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Telemedicine revolution saving lives in Ivory Coast

The fledgling technology has long been championed by health advocates for rural economies.

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Telemedicine revolution in saving lives in Ivory Coast

Every time Catherine Coulibaly’s 19-year-old son had to make a routine appointment with the cardiologist for his heart condition, she gritted her teeth as she silently counted the financial cost.

It wasn’t just the hospital fee — there was the transport, food and accommodation, too, all of it amounting to a hefty burden for an Ivorian family on a modest income.

But thanks to telemedicine – consultations that doctors conduct through the internet or by phone – this cost is now a fading memory. 

Her son can book an appointment at a telemedicine facility in a nearby town in northern Ivory Coast.

There, he is attached to monitoring machines which send the data sent to Bouake University Hospital in the centre of the country, where it is scrutinised by a heart doctor.

The fledgling technology has long been championed by health advocates for rural economies.

Ivory Coast has become an African testbed for it, thanks to a project linking the Bouake hospital’s cardiac department with health centres in several northern towns, some of which are a four-hour drive away. 

Telemedicine “caused a sigh of relief for the population of Bouake, Boundiali, Korhogo, everyone,” says Auguste Dosso, president of the “Little Heart” association, which helps families with cardiac health issues.

Some 45 percent of the Ivorian population live below the poverty line, according to the World Bank’s latest estimate in 2017. And the minimum monthly wage — not always respected — is only around $100, or 90 euros. 

Heart disease surging

The pioneer behind the scheme is cardiologist Florent Diby, who set up an association called Wake Up Africa.

In Ivory Coast, heart disease, diabetes and other “lifestyle” ailments are surging, Diby explained. 

“Urbanisation is making people more sedentary, and there’s the rise in tobacco consumption, changes in diet, stress,” Diby said.

Three decades ago, only around one in eight of the Ivorian population had high blood pressure — now the figure is one in four, on a par with parts of Western Europe.

But in Ivory Coast — and across Africa — well-equipped cardiology units are rare.

“Ninety percent of heart attacks can be diagnosed by telemedicine, so for us cardiologists it’s a revolutionary technology,” said Diby.

The beauty of the telemedicine scheme is that neither the doctor nor the patient has to travel far. 

The cardiac patient is hooked up to the electrocardiogram (ECG) and other diagnostic machines with the help of a technician in a local health centre, which is connected to a computer in Bouake’s University Hospital. 

The cardiologist there can then see the results in real time, provide a diagnosis and prescribe treatment. 

The five-year-old project has already linked 10 health centres to the seven cardiologists at Bouake, enabling 4,800 patients in other towns to receive consultations by telemedicine each year. The goal is to expand this to 20 sites, doubling the intake.

Expertise France, the French public agency for international technical assistance, subsidises up to 185,000 euros of the network, which pays for equipment such as computers, artificial intelligence software and internet connections. 

Diby is now calling for telemedicine to be expanded in other medical fields such as neurology and psychiatry, not just in the Ivory Coast, but across West Africa too. 

That opinion is shared by other experts. Sixty per cent of Africans live in rural areas, where shortages of doctors are usually acute.

But numerous hurdles need to be overcome, especially investment in computers and access to the internet, according to a 2013 analysis published by the US National Library of Medicine. 

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Culture & Tourism

Nigerian town celebrates self-proclaimed title of ‘twins capital of the world’

The town boasts of having the highest concentration of multiple births of any place on the globe.

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The sign greeting visitors at the entrance of Igbo-Ora in southwest Nigeria welcomes people to “TWINS CAPITAL OF THE WORLD”.

The town boasts of having the highest concentration of multiple births of any place on the globe. 

To celebrate its self-proclaimed title the town hosts an annual festival, now in its second year, that draws hundreds of sets of twins from around the country.

Donning different traditional clothes and costumes, the twins – male and female, old, young and even newborns – sang and danced at the latest edition this weekend to the appreciation of an admiring audience.

“We feel elated that we are being honoured today,” Kehinde Durowoju, a 40-year-old twin, told AFP as he hugged his identical brother Taiwo. 

“With this event, the whole world will better appreciate the importance of Ibeji (twins) as special children and gifts from God.”

Around them, twins moved in procession to show off their colourful outfits as magic displays and masquerades also entertained the crowds.

‘Twins tourism’

Population experts say the Yoruba-speaking southwest has one of the highest twinning rates in Nigeria.

Statistics are difficult to come by, but a study by British gynaecologist Patrick Nylander, between 1972 and 1982, recorded an average of 45 to 50 sets of twins per 1,000 live births in the region.

That compares to a twin birth rate of 33 per every 1,000 births in the United States, according to the National Center for Health Statistics.

Igbo-Ora is the epicentre of the phenomenon in the country. 

Residents in the town say that almost every family has some twins.  

Traditional leader Jimoh Olajide Titiloye knows all about this special quirk. 

“I am a twin, my wife is a twin and I have twins as children,” he told AFP. 

“There is hardly any household in this town which does not have at least a set of twins.”

He said the festival on Saturday was aimed at promoting Igbo-Ora as “the foremost twins’ tourism destination in the world” and that efforts were underway to get the town listed in the Guinness Book of Records. 

Royal father and King of Oyo kingdom Oba Lamidi Adeyemi, lll, looks on during the parade of twin mothers at the Igbo-Ora World Twins festival, designed to celebrate the uniqueness in multiple births at Igbo-Ora Town in Oyo State, Nigeria, on October 12, 2019. (Photo by PIUS UTOMI EKPEI / AFP)

Prominent Yoruba ruler, the Alaafin of Oyo, Oba Lamidi Adeyemi, said the festival “is a celebration of culture and recognition of Ibeji as special children in Yorubaland”.  

He said the birth of twins usually “heralds peace, progress, prosperity and good luck to their parents,” adding that parents should always take good care of them.

But while twins are seen as a blessing by many today, that has not always the case in parts of southern Nigeria. 

In pre-colonial times twins were often regarded as evil and were either banished to the “evil forest” or killed.

Scottish missionary Mary Slessor is widely credited with helping to curb the practice in the late 19th century.

Food or genes?

Scientists have not said definitively why Igbo-Ora has such a high number of twins. 

Local residents have a theory that it is down to the diet of women in the town. 

“Our people eat okra leaf or Ilasa soup with yam and amala.” community leader Samuel Adewuyi Adeleye told AFP.

Yams are believed to contain gonadotropins, a chemical substance that helps women to produce multiple eggs.

“The water we drink also contributes to the phenomenon,” Adeleye added.

Fertility experts are sceptical – and point to another explanation. 

They say there is no proven link between diet and the high birth rate, with the same food being consumed across the region. 

“It’s a genetic thing,” said Emmanuel Akinyemi, the medical director of Lagos-based Estate Clinic. 

“I think the gene for multiple births is in the region and this has been passed on from generation to generation.” 

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Conservation News

Young climate activists push for more awareness in Africa

No continent will be struck as severely by the impacts of climate change as Africa

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As Greta Thunberg and the Extinction Rebellion inspire climate protesters across the globe, young African activists say they still struggle to make themselves heard.

“No continent will be struck as severely by the impacts of climate change as Africa,” the United Nations Environment Programme said as it warned of increased flooding, widespread food insecurity and major economic losses.

But awareness remains low and a study from research institute Afrobarometer in August said that four in 10 Africans have never heard of climate change.

At the Climate Chance conference in Ghana’s capital Accra this week hundreds of campaigners, local government officials and business people from across the continent sought a way forward. 

Togolese activist Kevin Ossah, 22, led a mock United Nations debate that pitched participants playing the role of major polluters like the United States against those set to bear the biggest burden of the crisis. 

He said he admires the huge crowds taking to the streets from Sydney to Stockholm, but in his West African homeland — ruled by an authoritarian regime that has cracked down on protests — that wasn’t really an option. 

“As youths, we can’t be putting our lives in insecurity by entering roads and doing something that Greta is doing,” he told AFP. 

Instead, he plans to focus on more practical steps like planting trees, educating rural communities and writing to leaders calling for action. 

“I think the thing we can do is use communication and digital communications skills,” he said.

“We have to share information and let other people know about us and share the efforts that we are doing.”

See also: Uganda’s teen environmental activists calls for urgent climate change action

Local focus

Africa produces only a tiny fraction of global greenhouse gas emissions and the fight against climate change can often be seen as an issue more for people living in the developed economies of Europe, America and Asia.    

But those attending the conference insisted awareness could grow if local officials and activists focus on the problems Africans confront every day.   

Akwannuasah Gyimah, municipal chief executive of Asokwa in central Ghana, told AFP he was committed to increasing education about climate change to his constituents. 

As a starting point, he wants to target the poorly maintained vehicles that belch acrid black fumes into the faces of passersby in his region. 

“It is difficult to deal with this situation because the people don’t even understand what it means,” he said in reference to the environmental impact.

Benin’s former environment minister Luc Gnacadja said one problem was the lack of access to information and education on the issue. 

He said young people needed localised data about the impact that climate change is having on populations and the economy to help lead the fight. 

‘There will be change’

Crowds have taken to the streets in some African cities as part of the global protest movement — but their numbers have been tiny compared to elsewhere. 

Gnacadja said the bold tactics employed by young demonstrators in the West did not readily translate to the rigid hierarchies of societies where challenging elders is often a taboo.  

“They can’t just go ahead and speak like Greta Thunberg, of course, the youth in Africa will have difficultly to say ‘how dare you’,” he said. 

Those challenges did not seem to faze Patience Alifo, 23, from Ghana. 

The climate campaigner insisted that youth needed to be included in the debate — and that often it is the people in power who need educating the most.

Alifo said some authorities refuse to listen to young activists and the solutions they might propose. 

Even at the climate conference, she insisted, more young people should be represented.

“We are the current generation, and we are the ones who will face the consequences, if we have the knowledge about it, I am sure they (young people) will all be here to negotiate or advocate for good policies,” she said. 

And like activists across the world, she said campaigners in Ghana were getting bolder and would not be silenced or ignored. 

“Even though we are not seeing the desired results we believe that as we continue there is going to be a change.”

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Lifestyle News

Nigerian police rescue over 300 students from abusive ‘school’ in Kaduna

We found around 100 students including children as young as nine, in chains stuffed in a small room, all in the name of reforming them.

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Nigerian police rescue over 300 students from abusive 'school' in Kaduna
Picture taken on September 27, 2019 shows the facade of the Islamic boarding school where over 300 students of "different nationalities" were rescued on the eve in Rigasa area of Kaduna, in northern Nigeria. - Police in the northern Nigerian city of Kaduna have rescued more than 300 male students being held at an Islamic school where many had been tortured and sexually abused, a police spokesman said on September 27. A large police team stormed into a building in Rigasa area of the city late on September 26 where the victims including adults and minor were kept in "most debasing and inhuman conditions in the name of teaching them the Koran and reforming them", Kaduna state police spokesman Yakubu Sabo said. (Photo by STR / AFP)

Police in Kaduna, Nigeria, have rescued more than 300 male students being held at an Islamic school where many had been tortured and sexually abused, a police spokesman said Friday.

Officers raided a building in the Rigasa area of the city on Thursday where the victims including adults and minors were kept in “the most debasing and inhumane conditions in the name of teaching them the Koran and reforming them”, Kaduna state police spokesman Yakubu Sabo told AFP.

“We found around 100 students including children as young as nine, in chains stuffed in a small room, all in the name of reforming them and making them responsible persons,” Sabo said.

The school which has been operating for a decade, enrolled students brought by their families to learn the Koran and be rehabilitated from drug abuse and other illnesses, police said.

The proprietor of the school and six staff were arrested during the raid.

Victims at the facility were found padlocked to car hubcaps and had their hands and feet chained. Others bore scars down their backs. 

“The victims were abused. Some of them said they were sodomised by their teachers,” Sabo stated.

Police had been tipped off by complaints from local residents who became suspicious of what was happening inside the school.

During the raid on the school, police said they found a “torture chamber” where students were chained, hung and beaten.

Local police chief Ali Janga said that despite its claims to be an educational institution, the conditions proved that the facility was “neither a rehab (centre) or an Islamic school”.

Those held there “were used, dehumanised, you can see it yourself”, Janga said. 

Private Islamic schools are common in mainly Muslim northern Nigeria, where government services are often lacking.

‘Severe punishment’

One inmate quoted by Nigerian media described horrific conditions and treatment at the facility. 

“I have spent three months here with chains on my legs,” 42-year-old Bello Hamza said, adding that he was meant to be in South Africa studying for his Masters degree. 

“This is supposed to be an Islamic centre, but trying to run away from here attracts severe punishment; they tie people and hang them to the ceiling for that.”

Another victim Hassan Yusuf told AFP that he had been sent to the centre two years ago because he had converted to Christianity.

“They keep you incommunicado, you can’t talk to anybody,” the married father said.   

Television footage showed emaciated children being loaded into minivans and driven away for processing. 

Police said the victims were of varying nationalities and that some had been brought from countries in the region including Burkina Faso, Mali and Ghana.

The victims were taken to a camp on the outskirts of Kaduna where their identities were being documented to determine where they came from and to contact their families.

Parents of some of the victims from within the city, contacted by police were “shocked and horrified” when they saw the condition of their children, as they had no idea what was happening inside the school.

Parents were allowed to visit their children every three months, but only in select areas of the premises.  

“They were not allowed into the house to see what was happening… the children are only brought to them outside to meet them,” Sabo said.

“All they thought was their children are being taught the Koran and good manners as they looked subdued,” he added.

One of the men allegedly running the facility insisted to local television channels that the centre was simply teaching Islamic studies and that those chained up were “the stubborn ones who attempt to run away”.

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