Title  A MEDICAL MODEL FOR NIGERIA---death with a smile 
Release Date  2004-09-17 
Time  15:32:00 

Article Text 

SEPTEMBER 17, 2004. I have reprinted two articles below. The first indicates that only about 20% of the population of Nigeria believes in the existence of AIDS. (Thank God some people are listening to the truth.)

Of course, Nigerian officials lament the national “ignorance.” In truth, however, this rampant disbelief has to be a spillover from President Mbeki (president of South Africa) and his staunch refusal to buy into the fake HIV causation theory of AIDS.

Mbeki has publicly expressed his grave doubts about HIV and the body-destroying AIDS drugs which are the basic thrust of the “humanitarian AIDS programs” imported from the West.

The second piece below comes from the USAID site. USAID stands for US Agency for International Development. It has long been linked with the CIA, and the development it seeks involves interference run for outside investment $$ and transnational corporate incursions into nations.

The piece on its site is, indeed, boring to read. But if you can wade through it, you will see that Nigeria has become the target for a medical model imposed from the outside (USA), a model that seeks to burrow down into every community and establish better health through all sorts of medical interventions.

This may sound good on the surface, but when you see the 1998 horrendous mortality rates for babies in Nigeria, you canot escape the conclusion that everything BUT medical intervention is needed there.

You simply don’t get those death rates without STARVATION, LACK OF SANITATION, OVERCROWDING, CONTAMINATED WATER, STOLEN LAND, IMF OR WORLD BANK DEBT CRUNCHES, AND MEDICATIONS/VACCINES WHICH SEND ALREADY COMPROMISED IMMUNE SYSTEMS OVER THE CLIFF. (The combination of some or all of these factors is often flippantly called AIDS and is attributed to a virus supposedly discovered in a lab in Maryland.)

Note that the USAID fraud never mentions any of these true debilitating items.

This is a CONTROL program instituted through medical “share and care” hypocrisy.

The projected range of the USAID program is astounding. No stone will be left unturned.

The idea is to work what amounts to a religious conversion on the population of Nigeria---except the new religion is “medical care.” One of its goals is the achievement of brainwashing---inducing people to believe that their real problems stem from undiagnosed germ diseases and undelivered drugs and vaccines.

This is, of course, a diversion from the real factors, which I have listed above.

If you want proof, quit your job, starve yourself for a few months, drink dirty water, sleep in a shack, and THEN, after you get sick, start taking medical drugs for various diseases. See what happens to you.

Imagine the same thing happening to millions of other people. Weakening, debilitation, confusion, death.

It’s called war by other means, and it works. All the while, of course, idealistic platitudes fill the air.

This Day (Lagos)
September 14, 2004
By Josephine Lohor

Chairman of the National Action Committee on AIDS (NACA), Prof.
Babatunde Osotimehin, yesterday revealed that only about 20 per cent of
the country's 140 million population believed in the reality of

He told State House correspondents after the meeting of the
Presidential Council on at the Presidential Villa that "you will be
surprised that 90 per cent of Nigerians know about HIV/AIDS but only
about 20 per cent believe it is real."

President Olusegun Obasanjo, who chaired the meeting even lamented that
the level of HIV/AIDS prevalence in the country put at five per cent,
was still too high.

Issues discussed at the meeting include the need for more education and
awareness of the prevalence of the pandemic, inter-departmental
co-operation, level of assistance from donor agencies and other nations.

The president, according to a statement by the Senior Special Assistant
on Media, Mrs. Oluremi Oyo, quoted Obasanjo as commending donor
agencies for their assistance to the country.

During his briefing, the NACA chairman, Prof. Osotimehin explained that
the presidential council adopted some measures towards tackling the
menace of the deadly disease.

The measures, according to him, centered on how to increase more
awareness about HIV/AIDS at the community level, finding cheaper ways
of medication for patients, as well as information management system.

Others are the presentation of the Behaviour Chain Communi-cation (BCC)
strategy and a national policy on HIV/AIDS even as he solicited the
co-operation of governors and local government chairmen on the need to
stem the prevalence rate currently put at five per cent.

Osotimehin stressed that ministers from key ministries such as defence,
education, women affairs, heath and internal affairs attended the
meeting to underline the multi-sectorality of the pandemic.

The NACA chairman noted that HIV/AIDS was not just a health issue but a
development phenomenon, explaining that for this reason, "everybody has
to get on board."

On discrimination against person living with the pandemic, he declared
that the problem was being dealt with in various ways one of which was
the bill before the National Assembly, seeking to protect and provide
legal cover for them.

Osotimehin further pointed out that the Federal Government was planning
to increase the number of HIV/AIDS patients enjoying subsidised
distribution of anti-retroviral drugs from 15,000 to 30,000 before the
end of the year.

"As you might be aware, we are going to benefit from the global fund,
the President Bush Initiative which we hope will raise this number
(15,000) to 30,000 before the end of the year," he said.

The NECA chairman also said that government was collaborating with some
Nigerians abroad and local pharmaceutical companies to produce
anti-retroviral drugs.

And now, the USAID piece....

BASICS I Country Program: Nigeria

In Brief

In 1994, BASICS I/Nigeria was mandated to find innovative ways to meet the child health needs of poor urban communities. In 1995 the BASICS Urban Private Sector Integrated Health (UPSI) project facilitated the development of the private health sector partnerships within the predominately urban state of Lagos. Through 1998, rapid urban growth, expanding private health services, and the U.S. government sanction against direct agreements with any branch of the government of Nigeria prompted USAID to concentrate BASICS work in the Lagos sector. BASICS developed the Community Partners for Health (CPH) to fulfill the mandate.

The initiative linked community-based organizations (CBOs) and health facilities in low-income and high-risk communities to improve child health services and home health practices. The community-based CPH model entailed mobilizing a variety of commercial and non-profit health service providers—western, traditional, pharmacists, and patent medicine vendors—to partner with existing community organizations—religious, social, and occupational. At the household level, BASICS worked through community-based organizations to improve home care and care-seeking behavior, including the use of immunization and other preventive and curative health services. At the health service level, BASICS trained health facility staff and other service providers to strengthen the quality of services, expand their preventive services, increase their outreach into high-risk communities, and tailor services to meet the needs of the communities. This model was particularly innovative because it interacted both at the clinic and home levels where behavior change occurs. Moreover, it reached families and childcare providers through collaborations with well-established, existing CBOs.

After the 1993 military takeover of the Nigerian government, the country's economic and social conditions deteriorated, in part due to severe cutbacks in the funding and availability of public services. For example, in 1990, immunization coverage in Nigeria for most childhood antigens approached 80 percent, but, by 1993, it fell to 37 percent. Adequate nutrition is also a problem: thirty-six percent of the children in Nigeria under 5 are moderately or severely underweight. In the 1998

United Nations State of the World's Children report, Nigeria ranked as the 14th worst nation for child mortality rates, which were 114 for infants and 191 for children under 5 (per 1,000 live births). In deciding to work with Nigeria, USAID and BASICS were responding to a decline in international assistance to the country.

In 1994 U.S. government sanctions were applied to Nigeria because of evidence of human rights violations. USAID, which was granted an exemption from government restrictions for most child survival programs, proposed a private sector strategy for other USAID cooperating agencies that integrated key child health interventions, as well as family planning, women's empowerment, democracy and governments, and HIV/AIDS. BASICS piloted a CPH model in Lagos in six target neighborhoods, with early success in improving access to health services and information. Within a short time the model was introduced into northern Nigeria in the city of Kano. Five additional CPHs were established, which embraced the integrated model and actively included women's empowerment and democracy and government programs.

BASICS I worked in six target neighborhoods of six different local government areas of Lagos and the CPHs mobilized 250,000 people. In the northern district of Kano, BASICS worked in five target areas; in Kano, the CPHs mobilized approximately 640,000 people. Indirect impact through CPH members' contact with extended family and friends was estimated at 1.7 million in Lagos and 4.3 million in Kano. BASICS I worked in close collaboration with other international partners in Lagos and Kano: CDC, CEDPA, JHU, and FHI.

Objectives Under BASICS I
BASICS primary goals in Nigeria were to reduce child mortality and morbidity by improving maternal and child health and case management of childhood illnesses, and to develop and test sustainable models to improve the quality and coverage of child health services provided by the private sector.

1. Strengthen organizational management and planning in the private sector—Community Partners for Health (CPHs).

Eleven CPHs were established, creating a network of 19 private sector health facilities and 197 community-based organizations in Lagos, and five health facilities and 60 CBOs in Kano. They mobilized efforts to improve child and maternal health in their communities. The CPHs were established using data from the UPSI inventory that defined the size, composition, and service capacity of the Lagos/Kano urban health sector. The CPHs are registered as nongovernmental organizations (NGOs) and have established administrative and financial structures for operations, including memoranda of understanding (MOU), governing boards, constitutions, and bank accounts. They conduct income-generating activities: fundraisers, equipment rental, and cooperative associations to maintain financial sustainability. Insurance plans, established in several of the CPHs, reduce service fees and drug costs for CPH members and ensure provision of services to families who cannot afford health services. Three CPHs bought drugs in bulk using CPH fees for health services, and a majority of the CPHs established micro-credit and cooperative savings and loan associations for members.

The CPHs developed action plans, including a variety of community mobilization activities with youth groups, sanitation projects, and community immunization days. They have developed the capacity to collect data for local monitoring and for designing and implementing program interventions through UPSIs, household surveys around health facilities, mapping exercises, and health facility quality assurance assessments. Their membership is gradually expanding to adjacent communities.

2. Improve prevention practices and home-based care for the sick child through private sector community partners.

Each CPH developed an action plan that outlined activities to improve prevention practices and home-based care. Thirty health promoters from the CPHs were trained to work with community members using a range of behaviors related to preventive practices and recognition of danger signs and home case management of diarrhea, acute respiratory infection (ARI), and malaria. Curricula, information, education, and communication (IEC) strategies, and materials helped them mobilize their communities and teach caregivers to improve home case management for childhood illnesses. The youth of the communities were included in health activities as peer-to-peer health promoters, and they actively conducted education programs about HIV/AIDS, STDs, and drug abuse. All CPHs helped mobilize their communities for national immunization days (NIDs) and three CPHs conducted supplementary community immunization days in their neighborhoods.

Between 1996 and 1998, these activities resulted in increased immunization coverage for children 12 months of age. When the CPH communities were compared with the non-CPH communities for children 1 year of age (12 months), there was a higher percentage improvement in the CPH communities. In the CPH communities the immunization coverage in 1998 was BCG~53.6 percent, DPT3~47.4 percent, and measles ~42.0 percent; the coverage in non-CPH communities was BCG~44.2 percent, DPT3 ~41.2 percent, and measles~35.4 percent.

3. Improve quality and coverage of integrated child and reproductive health services (family planning, HIV/AIDS, and STDs) provided by private sector health facility partners.

All participating CPH private sector health facility partners had improved health service delivery. Curriculum and training materials were developed, and a core group of private sector providers were trained as trainers in case management of common childhood illnesses and immunization. Providers were trained in EPI and cold chain management, and facilities were provided with EPI essential equipment. In addition, a core group of 40 traditional birth attendants were trained in providing quality perinatal services, in affiliation with partner facilities for technical support and referral. As a result of the training, the immunization services improved and expanded. All CPH health facilities provided immunization services, including full planning and participation in community immunization and NIDs. In l997, the CPHs carried out 16,000 immunizations in the Lagos area and 4,000 in Kano. Patient loads at many local health facilities increased dramatically. The health facility partners established ORT corners and 100 percent were practicing improved quality case management of diarrhea. The CPH health facilities were also participating in health insurance plans that included reduced fees and drug costs for their members.

4. Strengthen and expand the role of female leadership and decision making among private sector community partners for health constituencies and service communities.

The CPHs expressed a firm commitment to strengthening the role of female leadership and decision making in their communities. All CPHs had female members on their governing boards, and within their structure there were women's empowerment committees. A core group of facilitators was trained in female leadership, women's rights, and income generation. They used the training materials to reach out to their partnership constituencies and members. Female members of the partnership governing boards were trained in democratic participation, legal rights, leadership, and income generation. A micro-credit and loan scheme was instituted in five CPH communities and included training in policies and procedures for loan disbursement and monitoring. Through a major democracy and governance initiative, 600 CPH members in Lagos and 800 CPH members in Kano were trained in democratic participation and women's political empowerment through mock parliaments. These groups were to address issues related to child survival, specifically promoting breastfeeding. Of particular significance was the progress women have made in the northern region of Kano, where the CPH female members advocated for women's literacy programs and obtained the support of the male leadership in promoting programs for improved health for women and children. Overall, 60 percent of the CPHs in Lagos and Kano implemented income-generating activities to improve the financial empowerment status of women.

Considerations for BASICS II and Beyond
The BASICS/Nigeria project focused on increasing the capacity of the community partners to strengthen their organizational structure, implementing interventions to improve and expand child health services, and sustaining those efforts through income-generation activities and NGO registration. Capacity-building activities for the community partners included household and facility assessments to provide data for tailoring child survival interventions and improving training programs. The current CPHs in Lagos and Kano will serve as models for new CPHs as the program expands to other urban areas in Nigeria.

The CPHs were meeting the criteria for sustainability as they continued to function more independently, maintaining their high participatory values, and building on the community's existing programs. Long-term sustainability of the CPH projects depends on their ability to resolve conflicts, adhere to the guidelines spelled out in their MOUs, and reach out to community groups and agencies working on related issues. Equally important is the cooperation among the CPH projects to learn from each other's successes and mistakes and to widen the scope of particular initiatives.

The CPH projects have encouraged citizens in Nigeria to identify their resources, develop their own abilities, and take action in their communities. The CPH model, therefore, has positive implications, not only for the future of public and child health but also for the broader task of local governance in communities worldwide.

end of USAID piece

JON RAPPOPORT www.nomorefakenews.com