Nigeria's First Digital Magazine for Doctors

Jan-March 2020     /    Issue 1    /      0.00

N

DOCTORS AS GOD'S
REPRESENTATIVES

BRAIN DRAIN

GIVE 'NIKE' A TRY

BREAST FEEDING
DESPITE THE BUZZ
Nigeria's First Digital Magazine for Doctors |
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Editor' colum
Olumide A. Elebute
   Welcome to the maiden edition of                            .
is
magazine primarily aims to showcase the beauty of medical
practice in Nigeria while at the same time remaining factual
in the dissemination of information bothering the health
sector. e entire work is to serve as a tribute to the ingenuity
and sacri ce of doctors in discharging their duties and in
promoting the tenets of the medical and dental profession. It
will su ce to say that this magazine is indeed 'a magazine of Patrons
doctors for doctors and by doctors'. Here constructive Professor Kofo Soyebi-Lagos
personal narratives relating to social or domestic life, speci c Professor Lekan Gbotolorun-Lagos
workplace challenges and other issues of key interest, that Professor Shola Kushimo-Lagos
Professor Aminu Mohammed
could be of immense help in meeting up with the demands of -Kano
our careers are freely divulged. I would on this note love to Professor Wole Atoyebi Lagos
end up by appreciating the Almighty God for overseeing this Professor Christopher Lukong-Sokoto
Dr.Niyi Ade-Ajayi- London
work through its long journey from conception to its
Professor Adesoji Ademuyiwa- Lagos
actualization. Secondly, my heartfelt gratitude goes to all Professor Kayode Adelusola- Ile-Ife
who have contributed their uota in making this magazine a Professor Christopher Bode   Lagos
Professor Emmanuel Ameh   Abuja
reality. I would be doing a great disservice to myself if I fail to
Professor Augustine Agbakwuru- Ile-Ife
mention my beloved wife and my kids for the encouragement Professor Afolabi Lesi- Lagos
and the immense role they all played in making this digital
magazine FOR DOCTORS 'a dream come true'.
An important topic for discussion is the problem of 'brain
drain'. e nation's health sector is still reeling from its
impact. e dire economic situation coupled with the bleak
future prospect has led to an exodus, that has been
unprecedented in the history of the nation. At this current
rate the country may be sacri cing an entire generation of
medics, who are leaving its shores in droves in search for
greener pastures. What is the hope of medical practice in this
nation?   is and a host of other uestions are be ing for
answers.
Nigeria's First Digital Magazine for Doctors |
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Contents 2
• Editor's column

• Brain drain 4

• Do you know? - Nigeria's first 7

• Health tips 8

- Breastfeeding despite the buzz

• The Sage's corner 13

- Doctors as God's representatives in patient's care

• Going for a break 17

- Give 'Nike' a try

• 'Health Science' 24

- Circumcision

27
• The Young shall grow

- My experience in 6 + x years
Cover picture - Courtesy of Dr. Chidiogo
Umeogu, a Senior Registrar at the 30
University of Portharcourt Teaching • Entrepreneurial insight
Hospital

- The world of photography in the eyes of a doctor

Nigeria's First Digital Magazine for Doctors |
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OLUMIDE ELEBUTE is a Consultant Paediatric

Surgeon at the Lagos University Teaching Hospital
and a Lecturer at the College of Medicine of the
University of Lagos.

Challenges
Brain drain is not without its attendant problems.
Doctors are an integral part of the middle class and
constitute a signi cant proportion of the country’s
consumer sector and are thus viewed as been
e Merriam-Webster dictionary de nes brain drain as ‘the necessary for the economic stability of the country.
departure of educated or professional people from one Also worthy of note is the negative impact it has on
country, economic sector, or eld for another usually for the health sector. e cost of undergraduate medical
better pay or living conditions'. education and specialist training in the country, which
Causes is one of the lowest in the world, is highly subsidized
Emigration to another land is not a recent development. by the government. Even with this, the doctor to
History has recorded instances of mass exodus mainly population ratio is being put at 1 to 5,000. is is short
brought about by wars. Apart from eeing con icts, social of the WHO stipulation of 1 doctor to every 600
upheavals or evading persecution with religious or ethnic citizens. Sadly, despite this gross shortage in medical
undertones, the next most common reason why many have personnel, Nigeria is still losing many to foreign
abandoned their place of nativity is in search of greener countries who are welcoming them with open hands.
pastures. e term ‘brain drain’ deserves particular mention e most distressing thing in this narrative is that the
as it de nes a relocation of a sizeable number of those who nation ends up churning doctors out, almost matching
could be described as ‘the economic drivers’ of a country to the proportion they are being generated. is colossal
another. It was rst used by the British Royal Society to loss is re ected in the fact that of the over 70,000
describe the departure of technologists and scientists to doctors in the registry of the Nigeria Medical and
Northern America in the mid-20th century. Overtime it has Dental Council, over half are practising beyond the
become a common parlance. On a global perspective much shores of this nation. One does not need a seer to
of the human tra c constituting ‘brain drain’ has been from decipher the economic implications of such loss to the
Asia to the more developed parts of the planet. e impetus nation. It has been reported that about $184,000 is lost
for this shi has been blamed on the growing demand for by Africa for every professional that leaves the
IT specialists and skills in the sciences and technology in continent. While this is a blanket uote, it is not
these 'receiving' countries, coupled with better economic di cult to imagine what the monetary loss would be
prospects, in terms of improved standards of living. is for every Nigerian doctor that leaves the country.
pattern is not much di erent from Nigeria. Within the Moreover, with loss in man power also goes, to a large
health sector, the trend in Nigeria is already reaching measure, loss in expertise, as all cadres of doctor are
worrisome proportions with the default route a er on the conveyor belt, exiting the country. e
completion of ‘med school’, by virtually every fresh medical situation has now become one of who would be next
graduate is to the Americas, Europe or Australia. Some to leave. e stake reality is that this situation is
have attributed abysmal government budgetary allocation unlikely to reverse if situation fails to improve.
to the health sector, poor work incentives and working
conditions as the major contributors to this worrisome
trend. Aside this, the prospect of career progression, better
pay package, not to mention superior living standard have
been more than tempting.  
Nigeria's First Digital Magazine for Doctors |
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Cure
Ojo and colleagues identi ed several factors vital
in stemming the ‘brain drain’ tide. Top on the list
are good leadership, good service conditions and
incentives as well as mass employment. While we
patiently wait for situation to improve, it has now
become a game of the survival of the ttest, not
to be the next victim to be swept into the brain
‘drain’ but better still may we as the popular
saying goes,  ‘if you can’t beat them, then join
them’.
References
•
eprints.covenantuniversity.edu.ng/1406/1/Bra
in Drain.pdf
•  Nigeria's medical brain drain: Healthcare
woes as doctors ee in by Mercy Abang
from
  www.aljazeera.com/indepth/features/niger
ia
• e brain drain: Old myths, new realities
Mario Cervantes and Domini ue Guellec
Directorate for Science, Technology and
Industry Page 40 from
oecdobserver.org/news/archivestory.php/aid
/673/ e_brain.
•  Oyowe A. Brain drain: Colossal loss of
investment for developing countries. e
Courier ACP EU. 1996;159:59–60.

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Nigeria's First Digital Magazine for Doctors |
7

DO YOU KNOW?
NIGERIA'S ST
Nigeria's rst medical doctor is Nathaniel King. Who became a medical doctor in 1874.
He died in 1884 at the age of 37 years.
(https://en.wikipedia.org/wiki/Nathaniel_King)

Nigeria's rst female Minister of Health is Professor Adenike Grange. She became
Minister of Health of the Federation in the year 2007
(https://en.wikipedia.org/wiki/Adenike_Grange)

Nigeria's rst female medical doctor is Dr Abimbola Silva. She graduated in 1951 and at
the time of her death she was the oldest living medical doctor.
(https://nigerianinfopedia.com.ng/ rst-female-medical-doctor-in-nigeria/)

Nigeria's rst Professor of Neurosurgery is Professor Emmanuel Olatunde ODEKU.

Born in the year 1927. He was the Head of the Department of Surgery, the University of
Ibadan from January 1969-September 1971
(https://www.nairaland.com/1184263/latunde-odeku-nigerias- rst-neurosurgeon)

Nigeria's rst-ever kidney transplant was performed at the Obafemi Awolowo

University Teaching Hospital in the year 2002, while the rst paediatric renal
transplant was at St. Nicolas Hospital, Lagos in 2008 (
https://www.vanguardngr.com/2009/08/nigeria-records- rst-succesful-kidney-
transplant/)

Nigeria's rst outbreak of Lassa fever was in the year 1969. The disease was named
a er Lassa town where it was rst identi ed
(https://en.wikipedia.org/wiki/Lassa_fever#Epidemiology).
HEALTH TIPS
Breastfeedin despit th
b zz
Nigeria's First Digital Magazine for Doctors |
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SEUN LADIPO-AJAYI is a Consultant Paediatric

Surgeon working at the Lagos University
Teaching Hospital. She is happily married with
three kids

F
    inding oneself pregnant as a female                     
practicing doctor comes with certain legitimate
fears and anxiety, especially regarding how to                     Invest in breast milk bags, lactation
be the best mother while holding your own at cookies/teas (if you care for them), electric breast
work. Here are a few tips that may be helpful; pump, expression /pumping bra ,nipple balm, breast
pads and freezer bag before delivery. Mendela,
Lansinor, Avent and Tommy Tippee electric breast
pumps come highly recommended. Manual pumps
can be taken to work, though they can be tiring and
you may not be able to maximize your pumping
sessions.
            Be determined. Make the decision to
breastfeed before your due date. You may nd
someone to be your accountability partner.
is needs to be settled before the baby arrives.
Else you will be confused when the challenges
arise (and believe me, they will).

                
                

                 Get comfortable with the fact that

you will pump more than you will directly
breastfeed a er resumption. Even between
feeding during your maternity leave, pump
constantly so that you will be adept when you
resume. Milk production follows a rule of
supply and demand, the more you feed/pump,
the more milk you make
                      2 weeks before you are due, massage
your breasts from the base towards the nipples as
o en as you can. is prepares the breasts (and the
brain) for the re uired function. If you have
lactation cookies, teas or granola ,start taking them
from 36 weeks
Nigeria's First Digital Magazine for Doctors |
                        A week or more to your EDD,
start practising drinking uids,( water, prune
juice, orange juice, tea, pap, custard, yoghurt,
pepper soup, coconut water etc). Goal is 2.5L of
pure uid daily apart from food. Make friends
with oatmeal, banana, berries, raw cocoa,
granola). Don't eat for two. It doesn't add to
your cache. Watch online videos on how to help
babies latch properly.
                       e rst milk you produce is very
important. If your baby is sleeping or is not with
you, please save it in a bag and freeze it. Don't
go 4 hours without breastfeeding or pumping
during your breastfeeding journey.
                  Get a breastfeeding scarf/drape for
public situations. Invest in a comfortable chair
at home for breastfeeding and pumping, a small
stool is an added advantage for your feet.
10
2
                        Clearly label milk containers
with date the milk was expressed, and write
baby's name on it if it will be given to a
childcare provider. Store milk in the back of
the freezer or the depth, not in the door or the
basket. Freeze milk in amounts of about 150mls
per bag, or in a bottle loosely covered because
it gets bi er on freezing. You can tighten the
bottle cap when the milk is frozen.
                         Pump 8 to 10 times a day. You
can do 10 to 20mins per session. is drives
your milk ow. Pump in the o ce or on-call
room in privacy. Colleagues will soon learn to
excuse you to do the needful. Matrons in
theatre o en have dedicated fridges. Make
friends with them and they will allow you to
store your expressed milk. Remember to put
the bags/bottles in a Ziploc bag for better
sanitation. Focus on emptying the breasts, it
drives better lactation. Don't beat yourself up if
your ow is not like someone else's. We all have
di erent capacities.
Nigeria's First Digital Magazine for Doctors |
Breast milk can be le to thaw on its own
or placed in warm(not hot) water. Use the
breast milk within 24hours of thawing it. For
example, bring a bag out of the freezer into
the fridge and use within 24 hours a er it is
melted. Once warmed up, use within 2 hours
and discard remnants.
Be smart. Express before theatre sessions,
rounds or clinics. It may embarrass you to
be sweating in front of patients/colleagues
because of engorged breasts.
Breastmilk storage guidelines
Room temperature
Cooler with ice         Up to 4 hours
Fridge                         Up to 24 hours
Freezer             Up to 3 days
Up to 6 months
11
2
Note. It is not a sin to give supplementary
feeds if all your best e orts fail. e goal is
to have a healthy baby and mother. Anxiety
and stress is not healthy. Remember, no two
child rearing experiences are the same.
Prepare to be surprised.
Breast milk is digested in 60-90mins.Be sure
to pack enough for your caregiver
Remember,the most intense and challenging
time is the beginning. You will learn to look
forward to the bonding that accompanies
breastfeeding
Be smart. Express
before theatre sessions,
rounds or clinics.
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The Sage's Corner
Nigeria's First Digital Magazine for Doctors |
DEJI SAMSON  is a Fellow of West African College of
Physicians. He is a University lecturer as well as
a  Consultant Public Health Physician with the Ekiti State
University and Ekiti State University Teaching Hospital,
Ado Ekiti respectively
DOCTORS’  AS  GOD’S REPRESENTATIVE
IN THE CARE OF PATIENTS
God's representatives
Doctors as major stakeholders in health care delivery
should see themselves as God’s representatives, to
cure sicknesses and diseases. One of the main thrust
of Christ's mission, while on earth, was healing the
sick, which He did everywhere He went. As God's
representatives, doctors are to toe this same line, by
facilitating the recovery of the sick. Unarguably, for
this objective to be realized there must exist a
harmonious patient-doctor relationship. e sick are
vulnerable and are already exposed to discomforts
attributable to their illnesses. An 'unwholesome'
relationship between them and the doctor could
worsen their health condition. No health practitioner
should view a patient's vulnerability as a licence to
demean, put up an unsavoury attitude or an air of
pomposity.
...no medical practitioner
should view a patients'
vulnerability as a licence to
demean...
14
2
Doctors as vehicles of compassion
God is compassionate and as His representatives,
the doctor should not be bere of this virtue.
Compassion could be viewed as the impetus that
moves caregivers to give their best to the ailing.
When doctors are subsumed by compassion, they
are more likely to have positive results in terms of
patient recovery, which ought to be the goal of
every single doctor. is virtue would make one go
out of his way to get the patient out of the
sickbed. Indeed, it could be said that empathy is
the antidote that patients are yearning for when
all before them appears bleak, even more desired
than the medications we are o en uick to
prescribe.
Diligence- a necessary trait
Furthermore, God wants His representatives to
be diligent in their duties just as He is diligent in
His work. e entire universe, its creation and its
maintenance are all pointers to this fact. Diligence
is the hub of every successful business.  Doctors
should be diligent in the care of their patients. is
would safeguard them against accusations of
mismanagement of patients. Avoidable deaths
occasioned by errors in handling machines or
administration of care could be reduced to the
barest minimum if all doctors uphold the ethics
and tenets of diligence at the workplace.
Nigeria's First Digital Magazine for Doctors |
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The responsible doctor

We should understand that as the
Consultant takes ownership of patients, he
does that on the behalf of God who owns For further counselling tips, be free to contact:
both the doctor and the patient. All doctors Dr Samson A. Deji,  
Head of  Department,
should do everything humanly possible, with
Department of Community Medicine,
the knowledge God has given them, to
Faculty of Clinical Sciences,
accelerate the recovery of patients under
College of Medicine
their care. ey should see the patient as Ekiti State University, Ado Ekiti, Nigeria OR send an
someone placed under their custody by God email to:- samdeji3@hotmail.com
to manage on His behalf.    
Generally speaking, representatives of any
personality o en give account to the one
who has sent them. Doctors in the same vein
will give account of their stewardship to
God who has called them into the health
vocation at the end of their time here on
earth. is salient fact should guide the
operation of every health practitioner.
God has endowed humans with various
skills and abilities with the intent of making
our world a better place. e ingenuity and
the knowledge He has entrusted into our
hands, as healthcare providers, is to serve
that prime purpose of bettering the lives of
others. e sanctity of human life is to be
upheld by ualitative health care delivery
from the major stakeholder in the health
sector, the doctors.

The sanctity of human life is to be upheld by

qualitative health care delivery from major
stakeholders in the health sector, the doctors.
 d

• Conducive environment for learning

• Well motivated, experienced, and dedicated
sta
• Broad-based curriculum
• Montessori method of teaching and
learning
• Emphasis on creativity and information
technology
o h o m ...
awa fr • Periodic free medical checks by experts
...hom • Etiquettes and Personality development
Goin fo brea
- relaxation sensation -
Give 'Nike'
a try!
Nigeria's First Digital Magazine for Doctors |
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Give 'Nike' a try! By Olumide Elebute

e Health profession o en leaves little or no
time for breathing space, like a short vacation
that many in the 'non-health'  line o en take for
granted but taking a trip downtown Lagos, no
matter how brief it may be, would de nitely be
worth the time, i.e away from the hassle of the
hospital environment. To any traveller to the
metropolitan city of Lagos, the prestigious Nike
art gallery is a place to be. e internationally
acclaimed centre derives its name from its
founder, Nike whose gradual climb from a
humble beginning to becoming one of the most
renowned art gurus in the nation has been a
source of inspiration to many. Nike Davies-
Okundayo or 'Nike' as she is popularly referred
to, started out on her journey to stardom by
toeing the path her parents, who were
traditional cra speople, once trod. At the
outset, she dedicated her time to weaving but
down the line saw her calling in promoting
Yoruba artistry, most particularly indigo cloth The frontage of the Nike Art gallery
dyeing which is fast fading away. During an building at Lekki peninsula
interview by CNN, she stated that her prime
Courtesy of Olumide Elebute
goal in establishing the gallery was to create
awareness of local wares and to promote
indigenous cra .

''Seated at the Lekki peninsula, the

art gallery has become home to over
thousands assorted artworks.....''

https://hotels.ng/guides/wp-
content/uploads/2017/08/nike4.jpg
Nigeria's First Digital Magazine for Doctors |
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A RICH COLLECTION OF
AFRICAN WORKS!!!

Off to Nike Art gallery.......

Seated at the Lekki peninsula, the art gallery has become home to over thousands assorted
artworks, some contemporary, while others are largely memorabilia. Leaving the Muritala
Muhammed International Airport to the site takes an estimated 40 minutes on a good day. For
those who are used to the blaring and honking of vehicular tra c in many megacities in the
continent, this should not cause any stir but to a novice, you are warned, it could be disturbing,
particularly in the Lagos mainland where the journey starts. e peninsula is accessed through
two major connecting bridges, the Eko and the third mainland bridge, both routes permit a
beautiful view of the South Atlantic Ocean, that borders the southern coast of Lagos. e
journey, however, assumes a somewhat di erent, less boisterous atmosphere when one crosses
over to the island.
Nigeria's First Digital Magazine for Doctors |
21

e all-white paint coat and the ex uisite

designs on the walls give this edi ce its
distinctiveness among other buildings found
within the locality. Far to the right of the
two-leaved black metallic gates leading to
the premises is a small cabin like structure,
where visitors are greeted to an assortment
of snacks and so drinks, all at a ordable
prices.

On arrival at the popular centre, the visitor

may be lucky to be personally welcomed by
Nike with her co-workers. Her unassuming
appearance makes the visitor feel very much
at home. Nike is a lanky 4 footer who
adorns herself, most of the time, with the
typical Yoruba attires. A er the usual
exchange of pleasantries, she typically starts
o by giving a rundown of what the gallery
has to o er and she is ever eager to divulge
part of her wealth of knowledge on native
arts to the in uisitive visitor. A guide
uickly continues from where she stops and
leads the way to the interior. e ground
           Chief(Mrs)Nike Okundayo
oor is stocked with an assemblage of
artistry.
Nigeria's First Digital Magazine for Doctors |
Although apparently a sharp departure from the
hospital setting, the gallery may still be reminiscent
of what may have been abandoned at work.
Starting from the bottom and climbing up to the
various tiers of the building one is just but forced
to appreciate the splendour of human ingenuity
and creativity. One work that may so readily catch
attention, particularly to the health practitioner, is
a lovely piece of cra which has the semblance of
a huge scrumptious cake- symbolic of the national
cake, adorned with alternating shades of green and
white icing, colours illustrative of the Nigerian
ag; its otherwise innocent appearance being
marred by ferocious-looking black ants' pillaging
and crawling away; a portrayal of the stack reality
of the CANCEROUS e ect of corruption to the
nation as a whole.
"So when next you
think of escaping
the hospital
environment try
'Nike' "
22
Moving to the other tiers, the visitor is
greeted with paintings of di erent styles,
summarily revealing the typical African life
and customs. Some of the artworks placed
on display are derived from various artist
and are up for sale; the gallery, however, has
proprietary rights over a vast number.  Back
to the front veranda where the tour begins,
the visitor reaches the climax of his
expedition with a wonderful display by a
traditional dance troupe, made up of female
dancers clad in traditional clothing, gyrating
to the drumming of their co-actors.
So when next you think of escaping the
hospital environment, try 'Nike'.
African Troupe getting ready to entertain visitors to
the gallery. Nike is seen wearing the red pointed hat
backing the camera. Picture courtesy of Olumide
Elebute
'Healt
Scienc '
Nigeria's First Digital Magazine for Doctors |
CIRCUMCISION
By Olumide Elebute, Consultant Paediatric Surgeon at the
Lagos University Teaching Hospital, Lagos, Nigeria
  Circumcision is the removal of some or the
entire foreskin of the penis that normally protects
and covers the glans[1[. e term is coined from
two Latin words ‘circum’ meaning around and
‘caedere’ to cut[2]. It is indeed the oldest and most
common surgical procedure performed in the
world[3]. Despite the growing wave of opposition
that has risen in recent times against the practice
of routine male circumcision in many parts of the
world, an average of 1 million is still being
performed annually in the United States of
America where the loudest call for its ban is being
heard and rather than diminishing, there has been
a steady and gradual rise in numbers performed
annually[4].  It has been estimated that 30% of
males are circumcised globally, with Moslems
comprising two-thirds of the total, with Jewish
and non-Muslims and non-Jewish men living in
the United States of America contributing 0.8 and
13% respectively[3].
Recently, there has being a greater call for
circumcision to be carried out in non-
circumcising communities following reports from
a study conducted by WHO of the signi cant role
it has played in reducing the spread of HIV
infection in Southern and Eastern Africa[5]. One
of the ndings of the study is that the practice of
male circumcision could avert two million new
HIV infection and 300,000 HIV/AIDS-related
deaths over the next ten years[6].Although the
routine circumcision tends to be promoted by
adherents of the mainstream religions, historically,
the practice predates Judaism and Islam with the
earliest record dating back to 2,300 BC in Ancient
Egypt[7]. Circumcision then as it is in many parts
of the world, particularly East Africa was
performed as a rite of passage and as a symbol of
manhood.
24
Aside from religious, cultural or ethnic determinants of
circumcision, there are well documented medical
indications for circumcision and these include phimosis,
paraphimosis[8]. It has e ually been accepted that
circumcision e ually pro ers some bene ts such as the
reduction in the incidence of penile cancer in the middle-
aged men and a reduced risk of genital human
papillomavirus (HPV) infection in the circumcised and
by extension a reduced risk in cervical cancer in their
sexual partners[9]. Although male circumcision is o en
viewed as a minor procedure and o en carried out in
many parts of the world by those without any formal
medical education or training, it is not without its own
inherent risk. Schwartz [10] stated that ‘ e estimated 1%
to 3% incidence of complications a er newborn
circumcision covers only the immediate postoperative
period prior to the infant's discharge from the hospital'.
e reported risks are haemorrhage in 1%, infection -
occasionally leading to sepsis - in 0.5%, meatitis and
meatal stenosis, urethrocutaneous stula, adhesions
between the glans and remaining prepuce, secondary
phimosis, and cosmetically unsatisfactory results. e rate
of subse uent repeat surgery to correct adhesions of the
glans, meatal stenosis, stula, and phimosis with buried
penis is unknown[10]. A study carried out in Kenya and
Nigeria uoted complication rates of between 17 to 35%
[11,12]. Many have advanced the high incidence of
complications in some studies as a good enough reason
why the practice should be abrogated in its entirety. But
with overwhelming evidence showing a protective role of
male circumcision against the scourge of HIV/AIDS, the
issue at hand in many uarters goes beyond the call for
the abolition of male circumcision but on how to make
the practice safer and to e ectively incorporate it into
man’s arsenal against heterosexual spread of the virus[13,
14, 15]. Most circumcision methods incorporate a dorsal
slit, to facilitate separation of the prepuce from the
underlying glans and thus allow excision of the prepuce
while avoiding the glans. is is particularly so with the
plastibell device which is the most popular method in
Nigeria.
Nigeria's First Digital Magazine for Doctors |
  Performing the dorsal slit could be fraught with
danger if there is an inade uate separation of the
inner preputial mucosa from the enshrouded glans
penis giving rise to pathological phimosis. Several
reports of glans injury following this maneuver have
been well documented. Aside from this possibility,
excessive haemorrhage from the dorsal penile
vasculature could occur following a dorsal slit.
Stretching of the prepuce with a haemostat without
recourse to a dorsal slit basically eliminates these
complications.   male circumcision for reduction of HIV infection risk: the
e Plastibell device is the most popular
circumcision method worldwide and more
speci cally in Nigeria. e popularity of the
Plastibell device is fully explained by its ease of use
and its cost [16]. It has witnessed high patronage
among circumcisers in much of the urban part of
the country, most importantly among those in the
medical profession. e complications ascribed to
Plastibell use include Plastibell migration,
haemorrhage, wound infection, meatal stenosis and
urethrocutaneous stula[16, 17, 18].
25
References
1.Brian J. Morris. CircInfo.ne . Male circumcision guide for
doctors, parents, adults and teens. 2
2010    http://www.circinfo.net/what_is_circumcision.html
2.Circumcision. http://en.wikipedia.org/wiki/Circumcision.
3.Male circumcision. Global trend and determinants of
prevalence, safety and accep ability. WHO and Joint United
Nations  Programme on HIV/AIDS,2007
4.American Academy of Family Physicians. Circumcision:
Position Paper on Neona al Circumcision. August 2007
Reaffirmed
5.Auvert B et al. Randomized, controlled intervention trial of
ANRS 1265 Trial. PLoS Med. 2005
6.Jeffrey et al. Is circumcision as good as HIV vaccine we’ve
been waiting for? Future HIV er (2008) 2 (1), 1-
77.UNAIDS(Part 1) Male circumcision:contex ,criteria and
culture available at
http://www.unaids.org/en/KnowledgeCentre/Resources/Featur
eStories/archive/2007/20070226_MC_pt1.asp
10.Schwartz, et al. "Pediatric Primary Care: A Problem-
solving Approach" pp 861-862
11.UNAIDS/CAPRISA Consul ation on Social Science
Perspectives on Male Circumcision for HIV Prevention:18-19
January 2007,Summary Report
12.Linus Okeke, Adanze A Asinobi, Odunayo S Ikuerowo.
Epidemiolo of complications of male circumcision in
Ibadan, Nigeria; BMC Urol. 2006; 6: 21.
Published online August 25 2006
13.K Peltzer et al.Editorial review: Male circumcision, gender
and HIV prevention in Sub-Saharan Africa: a (social science)
research agenda. Journal of Social aspect of HIV/AIDS.Vol
4.No.3 Nov.2007
  14.U.S  President’s Emergency Plan for AIDS Relief
http://www.pep ar.gov/documents/organization/114189.pdf
15.White RG et al. Male circumcision for HIV prevention in
sub-Saharan Africa: who, what and when? AIDS. 2008 Sep
12;22(14):1841-50
16.Seyed A. Mousavi,Hamid Mohammadja ari.Circumcision
with the Plastibell Device in Hooded Prepuce or Glanular
Hypospadias Adv Urol. 2009; 2009: 864816.
17.C.O. Bode, S. Ikhisemojie, A.O.Ademuyiwa. Penile injuries
from proximal migration of the Plastibell circumcision ring.
Volume 6, Issue 1, Pages 23-27 (February 2010)
18. Complications of circumcision in male neonates, in ants
and children: a systematic review. BMC Urolo 2010,10:2
Th youn shal
gro
...
Nigeria's First Digital Magazine for Doctors |
TOLUWALASE OLUWAFEMI is a Medical House o cer
at the Lagos University Teaching Hospital. Her hobbies
are reading and music.
c e i n y e ar s !
p e r i en 6 + x
M y e x
Medical school for me was a pretty eye-opening
experience, to say the least. A er the run-down
of what our rst year in the College of
Medicine, University of Lagos entailed, mixed
feeling were evoked. Enthusiasm, because of the
perceived regard the course represented, and
fears, because of the hurdles that lay afront.
From being neighbor to cadavers at least 2-4
hours every week, to the volume of books to be
read for understanding to be attained, to the
long standing hours during surgical procedures,
there were really worthwhile experiences.
e most challenging aspects for me were the
clinical arms of medical learning. is was
because, from prior educational experiences I
had garnered, it was easy to top-up knowledge
base from long sessions alone with a handful of
relevant books, a nice cool drink in hand, and a
serene atmosphere! Now we had to be face to
face with well-respected teachers and tutors,
colleagues and logically present cases of patients
who had been interviewed prior to the
rounds!  ‘What knowledge did I have that would
ever sound enough!’
27
I thought to myself o entimes. We had to be able
to communicate e ectively with the patients to
obtain the right information and a list of
di erential diagnosis based on the history gotten.
Sure this may not sound like a big deal to some,
but for introverts like me, it was! is was where
mentorship became extremely valuable, which
was fueled by reciprocal respect. Seeing those who
had gone before encourage me spurred me to the
feasibility of defeating this hurdle. Mentors
included students who were in higher classes than
I was, residents at the Teaching Hospital, and a
handful of consultants (including Dr Elebute O. A.
who gave me this opportunity via this avenue to
share my thoughts.)
Reading for exams demanded a lot of consistency
as trickles of learning snowballed into mighty
ocean of vast understanding of the human
anatomy, physiology, molecular pathology,
pharmacology, laboratory medicine, and
community medicine over 6+x years of
learning(strike actions inclusive!).  Because of the
extended length of learning, the input and
resources were a great deal.
Nigeria's First Digital Magazine for Doctors |
28
Time management, discipline, the malleability of
schedules, tenacity despite setbacks at exams, and the
consistent drive to out-do the previous successes are
extremely paramount if excellent will be consistent.
e paths to self-discovery and purpose must not be
jettisoned as well.

Our traditional curriculum is pretty narrow and

ascribes little emphasis on so skills such as e ective
communication. e sectioning of the medical
curriculum into basic and clinical arms are o en
rigidly adhered to, even mentally as teachings are
o en didactic and little room is le for novelty. e
SPICES curriculum which was newly introduced in
my college of medicine is laudable as it seems to
bridge the above mentioned gap. Its product is a
mindset that fuses and integrates ‘teachings within the
four walls’ with clinical encounters to improve the
overall well-being of the average patient. Medical
education need not be abstract and necessarily
complex. Propositions for computer so ware
application with user interfaces which organizes our
regularly updated, tropically-adapted lecture notes
with links to relevant materials in core course, if
materialized will be helpful. Mentorship programs
can also be improved on in medical schools
nationwide, as they play very important roles. e
shoulders of giants can make our generation see a lot
more than we do now.

Investments can also be made in medical arts and

graphics to simplify complex concepts in various
elds. We need more of texts such as ‘Microbiology
made ridiculously easy’ it simpli es complex concepts
graphically. Many medical students stru le with
nancial liabilities during their course of study, such
as I did, given its extended length of time, with the
interspersed internal and external strike actions from
various bodies. Scholarship applications are o en
rigorous and are awarded before the sophomore year,
with almost all students who come in via direct entry
missing out on that window of opportunity. More
scholarships can be made available for medical
students. More well-meaning moves made in recent
time by alumni associations including renovations of
dilapidated facilities, hostels, and lecture theaters.
ese made our stay a lot easier, and should be
continued!
The world of Photography in
the eyes of a doctor
Nigeria's First Digital Magazine for Doctors |
30
OLUWASEYIFUNMI ABIODUN is a
Medical House O cer at the Lagos University Teaching

Hospital. He is a Passionate Professional Photographer.

Photography as a pastime

Doing what you love most

At rst it was just about taking pictures of
My venture into Photography started when I was in my
friends, family and things that were
second year in medical school. Before then, I had
happening around me but gradually as I
always been interested in creative arts and
found myself amongst friends who shared
entrepreneurship, right from secondary school, all
the same interests and who where into
through my years in the Polytechnic as well as during
photography at a more serious level and had
my rst degree.
started much earlier than me. I started
Born the rst of 5 children to a mother who valued
getting referrals to take on paid clients
enterprise and encouraged our talents and natural
photography jobs.
inclinations also contributed to my love business.
e timing was also perfect as it was around
Growing up, books were my sanctuary especially
the time when there were so many social
illustrated books. I remember being introduced early to
activities going on in Medical school such as
the National Geographic Magazine. I loved to look at
departmental association dinners, sporting
the images, vibrant colours, skyscapes, animals, people
from di erent lands and cultures. Pictures introduced activities, award ceremonies and 'traditional
me to the world I never knew. ey broadened my nights'. It was also around that time that the
imagination about the world. With pictures, you can Congress of Medical and Pharmaceutical
travel back in time and witness moments in history as if Students Association held that very
you were there when they happened. So it was not a celebrated and colourful festival
surprise to me and to anybody who knew me then that 'COMPSSABRATION'.
I decided to go into photography seriously. In no time I had to come up with a business
name and structure in order to keep up with
the demands for my services. I decided to
stick with my name 'Seyifunmi' so it was the
birth of Seyifunmi

"With pictures, you can

travel back in time and
witness moments in
history as if you were
there when they
happened"
Family Portraits
Nigeria's First Digital Magazine for Doctors |
31

how it started.......
By my third year in medical school it
became more and more di cult to give
full attention and time to my studies as
well as investing time on the business
front. at year was one of the most
challenging years for me but it taught me
lessons. I could have easily dropped
photography to focus s uarely on my
studies but somehow I was convinced that
there was a way around it. A way in which
I could still do photography without it
a ecting my studies. I focused on time
management as well as prioritising what
was important. I also learnt to delegate
and outsource any part of a job that did
not necessarily need me at the core of
running things. I realized that apart from
studies and photography there were other
things that took my time which were non-
essentials. I eventually had to cut down
these activities and soon realized that I
was able to balance both school and
business much better than I had thought. I
must say I got better at managing my time
well so that by the time I was in my nal
year I did not feel stressed at all.

Commercial pictures taken for a Dental clinic in Lagos

Nigeria's First Digital Magazine for Doctors |
Being a medical student while running a
business, especially something like
photography also helped in a way. Most of
my clients turned out to be my teachers,
course mates, other students, parents of
students, relatives or other friends referred
by students.
I had the opportunity to meet the Provost
when he needed a photographer to take
certain landscape and architectural pictures
of the College for a presentation he was
scheduled to give outside the country. e
Chairman of the College of Medicine
Alumni Association whose daughter
happened to be my classmates at the time
also employed my services for his family
portraits.
32
Fashion Photography
Right now, my photography has de nitely
grown beyond the borders of medical school
but I still employ the same time
management skills I learnt as a medical
student even as a young doctor. Whether
I’m carrying a stethoscope on the ward or a
camera at a wedding, whatever your hand
nds to do, whatever you’re passionate
about you can do it excellently well with
discipline and dedication.
....whatever
you’re passionate about
you can do it excellently
well with discipline and
dedication.
Naija Docs Magazine.
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