Paul ADEPOJU

It started with a cough, an autumn hack that refused to go away, then came the fevers. They bathed and chilled him, his lungs clattered, his chest tightened and he ached with every gasp. During a wheezing fit at 4 a.m., he felt a warm knot rise from his throat. He ran to the bathroom sink and spewed a mouthful of blood.

I'm dying, he told himself, "because when you cough blood, it's something really bad."

It was really bad, and not just for him.

His father was in his office in the choice city of Peru as he tried to go about his daily chores in his dimly lit office. Suddenly, his phone buzzed with a call from a man who introduced himself as Ashkin from A.G. Holley, America's only functioning sanitarium. The doctor called with a clear message about his son's illness.

It's a rare disease, said Ashkin, hard to define. Your son is one of two people in the world known to have had this strain, he said.

"What happened to the other person?" his father asked.

"He died."

The controversial history of tuberculosis could be traced to homo erectus migration from Africa about 500,000 years ago to Europe. In a recent study that was published in December 7, 2009 issue of American Journal of Anthropology, this young man whose body was recently exhumed in Turkey, in the course of his sojourn (probably in pursuit of greener pastures) had a lowered immune system function arising as a result of interference in form of prevention of vitamin D synthesis by the action of melanin.

Melanin is the color pigment that make blacks black, and whites white. It is found to confer protection from the dangerous UV rays emitted from the sun while as well predisposes individuals to certain medical conditions like hypertension, cancer, multiple sclerosis, cardiovascular diseases, and infections like tuberculosis.

The role of melanin in predisposing an individual to tuberculosis arises when there is interference with the geographic biotic balance where like organisms, individuals are situated in locations that best suit they make up. Like homo erectus, Africans (except albinos) are heavily pigmented hence they could fair well in hot tropical countries while the Europeans who are majorly poorly pigmented can favorably survive in the cold low latitude countries of Europe. Due to migration and incessant search for the golden fleece, the world has found itself still under the heavy influence of tuberculosis as a result of the body trying to adjust to the fewer sunshine nature of lower altitudes.

Before the Alexander Flemming's (1881 - 1955) 1928 crude penicillin discovery and purification of antibiotic manufacture in 1945 by the British scientists- Howard Florey (1898 - 1968) and Ernst Boris Chain (1906 - 1955), exposure to abundant sunlight in sanitarium was the preferred 100% effective treatment for tuberculosis infections as sunlight stimulates the synthesis of cholecalciferol (vitamin D3) via the conversion of 7-Dehydrocholesterol (vitamin D precursor) to the active form only after exposure to sunlight. These complex steps subsequently lead to the reversal of signs, symptoms and aberrations brought about by tuberculosis and other associated infection. This innate immunity was potent enough.

However, in 1944 a critically ill TB patient was given a new miracle antibiotic and immediately recovered. New drugs quickly followed. They worked so well that by the 1970s in the U.S., it was assumed the disease was a problem of the past. But less than 25 years later, the world is worse than it once was. The major reasons for the comeback were immigration and travel. These  two broke down invisible walls that had contained TB.


According to Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, who was himself infected with tuberculosis while caring for drug-resistant patients at a New York clinic in the early '90s, "drug resistance is starting to be a very big problem. In the past, people stopped worrying about TB and it came roaring back. We need to make sure that doesn't happen again. We are all connected by the air we breathe, and that is why this must be everyone's problem."

In April 2009, the WHO sounded a global alarm on multi drug resistance when it conveyed the Beijing drug- resistant TB summit. At the gathering, the message was clear- the disease has already spread to all continents and is increasing rapidly. Even worse, WHO estimates only 1 percent of resistant patients received appropriate treatment last year, and there is a huge upburst in resistance.


Apart from inconsistent use of anti TB drugs, individuals are at risk of acquiring the drug resistant strains via another means.

TB germs can float in the air for hours, especially in tight places with little sunlight or fresh air. So every time someone with the deadly coughed, sneezed, laughed or talked, he or she could spread the deadly germs to others. According to the young man who had the first reported case in America,  "You feel like you're killing somebody, like you could kill a lot of people. That is the worst part."

WHO's latest data placed tuberculosis as the top single infectious killer of adults worldwide, and it lies dormant in one in three people, 10 percent of which develop active TB, and about 2 million people a year will die from it. The fascinating conundrum about tuberculosis is its treatment.

According to Associated Press, simple TB is simple to treat — as cheap as a $10 course of medication for six to nine months. But if treatment is stopped short, the bacteria fight back and mutate into a tougher strain. It can cost $100,000 a year or more to cure drug-resistant TB, which is described as multi-drug-resistant (MDR), extensively drug-resistant (XDR) and XXDR.

There are more than 500,000 cases of MDR tuberculosis a year worldwide and XDR tuberculosis killed 52 of the first 53 people diagnosed with it in South Africa three years ago. Multi drug resistant tuberculosis has been said to be a time bomb. It has become a man made problem that is costly, deadly, debilitating, and the biggest threat to all current TB control strategies.

Unlike America and other developed countries of the world, Nigeria has no fully operational sanitarium that could be saddled with managing new and virulent forms of the disease. Our current TB centers could be likened to the incidence of 1850 when about 25% of Americans and Europeans who were isolated in sanatoriums died in isolation. Nigeria's poor medical recording system is another setback to most STOP TB programmes since most drug sales are done over the counter. No one knows who is latently infected and how safe the next breath is, every inhalation is a risk for everyone since MDR TB does not have a distinct aroma. We all breath in fear, and are perfect ingredients for an epidemic disaster.

 So the question is: Is this a strain that's evolving? That's mutating? That's becoming more and more resistant?". I think the answer is yes. Nigerian doctors grappling with these new strains inadvertently give the wrong medicines, and so the TB mutates to become more aggressive and resistant.

Although they are well trained, Nigerian medical laboratory scientists do not have the resources to determine whether a patient's TB is drug-resistant. Their practice is resource- restricted to sputum culturing and timely  drug-susceptibility testing, while expensive processes are performed only in reference laboratories. However, all hope is not lost as WHO is working to make these methods more available in high-risk countries like ours as well as negotiating cheaper prices for second-line drugs.

"There's a lot of MDR and XDR-TB that hasn't been diagnosed in Nigeria and this poses a big public health threat, one that is stronger than the Libyan leader's division option.


It cost the state of Florida $500,000 to treat a Peru national with the first case of TB. They did it not because they love Peru, but for the fact that an untreated MDR TB is a disaster waiting to happen. As a country, we should borrow a leaf from Florida. We should not wait until disasters happen before we act.






The international community is also not left out. This year's celebrations mark the halfway point for the Global Plan to Stop Tuberculosis (2006 - 2015). With much at stake, a lot still needs to be done. TB is a highly mutant contagious infection that could be difficult to treat, and a potential tool for biowarfare.

As it stands, weaponizing XXDR TB is a simple task in the hands of a learned medical microbiologist (I can do it) and the cost of treatment ($500,000 per patient) could leave all countries of the world including America grounded like Nigerian Airways, therefore it's a viable option for terrorists. It therefore becomes imperative for all agencies, governments, bodies, relevant organizations and researchers to speed up the process of combating MDR TB to avert a global Armageddon.

How I wish we could reverse time and go 500,000 years back when sunshine, like the blood of Jesus, can wash us clean of every infirmity like tuberculosis.

While I totally agree with Rufus Oteniya's comparison of Zambia's case with Nigeria's current predicament, I will like to point out some salient facts why it might be impossible for such to surface in Nigeria.


Unlike Zambia, Nigeria has an enormous population and expansive demography which makes it almost impossible for those in authority to relinquish power. It's widely said that how powerful a man is solely depends on the size of his kingdom, and the number of people under his rulership. Zambians are not as numerous as Nigerians hence power is more valued here.


Before his current bed ridden status, Yar'adua acted like the Oluwo of Egbaland by administering oaths of secrecy on his cabinet members. While we are aware of the formality, no one, except the oath takers, knows the terms of the convenant, the sacrifices involved and aftermath effects on defaulters. The secrecy of the presidency makes it impossible for Nigerians to see the inside of Aso Rock, talk less of getting true reports on the health of their president.


Thirdly, those who ought to be reporting have also been compromised. PUNCH newspapers is now in the middle of several allegations and counter allegations emanating from a summarily sacked over ambitious journalist. The newspaper's managements are not the only ones with skeletons to hide. Politicians, especially Yar'adua loyalists have successfully infiltrated the media houses with exorbitant adverts, exclusive sponsorships, mouth watering and tongue drooping honorarium and several tempting overtures which are making publications that were once credible mere town criers for the government.


A forth fearful factor is that of the true state of the president's health. Considering the manner in which the issue is being handled, one begins to ideate that it's not just acute pericarditis that our president is suffering from. If the package, ferry, smuggle, hide-and-seek games are put into consideration, one begins to think of conditions like highly contagious extremely drug resistant tuberculosis, heart transplant or magun, among other scary health conditions that might keep us all at the edges of our seat in awe.


The silence of the opposition is another issue that makes it seem as if it's a normal thing for Nigerians, especially those voters who dared the harsh weather and sharp cutlasses on Election Day, to be kept in the dark. Till date, none of the hundred and something have made any concrete meaningful action to checkmate the continual desecration of the presidency. With members in both chambers of the national assembly, and strong members of the Governors' Forum, Nigerian opposition political parties and their candidates seem to find nothing wrong. The only set of voices being heard are that of activists, crusaders and those whose interest is not in the bounties of politics but the dividends of legitimate, good, vibrant and accountable governance. The Zambia's case was different as the voice of opposition was loudly heard from the Victoria Falls to Luanda!


Nigerians can also be blamed for the paucity of information on the health status of those at the helm of affairs. On the various streets across Nigeria, Nigerians go about their daily chores as if all is well in the well. They are unruffled, unconcerned and less bothered by the situation. National issues are only discussed when tabled with isi ewu, nkwuobi, pepper soup, idikangikong, paraga and ofe owerri. To them, the plight befalling Nigerian leaders are self inflicted. Nobody develops pericarditis when in power; it's been there all along.


It is quite disheartening that after 50 years of independence, Nigerian leaders still fail to fathom leadership, the opposition parties are not even aware of what opposition is all about while the only voices heard are those of well meaning Nigerians under the auspice of the Save Nigeria Group (SNG).


How will Nigeria fair if Prof. Wole Shoyinka had stayed with lecturing, if Yinka Odumakin stay only with the preservation of Awoism and Tunde Bakare preaches only on Sundays and at high profile events? It would have been worse than this. It is evident that even if Yar’adua camp decides to say the truth like Zambian political did, Nigerians are undeterred and summarily but regrettably uninterested.

My pastor, Bishop Maxwell C. Korie has a unique way of describing women. While men were refined once from the dust, women were double refined by a perfect God. Going by the Biblical point of view, the pastor's point is true but going by the tales of the plight of the African women, one doubts if they are actually God's handiwork. Let me explain.

African ancient cultural beliefs set men well above women as most responsibilities they are saddled with are majorly to support and cater for the head of the house, the man. The 21st century woman is however a product of extensive mutation of the normal female gene.

There is virtually almost no area that women are not challenging men. From medicine, music to mortuary, males are daily having their God- given egos challenged by the Biblical ribs. Gender equality is now an issue most employers contend with as the undue preference of male gender over female is a long gone issue. In sectors like banking and financial institutions, female employees are fast out numbering the male contemporaries.

The cases described earlier are of developed countries. In the third world nations however, women, especially those in the rural areas, are still languishing under the heavy impacts of ancestral gender bias, intimidation, compelled surbordination and barbaric cultural practices like genital mutilation and forced marriages.

It is a clear truth that the limited roles of women in Nigerian affairs could be traced to our inertia which makes certain illogical practices vital determinants in our affairs. Let's make some instances.

The National Assembly could not pass into law a bill prohibiting child marriages because they believed the tradition is a core part of the cultural practice of some tribes! How can these young, forced wives ideate and create to elevate the state?

In spite of all peculiar gender challenges and impeding cultural traditions, some Nigerian women are distinguished as amazons in their fields and worthy mentors for young girls, and boys alike.

They include Kudirat Abiola, Fela's mum, Dora Akuniyili, Oby Ezekwesili, and several others. They've shown that womanhood is not all about cooking, fashion and gossips. Like their male counterparts, some women had warmed their ways into our history's bad books.

People like Patricia Etteh, Iyabo Obasanjo, Prof. Adenike Granje (disgraced minister of health), and with due respect, madam first lady, Turai, are no longer epitomes of womanhood based on ridiculous accusations and allegations, just like their male counterparts.

Nigeria's recent events, and those on the international arena are showing all the differences between males and females are not reasons for good acts or bad attitudes, they are a factor of choices made.

In this regard, it is expedient for this year's International World Women Day ceremonies to recognize women daily making good choices in the daily chores and corporate duties, cultures making choices to respect women more, and governments and institutions who have chosen to work tirelessly towards the enforcement of gender equality and fairer treatment of women at all levels.

They are the reason for 8th March of every year. Their choices made the world a better place for all, let's thank them. To them I say Happy 2010 International Women day.

One of the issues that true Christians contend with on a daily basis is that of poking non Christians who boast of having complete knowledge of the Bible. While their mastery of the words of the Bible is quite commendable, same cannot be said of their understanding of the Christian faith.

According to my PC's dictionary, religion is a particular system of faith and worship and a life under monastic vows. In other words, and going by etymology, religion is a thing that one is devoted to. A devotion is a routine, a practice that is religiously carried out with the belief that by regularly observing the routine, one connects well with the Creator. For some religions, this is quite true. Examples of such include Islam, Buddhism and several others.

Moslems for example are expected to religiously say their Sallat prayers five times daily. That is religion, Christianity however is quite different. I know it's quite difficult to decipher, I'm gonna break it down for you.

Going by my personal encounter, christianity is a journey that starts with an encounter. For some, it's a voluntary decision while for somehow stubborn ones like me, God had to take it personal, taking us through several inundating experiences, challenges, battles and obstacles which made us realize that we need something and somebody beyond our normal realm, horizon and genus. In both instances however, there is no compulsion or threats because it's a choice that transcends into a relationship.

Unlike religions where members are literarily inducted and initiated usually from conception, a prospective Christian must have an insightful understanding of what he or she is entering into. It is more than daily chores, periodic events and astral obligations, it's an all encompassing extreme makeover!

From the outset when an individual somehow makes the bizarre decision to follow Christ and live a life by faith and not by sight, the lifestyle of a true Christian is gradually transmogrified into one similar to Christ's, although in a smaller way. Such stages include forsaking old ways, bad influences, sinful acts and unedifying circumstances. This stage is usually painful and extremely difficult.

One of the difficult things I forsook when I decided to be a serious Christian was the group I hung with. We did a lot of 'great' things together that were pretty fun. But when it became evident that they are gradually becoming a negative influence and unnecessary impedance to spiritual progress and self fulfillment, I made the somehow painful decision of letting them off my hook. Some Christians had to leave relationships, forsake families, lucrative jobs, and befitting residences to stand all alone in the midst of everything surrounded by nothing but their new way of life, the Christian faith. This has its good sides, even in the normal human realm.

People like these are not scared of making tough decisions and are confident in their God- given abilities. They are aware of the pains of sacrifices, and the sweetness of good success. They are inspired to go all the way and the extra mile knowing God is with them, and more importantly, they trust God to do everything through them.

Another peculiar nature of Christianity is the individual basis of relationships and diversities of encounters.

I once heard a non Christian describe the diverse Christian denominations as an indication of the uncertainty of the Gospel. In the true sense however, what the fellow failed to understand is that God interacts with Christians on an individual basis, and individual preferred modes of worship therefore varies. Since denominations refer to the mode of God worship, one million Christians are expected to have at least one million denominations. How about that?

The Bible is another aspect of Christianity that is grossly misunderstood. In just 66 books, it covers all aspects of human life and more- business, safety, warfare, medicine, music, geography, science, poetry, arts, vocations, philosophy, psychology, economics, human relations, love and sex!

The accuracy of Biblical facts also amazes science knowing that the chapters were written, preserved and passed down from generations that had no access to automated technology. Unlike other books that are said to come from heaven, the Bible was written by human beings and inspired by God and situations around. The Bible ordinarily is just like any other religious book, that is why anybody can pick it up and read without having the deep rhemaic insight that liberates, frees and clarifies an individual's heart.

The validity of Christianity is not in any writing on a baby's forehead, a Holy place, unusual book from heaven or anything AWOL. It is the too-simple-to-be-true nature of the Gospel.

This unbelievable truth daily gives hope to those passing through humanly hopeless situations. They are unshaken because of the truth that had helped out generations past. It worked then, and still at work now!