What can you do to sleep better? (In local parlance it will be ‘what can you do to help your ministry?’) Experts term this as sleep hygiene.

• For snorers, try finding a remedy for the snoring. I hear there are devices or medication these days to help with the problem. Ask your doctor.
• Stay off sleeping pills. Lucky enough in Nigeria, it’s no longer an OTC medication. These pills will cease to have any effect after prolonged usage and will only lead to an addiction.
• Do not smoke within six hours before your bedtime. I reserve this to those who have refused to heed the warning that smokers are liable to die young.
• Do not take food, medicine or drinks that contain caffeine or other stimulants six hours before bedtime
• Avoid heavy meals just before bedtime. Your delicious akpu and vegetable soup or asaro (yam porridge) does not make the cut. A light snack will do.

• Do not drink alchohol six hours before your bedtime.
• It helps to have a regular sleep routine, so go to bed and wake up the same time every day.
• While staying active and exercising regularly is highly recommended, strenuous exercise four hours before bedtime is not. In fact, exercises are more helpful to your sleep routine if done earlier in the day.

• Check your medication: If you cannot sleep and you take medications, it might be a good idea to see that your drugs are not the cause. If you check with your doctor and it is, it may be possible to get an alternative yet effective medication.
• Say no to drugs! Street drugs, obviously.

Other titbits include making your bedroom an enabling environment for sleep; eliminating noise (if that is possible in Lagos); turning off the lights; not watching television in your room; making sure your bed is comfortable (believe it or not, an old sagging mattress can affect your sleep); a warm drink or reading may help you get to sleep; and lastly, avoiding mentally demanding tasks such as studying before sleep time (I can hear the outcry of students reading this)

With the myriad of information on insomnia out there, no-one should suffer needlessly from a lack of sleep unless one chooses to. Sleeping and sleeping well should never be a luxury but always a necessity for anyone who wants to be more productive and live a better quality of life.

Golly, 2am already? I really must get to bed. Good night! Sleep tight!

*This concludes the article

As I tossed and turned on my bed last night and wished for sleep, I ironically thought about my decision to write about insomnia.

INSOMNIA. I didn’t give much thought to my poor sleeping habits until I mentioned it to a colleague at work one day and he said, ‘You need to go see a doctor.’ This response caught me off guard. Who in Nigeria goes to see a doctor to complain about sleep? My colleague’s suggestion was the first time I realized that it may be a serious problem – serious enough to seek medical help.

So let’s talk about insomnia. Its simplest definition is poor sleep. Poor sleep can mean waking up too early, not being able to get off to sleep, waking up for long periods in the night; and not feeling refreshed after a night’s sleep. So if you’re like me and you wake up and wait for your morning alarm to ring, you’re definitely a candidate for poor sleep. If you wake up at nights and have to count sheep to drift off again, sit up and pay attention to this write-up because poor sleep is your middle name. If it takes you a long while to sleep at the end of the day, please join the ‘operation sleep’ team. Medical experts believe that for most people it takes less than thirty minutes to fall asleep. If it takes you longer, it may be an indication of insomnia.

Research has brought to light the fact that our sleep requirements are as different as we are as human beings. While others can function effectively with 3-4 hours of sleep, others require say about 8-9 hours. I would really like to meet the ‘set awon 3-4 hours sleep geng’. They are such a lucky bunch! It has also been discovered that as you become older, it is normal to sleep less.

So what causes poor sleep? Anxiety, stress and depression are fingered as the most common causes of insomnia. Anger, grief, bipolar disorder and trauma (grouped under psychological and emotional causes) also are listed. Other causes of insomnia may be snoring (medically known as sleep apnoea) which causes the narrowing of the airways and reduces the amount of oxygen in the lungs, as such the snorer may wake up many times at night to breath properly.

Having certain illnesses may contribute to poor sleep e.g indigestion, mental health problem, hot flushes, coughs, leg cramps.Stimulants such as alchohol, caffeine and nicotine are not sleep-friendly. Street drugs such as cocaine, ecstasy, cannabis and amphetamines do your sleep no good. Some prescribed medication also have an effect on sleep. Diuretics, some anti-depressants, steroids, beta-blockers, some types of painkillers and some cold remedies can be added to this list. On-going scientific research to prove the relationship between screen time and insomnia has been in the news for years. One day soon, hopefully, the impact of electronic devices on sleep will have solid proof backing it.

It’s easy enough to dismiss insomnia as hogwash when it is experienced for a short time but over a long period, the consequences are not entirely pretty:

• Irritability: When you find yourself constantly snapping at the slightest provocation or having to refrain from biting off someone’s head for the smallest mishap (in some cases, you may actually not be able to refrain)
• Poor concentration: Your head feels all woozy and you struggle to fix your attention on the task you have at hand.
• Tiredness or fatigue in the day time: Do I need to explain this? In my own case, I’m so burnt out even though my work hours haven’t increased, I literally can’t wait to dash home from work and dive into bed. (Anything my colleagues are doing or telling me when its 5 minutes to close of business, hmmmm….they are on their own o!)
• Inability to do things well
• Loss of interest in usual activities.

The consequences listed above will ultimately result in a worse quality of life. I’m sure you figured that out by yourself already though!

*To be concluded

**Ogonna Kanu originally wrote this article for a magazine. It has been slightly modified for the DHI blog.

Lately, people have taken to social media to let out their trauma in search of support. Many times, a person makes this decision to share such intimate details of their life with the world because they don’t have a good support system–which doesn’t always mean they don’t have friends or family.

In the spirit of making the world a healthier place, here are five things you can do to support a friend/family member who is currently in a stressful psychological situation:

1) Validate their feelings: Persons who are experiencing a mental health crisis always tend to isolate themselves from others because they fear they will be misunderstood, judged or ridiculed for what they are feeling; and unfortunately, this does happen.

Validating a person’s feelings isn’t about agreeing or supporting whatever they feel i.e I feel worthless; but is about accepting the fact that THEY DO feel that way. Statements like ‘God forbid!’, ‘It is not your portion’ only help the person feel worse. Try statements like ‘it’s okay not to be okay’, ‘I get you’, ‘I love you no matter what’, ‘your feelings matter’.

2) Be Patient: If someone close to you is in a terrible mental space, you’ll have to be patient rather than pushy. Don’t push them to talk or answer numerous questions concerning what they’re feeling when they are not ready to do so.

By doing this, you’ll be making the situation more stressful for them. Try to, as much as possible go at their own pace. Make it clear that you are available for whatever it is that needs to be heard, in whatever way is most comfortable for them.

3) Encourage them: Usually, when people are struggling mentally all they want to do is just lay in bed to rest. While supporting what they need to get better, encourging them to have at least one daily goal e.g tidy my closet, can go a long way into diverting an intense depressive spiral.

4) Pay attention to non-verbal cues: don’t wait to be told everything before you act, be proactive by paying attention to what they might not be telling you. For instance, are there dark circles under their eyes? Do they pick distractedly at their food? Do they repeat certain actions like rubbing a particular spot on their body? Bring such things to their attention and try to get to the root of it together.

5) Do research: there’s a lot of specific information out there to help with whatever your loved one is dealing with, but you’ll never find it if you don’t look.

And while you’re at it, also pay attention to your own mental health.

Esohe Iyare, a DHI volunteer writes in from Lagos

In celebration of International Women’s Day, DHI is spotlighting Nigerian women who have founded NGOs and social enterprises that are making an impact in Nigerian communities.

Nkechi Cecilia Odebiyi’s Virgins Pride Foundation is totally refreshing. The NGO is interested in raising and building young women who have vowed to pursue chastity and honest living as a lifestyle and family tradition. It encourages abstinence, service to the community, skills and personal development and patriotism. In the past, it has organized purity day celebrations for young people, visits and celebrations for the widows and elderly in the community, skills training programmes and valentine’s day specials. In collaboration with the Lagos State Ministry of Education, it is currently working to re-introduce reading and learning culture in schools. You can find their activities at: https://web.facebook.com/groups/1592957857667757

Serving with Love was founded by 3 women who were moved by the level of poverty among women and children in the society. This NGO serves socially and economically disadvantaged women and children in Nigeria. They provide children, women and families with basic and essential needs and they run a Digital Life After School Programme that equips children from disadvantaged backgrounds with digital skills. You can check them out here: https://swl.foundation

Pad – Up Creations is the social enterprise brainchild of Olivia Onyemaobi. It was whilst she was on a campaign to raise awareness on sexual abuse against girls/women that she discovered that most females, particularly in the rural areas were having challenges with menstrual hygiene. They resorted to using any and every thing to curb blood flow during their monthly cycles. Olivia’s solution to this dilemma was the creation of re-usable and washable sanitary pads. The pad – up sanitary kit was born! Since its creation, over a million kits have been distributed, not only in Nigeria but in 13 other African countries. Pad-up also means employment for about 93 Nigerians. Check out their activities here: https://www.padupcreations.com/

Temitope Okunnu’s Fabe International Foundation through its programmes (Tidy Nigeria; Ecoschooling; Ecopreneurial training, mentoring and support; training on biogas, upcycling, recycling etc) is trying build a safer, cleaner and greener society where people and industries can thrive. It has as its mission to promote and improve environmental sustainability consciousness and attitudinal change by engaging young people and women in the identification, exploration and facilitation of sustainable eco-solutions to problems caused by the impact of climate change. It wants to create a positive impact on the environment and health of local poor people and biodiversity in Nigeria through advocacy and creative climate-smart solutions. Check out: https://fabeinternational.org/

Mamamoni Empowerment Foundation is a fintech social enterprise set up by Nkem Okocha. It seeks to close the credit gap for low income female entrepreneurs in rural and urban slum communities in Nigeria. In 2019, with the assistance of Union Bank, the Foundation set up an innovation hub in the Amuwo Odofin area (Lagos State) The hub offers vocational training to low income girls and women in urban slum communities. Since the Foundation’s inception in 2016, over 6,000 women have been provided with micro loans and received basic vocational and financial literacy skills. Learn more at https://www.mamamoni.org/

Cawstem was created as a tribe for African women in Science, Technology, Education and Mathematics (STEM) by Wamide Animashaun. It aims to help women stay in STEM and fill leadership positions. Members are inspired, supported, mentored and connected to resources, opportunities, events, peers and mentors in STEM.  https://www.cawstem.org/

Joy Life Alagbemi is a determined 14year old who deserves all the support and accolades we can give. She does not run an NGO but as a girl child advocate is way ahead of her peers and making her mark. She lends her voice to the plight of Nigerian girls at every opportunity she gets. Last year, in collaboration with the Swedish Embassy, she hosted a webinar tagged ‘Promoting Girl Child Education and Leadership in Nigeria.” She was also the main speaker at the events celebrating the International Day of the Girl Child. She is working to raise awareness and funds for the education of internally displaced children in Abuja. Her global project ‘I Subscribe’ is being organized to promote the rights, growth and development of the girl child. She also has a Whatsapp group where female teenagers (ages 10 – 17) interact and brainstorm solutions to problems they face as girls in the society. Please visit here for more information: https://www.linkedin.com/in/joy-life-alegbemi-a28561198/

Ever had to tell someone to dust the white off his/her hair? Ever comb your hair with white flakes falling to your clothes and your surround? Also felt like scratching your hair off your head? If you’ve had these experiences along with the feeling of a dry scalp, then you have most likely dealt with dandruff. Contrary to popular opinion, dandruff is not caused by poor hygiene although it becomes more noticeable when the hair is not well taken care of.

 

 

Dandruff usually occurs when there is an increase in the shedding of the old cells of the scalp. This leads to the accumulation of whitish/greyish flakes of dead scalp skin in the hair. The increase in shedding could be as a result of tinea capitis, popularly known as ringworm; eczema; allergic dermatitis which is a reaction to hair products; and seborrheic dermatitis – an overgrowth of yeast.

 

 

Treatment of dandruff does not usually involve a hospital visit. Simple regular washing of the hair can sometimes be enough. The main treatment though is to use anti-dandruff shampoos which have been found to be effective. It is important to read instructions on these hair products carefully to avoid adverse reactions. It is also important to note that complete cessation in the application of these treatments may lead to a re-occurrence. Hence, it is better to reduce the frequency of usage rather than to put a total stop to the treatment.

If there is no improvement after a month or there is an associated scarring of the scalp and severe itching occurs; or yet still an underlying medical condition occurs, then the hospital should be the next port of call.

 

**Michael Imeh, a DHI volunteer writes in from Lagos

December 12 – The day of our December outreach to the Eleko IDPs dawned bright and early. With the spike in the number of COVID 19 cases in the state, we made every effort to comply with NCDC’s guidelines. Although we knew how much all our volunteers wanted to be part of the visit, we had to make the difficult but necessary decision to make the journey with very few volunteers. The IDPs were also adviced beforehand to send a few representatives who would made up of men and women.

We set off at about 9.30am, making a stop to pick up Chief Jonah. An IDP himself, Chief Jonah has been our main contact person with the Eleko IDPs over the years. He was a traditional ruler in Chibok village before Boko Haram caused him to flee. He has continued to act as a leader/spokesperson for the approximately 300 people who fled alongside with him.

At 11.30am, our bus arrived the makeshift church which a generous pastor in the area makes available to the IDPs any time we pay a visit. The IDP representatives were waiting and after friendly banter helped us offload the drugs and food items we had brought. We went straight to the business of the day. One of our volunteers, Igeme, started off by giving an expert delivery on the importance of maintaining menstrual hygienic standards to the group of women who turned up. The idea was that they would educate other internally displaced women since all the women could not be there for the talk. Whilst Igeme interacted with the women, Henrietta, another volunteer, addressed the men. She talked to them about the pandemic and simple precautionary measures to take. Interestingly, the men participated. She appeared pleasantly surprised at their level of awareness and encouraged them to pass on any new knowledge they may have acquired to their brother IDPs.

With the end of the talks, our visit came to an end. The items donated items were left in the care of Chief Jonah and the other representatives to distribute. Our IDPs asked DHI to express their heartfelt gratitude to such generous donors and thanked us for our assistance over the years.

We left Eleko Beach at about 1pm wishing we could do more and yet fulfilled that our little had made our IDPs smile.

**Our gratitude goes to Cottage of Hope Empowerment and Rehabilitation, FoodBank, Standard Chartered Bank (Commercial Banking Section) Victoria Island, friends and relatives

 

International Volunteers Day is an annual event, celebrated every December 5 to acknowledge the contributions volunteers and volunteer-led organizations make to communities and the actualization of the United Nations’ sustainable development goals.

This year’s theme was ‘Together we can through volunteering’. The mandate was to bring to the fore the resilience and innovativeness which volunteers and organizations had employed to function and cope this year, bearing in mind that the pandemic has literally lasted throughout the year and is still on.

Doctors Health Initiative (DHI) was very excited to join in this year’s celebrations for the first time. Our International Volunteers Day (IVD) team made up of Pelumi, Ihioma, Margaret and Chidera set to work planning a Zoom presentation which held on the day.

The IVD presentation started at 4pm with Ihioma, a DHI volunteer anchoring the event. Our DHI president, Dr. Nkechi Asogwa was on hand to talk about the main focus and achievements of DHI. Chinenye Nzom, the executive director of Volunteers Hub Africa was our guest speaker. Her passion for the cause of volunteering was evident as she spoke about how she discovered volunteerism, starting a volunteer organization and the many benefits of volunteering. Chidera, another volunteer, rounded up the event with a brief discussion on future DHI activities and events to look forward to.

It was a short, impactful session which left everyone wanting more. The DHI team was delighted with the outcome and hope to replicate it next year.

Did you know that the brain is the number one sex organ in your body? I bet you never thought about it like that, did you? On a serious note, that’s why you really shouldn’t be missing our free Doctors Health Initiative weekly forum (aka the Hot Button Series) on Zoom.

In one of our discussions on fertility awareness based methods, Dr. Emmanuel Okechukwu, a natural reproductive health specialist, coined and explained “genito-centricity” and “cerebro-centricity” as the two philosophical divides in the family planning space. While cerebro-centricity espouses the brain as controlling the reproductive function, genito-centricity projects the genitals as being in control. Now, if the genitals have so much power, the sex organs are king and human beings are under subjection of the instinctual powers of eroticism. Clearly, we don’t or can’t have a say. We only act under authority. If our genitals are in charge, we take action without thinking and are exonerated from the consequences. Something doesn’t sound quite right here. That is to say, genito-centricity (genital focus) of human sexuality attempts to make us believe that once the reproductive organs are caged or controlled from the picture (preventing infections, dodging pregnancies) then hooray, humans can literally do anything they want, without repercussions.

Cerebro-centricity (brain-focus) of human sexuality, on the other hand, presents a broader view and if given deep thought, an upper hand in this argument. It does not only assert that reason is superior to action, but painstakingly sheds light on this claim. Cerebro-centricity recognizes that those feelings of admiration or likeness or love between a man and a woman originates from the brain. All the thinking, scheming and actions, which begin and nurture any relationship is controlled by the brain. In addition, in the development of the human person, the brain cells are formed way before the genital organs – the brain cells are formed within twenty five days of fertilization and the genital organs are formed between the second and third months after fertilization. The brain is also saddled with sending off signals to the hormones (follicle stimulating hormones etc) which in turn stimulate the genital organs to produce the secondary sex hormones such as oestrogen and progesterone. Cerebro-centricity allows for the full expression of sexuality as an innate trait of man. As man is a higher, rational animal, he needs to be fully aware of himself and make decisions through reasoning.

I am in agreement with the good doctor. Family planning realistically should start from a couple sitting down to make decisions based on sensible (brain-led) examination of their circumstances and definitely should not be limited to sidelining our reproductive organs.

As Nigerians are wont to say, ‘use your brain’, doesn’t cerebro-centricity just makes sense?

Ogonna Kanu, a DHI volunteer, writes from Lagos, Nigeria

Every Nigerian knows at least one story of a left-handed child who was scolded and beaten into becoming right-handed. Deviations from the cultural norms are consciously and subconsciously treated as unacceptable, even when there’s scientific evidence to support its normalcy. If you magnify the treatment given to lefties by a power of ten, then you’re close to understanding the stigma around mental illness in Nigeria.

Childhood is a stage that makes or breaks people especially in regard to mental health. It was the former for Mr Nwabueze, who has been living and thriving with ADHD – attention deficient hyperactive disorder:

Q: People aren’t exactly moved to consult psychiatrists, could you tell us how you got diagnosed?

Mr.N: You’re quite right. People don’t usually talk about mental illness in Nigeria. They feel like the black man should not have mental illnesses. I was very lucky to have an uncle who was a psychiatrist; and as children, he was always watching us to see if we had anything. So that’s how I got diagnosed with it and he started helping me handle it. So far, so good.

Q: Not a lot of people know about ADHD, are there any tell-tale signs, intrusive thoughts etc that people can keep in mind? Not that we’re encouraging self-diagnosis.

Mr.N: Well, it’s not a ‘popular’ mental illness. I remember when I got diagnosed my parents were asking ‘are you sure he doesn’t have some foreign mental disease?” There were some stereotypes associated with it. That is why I think I’m very lucky because he (my uncle) explained that my diagnosis didn’t mean I was mentally disabled, only that my attention span doesn’t last long—attention deficit hyperactivity disorder.

You know, it’s a disorder that typically affects boys. It shows itself between 9-15. They show signs of not being able to hold attention for a long time, and so it can be easily noticed. But above that age mark becomes tricky because it takes the form of other symptoms. So the tell-tale sign would be to observe your child’s attention span. An attention of 4-5seconds is a sign. There’s no need to panic anyway, it’s easily managed.

Q: You mentioned ‘stereotypes’, can you elaborate?

Mr.N: Yeah, there’re a lot of stereotypes! Given where we are—Nigeria. People don’t really talk about their problems, much less their mental disorders. Heck! We don’t even see psychiatrists when we are depressed, not to talk of when you have a child with a mental illness that he has to take medications for. From being chained, to be sent for deliverance in a Cele Church. Those who were not as lucky as me ended up that way. The African culture where we try to shy away from the fact that we are just as fallible as any race in the world, with depression and disorder and things they can’t understand and handle. Instead of looking for appropriate help, they take other measures.

Q: Let’s talk about medications for ADHD, could someone manage without them?

Mr N: The thing is ADHD really has an effect on adolescent boys. When they enter adulthood, the progression of ADHD slows. But if as a child medication is not administered, it actually gets worse as you come of age and brings all sorts of symptoms. Looking back at my own journey, I think people will better manage ADHD if use the medication early. If I hadn’t taken the medication I did, I would have had issues with school and doing things as an adult. The progress has been slow but the medication is very important, because the later symptoms can be so unpredictable and make adulthood difficult.

Q: Alright, but are there any behavioural therapy resources that also help?

Mr. N: yeah, I think the central behavioural therapy that anyone who has ADHD can use is the beautiful power of talking about your problems. That was the foundation of my therapy sessions with my uncle. He sort of made me feel very comfortable in my own skin, because back then I used to have very terrible panic attacks especially when I lose attention. I think ‘oh there you go again’, ‘you’ve started again’, ‘you’re losing attention!’ and I became concerned and didn’t want to talk to anyone about it. But when he (uncle) made it easier for me to talk, it was serious stress relief. The triumph starts with recognising that you have an issue, but knowing you can overcome.

It was really terrible back then, I used to feel like people were playing drums on my head and causing me to lose attention. I used to feel so bad. But he made it easy for me, and the medications made it easier for me to put my thoughts together without serving up complicated word salads. You need to talk; then the medications.

Q: Thank you so much for sharing this with us, any key advice/information you want to leave our readers with?

Mr N: Yeah! I have tons. First of all, ignorance is a disease that should be treated as a sin! We have to break the chains of ignorance due to religious, cultural principles that hold us down in Africa. We feel like we’re different; we’re not. Psychological problems know no colour or race, it’s blind. Everyone has issues and we have to grow beyond running to religious houses or shrines to solve them.

Technology has given us so much. We’re seeing what’s happening in the Eastern and Western worlds, no matter the religious hegemony, they are moving. Even with all the criticisms that Islamic movements have, there is a Sunni part of their beliefs that thrives in Saudi Arabia; their citizens no longer suffer. I don’t know why Africa has decided to hold on to mediocre ideas. The best we can do is to liberate our minds from teachings that cloud our judgements.

We are truly grateful to Mr Nwabueze for sharing his story. It is out hope that the information and stories we provide concerning mental health empowers more people to take charge of their mental health; and reduces the spiral of silence around this topic.

Feel free to let us know what you think about this article in the comment section.

Stay healthy. Stay happy.

Esohe Iyare, a DHI volunteer writes in from Lagos, Nigeria

Doctors Health Initiative is offering free medical advisory/consultations for the duration of the #EndPoliceBrutality protests.  Our helplines are listed below. We shall be honoured to serve you!