Medical Work in Nigeria
Tom is the head of the Family Medicine Department at the Jos University Teaching Hospital (JUTH), a 550-bed Nigerian government institution affiliated with the University of Jos. Family Medicine could be considered a specialty of common diseases. The threefold mission of the Department of Family Medicine is to perform each of these functions to the glory of God:
1) To promote academic excellence in the training of residents in the specialty of Family Medicine.
2) To provide compassionate, competent, and efficient front-line care to the public.
3) To conduct research relevant to common medical problems.
Tom multiplies his medical skills by training doctors in residency to tackle overwhelming health needs in a country afflicted by malnutrition, AIDS, and poverty. One in five children die before their fifth birthday of diseases like measles, diarrhea, pneumonia, and malaria. Doctors that Tom trains can address these medical challenges, and two have already joined him in training others. In the medical student curriculum, Tom is responsible to conduct courses on computers in medicine and on medical ethics. The ethics course gives medical students guidance in making moral choices in medical care.
Tom also has a heart for training Nigerian doctors in research. This training enables them to tackle relevant medical problems that are largely ignored by developed nations, but affect the health of millions in developing countries. Research is one element of Tomís expanding vision for establishing sustained development in Nigerian health. His research into the disease of rickets, a crippling affliction of the bones of children, has already contributed to better ways of treating the disease and will hopefully influence the care of affected children beyond the borders of Nigeria
The Family Medicine Department provides care for about 45,000 patients annually. The department also sends doctors to two rural health centers. Patient care encompasses both outpatient and hospital care, pediatrics, obstetrics, and surgery.
Tom is joined by 4 other Nigerian faculty in the Department of Family Medicine. Currently 25 residents are part of the training program. Tom also serves as an examiner for the Nigerian Postgraduate Medical College to conduct national level examinations for doctors in Family Medicine. Though he currently lectures to medical students under the Department of Medicine, Tom hopes to establish a Family Medicine curriculum for medical students. Tom also heads the Research and Continuing Medical Education Unit of the teaching hospital. The purpose of this unit is to conduct operational research and organize training programs for health care personnel.
Nutritional rickets remains prevalent among children in many developing countries. Characterized by inadequate calcification of growing bones, rickets causes considerable childhood disability . Bone deformities, like bowlegs and knock knees, result in impaired mobility, bone pain, and fractures. Children with rickets are often weak and inactive, and weakness combined with rib cage deformity predisposes affected young children to pneumonia. In a community survey of 220 children ages six months to three years in Jos, Nigeria, we noted leg deformities characteristic of rickets in 18 (8.3%).
Insufficient dietary calcium intake, rather than vitamin D deficiency, appears to be the cause of rickets among Nigerian children. The average intake of calcium among Nigerian children is 200 mg per day, far below the U.S. recommended daily allowance for children of 800 mg. We have also found that children with rickets who received calcium had more rapid healing than children who received vitamin D alone.
Rickets should be preventable in communities through increasing dietary calcium intakes in the at-risk age groups. However, the problem is how to achieve this using locally available sources of calcium, which will not only increase the dietary calcium content, but will also be culturally acceptable and affordable to most families. Thus, we are currently studying which Nigerian foods would be most suitable to include in diets of young children to improve calcium intakes. We are assessing whether rickets can be prevented at a community level by increasing the intake of calcium-rich foods.
Voice of America Interview
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