Medical Work in Nigeria
MISSION STATEMENT
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 Tom’s 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.
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