the car was out of sight. Not for a second did I imagine I was saying goodbye for the last time. The fuel subsidy crisis in Nigeria was the last thing we ever chatted online about. He became very involved in the demonstrations. I worried about his safety and he sent photos of himself and his friends at Lagos marches, looking happy and less skinny. He had found a cause to believe in. I was proud he was making a stand for a cause.

News that he was ill came out of the blue. I was in Yola, having taken a year out from working in the NHS to see the world. My mama got a call from one of his relatives saying that he was in hospital with a bleeding illness, cause still unknown. It was pretty serious and they were considering transferring him abroad as the healthcare available in Lagos was deemed inadequate. When my mother related the facts, I wanted to know more. What sort of bleeding? Was it related to a fever? Was Lassa fever the suspected cause? When my spoke to them again later, she was given more details. He had woken up that morning and told the friend he was living with that he wasn’t feeling too well. I think there was mention of a headache. He had been well the night before going to bed. His friend had gone with him to hospital and he either vomited or peed blood. The exact sequence is hazy but the gist of the story was that he had become sick rather quickly and what started out as an isolated bleed was now bleeding from multiple sources. He had been given a transfusion, we were told. He was conscious but seemed to be deteriorating.

When my mama related all of that news, I immediately thought the worst. When I burst into tears, she was alarmed. ‘He is alive,’ she said to me. ‘Don’t write him off.’ I tried to explain what I was thinking. I didn’t want to be a pessimist but unexplained severe generalised bleeding had a poor prognosis even with the best medical care. And he was not getting that. Not yet anyway. I had 2 professional experiences to draw on, both rather negative. My first experience of a patient with uncontrollable bleeding was in Malaysia on my medical elective in the 4th year of medical school. He was brought in by his heavily pregnant wife and a male relative to the A&E where I was working. He was very quickly diagnosed with Dengue Haemorrhagic fever. However, before any real treatment could be commenced, he went into cardiac arrest. With the medical students and his wife watching, the doctors performed CPR. It was horrific. He began to bleed from every orifice imaginable. His ears, nostrils, mouth. The blood was coming up the tube he had inserted into his lungs to ventilate him. The only part visible with no blood streaming out of it were his closed eyes. It was over as quickly as it began. It was obvious to everyone that he was far too ill to be saved. His wife was led away with the news.

The second experience was indirect. I was working in FMC Yola (Federal Medical Centre) and although Yola was ‘free’ from Lassa fever at the time, there were new cases being reported further south of the country. In fact, about 6 months before I had started working at FMC, there had been a patient with Lassa fever there and 2 of the doctors had contracted it from him. Unfortunately, 1 had died and the second had got to the Lassa Centre down south in time to be treated. He was one of the registrars on the paediatric team I was working with. So although he was okay, it seemed that mortality was quite high and only those who were diagnosed early and treated before they started actively started to haemorrhage (to bleed) were salvageable. Nabil’s story didn’t quite fit the bill because he had not complained of a fever and indeed had no fever in hospital. But it was my best guess with the facts I had and I feared the worst.

I pulled myself together eventually and prayed and waited with my mama. Next time we got an update, it was to say he was worse still, I suspect barely conscious at this stage. He was still bleeding despite all efforts and his parents were with him (they don’t live in Lagos). An air ambulance had been organised and he would be transferred abroad as soon as possible. We even heard he was being placed in the ambulance and I thought maybe there is some hope after all. That hope was short-lived. We got a call a few hours later to say that although his parents were in a flight to London, his air ambulance had never taken off. There were complications and unfortunately, he had not made it. I was so upset! All I could think is how his parents had no idea he had died and how they would have to make the return trip with that news weighing on them. To be honest, I have not asked them what happened exactly but it could only have been a terrible day.

I think the initial reaction of tears had taken the edge of my grief. I had started my grieving process before he was gone. I sat around in disbelief as my mama asked if I would be okay. As we made arrangements to go and visit his family, I could not stop thinking about how final death was. That was it for him, in this life anyway. I have no brothers so I whilst growing up, I found a handful of boys/young men to be my shining examples of decency in the male sex, my torch bearers when I felt dark about men in general. Nabil was one of them. Here was a gentle, calm, positive young man who believed in doing what was right, what was decent. He was respectful of God, his parents and our culture. He was a great friend and it was clear from the few times that I spent with him in the company of his family and friends that he was an all-round good guy. Losing Nabil was losing a little of the light in the darkness that sometimes surround men for me. Nabil was a good guy. Now he is no more. It took just over 2 days for a healthy young man in his mid-20s to sicken and die. Muslims would say it was time to go. I accept that but did it have to be such a horrible death? What did he ever do to deserve such an end? Why him?

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Be Your Own Yardstick

I will start by admitting that I, like most other people, did not like the way I looked for a long time. More accurately, I had insecurities about some parts of my body, some of which remain to date albeit in a very passive way. So I understand that as humans, we always want what we don’t or can’t have. I have worked very hard not to measure myself against people who bear no resemblance to me. I realised very early on that my genetics are out of my control so wanting to be someone completely different was a futile aspiration.

I have always been skinny or more politically correctly slim. I used to hate the word skinny when I was a teenager because to me, it represented a person who was gawky, awkward, boy-like and unattractive as a young woman. I realise that most girls put on weight around puberty and looking at the stick-thin waifs gracing runways, magazines and Hollywood movies, it is easy to see why they would aspire to be skinny like I was. I was completely oblivious to this as I was quite the tomboy and did not have any time for magazines when I was around puberty. The movies I loved were mostly animation and even if the girls/women portrayed in most Disney movies were on the smaller side, they all had the beautiful curves I adored. My mother has lovely feminine curves and so does my glamorous older sister. Perhaps being African where the culture predominantly celebrates curvaceous women had a bigger influence than I was conscious of too. My celebrity role models were Halle Berry, Julia Roberts, Jennifer Lopez and later Beyoncé and Alicia Keys all of whom have (and celebrate their) curves. All of those things meant that instead of the usual Western ideals of being a size 6, I was self-conscious. I wanted to be bootylicious and packaged in a short petite perfectly proportion frame.

The worse part for me was having to go shopping. Again, another aspect where I differ from the norm. It probably started out because I used to accompany my grandmother to the market in Lagos and she used to take her time visiting stall after stall finding the best quality food for the best price. I would follow impatiently, wishing she would speed up and within an hour, I would develop a painful ‘stitch’ in my side, making me want to sit on the ground (a massive no-no as it was rather murky in Lagos markets).

As I grew older and had to start participating in shopping for my own clothes, it was okay because my mama like me is impatient with shopping and she used to be quite military with it. When I became an adolescent, my mama decided to give me money for clothes shopping and it became my responsibility. The shoes, underwear and bags were easy enough because it was just a matter of looking to see what caught my eye. Clothes on the other hand was a nightmare! I vividly remember days coming back dejectedly after 6 hours on Oxford Street in London and trying on top after top and jeans after jeans and none of them fitting well. I would look in the mirror and see this anorexic figure staring back at me. Some of those days, I would be so demoralised that I would cry. Thankfully, although I haven’t put on much weight over the years, I have acquired some (slight) curves which means that I am now a proud standard size 6 or 8 depending on the shop. I can confidently go out to buy new clothes knowing now I will find things that fit. It is just a matter of finding the style I want for the price I am willing to pay for it.

The lesson I taught myself early on was that there is no use aspiring to become curvaceous like J-Lo overnight. Rationally I knew I was going through puberty and it would take time before I developed curves. Also I had seen pictures of my mama in her 20s (pre-children) and she didn’t have much in the way of curves back then. I also looked around my family and realised that most of the young girls were rather skinny. Fulanis in general are skinny folk anyway (think Masai-like physique, same ancestry). I would tell myself that just because Britain was predominantly British and it catered to the genetic makeup of that population did not make me unattractive. Many of my friends and family told me countless times that they would rather have my body than theirs but I thought they were lying to boost my confidence. I only started to believe them once I grew my curves and became more body-confident and got strangers complimenting the way I looked.

I am still not a massive fan of the mirror and often forget to look at myself in it. I still find some of my features surprising and often when someone mentions something about my facial features, I have to go and look in the mirror to work out what they are talking about. I’ll give you a classic example of my lack of self-awareness. I was 14 years old when my sister and I went into a shop I had never been too. I turned a corner and caught sight of a girl who I thought looked vaguely familiar and I mentioned that to my sister casually. It probably didn’t help that at that age, I was still in denial about my short-sightedness so did not have perfect vision. My sister looked at with a smile like I had made one of my endless jests. I was confused. It dawned on her in seconds that I genuinely had seen myself and did not realise it was me staring back from the mirror. Oh well!

In general, I guess it is a good thing that I am not self-conscious about what others see when they look at me. I care more about presenting a professional look when I am at work and a ‘nice’ look outside of that. All my adult life, I have chosen an extra 5 minutes in bed over putting on makeup in the morning. Thankfully, being sexy or desirable are not issues I care about. My dear husband assures me that I have those characteristics in abundance anyway and it is only in his eyes that it is important I am those. To anyone else, it really doesn’t matter to me what they think of how I look as long as they see that I am a decent and caring girl inside.

My message is simple – I value what sort of a person I am inside more than out and because of that I do not compare my ‘beauty’ to others. I have simply learnt to embrace and even love the body I was blessed with. I see beauty in all body sizes and shapes, colour, height etcetera. As Christina Aguilera says in her song Beautiful and I paraphrase – ‘I am beautiful, no matter what they say. Yes, words can’t bring me down. I am beautiful in every single way. Yes, words can’t bring me down…Oh no! So don’t you bring me down today…And everywhere I go, the sun will always shine.’ Preach! Belief in your beauty, regardless of what people say because there will always be critics but that is their problem, not yours my friend.

My Very Own UN

My sister is (or should that be was) a social butterfly. She always had more than friends than she knew what to do with and she never had issues making new ones. A classic extrovert. I considered myself an introvert for most of my youth. Now with more self-awareness, I know I am more of an extrovert than an introvert but I am pickier than my sister, the true extrovert. Because I have been so picky, I think I have ended up with the best friends in the world.

Some of the people I am talking about might not realise how much I value their friendship or indeed that I am talking about them but I hope when I describe how fabulous they are, they will realise how great and valued their friendship is to me. When I was little and my mama was my only role model, one of the things I thought was absolutely amazing about her and her life was her array of friends. They were young and old, some local, many from far afield (and being in Yola that is quite something I tell you). Some Muslim, some Christians. Some skinny, some fat. Some beautiful, some not so beautiful. Some quiet, some loud. Many feminists like my mama. All sorts. The one unifying thing about them was that they were kind and caring, they spoke to me like I mattered and they were passionate. If she ever needed anything around the world, all she had to do was pick up the phone or send an email and the cavalry would arrive. Subconsciously, as I grew up, I think I looked for all those things in my would-be friends. I think I succeeded in developing my very own passionate, kind, caring, loving, helpful and loyal circle of friends. The inner circle is a small one compared to my mother’s but I happen to believe the best things come in small packages. I will talk about my current inner circle in no particular order as I value them all fairly equally. I won’t mention my mama and my sister but they are my best friends and are the core circle.

First one is my Ethiopian friend who I met in 2001 who I shall call Lizzie. We were in the same tutor group in Gladesmore Community School (10AH massive) and we both joined in year 10 so we had common group but our big unifier was where lived and that we had to get 2 buses to get to school. So, earlier than the other pupils, we were up and out, dragging sleepy bodies onto the 144 which I caught at the first stop in Muswell Hill and Lizzie would hop on 4 or 5 stops later in Hornsey. We were normally quiet in the 144 but by the time we got on the 41, we were awake enough to chat. It was on the 41 that I got to know Lizzie’s life story and about her very grown up relationships. At this stage, I had never had a proper boyfriend and despite having a crush at school, I wasn’t really interested in a relationship. So I lived vicariously through her. We also bonded over our love of heels (low enough to wear to school and get away from censure) and long braids. Also I have been mistaken for Ethiopian so we had a similar slim innocent look. We have remained friends over the years, closer after school than in school, through her babies and marriage, through my medical school. Lizzie was a bridesmaid at my wedding and she regularly makes the drive up to Birmingham from London to visit. Even though we had periods were we got too busy with our lives, she has remained a constant. We may drift (although not so much now) through complacency but we never fight and we are there to listen. So here is to my yummy mummy Landan friend. For being constant and loyal and inspiring me to be more glamorous and feminine.

Next is my Northern Nigerian friend who I shall call Halima. We met in 1996 in Queen’s College, Yaba Lagos and we were friends from the very beginning. It was the Hausa lessons that cemented the friendship and as we were both boarders, prep times and dinner times were there for us to foster the relationships. In another blog, I have mentioned Na’ima and I was close to a couple of other girls, 2 of whom were boarders. Halima was in a ‘House’ located all the way across the quadrangle which thinking about now wasn’t so far but during those years was enough to make visiting her during weekends a significant event. She was responsible for the one and only time I had periwinkles (the hairstyle) for Sports day in JSS2 (see blog on that). Those periwinkles make an appearance on my first ever British passport and my husband loves the photo so much he keeps it by his bedside. She was one of the only girls whose homes I would visit outside school too and I knew her family so that made her more special than many others. Post-QC, she is certainly the one who would always make an effort to come and see me whenever I went to Nigeria. I knew about her wedding as soon as she had a date in mind because she wanted me to be able to jiggle my doctor on-call to make it there.  I am so glad I did. We shared her pregnancy from across the distance too. In all these years, I do not remember ever fighting with Halima. She is probably one of the gentlest and sweetest women I know and her son and husband are so lucky she is theirs. Despite being many thousands of miles apart and despite our other friends from that era being on social media and living in close vicinity to her, Halima is the one of all that I would be able to count on today if I needed a friend in Abuja. What a sweetheart!

Then there is my Southern Nigerian friend, let’s call her Tolu. I met her through NLI which is a (NGO) Nigerian initiative to promote young accomplished Nigerians living at home and abroad to be the champions that make Nigeria great once again. NLI was in 2010, or was it 2009? I came from here and she came from the US. We bonded over our passionate pitches and speeches. Never before had I met a young woman who seemed so like me. She exuded integrity and honesty and passion. When I told my husband about her, the words I used were ‘Tolu motivates me to be a better person. I wish she lived nearby so I could be in her presence regularly’. Being next to her or chatting with her on the phone or on social media never fails to give me a positive boost. Tolu to me is everything a young Nigerian should be and she makes me so proud to be in the same circle as hers. If I could choose anyone for my baby to be like, it would be Tolu. She went through a very harrowing time a couple of years ago and being so positive and so strong, she didn’t say anything for a long time because she is that type of a person who will be everyone’s shoulder but have no shoulder to lean on herself. She has come through all of that in a way that is no less than heroic. She is generous and kind. She is a wonderful listener. She is passionate about life and justice and selfless in her outlook. Maybe I don’t want my baby girl to be like her, maybe I want to be like Tolu. Anyway, if you are reading this my love, I might not have said in so many words but your strength, honesty, passion and selflessness makes you wonder woman in my eyes and I could not be prouder of you. I hope your dreams for Nigeria and the world come through because this world is so much better for having you in it.

Following on neatly is my only fellow Iro-Nigerian, who I call Irish anyway. She is Irish in all the best ways possible except she lacks an accent being southern England-bred (sadly but she can put on a pretty good one). We went to medical school together and once again it was fate that brought us together because we met in student halls in 2004. Being the only two medics in the flat of 6, naturally we became close pretty quickly as we were together pretty much all day every day for the first 2 years of our medical school. We were up ridiculously early and gone all day. We couldn’t party any night of the week like a certain somebody we lived with. We had plenty of work and exams to keep us busy. The first thing about Irish is that she is a morning person. I am most definitely not. She would wake up at dawn even on weekends and whistle cheerfully. She had these dryer sheets that smelled of fresh laundry…even today, that lovely fresh scent equates to Irish to me. She has tremendous boobs (sorry Irish but I feel they need to be celebrated) and the loveliest bouncy hair which is NOT mousy brown as she used to claim. She is one of those friends I have never fallen out with. It’s strange to think but we don’t have fights at all. Perhaps it is because she doesn’t tend to get dragged into one of my deep philosophical conversations because she is quite squeamish with deep emotional stuff and would rather the happier topics. That is not to say that she won’t indulge me if I need to offload. She makes the best butter icing cupcakes and has managed to teach me to bake a couple of things. She loves sunflowers. That is in a nutshell Irish to me. She is little Ms Sunshine with a spine of steel underneath all the Gaelic charm. She will stand up for what she believes in and will call you out if you do something wrong but all with the sweetness of honey. She has dealt with family issues that would faze many but she remains unfazed and strong. She also has lovely blue eyes and dimples which I would give my little toes for. Oh and she gives the best hugs ever! If Tolu is the girl I want my daughter to grown up to be, Irish is the woman I want to be for my children. I want to be all sunshine and sweetness and quiet strength and I want to be charming just like her when I grow up.

Then there is my Indian friend who around birth was inadvertently called One on some documentation and that is my name for her which I shall stick to. She is the only one of my friends who is younger than I am. We met whilst I was out doing clinical experience in SEWA rural, Jhagadia – a village in Gujarat State, India. She was out there too doing field research and being the only other single girl resident in the flats on hospital grounds, we instantly gravitated to each other and became fast friends. She is a biomedical scientist. We quickly found common love in tea and laughter and feminism. We quickly fell into a routine. She would come over after ‘work’ to put her water in my fridge and we would go over to hers for tea. I would usually drape myself all over her bed and even occasionally on the cool floor for it was pregnant with heat during my 3 months there. My friendship with her is very similar to the one I have with Safa except the age difference and my having a bit more life experience. And our life stories seem to mirror each other down to meeting the ‘wrong’ boy as defined culturally but actually believing them to be our Mr Right. Unlike Safa though, she is the only one of my friends who is shorter than I am so I feel refreshing normal size next to her. One is rather fearless I think and having lived in remote Jhagadia for a whole year, she then applied for a post-graduate course in the US and off she went to live in NY. Now she is in Malawi, again independently sourced job and seems to be flourishing. What makes her so special goes beyond her fabulous tea, her wicked sense of humour and independent spirit. She is also very honest and open, kind and supportive, generous and when she loves, she gives it her all. One is going to be great someday soon. Mark my words!

Last but not least is my youngest adopted mama, Farah for today. I met her in 2009 as a lowly FY1 doctor in the crazy world of City Hospital (Birmingham). She was soon to be medical registrar and had a reputation for being brutally honest and fierce. Did that put me off? No! I love my women fierce and fearless so we became friends in the mess when I was on surgery and actually had time to go to the mess every day. I loved her unconventional ways and I think she liked me because though small and ‘quiet’ on the face of it, I gave as good as she gave and never seemed to take it personally when that sharp tongue was pointed my way. Despite the difference in years, in the hierarchical world of medicine, we remained friends over the years and have grown closer since we stopped working together. She is another one from a Muslim background who was born into the religion and though respects me for practicing, is not of the same opinions about it. I respect that despite being from a middle-eastern background, she is honest enough to say this is how ‘I’ feel about religion and all that comes with it. I love that despite that prickly first impression she gives out, she is a big old softie with a heart that is good as gold. She is loyal and supportive and she is always there for me if I need her. She wore a polka dot dress to my wedding – if for nothing else, I will love her forever. What a woman! Farah I salute you. You are one of my heroes.

There you are dear readers, my wonderful array of close companions without whom I would be less of the woman I am today. I will take this opportunity to say that for the reasons I have mentioned above and for many more that I cannot put into words, I feel privileged to have met and befriended you all. Thank you for all the love and support. I love you all.

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?

Brummie Beautiful

Before I became a Brummie, I lived in London. My oldest friends in the UK mostly live in London and most thought I would be back to London first chance I got after uni. I had other ideas. When I applied to study at the University of Birmingham, my top reason was not how well the University did in the overall league tables (it is one of the top ones) or the style of teaching at their Medical School (systems-based learning with early clinical contact which suited me perfectly) or even the extra-curricular opportunities available (our uni loves sports and music). I just knew that the Midlands was the place my heart felt the strongest pull towards.

I first visited the Midlands a year after moving to the UK when we went to Nottingham to visit an old classmate of my mama who happens to be a GP whose son was at the Medical School in Birmingham. I loved the idea of the Midlands, ironically it brought to mind Tolkien’s Lord of the Rings which is based around Birmingham and the West Midlands but I didn’t know that then. There was something about the calmer pace of life that I was immediately drawn to and the open spaces and clean air in Nottingham. My London stresses simply fell away and yet it felt like there was enough to do for me here. The best way I can describe how I felt is that my pulse matched the pulse of the Midlands.

Knowing how I felt about the Midlands and having spoken to the medical student son of the GP friend of my mama’s, I knew that my 2 certain UCAS application spots for medical school would be Nottingham and Birmingham. I ended up applying for a spot in Imperial College and Kings College (both to match my Queens College pedigree). I persuaded my mother to accompany me to the Open Day at the University of Birmingham and my top choice became Birmingham. I loved it all. From New Street Station which to be honest wasn’t all that (although we are awaiting our new state-of-the-art concourse and generally more beautiful station which is being worked on as I write). To the pace of the life – there was enough bustle for me not to be bored bearing in mind my Lagos and London background. To the mix of people – black, brown, white and many shades in between of all shapes and sizes and how happy majority of people seemed to be as they rushed around shopping and working. And finally the beautiful grounds of the University of Birmingham which impressed me from the moment I stepped out of University station and cast my eyes on the Iron Man on the little roundabout leading to the main University Campus.

The longer I have lived in Birmingham, the more in love I have fallen with it. People are scornful of the ‘accent’. Err, the accent y’all think is Brummie is actually Black Country and majority of people in Birmingham City do not sound anything like that! And I don’t even mind the black country brogue despite the fact that when those people speak to me, I have to focus really hard and find myself staring at their lips as if I can lip-read. The other common misconception is that it is all warehouses and dirty ugly buildings which I am sure are a stereotype from the war days. Well, you should see Birmingham now. We have lovely centuries-old cathedral and buildings, many right in the centre of town. We have a beautiful open market on weekdays behind the Bullring and the Rag Markets which are closed also behind the Bullring. I cannot not mention the Bullring because it is now a major family attraction for all its shopping and food court. Also the Mailbox which is glamorous sister of the Bullring with its more expensive designer shops and trendier restaurants, bars and clubs. There is the Arcadian with all of its entertainment by night and dining facilities by day. Our China/Oriental town is thriving right next to the Arcadian with Chinese supermarkets and many restaurants to choose from.

The Jewellery Quarter is simply the place to be if you are looking for a great deal on diamonds and precious metals. If you take your time browsing, you will find jewellery shops with beautiful antique one-off pieces like the pearl bracelet I wore on my wedding day. There are also jewellers there who will for a fee design unique pieces for you or use an old stone to design a new piece or re-structure an old necklace or bracelet to suit you. I lived in the JQ so you could say I am partial but it is a lovely place to live with lots of flats perfect for single young professionals or newly cohabiting partners who are yet to start having a family. The cemetery is a peaceful place to hang out…it is a proper old-school one with large tombstones and in many spots, whole families laid to rest together over the years. For the year I lived there, I would walk through the cemetery every morning and evening and say a prayer for those whose bodies were laid there and I would wonder about their stories and smile at the fresh flowers placed at gravesides.

The biggest thing for me though is the people of Birmingham. Of course we have our EDL-racists, our illiterate chavs, our stinky tramps and our gangs which are not the best but which large city doesn’t have them? As the second largest city in the UK, we have our fair share of the not-so-desirables but you have to look deeper than that. We are a melting pot of all the races of the world. The ‘minorities’ here are not minorities. We have large communities of Indians, Pakistanis, Chinese, Jamaican, Nigerian, Ethiopian, Polish and Iranians. You name it, we have got them in fair numbers in Brum. With all these groups comes the variety of music and food on our streets. We have festivals to cater for all the different groups. We celebrate Eid and Diwali with as much gusto as Christmas. We have plays celebrating all the different cultures. The highlight for me, we have children that are more mixed than in any place I have lived. We have the unlikeliest of mixes…black and Chinese, black and Indian, Pakistani and English, Spanish and Turkish, even Nigerian and Polish. As a paediatrician, it is a privilege for me to get an insight into these families and appreciate the diversity of my home. Simply put, they say home is where the heart is. For me, Birmingham is where my heart is.

Mythical Malaria

My mama came back to London from a visit home to Nigeria in 2002 and felt feverish. Like most people where we come from, she thought it might perhaps be malaria but wasn’t unduely worried so decided to wait and see. On the Monday, she had the typical malaria vomit so she thought ‘I best get some antimalarials before it flattens me’. That evening, I came home from college, cooked dinner and waited for my mum to be home around 7pm as usual. 7pm came and went. Then 8pm which is when I realised something was up. I called her phone which went straight to voicemail. She did come home late sometimes especially on Mondays so I wasn’t all that worried but I did feel she shouldn’t work so hard.

She came in at 9pm irritation written all over her face. ‘What did she do this time?’ I asked, assuming it was the lady who had recently been promoted to the top position in their human rights NGO office who seemed to have gone power-mad and was intent on taking all the joy out of my mama’s life. My mum shook her head and over dinner told me about her ordeal in Whittington Hospital. Basically, she had tried to call her GP for an appointment and had no luck (what else would you expect in a London GP?). After work, she went straight to the closest A&E (Whittington Hospital) rightly thinking that she should not wait until her GP had an appointment for her to get treatment for malaria. Rookie that she was, she got straight to the point when asked what the matter was. I think I have malaria, she said. Pandemonium broke out. She was ushered in ahead of everyone else into a side room to isolate her. She had blood drawn before she could say ‘what’s up?’ and they were admitting her to a ward. When she finally got someone to stop and talk to her, she was informed that she would be going to the ward shortly and they would need at least 2 more blood samples off her as per the malaria protocol and she was being isolated. I wasn’t there but I know the look of amazement that my mama would have had.

Long story short, she refused to be admitted. She told them under no circumstances was her daughter going to be left alone all night, never mind I was 16 and had stayed the night alone before, in fact more than 1 night in a flat alone in Lagos at the age of 15 which was a damn sight more dangerous than Muswell Hill in London. Anyway, the doctors were beside themselves and there was a lot of hand wringing because malaria in UK is kind of a big deal and there are strict protocols and the Health Protection Agency red tape to jump through. My mama was not to be persuaded. She said she would be off within the hour and either they give her oral medication to go home with or she would walk out without. Either way, she was going to her baby. After a lot of negotiation, they gave the oral medications and she came home to tell me the story. The deal was that she had to go back in for her second blood test before work and for them to make sure she hadn’t developed cerebral malaria and died on them. Mama and I rolled around laughing at all this hoo-hah over something as simple as malaria.

So obviously we are not entirely looney and we know malaria is potentially serious and in a few cases even fatal despite medication. Since you, my readers, are not all medics like me I will explain the things that the media and doctors in the UK it seems don’t appreciate at first glance. There are 4 strains of malaria and 1 of these strains is the bad boy of malaria. It is called Plasmodium falciparum or P. falciparum. The millions of deaths from malaria are mostly due to this strain of malaria but actually most malaria is of the other 3 strains and in Nigeria, most people will get at least one bout of malaria in their lives. As children, we all got malaria several times. I think I was one of the lucky ones who only got 3 bouts of malaria in my life and the last time I had malaria was when I was in primary school (coming up to 20 years ago). Actually a lot of the malaria burden is probably not even malaria because we are so used to malaria that anyone who has a fever longer than a day and that is high enough to make them want to lie down, self-diagnoses malaria and trundles off to the chemist to get antimalarials (we don’t need prescriptions per se).

Now back to P. falciparum. This bad boy is the strain that causes cerebral malaria i.e. it likes to infect the brain and so makes you delirious and causes seizures and can rapidly kill you because the fever is so high causing all your body enzymes not to work (so your bodily processes a.k.a. your metabolism stops) and the seizures can be very hard to control so starve your brain of oxygen, turning it into mush and in most cases, killing you unless you get IV (intravenous) antimalarials and fluids very early on.

I do not make light of this malaria at all. I worked in FMC Yola for 4 months and I saw more children die from it than I would like to recall. It is terrible. But let’s put it into perspective. The Centres for Disease Control and Prevention (commonly known as CDC) has the following stats. Nigeria is one of the countries where malaria is endemic and transmission is rife, everywhere in the country. In 2012, there were 207 million individual cases of malaria reported worldwide and of them 627,000 died. That makes it a death rate of 0.3% – which is not as high as pneumonia or diarrhoeal illnesses. And that includes P. falciparum and the other 3 strains of malaria.

Now here are my own stats. Of all the cases I know that have died of malaria, they are mostly children or very old or people with other illnesses making them too weak to fight off malaria like those with sickle cell disease. Usually, these patients would have had the fever for longer than a week and their bodies would have tried to fight for so long and then got to the stage they have nothing left to fight it with so that by the time they are admitted, they are wasted, dehydrated and their body salts are so abnormal that this is what gives them seizures and kills them. Even those with the bad boy strain are usually completely fine if they get treatment in a timely fashion. And this treatment is highly effective for majority of cases and is just as effective given orally as long as the person is not vomiting copiously (which sadly does happen with malaria).

So I am writing this not only to debunk the knee-jerk panicked reaction of UK-trained and UK-based doctors with no first-hand experience of malaria but also to educate. Some strains of malaria can be as bad as the common cold. Some can be as bad as avian flu which although it is a ‘cold’ virus is more dangerous and needs treating. All malaria infection should ideally be treated even if it is a mild infection. People like me who lived a long time in a malaria endemic area develop resistance so malaria for us is much less of a big deal generally than for a malaria-naïve person. Also those of us with the sickle cell trait have extra protection against malaria. But for you who are not so lucky, you should absolutely take antimalarials when you travel to endemic areas. You should absolutely have mosquito repellents and in addition, wear long sleeves (or as Nigerian girls do have a light scarf wrapped over your neck, shoulders and arms) to prevent the persistent mozzies from nibbling on your ‘fresh’ blood. If you are white or even just a fair brown person, be extra careful as mozzies are attracted to fairer softer skin too. I would also sleep under a mosquito net.

Take it from me because although I am fairly immune to malaria I think, I am one of those ‘special’ people that give off the pheromones that drive the mozzies wild. It doesn’t matter if there is only 1 mozzy that gets into the room of 20 people and they are all in bikinis or even bare-chested, I will be the one bitten through my scarf and long skirt. I will be the one walking around scratching the large lumps left behind by each mozzy that found me. I will be the one waiting impatiently for my near-abscesses to heal weeks after I have come back to Birmingham. Le sigh!

Unfortunately despite your best efforts, you may still catch malaria. So if you have recently been to sub-Saharan Africa (or the other endemic regions, see CDC for more information) and you develop a fever high enough to give you the shakes (rigours), run to the doctor. If your bones and joints all begin to ache and all you want to do is sleep in addition to a fever even if mild, I would get tested. And definitely pack an overnight bag if you develop a fever then start to puke up your guts and the vomit is green has such a bitter taste it makes you want to puke again despite having nothing left. That is the malaria vomit (bilious vomiting in medical speak) and you will be admitted and isolated and the whole she-bang if you do seek medical advice which you should. In fact, pack a bag that will last at least 3 days and make sure you have books/a laptop/cards/smartphone/sketchpad or whatever else you need to keep your sanity because being in isolation is no fun. Also be prepared to be pricked several times for blood cultures. But it is for your sake that all this is being done so don’t hate on my fellow doctors ok? Stay safe!