Opinion

Challenges Of Paediatric Surgery In Nigeria

Published

2 years ago

December 8, 2023

According to the United Nations Children’s Fund (UNICEF), Nigeria is a ‘country of the young’ with 92 million of its over 200 million population under the age of 15 years. Also, according to Professor of Paediatric Surgery at the University of Lagos, and former Chief Medical Director (CMD) of University of Lagos Teaching Hospital (LUTH), Prof Christopher Bode, the number of children under 5 years old in Nigeria are over 30 million, with about 7 million new babies being born yearly. Prof Bode was the keynote speaker at the second edition of memorial lecture, held last week at the University of Port Harcourt, in honour of one of the pioneers of paediatric surgery practice in Nigeria, late Dr. Melford Graham-Douglas.
According to him, paediatric medicine is the medical care of children, a broad name for treatments for those from zero to 15 years of age, of whom Prof Bode observed are tender and voiceless, because they mostly can’t speak for themselves, depending on their parents for important lifecare decisions. Paediatric surgery which deals with surgical cares, mostly of birth defects in babies, demands the utmost skilled personnel, equipment and specialist handling, considering the tenderness of babies. Since the introduction of paediatric surgery in Nigeria, child-care professionals have continued to champion the awareness that children need specialised healthcare and infrastructure more customised to their needs as distinct from general medical practice.
Despite the achievements made so far in Nigeria in reducing infant mortality rates from previously untreatable birth defects, thanks to the foresightedness of pioneer paediatric surgeons like the late Dr Melford Graham-Douglas, enormous challenges still face the discipline from achieving its full objectives.As part of the general challenges of the Nigeria healthcare system, health screenings for disorders are mostly relegated out of ignorance, to the effect that paediatric cases requiring earlier surgeries are presented late, while most children are unable to communicate their health challenges. Where emergencies occur, paediatric surgeons have had to wait endlessly, for the general surgeons to free-up adult theatres before they could exercise efforts to rescew babies in critical conditions.
Considering that children are different in size and physiology, their cases become more delicate. Their body surface to mass ratios are much higher than in adults, that they dissipate body heat faster in normal ambient temperatures, and easily catch cold in the cold conditions of adult surgical theatres. Warmer surgical theatres designed and dedicated for children are always needed or they easily succumb to life-treathening hypothermia. Basic amenities are also needed to transport children in warm ambulances, especially babies, from hospitals of first call, to the centre of definite care.Paediatric surgeons also need to monitor children’s blood levels with specialist care because children have very low blood volumes that a minor loss could tip the balance between life and death. Due to anatomic differences from adults, children need special anaesthesia to undergo successful surgeries, and careful drug calculations to cope with their tender metabolic systems, their airways being so narrow, many routine anaestetic steps in adults are unsuitable for newborns and infants.
Drugs and the amount of fluid infusion to be administered to a child must be carefully calculated to conform with body weight, and in isothermic conditions. These are reasons paediatric surgery is such a speciality area that requires the skills set and infrastructure it deserves. It has been a huge challenge to practitioners who have had to work in poorly equipped environments. Paediatric surgery units in Nigeria should therefore be provided with neonatal intensive care units (NICUs) and paediatric intensive care units (PICUs) to ensure adequate post-surgery cares for babies and children, in addition to providing exracorporeal membrane oxygenation (ECMO) machines.Prof Bode however regrets that low man power remains a challenge in the field. According to him, in a survey conducted in Nigeria, about 2.9 million Nigerian children live with surgically correctable conditions, meanwhile there are just 38 treatment centres and only 115 paediatric surgeons in the country, some of whom have left for greener pastures, leaving a workload of about 25,000 patients per surgeon. There are only 22 professors of paediatric surgery to train needed personnel. There is therefore a need to create significant incentives that reverse the exodus of skills.
The labours of specialist surgeons like the late Dr Melford Graham-Douglas, who worked tirelessly to save lives remain commendable and they need being immortalised as an encouragement to others. There is need to celebrate those who served humanity selflessly and bequeathed a legacy of patriotism and hardwork.Late Dr Melford Graham-Douglas was the first African surgeon under the British Technical Assistance Scheme. He was a fellow of the British Association of Paediatric Surgeons, a fellow of the Royal College of Surgeons of Edinburg and England and a fellow of the American College of Surgeons. He was the first registrar of the Nigerian Medical Council, was among the founding fathers of the University of Lagos, as well as being a council member of the universities of Ibadan and Port Harcourt, respectively. Back home, he served the Rivers State Ministry of Health as permanent secretary who laid the foundation of health infrastructure in the state. He was honoured with the Order of the Federal Republic (OFR).
An icon of the Orubibi Group of Houses in Abonnema, the University of Port Harcourt honours late Dr Melford Graham-Douglas with a Professorial Chair in Paediatric Surgery at the university’s College of Health Sciences, in recognition of his contributions to humanity. The chair, currently occupied by Prof Amabra Dodiyi-Manuel, is dedicated to research and development in paediatric surgery.Government should build upon the foundations established by men like late Dt Graham-Douglas to equip the College of Health Sciences of the great University of Port Harcourt, with state of the art facilities in paediatric surgery, as a centre of reference within the South-South region. As it stands today, there is no significant paediatric surgery centre in the region. The management of UNIPORT should engage both federal, state and regional stakeholders to ensure this becomes a reality.

By: Joseph Nwankwo

Opinion

Trans-Kalabari Road: Work In Progress

Published

5 days ago

January 12, 2026

The Tide

Quote:”This Dream project is one of the best things that have happened to the people and residents of Degema, Asari Toru and Akuku Toru Local Government Areas in recent times.”

This is the concluding part of this story featured in our last edition.

Good road network helps farmers to convey their agro-allied products to commercial hubs where buyers and sellers meet periodically to transact business. Road network engineers and motivates people resident in unfriendly geographical terrains, like riverine areas, to own property and shuttle home with ease. Some people will prefer living in their own houses in a more serene and nature-blessed communities to living in the city that is fraught with pollution, and other environmental, social and economic hazards. Prior to the cult epidemic that ravaged parts of Rivers State, the Emohuas, Elemes, Ogonis, and Etches were known for rural dwelling. Most public servants from these areas do their official and private transactions from their villages. For them it was comparatively easier to live in the village and engage in a diversified economic endeavours through farming, fishing or other lucrative business without outrageous charges and embarrassment associated with doing business in Port Harcourt, where land is as scarce as the traditional needle.

That is why the decision to construct the Trans-Kalabari Road by the administration of Dr. Peter Odili was one of the best decisions that administration took. When Dr. Odili vacated office as the Rivers State Governor, Rt. Hon. Chibuike Rotimi Amaechi took over and awarded contracts for continuation of the road project which in my considered view is the felt need of the people of Degema, Asari Toru and Akuku Toru Local Government Areas. Unfortunately, Rt. Hon. Amaechi’s efforts to drive the project was sabotaged by some contractors some of whom are Kalabari people. The main Trans-Kalabari Road is one project that is dear to the people and residents of Degema, Asari Toru and Akuku Toru Local Government Areas of Rivers State. This is because through the road commuters can easily access several communities in the three local government areas. For instance, the road when completed will enable access to eight of the ten communities in Degema Local Government Area, namely: Bukuma, Tombia, Bakana, Oguruama, Obuama, Usokun, Degema town and the Degema Consulate. It will also link 15 of the 16 communities in Asari Toru Local Government Area. The communities are: Buguma, the local government headquarters, Ido, Abalama, Tema, Sama, Okpo, Ilelema, Ifoko, Tema, Sangama, Krakrama, Omekwe-Ama, Angulama. The road will also connect 14 of 17 wards in Akuku Toru Local Government Area, and other settlements. It is interesting to note that It is faster, and far more convenient and economical for the catchment Communities on the Trans-Kalabari Road network to go to the State Capital than the East West Road. The people of the three local government areas will prefer to work or do their transactions in Port Harcourt from their respective communities to staying in Port Harcourt where the house rent and the general cost of living is astronomically high.

Consequently, development will seamlessly spread to the 28 out of 34 communities of Degema, Asari Toru and Akuku Toru Local Government Areas. The only Communities that are not linked by the road project are Oporoama in Asari Toru, the Ke and Bille Communities in Degema Local Government Area and the “Oceania” communities of Abissa, Kula, Soku, Idama, Elem Sangama of Akuku Toru Local Government Area. But because of the economic value of the unlinked Communities to Nigeria, (they produce substantial oil and gas in the area), the Federal, State Governments and the Niger Delta Development Commission (NDDC), can extend the road network to those areas just as Bonny is linked to Port Harcourt and the Lagos Mainland Bridge is connecting several towns in Lagos and neighbouring States.Kudos to previous administrations who had constructed the Central Group axis.

However, what is said to be the First Phase of the Trans-Kalabari Road project is actually a linkage of the “Central Group” Communities which consists of Krakrama, Angulama, Omekwe. Ama, Omekwe Tari Ama, Ifoko, Tema, Sangama. It is the peripheral of the Trans-Kalabari Road. The completion of the Main Trans Kalabari project will free Port Harcourt and Obio/Akpor areas from congestion. It will motivate residents and people of the three local areas to contribute to the development of their Communities. If the Ogonis, Etches, Emohuas, Oyigbos, Okrikas, Elemes can feel comfortable doing business in Port Harcourt from home, residents and people whose communities are linked to Port Harcourt through the Trans-Kalabari Road will no doubt, do likewise. The vast arable virgin land of the Bukuma people can be open for development and sustainable agricultural ventures by Local, State and Federal Government.

It is necessary to recall that the Bukuma community was host to the Federal Government’s Graduate Farmers’ Scheme and the Rivers State Government moribund School-to-Land Scheme under Governor Fidelis Oyakhilome. Bukuma was the only community in Degema, Asari Toru and Akuku Toru Local Government Areas that has the capacity to carry those agricultural programmes. However the lack of road to transport farm produce to Port Harcourt and facilitate the movement of the beneficiaries of the scheme who lived in the community which is several miles away from the farms, hampered the sustainability of the programme. The main Trans-Kalabari Road remains the best gift to the people of Degema, Asari Toru, and Akuku-Toru Local Government Areas. Kudos to Sir Siminilayi Fubara.

By: Igbiki Benibo

Opinion

That U.S. Capture of Maduro

Published

5 days ago

January 12, 2026

The Tide

Quote:”Strategic convenience does not nullify sovereignty. Political frustration does not authorise military abduction.”

The first part of this story was published in our last edition.

In Africa and the Middle East, regime change—whether by invasion, proxy warfare, or sanctions—has often left behind fractured states, weakened institutions, and prolonged instability. Washington’s motivations in Venezuela are widely understood: vast oil reserves, alliances with U.S. rivals, and symbolic defiance of American influence in the Western Hemisphere. But none of these reasons confer legal or moral legitimacy. Strategic convenience does not nullify sovereignty. Political frustration does not authorise military abduction. If every powerful nation acted on its grievances in this manner, global chaos would inevitably follow. International law provides mechanisms for accountability. Under the Rome Statute of the International Criminal Court (ICC), individuals accused of crimes against humanity or other grave offences are subject to investigation and prosecution through judicial processes.

Likewise, extradition treaties, mutual legal assistance agreements, and Interpol mechanisms exist to ensure accountability while respecting due process. These frameworks were designed precisely to prevent unilateral enforcement of “justice” by military force. The most profound consequence of America’s action may not be in Caracas, but in the precedent it sets. If the world accepts that a superpower can unilaterally depose another country’s president, then the foundation of the international system is weakened. Sovereignty becomes conditional—no longer a right, but a privilege tolerated at the discretion of the powerful. Going forward, if another country invades its neighbour, will the United States retain the moral authority to impose sanctions or demand restraint? Some analysts already warn that parallels between Russia’s actions in Ukraine and America’s conduct in Venezuela risk further eroding global norms. Selective adherence to international law breeds cynicism and accelerates the drift toward a world governed by force rather than rules.

Power—military, economic, or political—should serve human progress and collective well-being, not domination and destruction. For African nations, many of which emerged from colonial rule through bitter struggle, this precedent is especially alarming. Sovereignty is not an abstract legal concept; it is a hard-won shield against external domination. Any erosion of that principle anywhere weakens it everywhere. Africa’s painful history of foreign interference makes this lesson especially urgent. For me, the real issue is not whether Nicolás Maduro is a good or bad leader. That judgment belongs, first and foremost, to the Venezuelan people. The larger issue is whether the international system still operates on law—or has quietly reverted to hierarchy. If America insists it is defending global order, it must ask itself a difficult question: can an order survive when its most powerful guardian feels entitled to violate it? Until that question is answered honestly, the capture of a foreign president will remain not a triumph of justice, but a troubling symbol of a world drifting from law toward force.

If the United States felt so strongly about the allegations of terrorism, drug trafficking against Maduro, were there no other lawful options? Judicial accountability, diplomacy, regional mediation, and multilateral pressure may be slow and imperfect, but they reflect respect for international law and sovereign equality. Military seizure is a blunt instrument. It humiliates institutions, radicalizes populations, and hardens resistance. It may remove a leader, but it rarely resolves the underlying crisis. History teaches that military interventions seldom result in stable democratic outcomes. More often, they breed resentment, resistance, and long-term instability. For the sake of global order and the rule of law, the United States should reconsider this path and recommit to diplomacy, legal cooperation, and respect for the sovereign equality of states. Former U.S. Vice President Kamala Harris reportedly described the invasion of Venezuela as “unlawful and unwise,” warning that such actions “do not make America safer, stronger, or more affordable.” Her words reflect a growing recognition, even within the United States, that force without legitimacy undermines both moral authority and global stability.

Should what happened in Venezuela serve as a wake-up call for corrupt African leaders who undermine the people’s right to choose their leaders? The answer is yes. The capture of Maduro should alarm African leaders who manipulate elections, weaken institutions, suppress opposition, undermine citizens’ rights, or cling to power at all costs. Venezuela faced widespread criticism over disputed elections and repression long before this episode, and that context shaped how the world reacted. This does not justify foreign military intervention, but it highlights an uncomfortable truth: prolonged democratic decay isolates nations and invites external pressure—from sanctions to diplomatic censure. Global opinion matters, and legitimacy at home strengthens sovereignty abroad. The Economic Community of West African States (ECOWAS) and several African leaders have rightly condemned the events in Venezuela, invoking the principles of sovereignty and non-interference enshrined in international and regional law.

Beyond condemnation, however, African leaders must look inward. The continent’s future cannot be built on repression, constitutional manipulation, and personal greed. Leadership must reflect the will of the people, not desperation for power. Two days ago, a social commentator on a radio station argued that Trump’s action—though condemnable—demonstrates how far a leader can go for his country’s interest. According to this view, he did not intervene in Venezuela for personal enrichment, but to strengthen his nation. In stark contrast, many African leaders plunder their own countries. They siphon public resources, impose crushing taxes and harmful policies, and leave their citizens poorer—all for selfish gain. That contradiction is the deeper lesson Africa must confront.True sovereignty is protected not only by international law, but by accountable leadership at home.

By: Calista Ezeaku

Opinion

Kudos Gov Fubara

Published

2 weeks ago

January 2, 2026

The Tide

Please permit me to use this medium to appreciate our able governor, Siminalayi Fubara for the inauguration of the 14.2-kilometre Obodhi–Ozochi Road in Ahoada-East Local Government Area. This inauguration marks a significant milestone in the history of our communities and deserves commendation. We, the people of Ozochi, are particularly happy because this project has brought long-awaited relief after years of isolation and hardship.

The expression of our traditional ruler, His Royal Highness, Eze Prince Ike Ehie, JP, during the inauguration captured the joy of our people. He said, “our isolation is over.” That reflects the profound impact of this road on daily life, economic activities, and social integration of the people of Ozochi and other neighbouring communities. The road will no doubt ease transportation, improve access to markets and healthcare, and strengthen links between Ahoada, Omoku, and other parts of Rivers State.

The people of Ahoada, Omoku, and indeed Rivers State as a whole are grateful to our dear governor for this laudable achievement and wish him many more successful years in office. We pray that God endows him with more wisdom and strength to continue to pilot the affairs of the state for the benefit of all. As citizens, we should rally behind the governor and support his development agenda. Our politicians and stakeholders should embrace peace and cooperation, as no meaningful progress can be achieved in an atmosphere of conflict. Sustainable development in the state can only thrive where peace prevails.

Samuel Ebiye