The Novartis Foundation launches Healthy Schools for Healthy Communities with the University of Basel and other partners

PRESS RELEASE

The DASH study provided evidence that improvements in children’s nutrition and physical activity not only contributes to their cognitive performance in school, but can also contribute to a reduction of hypertension, heart disease, and overall cardiovascular risk factors
BASEL, Switzerland, October 11, 2017/ — The Novartis Foundation (www.NovartisFoundation.org) and the University of Basel (http://APO.af/QvHtDX), together with other partners are pleased to announce the launch of Healthy Schools for Healthy Communities. The initiative aims to address poor health in disadvantaged schools in South Africa and is the first Novartis Foundation program to include the education sector, bringing new opportunities for achieving impact.

Following the successful first stage of the Disease, Activity and Schoolchildren’s Health (DASH) research project, coordinated by the University of Basel in Port Elizabeth, South Africa, this second phase builds on learnings to further develop and scale successful interventions to more schools in the country, and potentially across other geographies in the future.

The goal of Healthy Schools for Healthy Communities (known locally as ‘KaziBantu’) is to improve the overall and cardiovascular health of schoolchildren and their teachers. Its focus will be on promoting health literacy, ensuring a formalized physical exercise program, providing access to medical examinations including anti-helminthic treatment, monitoring cardiovascular risk factors and providing nutritional supplementation where necessary.

In 2014, a partnership between the University of Basel (http://APO.af/QvHtDX), the Nelson Mandela University [1] (www.Mandela.ac.za) and the Swiss Tropical and Public Health Institute (http://APO.af/DGkMqD) created the DASH project to identify the causes and address the impact of poor health on children in schools from disadvantaged neighborhoods in Port Elizabeth.

The program investigated the health and wellbeing of children in eight schools, with a particular focus on the link between physical activity, infectious diseases and risk factors for cardiovascular and metabolic disease. This study was the first of its kind for African children and discovered that one-third of all examined schoolchildren had high blood pressure, while 16-21% were overweight or obese. [2]

The DASH study provided evidence that improvements in children’s nutrition and physical activity not only contributes to their cognitive performance in school, but can also contribute to a reduction of hypertension, heart disease, and overall cardiovascular risk factors. Physical activity was also found to correlate with health-related quality of life. To date, little to no comprehensive interventions have been examined to address cardiovascular health among students and teachers in low-income school settings. The aim of this expansion phase from DASH to Healthy Schools for Healthy Communities is therefore to generate the evidence that simple interventions can improve cardiovascular health.

“At the Novartis Foundation, we realize that the complex nature of cardiovascular diseases makes achieving impact, scale and sustainability extremely difficult. No single actor can tackle hypertension alone and to address hypertension and its complications, multisector and multidisciplinary action is needed. That is why we are excited for Healthy Schools for Healthy Communities to enter this new phase, and to work to further develop the initiative with our partners,” said Ann Aerts, Head of the Novartis Foundation.

In collaboration with many partners, the Novartis Foundation is working to address hypertension around the world – from pilot models to approaches that aim to achieve impact at scale from the start.

Launched this year, Better Hearts Better Cities convenes networks of multisector partners to contribute expertise and resources to solutions that improve cardiovascular health at scale in cities.

The other hypertension programs supported by the Novartis Foundation – Communities for Healthy Hearts in Vietnam and the Community-based Hypertension Improvement Project (ComHIP) in Ghana – aim to bring hypertension detection and management closer to local communities by maximizing hypertension screening and awareness opportunities.

As its first program to include the education sector, Healthy Schools for Healthy Communities marks an important next step in the Novartis Foundation’s multisector approach to addressing hypertension. As with all our programs, learnings from Healthy Schools for Healthy Communities will inform other hypertension initiatives as part of an ongoing process of evaluation and adaptation.

The Novartis Foundation’s partners for this initiative include the University of Basel, the Government of South Africa, the Nelson Mandela University, and the Swiss Tropical and Public Health Institute (Swiss TPH).

Hedwig Kaiser, former Vice President for Education at the University of Basel, notes that “KaziBantu or Healthy Schools for Healthy Communities offers an opportunity to continue the successful work we have already started, continue to make improvements and, through collaboration, impact the lives of many more children in South Africa.”

“To address rising rates of obesity and poor heart health, we all need to work together and start early. Through KaziBantu, if we can build health literacy and foster better health in our children from a young age, then we can look toward healthier generations in the future,” stated Professor Lungile Pepeta, the Dean in the Faculty of Health Sciences at the Nelson Mandela University.

Peter Steinmann from Swiss TPH said, “Our research during the DASH program found that a third of children were hypertensive. This is a staggering number when you consider these are children in primary school. We’re pleased to be part of the continuation of this project and hope it will be able to positively impact the lives of many more children in the future.”

Source : APO

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New Gates Foundation Report Against Global Poverty and Disease

Bill and Melinda Gates Call for Strong Leadership to Address “Solvable Human Misery”

The Bill & Melinda Gates Foundation, on September 13 2017, launched an inaugural annual report showcasing the remarkable progress that has been made in reducing extreme poverty and disease in recent decades, but issuing a stern warning to the world that future progress is in jeopardy.

Goalkeepers : The Stories Behind the Data, co-authored and edited by Bill and Melinda Gates and produced in partnership with the Institute for Health Metrics and Evaluation at the University of Washington, highlights past progress against some of the most devastating issues facing poor countries and uses breakthrough data projections to forecast good and bad future scenarios – with millions of lives hanging in the balance.

In all, the report tracks 18 data points from the UN Sustainable Development Goals, or Global Goals, including child and maternal deaths, stunting, access to contraceptives, HIV, malaria, extreme poverty, financial inclusion and sanitation. The report looks beneath the numbers to pinpoint the leaders, approaches and innovations that made a difference.

Through the data and first-person accounts from six contributors, the report showcases the stunning progress the world has made in the past generation: cutting extreme poverty and child deaths in half and reducing HIV deaths and maternal deaths by nearly half, among many other accomplishments. But as the report shows, serious challenges remain – including deep disparities between countries – and future progress is not inevitable.

The projections are showcased in charts and explore three potential 2030 scenarios for each indicator. The first is what could happen if we continue along the current path, based on past trends – without significant changes to approaches or current spending levels. Two additional scenarios provide a glimpse at a better and worse future: what could happen with strong leadership, innovation and investment and, starkly, what could happen if attention and funding waned. For example, a mere 10 percent cut in global donor funding for HIV treatment could result in more than 5 million more deaths by 2030.

In their introduction, Bill and Melinda Gates express concern that shifting priorities, instability and potential budget cuts could lead the world to turn away from its commitments, jeopardizing the positive trajectory needed to end extreme poverty and wipe out diseases by 2030.

“This report comes at a time when there is more doubt than usual about the world’s commitment to development,” Bill and Melinda Gates state in the report. “Take it from the point of view of justice, or take it from the point of view of creating a secure and stable world: development deserves our attention.”

Bill and Melinda Gates will produce the Goalkeepers report every year through 2030, timed for the annual gathering of world leaders in New York City for the UN General Assembly. In 2015, world leaders committed to the Global Goals, which are focused on ending extreme poverty and fighting inequalities. The Goalkeepers report focuses on a subset of the indicators in the Global Goals and is designed to highlight best practices and help hold the Gates Foundation, its partners and leaders around the world accountable. It will document not just what is working, but where the world is falling short.

The report includes first-person accounts from leaders whose innovations and policies have already made a difference – from tackling stunting in Peru to increasing uptake of modern contraceptives in Senegal to bringing more women in India into the formal financial sector.

It is clear from the report that decisions the world collectively makes in the next couple of years will have a significant impact on the futures of millions, if not billions, of people. Leadership, Bill and Melinda Gates argue, will make the difference in which path the world takes:

“Poverty and disease in poor countries are the clearest examples we know of solvable human misery. It is a fact that this misery is solvable and we have it within our power to decide how much of it actually gets solved. Let’s be ambitious. Let’s lead.”

In conjunction with the report, the Gates Foundation will be hosting two Goalkeepers Events in New York City around the UN General Assembly. Former President Barack Obama, Her Majesty Queen Rania Al Abdullah of Jordan, UN Deputy Secretary-General Amina J. Mohammed, Malala Yousafzai, Richard Curtis, screenwriter, producer and film director, and Stephen Fry, actor, writer and presenter will join events on Sept. 19 and 20. Participants will celebrate progress toward eliminating disease, inequality and poverty around the world, and inspire a new generation of advocates to work towards sustainable development. On the evening of Sept.19 the Goalkeepers Global Goals Awards dinner will honor outstanding activists and groups who have demonstrated a positive impact on people’s lives and are inspiring others to accelerate progress and leave no one behind. The Gates Foundation will livestream the Sept.19 and 20 Goalkeepers events.

About the Bill & Melinda Gates Foundation
Guided by the belief that every life has equal value, the Bill & Melinda Gates Foundation works to help all people lead healthy, productive lives. In developing countries, it focuses on improving people’s health and giving them the chance to lift themselves out of hunger and extreme poverty. In the United States, it seeks to ensure that all people—especially those with the fewest resources—have access to the opportunities they need to succeed in school and life. Based in Seattle, Washington, the foundation is led by CEO Sue Desmond-Hellmann and Co-chair William H. Gates Sr., under the direction of Bill and Melinda Gates and Warren Buffett.

About Goalkeepers
Goalkeepers is the foundation’s first annual report and global event dedicated to accelerating progress towards the Sustainable Development Goals (or Global Goals). By sharing stories and data behind the Goals, we hope to inspire a new generation of leaders – Goalkeepers who raise awareness of progress, hold their leaders accountable and drive action to achieve the Goals.

About the Global Goals
On September 25th 2015, at the United Nations Headquarters in New York, 193 world leaders committed to the 17 Sustainable Development Goals (or Global Goals). These are a series of ambitious targets to achieve three extraordinary things in the next 15 years: end extreme poverty; fight inequality and injustice; and fix climate change.

Source : Bill and Melinda Gates Foundation

Congo-Kinshasa: New Study Reveals Economic Toll of Malnutrition in Democratic Republic of Congo

The Cost of Hunger in Africa (COHA) study was undertaken by the government of DRC in collaboration with the United Nations World Food Programme (WFP), the African Union Commission (AUC), the New Partnership for Africa’s Development (NEPAD), and the UN Economic Commission for Latin America and the Caribbean (ECLAC).

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The study shows that the losses are incurred each year through increased healthcare costs, additional burdens to the education system and reduced workforce productivity.

“I welcome this important joint initiative which will contribute significantly to the government’s efforts to minimize the loss of human and economic potential to malnutrition,” said DRC Prime Minister and Head of Government Bruno Tshibala Nzenzhe, at the launch ceremony in Kinshasa. “Malnutrition is a silent emergency, accounting for nearly half of all infant deaths. For the country to develop, we need to address this situation urgently.”

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According to the report, DRC could save up to CDF355 billion (around US$383. million) by 2025 if the prevalence of underweight children is reduced from 11 to 5 percent and if stunting (low growth for age) is reduced from 43 to 10 percent.

“These results call on all of us to act now to avoid future losses caused by hunger,” said WFP Country Director in DRC, Claude Jibidar. “I’m convinced that with the understanding we now have of the terrible economic and social impact of malnutrition on children, we and our partners can work with the government to make a real difference to this alarming situation.”

“In line with Agenda 2063 – ‘The Africa we want’ – we seek to completely eliminate hunger and food insecurity on this continent during coming decades,” said Kefilwe Moalosi, speaking on behalf of the African Union Commission and NEPAD. “Africa has the potential to reap a demographic dividend from a young, educated and skilled workforce. But this potential can only be harnessed if we continue to invest in the health and nutrition of its people, particularly its women and children, and secure the necessary economic growth”.

The Cost of Hunger in Africa study has so far been conducted in 11 countries. The economies of these countries suffer an estimated annual loss associated with child undernutrition that is equivalent to between 1.9 percent and 16.5 percent of GDP. Results of recently undertaken COHA studies are due to be released soon in Mozambique and Zimbabwe. Similar studies are being planned for Mali and Mauritania.

Source : United Nations  World Food Programme

National Allied Health Professionals Condemn the Commercialization of Health Facilities in Nigeria

The National Union Of Allied Health Professionals(NUAHP) has again condemned the  commercialization of the nation’s  health sector, which it described as a disservice to Nigerians.

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The union made this position known recently, in a communique it issued and signed by the union’s National President and  General Secretary, Dr. O.C Ogbonna and O.A Obisesan  respectively at the end of its  National  Executive Council Meeting in Jos, Plateau state.

 

” The Union once again condemns in strong terms the commercialization of Public health facilities in the name of Public Private Partnership (PPP) concept to a profit making venture to the detriment of patients/clients which has led to untold hardship on Nigerians. We therefore demand that the original concept of PPP which was meant to make quality healthcare available, accessible and affordable be reverted to, so that all Nigerians anytime can access quality health care services in the government owned hospitals. The union say No to privatization and commercialization”.

The communique maintained that the union was still contending with a number of challenges, stating ”The Union noted with dismay, the discriminatory act of the Federal Ministry of Health (FMOH) in actualizing the central placements of House Officers while neglecting Interns of other Health Professions. The Union therefore demand that the FMOH should immediately include interns of the other Health Professions in the proposed central placement scheme for equity, fairness, justice and to avoid marginalization of other Health Professionals”.

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”The Union expresses serious concerns and frown at the unnecessary delay of appropriate agencies which includes FMOH, Office of the Secretary to the Federal Government (SGF), Salaries Incomes and wages Commission (NSIWC) in coming up with the approved adjusted CONHESS Salary Scale. The Union hereby demands the immediate release of the scale and implementation effective from Jan, 2014. If this is not done on or before August, 31st, 2017. The Union may be forced against her wish to declare industrial strike to press home her demands”.

The Union observes the consistent high level of attrition of Health professionals due to retirement, death, or relocation to greener pastures without replacement. This has brought acute shortage of man power and heavy work load on Health Professionals. In the same vein, the Union frowns at the illegality of employing locum/volunteer workers rather than the employment of permanent staff”, the communique concluded

 

 

 

 

 

 

 

 

South Sudan: Botched Vaccine Campaign Kills 15 Children in South Sudan

At total of 15 children have died in South Sudan after being given contaminated measles vaccines. Health officials said that the vaccines had been improperly refrigerated and were also administered by an untrained team.

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The UN has appealed for more funding to help nearly two million people who have fled South Sudan. A World Food Programme (WFP) official called their suffering “unimaginable.” (15.05.2017)

A new study has found that cases of the highly contagious disease have jumped significantly in the past year. Adults are poorly informed about their own vulnerability, the report found. (24.04.2017)

Children in rural South Sudan died as a result of a bungled vaccination campaign to combat measles, the United Nations and South Sudan’s government announced on Friday.

South Sudanese Health Minister Riek Gai Kok expressed “deep regret and sadness” at the deaths of the 15 children, who lived in the rural, south-eastern village of Kapoeta.

An investigation into the deaths supported by the World Health Organization (WHO) and the UN children’s fund UNICEF found that the children died as a result of “the administration of a contaminated vaccine.”

Around 300 children up to 5-years-old were treated during the four-day campaign which saw the local team using a single reconstitution syringe to mix multiple vaccine vials. The UNICEF-supplied vaccines were also kept in a building with inadequate refrigeration.

Another 32 children suffered from fever, vomiting, and diarrhea, but were able to recover from their symptoms, a joint statement from the WHO and UNICEF said.

Children administering vaccines

Although local teams had been trained by development partners and the WHO, the investigation showed that local officials failed to follow immunization guidelines.

“We have to look into why the training was not passed on to the teams on the ground,” said WHO spokesman Tarik Jasarevic in Geneva.

South Sudanese Health Minister Kok also noted that the team that administered the vaccines was not well-trained.

“The team that vaccinated the children in this tragic event were neither qualified nor trained for the immunization campaign,” Kok told a news conference.

The untrained team also recruited two children aged 13 and 12-years-old to administer the vaccines, the health minister added.

The risk of measles remains high in South Sudan due to an ongoing military conflict that has killed tens of thousands and seen almost 2 million people flee the country. According to the UN, the country has suffered from measles outbreaks caused by a backlog of unvaccinated children.

Source : DW

We Have Taken Measures To Curb The Spread of Meningitis-Delta Govt.

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The Delta state Government has declared that it has taken measures to curb the spread of meningitis in the state, even as it insisted that there has been only one recorded case of the disease.

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This declaration was made in Lagos on Wednesday, by the state Commissioner for Health, Dr. Nicholas Azinge.

“Delta state is safe from meningitis. We have measures in place to combat it. We are ready medically.

“We may have to address the state to clear the air on the reported case soon. The ministry of information will see to that,’’.

“There is no outbreak of meningitis in Delta state. To refer to a case as an outbreak, you must have witnessed five cases out of 100,000 cases among the population.

“It is true we have few cases reported, but only one was confirmed and unconfirmed maybe two people.

“Meningitis is not like Lassa fever that spreads easily. If we have a reported case of one victim, then that is not an outbreak, we need to have at least five cases”, Dr. Azinge declared.

Meningitis Kills 21 In Sokoto, As Health Workers Contend With Witchcraft Beliefs Among Populace

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The total number of deaths recorded as a result of the outbreak of Cerebrospinal meningitis epidemic in Sokoto state is now 21.

This disclosure was made early in the week,  by the  State Commissioner for Health, Balarabe Kakale.

Kakale, listed the Local Governments affected by the epidemic to include, Kebbe, Bodinga, Rabah, Wamakko, Gada, Dange/Shuni and Tureta.

He stated that the belief in witchcraft was making the fight against meningitis difficult, while lamenting that  families were refusing to bring suspected cases to the hospital attributing the illness to witchcraft.

He said that the state government had,  set up, organized 15 medical teams made up of over 150 medical personnel.

According to the Commissioner, the  teams were strategically positioned across the 23 local government areas of the state and were fully equipped with ambulances and provided with free drugs and medicament.

  He also disclosed that emergency response teams had also been deployed by the state government that went around conducting house-to-house search, definition and management, at home and hospitals. No fewer than 330 mixed cases of severe malaria and meningitis had been treated across the seven most affected local governments.

He further disclosed  that out of the 330 cases, 40 were confirmed in the laboratories to be cases of meningitis, out of which 14 deaths were recorded and these deaths excluded the 7 earlier recorded in parts of Gada local government.

He  noted that thousands of other cases were treated at primary health centres in the local governments. He also added that there were some cases from Koko in Kebbi state which worsened the epidemic.

The Commissioner reiterated that it was quite saddening that the people of the state attributed the disease to witchcraft as suspected cases with obvious symptoms of the disease like vomiting, high fever, headache and stiffness of the neck were not brought to the health facilities.

He  advised people of the state to disregard rumours of witchcraft and take all suspected cases of the disease to hospitals on time, warning, that keeping suspected affected persons at home will only make the disease worse and cause transmission to other members of the family.

“Residents should reduce the number of persons that take care of confirmed meningitis patients, avoid sleeping in overcrowded rooms and also ensure personal and environmental hygiene”, Kakale concluded.

Cases of Suicide Attempts On The Increase In Nigeria-Consultant Psychiatrist

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A Consultant Psychiatrist has said that over 10 per cent of referral cases at the Lagos University Teaching Hospital(LUTH),Lagos, Nigeria were suicide attempts.

According to Dr. Yewande Oshodi, who made this declaration at a programme organized by the hospital to campaign against suicide,the increasing rate of suicide in the country, could be attributed to the stigma associated with mental health .

”The stigma of psychotics and mental health makes it difficult for people to come out when they are going through issues”, Dr. Oshodi said.

She maintained that over a five-year study period, 7.2 per cent of the cases referred to psychiatry consultation-liaison services in LUTH were suicide related cases, while noting that  reports had shown that during lifetime, about 3.0 per cent of Nigerians have had thoughts of ending their lives, 1.0 per cent will plan on how to kill themselves, while just under 1.0 per cent will carry out the actual attempt.

Dr Oshodi also disclosed that suicide was the most unfortunate incident anyone could like to experience or lose a loved one to.

Africa: Get Rich or Die Trying – the Chinese Multinational Scamming Millions From Ugandans

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Thousands of people in Uganda have signed up to a company believing it will cure all their illnesses and help them make a fortune. It is more likely to do the opposite.

This article is republished here to coincide with the new documentary Uganda’s Health Pyramid, aided by African Arguments, into the company TIENS in Uganda. The film, made by Banyak, will be available on AlJazeera from 1st February 2017. The article below was originally published on Think Africa Press (now defunct) in 2014. As the documentary shows, not much has changed.

On the corner of a bumpy, red-soil road in the rural town of Iganga in eastern Uganda, there lies a small store. A handful of people mill around the entrance in the glaring sun, waiting their turn to enter. They are the main source of activity on this placid street, but their patient presence barely betrays the hubbub within.

Inside, almost a dozen people sit crammed on makeshift benches around two edges of the stifling room. Most of the remaining space is taken up by a shop counter, behind which are shelves piled high with vibrantly-coloured health products covered in Chinese characters.

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A couple of customers compete with a baby wailing as they read out lists of products to the shop attendants who pick them off the shelves. Every now and then, the door in the corner opens. Someone steps out, usually holding a piece of paper, and the person sitting closest steps in.

Beyond that doorway is an even smaller room, windowless and illuminated by a single light. As I peer in, three people are undergoing diagnostic tests, a woman is standing on a machine that hums loudly as it vibrates, and a few more patients are waiting slumped along the wall.

Wasswa Zziwa Edrisa – or “Doctor Wasswa” as he is known here – stands in the centre wearing a fresh, chequered shirt on his back and an unwavering grin on his face. With the easy charm of a seasoned salesman and the swaggering self-assurance of Uganda’s national bird and symbol, the crested crane, Wasswa welcomes me in.

“I will show you how we help so many people,” he says, beaming. “Let me show you the machines.”

“This is one of the scanners,” he explains, pointing to a piece of kit that looks a bit like a 1970s radio. “It shows everything. We can see if you have diabetes, kidney deficiencies, liver problems, eye problems. Everything.”

Wasswa explains that the test works using a traditional Chinese understanding of the body whereby different points of the hand relate to different internal organs. We watch as an attendant prods a patient’s left palm with a metal tip, making a little meter light up. When the light goes green, he explains, it means that part of the body is fine, but if it goes orange it indicates a problem.

Next Wasswa points me to the corner where a woman is standing on a small machine and holding onto a pair of handlebars to which she is harnessed. Her whole body blurs in the dim light as the platform beneath her vibrates rapidly, its droning buzz filling the room.

Similar machines can be found in many gyms these days and are meant to help tone muscle, but the uses Wasswa presents are quite different.

“This is a blood circulation massager,” he announces. “You see how she sweats. It opens the vessels and deals with paralysis. It helps people with stroke.”

Wasswa then shows me another diagnostics machine, this one connected to a laptop. As the patient holds on to an appliance plugged into the computer, pictures of different organs flash up on the screen for a few seconds each as a dial next to it oscillates erratically. After a minute, a one-page document pops up, listing how well his organs are functioning.

In the airless room, Wasswa runs through a few more devices – a face pain remover, a blood pressure reducer, a necklace that removes radiation – before squeezing past bodies and chairs to get back to the first patient we met. By now his diagnostic test is complete. He tells me that he came to the store because of some mild pain around his mouth, but Wasswa breaks the news that there are more serious things about which he ought to be concerned.

“Ah, he has a problem with his spleen,” says Wasswa, nodding knowingly. “At times, he gets constipation and some swelling in the legs and arms. There is also some paralysis in the legs. He gets headaches. At times he feels dizziness. His brain arteries need to be detoxified. He has kidney deficiencies. He has bad chest pain. He has high cholesterol. He has poor circulation. And he has problems with his stomach.”

The roster of the young and healthy-looking patient’s conditions seems extreme, but Wasswa is not perturbed.

“He needs to improve his circulation by using our machines and he will need to take our products. If he uses them, he will be fine,” he reassures.

Back in the light and noise of the waiting-room-cum-pharmacy, Wasswa shows me some of these products. He picks goods off the shelves, ranging from capsules to toothpastes to body creams, and stacks them on the counter as he explains what they each do. “This takes away all the radiation in your body. This helps with diabetes. This treats ulcers. This is for slimming. This adds more white blood cells to your system. This is for people who are mentally disturbed,” he says.

“These medicines are good for everything,” he concludes finally, the pile of products on the counter now complete. “If you have cancer, we can help. If you have HIV, we can help. Even if you have a hernia or a tumour or appendicitis, you just take our products and they will disappear.”

This small store in eastern Uganda employs a handful of staff and, according to Wasswa, receives dozens of patients each day. Wasswa is also frequently heard on local radio advertising his services and has made quite a name for himself in the area. He was previously a school teacher and says his parents were “peasants”, but now, in his 30s, he is anything but. These days, Wasswa drives a shiny four-wheel drive, wears sharp suits and even goes on jet-setting trips around the world. All this makes him quite the exception in Iganga, but across Uganda, this young ‘doctor’ is by no means a solo pioneer and his store is by no means unique.

Similar stores can found all across the country, from Kasese in the west to Soroti in the east, and from Gulu in the north to Entebbe in the south. There are four such outlets in Kampala alone. These stores offer the same diagnostic tests, stock the same range of products, and above all their doors, there hangs the same innocuous green and orange sign which reads: “TIENS: Together We Share Health And Wealth.”

TIENS – also known as Tianshi – is a multinational company based 10,000 miles away in the Chinese metropolis of Tianjin. It was founded in 1995 by Li Jinyuan, who has since become a billionaire from the venture. The company has established branches in 110 countries including 16 in Africa, employs over 10,000 staff globally, and reportedly enjoys net profits worth hundreds of millions of dollars each year.

TIENS first began tapping into the Ugandan market in 2003 and it has grown steadily ever since. There are now around 30 stores across the country, TIENS distributors regularly engage in outreach programmes to rural communities, and according to the company’s national chairperson, Kibuuka Mazinga Ambrose, TIENS-Uganda has an annual turnover of around $6 million.

The company has even bought the most prominent advertising spot on the Health Ministry’s official calendar, a particularly brazen move given that none of its outlets are registered health facilities.

Patients who come to TIENS seek help for a whole range of conditions – from malaria to paralysis – but they tend to tell similar stories of how they arrived here. Typically, they say that they first went to public facilities (some told me they had even visited two or three), but were either not seen to or found the treatment ineffective. TIENS is almost always a last resort. But in a country whose healthcare infrastructure is riddled with chronic problems and which, by some measures, ranks as one of the worst in the world, the last resort is often one that needs to be taken.

In many areas of Uganda, public health facilities are virtually inaccessible, while those who do manage to reach them may find their walls crumbling, their clinics under-staffed, and their shelves bereft of drugs. Although the government has promised to invest more in the sector, much of the country’s healthcare infrastructure is in decay. Doctors and nurses are over-worked and underpaid, and although services are meant to be free, in reality patients face many hidden costs.

In this context, stores like Wasswa’s – with its quick turnaround, attentive staff and fully-stocked shelves – offer an appealing alternative. The always conclusive diagnostic tests are highly convenient; attendants’ claims about the healing powers of TIENS products may well be reassuring; and many patients say the fact the medicines travelled thousands of miles from China suggest they must work.

Many customers who use TIENS products also insist that they do work.

On the Friday morning after my tour of Wasswa’s clinic, the courtyard next to the outlet is packed. Over a hundred people sit on plastic chairs facing forwards while latecomers lean against the back wall. A red tarpaulin sheet shields the crammed attendees from the sun and gives the whole atmosphere an eerie pink hue.

‘Doctor Julius’, a man in his late-30s with an intense glare and impatient demeanour, stands at the front. He has just finished explaining the healing powers of TIENS toothpaste – which as well as cleaning teeth, can be used to treat ulcers, angina and skin problems amongst many other conditions – and he invites attendees who have used the product to give testimony. Four hands go up immediately.

“I had terrible problems with my teeth,” says the first speaker. “I went to see doctors but a new tooth had to be uprooted every week. When I started to use TIENS toothpaste, the pain went away.”

The next patient tells a very similar story before two mothers relay how the toothpaste cleared up their respective children’s skin rashes and burns.

Every now and then over the next few hours, many more attendees are invited to recount their experiences of using TIENS products. We hear how a man with back pain can now walk, how another man was cured of vertigo, and how a woman’s child was once bed-ridden but is now running around. At one point, Wasswa looks particularly pleased as a mother tells of how her young son – who she had taken to three separate public healthcare facilities before he was cured of cerebral malaria by TIENS – now wants to change his name to ‘Doctor Wasswa’.

“You see, these products work,” Wasswa announces after one of the testimonies. “At hospitals, they will ask you how you feel, but here, we tell you how you feel. At hospitals, they treat signs and symptoms. Here, we treat causes. At hospitals, they give you medicines made from chemicals which are harmful and can give you ulcers. Here, we use herbal medicines which have no side-effects.”

“This is real,” he continues. “This is Chinese herbal medicine based on 5,000 years of traditional medicine and it works.”

In Kampala, I test this out for myself. I visit a couple of the company’s stores, nestled in the city centre’s endless bustling plazas, and in one of them, managed by an intense man named Frank, I get tested.

Frank, the self-declared “best in the business” at doing diagnostic tests, seems thrilled at my presence and bundles me across to the end of the room. He sits me down and pulls across a thin curtain to give us a modicum of privacy from the handful of waiting patients. He takes out a battered looking hand-held device, pushes a 9-volt battery into its back and plugs a wire into it that branches into two metal tips. He gives me one of the electrified points to hold in my right hand and says he will use the other to press points on my left palm. With a grave look on his face, Frank instructs me to tell him when I feel a tingling. This seems to be a more basic version of the first test I’d seen in Iganga.

To begin with, I report whenever I feel something, which is every single time the tip touches my hand, completing the basic electric circuit. Frank nods excitedly when I do so and explains that I have a serious problem in whichever part of my body he is testing. After a while, however, I decide to stop reporting every time I feel a tingling. Frank lets me get away with one, but after that he frowns when I stay silent and simply keeps the metal point on my hand until I give in, sometimes rubbing my hand and even licking the metal tip if I am being particularly resistant.

In the end, Frank writes out a list of around 25 health conditions including “liver disorder,” “STROKE,” and “enteric fever [aka severe typhoid],” and prescribes a roster of products that comes to over USH 1 million ($400).

Before committing to his costly regimen, I decide to get a second opinion.

In the bright, clean reception of Beijing Clinic, a private health facility in Kampala, I relate my experience to a young Ugandan doctor, who trained and qualified in China, specialising in traditional Chinese medicine. The doctor, who prefers not to be named, laughs as I explain the machines I saw in Iganga and the test I underwent in Kampala. “No machine can test all those things like they claim,” he says.

Next, I show him the TIENS Information Guide, a booklet from which it seems Julius and Wasswa get most of their information. On page 3 of the booklet, a short disclaimer warns: “Tianshi Company does not make any medical claims whatsoever.” However, the next 60 pages are filled with bold declarations about the powers of its products and instructions on how to treat different diseases.

“Whatever this is, it is not Chinese medicine,” says the Chinese-trained doctor with a combination of amusement and incredulity. He chuckles as he reads how TIENS medicines are supposed to treat about a dozen different conditions each, from preventing cancer to reversing impotence to promoting “the growth of children’s reproductive organs.”

However, the doctor’s amusement soon turns to horror as he reaches the section of the booklet advising distributors on what steps to take when patients are suffering from different diseases. TIENS customers are typically encouraged to undergo diagnostic tests in store, but most who go to TIENS have previously been to hospital and know some of the conditions from which they are suffering. The company guide offers clear and easy instructions on what they should be prescribed.

Of the few hundred conditions listed – which span from AIDS to Yellow Fever – a handful include the recommendation to ‘see a doctor’. But the rest just list a few products to be taken.

“This is a death sentence,” mutters the doctor, falling silent.

One of the most repeated claims by TIENS distributors is that because the products are ‘herbal’, they have no side-effects. This assertion is used to elevate them above Western medicines, which they say are made from chemicals and so can be harmful, but the claim is also used to suggest that there are no dangers involved in taking them.

“Even if I tell you to swallow one and you swallow four, there will be no problems,” Wasswa had insisted. But when put to the Chinese-trained doctor in Beijing Clinic, he just shakes his head. “That is a flat out lie,” he says.

He recalls that last year, he was consulted by police after a man suffering from kidney problems died suddenly from liver failure. A toxicology report found that he had had a toxic overdose and it was suggested that the TIENS supplements the patient had been taking without his doctor’s knowledge had either caused additional problems or reacted badly with other medicines. The man’s family could not afford to get a more detailed medical report, however, and declined to take the matter further.

At another private clinic in Kampala, Dr Wen, a highly-regarded practitioner with three decades experience, is similarly concerned. “This is not medicine,” he says, “but it is still dangerous. Everything has side-effects. Even herbal medicines and herbal supplements used wrongly can kill.”

I contacted Uganda’s Health Minister, Ruhakana Rugunda, repeatedly for comment, but received no reply.

Apart from the story of the kidney patient, I didn’t come across other rumours of deaths, but cases of the products not working as miraculously as promised were easy to find. After all, TIENS products are not medicines. Some of the company’s goods have been registered with Uganda’s National Drugs Authority, but as ‘food & dietary supplements’. In fact, stories of TIENS products not fully working were even common amongst some of TIENS most ardent fans.

Back in Iganga, with the courtyard seminar over and Wasswa busy talking to a small circle of attendees eager to hear more, Sarah*, 25, moves towards the back of the courtyard closer to where I am sitting.

During the seminar, she had given testimony telling of how she’d taken her baby boy, who was suffering from sickle cell anaemia, to several hospitals before she came to TIENS. Many of those who told their stories directed them matter-of-factly at Julius or Wasswa, but Sarah had turned to face the crowd and spoken passionately as she’d explained how the products worked wonders.

Asked a few more questions after the symposium, however, her story reveals itself to be far less straightforward. It transpires that her son is still ill. So ill, in fact, that she recently quit her nursing job to look after him full-time. Sarah nevertheless insists that the TIENS medicines work and says the reason her son is still suffering is because his treatment is incomplete. She bought half the products the boy needs for a full recovery but is struggling to find the money to purchase the rest.

Robert, 30, tells a similar tale. He too claims to be a firm believer in the healing powers of TIENS, and acted as my translator throughout the seminar, seemingly on Wasswa’s instruction. Robert says that he came to TIENS with kidney problems and maintains the products worked where hospital treatments failed. Like Sarah’s son, however, he admits that he is still in pain. Firstly, he attributes this to the fact that his kidney treatment is incomplete; he too has had financial difficulties. Secondly, he explains that the TIENS diagnostic test revealed his kidneys are not his only problem; while his original condition may have improved, he now knows he is suffering from other conditions that need to be cured too.

Sarah and Robert reveal that they have each spent USH 460,000 ($180) on products so far, paying in instalments from what they could borrow or scrape together. Sarah says she needs USH 500,000 ($200) more to complete her son’s treatment, but doesn’t know where the money will come from given that she is now jobless and that the father of her son is in school. Robert says he needs around USH 200,000 ($80) more, but says that as a “peasant”, he too will struggle.

“I haven’t balanced it well,” he says, “but I hope it will balance out soon. I am still feeling pain.”

It is not a coincidence that Robert, Sarah and a few others who spoke to me had all purchased exactly USH 460,000 worth of products. Nor is it an inexplicable peculiarity that individuals with no reliable source of income had shelled out what little they had, and more, on TIENS products. After all, TIENS is more than just a supplier of health supplements.

In the symposium in Iganga, once Julius had waxed lyrical about various products, it was time for Wasswa to take over the stage to talk about another benefit of TIENS. Though not before Julius had the opportunity to rouse the crowd.

After finishing his demonstration of TIENS’ disease-curing sanitary pads, Julius put down the product and strolled ponderously along the front of the courtyard before turning to face the audience. “Tianshi!” he shouted suddenly. “Together we share!” came back the reply on cue, a hundred voices amplified by the concrete walls. “Tianshi!” Julius proclaimed a second time, a little louder. “One dream!” came the soaring response. “Tianshi!” yelled the doctor a third time. “The best of all!!” bellowed the crowd.

Next, Julius taught the audience a new trick. Since all points in ours palms relate to different internal organs, he explained, clapping stimulates the whole body and works as a kind of “first aid.” He held his hands apart and, together with the crowd, clapped out a rhythm that crackled across the courtyard. Julius explained that the louder you clap, the greater the benefits to your internal organs, before holding out his hands and going again. And again.

Finally, looking satisfied, Julius completed his session and handed over to Wasswa.

“TIENS is not just good for your health,” the salesman proclaimed, taking to the stage, “it is also good for your wealth. If you register with TIENS, they will start to pay you. You come here for treatment, but over time, you will start to get a salary.”

Over the next few minutes, Wasswa explained that this is what he had done and that he was not only receiving thousands of dollars every month now, but had been taken on international trips by the company, received huge cash bonuses and been given a brand new car.

“When you reach a certain level, you start earning,” he said. “And it does not matter if you have no qualifications or education. TIENS does not care if you are educated. TIENS only cares how many products you buy and how many people you recruit.”

Wasswa said these words with a weighty earnestness, but they were not news to half the courtyard. Robert, Sarah and many others around them – all recognisable by the golden lion-shaped badges they were wearing – were not just TIENS patients, but members and distributors already. They were here on Wasswa’s instructions to give testimony and help convince others to join too. For these returning members, TIENS is not just a medical supplier, but a livelihood, an investment, and a chance to follow in Wasswa’s jet-setting footsteps.

Sitting behind his desk at the TIENS-Uganda headquarters, located at the top of King Fahd Plaza on a busy street in Kampala, Kibuuka Mazinga Ambrose is delighted to explain how the business model works in more detail.

“Anyone can join,” says the company chairperson, wearing a bright yellow TIENS-branded cap. “All you need to do is pay a small initial fee of $20.” Once you have done this, you can buy products at wholesale prices and sell them on at a profit. However, this is just the start, he says. You don’t get rich by selling a few bottles of herbal supplements. Under TIENS’ model, there are eight ranks and you need to move up the levels to really start enjoying the benefits.

The first few levels can be reached simply by buying more products, which essentially brings with it a small discount on goods. However, to get to the bigger rewards, you need to start recruiting others. This way, you receive a commission whenever they make purchases and also get rewarded if they recruit their own followers.

The more people you recruit and the more they recruit in turn, the higher you move up the rankings, and soon you can just sit back and watch as the commissions roll in. Furthermore, once you’ve reached the 8-star level and keep growing your network, you will eventually become a Bronze Lion, then a Silver Lion, then a Gold Lion, and enjoy rewards of cash prizes, international trips, a brand new 4×4 car, a luxury yacht, a private jet, and finally a “Luxurious Villa Palace.”

“It’s all about growing your network; their success is your success,” says Ambrose cheerily. “TIENS does not care who you are. Anyone can do it, and there is no limit on what you can earn.”

As the TIENS Guide puts it, joining the company means: “You stop struggling financially,” there is “little risk of losing”, and “if you work for 5 years you can retire.”

According the company website, over 200,000 Ugandans have joined TIENS, eclipsing even the number of government school teachers in the country.

Given Uganda’s high rates of unemployment – youth unemployment is over 80% according to some estimates – the appeal of membership is clear to see. Decent jobs are scarce and rags-to-riches stories like Wasswa’s are even scarcer.

Furthermore, the company’s image is significantly helped by the Ugandan government. Not only does TIENS advertise on the Health Ministry’s calendar, but according to Wasswa, around ten MPs are members of the company and at the Iganga seminar, Stephen Wante, the mayor of Bugembe, made a guest appearance. In 2011 meanwhile, Vice-President Edward Ssekandi officiated a ceremony in which a distributor was awarded a car and organised for TIENS to donate some of its products to a government health centre. A photograph of the Ssekandi shaking hands with TIENS’ president also has pride of place on the company website.

However, despite all of TIENS’ promises of wealth and perceived legitimacy, actually making money from the scheme is virtually impossible. At the TIENS headquarters, where members can print out their balance sheets, many leave the office holding spreadsheets indicating that they are owed almost nothing, if anything at all. Meanwhile, back in Iganga, several members who had joined several months ago, attended every biweekly seminar, bought lots of products, and gone on recruitment drives, revealed that they had not earned any notable income either. It seems many others have also abandoned the scheme after finding they could not make it work.

According to most TIENS members – both those who are profiting and those who aren’t – the reason for these failures is simple: the individual did not work hard enough. When I asked Sarah why she thought she hadn’t made any money after being a member for five months, for example, she hesitated before Robert helpfully chipped in to say “it means she is not performing well.” Yet Robert had barely received any income either, despite having been a member for six months and having recruited nine people. Other members who had yet to make money also suggested their situation was down to bad luck or poor performance.

This feeling was perhaps most starkly expressed after the seminar as I spoke to Wasswa within earshot of three members, all of whom had been distributors for up to six months yet not come anywhere close to getting a decent income. I asked Wasswa how long it typically takes to break even. “Some people can take a month, but sometimes maybe two months,” he replied. What if someone has been working hard but hasn’t started getting an income after 6 months, I followed up. “Six months?” Wasswa exclaimed. “No, it’s rare. Very rare. If someone is serious, they should be on a high level and earning well after six months.”

I looked over at the three recruits who all just stared at the floor, looking sheepish and, I thought, ashamed.

The reality, however, is that failure under TIENS is not the individual’s fault. In fact, for the vast majority of members, the business model is designed to fail. TIENS in Uganda appears to be little more than thin-veiled pyramid scheme.

Recruiters emphasise that to join, all you need to do is pay a $20 membership fee. But in reality that is only the start. Members have to buy products to move up the rankings and then continue to buy goods to keep their accounts open.

Members could make money selling these products, but the idea of shifting all these goods is a non-starter. Not only does each distributor have to compete with 200,000 other sellers as well as 30 well-established stores, but it doesn’t even make economic sense for customers to buy from individual members when they could sign up to TIENS themselves and get much lower prices anyway.

This is perhaps why Wasswa and other recruiters barely even mention selling products and why the emphasis instead is very heavily on “growing your network.” The incentives for signing up new members are higher than those for sales; the training sessions teach recruits how to sell membership rather than goods; and the TIENS Guide’s main piece of practical advice is a 6-step plan of how to “make a name list of at least 100 in a shortest time possible.”

If not from selling products to the public then, the bulk of the money in the TIENS system comes members’ own pockets as they pay to join, pay to move up the rankings, and pay to keep their accounts open. And it is this same money that finances top-level distributors’ huge salaries, shiny new cars and trips around the world. Given all the money in the system comes from members, the only way this tiny elite profits is because the rest of Uganda’s 200,000 members do not.

TIENS refer to itself as a ‘multi-level marketing’, but in reality it seems to be an unsustainable and fraudulent pyramid scheme designed to extract money from the many to pay the salaries of a few.

I later contacted Ambrose, Wasswa and Jamba George, another 8-star recruiter, for their response to these allegations, but they all declined. The manager of TIENS-Uganda, a Chinese expatriate, and the company’s global headquarters in Tianjin did not make a comment either.

It should also be noted that TIENS is not just in Uganda, nor is it the only scheme of its kind. The American firms Forever Living and GNLD also deal in health supplements and follow a multi-level marketing model, while TIENS’ presence on the continent seems to be particularly strong in West Africa, Ethiopia and Zimbabwe. It is further notable that TIENS has offices in many Western countries, though the products there seem to be marketed more directly as mere food supplements.

Back in the courtyard in Iganga, Robert is listing the products he was prescribed six months ago. Like so many others faced with Uganda’s struggling healthcare system, Robert ended up seeking alternatives and eventually ended up at Wasswa’s busy but welcoming clinic.

The products worked, Robert insists. Up to a point. He just wishes, he says, that he could finish the treatment and be fully cured of his kidney problems as well as the other health conditions detected by the diagnostic test he underwent. But he cannot afford it.

Robert has no other jobs – he says there are hardly any jobs available in the area – and has five children to support. When he joined the company half a year ago, he thought TIENS was the answer to all his prayers, but he is still in pain and deeper in debt.

“Money is a problem, he says. “It is not easy to recruit people and I spend USH12,000 ($5) every week on transport to come to these seminars.”

I ask him why he is still part of the company despite losing money each week. He pauses for a moment before answering, “I believe I will balance my accounts soon. And I am close to moving up to the next level when I will be able to earn more.”

He explains that a technical misunderstanding delayed him moving up a rank, but that it should be sorted out soon. I point out that even if he moves up a level and earns slightly more than now, he will still be earning a tiny fraction of what he has invested. He nods in agreement, but adds, with a faint smile, “But with TIENS, time is on your side.”

But what if it still doesn’t work out, I push. What if Wasswa is the exception that proves the rule? What if it never works out?

Robert looks me in the eye for a few seconds before gazing out across the courtyard where a few groups of attendees are still standing around chatting.

“If the money defeats me, ” he says quietly, turning back to me, “I will disappear.”

*Some names have been changed to protect interviewees’ identities.

James Wan is editor of African Arguments. He was an associate producer on the Aljazeera documentary Uganda’s Health Pyramid. He is a fellow of the China-Africa Reporting Project, managed by University of Witwatersrand.

Source : African Arguments

Providing Free Health Care For the Indigent, Without Catering for Health Workers Is Nothing-NAUHP

As the Federal Government positions to provide free medical services to 3,000 residents of Ibadan, the capital of Oyo state, through the University College Hospital(UCH)Ibadan, Allied health professionals in the hospital insist that the figure is a far cry from those in actual need of  medical services in the state. Chairman of the Nigeria Union of Allied Health Professionals(NUAHP)UCH branch, who also doubles as the Deputy President(South) of the union, Comrade Oulsegun Sotiloye explains why this is so. Excerpts :

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What is your reaction to the free medical initiative of the Federal Government soon to commence in Ibadan ?

It is ordinarily to be a good development. Government giving free medical services to indigent patients. However, when you compare the number that will be attended to, 3,000, Oyo state alone, if I am not mistaking will be having about 3 to 5 million people. And of this number, your guess would be as good as mine, as regards the indigent patients.  The number that will be catered for, is a very small fraction of the number of indigent patients in the state. It is like a drop in a mighty ocean, we still have a long way to go, we need to revamp our primary health care programme. So that people will have health centre close by, where they can readily access affordable, quality and accessible health care. As we have it now, most people who are enlightened or have the financial capacity to come to UCH, which shouldn’t be.  The UCH as a tertiary health institution should be attending to special cases that cannot be attended to at the primary health care level or the secondary  health care level, but because these other tiers of health care are virtually non existent, that is why we have a situation whereby, almost everybody comes to the UCH.  If we have primary health care that is well funded, well equipped and well manned by health care personnel, a lot of the cases that end up here, would have been nipped in the bud. Even the preventive aspect of health care would have been taken care of, at the primary health care stage. My advice is that, it is good, but there are other things, we can do to prevent people, coming down with all kind of diseases, we are having. As I am speaking to you, our members morale is very low, because quite a number of our agreement, we had with the Federal Government are yet to be implemented, this is very worrisome. So, saying you are taking care of indigent patients and the people who are supposed to care for them are not happy, it is not a very good thing.