Our Humanity; a Top Consideration

It is becoming clearer by the day that despite artificial borders and differences in political leanings, religions and culture, we are simply Humanity. We all feel pain, share joy, experience frustration and seek for better lives for ourselves and loved ones. It was therefore heart wrenching to see countless number of refugees and migrants perishing in the Mediterranean Sea in attempt to escape the horror they face in their "home" of circumstance. However, the concept of "home", "our home", "our country" or "our land" has come in the way of embracing our shared humanity and the result has been a huge global refugee and migrant tragedy recently captured by the body of drowned 3 year old boy washed ashore. It is a serious opportunity to rethink our humanity and our shared values.

It is not uncommon to talk about professionalism, academics, and various institutional frameworks for governance, business, and the general polity. What may be missing sometimes may be an appropriate recognition of what the end is supposed to be. The aforementioned are undoubtedly means of achieving some end but the ultimate end is enhancing our humanity; positing our humanity into proper perspective; making the lives of people around us more wholesome and meaningful; developing the human capital towards realizing our goal of making our communities a better place. Nations, especially the developed countries, which are currently witnessing influx of refugees or immigrants, may need to change the narrative from being that of "fear and apprehension of being invaded" to a humanity narrative of "precious human capital that could drive positive change and innovation for greater progress". Humans are at the core of any development, prosperity and advancement in any geographical space. It is therefore time we started appreciating the value of our humanity in contextualizing policies and operations.

Meanwhile, some sense of order is required for any meaningful progress to be accomplished. Documentation is one of the vital tools in achieving our humanity essence. Therefore, as great human movement of refugees and migrants (unfortunately largely due to man-made disasters and violence) of our generation continues, neighboring and other concerned countries should prepare to make the process of documentation less cumbersome, transparent and devoid of profiling prejudices. We must understand that where we call "home" today was probably where our great grandparents migrated to in some distant past. One may need to check out some history about countries in the world starting in alphabetical in order to get a sense of “home” redefinition.  "Home" is in a constant state of flux and only the humility and consideration in our humanity that can bring that message home that we are not completely at "home" until everyone has a place to call "home". Forensic tools could be deployed to ensure that everyone is accounted for in manner that seeks to provide for their needs and track their progress in settling into a new environment. Good News is that in any community or groups, there are far more good people than the bad ones, who unfortunately tend to grab the headlines most times. However, trusting our humanity emboldens our common good and at the same time represses the operation and relevance of evil. We can only achieve this by focusing more on our shared values rather than on things that divide; rather than on things that cause us to fear and distrust; and rather than on terror. Humanity is a team work and we belong to one another. And this is the meaning of any skills, talents, professions or institutions we may hold. The true expression of these items is in promoting our humanity.

While I was Away....

I've missed my readers on this blog for some months. It has been a very eventful period since April 2015 when my last post was made. There have been new developments in Africa regarding the practice of Forensic Medicine and how Africa engages in addressing certain challenges on the continent and beyond with forensic knowledge and skills. Earlier this year, in the first week of March 2015, African practitioners gathered in Nairobi under the auspices of the African Society of Forensic Medicine (ASFM) for the annual forensic conference to discuss the theme: Forensic Management of Violence in Africa. Sub-themes included Management of Terrorism and Armed Conflict, Management of Sexual and Gender Based Violence and Interpersonal Violence and Injury Interpretation. Stakeholders like UN Women, International Committee of the Red Cross (ICRC), and other stakeholders were in attendance to contribute in charting a way forward towards reducing the scourge of violence in Africa especially with the upsurge in armed conflict and terrorism. Incidentally, where there is armed conflict or terrorism, sexual and gender based violence increases. The case of the Chibok girls abducted by the marauding Boko Haram terrorists in Nigeria underscores the unfortunate nexus. Practical discussions were held on modalities of managing violence and the urgent need for nation states in Africa to adopt standard protocol that will guide practitioners in offering appropriate services. Emphasis was also placed on the urgent need for infrastructural and human capital development in forensic medicine and science in Africa.

Towards addressing great human distress associated with unidentified bodies following disasters, some of which are precipitated by violence, a dedicated team of African volunteers who could be deployed at short notice to assist communities plagued by mass causalities was inaugurated. The team named DVI Team Africa is the first of its kind in Africa and volunteers are mainly practitioners in forensic medicine and science. It will be easier to mobilize much needed support to assist in disaster management in any parts of Africa where such assistance is needed. The team could also contribute to international disaster management beyond Africa, when such involvement required. It is commendable that African practitioners are stepping up to being part of the solution to a complex and pervasive problem on the continent.

Meanwhile, many events of forensic relevance have taken place during this "leave of absence" period. There was a focus on the unregulated fertility practice in Nigeria, an alarm I had raised in my earlier blogs. An investigative journalist unraveled just a portion of this sordid story in the second week of August under the title: Ovum trading: Inside Nigeria's multi-million naira human egg business. I will be writing more on this and other issues in subsequent posts.

Finally, I wouldn't want to be away for a long time like in this case. However, work situation and exigencies sometime conspire to attenuate our commitment to other important issues. Working on maintaining a delicate balance is a continuous effort. And thanks for staying with this blog. Your comments will be invaluable to gaining more understanding about what happens around us in our different points of view.

It's not usually a Stranger lurking in the Dark: "Father in Court for Raping Daughter"

The headline from a national daily, Punch Newspapers, underscores the importance of dismantling myths about sexual violence against women and children.

Not infrequently, we do not look in the right places in the fight against sexual violence in our communities. Women and children continue to suffer in silence, often out of shame and intimidation in homes and amongst family members in the hands of close relations including husbands, fathers, uncles etc. When the violation eventually blows open, it is usually too late as the victim often turns up dead in the morgue or severely injured in the hospital. I have seen some cases and it is truly pathetic. Accepting that perpetrators of sexual violence could be close family members, relations, friends and others in a trusting relationship, could go a long way in curtailing this malady.

Meanwhile, it is important that Women and Child Protection agencies are recognized as important means of addressing the scourge of violence against women and children. States should set up functional protection agencies in the relevant ministries to carry out necessary duties to ensure that children suspected of being abused at home (such suspicion may first be made in a hospital or other public facilities) are followed up with appropriate investigation and treatment, and are subsequently protected in safe shelters where applicable. Schools and places of worship are also potential places for abuse of children and women, and could also serve as a veritable vehicle for the prevention of abuse if appropriately channelled. 

Unfortunately, many States in Nigeria in particular, and Africa in general, do not have Women and Child Protection agencies established by the State with requisite powers, responsibilities and resources. I've held advocacy meetings with some government officials on the need for this very important agency of the State. On 23 October 2014 at a symposium organized by the Child Protection Network, an NGO in Ibadan on the Implementation of Child Rights and at a similar event on 3 December 2014 organized by Star Children Initiative, another NGO also in Ibadan, on Promoting Accessibility and Harnessing Resources for Children with Disability in Nigeria, we reiterated the urgent need for a Women and Child Protection agency that will provide specialist assessment and offer necessary services to children, women and their families where there is suspicion of, or ongoing abuse, maltreatment or neglect. This will also facilitate the institutionalization and standardization of the quality of care provided to survivors of sexual violence and other forms of violence. There should also be some piece of legislation that will make it mandatory for teachers, health professionals (especially family physicians and paediatricians), leaders of faith-based organizations/worship places, etc, to report suspected cases of sexual and other forms of violence to relevant State agencies for prompt action. Failure to do so by these professionals and organizations should be a severe liability as a criminal breach of trust or connivance. Preemptive surveillance and promoting safe environments will facilitate the primary prevention of sexual violence against children and women, and would be a better option than the best forensic and medical management of survivors.

It still holds true that prevention is better than cure. Nonetheless, appropriate forensic medical management and other specialist therapeutic services are inevitable in the fight against sexual violence and other forms of violence especially targeted against children and women in our communities. The time for action was yesterday; we earnestly need to catch up!

Misdirected Messaging in Sexual Violence against Children and Women

A couple of days ago, I read a newspaper headline and couldn't believe what a high ranking government official in one of cosmopolitan states in Africa was quoted to have said. The headline, Pupils urged to resist sexual abuse, once again portrays a basic lack of understanding of this subject by those whose responsibility is it to protect these children from predators. At the said workshop on violence and sexual abuse for secondary school pupils in Alausa, Ikeja, Lagos, Nigeria, a celebrity in attendance  "advised students to be careful of how they dress and the way they react to sex abuse". This is a myth that has been perpetrated by the society. A girl is not raped because of her dressing. She is raped because someone made a conscious decision to abuse his position or power and exert control over her. We are only feeding the beast, a subject of my earlier post, if we keep giving perpetrators excuse for the violation inflicted on the victims.

Meanwhile, we need to ask our government officials and agencies how exactly these pupils are supposed to resist sexual abuse. A director in the ministry of Justice, Clara Ibirogba, who spoke on behalf of the attorney general of the state provided the answer:..."pupils should avoid watching bad films, exposing private parts and reading pornographic materials."
Clearly this is a manifestation of lacking of understanding of basic issues in sexual violence and the need for proper education of policy makers and government agencies in the fight to curb this menace.
Reading through the news report shows the enormous responsibility placed on children in the fight against sexual violence and that invariably implies that they share a major blame for any failure in this regard.
This is bad messaging. It should not happen.
We need to start focusing on the perpetrators and direct attention to appropriate quarters.
Again, victims of sexual do not invite rape upon themselves. No, someone violated them and that person carries the entire responsibility. It is this kind of misdirected message that emboldens perpetrators and essentially puts their victims in the dock of public court. How could we ask children and victims of sexual violence to resist sexual abuse? Placing them on that danger line defeats the message. Society must go after predators and ensure our children are protected.

It is this attitude and poor treatment of victims that made the mother of a girl allegedly raped by a security man, again in Lagos, to cry out in a recent media headline: Police blame me for my daughter’s rape, protect rapist – Mother of eight-year-old girl raped by security man
The link provides a typical example of how deep in the hole we are about solving the problem of sexual violence especially against children and women especially in Africa. A major link in this fight, state agency like the police, is so weak in this regard that it has become part of the problem. The sad story of this woman is replicated all over.
Aggressive training programme for the police, setting up special police unit for sexual violence (often general duty police officers regard sexual violence as "domestic affair" despite the provision in the criminal code), and enlightenment for the general public on sexual violence have become an urgent need in our communities.
The agony of this hapless woman should not be the order as it is presently.

When it Feels Like Giving Up

Dear blog visitor and reader, I apologize for my long absence on blog posts. Too many factors came in the way. I had actually written some materials to post on my link but the sheer volume of occurrences of some of the issues in question and the apparent feeling of helplessness in addressing them was quite overwhelming. One of the issues is sexual violence especially childhood sexual assault. There was hardly a day that would go by (on monitoring media reports), that another gory story of a violation of a child would not turn up. After the usual apparent outrage by the public, the matter naturally dies off and nothing is done to tackle the issue.
The police appear ill equipped to handle these cases because of poor or lack of training in this aspect and lack of requisite equipment, and there are also obstacles occasioned by lack of protocol for collection of credible evidence and attendant technical blockades in the judiciary.
Generally, the issue of management of sexual violence is not a priority for a health sector grappling with budget issues while facing myriads of communicable and non communicable diseases prevalent in our communities.
This and other forensic issues remain an orphan in most of African countries. Everyone talks and pities the situation but there is very little investment in human and material resources, and practically no institutional changes are implemented in tackling the fundamental problems.
I've made presentations before stakeholders, government agencies and NGOs, and I've met with government officials whose offices I reckoned could drive a change. However, the status remains the same and there is a tendency of thinking it is a hopeless situation in our generation to take concrete action in protecting the vulnerable in our community. I've attended to cases of sexual violence in children which reached a dead end even before actual case management began because the kind of multidisciplinary and multi-agency team work required to make any meaningful impact is simply lacking.
So where do we go from here?

2014 ended on a most tragic note. The sudden death of my teacher, senior colleague, a mentor and friend shattered any fragile stability in place. Prof Effiong Essien Udo Akang, an eminent Pathologist and Neuropathologist, was the best friend a colleague could have. He was ever supportive and was a shoulder for younger colleagues to lean on especially when disillusionment beckoned. He was also my Head of Department. The sudden and unexpected nature of the incident made it even more painful. One can only hope for some recovery from this irreparable trauma occasioned by the sudden exist of someone I had interacted with on daily basis for as long as I could recall. He was my family; he was dependable and someone to confide in.

Prof Akang died on 31 December, 2014. He left a huge void that may never be filled and I will miss him every day of this life; every day I pass beside his office door almost knocking as usual to exchange ideas or pleasantries. Indeed it is hard to say Goodbye!

The Right to Die and Some Matters Arising

Brittany Maynard, 29, who was diagnosed with a stage 4 glioblastoma, a terminal and aggressive brain tumour, eventually ended her life Saturday, November 1, 2014, in Portland, Oregon, with a fatal dose of barbiturates which was prescribed by a physician.

In a video released a couple of days before her death, she indicated that her greatest fear was losing the capacity to make the choice to take her life. She was diagnosed with an aggressive brain tumour in January 2014 and was told in April 2014 that she would have six (6) months to live. However, at the end of October 2014, she was still alive and functioning. Eventually, she decided November 1, 2014, was the right date to end her life. 

The story brings up several issues which may deserve some closer look in examining the concept of the Right to Die:

1. What should be the role of physicians in this circumstance considering the Oath medical doctors swear to preserving life? 
2. When doctors tell some terminally ill patients that they have a certain period to live, what exactly do they mean by that considering that many patients have defied such “predictions”, sometimes living functional lives weeks, months and years past predicted time? Have we ever correctly predicted the biology of a particular tumour or course of disease in different people at different times and places or even the same disease in a particular person at different times and places? 
3. What is the role of social media in people’s decision to end their lives and when to end it? 
4.  Was Brittany under any form of pressure to end her life in line with the predicted time and expectations of the considerable following garnered on social media taking into account she was reconsidering the early November date she had set because she felt well? Could there have been some pressure to meet certain expectations? 
5. Is there some danger of bandwagon effect and other unintended consequences in streaming such delicate and irreversible decisions on social and conventional media as was the case in Brittany Maynard? 
6. Is the Right to Life the other side of the coin of the Right to Die? If not, why do we choose to treat these two realities of existence differently about our rights therein? 
7. Have we considered all those who are really hurt in such assisted suicide as was the case of Brittany and do such people deserve to be heard dispassionately?
8. Is it possible to step out of the usual sentiments and debate assisted suicide with mutual respect and consideration to all the different positions or views, especially with all the media frenzy that has accompanied the index case? 
9. How do we protect vulnerable people, elderly and disabled people who may suffer irreversible harm should assisted suicide be legalized considering the enormous pressure references like that of Brittany could bring about?
10. Could assisted suicide be used, albeit inadvertently, as a cost-cutting measure in a broken, expensive and ineffective healthcare system? 
11. What will be the death certificate of Brittany Maynard bear as the cause and manner of death?
12. What are other matters arising in your respective jurisdictions?

Meanwhile, my sympathies to the family and friends of Brittany at their loss, and also to all those who wished she had lived even a day longer. We should be encouraged to discuss the circumstances surrounding her death and take a hard look, devoid of sentiments as much as possible, in evaluating what this circumstance presents to the rest of the community in this push for the Right to Die. I invite as many people as are willing to contribute in addressing any of the eleven issues raised above (and more) as I’m personally eager to listen and learn from what others think should be our approach to this very delicate and somewhat controversial and divisive subject.

Eric Duncan is Dead: We Must Stop Ebola!

Initially, Ebola virus disease (EVD) appeared to be a problem of a few West African countries, but not anymore. EVD is now in America and in Europe and perhaps in other yet to be identified locations. Effectively, EVD is now a global disease. However, our response to Ebola has been more of fear filled approaches, mixed messages and poor coordination. Screaming headlines in the press do little to educate than plant more fear, often irrational fear, about the disease thus posing greater danger to efforts at curtailing and containing the disease. Misinformation about the EVD has led to attacks, with some fatal outcomes, on some health workers in West Africa, and even in the more enlightened Western countries, the hysteria (significantly fueled by media hype) that has greeted the initial cases of EVD has been largely borne out of insufficient information and communication about the nature of EVD. The whole world must face the collective challenge Ebola has posed to humanity at this time. This is not a time for apportioning blame. It is a time for doing the right thing right on time.  It is time for collaboration and sharing information about any experience gained in containing the disease in some countries. It is time to provide human and material resources to affected countries and join forces to take down Ebola.

Eric Duncan eventually succumbed to this virus in the US. It is quite of concern that while he was battling for his life, his own mother country was preparing to prosecute him for "exporting Ebola knowingly" and the affected State in the US was also considering the possibility of bringing charges against him despite denials from his family that he was not aware of coming into contact with any index EVD patient back in Liberia. He didn't stand a chance to survive if survival depended on goodwill of the authorities. And he didn't survive. We must stop Ebola on fairness and justice. We must stop Ebola on equal treatment and care. We must stop Ebola by valuing the life of every person irrespective of what their circumstance might be. We can stop another Eric Duncan from dying anywhere in the world. The world has always succeeded when we pull together in the face of challenges. Therefore, to successfully stop Ebola, lots of doses of goodwill, expertise, volunteers, money and other resources are required.