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Challenges Of Paediatric Surgery In Nigeria

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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

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Opinion

Empowering Youth  Through Agriculture 

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Quote:”While job seeking youths should  continuously acquire skills and explore opportunities within their immediate environment as well as in the global space through the use of digital platforms, government, corporate/ multinational organizations or the organised private sector should generate skills and provide the enabling environment for skills acquisition, through adequate funding and resettlement packages that will provide sustainable economic life for beneficiaries”.

The Governor of Rivers State, Sir Siminalayi Fubara, recently urged youths in the Rivers State to take advantage of the vast opportunities available to become employers of labour and contribute meaningfully to the growth and development of the State. Governor Fubara noted that global trends increasingly favour entrepreneurship and innovation, and said that youths in Rivers State must not be left behind in harnessing these opportunities. The Governor, represented by the Secretary to the State Government, Dr Benibo Anabraba, made this known while declaring open the 2026 Job Fair organised by the Rivers State Government in partnership with the Nigeria Employers’ Consultative Association (NECA) in Port Harcourt. The Governor acknowledged the responsibility of government to create jobs for its teeming youth population but noted that it is unrealistic to absorb all job seekers into the civil service.
“As a government, we recognise our duty to provide employment opportunities for our teeming youths. However, we also understand that not all youths can be accommodated within the civil service. This underscores the need to encourage entrepreneurship across diverse sectors and to partner with other stakeholders, including the youths themselves, so they can transition from being job seekers to employers of labour,” he said. It is necessary to State that Governor Fubara has not only stated the obvious but was committed to drive youth entrepreneurship towards their self-reliance and the economic development of the State  It is not news that developed economies of the world are skilled driven economies. The private sector also remains the highest employer of labour in private sector driven or capitalist economy though it is also the responsibility of government to create job opportunities for the teeming unemployed youth population in Nigeria which has  the highest youth unemployed population in the subSahara Africa.
The lack of job opportunities, caused partly by the Federal Government’s apathy to job creation, the lack of adequate supervision of job opportunities economic programmes, lack of employable skills by many youths in the country have conspired to heighten the attendant challenges of unemployment. The challenges which include, “Japa” syndrome (travelling abroad for greener pastures), that characterises the labour market and poses threat to the nation’s critical sector, especially the health and medical sector; astronomical increase in the crime rate and a loss of interest in education. While job seeking youths should  continuously acquire skills and explore opportunities within their immediate environment as well as in the global space through the use of digital platforms, government, corporate/ multinational organizations or the organised private sector should generate skills and provide the enabling environment for skills acquisition, through adequate funding and resettlement packages that will provide sustainable economic life for beneficiaries.
While commending the Rivers State Government led by the People First Governor, Sir Siminilayi Fubara for initiating “various training and capacity-building programmes in areas such as ICT and artificial intelligence, oil and gas, maritime, and the blue economy, among others”, it is note-worthy that the labour market is dynamic and shaped by industry-specific demands, technological advancements, management practices and other emerging factors. So another sector the Federal, State and Local Governments should encourage youths to explore and harness the abounding potentials, in my considered view, is Agriculture. Agriculture remains a veritable solution to hunger, inflation, and food Insecurity that ravages the country. No doubt, the Nigeria’s arable landmass is grossly under-utilised and under-exploited.
In recent times, Nigerians have voiced their concerns about the persistent challenges of hunger, inflation, and the general increase in prices of goods and commodities. These issues not only affect the livelihoods of individuals and families but also pose significant threats to food security and economic stability in the country.  The United Nations estimated that more than 25 million people in Nigeria could face food insecurity this year—a 47% increase from the 17 million people already at risk of going hungry, mainly due to ongoing insecurity, protracted conflicts, and rising food prices. An estimated two million children under five are likely to be pushed into acute malnutrition. (Reliefweb ,2023). In response, Nigeria declared a state of emergency on food insecurity, recognizing the urgent need to tackle food shortages, stabilize rising prices, and protect farmers facing violence from armed groups. However, without addressing the insecurity challenges, farmers will continue to struggle to feed their families and boost food production.
In addition, parts of northwest and northeast Nigeria have experienced changes in rainfall patterns making less water available for crop production. These climate change events have resulted in droughts and land degradations; presenting challenges for local communities and leading to significant impact on food security. In light of these daunting challenges, it is imperative to address the intricate interplay between insecurity and agricultural productivity.  Nigeria can work toward ensuring food security, reducing poverty, and fostering sustainable economic growth in its vital agricultural sector. In this article, I suggest solutions that could enhance agricultural production and ensure that every state scales its agricultural production to a level where it can cater to 60% of the population.
This is feasible and achievable if government at all levels are intentional driving the development of the agricultural sector which was the major economic mainstay of the Country before the crude oil was struck in commercial quantity and consequently became the nation’s monolithic revenue source. Government should revive the moribund Graduate Farmers Scheme and the Rivers State School-to-Land agricultural programmes to operate concurrently with other skills acquisition and development programmes. There should be a consideration for investment in mechanized farming and arable land allocation. State and local governments should play a pivotal role in promoting mechanized farming and providing arable land for farming in communities. Additionally, allocating arable land enables small holder farmers to expand their operations and contribute to food security at the grassroots level.
Nigeria can unlock the potential of its agricultural sector to address the pressing needs of its population and achieve sustainable development. Policymakers and stakeholders must heed Akande’s recommendations and take decisive action to ensure a food-secure future for all Nigerians.

By: Igbiki Benibo

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Opinion

Of Protests And Need For Dialogue 

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Quote:“.Across Abuja, Anambra, and Lagos, a common thread emerges: a disconnect between authority and empathy. Government actions may follow policy logic, but citizens respond from lived experience, fear, and frustration. When these realities collide without dialogue, the streets become the arena of engagement”

It was a turbulent week in the country, highlighting the widening gap between government intentions and public perception. From Abuja to Anambra and Lagos, citizens poured into the streets not just over specific grievances but in frustration with governance that often appears heavy-handed, confrontational, or insufficiently humane. While authorities may genuinely act in the public interest, their methods sometimes aggravate tensions rather than resolve them.
In Abuja, the strike by workers of the Federal Capital Territory Administration (FCTA) and the Federal Capital Development Authority (FCDA) under the Joint Union Action Committee (JUAC) brought the capital to a near standstill. Their demands included five months’ unpaid wages, hazard and rural allowances, promotion arrears, welfare packages, pension and National Housing Fund remittances, and training and career progression concerns. These are core labour issues that directly affect workers’ dignity and livelihoods. Efforts to dialogue with the FCT Minister reportedly failed. Even after a court ordered the strike to end, workers persisted, underscoring the depth of discontent. Threats and sanctions only hardened positions.
The FCT crisis shows that industrial peace cannot be enforced through coercion. Dialogue is not weakness; it is recognition that governance is about people. Meeting labour leaders, listening attentively, clarifying grey areas, and agreeing on timelines could restore trust. Honesty and negotiation are far more effective than threats.
In Anambra, protests by Onitsha Main Market traders followed the government’s closure of the market over continued observance of a Monday sit-at-home, linked to separatist agitation. Governor Chukwuma Soludo described compliance as economic sabotage, insisting Anambra cannot operate as a “four-day-a-week economy.” While the governor’s concern is understandable, threats to revoke ownership, seize, or demolish the market risk escalating tensions. Many traders comply out of fear, not ideology. Markets are social ecosystems of families, apprentices, and informal networks; heavy-handed enforcement may worsen resistance. A better approach combines persuasion, dialogue with market leaders, credible security assurances, and gradual confidence-building. Coordinated political engagement with federal authorities could also reduce regional tensions.
In Lagos, protests erupted over demolition of homes in low-income waterfront communities such as Makoko, Owode Onirin, and Oworonshoki. The state defended these actions as necessary for safety, environmental protection, and urban renewal. While objectives are legitimate, demolitions drew criticism for lack of notice, compensation, and humane resettlement. Urban development without regard for human consequences risks appearing elitist and anti-poor. Where demolitions are unavoidable, transparent engagement, fair compensation, and realistic relocation must precede action to maintain public trust and social stability.
Across Abuja, Anambra, and Lagos, a common thread emerges: a disconnect between authority and empathy. Government actions may follow policy logic, but citizens respond from lived experience, fear, and frustration. When these realities collide without dialogue, the streets become the arena of engagement.
Democracy cannot thrive on decrees, threats, or bulldozers alone. Leaders must listen as much as they command, persuade as much as they enforce. Minister Wike should see labour leaders as partners, Governor Soludo must balance firmness with sensitivity, and Lagos authorities should align urban renewal with compassion and justice. Protests are signals of communication failure. Dialogue, caution, and a human face in governance are not optional—they are necessities. Police and security agencies must respect peaceful protest as a constitutional right.

By:  Calista Ezeaku

 

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Opinion

Empowering Youth  Through Agriculture 

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Quote:”While job seeking youths should  continuously acquire skills and explore opportunities within their immediate environment as well as in the global space through the use of digital platforms, government, corporate/ multinational organizations or the organised private sector should generate skills and provide the enabling environment for skills acquisition, through adequate funding and resettlement packages that will provide sustainable economic life for beneficiaries”.
The Governor of Rivers State, Sir Siminalayi Fubara, recently urged youths in the Rivers State to take advantage of the vast opportunities available to become employers of labour and contribute meaningfully to the growth and development of the State. Governor Fubara noted that global trends increasingly favour entrepreneurship and innovation, and said that youths in Rivers State must not be left behind in harnessing these opportunities. The Governor, represented by the Secretary to the State Government, Dr Benibo Anabraba, made this known while declaring open the 2026 Job Fair organised by the Rivers State Government in partnership with the Nigeria Employers’ Consultative Association (NECA) in Port Harcourt. The Governor acknowledged the responsibility of government to create jobs for its teeming youth population but noted that it is unrealistic to absorb all job seekers into the civil service.
“As a government, we recognise our duty to provide employment opportunities for our teeming youths. However, we also understand that not all youths can be accommodated within the civil service. This underscores the need to encourage entrepreneurship across diverse sectors and to partner with other stakeholders, including the youths themselves, so they can transition from being job seekers to employers of labour,” he said. It is necessary to State that Governor Fubara has not only stated the obvious but was committed to drive youth entrepreneurship towards their self-reliance and the economic development of the State  It is not news that developed economies of the world are skilled driven economies. The private sector also remains the highest employer of labour in private sector driven or capitalist economy though it is also the responsibility of government to create job opportunities for the teeming unemployed youth population in Nigeria which has  the highest youth unemployed population in the subSahara Africa.
The lack of job opportunities, caused partly by the Federal Government’s apathy to job creation, the lack of adequate supervision of job opportunities economic programmes, lack of employable skills by many youths in the country have conspired to heighten the attendant challenges of unemployment. The challenges which include, “Japa” syndrome (travelling abroad for greener pastures), that characterises the labour market and poses threat to the nation’s critical sector, especially the health and medical sector; astronomical increase in the crime rate and a loss of interest in education. While job seeking youths should  continuously acquire skills and explore opportunities within their immediate environment as well as in the global space through the use of digital platforms, government, corporate/ multinational organizations or the organised private sector should generate skills and provide the enabling environment for skills acquisition, through adequate funding and resettlement packages that will provide sustainable economic life for beneficiaries.
While commending the Rivers State Government led by the People First Governor, Sir Siminilayi Fubara for initiating “various training and capacity-building programmes in areas such as ICT and artificial intelligence, oil and gas, maritime, and the blue economy, among others”, it is note-worthy that the labour market is dynamic and shaped by industry-specific demands, technological advancements, management practices and other emerging factors. So another sector the Federal, State and Local Governments should encourage youths to explore and harness the abounding potentials, in my considered view, is Agriculture. Agriculture remains a veritable solution to hunger, inflation, and food Insecurity that ravages the country. No doubt, the Nigeria’s arable landmass is grossly under-utilised and under-exploited.
In recent times, Nigerians have voiced their concerns about the persistent challenges of hunger, inflation, and the general increase in prices of goods and commodities. These issues not only affect the livelihoods of individuals and families but also pose significant threats to food security and economic stability in the country.  The United Nations estimated that more than 25 million people in Nigeria could face food insecurity this year—a 47% increase from the 17 million people already at risk of going hungry, mainly due to ongoing insecurity, protracted conflicts, and rising food prices. An estimated two million children under five are likely to be pushed into acute malnutrition. (Reliefweb ,2023). In response, Nigeria declared a state of emergency on food insecurity, recognizing the urgent need to tackle food shortages, stabilize rising prices, and protect farmers facing violence from armed groups. However, without addressing the insecurity challenges, farmers will continue to struggle to feed their families and boost food production.
In addition, parts of northwest and northeast Nigeria have experienced changes in rainfall patterns making less water available for crop production. These climate change events have resulted in droughts and land degradations; presenting challenges for local communities and leading to significant impact on food security. In light of these daunting challenges, it is imperative to address the intricate interplay between insecurity and agricultural productivity.  Nigeria can work toward ensuring food security, reducing poverty, and fostering sustainable economic growth in its vital agricultural sector. In this article, I suggest solutions that could enhance agricultural production and ensure that every state scales its agricultural production to a level where it can cater to 60% of the population.
This is feasible and achievable if government at all levels are intentional driving the development of the agricultural sector which was the major economic mainstay of the Country before the crude oil was struck in commercial quantity and consequently became the nation’s monolithic revenue source. Government should revive the moribund Graduate Farmers Scheme and the Rivers State School-to-Land agricultural programmes to operate concurrently with other skills acquisition and development programmes. There should be a consideration for investment in mechanized farming and arable land allocation. State and local governments should play a pivotal role in promoting mechanized farming and providing arable land for farming in communities. Additionally, allocating arable land enables small holder farmers to expand their operations and contribute to food security at the grassroots level.
 Nigeria can unlock the potential of its agricultural sector to address the pressing needs of its population and achieve sustainable development. Policymakers and stakeholders must heed Akande’s recommendations and take decisive action to ensure a food-secure future for all Nigerians.
By: Igbiki Benibo
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