Across the world, healthcare leaders and stakeholders have launched a number of initiatives to improve patient safety and eliminate preventable harm within healthcare facilities. A number of goals have been set and several sustainable actionable plans have been designed. The initiatives, plans and goals are impressive, and we are hoping they can transcend to healthcare systems across Africa and particularly in Nigeria where I am domiciled.
Healthcare facilities were not originally designed to harm patients. They should be a place where patients receive care and empathy to heal the body, mind and soul. In the words of Florence Nightingale, “the very first requirement of a hospital is that it should do the sick no harm.” This is a clear mandate to both the stakeholders who sit on boards and to the caregivers who care for patients. We are all collectively responsible for ensuring that patients return home to their loved ones unharmed.
This mandate can become reality only when leadership commits to patient safety and positive patient outcomes – and this is where we largely get it wrong in Africa as a government and as a people. From my experience, a culture of safety is the bedrock for eliminating preventable harm in hospitals.
One of the concerns is that our hospitals do not give due consideration to the safety and health of caregivers. This box has long been left unchecked and this shortcoming correlates to negative impacts on the safety of patients. For example, most hospitals do not have procedures that consider the vaccination profile of healthcare employees. Some healthcare workers have existing health concerns when they are employed, which leads to infecting the patients they manage. Compulsory vaccination of the employees should start at recruitment. This would give staff some relief knowing he or she is covered against certain preventable infections.
We have to address the healthcare work schedule in Nigeria. Most healthcare systems have two shifts of 10–12 hours each. This leads to exhausted workers and tired workers make mistakes. These schedules are set for a couple of reasons: either the hospital does not want to pay more in wages to have the appropriate number of healthcare workers or there is a shortage of healthcare workers.
The lack of a safety culture is also responsible for certain situations in which there are no documented work procedures or processes to ensure patient or staff safety. In most cases, we see different processes being used by different healthcare workers in same facility, this is both frightening and intolerable; and leads to poor patient outcomes.
We also have a high rate of surgery site infections and injuries. Most are never reported or documented so we can learn from them, and they are never disclosed to the patients or their families. This immense absence of honesty of care goes against the principles of CANDOR. Patients that get infections experience longer hospital stays and they are still made to pay for the extended admission for a problem that was caused by the healthcare system. This happens daily in healthcare facilities here.
There is a shortage of healthcare professionals in Africa and most countries in Sub Sahara Africa have few qualified doctors or nurses. Some hospitals are even forced to train young secondary school teachers as nurses. This has given rise to a high number of quacks who are not registered with professional councils and are never guided by any code of practice.
The latest data from the World Health Organization reveals that Nigeria’s Physician-to-Patient ratio is 4 doctors to 10,000 patients. Compare that to countries like Qatar, which has 77 physicians to 10,000 population. According to the 2014 WHO report, Nigeria has only 150,000 registered nurses for a population of 160 million, a ratio of 1 nurse to 1,006 people. The WHO standard is 22 nurses to 10,000 population. In Nigeria, we train and graduate healthcare professionals, but they do not stay to practice due to our poor healthcare infrastructures and discouraging remuneration.
Poor healthcare funding is another key issue. Nigeria’s annual healthcare budget is less than 4 percent of the National Budget, public hospitals are not funded even for the right drugs or diagnostic equipment, let alone investment in training and integrating patient safety into behaviors and systems. This leads to a poor infection management system and poor levels of disinfection and sterilization. Personal protective equipment needed by healthcare workers are insufficient, we lack hand sanitizers, and most times there is no running water for caregivers to wash their hands after handling patients. I have witnessed a nurse, during delivery with a failed suction machine, use her mouth to suck the baby, that was all she could do, these are some of the lines of risks to both patients and even the care giver.
A number of hospitals are even allowed to operate without regulatory registration. In these facilities, patients are harmed daily basis without any reporting. This is where the government has absolute responsibility. Patient safety has to be at the front line of healthcare discussions and our national agenda.
We need to look at things differently. First, we need to look at the healthcare system as a workplace before seeing it as a place in which we seek care. Then let’s consider safe processes as part of the infrastructure of healthcare facilities, the spaces have to be designed to reduce patient harm. We need to review the increasing number of hours in healthcare shifts, accidents will surely happen through overwork and overdraw of healthcare workers. We need to start creating a culture of incident reporting and give assurances that we will not be blamed. Then we can use the incident as a learning moment.
Most importantly, we need to improve our healthcare infrastructure and increase our healthcare budget. Without these two factors, patient safety and good treatment outcomes will only be a dream. In the WHO Abuja Declaration (2000), it was agreed that healthcare funding should be increased to at least 15 percent of the National Budget. Most countries across Africa, including Nigeria, have yet to acknowledge or meet this agreement.
We need to start the dialogue from here.
Workplace mental health is a growing concern in Africa with daily increasing burden as a result of the fast mutation in work pace, work processes and changes in employment patterns. This is expected to go even worse as we all gradually slide into the new global concept known as the “Future of Work” which will be characterised by very high technology, high use and dependency on machines and robots who will fiercely compete for work with their human counterparts. This will further change the entire landscape of workplace mental health with an increased burden of disease traceable to excess work demand, burnout, longer hours of work, workers overdraw, the fear of loss of job, lone worker syndrome which will further dismantle the existing human interactions and socialization between and amongst workers in workplaces.
There is an urgent need to change the notion of seeing an employee solely as a tool for the profitability of the employer who makes little or no provision for the maintenance of the employee’s health and wellbeing. This is very crucial because these same employers have dates when their machines are due for servicing and they never fall short of those dates but they never in same way have a scheduled dates within their calendars for employees’ health and wellness assessment.
Concerns as highlighted above are underpinned with the absence or poor legislation on mental health at work in Africa. Owing to the fact that even mental health was not amongst the illness classified by ILO in the list of Occupational diseases, most countries in Africa still lag behind in trying to have mental health concerns captured and rightly provided for in workplace safety and health legislations. There exist a number of countries now that have National Mental Health Act or Policies but these are domiciled with the Ministry of Health while most OSH Departments or Agencies are under Ministry of Labour and Employment. In a number of those mental health policies, it is assumed there was never a broad consultations that included the Ministry of Labour and Employment and other Workplace safety and health stakeholders in arriving at those polices hence these actors do not see themselves as co-owners of such policies. Absence of these policies has made it difficult in holding employers accountable for violation of national workplace mental health provisions, we must first have a document of reference before holding employers accountable.
We need a strong political will for review and updating of existing National legislations. A number of countries across Africa govern their workplaces with highly obsolete OSH legislation that have no bearing with the new workplace and work-life-balance realities, no element of mental health and employees’ wellbeing provisions. The urgent need for an early review of these documents is so crucial, at OSHAfrica we are doing something about this. Even where these documents or legislations exist, they are not promoted or sold to employers of labour, instead they are stacked in a certain office where they are made unreachable to those who need to interpret and domesticate them into their corporate OSH policies.
Advocacy and education and the right definition of what workplace mental health is all about will be a quick fix to the current level of information deficit along the lines of mental health and wellbeing at work. The mentality and understanding of mental health generally has to scale up if we must change the current perception of mental health in Africa. There are currently little or no definite programs that are directed at mental health at work and psychosocial hazards that are imminent in our current workplaces.
In having an honest conversation and drawing programs on mental health at work, it will be wrong to isolate business leaders, Human Resources Managers, employers of labour and others who are daily actors in the implementation of these policies and programs. This is the current situations across many countries in Africa, there is an urgent need to shift from the idea of developing a policy for them and embrace the friendly participatory approach of developing a policy with them. Let them own it.
Mental Health Treatment and Rehabilitation.
Stigma: When we talk of mental health stigmatization, we must first also look at the current location and design of mental health facilities. This is the root of the stigma.
In many facilities, mental health units are located in some isolated and lonely wing of the hospital almost far off other adjoining facility. This makes it so obvious to identify any patient walking towards that direction for care as patient having a mental illness. This on its own, turn people away from accessing care.
We have specialised facilities called Psychiatrist Hospital, owing to the poor level of information on mental health in our locality, no one wants to wake up, get dressed and walk into a psychiatric hospital. He is careful and ashamed of who may have seen him walk in, he ends up not accessing the service and his condition is left untreated. So we need to look at the location and design.
Shortage of mental health experts: The region needs more mental health experts. Virtually every country in Africa needs more hands to support the system in managing mental health. Kenya with almost 50 million population has only 80 Psychiatrists and 30 clinical psychologists, Nigeria has 130 Psychiatrists as documented in many studies but lately Association of Nigeria Psychiatrists through their website reported are now 250 Psychiatrists for 200 million population. This shortage of mental health experts is common. Ethiopia with a population of 61 million people has only 10 Psychiatrists, the shortage led to an estimated 85% of emotionally disturbed people seeking help from traditionally healers, this is according to a publication by Prof Oye Gurege etal
Training of healthcare workers on mental health: When you are presented with co-morbidity of physical illness and mental illness, only the physical illness are mostly taken care of in the hospitals at the expense of mental health or other emotional disorders. The patients are allowed to leave with a mental health condition that was not even diagnosed let alone being treated.
Funding is a critical issue. At the Abuja declaration 2001, leaders of all countries in Africa met and pledged to increase the healthcare budget to 15%. Only 1 country has met this target, 26 countries have increased theirs, 11 countries have reduced theirs and there were no significant trend in the other 9 countries.
In most countries in Africa, only an average of 1% or less of their healthcare budget is allocated to mental health when compared with 6 – 12% allocation in Europe and North America. This poor funding does not allow growth and improvement in management of mental illnesses in the region.
Insufficient mental health facilities: There are no enough mental health departments or facilities, even when they exist, they are mostly in the cities. How do we cater for people who live in rural communities knowing that mental illness does not discriminate or have location biases? This has led to wide spread of traditional practice including spiritual healers in mental health who end up complicating the presenting conditions with physical tortures and leaving their victims in chains.
OSHAfrica and AU-DA partnership project
We are currently reviewing the Occupational Safety and Health legislation across the 54 African countries, we are looking for the similarities and peculiarities in content and also making provisions for areas that were hitherto not covered or were not adequately covered inn existing legislations. Upon completion of these reviews, we will come up with a harmonised document called “The African Occupational Safety and Health Act” which will be presented for further review by the African Union leadership for adoption and possible sign off for use across all 54 countries in Africa.
One of the key things we have in mind while on this project is to make clear and robust provisions for:
In this partnership, we are also looking at how we can run Train-The-Trainer program on mental health at work across all the 5 sub regions in Africa.
Another discussion we had along this line is designing a Mental Health at Work Training for Business Leaders, this is currently in the mandate of the Scientific Committee in charge of OSH Education and Competency Improvement.
My dear readers, i came across this article written by Reihana Mohideen, a socialist feminist from Manila Philippines, i had to read it over and over again to my amazement. I became caught up in a web of emotion when i read about President Fidel Castro going to give assistance and rescue support in an area that has the highest risk when Cuba was hit by a disaster. No one could have asked for anything more.
We have always sang this in our blog articles that nothing happens outside leadership will and commitment, we cannot categorically say Cuba is a high income earning country but there is a political will to secure the lives of its population from those natural disasters peculiar to their geographical locations. Imagine being hit between 1996 and 2002 with 6 major hurricanes but see the minimal number of people lost to those 6 incidences. Their school curriculum has been fully laced with emergency preparedness and response contents, training are made available to everyone annually.
Maybe we just juxtapose this with the Philippines and Haiti scenarios where corruption and mental slavery have taken priority seat over the safety of the people and in some cases where standard has become an issue not to be discussed or evaluated. It rends my heart when mass of people are allowed to die through avoidable deaths when it could have been prevented if we only tried. The last disaster that hit Japan has been the biggest of it all but it did not catch the Japanese Government napping, preparations were in place and people knew what to do, teams were deployed immediately to the regions affected and lots were salvaged and lives were saved. We do not make preparations in the face of disaster; it is planned and prepared for in advance. People can only respond to the capacity they have been trained, we need to build and develop disaster management capacity to give some sort of mitigation which always goes a long way. Disaster naturally overwhelms everyone; the need to prepare is a huge succour.
The “Cuban Way” is the way and i challenge everyone to look into what his country has put in place from political will to attitude, training and the likes. I think we need to talk to our governments and leaders on the need to look inward; we cannot afford to continue this way. Cuba has proved to us that ability to prepare is not a function of funds but a deliberate effort to identify what you are faced with and make provisions for its mitigation. We will praise New Zealand for the standard they have set in quality building structure and codes, this is worth emulating.
Please read the article below and make your opinion felt. Remember Salus Populi Suprema Lex (The Safety of the People is the Supreme Law).
September 8, 2010 — Comparisons must be made between the impact of the September 5 earthquake on Christchurch, New Zealand, and the quake that hit Haiti in January. The nature of a global system that maintains these inequalities should be exposed over and over again. In Haiti – with a population of around 9 million – some 250,000 people died in the earthquake and (according to government figures) 200,000 were injured and 1 million were made homeless. Some eight months later disaster still grips peoples’ lives. Fortunately, but in a staggering contrast, no lives were lost in New Zealand, although the earthquake was of a similar — but slightly more powerful — magnitude (7 on the Richter scale).
New Zealand’s building codes set a world standard in seismic building regulations and are incorporated into the building codes of several countries, including the Caribbean Uniform Building Code. Haiti, on the other hand, had no known building regulations. According to a report provided to the Global Task Force on Building Codes by a member of a disaster risk management team that visited Haiti prior to the earthquake in 2009, Haiti reportedly has some building regulations, but they were not focused on building safety and were rarely implemented. Haitian civil engineers and architects said that any codes used for professionally designed and constructed private buildings would not be Haitian – but would depend on where that person studied (USA being most common). Donor-funded buildings are usually built to a standard stipulated by the donor or by the professional in charge. The State University’s engineering curriculum did not have any substantive elements on building codes.
The Philippines is one of the countries’ most vulnerable to earthquakes and studies have found that the country’s school children are especially vulnerable due to substandard building construction. Tens of thousands of people could die, in Manila alone, from an earthquake of the magnitude that hit Haiti and New Zealand. The building industry is riddled with corruption, undermining the implementation of building industry safety standards and regulations. The urban poor, who are a significant proportion of the urban population, live in hovel-like structures that are assembled with flimsy pieces of cardboard, wood and discarded roofing materials, easily washed away by rains and typhoons. Typhoon Ondoy, which hit the country in October 2009, killing thousands of people and displacing tens of thousands, gives us a terrifying preview of what an earthquake could unleash.
But the problems faced by those of us living in Third World countries in coping with disasters goes beyond the inadequacy of building regulations. The basic problem is poverty. A glance at the UN’s ranking of countries based on its Human Development Index (a measurement of education, life expectancy and income) is an indicator of the problem. Haiti’s ranking is 149 to New Zealand’s ranking of 20 (out of 182 countries). Philippines ranking is 105. The massive numbers of lives lost in disasters is a direct result of poverty. The poor in the Third World are more vulnerable, including to climate change-induced disasters, than those in the industrialised countries.
However, even a poor country can take effective measures to mitigate the loss of lives and injuries if there is political will in government to prioritise protecting the lives of its people. If New Zealand sets the world standard with its seismically safe buildings, then Cuba sets the world standard on how a poor country can save lives during disasters. And the Cuban example has been acknowledged and praised even by those not partial to the Cuban Revolution, such as the United Nations, which identifies Cuba as a case study in disaster risk management. Between 1996 and 2002, six major hurricanes hit Cuba, killing 16 people out of the total 665 deaths in the affected countries. Hurricane Charlie killed four people in Cuba and 30 people in Florida. When Hurricane Ivan threatened Cuba, the country evacuated 1.9 million people, 17% of the population, over 15 days. All shelters were staffed with nurses, and doctors were sent to the high-risk areas. Then-president Fidel Castro went to the highest-risk area to assist the effort. No one was seriously injured or killed as a result of the hurricane.
According to the International Secretariat for Disaster Reduction (ISDR), the UN body that focuses on disaster reduction, “the Cuban way could easily be applied to other countries with similar economic conditions and even in countries with greater resources that do not manage to protect their population as well as Cuba does”. The ISDR says that Cuba is an example that the vulnerability of people can effectively be reduced with low-cost measures and strong determination. According to the ISDR the Cuban authorities are determined to implement disaster reduction policies in Cuba. “It is part of their development planning and their culture, which play a key role in saving lives and livelihoods. This illustrates the importance of a strong political will … Leaders of countries around the world have at their disposal the knowledge needed to reduce risk and vulnerability to hazards. Even poor countries are not entirely without options to mitigate or prevent the consequences of hazards. What is often lacking are concrete programs of action and the political will to implement policies and measures.”
This Cuban “political will”, however, does not emanate from particular individuals or even governments. The “Cuban way” is the logic of a society – an entire social, economic and cultural system – that places human beings and their needs as its central and fundamental priority. Cuba’s economy and society are based on socialist principles prioritising people before imperialist profits, resulting in the highest levels of human solidarity and culture. Haiti, in contrast to Cuba, tragically and despite its heroic and historic struggles against colonial slavery, has been exploited for decades by imperialism, which has intervened in its political affairs with impunity, supporting coups and organising military interventions to overthrow pro-people governments, a history that we in the Philippines are familiar with as a result of our own semi-colonial relationship with and dependence on the United States.
The Cuban government is unique in that it has paid an equal amount of attention to the structural and physical aspects of disaster preparedness, but has also created a “culture of safety” through successful education and awareness campaigns. The ISDR points to education as one of the main reasons for the low level of hurricane mortality rate in Cuba compared to its neighbours. Disaster preparedness, prevention and response are part of the general education curriculum. People in schools, universities and workplaces are continuously informed and trained to cope with natural hazards. From their early age, all Cubans are taught how to behave as hurricanes approach the island. They also have, every year, a two-day training session in risk reduction for hurricanes, complete with simulation exercises and concrete preparation actions. This facilitates the mobilisation of their communities at the local level when a hurricane hits Cuba. Cuba’s entire adult population is literate and therefore can access educational materials about disasters. The Cuban Red Cross, which provides teaching material, is reinforced by training courses and disaster drills for parents in the workplace, as well as by radio and television broadcasts.
There is an adequate road system in the country that facilitates speedy evacuation and building codes are enforced, which reduce the element of highly vulnerable substandard construction. Approximately 95 per cent of the households in the country have electricity and therefore can access information about disasters through radio and television. Most importantly, the Cuban population is mobilised through a range of social, professional and political organisations in the country that provide structures that can quickly mobilise the entire population in disaster.
All these features of Cuba’s disaster management program are direct results of the gains of the Cuban Revolution, which has created one of the most socially conscious, educated and politically organised and mobilised people in the world. We, in the Philippines, have much to learn from the “Cuban way”.
[Reihana Mohideen is from the international desk of the Partido Lakas ng Masa (Power of the Labouring Masses Party. This article first appeared at Reihana Mohideen’s website, Socialist Feminist.]
We have observed incident trends of late amongst localities and even countries; it has become a very disturbing issue the spate of flood risk exposure amongst vulnerable settlements and communities. This disturbing flood disaster has again been identified as one of the fall outs of global climate change which we have all been collectively responsible for. This trend would continue and even go worse if we do not see the care of environment as our individual and collective responsibility, the need to change our attitude towards the mother earth is of utmost concern if we really desire to put a check or control to these natural disasters that we are left to contend with.
Many communities in Nigeria suffered colossal loss 2012 owing to the unexpected flood disaster that ravaged some parts of Nigeria. This could have been avoided or mitigated if we clearly identified and recognise the peculiarity of risk we are exposed to base on our geographical positioning. It does not really matter how you pay deaf ears to the sound and presence of those risks, one thing that is clear is that they will surely occur whether you plan for them or not. Planning will help mitigate the effects and facilitate quick and better recovery.
The best and most important approaches to disaster management are Planning and Right Attitude. These two factors are key components in effective disaster management. Planning talks about the conscious preparedness you have put in place to mitigate disaster should they occur, this spans from strong framework policies driven by government, people engagement and participation, funding, partnerships, education and training, Health, provision of relief camp and materials etc. These and many more constitute part of the planning processes and must be sequentially designed, tested, evaluated and reviewed routinely.
Flood as it concerns us in the context of this presentation has been defined as an overflowing of a large amount of water beyond its normal confines or boundaries, especially over what is normally dry land.
Flooding is said to occur when land not normally covered by water becomes covered by water or when heavy rainfall overwhelms the drainage capacity of the local area.
Flood disaster always has a huge impact on:
Flood risk is mostly caused by the effect of climate change such as severe rainfall and rising sea levels which normally increases the risk of already affected areas and put other areas that may not have been flooded in the past at risk also. We need to me more vigilant than we were in the past as a way of adapting to the reality of climate change in ensuring the risk of future flooding is integrated into the planning through spatial planning processes at State, Regional and Local levels.
Flooding seem to be catching up with most emerging metropolis and mega cities like Lagos, Mexico, New York and the likes. This is due to the massive economic development projects to meet the socio-economic need being embarked upon without due hydrological and environmental consideration, this most times leads to destructive incidences even in regions that used to be considered safe.
Lagos is a coastal city bound to experience coastal flooding caused by higher sea levels than normal, largely as a result of storm surges, resulting from the sea overflowing into the land. There is also the issue of inland flooding which is caused by intense or prolonged rainfall which Lagos has of late been characterised with.
Coastal flood is greatly influenced by 3 factors namely:
Flooding may also arise from failure of infrastructures designed to store or carry water or to protect an area against flooding e.g. the breach of a dam, leaking canal or a burst water main, breach of a flood defence, failure of a flap valve or pumping station or blockage of a pipe or culvert. The impact of such sudden flood unset can be severe and must be assessed in planning.
Interestingly, Lagos, apart from being the industrial and commercial hub of Nigeria and the West African sub-regions, it is also the biggest city in West Africa, and it is projected to be one of the world’s five largest cities by 2015 (Federal Ministry of Education and Research, 2004). It has a very diverse and fast-growing population, thus normal pressures of urbanization and forces of modern development has resulted in the city expanding to nearby suburbs like Lagos NE, which politically covers Lagos and Ogun states of Nigeria.
Unfortunately, the encroachment and development of the suburb best quality farmland, large scale massive deforestation and loss of surface vegetation are being carried out in an unplanned mode. Even the encroachment of urban facilities on Ogun River and its tributary floodplain (waterways) and unprecedented land reclamation without strict adherence to land use and natural waterways planning, is also evident. With all these indiscriminate occurrences, we wonder if the Land Use Act is still an effective Act to implement or does it need an upscale in form of review or some people are not just able to enforce the content of the document. If we allow this spate to continue, the disaster that we are currently faced with will be nothing compared to what is to come. Urgent behavioural change has to be pursued and achieved to enable us have a sustainable environment, not void of risk but environment where risks are under considerable control. Flood is therefore being aggravated through numerous physical and social alteration of the natural environment, which has increased the impervious surfaces (Oyebande, 1990), and occupancy of unsafe land and hazard prone region, without an appreciable harmonizing scheme between nature and the developmental activities. This has created a lot of social and economic cost on the environment and the citizenry. The need to resolve the severe flood incidence within parts of Lagos NE, call for proper estimation and mapping of floodable areas at acceptable risk level, in order to provide essential tools needed towards attaining an integrated flood pre-disaster and lead-time scheme within the region.
Having this background in mind, we need to assess the levels of plans and preparedness measures we have put in place to ensure the potential impact of flood at the really of hazard is rightly minimised. The approach to this is to identify the vulnerable groups, their different levels of exposure and what we all stand to lose. Flooding has been known to induce the following:
Flood also has impactful damage on properties in diverse ways as highlighted below:
Public infrastructures are not left out in the potential damage and they come in the forms below:
Having taken our time to carefully look at the effect of flood disaster and how it impacts on human beings and our entire environment, i would rather think it should be given a very significant place in day to day running of government if indeed the government owns the responsibility to secure lives and properties of the citizenry. Budget and requisite funding should be made available and rightfully deployed and appropriated in the interest of the people and the environment at large. There is the need to have a legal document on National, State, Regional and local disaster management which must be made available or made accessible to everyone so we all know what our roles are when it comes to disaster management. Most times, what we see or hear is mere political boastful statement that amounts to nothing at the end of the day.
It might interest you to know that the geographical land mass affected by the disaster that struck Haiti was far less than the geographical land mass affected by the disaster that struck Chile and even Japan. But Haiti suffered more loss compared to Chile and Japan, this is a clear indication of the economics of disaster preparedness plan with high commitment of time and resources.
Like we all may have known, disaster management comes in 4 circles namely:
Preparedness: Readiness activities effected to minimise loss or damage
Response: What we do when disaster strikes
Recovery: When we start to ask questions on what we have learnt and what we can do to make the next if any, better.
Mitigation: All the things we can do to make us survive disaster
These all involve a thorough risk assessment which must cover plans as:
Communication: This has to do with information ins and outs. In time of disaster people need to know what to do, the safe places to evacuate to if they have to, the roads that are open and safe to drive through, where to get treatment or food during such situation. The designated authorities most times have what is referred to as incident command system that has a number of structures which also covers communication. You all need to have a family or personal preparedness plan and a jump bag which must include a small battery powered transistor radio to get information and instructions on development outside your immediate environment.
Security: In most disaster situation the most important concern is not to add to the burden of work already getting everyone overwhelmed, whether you are a responder or not you also need to get back home safely at the end of the day hence the need for security plan as an important consideration.
Authority: In situation as disaster, the need to have someone who has been appointed to take charge is important else everyone does what he or she likes and complicates issues for everyone. We need to plan for an incident command system and appoint someone who have been trained and experienced to take charge; he is the leader of the entire disaster management structure.
Disaster management comes with basic need as:
We also need to know in time of disaster, we also need to help when we are in a better state to do that. We also need to know what the “old normal life” and the “new normal life” means and our ability to adapt to the new normal life psychologically will help us a great deal. You may have owned and lived in a very comfortable apartment with Jacuzzi but you may have to sleep on a debris hut with minimal cold shield during disaster. You need to condition your mind to be able to survive this difficult period and you also need to make personal survival plan for basic needs that will last you for a minimum of 3 to 7 days. Meals Ready to Eat (MRE) are mostly what you will have to depend upon (mostly dry and canned food), you may have food to cook and there is no water, no gas or stove or even cooking pot. But with dry or canned foods, they do not perish easily and they are as good as food on-the-go.
Have you ever asked what could be done when you run out of potable water? In disaster situation, you may need to create potable water by treating water with drops of chlorine bleach, iodine tablets, steri pen and other filtration system. Boiling is an option but it is a luxury in a disaster situation, you can also use other means of water filtration systems. All these mentioned above is to kill the germs (bacteria and virus) so you do not get sick of enteritis but this cannot take care of the particulates but the filtration system does. You need an average of 1 gallon of water per person per day, so you need about 7 gallons of water to survive for 7 days. This is important so you do not suffer dehydration that could make you vulnerable to illness.
To be continued………………………………
Some of this information shared is from the work of Olusegun Adeaga of Department of Geography University of Lagos, other personal research and teaching from Dr. Michael Beach who is my course instructor in my on-going course on Disaster Management at University of Pittsburgh, Pennsylvania USA. I should be done in 3 weeks when i will have the time to share a number of new things with you.
Thanks for always following my blog and the very good comments left behind are really encouraging. Keep them coming.
There has been growing concern globally on the way we live in different regions across the world and the global crisis that looms if current individual and collective actions are not corrected.
Food waste or food loss is any food material that is discarded or unable to be used. In the context of this presentation, we will need to refer to this as not been used judiciously. It is also important to note that food waste comes in chain and in cycles which affect every region of the world in line with their lifestyles, standard and local belief systems.
Roughly one third of the food produced in the world for human consumption every year (approximately 1.3 billion tonnes) gets lost or wasted. This is an alarming loss percentage that we all should get worried about and understand food is not just the cost of the food wasted; but cost of other variables in both direct and indirect cost.
Every year, consumers in rich and developed countries waste almost as much food (222 million tonnes) as the entire net food production of sub-Saharan Africa (230 million tonnes). If this volume of food wasted can be saved, it means it could almost feed a sub-region in Africa for a whole year and this gives me a whole lot of reasons to get even worried the more. 222 million tonnes of food waste is no joke.
In developing countries food waste and losses occur mainly at early stages of the food value chain and can be traced back to financial, managerial and technical constraints in harvesting techniques as well as storage and cooling facilities. This is a peculiar food waste control gap that is peculiar to developing countries but this can be strengthened if farmers and food producers can have the confidence and support of government through investment in infrastructures such as good storage facilities, transportation for moving food and food products, expansion of food and packaging industries, reliable electricity, all these put together can reduce considerably the amount of food loss and waste. Invariably, the food waste in developing countries is more in the production chain than in consumerism.
This does not ultimately rule out the fact that we also have food waste at the consumer’s stage in developing countries. This is mostly associated with cultural belief systems and life style of the people. I live in Nigeria in Africa where visitors must be fed before they leave irrespective of whether they are truly hungry or not. We most times serve such visitors more than enough food that they could ever finish, we end up having leftovers that may never be eaten but thrown to the dust bin. What we need to know is that as we are busy wasting those food, there are millions of children across the world that have no food to eat and languishing in malnutrition. Food is too good to be wasted, we need to stop this trend and we need to reduce food waste now so we can prepare for possible future food shortage.
In medium and high income countries, food is wasted and lost mainly at later stages in the supply chain. Differing from the situation in developing countries, the behavior of consumers plays a huge part in industrialized countries. This dynamics could be seen to have some underlying social economic status factors, people shop for and most times cook more food than they need and bulk of these food never get to the dinner table. Most potent way of dealing with food waste is to reduce its creation. Consumers can reduce their food waste output at points-of-purchase and in their homes by adopting some simple measures good enough to stop food waste no matter how small. This includes planning when shopping for food and spontaneous purchases are shown as often the most wasteful. Proper knowledge of food storage reduces foods becoming inedible and thrown away, infrastructures also play a key role in this direction.
In the United States 30% of all food, worth US$48.3 billion, is thrown away each year. It is estimated that about half of the water used to produce this food also goes to waste, since agriculture is the largest human use of water (70%). (Jones, 2004 cited in Lundqvist et al., 2008).
United Kingdom households waste an estimated 6.7 million tonnes of food every year, around one third of the 21.7 million tonnes purchased. This means that approximately 32% of all food purchased per year is not eaten. Most of the food waste (4.1 million tonnes) is avoidable and could have been eaten had it been better managed (WRAP, 2008; Knight and Davis, 2007).
In the USA, organic waste is the second highest component of landfills, which are the largest source of methane emissions. Methane is one of the most harmful greenhouse gases that contribute to climate change. Methane is 23 times more potent than CO2 as a greenhouse gas. The vast amount of food going to landfills makes a significant contribution to global warming, this clearly states that the impact of food waste has both environmental effect through the use of chemicals such as fertilizers and pesticides, more fuel used for transportation, land use and cost of all these which has an overall financial impact.
We also need to consider other associated impact food waste has on water. We already know that agriculture already has the largest human use of water which is put at 70% (around 550 billion cubic metres of water is used to grow crops that never reach the dinner table), before we waste food we should also think of the impact this waste is going to have on water also.
In a document released by Food and Agriculture Organisation (FAO) “Food Waste Footprint” it was stated that under current production and consumption trends, global food production must increase 60% by 2050 in order to meet the demands of the growing world population. The current world population of 7.2 billion is projected to increase by 1 billion over the next 12 years and reach 9.6 billion by 2050. This means by 2050, we have an extra 2.4 billion mouths to feed and this will also place more demand on water needed for food production.
Food waste comes in different stages and cycles which range from:
When we weigh issue of food waste in several balances it does not favour the world in any way and changing the trend needs individual contribution. You need to take a personal pledge while I take mine irrespective of the part of the world we differently live in, we need to stand for this and conscientiously adopt food saving strategies for the sake of the future of the world. Children in different parts of the world are ravaged by poverty and hunger, the absence of relative peace due to widespread of wars and regional conflicts across Africa and some other parts of developing regions also lead to a number of children being orphaned. We also need to understand the concept of globalization which has removed trans-border barrier which leads to ease of migration by citizens of different countries that are either hit by national conflict or poverty. There are currently 9.7 million worldwide refugees according to United Nations High Commission for Refugee and these people take refuge in different countries or cities and remember we need food to feed this mass of people.
When you take a position to contribute to the global campaign against food waste in your country and we all do same in our different countries, we would make the world a better place. No one individual can do this alone, when we all come together it means we all have the strength to make it work. If one can save a plate of meal to feed one and another saves a plate of meal to feed another, we will together be able to feed our growing population through the collective efforts of you and I. This is the way forward; it is the right thing to do.
Take a stand today and make it count, our collective decision is an investment for a sustainable global population.
Kindly read and leave a comment.
Today, October 15 is Global Hand Washing Day (GHD) a day set aside by the United Nations in 2008 in Stockholm to initiate Public Private Partnership for Hand Washing (PPPHW). The theme for this year is “Clean Hands Save Lives”.
Hand washing with soap and water is the most effective and inexpensive way to prevent infectious diseases as diarrheal and acute respiratory infections which take lives of children in developing countries and regions of the world. Even in healthcare, hand washing is the most effective prevention of healthcare acquired infection which is very prevalent within the healthcare space.
Hand hygiene as it is also called was discovered in the 19th century by an Obstetrician called Ignaz Semmelweis while working at the University of Vienna. He discovered that there was a high difference regarding Puerperal fever in women in two different wards. A Puerperal infection otherwise known as puerperal sepsis is a condition that occurs when a new mom experiences an infection related to giving birth. The ward with the highest prevalence of Puerperal fever was the one where medical students and Physicians delivered the women while the other wards, the women were delivered by midwives.
He also saw that medical students and Physicians went directly from performing autopsies to delivering women. He decided to add washing hands with chlorinated lime solution for the medical students and Physicians before going into delivery wards. He saw that the incidence of Puerperal fever decreased significantly from 16% to 3% in the most affected ward. In the wards where the midwives delivered the women it stayed the same 7%. And this became the turning point in the healthcare sector where hand washing became credited as a very key component of infection control. Now you know why we take it so seriously.
As we mark the Global Hand Washing Day today, please remember to tell someone hand washing save lives. Educate someone to wash hands after using the toilets, wash hands before and after food, wash hands before and after touching a sick person, wash hands before and after touching a broken skin. We cannot afford to add to the statistics, let’s just wash hands because it really costs us nothing.
Enjoy the rest of the hand washing day.
When we again look at preventive health contextually, we will rather refer to it as an approach by an individual, a family or a population group in taking proactive actions towards disease prevention. I would want us to take note of the words “Proactive Actions” which clearly tells us, we do not act in the face of the disease or illness but an action taken in advance to forestall possible occurrence of such diseases.
Taking a quick study of the recent outbreak of the dreaded Lassa fever which is a part of the haemorrhagic virus, I realised it has it traces and foot prints on same parts as Ebola virus, running within the four volatile Ebola virus susceptible Nations (Nigeria, Sierra Leone, Liberia and Guinea). I suddenly perceive there are a number of things we might not be getting right here and one of such things is obviously hygiene.
Hygiene is almost like the bedrock of preventive health, most of the common diseases arising in deaths are very preventable through effective and sustainable standard of hygiene. These four countries are characterised with a high level of compromised hygiene standards which suddenly gets better at the outbreak of a viral disease and drops as the disease and scare comes to an end. This totally makes us reactive and being reactive only deals with surface indicators which the root causes are never unveiled and neither are they attended to in right manner.
As a nation and as a population, we must first deal with our commonalities before taking advantage of our peculiarities and this is a workable approach to safe health. Travel Medicine has told us that one of the fastest ways to spread infection across international borders is through travelling. Infections travel with its host looking for other vulnerable people to infect.
I was in all honesty thinking that these countries that have been infected with Lassa fever over and over again should have made it an issue of National priority to create a lasting prevention to Lassa fever virus by collectively creating a joint framework agreement on this issue. According to the WHO, between 300,000 – 500,000 cases of Lassa fever happens in this sub region annually and about 5,000 deaths are recorded, this is 1% case fatality rate (CFR). This is not a good one, the need to stop the outbreak of the virus is important.
Studies have revealed that women who are in their third trimester of pregnancy are at a higher risk with only 1 in 10 fetal survival rate. When this happens, healthcare workers mainly bother to same only one person and that is the pregnant woman and this is most times through abortion. I think this can be prevented. We have it here with us now, but do not forget we also have women who are pregnant in our midst. Recommendations are focused on regular hand washing, keep all foods in rodent-proof containers, keep the home as clean as possible all the time (rats are attracted to dirty and unclean environment). Also keep your windows closed at night, this guides against possible inhalation of very light particles infected by faeces or urine of rodents. This is not the best of times to drink garri soaked in water, most Nigerians love this meal but we must understand our new abnormal situation which is avoidance of soaked garri in water as meal. The virus will not survive in temperature that is up to 55 degree centigrade, this means you can use your garri for Eba (Garri in Hot Water) and also ensure your food is adequately cooked.
As we all come together to battle this scare of Lassa fever, we must not forget the fact that all cases end up in hospitals and hospitals are not manned by ghost but healthcare workers who are also as human as we are. The case of the Late Dr. Ameyo Adadevoh and the national sacrifice she made during Ebola outbreak in Nigeria should still be fresh in our minds.
Healthcare workers will surely have secondary contact and this is part of the risks they have in their job, but the need to also know what precautions to take as healthcare workers will not only protect them but also reduce the spread of the virus as well as national incidence statistics. There are already establishment of transmission of the virus through body to body contact or nosocomial routes which can be avoided through barrier nursing methods, VHF isolation prevention and having an effective infection control process guidelines. These may include wearing of protective clothing (PPE) such as masks, gloves, gowns, goggles etc. Other control measures are complete sterilization of equipment, isolation of infected patients from contact with unprotected persons until the disease runs its course. We must not forget that Lassa fever has no vaccine yet through trials are on in this direction.
Talking about the disease running its cause, it is important to know that the disease lasts for 4 weeks but it has 3 weeks incubation period. In Nigeria as at today, we have 212 suspected cases in 62 Local Government Areas, 63 deaths recorded in 6 months and 17 States out of the 36 States in Nigeria have already recorded the presence of Lassa fever.
What this tells us is that the need to increase awareness and advocacy on the prevalent of this disease is of crucial importance. We cannot sound and resound this enough; we need to take the message to children in schools, to churches and mosques, market places, offices, motor parks and every available public place. We need to create enough information oxygen within this space; the people need to be aware of the role expected of them to play in such a very sensitive time in the life of their nation.
We can only reduce the spread of this virus, reduce the casualty rate if we all can talk about this in all places. There is no need to wait for the next man to be infected; it is a preventive health approach and strategy if you tell the next man how to conduct himself from getting infected by this virus. Tell him all that there is about this disease, you will only be saving yet another life.
I do not like gossip but if we must gossip let it be about Lassa virus, it will be credited on to you as positive gossip in the right direction. Lives are at risk here.
Play your role!
Oxford dictionary defines sleep as “a condition of body and mind which typically recurs for several hours every night, in which the nervous system is inactive, the eyes closed, the postural muscles relaxed and consciousness are practically suspended”.
Mirriam-Webster sees it “as the neutral periodic suspension of consciousness during which the powers of the body are restored”.
The MacMillan dictionary for students defines sleep as “a naturally recurring state characterised by reduced or absent consciousness, relatively suspended sensory activity and inactivity of nearly a voluntary muscle”.
A slightly more scientific definition can be found in Stedman’s Medical Dictionary which sees sleep as “a natural periodic state of the mind and body, in which the eyes usually close and consciousness is completely or partially lost, so that there is decrease in bodily movement and responsiveness to external stimuli”.
The common threads in these descriptions, which appear to be necessary element in the definitions of sleep, are:
We can see how sleep is an integral part of our overall health and mental wellbeing. Sleep helps our brain to function well. When we are sleeping, a lot of healing goes on, our brain gets ready for the following day. But when we do not sleep, we create health problems that are acute and chronic. When we do not sleep, we are susceptible to taking very wrong decisions; we become so irrational in thinking, leads to accident and business failure through inability to make the right decisions. We most times feel we are supermen when we burn candles into late nights working, most of us even brag about it “you cannot believe I slept at 2.00am this morning”. Bravo to you! Your friends see you as a hardworking superman but you can never quantify the cumulative harm you are doing to health.
It is important to know that adequate sleep improves:
In terms of physical health:
So which ever balances the issue of sleep are weighed, it is safer to have adequate sleep knowing that our body will surely malfunction by the absence of sleep. We always think we have cheated nature by using the night meant for sleep and rest for the work we brought home from our offices. The body always have a way of demanding for it and we struggle with repayment, it is like paying for a loaf of bread already eaten. How difficult this always turns out. But we need to know there is a regulator called the “circadian rhythm” which is often referred to as the “body clock”. This is a 24-hour cycle that tells our bodies when to sleep and when to be awake. So this body clock waits for you in the day time to demand for the sleep owed during the night hours, this is why you see most people having micro sleep and dosing off at intervals during work.
WHO IS AT MOST RISK FOR INADEQUATE SLEEP?
HOW MUCH SLEEP DO WE REALLY NEED?
|Classification||Age||Recommended Hours of Sleep|
|The Elderly||>65 years||7 – 8 Hours|
|Adults||26 – 64 years||7 – 9 Hours|
|Young Adults||18 – 25 years||7 – 9 Hours|
|Teenagers||14 – 17 years||8 – 10 Hours|
|School Age||6 – 13 years||9 – 11 Hours|
|Pre-School Age||3 – 5 years||10 – 13 Hours|
|Toddlers||1 – 2 years||11 – 14 Hours|
|Infants||4 – 11 months||12 – 15 Hours|
|New-born||0 – 3 months||14 – 17 Hours|
These are the recommended hours of sleep based on age classification, but you will realised we are never able to meet these hours of sleep. The more we drift out of these brackets, the more our immunity is affected making us vulnerable to infections and even making infections last longer than necessary. Getting enough sleep is very crucial to our overall wellbeing.
LONG AND SHORT TERM EFFECTS OF SLEEP
IMPROVING YOUR SLEEP
Maintain sleep hygiene: Make your bed room a place for sleep and not an extension of your office. Go into the bed room only when you are ready to sleep, go in with a conscious mindfulness that you are going to sleep. Leave every work and task behind and switch off the lights before getting into the bed.
You must make conscious efforts to make your bed room and your bed look attractive and inviting, do not treat your bedroom without concern and see it as a very important place where you end your day. Some people sleep better in hotel rooms than they do in their homes, the difference is only the sleep environment. You can make yours also relaxing.
You need to develop a sleep pattern, maintain roughly the same bed time and wake time throughout the entire week. Your body over time gets used to this timing.
Keep your bedroom dark and cool, keeping all kinds of lights out. If you must use light, use “sleep friendly” light bulbs. Television in the bedroom is a great source of distraction leading to sleep deprivation.
Do not use the bed as a dining table or desk; it defiles the term “BED”. This makes our bed attractive to ants and other crawling insects that in turn disturb our sleep.
Most importantly, do not bring in your gadgets or phones into your bed room when you are ready to sleep. If you must bring them in, you either switch them off or put them on silence mode. One email or an sms that drops into your phone can deprive you of sleep the entire night. Yes, global economies but your health must not be made to melt with it.
SCHEDULING YOUR MEALS AND PHYSICAL ACTIVITY
Sleep diary: Popularly known as written log. You can use this to know the number of hours you sleep every day. Keep a sheet by your bed side, when you are ready to sleep write the time down, each time you wake up to use the convenience write wake up time and sleep time. This will help you know how many hours of sleep you are getting and how consistent it is.
Tracking device: These are electronic devices worn on the wrist, ankle, chest or head. It depends on the one you find convenient. It helps you track your hours of sleep, some of them also track both your stress level and your heart beat.
Smart Phone Apps: A number of these sleep tracking applications are on Play Store in your mobile phones, you can download them and use them to track your sleeping pattern.
Medical Evaluation is necessary if you suffer from severe sleep deprivation or disorders.
WHAT IS POOR SLEEP
When we talk about poor sleep, we are talking about a number of sleeps and sleep related disorders. Prominent amongst these are insomnia and chronic insomnia.
Insomnia is defined as a state of habitual sleeplessness or inability to sleep. This affects about 10% of a population.
Sleep Apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. This ultimately affects your ability to getting good enough sleep. Sleep apnea affects 20% of a population; many people have sleep apnea without knowing. It is important to always seek a Physician’s review.
Restless Leg Syndrome: If you have followed us in our blog www.ohsmcomng.blogspot.com, you will see the article we had written on restless leg syndrome. It is a must read. Restless Leg Syndrome popularly known as RLS, is a neurological disorder characterized by throbbing, pulling, creeping, or other unpleasant sensations in the legs and an uncontrollable, and sometimes overwhelming, urge to move them. One of the causes of RLS is excessive use of excess high heels shoes; this has become a global concern at workplace. This has a strong interaction with the duration of use, frequency of use and height of heels. Ladies are more involved in this, it makes them look really elegant but we must look at the health risk. When these unpleasant sensation starts, it will surely deprive you of sleep, 5% of a population suffer from RLS.
Circadian Rhythm disorders have 2% prevalence in a population group and this also leads to sleep lose or sleep deprivation.
Narcolepsy is another condition that is prevalent in 2% of a population. Narcolepsy is a condition characterized by an extreme tendency to fall asleep whenever in relaxing surroundings. This is witnessed every day in our environment, it is most common amongst new born. But this also tells us the relationship between a relaxed environment and sleep, so we must strive to make our bedroom more relaxing for the sake of good sleep leading to improved health outcomes.
Mild and moderate sleep complaints. This has 50% prevalent in a population, most people complain of these but they are never sure of what the real causes are but I am sure you will know that a number of factors are responsible after reading this article.
There is also a condition called dysomnia which is a diametrical opposite of insomnia. We will not be able to take all that now; I will need you to follow us in the next edition for the continuation of these issues bothering on sleep and health. We will be taking the concluding part in the next edition focusing on chronic insomnia, National Sleep Foundation Guidelines on Sleep and a number of other concepts.
I can be reached using firstname.lastname@example.org
Reference: Dr. Punam Ohri-Vachaspati’s presentations in Arizona State University
I am a member of International Commission on Occupational Health (ICOH); I was at the 31st ICOH Congress 2015 held May 31 – June 5, 2015 in Seoul South Korea. I sat in ICOH General Assembly on 5th June 2015 when I colleague raised a question on the increasing rate of migrant workers death in Qatar because of the quest to impress the world in 2022 FIFA World cup. I tried to listen to the response of ICOH and its position on this issue but I got worried the more I listened. In my mind, I concluded this as a case no one can look into while the death toll even increases in the days and years ahead. This prompted me to look for reports on this issue and the level of the work done so far in this direction. I became more worried the more lines I read.
Amongst all the reports, I asked myself where is ILO? where in WHO? and where are the Human Right Lawyers? I felt a bit of Amnesty International’s report and I was wondering why everyone is quiet over these sad occurrences, we watch healthy young men slaughtered at work in an attempt to earn a legitimate means of livelihood and the whole world is quiet? If the right to safe and healthy work place is a human right, then we have all failed these murdered migrant workers by such a collective global silence. No life should be lost because the world wants to watch football matches, the football pitches are all stained with innocent migrant workers blood, when we all seat down on those stadia upon completion what do we really see? You may see beautiful matches played but most of us will not see those matches but stains of blood because that is what the stadia in Qatar and the adjoining structures will remind us of.
I got sad when I read the report that after five years of securing the bid to host the World Cup, Qatar’s government is just issuing a statement that significant progress was being made to improve lives and labour conditions of guest workers in Qatar. Who is going to speak for these workers who have got no voice because they have been banned from union representation, who is going to speak for them when the home government in Nepal has issued a careless statement that the migrant workers suffer stroke because they are adjusting to air conditioner system. The government of Nepal’s interest and concern is only the remittance repatriated home by these people, this forms almost 30%of Nepal’s GDP. Is this enough for any responsible government to keep silent and what her people die in their workplaces? “Your life becomes wrecked when those who would have spoken in your defence turn their back against you to share Champaign with your adversary”. This is sad!
Qatar was once one of the poorest Gulf States, now one of the richest countries in the region as a result of the large exploitation of large oil and gas fields since the 1940s. It has more than 15% of world’s proven gas reserve. It got its independence 1971, has the world’s richest country per capita and ruled since mid-19th century by the Al Thani’s family.
Qatar has also been identified as a middle power due to the ways it has projected itself to the world and Qatar is also an influential player in the Arab world.
Qatar has a population of 1.8 million people according to 2013 report which also states Qatari citizens are only 280,000 of the population while expatriates are 1.5 million people. This makes Qatari nationals merely 13% of the country’s population. According to 2013 report, Qatar has 545,000 Indians, 341,000 Nepalese, 185,000 Filipinos, 137,000 Bangladeshis, 100,000 Sri Lankans, 90,000 Pakistanis and many other nationals. This is the biggest ratio of migrants to citizens in the world.
Qatar will be the first Arab country to host the FIFA World Cup having won the controversial bid to host the 2022 World Cup and this marks the beginning of man slaughter in workplaces in Qatar. Though there are talks that the small but wealthy Gulf state would be stripped of the competition, amid allegations of corruption at world football’s governing body FIFA. “Qatar 2022 is now being investigated; FBI and Swiss are counting the alleged cost of bribes while Nepal is counting the actual cost of lives”. But will this justify or make up for the blood of innocent and harmless migrant workers who are slayed or killed every other day (an average of one death per day) in Qatar workplaces and yet the world seems to pay deaf ears? We allow evil to prevail when the good ones who ought to speak keep a mum silence and that is currently the case in Qatar. The government of Nepal leads the position of utmost silence that is interpreted to mean “you cannot bite the finger that feeds you”. Really sad!
Recently, a story of a Nepalese named Shiva Tamanga who was murdered in Qatar by a Bulldozer in construction site on 19th April, 2015 as reported by John Irvine, a Senior Special Correspondence at ITV. Shiva only left Nepal to work in Qatar six months before his workplace death leaving behind his pregnant wife; he was brought back to Kathmandu international airport in a coffin after six months. At monks chanted at his cremation, his mother wailed and his widow passed out. This is the story of Shiva Tamanga, one man down but who is next as Qatar’s construction continues.
A number of hardships are suffered daily by migrant workers I Qatar. According to ITV correspondence, one of the Nepalese migrant workers he interviewed anonymously complained about poor treatment and rotten food leading to food poisoning resulting in deaths of three to four workers in his company in Doha each month. He also complained he was having his holiday for the first time in three years because his employer has always refused to release him. He was eventually allowed to go home on this holiday on the condition that he accompanies a body (dead worker) in this journey.
If the world indeed gathers in 2022 to either play or watch world cup matches played in Qatar that will be seen as a global approval and justification for the gruesome deaths of those migrant workers who fall victims to poor labour legislation that has fanned into flame uncontrollable unsafe workplaces scattered all over Qatar. The speed at which construction of roads, stadia, new hotels and other facilities is currently going on at the expense of the huge population of migrant workers currently working in Qatar, needs to be brought to global pedestal for objective balancing. This is wicked, shrewd, rude, inhuman, and unacceptable and must be collectively criticised in one voice. The blood cries of innocent workers killed cries so loud yet everyone pretends not to hear.
According to a recent graphics form Washington Post which suggested that as many as 1,200 migrant workers have died in Qatar since 2010, compared to handfuls of deaths before other recent global sporting events. A number of media outlets worldwide – including Channel 4 News repeated that figure of 1,200 deaths while the Qatar government has responded disclaiming those figures and tag them as untrue. These 1,200 deaths are claimed to be nationals of India and Nepal alone according to figures released by local embassies of both countries.
If indeed these figures are untrue, it is the responsibility of the government of Qatar to tell us the truth supported with evidence.
You will agree with me that most of these deaths are not reported and even deaths that are occupational risk induced could be also wrongly classified. The reason is not far from the poor Labour Legislation in Qatar. In any event, the source of the “1,200 dead” figure which originates in the 2013 report by the International Trade Union Congress (ITUC) is simply the total deaths among the Indian and Nepalese migrant population, not deaths from accident alone or just deaths among construction workers.
So how many people have died while working specifically on World Cup 2022 projects? We do not know but this government of Qatar says it is ZERO! The question is how true is this claim by the government?
There are many numbers of quotes out there like the one in this report from German newspaper Die Welt: “some time ago, Hamid said a worker fell to his death from the roof of a building on an adjacent construction site. In November, 2014 a man had been burnt to death in a fire incidence”.
But this this is hearsay, the kind of evidence that would not stand up in a British court, and it is not clear whether the “adjacent construction site” had anything to do with the World Cup. But Amnesty International says it has “no reason to doubt” the claims that no lives have been lost on World Cup construction sites, although it argues that we need a broader definition of World Cup-related building work, saying: “Most major construction projects in Qatar are related to the World Cup”.
The law firm DLA Piper which was contracted by the government of Qatar to carry out an independent review of Qatar’s labour laws, found evidence of at least 22 worker-related deaths among Indian, Nepalese and Bangladeshi migrants in 2013 alone. That is out of the 600 total deaths among migrant workers from these three countries in that year.
Now we begin to wonder where the claims came from by the government of Qatar that no worker has died working in Qatar on the World Cup projects, we are all worried and hold the opinion that Qatar government has a lot to hide in this regard. The earlier they tell the world the truth on this matter, the faster help comes their way.
How dangerous is working in Qatar?
The Qatar government’s press release gives the impression that there are no health risks at all attached to being a foreign worker in Qatar but quite the opposite is the fact. There are more than 1 million migrant workers in Qatar, the Global Burden of Disease published in “The Lancet” in 2012 states that more than 400 deaths might be expected annually from cardiovascular disease alone among Qatar’s migrant population.
Figure sourced separately by the Guardian from Nepalese authorities suggests the total deaths during that period could be as high as 188. In 2013, the figure from January to mid-November was 168.
“We Know that people who work long hours in high temperature are highly vulnerable to fatal heat stroke, so obviously these figures continue to cause alarm”, said Nicholas McGeehan, the Middle East researcher at Human Rights Watch.
It is Qatar’s responsibility to determine if deaths are related to living and working conditions, but Qatar flatly rejected a DLA Piper recommendation to launch an immediate investigation into these deaths last year. It has been quoted in some quarters that the spate of the current heart attacks among migrant workers in Qatar is as a result of dehydration suffered by workers because they are not provided enough water to drink in their workplaces.
The Embassy of Nepal said 191 Nepalese workers died in 2013, adding that “most deaths were a result of cardiac arrest”, according to DLA Piper. A former Nepali Ambassador to Doha has put a more precise figure on the proportion of migrant worker death attributable to “sudden heart attack at 55%”.
Data on causes of death in Qatar is weak, the report adds, as autopsies and post mortem on people who die sudden and unexpected deaths are forbidden by Qatari law unless a crime is suspected. As things stand, there are few reliable statistics on workplace accidents and deaths in Qatar.
Qatar’s current health strategy document states: “Qatar’s vast population of male labourers, primarily in the construction industry, has limited access to healthcare services and also operates in hazardous environments”.
Workplace injuries are the third highest causes of accidental deaths in Qatar. And yet, Qatar does not have national occupational health standards or guidelines and there is limited data on workplace-related fatalities.
It becomes really difficult when even media professionals are not allowed to report on what’s going on in this country. Qatar gets a red rating from Reporters Without Borders, indicating a “difficult situation” for press freedom. Last month a BBC team was arrested and interrogated while trying to talk to migrant workers on fatalities and work conditions in the country.
I strongly believe this is an unhealthy practice that must be collectively condemned in strong words. You cannot expose workers to harsh and unsafe work conditions and want to shield this in secrecy. No, it does not work that way.
ITV News managed to film Nepalese workers in the country, as well as the families of dead migrant been flown back to Nepal in coffins. Nepal’s Minister for labour, Tek Bahadur Gurung, blamed the heart attacks on a problem of “orientation”, saying workers were dying after suddenly turning on the air conditioning in their living quarters.
The suggestion was that the Nepalese government would be reluctant to criticise foreign “partners” like Qatar given the amount of money sent back by Nepalese working abroad. These remittances made up 29 per cent of Nepal’s entire GDP in 2013/14. What a shame and human sacrifice by a country just to earn GDP at the expense of slayed citizens working abroad. It is not normal!
Sadly, we have seen that Nepalese migrant workers are faced with absolute betrayal from even the government of their home country. When truth is slaughtered on the altar of gains, this is always the result. The question is, “who now fights for the right of these helpless sets of people when those who are supposed to negotiate their rights have turned their faces against their collective hurts”. When a government issues a statement as this, it is taken as an approval of injustice and a continuation in status quo.
No matter the amount of remittances contributed to the GDP of Nepal, no amount of money is worth the slaughtering of healthy men who went to work in Qatar in quest of legitimate means of survival. The statement credited to Nepal’s Labour Minister should be used to make a case against him for aiding and abetting the increasing death of Nepalese migrant workers in Qatar. This is such a sorry state which I think Amnesty International should look into.
There are a number of other claims ranging from:
This may only be a partial list, a number of issues possibly exist which are not accessible to the media because of the system that operates in Qatar.
The major report commissioned by Qatar into its treatment of migrant workers produced more than 60 suggested reforms and a confirmation that hundreds of migrants have died and many of them from unexplained sudden illnesses over the past two years, at a rate of more than one death a day. The report by international law firm DLA Piper calls for changes in the much criticized “kafala” system that ties workers to their employers.
Though the artists’ impressions of Qatar’s 2022 World Cup venues, like the Qatar Foundation Stadium, are impressive – but criticism over treatment of migrant workers has dogged the development.
It has been published in a number of papers that there has never been such high worker mortality recorded in the history of nations’ preparations to host the World Cup or any international sports tournament, from Beijing Olympics to Brazil World Cup. A number of people have though argued from different quarters that the deaths in Qatar has nothing to do with the World Cup because construction has been on-going in Qatar even without the World Cup host plan. But the Director of campaign of the International Trade Union Congress (ITUC), Tim Noonan says “although the World Cup stadium was only started last year, subways, hotels, and even an entire city are currently being built, not to mention an airport, numerous roads, a new sewage system in central Doha and 20 skyscrapers. “It needs to be remembered that the infrastructure program in Qatar is entirely built around the delivery date of the World Cup in Qatar”. Tim also said about 900 foreign workers will die per year in Qatar in the years leading to the tournament.
I took time to do this report using information that have been published on the ills in Qatar hoping it will create clarity on these health and safety concerns centred around the migrant workers in that country. We cannot all pretend to keep quiet over these issues while every day that passes, a migrant worker dies. They must not be our relatives before we show honest concerns, we must first see ourselves as “We” (fellow global citizens) before we see ourselves as “I”. “We are all we have”, when we close our eyes to the death of innocent migrant workers, we reduce our collective strength. “The weak needs the strong to stand for him and the strong needs the weak to show the might of his strength”, we all may not have voice that can be far heard but he who has lost his voice needs a brother to speak for him.
The whole world and global political powers may pretend not to know about the goings-on in Qatar, but we all need to remember that we are accountable to our own conscience. As popularly put by the Nigerian Guardian newspapers “Conscience is an open wound, only truth can heal it”. I will rather be caught speaking or fighting for a course than take the non-partisan position for fear of being tagged. What is wrong is wrong, no matter the balances where they are weighed and it is our responsibility to speak against them in clear terms.
It will make a global sense, if we all rise and speak against this ill in Qatar and migrant workers get saved than getting excited watching matches in Qatar stadia stained by the blood innocent migrant workers.
I am only an Occupational Health and Safety practitioner in Nigeria and these are my concerns.
I can be reached at: email@example.com
www.itv.com : John Irvine
We are having a new wave of challenge in Nigeria which bothers more on the safety of the school child and the negligence in school management.
It is global desire that every child has access to quality education across regions of the world, we in Nigeria in African region are battling towards ensuring this goal is achieved. There are obvious challenges ranging from the state and standard of education coupled with the cost of education. These are huge enough challenges for parents owing to the failure on the part of government in their inability to provide requisite and enabling infrastructures in schools and measurable regulations of the entire educational system. There are public schools which are generally a far cry of what schools in the real sense should be, there are places where children seat on the floor to learn and even in some regions within the country where children learn under trees or buildings without roofs. I get really worried what kind of education or learning that can be achieved under such conditions.
In trying to find a way out of this total mess in Nigerian education sector, access to quality schools have fallen into the hands of the private sector groups even some of these schools are owned by individuals who destroyed the education sector when they were in government. Parents in their honest desire to give their children quality education have swooped into patronising these private schools where a child access to quality education is sold at an astronomical rate beyond what most parents can even afford. This has placed parents under increased daily pressure and undue stress which has become a huge confounder of the decreasing health expectancy of the Nigerian people.
It has become even more frustrating the government inability to rightly regulate these schools and this failure on the part of government bites the emotions of parents and sometimes leaves most parents with very heavy traumatic experience. The quality and standard in academic delivery is an issue for another day but in the context of this expression we need to look at the issue that bothers on the health and safety of these children while under the care of the schools.
Lately, we have heard of a number of cases where kids who were conveyed to schools by the school bus which their parents are invoiced for, end up being killed due to the carelessness and recklessness of the school bus drivers. This further leaves the parents with such an enormous pain that nothing can sooth. I cried helplessly at work one afternoon when my wife called me on the phone to tell the school bus that my children ride on has killed a school child under the driver and the minder’s care, i literally died at the break of that news. The boy who was about 3 years old, an only son of his parents was crushed by the school bus right before his two elder sisters who alerted from the same school bus, what a trauma. I was told the boy got down from the bus but his water bottle fell from him and rolled slightly towards the tyre of the bus and the boy went for the water bottle the bus was suddenly reversed and crushed the boy to death right in front of his house. As i write this story, there are still tears in my eyes because i am yet to get over this heart renting picture. I am grateful to God for his mercies everyday, placed in the same condition as this parents i am not sure i will survive but i thank God each time i see the parents of this little boy and the way God has helped them to manage and cope with the situation. There are cases too many to recount.
There was another case where a school bus loaded beyond the capacity of the bus was conveying children to school and it caught fire, some children died while some were rescued.
Many questions begging for answers.
If the future we hope for must be better than what we currently have, then the need to look inward schools is a strong imperative of everyone including the machinery of government irrespective of political differences. This is the future.
Parents pay so much and for these services and hurting them having collected their hard earned money is a disservice and a criminal act. A story of another family who sent their 3 months old son to a creche, they have such a heart touching story to share on how their son was manhandled in the creche and how the boy eventually died.
Both parents work and they had to send their 3 months old son to creche, they drop him on their way to work and pick him while returning from work. This fateful day, they picked the child home after work and in the middle of the night, the child started crying uncontrollably with running temperature and they tried managing him till about 5.00am when they had to rush him to a hospital where the boy’s uncle works. Immediately they got in, they admitted the boy into an intensive care unit without delay, they battled endlessly to save his life. The Doctor came out of the ICU much later and told the father of the boy, “this is a very serious case, the boy has a damage in his brain”. Obviously, this boy must have fallen while in creche and hit his head and the incident was never reported to the parents yet the boy was under a creche paid for by a labouring parent. May God bless the soul of that little boy who eventually died out of human negligence in what was trusted in to their care.
I am sure many of us have read the stories i had published on the incident that involved my son and a daughter of another family who lost their lovely daughter called Morenike under same negligence www.facebook.com/changingtheworldnetwork.
We all cannot keep quiet and allow such evil to prevail, we have put up a social movement called “Movement Against Negligence In Schools” (MANIS) it is non government and non profit social movement and we are calling on all parents and interest groups to identify with this movement, lend their voices, file in complaints, it must not be your child but when you speak out for some person’s child, angel will watch over your own.
Go to our facebook page and like it www.facebook.com/groups/advocacyforchildsafetyatschools and www.facebook.com/changingtheworldnetwork we are using both pages for this change.
Please publish your stories in these pages and let’s put energy together on this issues and ensure we stop these wrongs.