Docotal visits IDP camps of Borno state, Nigeria

Raising awareness in the IDP camps of El-Kassim and El-Yakub, Borno state Nigeria on Cardiovascular diseases and associated risk factors.

Borno State, the “Home of Peace” is located in Nigeria’s North-east region. It is known for rich and diverse cultural heritage dating back to over one thousand years. However, the region has experienced a turbulence characterised by insecurity and instability since the upsurge of Boko Haram insurgency in 2009.

The conflict has displaced over 2.9 million people in the region with more than 20,000 lives lost. Consequently, despite the migration in hundreds of thousands to neighbouring countries such as Chad, Niger and Cameroun precisely over 778,000 (source UNHR), most of the Internally displaced persons(IDPs) are located in Borno state, the epicentre of the conflict specifically living in camps (IDP Camps) and Host Communities1,2.

In view of the prevalence and growing burden of non-communicable diseases(NCDs) and Cardiovascular (CVD) morbidity and mortality in the IDP camps. I was hosted by a prestigious non-profit organisation based in Maiduguri called Hallmark Leadership Initiative(HALI), on a pilot medical visit to both El-Kassim and El-Yakub IDP Camps in Maiduguri Borno state with the consent and approval of the State Ministry of Health. In collaboration with Kaumi Shehu Medical Services Ireland and Docotal Health Foundation, on the 12th February 2022.

I was honoured and blessed to visit both IDP Camps in other to kick off a Health promotion programme, i.e. a 2-hours community sensitisation and awareness programme on Cardiovascular disease (CVD) associated risk factors. Followed by an immediate 3-day Free CVD Clinic (14th,15th and 16th February 2022).  

In attendance was the State Director of NOA Mr. Jaafar Imam, Religious Leaders and Community Elders. Their support was enormous and highly appreciated.

CVDs is a significant public health concern responsible for a high burden of morbidity and considered as a “silent killer”. Most people in Nigeria are unaware of the alarming signs and symptoms of Stroke or Heart attack, despite reports showing 11% of over 2 million NCD deaths in the country was attributed to CVDs. Also, considered the number one cause of death globally 3,4.

Therefore, the aim of this programme was to estimate the awareness of CVD and associated risk factors in people living at El-Kassim and El-Yakub Camps, Maiduguri Borno state using a validated questionnaire.

Inclusion criteria adapted for the 3 days Free CVD Clinic was: all patients 40 years of age, Family history of CVD, Diabetes in first or second degree relatives. Past Medical History of Hypertension, Cerebrovascular disease and Diabetes.

We maintained and followed all Covid-19 protocol and guidelines in accordance with NCDC. 96 participants visited the clinic facilitated with Volunteers and a Nurse practitioner. Following the successful awareness day which was very interactive and interesting, only 15% respondents overall had good awareness of CVD and associated risk factors.

High number of the respondents approximately 73% were not aware of early warning signs and symptoms of Stroke or Heart attack. Hypertension and Stroke were the most commonly identified types of CVD at 32%. However, the awareness of commonly modifiable CVD risk factors such as high fat and salt and intake, lack of physical activity, socioeconomic and psychosocial factors was insufficient. 

Moreover, due to the unprecedented programme conducted in their midst, the majority of the participants were eager to consult with a list of numerous complains, symptoms and medical issues prior to the Free CVD Clinic.

The Clinic was successfully conducted and coordinated with the help of our organising team. The Nurse practitioner triaged and registered each and every patient, documenting vital signs such as blood pressure, SpO2, HR, BMI prior to doctor consultation. I was really amazed with the high turnout and attendance of the patients during these wonderful 3 days of free diagnosis and treatment.

Alarmingly, most of the patients presented with elevated blood pressure, diabetes, heart failure, hypertensive crisis and complications of stroke and diabetes mellitus. Similarly, the Free CVD Clinic offered not only free medical treatment for these patients but also health promotion on the early detection and proper management of risk factors. It was a memorable event confirmed by the faces of joy and happiness in most of the participants.

Among the 96 participants screened for the clinic, 54 were Male and 42 Female patients. 47.9%(46) Hypertension, 26%(25) Dyspepsia/GERD ,18.8%(18) Diabetes mellitus, and 5.2%(5) eye disorders (cataracts, glaucoma).

Most patients had several presenting complaints with at least diagnosis of 2 CVD on consultation. Finally, the results outlined in this successful medical intervention specifically in the IDPs of El-Kassim and El-Yakub, showed the high prevalence of CVDs. Nearly half of the participants were hypertensive (47.9%) followed by Dyspepsia/GERD and Diabetes mellitus. Dyspepsia and GERD was the most prevalent overall complaint and diagnosis of a Non-Cardiovascular disease.

Immediate medical treatment with repeat prescriptions was provided to all patients. Subsequent continuity of care by a regular Health professional in an established community clinic within the area would be the most ideal recommendation. These activities can directly or indirectly benefit the Host communities and improve the health outcomes within a period of time.

More collaboration with partners and additional funds would be needed for specialized outreaches involving Ophthalmologist, Gastroenterologist, Psychiatrists to name a few in other to address other major issues and complaints raised by both the IDPs and community leaders.

Sources

1. https://www.unhcr.org/en-ie/nigeria-emergency.html.

2. Closure of camps for internally displaced persons in Maiduguri, Nigeria: https://tinyurl.com/dx988c3h

3. https://www.afro.who.int/news/diet-and-exercises-are-pivotal-preventing-cardiovascular-diseases.

4. Cardiovascular epidemiology in Africa, European Heart Journal, Volume 37, Issue 42, 7 November 2016, Pages 3185–3188, https://doi.org/10.1093/eurheartj/ehw471

Dr. Laminu Kaumi is the CEO Kaumi Shehu Medical Services Ltd, Ireland. Chairman BOT Docotal Health Foundation. Member European Primary Care Cardiovascular Society (EPCCS).

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