mansag january 2018 nwokolo taught us about the emerging use of anti-retroviral medication...

TABLE OF

CONTENTS

a brief summary of MANSAG's year so far

FROM THE

PRESIDENT'S DESK03

MANSAGISSUE NO. 24 | FEBRUARY 2018

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Impact of Brexit on Healthcare Professionals in Diaspora

recap of event on the 27th Jan 2017

MANSAG NEXT

GENERATION EVENT06

an interview with actress Roseline Sanni-Ajose

HAVING IT ALL AND

STICKING IT TO THE

MAN

08

what you missed at the OctoberConference

MANSAG

CONFERENCE: THE

HIGHLIGHTS

11

thought-provoking discussion at aMANSAG conference session

STORIES BURIED

WITHIN NIGERIAN

POLIT ICS

14

EDITOR'S

LETTER

David Nunn's summary of his work in a resource poor setting

REDUCING DEATHS

FROM CERVICAL

CANCER IN NEPAL

18

Welcome to a new year and to a new edition of the MANSAG newsletter!

This edition celebrates our highs of the past year - including our amazingly successful conference in Lincoln in October 2017 as well as celebrating the achievements of our members!

We also have some exciting events to entice you with this year...

MANSAG Next Generation has held a successful drinks and networking night on Saturday 27th January 2018 in London, so look forward to more Next Generation networking events to come! And of course we have our annual Educational Symposium and Spring Charity Ball to look forward to in the coming months!

So sit back, keep reading and enjoy!

Dr. Linda Onyeocha Editor-in-Chief, MANSAG

P A G E 2 | M A N S A G

review of Dame Anionwu's autpbiography

BOOK REVIEW: MIXED

BLESSINGS16

Douglas Okor and colleaguesshake up neurosurgical services

TOGETHER WE ARE

RECALIBRATING

NEUROSURGICAL

SERVICES IN NIGERIA

23

a trainee's experience of the mentoring session at the October conference

MENTORING20

Jonathan Makanjuola perfects his endourosurgical skills in Sri Lanka

ENDOUROLOGY

FELLOWSHIP IN SRI

LANKA

21

Andrew Alalade gives hisexperience of winning this award

BLACK BRIT ISH

AWARD WINNER 2017 25

report of MANSAG/NIDSGtraining mission to Jos

PSYCHIATRIC TRAUMA

TRAINING MISS ION27

FROM THE

PRESIDENT'S

DESK

Dear Members and Friends of MANSAG,

Welcome to the first edition of the Newsletter for 2018, I hope you are well settled into the year and have developed a strategy for coping with whatever the year throws up.

While we were beginning to feel comfortable with the pace of the new year, we were rudely aroused from our somnolent state by the High Court ruling regarding our colleague, Dr Hadiza Bawa-Garba following the tragic death of a 6-year-old boy in 2011 and the subsequent erasure of her name from the medical register; a decision that has elicited a spontaneous and impressive outpouring of widespread national professional revulsion and condemnation of the GMC.

The death of a child engenders inconsolable grief for the parents, their friends and family; we extend our heartfelt sympathies to them. We are, however, profoundly concerned at the scapegoating of an individual hardworking, conscientious doctor with an unblemished career prior to the incident, for systemic failures in an


underfunded and understaffed NHS Trust. MANSAG had been in touch with and supporting Dr. Bawa-Garba since late 2015 and continues to do so in every possible way. We contacted her recently and she gave us an indication, going forward, as to how best we can continue to support her, which will be communicated to members and friends of MANSAG shortly. Dr. Bawa- Garba’s case brings into sharp focus, the general feeling in the profession that the GMC’s organs have become anti-doctor, and that there is an urgent need for systemic failures in the NHS to be addressed rather than scapegoating of individual doctors, of any race, nationality or creed for these failures. We will be raising these concerns at the next GMC’s BME Forum meeting.

On a different note, when this Executive Committee assumed office on 24 October 2015, its prime objective was to increase the membership and in particular, infuse new blood into the organisation. We have relentlessly pursued this objective through various activities initiated by the young people, the latest of which was the MANSAG Next Generation Event in London on 27th January 2018. These events have succeeded in attracting new blood into the organisation which bodes well for its future.

In keeping with the remit of our Overseas Development Committee, MANSAG, in collaboration with the Nigerian Internally Displaced Persons Diaspora Support Group (NIDSG), sent a 4-person Psychiatric Trauma Counselling Training Mission to Jos, Nigeria from 20 – 23


THIS IS A CALL FOR NOMINATION OF

CANDIDATES FOR THE MANSAG 2018

ELECTION .

THOUGH THE ELECTIONS WILL TAKE PLACE IN

APRIL 2018 , THE NEWLY ELECTED OFFICERS

WILL COMMENCE THEIR ROLES IN LATE

OCTOBER 2018 .

EACH CANDIDATE MUST BE NOMINATED BY AT

LEAST ONE PAID UP MEMBER IN GOOD STANDING .

EACH CANDIDATE SHOULD ALSO SUBMIT A

STATEMENT OR MANIFESTO (MAXIMUM 200

WORDS ) . PLEASE SEND BOTH BY EMAIL TO

DRSGIMBA@GMAIL .COM

THE CLOSING DATE FOR SUBMISSIONS IS 1 1TH

MARCH 2018 (23 .59 HOURS ) .

CALL FOR

NOMINATIONS

1. President

2. Secretary

3. Treasurer

4. Financial Secretary

5. Publicity and Fund Raising Secretary

6. Welfare and Social Secretary

7. Trainees' Representative

8. All ied Health Professionals (AHP)

Representative

November 2017. I wish to thank the mission team comprising of Drs Wale Lagundoye, Zainab Imam, Femi Adebajo and Chukwuma Geoffrey for stepping forward and taking time out to undertake the counseling training workshop. Reports confirm that this was a successful and worthwhile venture.

I wish to thank Mr. Ibrahim Bolaji and the Lincolnshire LOC for organising the 2017 Lincolnshire Annual Scientific Meeting and AGM in October 2017. It was a well attended and coordinated event that ensured participation of the various constituencies of healthcare professionals. We were delighted to host the presidents of our

sister diaspora organisations (ANPA, CANPAD, NMA-Germany, NNCAUK), NMA. The Acting Registrar of the Medical and Dental Council of Nigeria (MDCN), the representative of the Minister of Health and the President of the Pharmaceutical Society of Nigeria. More details of this event are described in the pages of the Newsletter.

Finally, 2018 is an election year and I would encourage all, especially the young people, to engage in the process and stand for election to the various posts. The future of MANSAG rests squarely on your shoulders!

Babatunde A. Gbolade MANSAG President


[email protected]

IF YOU WOULD LIKE TO CELEBRATE YOURACHIEVEMENTS, THOSE OF OTHERS, ORSHARE YOUR NEWS, THEN SEND YOUR

ENTRIES TO:

MANSAG NEXTGENERATION EVENT

DR MIKE EHIMA

In keeping with the organisation’s desire topromote networking, collaboration andmentorship between junior consultants, traineedoctors, allied health professional and medicalstudents, the planning committee, ably led byDr Yinka Gbolahan, were heartened to see somany people of differing levels of seniority intheir respective professions interacting.

From the “flying doctor” doing internationalpatient transfers to a doctor who runs a healthstart-up in Nigeria and a Consultant who alsoruns an event management company, it was ahugely diverse crowd, showcasing theincreasing trend of health professionals seekingnon-traditional routes of progression andexcelling in extra-curricular activities. Fittingly,Dr. Abeyna Jones of Medic Footprints was alsoin attendance and shared her personalexperiences of the challenges and successes ofbeing a doctor and an entrepreneur.

Those in attendance also heard short speechesfrom a variety of people including MANSAGPresident, Mr. Babatunde Gbolade and FinancialSecretary, Dr. Chris Agbo who shared stories ofthe significant contributions that the MANSAGfamily made towards their early journeys andprofessional successes, highlighting the benefitsof being part of the organisation. Dr. Baba Inusagave an insight into the tremendous work he

On the evening of 27th January 2018, MANSAGNew Generation held its 2nd annual networkingevent in a beautiful location in London and it wasan extremely well-attended event with the addedbonus of an open bar, fantastic food and evenbetter company and conversations.

has been doing in Nigeria and how he has taken people of different levels of experience – from medical students to experienced GPs – out to Nigeria to get involved. If you would like more information about how to get involved, please contact the MANSAG magazine editor.

It may sometimes feel like one is charting their own path through Medicine and the healthcare profession and it can often feel like a lonely journey, but MANSAG’s desire to draw the so- called “new generation” closer into the network was evident from the interaction and business- card exchanges.

At a time when healthcare is facing significant challenges in retaining its workforce, maintaining their morale, the ripples of the judgment against Dr. Hadiza Bawa-Garba are being felt across the profession. Suffice it to say that there is power in unity, there is power in numbers and we can all, individually and collectively, achieve more with greater collaboration.

Whatever path you have chosen to follow, it is unlikely you are the first to have ever done it and the wealth of experience and expertise that lies within the MANSAG body means there is always somebody to give advice about the pitfalls to avoid.

The MANSAG executive committee has supported their words with action and are offering a one-time 50% reduction in the annual membership fees for trainees, allied health professionals, and medical students. For only £25, you get access to a host of benefits that MANSAG provides but more importantly, you are becoming part of a family who is determined to support you to be the best you can be. Visit http://www.mansag.org/subscription-plan/ to join and I hope to see and get to know many more of you at future MANSAG events.


HAVING IT ALL AND STICKING IT

TO THE MAN

LINDA ONYEOCHA ANDLAURA ONYEOCHA

Q. You have had quite a varied careeralready; what made you want to go intonursing? A. Nursing is all I've wanted to do since I wasa child. When I was a little child I used tostay with my mum’s sister during theholidays, who worked with the police as anurse in their hospital. I worked with hersometimes; she would make me do all thelittle tasks. So the idea of looking afterpeople really hit me then; [I decided] thatyes, this is what I want to do when I grewup.

Q. And do you still practice as a theatrenurse? A.I still do work; at the moment I work as arecovery and anaesthetic nurse.

Roseline Sanni-Ajose is not only aninternational award-winning actress andproducer, she is also a theatre nurse,wife and mother of two. In an interviewwith MANSAG about her upcomingmovie ‘After the Rain’ she discusseschasing passions, having it all andchallenging gender inequality in theNollywood entertainment industry.

Q. You do charity work, you’re a wife, a theatre nurse, and an actress. How do you manage your time and juggle so many responsibilities? A. It's all about planning ahead and managing your time well and family support as well. It's quite challenging, but thank God, I have a very supportive family. My husband is very supportive. He takes time off work to help me with the children. Without my family, it wouldn’t be possible at all!

Q. Did you get your first role through acting school? A. No, I had been doing the odd role from London-based movie producers in London


before I finally committed to acting. I believe that professionals have to know at least a little about [acting], so I did a six month crash course called ‘From Script to Screen’ at City Academy. Then I started producing and acting in my own and other people’s films as well.

Q. : How challenging it was for you to enter the entertainment industry? Do you have any advice for aspiring actors? A. : I'll start with the advice. As a young woman, I was encouraged into my first role in 2005. Being a pretty young girl, light skinned, everybody loved what they saw. I found it challenging when men came on to me, saying they wanted to date me. So from 2005 I just told everybody no, I wouldn’t act until I was fully ready. So to the younger ones: men will always come at you with the very forceful [claims of], “I’ve got money…You have beauty… I can make you become this and that” – all of that is lies! Please, when you meet men, don't offer them your body. Offer them your brain or your skills...When you tell them you're not interested in their money, that you're interested in them showing you how to make the money then they begin to see brain and skills coming into place. They'll drop the “I want to date you” business. So that's always my advice to the younger ones who want to come into the industry.

Q. : What other challenges did you face

when you started off in the entertainment industry? A. A [challenge] was the domineering attitudes of male producers who think, “What does she know? Is it because she’s beautiful she thinks she can take over our industry?” It’s not about that. It's about you following your dreams about you following your passion. This is what I want to do but in our industry, they can tell you blatantly to your face, “What do you know? You don't know anything so stop producing and just act. You were made to be in the kitchen.” Well, hello it’s not about that; I’m following my dream!

Q. At the MANSAG conference we watched your new movie In a Strange Land. What was your inspiration? A. Strange Land is a true story about a young lady trafficked from Nigeria and England. A woman had seen my first project, Labo: My Life Is a Journey and then decided that because I was a female producer I would believe her story. We met and she narrated her story to me; we decided to make it into a motion picture to raise awareness and alert people that these things are still happening, so how do we stop it? Since I have made the movie a lot has been coming up about slavery including the recent atrocity in Libya that nobody knew anything about until recently. What they are doing to our people is so bad. So I'm really very satisfied with the idea that the production of this film can save people's lives.


Q. And all proceeds from the movie are going to help those affected in Libya? A. Yeah, yeah!

Q. Are you like the characters you play? How would you describe yourself? A. What I’m like in the movie and my personal life is totally like miles apart. I’m an easygoing person, an understandable person I love humanity and I love to give. And I keep praying God will provide big money for me, like Bill Gates or Dangote so I can help people.

Q. Do you have any new projects you want to tell us about? A. I actually have a movie coming out mid- next year called “After the Rain”. [It] basically helps the voiceless retired people in Nigeria whose pensions have been hijacked, leaving them dying of common sicknesses...because somebody is sitting on their pensions. The story focuses on a young lady whose father is dying of kidney disease and needs dialysis. In search of a way to secure treatment for her father, she encounters something that she didn't plan for.

Q. When is it out? Where is it being shown? A. Hopefully, the film will air on Nigerian TV next summer and be released on DVD for UK circulation.

Q. What are some of the main challenges you have when producing a project? A. Money? You have to write tons of proposals to companies, corporate people and individuals. Some of them never get back to

you. Some of them respond and they want to have a meeting in a hotel; you get there and they'd tell you something else, you know? In some situations when I was in Nigeria, they tell you to your face, “Well, if you need my money, you can give me...” I don’t want to mention the words.

Q. Are you involved in charity work? A. I've always wanted to have my own charity. I became the media ambassador for a children’s charity. We go to Nigeria two to three times a year and operate open-heart surgery on children who need it. There is another children’s charity called AFROCAU, who protect vulnerable children who have been trafficked from Nigeria, Ghana, or other parts of Africa to the UK and help them to adapt to a normal life. I was also an ambassador for the Serbian- Nigerian Chamber of Commerce because I'm a nurse. We go every Saturday to offer free blood sugar, blood pressure and HIV tests.

Q. Is there anything else that you want to tell our readers? A. If you have a good passion and you believe in your dream, keep chasing it. Even though it's tough, even though it’s hard, keep chasing it and a one day you'll get a breakthrough.

In a Strange Land premieres on Friday, 2nd February 2018 at Silverbird Cinema, Ikeja, Lagos, Nigeria. The DVD is set for release in the UK later this year.

P A G E 2 3 | M A N S A G P A G E 1 0 | M A N S A G

28TH ANNUAL MANSAG CONFERENCE:THE HIGHLIGHTS

DR LINDA ONYEOCHA

This action-packed weekend started offwith leisurely activities for members to joinin and discover Lincoln, including a round ofgolf, a trip to Lincoln University, as well as atasty reception and a brainstorming sessionto get the brain going.

We were then treated with a screening ofRoseline Sanni-Ajose’s “In a Strange Land” –a tragic tale of domestic abuse of a housegirl trafficked into London. Roseline, an

MANSAG held its 28th Annual Conference inLincoln on 27th-29th October 2017. If youmissed out, then you missed out! But not tofear, I have written a handy recap of whathappened over this amazing weekend. We alsohave some articles from and about some of ouramazing speakers throughout the day, as wellmany pictures for you to vicariously live theevent through.

international award-winning actress and movie producer held a short Q&A session after the screening and has given MANSAG an exclusive interview about her upcoming film premiere and new ventures on page 8.

Breakfast on Day Two gave all a chance to reconnect with old friends and to meet new faces. We opened with national anthems as well as an opening address from MANSAG President Mr. Tunde Gbolade and from the Lincoln LOC Chairman, Mr. Ibrahim Bolaji.

Our first session of the conference was given by Dr. TAB Sanusi called “Stories Buried in Nigerian Politics”. See page 14 for a thoughtful summary of the discussion from Dr. Maurice Sanomi, the sessional chair.

Session Two was given by Alhaji Yakasai, President of the Pharmaceutical Society of

P A G E 2 3 | M A N S A G P A G E 1 1 | M A N S A G

Nigeria, on “The Use and Abuse of Pharmaceuticals”. This detailed talk describing the manifestation of Nigeria’s poor pharmaceutical infrastructure by its symptom, the abuse of medication, was deepened by commentary from Mrs. Gloria Morenike Ojo and Mrs. Ajibola Gbadebo.

The “Impact of Brexit on Healthcare Professionals in Diaspora” was then discussed in Session Three by Professor Dilly Anumba and the nursing perspective (both opportunities and threats!) given by Ms. Felicia Kwaku.

We were then treated with a series of 4 oral presentations from creative innovators, freethinkers and future leaders from within MANSAG. Femi Ogunremi told us about an innovative handheld device that can detect small breast tumours called AreaDoc and BREASTi by Monitor Healthcare Ltd. Dr. Nneka Nwokolo taught us about the emerging use of anti-retroviral medication prophylactically to reduce the risk of acquiring HIV and her department’s work in proving its efficacy. Dr. Bola Odufuwa gave a riveting talk on the importance of screening for and treating glaucoma in Africans early along with a very visual representation of the brain’s way of masking early field defects. Dr. Kehinde Gbolade, our very own MANSAG President’s daughter, showcased her new note-taking application SERMAUREI, based on her personal experience with litigation as a dentist and her strive for perfect clinical record taking!

Professor Dame Elizabeth Anionwu then talked to us about her amazing life and career journey, a review of her book Mixed Blessings of a Cambridge Union can be read on page 16. Prof Frank Chinegwundoh MBE gave a talk on prostate cancer awareness in Nigeria including the extensive challenge of providing effective and timely treatment with only one functioning radiotherapy suite available in Nigeria in a private hospital. There are many obstacles to overcome! Mr. David Nunns then gave a talk on his strategies for improving screening and early detection of cervical cancer in a low resource economy in Nepal, see page 16 for a summary of his work. Professor Rose Anorlu also talked about her experiences with increasing cervical cancer screening and awareness in Nigeria.

We then had breakout sessions where Professor Angie Doshani talked about her life and experiences as a mentor, and our MANSAG trainee Yinka Gbolahan has written personal reflections of this talk on page 20. Mr. Brian Pearson then gave a talk on NHS Pensions with handy hints and tips on pension taxation.

After a short break, all dressed up and put their dancing shoes on for the Gala Reception for an evening of great food and even greater company! Pictures on page 13. I’m sure everyone who was able to make it along to Lincoln had an excellent weekend, and to those who only made it in spirit, make sure you don’t miss out next year!

P A G E 1 2 | M A N S A G

STORIES BURIED INNIGERIAN POLITICS

DR MAURICE SANOMI

I was charged with the responsibility ofchairing this session at the conference. This session generated a lot of debate, as ittouched on the issue of medical practice andmissions to Nigeria and why the MDCNseems not to be facilitating this process forthose who are willing to sacrifice their owntime and resources to give back to theNigerian state. One would naturally assumethat charitable acts, such as medicalmissions, will be encouraged and warmly

This is what you missed at the 28th MANSAGConference October 2017... The topic was “Stories Buried in NigerianPolitics: Medical and Dental Council of Nigeriaand Nigerian Doctors and Dentists in Diaspora,Quo Vadis?” The Speaker was Dr. TAB Sanusi, ActingRegistrar, Medical and Dental Council ofNigeria (MDCN).

embraced by the Nigerian state and its agents and officers; however, the experience of some of those who have tried to give back to communities back home through these missions have not always been that of encouragement or of a welcome with open arms.

The question, Quo Vadis? Is a Latin phrase meaning “where are you going”? This appears to be a very pertinent question in the circumstances, giving that often, our individual and collective efforts to give back to our communities back home have been met with nothing but frustration.

Where are we in diaspora going with the Medical and Dental Council of Nigeria? Quo Vadis? We can ask ourselves this question repeatedly and we are sure to get varied answers each time. Our experience often


depends on our individual circumstances, which part of the country we visit, who we know at the other end and what ‘season’ we visit. Can the MDCN be seen by Doctors and Dentists in the diaspora as collaborators in helping to facilitate our passage through the minefield of returning to Medical Practice in Nigeria, or are they, in fact, the mine layers?

Returning to full-time medical practice in Nigeria, judging by the experiences of some of those who have made the leap, can be very frustrating, with a lot of unknowns; having to pay the backlog of registration fees was raised as one of these issues. We asked Dr. Sanusi why one had to pay the backlog of registration fees for the years they have been absent from the country before they can re- register with the council; his response drew some laughter “we should actually make you all sit an examination first, so for us to say just pay registration fees backlog only shows we have been very benevolent”. He was right, other nations may have asked for prospective returnees to sit an examination or take a refresher course before re-joining their Medical Register.

The Acting Registrar, Dr. Sanusi, also raised a few other valid points; he addressed the issue of medical personnel wrongly assuming they do not have to register or contact the MDCN before they can practice or operate as medical personnel within the Nigerian state. In order words, they are flouting the laws and rules of the country which requires Medical Practitioners to be registered and licensed by the MDCN before they can practice, legally, within the Nigerian state. Such regulations, as obtains in other settings, should be considered before anyone embarks on a

medical mission or return to medical practice in Nigeria. Drawing a parallel with what happens in the UK, he noted that no doctor can practice legally, anywhere in the UK, without a license from the General Medical Council; so why do we think that we can just drop into Nigeria and practice medicine without registration with the equivalent regulatory body?

The MDCN is the regulatory body charged with maintaining standards of medical practice, on a national level in Nigeria, so its role must be taken seriously and respected. Medical missions usually bring in equipment and drugs to support the struggling medical sector; however, there is the suspicion, and sometimes outright accusation, that some missions bring in substandard equipment and expired or near expired drugs. There may be some truth to this, however, well organised and coordinated missions most often come prepared with modern equipment and drugs to alleviate the suffering of our people in Nigeria.

He also talked about the safety of the personnel visiting during such missions; if the MDCN is informed well in advance of any mission, they can liaise with their state contacts to provide the necessary assistance to those visiting which may then improve the issue of safety and overall success of the mission. Overall, this was a very useful session in helping to understand our relationship with our regulatory body back in Nigeria for those who harbour the ambition of one day returning to medical practice in Nigeria, or those considering medical missions to Nigeria. Quo Vadis?


THE ADVENTUROUS LIFE OF DAME ELIZABETH ANIONWU

DR LINDA ONYEOCHA

Dame Anionwu describes discovering heridentity, having been born of mixed Irishand Nigerian descent, to an unmarriedmother in a society where this was just notdone - and finally reconnecting with herfather and being welcomed into her Nigerianhome. If you thought her talk wasinspirational, then you should read herbook, Mixed Blessings from a CambridgeUnion (available on Amazon). I highlyrecommend this book, especially to trainees

It was a pleasure to hear Professor DameElizabeth Anionwu DBE CBE FRCN FQNI PhD atMANSAG’s October Conference 2017 talk usthrough her journey as a young girl growing upin a Catholic Convent to becoming an award-winning health visitor who not only workedtirelessly to establish the first Sickle CellCentre in London but also worked tocommemorate the forgotten nurse, MarySeacole.

at the start of the career and to those at a crossroad on their career paths. This book offers excitement, inspiration and a new understanding of the word passion!

As a young GP trainee, at the beginning of my journey, I feel extremely fortunate that there are countless possibilities and opportunities open to me, and I often find myself questioning where I should focus my efforts next. Mixed Blessings has inspired me, and given me three key ideas to take with me to work and to use to guide my future steps. These are (1) Passion, (2) Adventure and (3) Determination.

(1) Passion Dame Anionwu decided at a very early age that she wanted to be nurse, based on a great encounter with a friendly nurse who treated her eczema as a child. She focused


on her interests in all aspects of her career, from the joy she received from talking to patients on the ward, to caring for patients in their homes, to appreciating the impact of Sickle Cell services all over the world. At every stage she followed heart and so enjoyed a very varied career, from being a midwife in the UK and in France, to being a health visitor exploring and understanding the under-recognised Sickle Cell Disease and its impact on the families of those who suffer with it before going onto complete her PhD, lecture on the subject and help to set up services worldwide

This is a valuable lesson for all of us thinking about our next move -listen, actively engage with the human stories around us, and as we find ourselves becoming fascinated in a subject then delve deeper and fully investigate that passion!

(2) Adventure Another significant theme in this book is a sense of adventure. Who decides to cycle cross-country without the security of Google Maps and ends up spending a night in a stranger’s home or hitch-hikes across Europe multiple times and always manages to talk themselves out of trouble, or moves to France to become an au-pair because they like the language? Dame Anionwu definitely has a sense of adventure!

And that sense of adventure spurred her on to continue taking the next steps in her career and to challenge herself in new ways. That’s definitely a take-home message for us –be brave, challenge yourself and take the next step! . (3) Determination The hard work that Anionwu has put in in every step of her journey is impressive, and that’s a step that cannot be missed. From


her overcoming her disadvantages in early life with the sheer will and determination of both her and her mother, to persevering and achieving despite setbacks. Dame Anionwu describes her amazing personality in her book, as well as resilience, an Igbo mindset towards work and a level of energy and determination that has led her to a successful and impactful career.

These are just a few of the lessons that I picked up from reading Mixed Blessings from a Cambridge Union. Explore what you love, stay engaged, be brave, get involved and put 100% into everything you do. And if you haven’t already, I strongly suggest picking up this book, and prepare for an injection of motivation!

REDUCING DEATHS FROM CERVICALCANCER IN NEPAL – A PARALLEL

WITH NIGERIA?

DAVID NUNNS, CONSULTANT GYNAECOLOGICALONCOLOGIST, NOTTINGHAM

The natural progress of the disease, fromthe precancerous stage to the developmentof cancer typically takes 10 – 15 years, thusmaking detection and treatment ofprecancerous cells possible, saving manylives. Globally, cervical cancer is responsiblefor more than 270,000 deaths annually and85% of these occur in developing countries.The disease is largely preventable.

What is the need in Nepal? Nepal, like many other low incomecountries, is seeing a transition in causes of

Infection of the cervix with a virus called theHuman Papilloma Virus (HPV) is common, andthis can lead to precancerous changes in asmall number of women. Around 20% of thesewomen with high-grade precancerous changewill progress to cancer of the cervix. Sadly, formany women in low resource settings, cervicalcancer is advanced at presentation and oftenleads to premature death.

morbidity and mortality from infectious diseases and maternal deaths to non- communicable diseases (NCDs). Currently, over 60% of deaths in Nepal are attributable to NCDs, of which cancer is an important part. Despite cervical cancer being the most common female cancer in women aged 15-44 in Nepal, and the leading cause of cancer death in Nepal, currently less than 2% of women are screened. An absence of a screening programme results in a high number of deaths from the disease.

Current Context Visual Inspection with Acetic Acid +/- Lugol’s Iodine (VIA +/- VILI) is the recommended screening method which screeners are being trained to use. Regarding treatment of identified precancerous lesions, in the absence of histopathology facilities as in Nepal, a single visit approach (“see and treat”) is suggested, with cryotherapy (freezing) or thermocoagu-


lation (heating) the cervix as a first line treatment. PHASE Worldwide through their partners in Nepal, the Nepal Network for Cancer Treatment and Research (NNCTR) and the clinical community have piloted and implemented thermocoagulation in a number of screening camps between 2015 and 2017. The treatment has an excellent safety record and acceptability by both clinicians and patients. When staff is trained in the use of the treatment we have shown that they can sustain knowledge and skills in its use.

Partnerships are important With our partner organisation in the UK (PHASE Worldwide) we have been working with the Nepal Network for Cancer Treatment and Research (NNCTR) on cervical cancer prevention in Nepal for almost 10 years. This is a screening NGO in Nepal. We have carried out:

1. training Nepali health professionals in screening and early treatment of cervical cancer and pre-cancerous lesions

2. hands-on workshops in the hospital

3. exchange visits with UK hospitals with nurse training

4. screening camps (approx. 1000 a camp)

5. training for pathologists and biomedical scientists

6. quality assurance – ensuring the right patients are being treated

PHASE Worldwide and NNCTR recently completed a two-year project, funded by the Tropical Health and Education Trust (who are funded by DFID), which improved screening for cervical cancer in Nepal. There are fully operational colposcopy clinics in the hospitals in Nepal thanks to this programme of work. PHASE has also built a reputation for improving cervical cancer screening in Nepal and have a relationship with key clinical, implementation and government stakeholders.

As part of the next stage of this work, a population-based screening approach, PHASE Worldwide have developed a project working more closely with PHASE Nepal, our long-standing partner.

References •http://www.hpvcentre.net/statistics/reports/ NPL_FS.pdf •https://phaseworldwide.org/publications/nati onal-guideline-cervical-cancer-screening- prevention-nepal/ • Single Visit Approach for Cervical Screening Prevention using a Mobile Clinic Service. Singh M et al. Journal of the Institute of Medicine, April 2016 38(1)11-14.


Mentoring Parallel Session: What you missed at the 28th MANSAG Conference October 2017.

The mentoring talk was given by the vibrant Obstetrics and Gynaecology Consultant Ms. Angie Doshani from University of Leicester NHS Trust. The talk was very well attended by both mentors and mentees and Ms. Doshani did a fantastic job of holding the audience’s interest.

She started off with a brief introduction to her journey and how the mentors in her l ife have shaped her career as well as l ife outside of work. She briefly touched on some theory with the skil led-helper model and emphasised how important it is to be very self-aware when embarking on taking up a mentoring role.

The talk was also speckled with some inspirational quotes from the mentors in her l ife such as ‘if you cannot figure out your purpose, figure out your passion for your passion will lead you to your purpose" and my personal favourite, “If you light a lamp for someone else it would also provide light unto your path’.

Her talk left us energised and encouraged to take up mentoring roles and gave good tips how to do this effectively. We hope that in the not too distant future we can see the fruits of her talk in a formal MANSAG organised mentoring scheme for trainees and even new consultants!


A MENTORING SESSION

DR YINKA GBOLAHAN

ENDOUROLOGY FELLOWSHIP IN SRILANKA, DECEMBER 2017

JONATHAN MAKANJUOLA BSC (HONS), FRCS(UROL) CONSULTANT UROLOGICAL SURGEON

I was approaching the end of my trainingand this fellowship appealed a great deal. Ichose to visit urological units in Sri Lanka,as in my final rotation at King’s CollegeHospital; they had a proud tradition ofhosting senior Sri Lankan trainees over thepast 15 years. I aimed to develop mytechnique in percutaneous nephrolithotomy(PCNL) for the surgical treatment of stonedisease. I understood the operativetechnique and had performed cases as a

The World Congress of Endourology (WCE)was held in London in 2015 and was supportedby the British Association of UrologicalSurgeons (BAUS). There was a BAUS emailafter this meeting to announce that newfellowships were to be established. The aim ofthese fellowships was to allow the exchange ofendourology skills and knowledge worldwide byUK trainees learning in overseas centres.

trainee but needed the volume of cases offered in south-east Asia, with the very high incidence of stone disease. I chose to divide my fellowship between Kandy Teaching Hospital, and the Colombo South (Kalubowila) Teaching Hospital.

I traveled to the capital Colombo on Friday 6th October 2017 and made the three-hour journey by car to Kandy to undertake the first part of my fellowship. Kandy is the second largest city in Sri Lanka and the capital of the Central Province of Sri Lanka. The hospital has over 2,200 beds, 78 wards, 10 intensive care units (ICUs) and 24 operating theatres.

On my first day I was met by my trainer, Mr. Manjula Hearth, a consultant urologist whom I have known for over seven years. In my first week, I was involved in six PCNLs.


I had highlighted my training needs with the local trainers and in the first few cases I observed the technique of Consultant Urologist Mr. Kanchana Edrisinghe, who has performed over 1000 PCNLs. Buy the end of the month I performed over 40 PCNLs. The final part of the fellowship was spending time with Professor Srinath Chandrasekera at the Colombo South Teaching Hospital (Kalubowila) in the capital city Colombo. Prof. Chandrasekera had organised a fantastic teaching programme for me. He had arranged parallel theatre lists with PCNL cases. It was an intense day but with the guidance of Prof Chandrasekera and his team I was well supervised and guided though six cases in total. The cases selected were variable in level of difficulty but it was good for me to operate on more challenging cases such as a complete staghorn stone and stone in a calyceal diverticulum. It was a brilliant experience and one that I will never forget!

The fellowship experience was truly amazing! I am fortunate to have been selected as one of the first BAUS/WCE endourology fellows. I have achieved all of my objectives, such as gaining competency in performing PCNLs. I have met some wonderful people during my time in Sri Lanka and made some lifelong friends. In total during my six weeks in Sri Lanka

I performed over 50 PCNLs, 10 open nephrectomies/pyloplasties, five laparoscopic procedures and one complex vesico-vaginal (VVF) repair. These numbers for PCNL would be one of the highest in the UK with regard to volume in a year by a single surgeon, and this was achieved in six weeks. As I reflect on the overall experience, I feel that if possible all trainees should leave the UK for period of training before starting consultant jobs. It has given me more confidence in my ability, a break from the stress and stains of the NHS and the ability to test oneself in a different environment. This fellowship comes highly recommended to all trainees and new consultants who want to consolidate their operative numbers in PCNL and have a truly amazing life experience.


TOGETHER WE ARE RECALIBRATINGNEUROSURGICAL SERVICES IN NIGERIA

DOUGLAS EMEKA OKOR MBBS, MRCSED, FRCSED NEURO.SURG CONSULTANT NEUROSURGEON, BRAIN AND SPINE SURGERY CONSORTIUM, ABUJA

Spine Fixed in Abuja (SFIA) was a specialpurpose vehicle for promotion and advocacyon the capacity to delivery complex spinalservices in Abuja specifically and Nigeriagenerally. In a metamorphosis driven by anidentified need, the Brain and Spine Surgery(BASS) Consortium, which now incorporatesSFIA was born early in 2017 to address themainstream issues of collaboration andpartnerships in providing additionalcomplex, high-end Neurosurgical services inNigeria.

BASS has continued to provide complexspinal services with very goodoutcomes. Interestingly in the last one year,since the solidification of bettercollaborations, the simple descriptive

“Complacency is the recipe for stagnation -continuous positive metamorphosis andshifting the goal-post is the hallmark ofexcellence” (Douglas Emeka Okor, 2017)

statistics has shown that there has been a significant surge in the number of complex Brain surgery cases performed in Abuja by Team BASS. Not only have the numbers of cases done increased, the outcomes have also significantly improved. The reason for this is not farfetched. We have decided to do things differently to get better results.

The first thing we changed at Team BASS was to increase the collaboration level. Since we understand that the delivery of complex neurosurgery care requires the pulling together of individuals, groups and organisations who share the drive to deliver quality healthcare backed by set safety standards, we decided to forge partnerships that will promote excellence in brain and spine care for Nigerians. The Brain and Spine Surgery Consortium in 2017 has therefore gone into a firm partnership with Zitadel Medicals and Diagnostics Ltd. Zitadel has provided rock solid hardware that enables the delivery of complex brain and


spine surgery care while BASS provides the specialist capacity. Zitadel has 3 facilities in different states/cities in Nigeria. These are in Abuja, Port Harcourt and Uyo. The Abuja and Port Harcourt branches have both diagnostic and operating theatre capacities while the Uyo branch just has diagnostic capacity.

The Part 3, Section 24 of the Nigerian National Health Act states that; The Federal Ministry of Health, State Ministry of Health, Local Health authorities, Private healthcare providers must disseminate and display information at facility level about services they provide. This is something BASS encourages every healthcare organisation, especially the “real private health sector players” who are doing a great job, blazing the trail when it comes to delivering complex tertiary/specialist care and helping to reverse medical tourism. This is really important as recent figures suggest that Nigeria lost up to 2.8 billion dollars to medical tourism in 2016. BASS is has therefore in the quest to recalibrate the Nigerian health care terrain engaged with using every available media to empower and provide Nigerians with information about their health – especially about medical conditions that affect the Brain, spine, spinal cord and nerves.

Further more, the BASS team sends representatives to Nigerian Medical Association state chapter conferences, other specialist scientific conferences, media agencies (Radio and TV) to advocate and promote the new realities that a good chunk (more than 80%), of complex brain and spine surgeries are done safely with very good outcomes in Nigeria. Complex brain surgeries done in the last one year by the BASS team in collaboration with Zitadel

and Wellington Neurosurgery Centre include; microscopic and endoscopic transphenoidal resection of pituitary tumours, craniotomy for resection of complex brain tumours and clipping of brain aneurysms.

Team BASS is deeply passionate about delivering quality service with patient safety as the foundation of all we do and so are the partners we work with. We share the common goal of changing the Nigerian healthcare narrative, especially in neurosurgery. The real life stories below will bring closer home, the recent strides that have been taken in recalibrating neurosurgical services in Nigeria.

1. An 86 year-old lady with a story of lower back and lower limb pains that spanned almost 20 years. A year prior to her presenting to BASS, her symptoms progressively worsened to the point where she had significant difficulty standing and walking. An MRI scan of her lower spine showed significant arthritic wear and tear with compression of the nerves to her lower limbs, bladder and bowel. To put it simply, her quality of life was virtually non-existent. She underwent a complex spinal procedure to decompress these nerves plus instrumented fixation of the spine. She was mobilizing and out of hospital 10 days after this operation.

The road may be long and fraught with challenges and we understand we cannot do it alone. However, there is no stopping us at Team BASS and our partners who are deeply passionate about delivering quality service with patient safety as the foundation of all we do because... #TheNigerianPatientsAreWorthIt!


THE BLACK BRITISH BUSINESSAWARDS 2017

ANDREW F. ALALADE FRCS (SN) – NEUROSURGEON, NHS & MANSAG PRO

Other categories included – Arts and Media,Professional Services, Consumer andLuxury, Financial Services andEntrepreneurship. The founders of theBBBAs (Melanie Eusebe and SophieChandauka), set it up with the aim tocelebrate trail-brazing members and risingstars of the black British businesscommunity. Some of the intended objectivesinclude transcending stereotypes,promoting social mobility and inspiringconfidence in the strength of the ethnicminority talent pipeline across differentsectors in the United Kingdom.

The nominees were all invited forinterviews/judging day in Central London on

Sometime in May 2017, I received a surpriseemail from the organisers of The Black BritishBusiness Awards (BBBA) notifying me that Ihad been nominated for one of the awardcategories i.e. the STEM (Science TechnologyEngineering Mathematics) category.

the 6th of July, 2017 where we were grilled by a set of stern-looking panellists (well, I think one of them did smile a little bit….). It was reminiscent of a job interview where a candidate got asked tough questions regarding one’s CV, achievements and the reasons for the nomination. I was particularly impressed by the other nominees, as we gathered to chat in the tea room before getting called in. It was refreshing to see so many black professionals with wonderful achievements. I left the venue feeling a sense of pride for the ethnic minority groups in the United Kingdom.

I had first heard of The Black British Business Awards sometime in 2015 after I spoke at a Charitable Trust event organised for youths in South London. I went there to mentor kids interested in STEM and gave a talk about my career so far, as well as the challenges I faced during my time as a neurosurgery trainee while progressing


through the formal run-through programme. The feedback was great, and I did not think too much of it again until RA emailed me shortly to tell me my name had been sent in to the BBBAs. R.A. had been one of the people in the audience on the day. Among other things, the panellists asked me about this specific episode in 2015 too.

They were also interested in my other mentoring activities, my subspecialty fellowships, leadership roles in surgical societies, the work I had done in improving brain tumour referrals within the Essex network and the book chapters I authored in 2 popular surgical texts. I made sure I told them about MANSAG too. One could tell they were seasoned experts as they left no stones unturned. It felt like something out of the “final interviews of Sir Alan Sugar’s The Apprentice”.

Well, I survived the interviews and left. Life resumed as normal until I found out sometime in September that I was among the finalists featured in The Daily Telegraph. In total, there were 36 finalists selected across the different sectors. Other finalists in the STEM category were Olutayo Arikawe (Pharmacist – YPG Project), Derrick Dunkley (National Grid) and Paul Morrison (Hewlett Packard Enterprise).

The Awards Luncheon on the 19th October was a big event and the sponsors included several bigwig companies like Bloomberg, Barclays, JP Morgan, Cisco, Thomson Reuters etc. The compere for the day was the funny Chizzy Akudolu (TV watchers will remember her as “Mo Effanga” on Holby City), and she did an impressive job of keeping the audience entertained throughout.

As the finalists were kept waiting in a lounge just before the main event, I took the opportunity to chat with others. Andrew Ramroop OBE (Maurice Sedwell on Savile Row) did amuse me with his witty and intelligent remarks. He was named the Black British business person of the year, and he kept the audience spell-bound when he narrated the story of how he was initially turned down by several tailoring houses in London after he graduated from the London College of Fashion. Some of the other people I got to chat with were Femi Oguns MBE (actor & popular drama agent for some of Britain’s popular stars e.g. John Boyega), Sandra Federighi (Global CFO Stella McCartney), Adrian Grant (Executive Director of Michael Jackson’s Thriller Live) and Lenique Louis (Award-winning jewellery designer). You could bet I felt like a kid in a sweet shop!

At the ceremony, Sajid Javid, the Secretary of State for Communities & Local Government gave a speech on the importance of focusing on the contribution being made by the black community in the UK, while also highlighting that there is still so much to do. The awards were announced, and I suspect I did have a bout of atrial flutter when it was time for the STEM category. Anyway, it resolved spontaneously soon after as I heard my name being called – “Andrew Alalade, NHS Neurosurgeon – Winner Senior STEM category”. It did seem like I was in a bit of a daze as I trudged past the chairs and tables to receive the award. I must have a shed a tear or two too, while giving my acceptance speech. Thankfully, my wife was there to make sure I didn’t make a mess of myself.!


MANSAG/NIDSG PSYCHIATRIC TRAUMACOUNSELLING TRAINING

MISSION TO JOS, NIGERIA

DR. WALE LAGUNDOYE, MBBS, FRCPSYCH, CONSULTANT IN ADDICTION PSYCHIATRY

The Medical Association of Nigerians AcrossGreat Britain (MANSAG), in collaborationwith the Nigerian IDP Diaspora SupportGroup (NIDSG ) having identified thechallenges around access to themanagement of associated mental healthdifficulties when they arise in thispopulation, sent a 4 person Mission team toNigeria to undertake Psychiatric traumaCounselling Training in Jos, Plateau statefrom 20th -23rd Nov 2017 .

The United Nations Council for Refugeesestimates that forced displacement frominternal conflicts in Nigeria has resulted inover 1.7 million internally displaced people(IDP). Majority of this IDP is situated inrefugee camps often sited outside major cities particularly in the states in Northern Nigeria.The health needs of internally displaced persons are provided by a number of differentorganisations, emotional and mental health difficulties are common within thispopulation.

The Mission team comprising of Dr. Wale Lagundoye (Course coordinator and mission lead), Dr. Zainab Imam, Dr. Femi Adebajo, Dr. Geoffrey Ijomah (Consultant Psychiatrists) working in conjunction with Dr. Mwanmut Chair of the local stakeholders' group and specialist psychiatrist Dr. Chris Piwuna. Strategic and local logistics were provided by Mr. Kevin Obi, Chair NIDGS, Dr. Chris Agbo, MANSAG Overseas Development Subcommittee Chairman, The United Nations Population Fund, UNFPA courtesy of the country head, who provided transportation and security logistics including sending two observers who actively participated in engaging participants and local stakeholders in making the mission a success.

The training workshop was designed to increase the capacity of local counsellors to recognise, work with and provide basic psychological interventions to internally displaced persons suffering from providing



Dr Maurice Sanomi "Stories Buried Within Nigerian Politics" Page 14

psychological trauma from their experiences following attacks by Boko Haram insurgents resulting in their displacement. It aimed to provide a practical culturally appropriate training package that built on the existing skills of the participants.

Initial reports indicate that the program was a successful and worthwhile endeavour, the team was well received by the host community. We provided training for 50 participants from a range of professional backgrounds including three representatives of IDP’S who had experience of the trauma’s associated with these conflicts (their account of this experience and the extraordinary courage of this individuals remains seared in our memories and I am grateful for their input). The team and participants visited a transition camp run by the Stefanos Foundation, which was useful in providing further insight into the ongoing plight associated with displacement and the challenges ahead. At the end of the program, participants were given certificates of participation. We have developed a register of the participants and are scheduled to initiate a What’s App group

to maintain a network of frontline professionals. We have started to evaluate the data collected from this pilot exercise and hope to publish our findings later in the year. We have submitted an abstract outlining the initial finding from this initiative to a conference on Transcultural Psychiatry, The Royal College of Psychiatry, scheduled for later this year as a means of sharing learning that could be of benefit for future similar training programs.

On behalf of the members of the mission team, I would like to acknowledge the support of Dr. Chris Agbo Chairman MANSAG Overseas Development Subcommittee, MANSAG president, Mr. Gbolade, and Secretary Prof Rotimi Jaiyesimi, Mr. Kevin Obi Chair NIDSG, Dr. Diene Keita- Country representative UNFPA. Dr. Mwanmut, all the participants and local stakeholders without whom the program would not have been possible for their support and contributions.

I am grateful for the opportunity granted me to serve MANSAG, NIDSG and our motherland Nigeria.

THE CONTRIBUTORS:

Dr Mike Ehima "MANSAG Next Generation Event" Page 6

Barr Laura Onyeocha "Having it all and Sticking it to the Man" Page 8

Thank you for reading this edition of MANSAG. We love celebrating the achievements of our members as well as connecting and inspiring like-minded individuals. If you would like to publish an article, send your entry to [email protected]. We are also looking for an extra member to join our team, if you would like to get involved with producing the next edition of MANSAG, then contact me on [email protected]. Dr Linda Onyeocha Editor-in-chief, MANSAG

MANSAG'S EXECUTIVE COMMITTEE

MANSAG PRESIDENT Mr Babatunde A. Gbolade Consultant Gynaecologist / Director of Fertility Control Unit

MANSAG SECRETARY Professor Rotimi A. K. Jaiyesimi Associate Medical Director for Patient Safety & Consultant Obstetrician & Gynaecologist

MANSAG TREASURER Dr Nwakuru Nwaogwugwu GP – Clinical Lead for Southwark Nursing Homes / Darzi Fellow

MANSAG FINANCIAL SECRETARY Dr Chris Agbo Consultant Nephrologist

MANSAG SOCIAL & WELFARE SECRETARY Dr Dorothy C. Apakama Consultant in Emergency Medicine

MANSAG TRAINEES’ REPRESENTATIVE Dr Yinka Gbolahan Urology Registrar

MANSAG ALLIED HEALTH PROFESSIONS REPRESENTATIVE Mrs Olivia Rufai Clinical Specialist Sonographer

MANSAG PUBLICITY AND FUNDRAISING SECRETARY Mr Andrew F. Alalade Neurosurgeon

The Sub-Committees below support the Executive Committee: Professional and Judicial Advisory Education Subcommittee Publicity, Membership, and Fund-raising Overseas Development


Mr David Nunns "Reducing Deaths from Cervical Cancer in Nepal -a parallel with Nigeria" Page 13

Dr Yinka Gbolahan "A Mentoring Session" Page 20

Mr Jonathan Makanjuola "Endourology Fellowship in Sri Lanka' Page 21

Mr Douglas Okor "Together we are Recalibrating Neurological Services in Nigeria" Page 23

Mr Andrew Alalade "Black British Award Winner 2017" Page 25

Dr Wale Lagundoye "Psychiatric Training Mission to Jos for MANSAG Executives" Page 27

mansag january 2018 nwokolo taught us about the emerging use of anti-retroviral medication...

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