…to sanction violators of peaceful democratic process
=By Funmi Falobi=
United States and United Kingdom have reiterated their support for a genuine free, fair, transparent and peaceful 2019 elections in Nigeria.
According to the two world power, the conduct of the coming elections in the country is important not only for Nigeria, but for the African continent.
The US in a statement said that, “The United States government does not support any specific candidate or party in Nigeria’s upcoming elections. The United States supports the Nigerian democratic process itself. We support a genuinely free, fair, transparent, and peaceful electoral process.
“We, and other democratic nations, will be paying close attention to actions of individuals who interfere in the democratic process or instigate violence against the civilian population before, during, or after the elections. We will not hesitate to consider consequences – including visa restrictions – for those found to be responsible for election-related violence or undermining the democratic process. Under U.S. immigration law, certain violations may also lead to restrictions on family members.”
The US added that it welcome the signing of peace pledges by Nigerian candidates and their commitment to a peaceful electoral process.
Similarly, the UK said that it will continue to provide significant support to Nigeria’s Independent National Electoral Commission, INEC, and to Nigerian civil society to help them deliver credible elections. It further said that it will also regularly engage with actors across the political spectrum to encourage them to respect electoral rules and maintain an atmosphere of peace and calm.
“The British High Commission in Abuja would like to reaffirm our strong support for free, fair and peaceful elections in Nigeria. We and our international partners remain committed supporters of Nigeria’s democracy. We do not support any party or individual and believe that the Nigerian people should be able to choose their leaders in an environment free from hate speech and insecurity. “
The UK said it will deploy an extensive observation mission for the forthcoming elections, including coordinating with the European Union, EU’s Election Observation Mission. “Our monitors will in particular be looking out for any attempts to encourage or use violence to influence the elections, including on social media. We would like to remind all Nigerians that where the UK is aware of such attempts, this may have consequences for individuals. These could include their eligibility to travel to the UK, their ability to access UK based funds or lead to prosecution under international law.
Two Nigerian non-governmental organisations, Media Rights Agenda (MRA) and the Institute for Media and Society (IMS) have been named among 15 “Global champions of free expression” that have been shortlisted for the 2019 Index on Censorship Freedom of Expression Awards.
In a statement issued in London, the United Kingdom-based campaigning organisation, Index on Censorship, announced the 15 shortlisted individuals and organisations from around the world, saying they were drawn from more than 400 crowd sourced nominations which include “artists, writers, journalists and campaigners fighting for freedom of expression against immense obstacles.”
“Free speech is the cornerstone of a free society – and it’s under increasing threat worldwide. That’s why it’s more important than ever to recognise the groups and individuals willing to stand up for it,” Ms Jodie Ginsberg, CEO of Index on Censorship, said in the statement.
The Awards fellowships are offered in four categories, namely: Arts, Campaigning, Digital Activism and Journalism. Final winners in each category will be announced at a gala ceremony to be held in London on April 4, 2019.
Judges for this year’s awards include the award-winning investigative journalist and Rappler.com Editor-in-Chief, Maria Ressa; actor and filmmaker Khalid Abdalla; computer scientist and author Dr. Kate Devlin; and writer and social activist Nimco Ali.
Index on Censorship noted in its statement that Media Rights Agenda “has spent the last two decades working to improve media freedom and freedom of expression in Nigeria by challenging the government in courts,” adding that “Through its active legal team, MRA has initiated strategic litigation targeting dozens of institutions, politicians and officials to improve the country’s legal framework around media freedom.”
It said MRA’s “persistent campaigning and lawsuits on freedom of information have helped improve access to government-held data.”
Index on Censorship noted that IMS “aims to improve the country’s media landscape by challenging government regulation and fostering the creation of community radio stations in rural areas at a time when local journalism globally is under threat” and praised the organisation for combining “research and advocacy to challenge legal restrictions on the media as well as practical action to encourage Nigerians to use their voices.”
The International Press Center, IPC, has demanded the immediate release of Yinka Badmus, a photojournalist with Talk Village International in Lagos.
In a report by Vanguard Newspaper dated January 11th, 2019, Badmus, 24, was arrested on New Year eve by policemen attached to the Lagos State Anti-Cultism unit for wearing dreadlocks, which the officers allegedly said made him look like a cultist while eating noodles at Pedro Bus stop, Gbagada, Lagos.
In a statement, Lanre Arogundade, Director, IPC, said it was unconstitutional for him to have been detained for many days before he was eventually arraigned and remanded on the orders of an Ogudu Magistrate Court, Lagos.
Arogundade pleaded with the Lagos State Commissioner of Police to step into the matter so that the photo journalist could regain his freedom.
The IPC Director also enjoined journalists to be mindful of their safety and ensure they have a means of identification on them at all times.
Yinka Badmus is currently being held at Ikoyi Prisons.
As 2019 elections are gathering momentum, Nigerian journalists have been tasked to shun hate speech and embrace best practices in the electoral reportage.
Similarly, journalists are also urged beyond reporting, to have the mindset of entrepreneurs in order to harness opportunities.
This was the submission at a two day workshop organised by the International Press Centre (IPC) in conjunction with European Union support to Democratic Governance in Nigeria (EU-SDGN) for journalists in the South West region held at Osogbo, Osun State with the theme, “Best Practices and Professional Reporting of the Electoral Process.”
According to the IPC Director, Lanre Arogundade, the event was organised to critically examine the interconnections between the public, the media and elections towards developing an agenda that seeks to strengthen the role of the media in facilitating a credible electoral process.
“It is expected that this training will help participants to understand and imbibe the principles of fairness, diversity and objectivity in reporting the electoral process and the elections with the anticipation that this meeting will provide an integral opportunity for journalists to share their experiences to ensure best practice reporting for the 2019 elections,” he said.
In his speech, Muyiwa Popoola, Professor of Journalism, Communication and Media Studies, Ajayi Crowther University, said the way the media report issues contributes to conflict and violence.
Speaking on the topic, “Towards 2019: Avoiding Hate Speech and Being Conflict Sensitive in Election Reporting,” Popoola said Nigerian reporters have responsibility to cover the fact but avoid stoking hate speech.
“Nigerian media professionals should always endeavour to evaluate before they publish. They should be conflict sensitive oriented by adopting Conflict Sensitive Reporting (CSR) style. How we report conflict determines our safety in the land,” he said.
While enjoining journalists to uphold ethical professionalism in reporting the 2019 elections, the university don said, “As journalists, we should not just be searching for scoops, we should research, we should not be lazy journalists. In our reportage, we should look for shadow parties to reduce political conflict in the country.”
On his part, David Ajikobi, Nigerian Editor, Africa Check, took participants on eliminating bias in election reporting.
He enjoined journalists to get new skills necessary in fact checking and use such to present correct facts since readers tend to believe more in what they read from journalists.
Warning journalists not to fall victim of fake news, Ajikobi declared that in the next elections, fake news will be a threat – Facebook, Whatsapp, Twitter, fake news websites.
“A fact is what can be checked and backed up with evidence. Asking questions is the basis of fact checking. It makes leaders accountable before they act,” he said.
The fact checking expert took journalists through some tools they could use to verify pictures often used to propel fake news.
“As journalists you must be careful not to fall for fake accounts when you are using the social media as news source because your credibility built over the years can vanish when you share false information,” he warned.
Consequently, Taiwo Obe, Founder, Journalism Clinic, advised journalists to have the mindset of entrepreneurs.
Using his own media experience, Obe, who had invested over 40 years in journalism, went beyond the training outline to encourage journalists to think differently in order to maximise their career opportunities.
Speaking on the topic entitled “Enhancing Election Reporting in the Digital Age,” Obe said,
“If you have not trained your mind in what you do daily I want you to re-condition it and if you are not critical about your thoughts, you would be doing the same routine. It is necessary to do a self worth analysis.
Internet has no boundary don’t limit yourself. It is inferred that journalism has moved don’t limit yourself.”
Obe also took participants through career enhancing tools necessary for 21st century journalists. This include: Quick, Anchor, Google earth, Nimbles, Facebooklife among others.
Lagos State Governor, Akinwunmi Ambode said that 1,252 farmers have been empowered by the State Government under its agricultural value and empowerment programme aimed to reduce poverty in the State.
Ambode who made this known at the flag off ceremony of the 2018 Agricultural Value Chains Empowerment Programme noted that the 1,252 farmers in the state have been supported in various farming enterprise and empowered to boost their productive capacities in line with the State’s food security objective.
The governor who was represented by the Commissioner for Agriculture, Mr. Oluwatoyin Suarau stated that the programme is a strategic approach employed by the state government to enhance productivity and improve standard of living of small holder farmers, fishermen, agro processors and marketers through the provision of inputs, productive assets and capacity building so as to ensure the steady supply of food to Lagosians.
He noted that food security became a major challenge as a result of the drastic decline in oil revenue stressing that it has now become imperative to conserve foreign exchange by reviving the agricultural sector through policies and programmes that will encourage more people to go into farming and increase food production.
Ambode added that the state government as a matter of policy has ensured that basic infrastructural facilities are evenly distributed across the state especially in rural communities despite the fact that most farming activities are based in the rural and semi urban areas.
“Our objective is to make our communities liveable and centres of economic activities. This strategy we believe will reverse the trend of rural to urban migration and also make farming more attractive especially to young people,” he said.
While stressing that his administration is committed to ensuring food self-sufficiency for the teeming population through well designed and thought initiatives, the governor said that his administration will not relent in its effort to encourage farming activities in the rural communities by reducing the infrastructural gap between rural and urban centres.
He added that the State Government has procured a 32 metric tons per hour rice mill to sustain the production and processing of local rice in the state which will create over 500,000 jobs in form of manpower to operate the mill directly.
Earlier in his address, the Permanent Secretary, Ministry of Agriculture, Dr. Olayiwole Onasanya explained that the state government through various farming enterprises which include egg marketers, piggery, butchery, poultry production, vegetable production, perishable produce trading, sheep and goat production, aquaculture, fish feed input, artisanal fisheries and fish processing is working towards food sufficiency .
The International Press Centre (IPC) is highly concerned about the reported gun-attack on journalists who were covering the Lagos State rally of the All Progressives Congress (APC) in Lagos on Tuesday, January 8, 2019.
According to news reports, among those that were affected by the unwelcome activities of gun wielding elements were the group political editor of The Nation Newspaper, Emmanuel Oladesu, News Telegraph correspondent, Temitope Ogunbanke and Ibile Television cameraman, Abiodun Yusuf.
The News Editor of The Nation confirmed the incident to IPC stating that Mr. Oladesu was hit by a stray bullet and was receiving treatment in a hospital although in stable condition.
In a signed statement by the Director, Lanre Arogundade, IPC hereby reminds all political parties that the Nigerian Media Code of Election Coverage obligates them to ensure the safety of journalists covering their activities including campaigns.
The organisation therefore calls on the Lagos APC to urgently take appropriate steps to apprehend the alleged perpetrators of the bizarre attack with a view to handing them over to the law enforcement agencies for immediate prosecution, also as provided by the Code of Election Coverage.
IPC calls on all journalists covering the ongoing campaigns to keep themselves abreast of all safety measure.” They should learn to stay away from political activities where rival gangs engage in show of force especially through display of weapons.
Journalists covering the elections should also bear in mind that they constitute dangerous assignments requiring them to take insurance cover especially from their employees,” Arogundade said.
IPC appeals to the security agents on electoral duty, especially the Police, to consider the protection of journalists as part of their responsibility as envisaged by and indeed provided for by the Nigerian Media Code of Election Coverage.
“From the evidence available, 28% of all maternal death in Nigeria is caused by excessive bleeding after child birth. 28% means that in almost every four women, one of them die as a result of Postpartum Hemorrhage and that is something that needs attention in terms of addressing maternal deaths in Nigeria”.
Maternal mortality and consequential social dysfunction
Sitting with a forlorn face and wondering what the future now holds, Mr. James Ogbe’s* life has not been the same following the sudden death of his wife as a result of post-delivery bleeding she experienced few hours after the birth of their second child. With a six year old girl and the new baby to now take care of, James Ogbe is not only mourning the untimely death of a loving wife, but also faced with the task of taking care of his two young children alone.
“How do I live on with life now? Where do I start from”, he said, with a voice laden with sadness. Why did she have to die? Please take away the baby, give me my wife back. Please give me my wife back!”, he demanded, expecting an answer from the nurse, that Saturday morning, minutes after he was told that his wife had died.
“I don’t want this baby, just give me my wife. Please give me my wife”, he repeated, with eyes fixed on the walls, above the nurse who was carrying his new-born baby. As he looks on at the wall vaguely, droplet of tears streams down his face. “Please give me my wife”, he muttered again and again, as a family member and another, a member of his church, rally round to hush him from further lamentations.
‘When she delivered, there were no issues at all. The labour period didn’t take long and the delivery was also normal. There’s wasn’t any much anxiety throughout it all. We had talked for some minutes after giving birth and we were even already hoping she would be discharged by the next morning”, Ogbe recounted.
“The next thing I heard later was that she was bleeding and that she needed extra blood as she had used three pints already. I was told that she may need a fourth one, so I had to go in an ambulance from the General Hospital, Ijaiye to Island Hospital, Lagos to get extra blood as their stock was already exhausted. By the time I came back with the blood, they told me she had died” Ogbe explained.
“How can she die from bleeding? Somebody that was okay and I saw and spoke with? I got the blood she needed, yet she still bled and died, why? How?”, he asked, lamenting.
Now, months later, with wife buried and family support rendered, the reality of the loss of a dear wife and the challenge in taking care of two little kids has gradually re-shaped the horizon for James Ogbe. Though the support from family, relatives and church members had helped in gradually and slowly dissipating the grief, there yet remain an un-answered question in the heart of James Ogbe and many others, relating to the circumstances that led to his wife bleeding to death after what seems to be a successful delivery of his second child.
“We picked that hospital because it was one of the best general hospital in Lagos. Why things twisted is still a mystery, and I wake up everyday seeking for answers”, he notes, as he tries to pick up his life again, each day driving home the reality that he has become a widower at just 36!
Understanding Postpartum Hemorrhage
James Ogbe’s questions may remain un-answered, as it is with many Postpartum Hemorrhage deaths in Nigeria. According to a 2016 report by the International Journal of Women’s Health (IJWH), post child-birth bleeding, medical known as Primary Postpartum Hemorrhage (PPH) is defined as blood loss from the genital tract of 500 mL or more following a normal vaginal delivery or 1,000 mL or more following a cesarean section within 24 hours of birth.
Giving a more simplified definition, the World Health Organization (WHO) in its June 15, 2017 recommendations on the World Maternal Antifibrinolytic (WOMAN) Trial on Prevention and Treatment of Postpartum Hemorrhage, defined PPH as a blood loss of 500 ml or more within 24 hours after birth. It noted that PPH is the leading cause of maternal mortality in low-income countries, and the primary cause of nearly one quarter of all maternal deaths globally. It was stated that most deaths resulting from PPH occur during the first 24 hours after birth. Interestingly, the WHO report also pointed out that the majority of PPH death could be avoided through the use of prophylactic uterotonic during the third stage of labour and by timely and appropriate management.
In Nigeria, an organization established as a response to the rising maternal morbidity and mortality rates in the country, the Community Health and Research Initiative (CHR) also shares the same concerns with the WHO, that timely and appropriate attention to post-delivery bleeding is critically important, especially because PPH occurs without warning, and a woman with severe PPH can bleed to death within a few hours if not rapidly and adequately treated.
As part of advocacy efforts to address the mortality resulting from PPH, an advocacy brief by CHR, titled, ‘simple facts about postpartum hemorrhage’ notes that the main cause of PPH is the failure of the uterus to contract after childbirth due to a number of reasons including lacerations in the birth canal, uterine rupture, retained placenta tissue and blood coagulation disorders. The document however noted that, “PPH can be prevented through the provision of appropriate medication and the administration of a class of medicines called uterotonics”. According to the advocacy brief, “postpartum hemorrhage death could be prevented if all women were given a high quality uterotonic immediately after delivery.”
The challenges in using Oxytocin in PPH prevention
Giving an insight about PPH, Dr. Musa Mohammed Bello, a Consultant Public Health Physician and member board of trustees of CHR, explained that Postpartum Hemorrhage which literally means excessive bleeding after child-birth is a condition that is very common among women and child delivery in Nigeria.
“We all know that in developing countries like Nigeria, maternal mortality or death of women during pregnancy, child birth or after child birth is very common, especially in Africa”, he said.
He further pointed out that though PPH deaths are easily preventable by the administration of an uterotonic drug, which helps to stop a woman from bleeding after child birth, he however emphasized that the conditions of storage and handling of the drug matters.
“Actually there are drugs that are supposed to be used to prevent Postpartum Hemorrhage. These drugs are very good, and they have been experimented and recommended to be used. These drugs have an umbrella name called uterotonic, which means group of drugs that causes contractions of the uterus of the womb after child birth. There are many of them, for example, there is Oxytocin injection, there is Egometrine injection, and there is Misoprostol tablet”, he explained.
“Out of these, Oxytocin is the most preferred first line drug of choice, but there is an issue with it in that it requires maintenance of content; you need to store it in a cold compartment between a temperature of 2 to 8 degrees Celsius for it to remain effective, but unfortunately, in developing countries like ours, we have problem with power so maintaining the content, refrigerating because of electricity problem is usually difficult, so these drugs are not performing the functions we expect them to perform, because of the heat nature”, he added.
Expatiating, he said: “So you find out that a woman has delivered, she’s bleeding and they gave her Oxytocin injection 3-4 times and it’s still not working because it has lost what we call efficacy due to temperature effect”.
Also giving credence on the need for a proper policy framework for the procurement and distribution of essential drugs, the National Chairman of the Association of Community Pharmacists of Nigeria (ACPN), Comrade Samuel Adekola, a pharmacist by profession, noted that despite all the effort to reduce maternal mortality in Nigeria, a critical mass of women still die with PPH being one of the leading causes of such deaths. While agreeing that Oxytocin as a first choice of drugs could be used to manage the situation, he however pointed out that for oxytocin to be effective, it must be stored at a specified temperature at all times.
“Oxytocin is the preferred first line drug of choice for the treatment of PPH. However it is the drug that has peculiarity in terms of transportation and storage, as it has to be stored between 2 and 8 degree Celsius. The drug has to be in a cold storage system at all times for it to remain effective. This is the challenge because of our environment, we have the problem of light and the problem of infrastructure. The fridge for storing a vaccine like oxytocin is not available in many places and where it is available, there may be no electricity to power them and yet people still give the drug, because it is there in the store”, he noted.
“Unfortunately, there is no means of knowing whether the temperature and the environment have affected it (Oxytocin), so they still give it because it is there in the store, irrespective of whether the condition of storage is as prescribed”, he pointed out.
“It is this challenge of the storage of Oxytocin that has given rise to research and development to another variety known as Carbetocin, which has been tested and proven and is now the drug being advocated, for the treatment of Postpartum Hemorrhage”, he added.
From Oxytocin to Carbetocin, hope rises
It would be recalled that sequel to the need to address the challenges associated with the use of Oxytocin in humid regions, the Word Health Organization (WHO) in June 2018 announced the report of a study on the formulation of a new drug for the treatment of postpartum hemorrhage in low and middle-income countries. In the study, published in the New England Journal of Medicine, an alternative drug – heat-stable Carbetocin – was recommended to be as safe and effective as Oxytocin in preventing postpartum hemorrhage.
“This new formulation of Carbetocin does not require refrigeration and retains its efficacy for at least 3 years stored at 30 degrees Celsius and 75% relative humidity”, a portion of the study stated.
The clinical trial, the largest of its kind, studied close to 30 000 women who gave birth vaginally in 10 countries: Argentina, Egypt, India, Kenya, Nigeria, Singapore, South Africa, Thailand, Uganda and the United Kingdom.
“The development of a drug to prevent postpartum hemorrhage that continues to remain effective in hot and humid conditions is very good news for the millions of women who give birth in parts of the world without access to reliable refrigeration,” Dr. Metin Gülmezoglu of the Department of Reproductive Health and Research at WHO, had said.
Acknowledging the WHO report, Comrade Adekola notes that Carbetocin has the advantage that it does not require any special condition other than keeping it at the normal room temperature. So it is a good alternative for effective treatment of PPH.
“This drug has been tested and would soon be released by WHO as the first line choice for the treatment of PPH. It is an injectable like Oxytocin, and also heat stable.
“We are calling on government at the national, state and local level to make this drug available, as it has the advantage that it can be stored at room temperature and there are no environmental factors affecting it like Oxytocin. Government should therefore do what they need to do to make this drug available so that every pregnant woman can have access to this drug, when the need arises”, he added.
Meanwhile and in the same vein, Dr. Aminu Magashi Garba, Coordinator, Africa Health Budget Network, Abuja is urging for a multi-stakeholders involvement in mitigating maternal mortalities in Nigeria.
“From the evidence available, 28% of all maternal death in Nigeria is caused by excessive bleeding after child birth. 28% means that in almost every four women, one of them die as a result of Postpartum Hemorrhage and that is something that needs attention in terms of addressing maternal deaths in Nigeria”, Dr. Magashi Garba noted.
“One thing we advocate for is that the government has to put money down in purchasing quality drugs that will stop bleeding after child birth. Quality drugs is beyond just buying a drug but also involve the process of transportation and the storage of such drugs. Government, in ensuring the quality of drugs must also put into consideration the conditions of storage and distribution process. So in the situation now that government cannot do that, we are in support of the alternate drug called Carbetocin which can be under normal room temperature for up to three years and is also an injectable that is effective like oxytocin”, he said.
Forging a common front through advocacy
Working in collaboration with CHR, Dr. Magashi Garba noted that the CHR and partner organizations are already undertaking a number of advocacy initiatives to rally stakeholders support involving the media, civil society as well as government agencies, especially relating to health matters, on measures to mitigate maternal mortality in Nigeria.
“As an organization, we are focusing on advocacy to the key stakeholders that we believe take decisions relating to procurement, storage and distribution of drugs; those that take decision concerning the type of drugs that should be in our essential drug list that need to be put at federal and state level for procurement and then those who are the key frontline health workers that needs to be sensitized on the use of this new drug, Carbetocin in the treatment of PPH.
‘We need to sensitize our people and involve all stakeholders about the burden of postpartum hemorrhage and maternal mortality so that all women delivering in the health facility will receive the care they are supposed to receive’ he added.
The need for enabling policy framework
Meanwhile, it is a welcome development to note that the Nigeria Health Ministry has also endorsed the WHO formulation of Carbetocin as effective as oxytocin, for the prevention of excessive bleeding. According to the Nigerian minister of health, Professor Isaac Oyewole, speaking at a health forum on eradication of Polio, in Kano, the WHO recommended heat-stable formulation of Carbetocin, is a ‘welcome development, and capable of lowering incidence of death among Nigerian women during childbirth.’
This statement by the Minister, it is hoped, will translate to a policy that aids pregnant women to better cope with post child-birth bleeding issues through an effective drug administration mechanism that ensures the provision and use of Carbetocin as a key essential drug for the treatment of postpartum hemorrhage in Nigeria.
However, though Carbetocin, manufactured by Ferring Pharmaceuticals is available in Canada, the United Kingdom and many other countries, there is still the need to have some advocacy in creating the enabling policy framework to list it as an essential drug in the treatment of PPH in Nigeria and many other Africa countries.
Though, human error sometimes may contribute to mortalities, an effective drug administration mechanism, would certainly help reduce maternal mortality and save pregnant women from dying, thereby eliminating the social dysfunction associated with the such deaths during child-birth; either as a mother, or as a wife.
*Editor’s note: *James Ogbe is herein used as a pseudo name.