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Reducing Maternal Mortality Within Legal Framework 

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When Cynthia was raped by her abductors, who later released her, she knew she was in for more troubles. Missing her menstrual period for two months heightened her fears.
Testing positive for pregnancy broke her further.
She wasn’t  ready to swallow another bitter pill – keeping the unwanted pregnancy from ‘evil’ men.
The unpreparedness, stigmatisation and fear of the unknown got the larger part of the 35-year-old and her blood pressure became high. She thought of only one way to get out of her troubles – termination of the pregnancy.
She unfortunately opted for a ‘quack doctor’ to avoid shame but, alas, the unsafe abortion resulted in complications that took her life.
Sadly, Cynthia  is among 14 per cent of Nigerian women who have died as a result of unsafe abortion.
According to the World Health Organisation (WHO), unsafe abortion is a leading but preventable cause of maternal deaths and morbidunsafe
It can lead to physical and mental health complications and social and financial burdens for women, communities and health systems.
Unsafe abortion, as defined by WHO, is a procedure for terminating an unintended pregnancy, carried out either by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards or both.
Data from WHO shows that globally, 4.7 per cent to 13.2 per cent of annual maternal deaths can be attributed to unsafe  abortion.
Every year, an estimated 287,000 maternal deaths occur globally to which Nigeria contributes 14 per cent. Unsafe abortion accounts for about 10 to 14 per cent of maternal morbidity and mortality in Nigeria.
In an effort  to reduce preventable maternal deaths, Lagos State Government, on June 28, released a document entitled “Guidelines on Termination of Pregnancy for Legal Indications.”
The 40-page document modelled after the National Guidelines for Legal Indications (2018) prepared by the Federal Ministry of Health is designed to provide guidance to medical practitioners and other stakeholders on when it is lawful or unlawful to terminate a pregnancy.
According to Lagos State Government, the goal of the document is to serve as a tool for provision of safe termination of pregnancies within the legal framework in circumstances whereby continuation of such pregnancies threaten the lives or physical and/or mental health of women.
It hopes that the Guidelines will help to reduce maternal morbidity and mortality in Lagos and, by extension, Nigeria.
It notes that Nigeria has the second-largest burden of maternal mortality globally, after India, regretting that many of the deaths are of known causes and preventable.
According to the state, a neglected area of preventable maternal deaths is related to the provisions of the Nigerian Abortion Law.
It acknowledges that the Nigerian Abortion Law permits  termination of pregnancy in circumstances where the continuation of pregnancy threatens the mother’s life but “unfortunately, no formal efforts have been made through the development of policy instruments, guidelines or tools to implement these provisions to save the lives of Nigerian women whose existence is threatened by continuation of their pregnancies”.
It points out that induced abortion is illegal in Nigeria except when performed to save a woman’s life and that the penal code and the criminal code allow this exception, with specification of criminal penalties for non-compliance.
Lagos State had reviewed its abortion law in 2011 to extend the provisions to the mother’s physical health.
“Consequently, this Guidelines for Lagos State is intended to standardise practice and build the capacity of medical professionals in public and private facilities to identify pregnancies for which the law is intended so that ethical and safe management can be instituted.
“The document provides information on subsisting Nigerian law on termination of pregnancy, Lagos State revised law 2011, a compendium of medical conditions and circumstances where the continuation of pregnancy endangers the woman’s life, and describes the step-by-step options for ethical and safe medical management.
“It is envisaged that the enunciation, deployment and use of this Guidelines will preserve the lives of pregnant women from dying and assist those whose physical or mental health would be compromised with the continuation of their pregnancies,” it says.
According to the state, medical conditions that may constitute a threat to the life and physical health of a pregnant woman and make her to benefit from safe legal termination of pregnancy include obstetric and gynaecological conditions such as genital tract cancers, severe fetal conditions or malformation not compatible with extrauterine life.
Other conditions are heart and vascular diseases, including uncontrolled hypertension in the first or second trimester, pre-eclampsia and eclampsia and pulmonary embolism.
Kidney diseases, cancers, blood diseases, autoimmune diseases, diabetes mellitus refractory to treatment or with organ failure, can pose a threat to the life and physical health of a pregnant woman.
Similarly, psychiatric and other mental disorders which include psychiatric disorders with suicidal ideation, severe depression with suicidal tendencies, which may occur in rape and incest, can constitute a threat to the life and physical health of a pregnant woman.
Lagos State believes that having  guidelines on safe termination of pregnancy for legal indications is very important as no woman should lose her life or have her physical or mental health compromised from conditions that can be prevented or addressed.
“It is in this regard that it is important to disseminate and implement the Guidelines as accepted by the Government of Lagos State to ensure that every woman in Lagos State gets the right care she deserves at the right time and place for safe termination of pregnancy for any legal indications,” the government states in the document.
It highlights standards and best practices with regard to legal indications, pre and post procedure care, methods and monitoring.
At the launch of the document, DrOlusegunOgboye, Permanent Secretary, Lagos State Ministry of Health, had said that the document was for safe termination of pregnancies within the ambit of the Criminal Law of Lagos State.
According to Ogboye, the document will provide evidence-based data and other information for health workers in public and private sectors with requisite skills to provide safe termination of pregnancy to reduce preventable deaths.
He gave  the assurance that the document had undergone  consultations with relevant technical stakeholders within the legal and health service context in the state and also with key opinion leaders in South-West Zone.
However, the state government’s release of the Guidelines has been frowned at by some residents and religious groups.
The Catholic Archbishop of Lagos, Most Rev. Alfred Martins, describes the release as legalising abortion through the backdoor.
Martins is worried that the Guidelines will create room for indiscriminate procurement of abortion.
He says it is untrue that all stakeholders were consulted in the process of drafting the Guidelines.
“The issue of abortion touches very much on ethical and religious sensibilities, and religious bodies were not consulted.
“Certainly millions of Catholics, who have always maintained their strong opposition to legalisation of abortion in any guise, were not consulted.
“The baby in the womb is a person that is distinct from the mother though he is in the mother’s womb; so, not even the mother has the right to kill him, talk less of the government purporting to give legal backing for their murder.
“We need to continue to explore ways of providing support for women who find themselves in difficulty as a result of their pregnancies rather than thinking of aborting a child who is innocent of the difficulty that the mother may be going through.
“Any attempt to terminate the life of an unborn child is tantamount to murder and should be treated as a capital offence,” Martins argues.
The cleric advises that focus should be on proper enlightenment on human sexuality and collaboration, in order to support women who get pregnant without being ready for the pregnancy.
Prof. Adetokunbo Fabamwo, Chief Medical Director, Lagos State University Teaching Hospital and a contributor to the development of the Guidelines, clarifies that  the document does not support indiscriminate and illegal procurement of abortion.
“There are only two lawful grounds for therapeutic termination of pregnancy, and they are for preservation of a mother’s life and preservation of the woman’s physical health.
“We are not allowed to conduct pregnancy termination because someone says ‘I don’t want this baby; I’m not ready for it or I’m too young for it.
“The guidelines make it clear to public and private hospitals in the state what is allowed under the legal ambit in Nigeria,” Fabamwo, a Professor of Obstetrics and Gynecology, explains.
On the implications of the Guidelines to the state’s maternal health indices, Fabamwo is convinced that it will reduce maternal mortality and morbidity arising from unsafe abortion, since therapeutic abortion will be conducted by specialists in obstetrics and gyneacology.
For DrTunjiAkintade, a former Chairman, Association of Nigeria Private Medical Practitioners, the state government should be praised for coming up with the Guidelines which, he says, will improve maternal health.
He regrets that many women have died as a result of unsafe abortion.
Akintade is of the opinion that  restricting access to safe abortions means will drive women into unsafe abortions, resulting in complications and, in some cases, deaths.
“Over the years, medical practitioners have been scared of prosecution, even when the life of a woman, her baby or her mental health is threatened due to  pregnancy; they feel so reluctant to do anything to save her.
“Such a woman does not need to suffer based on a medical condition that got worse due to her pregnancy, and delay in providing medical intervention for such a woman can lead to death.
“We need to remove prejudice when lives are at stake. More so, every pregnancy is not the same; some women might have it easy while some might not.
“People  should move beyond criticism and trying to force their religious beliefs on others,” he argues.
Akintade points out that proper documentation of the process is emphasised on the Guidelines to check abuse.
In reaction to the condemnation of the release of the Guidelines in some quarters, the state Gov. BabajideSanwo-Olu, on July 7, directed suspension of the implementation of the Guidelines.
In a statement released by the state Commissioner for Health, Prof. Akin Abayomi, the governor directed further sensitisation of key stakeholders and members of the public to ensure a clearer understanding of the objectives of the Guidelines.
According to him, the state ministry of health is seeking different methods to eliminate illegal abortions and ensure that a mother does not die at childbirth  and disrupt an entire family unit.
The governor is worried that illegal abortions and high risk pregnancies leading to unresolvable complications, rank high among contributors to maternal mortality.
According to him, the focus of the Guidelines is on creating opportunities to reduce maternal mortality in line with existing laws.
“In this regard, it became imperative to examine, in keeping with existing national and state laws and policies, if there are indeed justifications and medical reasons to offer abortion to a woman whose life is threatened by a pregnancy.”
Sanwo-Olu says suspension of the implementation of the Guidelines will enable the state executive council to deliberate on the matter and ensure adequate public sensitisation and stakeholder engagement to reach a consensus required for a successful guideline development.
Analysts urge expedited deliberations, sensitisation and engagement of stakeholders to ensure timely resolution of any issues around the Guidelines and take desired actions that will save lives of more pregnant women.

By: Oluwafunke Ishola
Ishola  writes for News Agency Of Nigeria.

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 Malaria Burden And Public Health In Nigeria 

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It is worrisome that Nigeria has  the largest  Malaria deaths in the world. According  to the  2022  World.Malaria Report, Nigeria  contributes about  27 percent of  the global burden of Malaria disease, and about 31.3 percent of deaths , the highest in the world.
Malaria accounts for 30 percent of childhood deaths,.60 percent  of outpatient visits to health facilities   across Nigeria.
According  to statistics  reeled out by the Federal Ministry  of Health and Social Welfare,  “Globally,  there are an estimated 249million  malaria cases  and 608,000 malaria deaths among 85 countries.
Such reports leave much to be desired in a nation so blessed  with natural resources and manpower. While Nigeria  is struggling  with Malaria burden, Cape de Verde, today live Malaria-free, according to the
World Health Organization (WHO) certification  and rating.
This declaration by the global health Organisation about Cape Verde  is very cheery and means so much to me considering the economy, size and polity of the country.
Unlike Nigeria with more than 44 mineral resources spread across 500 locations  in the country,  Cape de Verde, has no natural resources. Its developing resources is mostly Service-oriented with growing focus on tourism and foreign investment.
My worry is that even with abounding natural and human resources of unimaginable quantity in Nigeria,  Malaria programmes are either grossly underfunded, misappropriated or   embezzled with impunity.
According  to a Senior Associate  at the John Hopkins Bloomberg  School of Public.Health, Soji  Adeyi, Nigeria  should begin  to increase internal funding.for malaria elimination.
Nigerian citizens still wallow in the orgy of leadership-induced pain, poverty and sorrow more than 63 years after political independence.
Malaria that is alien to the natural resources-barren Cape de Verde is endemic in Nigeria and is one of the leading causes of death of children under the age of six and pregnant women. Malaria is an household name in Nigeria so much so that its drugs and treatment have skyrocketed like a phoenix and outrageously outside the reach of the teeming less privileged citizens of Nigeria. The situation was so alarming that the National Assembly, some time last year urged the Federal Government to declare Malaria an emergency in Nigeria as matter of urgent national interest. Because it is an ailment that only the poor and vulnerable suffer, that motion is treated with levity and perhaps consigned to the trashcan of not-feasible declarations.
Without any iota of doubt, Nigeria has the resources to fight and conquer malaria. If Cape de Verde could, Nigeria can as well if the leadership of the country is committed to do so.
At.an event organised  by.the Federal  Ministry of Health and Social Welfare recently,  themed “Ministerial  Roundtable  Meeting: Rethinking  Malaria Elimination in Nigeria “representatives of national and international  health organisations, analysed the country’s  anti-malaria strategies  over the past years.
Experts recommended new approaches to fighting  the malaria epidemic in Nigeria which seems to have defied continuous attempts to reduce the Malaria burden in Nigeria to zero.
Adeyi of the John Hopkins Bloomberg  School of Public Health advocates increased internal funding.of all Malaria programmes to eliminate Malaria. According  to him,, “Each year reliance on external funding  needs to be reduced. I looked at the summary of  Malaria reports from 2008 till now and what has been common is the complaint about the lack of funding.  If this is a  recurring  problem, what should be done is to  find  a new approach.”
In his view, Abdu Muktar,  National  Coordinator  of the Presidential  Healthcare Initiative,  called for the local production  and manufacturing  of medical supplies as well as reducing Nigeria’s  dependence on drugs imports.
According to him, the local production  of anti-malaria and.related.medication will consider.the peculiarity of the country’s  terrain, population  and burden  and.would improve access to effective  treatment.
For his part, the regional. Director of World Health Organisation  (W.H.O.),  African Region, Matshiddiso  Moretti, advised Nigeria  to accelerate  its efforts to end Malaria  by relying  on  adequate data for the implementation  of health policies.
It has been rightly  said that Nigeria is rich but its people are abjectly poor because of the abysmally poor leadership that has characterised governance in the country since the inception of self-rule.
If the millions of public funds stashed in private and foreign accounts, misappropriated and or embezzled are judiciously used, no doubt, the issues of malaria, unemployment, decaying and dilapidated infrastructure and marginal underdevelopment with the attendant multi-dimensional socio-economic challenges, would have since been addressed.
How will Nigeria ascribe to herself “Giant of Africa” when she has not been able to achieve the healthcare demands and requirements of Nigerians? How can Nigerian leaders audaciously lull its citizens to believe that they are working for the welfare of Nigerians when the seeming little things that matter are not attended to. Even welfare-oriented programmes are being truncated by greed and inordinate desire to amass wealth at the expense of the public.
The  anomaly of diversions, misappropriation, outright embezzlement, and several others are the reasons Nigeria’s present and successive governments could not win the fight against malaria which health and medical practitioners say  poses the greatest threat to life than the dreaded HIV/AIDS. This suggests to me that the mortality rate caused by HIV/AIDS is grossly disproportionate to deaths caused by malaria.
Malaria is commonly believed to be caused by mosquitoes which breed in  dirty environment, especially where there is stagnant water. A lot of communities in Nigeria even the Sandfilled area of Borikiri in Port Harcourt is so mosquito-infested that residents cannot sleep without nets. It is a nightmare to sleep without a net.
The Federal, State, and Local Government should initiate programmes to end malaria scourge in the country. They should intentionally and proactively channel the people’s money to their welfare. Malaria eradication is a public welfare-oriented programme so government at all levels must prosecute it with adequate funding that must be supervised and accounted for, to avoid the unfortunate incidents of the Humanitarian Affairs Ministry and several other Ministries, Departments and Agencies that have used programmes and projects as smokescreen to siphon public funds.
While there should be a dedicated funds to fight malaria and defeat it over  a period of time, environmental sanitation exercises, to clear the drains, gutters and grass should be stepped up. This consciousness should be cultivated and imbibed by all.
The legitimacy of any Government is derived from the people, so Government exists for the people. No amount of money spent on the welfare of the people is too much for them. After all, the people remain the benefactors that those in Government, who in an ideal situation are stewards, are supposed to be accountable to.
The administration of President Bola Ahmed Tinubu should ensure that no stone is left unturned in achieving this lofty and laudable project.

Igbiki Benibo

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Curbing Substance Abuse Among Nigerian Youths

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In September 2023, a 24-year old lady had a birthday party in a South-West state where one of the guests offered to sell sachets of ‘Milo’ for N1,500 each. The guest, a young lady, had mixed marijuana with Milo and put same in Milo sachets, which had been so expertly sealed that no one would have suspected what the content of the sachets was. The guests at the party rushed the ‘Milo sachet’ and went on a binge, drinking and smoking themselves to get ‘high’. After getting high, fight eventually broke out among them and security operatives had to be brought in to maintain the peace. It was at that point that unsuspecting members of the public got to know that the party guests had gone on a marijuana trip. According to the World Health Organisation (WHO), substance abuse, or misuse, is the harmful use of psychoactive substances, including alcohol and illicit drugs. A psychoactive substance is a drug that affects how the brain works and causes changes in mood, awareness, thoughts, feelings, or behaviour. Examples of psychoactive substances include alcohol, caffeine, nicotine, marijuana and some pain relievers. Other substances abused by Nigerian youths include, ice, molly, cannabis, tobacco, cigarettes, cocaine, sedatives, kolanuts, analgesics, glue, heroine, energy drinks, miraa, tramadol, tranquillisers, cough drops,antimalarial and antibiotics.
Substance abuse is detrimental to health and wellbeing of those involved in it. A Nigerian singer, Joshua Iniyezo aka Solidstar, recently disclosed how substance abused nearly ruined him. According to him, he was introduced to a banned substance called Ice in 2021. He said the substance made him see himself as “a king’’ who didn’t have to pay for any item. One day he walked from Awoyaya in Lagos Mainland to the Oriental Hotel a distance of about 32 kilometres.  Another singer, Inetimi Alfred, popularly known as Timaya, said he was introduced to Molly, a synthetic drug with psychedelic effects. The drug initially brought him happiness but eventually led to detrimental effects on his health, including weight loss and financial struggles. His words: “When I took it, I did not understand myself. I was so happy that I dashed all the money in my pocket. So I wanted to just keep feeling like that. That was how I lost a lot of weight. I was not eating, I was just happy. When I said I was taking Molly, I was taking like three pills every day and it felt like medication. I got kicked out of jobs and contracts… people I was doing business with did not want to work with me again.”
So, substance abuse makes the youth to get ‘high’ but it does more than that. It can make them paranoid, it can precipitate heart attack or failure, stroke, seizures, sleep disorders, drowsiness, nausea, respiratory depression, fatigue, disorientation, impairment in memory, learning, concentration, and problem-solving, hallucinations, decline in academic performance, etc.  As seen in the case of Timaya, it can result in job loss and can pose a threat to relationships. There is also the tendency to engage in criminal activities when ‘high’. Substance abuse among Nigerian youth is nearing the status of a pandemic. According to the National Drug Law Enforcement Agency (NDLEA’s) statistics, about 40 per cent of Nigerian youths between 18 and 35 years are deeply involved in the abuse of drugs. What does the future hold for the country if 4 out of every 10 young people are engaged in substance abuse?
The media is central to our lives. The media shapes our perception of the world. The media is actually the gateway to the mind. The media accesses the mind through the eyes and the ears. So, media contents are food for the mind. The mind is where decisions are made and where opinions are formed. Since the media has access to the mind, the media subtly controls the mind and plays a major role in the decision-making process. So, when the media projects something as good many people in the society take a cue from the media and believe that it is good. In the same vein, when the media projects an act as evil, the society largely avoids it. The media never leaves anything it comes in contact with the same way; it always affects them one way or the other. The media affects individuals in six various ways.  The media can affect cognition, which is the mental process. By affecting an individual’s cognition, the media affects his perception to the extent that he begins to see a particular phenomenon in a new light. The media also affects beliefs. The Western media has consistently showcased the Western culture as being superior to the African culture and this, to a degree, has been absorbed by some Africans who try all they can to travel abroad for ‘greener pastures’ only to get there and find out that the grass is always greener on the other side.
The media also affects attitude. If a child is exposed to violence, he begins to see violence as an option and will be tempted to try same every now and then. Another media effect is affect. This has to do with feelings, emotions and moods. Seeing a scene on television or reading about an event can affect the mood of an individual throughout the day. Media also has psychological effect on its audience. This means the media can affectthe orientation of people. The media also affects the behaviour of its users. Behaviour is the culmination of all the effects of media exposure that have been listed. By the time cognition, belief and attitude are affected, behaviour will change. Ladies and gentlemen, in light of the above, I will like to submit that advertently or not, the media has been encouraging substance abuse. This is a global phenomenon and not a Nigerian thing. When a television ad presents a successful musician with a bottle of an alcoholic drink at the background, though the focus of the advertiser from all intents and purposes will be to draw the attention of the society to its alcoholic drink, but the loud message is that “To be as successful as the musician in the ad, take alcohol”. Or, “Successful people take this alcohol; don’t you want to be like them?”
When a musical video glamourises boozing and smoking, what is the message to the society? A song like ‘FotiFoyin’ (brush your teeth with alcohol) encourages the youth to consume alcohol, while a musical video like ‘Asake Loaded’ celebrates smoking. The producers of these musical contents are role models in the society. Some of them are even brand ambassadors. If, as we said, the media is the gateway to the mind, what is the message of these media contents to the society?   The media has to be alive to its social responsibility if Nigeria will win the war against substance abuse by the youth.  The social responsibility theory of the media mandates the media to put the societal wellbeing at the centre of its activities.
This theory says that the media has a responsibility to the society and should always work in the interest of the society. While a media outfit may be a business organization that must make returns to its shareholders, the operators of the business must realize that they will only continue in business if the society survives. If the society is destroyed, the business outfits operating in it will also go down. The easiest way to destroy a society is to destroy its youths.
If the media understands this responsibility and upholds it, it will be clear that the future of the youth who are being exposed to substance abuse is of more importance than the immediate pecuniary gain they will make by pushing out deleterious contents that will push the youth into seeking substances that would make them high.
The media is a major factor in the wellbeing of the society because it plays a major role in what is permissible or prohibited. This is done through what it promotes or refrains from promoting.
As part of its social responsibility, the media should embark on sensitisation of the public on the dangers inherent in substance abuse. This should be continuous and sustained as the media’s contribution to the wellbeing of society.
The government is the most important factor in curbing substance abuse because government is a change agent. Whatever the government permits gains prominence and whatever it prohibits is frowned at.
Government can curb substance abuse through orientation and reorientation. By deploying its massive resources, the government can get across to all strata of the society on the ills of substance abuse and why it is pertinent for it to be spurned by the youth. By making use of all channels of communication and all media outlets, the government can drive home the point on why substance abuse should not be embraced by the youth.
Another means the government deploys to curb the spread of substance abuse is regulation. The Federal Government has, over the years, come up with various regulations to reduce substance abuse in the country. These include:
The Indian Hemp Decree No. 19 of 1966.
The Indian Hemp (Amendment) Decree No. 34 of 1979.
The Indian Hemp (Amendment) Decree, and the Special Tribunal (Miscellaneous Offences) Decree No. 20 of 1984.
The Special Tribunal (Miscellaneous Offences) (Amendment) Decree of 1986 and the National Drug Law Enforcement Agency Decree No. 48 of 1989 (as amended by Decree No.33 of 1990, Decree No 15 of 1992 and Decree No. 62 of 1999). These laws were harmonized as an Act of the parliament, CAP N30 Laws of the Federation of Nigeria (LFN) 2004. This Act established the NDLEA.
The government also fights substance abuse through Enforcement.
The National Drug Law Enforcement Agency (NDLEA) is the agency of government primarily saddled with the enforcement of substance abuse laws. The agency, which is under the Federal Ministry of Justice, is charged with eliminating the growing, processing, manufacturing, selling, exporting, and trafficking of hard drugs. The agency was established by Decree Number 48 of 1989. (1) The NDLEA is present in international airports, seaports, and border crossings.
The last leg is prosecution.
Section 11 (a) of NDLEA Act makes it an offence for a person, who having no lawful authority to do so, to engage in the importation, production, manufacturing, processing, growing and planting of cocaine, heroin, LSD or any other drugs of similar nature. The offence is punishable on conviction with life imprisonment. Section 11(b) and (c) also spell out punishments for those who contravene NDLEA laws. The import is that NDLEA is the primary agency with prosecutorial powers on substance abuse. The Nigeria Police Force can also prosecute.
Of the four legs to combating substance abuse, it is only orientation and reorientation that involve the three tiers of government. The remaining three, regulation, enforcement and prosecution are within the ambits of the federal government. How can NDLEA be on top of the situation of those smoking igbo at Igbo Ora or those sniffing Kushy at Kishi?
The point here is that substance abuse among Nigerian youths is on the rise because the strategy is wrong. Every criminality is local. Therefore, criminality is best fought or combated at the local level. Nigeria cannot successfully overcome the challenge of substance abuse among the youth unless the states and local government authorities are fully involved in it. That brings us again to the issue of the elephant in the room: restructuring.
We need to restructure the policing system as well as the substance abuse regulation and enforcement systems to defeat substance abuse among the nation’s youth.
The media and the government have critical roles to play in reducing substance abuse among the youth. The media needs to take its social responsibilities seriously and ensures that it projects values that would make the society better and stronger.
The government needs to take its sensitization and orientation responsibilities very seriously. Then, the system of government that makes the fight against substance abuse more of a matter of the federal government needs to be tinkered with so that all tiers of government can own the battle and deliver our youths from the jaws of substance.
Olanrewaju is Special Adviser (Media)/Chief Press Secretary to Oyo State Governor.

By: Sulaimon Olanrewaju

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Curbing Substance Abuse Among Nigerian Youths

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In September 2023, a 24-year old lady had a birthday party in a South-West state where one of the guests offered to sell sachets of ‘Milo’ for N1,500 each. The guest, a young lady, had mixed marijuana with Milo and put same in Milo sachets, which had been so expertly sealed that no one would have suspected what the content of the sachets was. The guests at the party rushed the ‘Milo sachet’ and went on a binge, drinking and smoking themselves to get ‘high’. After getting high, fight eventually broke out among them and security operatives had to be brought in to maintain the peace. It was at that point that unsuspecting members of the public got to know that the party guests had gone on a marijuana trip. According to the World Health Organization (WHO), substance abuse, or misuse, is the harmful use of psychoactive substances, including alcohol and illicit drugs. A psychoactive substance is a drug that affects how the brain works and causes changes in mood, awareness, thoughts, feelings, or behaviour. Examples of psychoactive substances include alcohol, caffeine, nicotine, marijuana and some pain relievers. Other substances abused by Nigerian youths include, ice, molly, cannabis, tobacco, cigarettes, cocaine, sedatives, kolanuts, analgesics, glue, heroine, energy drinks, miraa, tramadol, tranquillizers, cough drops,antimalarial and antibiotics.

Substance abuse is detrimental to health and wellbeing of those involved in it. A Nigerian singer, Joshua Iniyezo aka Solidstar, recently disclosed how substance abused nearly ruined him. According to him, he was introduced to a banned substance called Ice in 2021. He said the substance made him see himself as ‘’a king’’ who didn’t have to pay for any item. One day he walked from Awoyaya in Lagos Mainland to the Oriental Hotel a distance of about 32 kilometres.  Another singer, Inetimi Alfred, popularly known as Timaya, said he was introduced to Molly, a synthetic drug with psychedelic effects. The drug initially brought him happiness but eventually led to detrimental effects on his health, including weight loss and financial struggles. His words: “When I took it, I did not understand myself. I was so happy that I dashed all the money in my pocket. So I wanted to just keep feeling like that. That was how I lost a lot of weight. I was not eating, I was just happy. When I said I was taking Molly, I was taking like three pills every day and it felt like medication. I got kicked out of jobs and contracts… people I was doing business with did not want to work with me again.”

So, substance abuse makes the youth to get ‘high’ but it does more than that. It can make them paranoid, it can precipitate heart attack or failure, stroke, seizures, sleep disorders, drowsiness, nausea, respiratory depression, fatigue, disorientation, impairment in memory, learning, concentration, and problem-solving, hallucinations, decline in academic performance, etc.  As seen in the case of Timaya, it can result in job loss and can pose a threat to relationships. There is also the tendency to engage in criminal activities when ‘high’. Substance abuse among Nigerian youth is nearing the status of a pandemic. According to the National Drug Law Enforcement Agency (NDLEA’s) statistics, about 40 per cent of Nigerian youths between 18 and 35 years are deeply involved in the abuse of drugs. What does the future hold for the country if 4 out of every 10 young people are engaged in substance abuse?

The media is central to our lives. The media shapes our perception of the world. The media is actually the gateway to the mind. The media accesses the mind through the eyes and the ears. So, media contents are food for the mind. The mind is where decisions are made and where opinions are formed. Since the media has access to the mind, the media subtly controls the mind and plays a major role in the decision-making process. So, when the media projects something as good many people in the society take a cue from the media and believe that it is good. In the same vein, when the media projects an act as evil, the society largely avoids it. The media never leaves anything it comes in contact with the same way; it always affects them one way or the other. The media affects individuals in six various ways.  The media can affect cognition, which is the mental process. By affecting an individual’s cognition, the media affects his perception to the extent that he begins to see a particular phenomenon in a new light. The media also affects beliefs. The Western media has consistently showcased the Western culture as being superior to the African culture and this, to a degree, has been absorbed by some Africans who try all they can to travel abroad for ‘greener pastures’ only to get there and find out that the grass is always greener on the other side.

The media also affects attitude. If a child is exposed to violence, he begins to see violence as an option and will be tempted to try same every now and then. Another media effect is affect. This has to do with feelings, emotions and moods. Seeing a scene on television or reading about an event can affect the mood of an individual throughout the day. Media also has psychological effect on its audience. This means the media can affect the orientation of people. The media also affects the behaviour of its users. Behaviour is the culmination of all the effects of media exposure that have been listed. By the time cognition, belief and attitude are affected, behaviour will change. Ladies and gentlemen, in light of the above, I will like to submit that advertently or not, the media has been encouraging substance abuse. This is a global phenomenon and not a Nigerian thing. When a television ad presents a successful musician with a bottle of an alcoholic drink at the background, though the focus of the advertiser from all intents and purposes will be to draw the attention of the society to its alcoholic drink, but the loud message is that “To be as successful as the musician in the ad, take alcohol”. Or, “Successful people take this alcohol; don’t you want to be like them?”

When a musical video glamourises boozing and smoking, what is the message to the society? A song like ‘FotiFoyin’ (brush your teeth with alcohol) encourages the youth to consume alcohol, while a musical video like ‘Asake Loaded’ celebrates smoking. The producers of these musical contents are role models in the society. Some of them are even brand ambassadors. If, as we said, the media is the gateway to the mind, what is the message of these media contents to the society?   The media has to be alive to its social responsibility if Nigeria will win the war against substance abuse by the youth.  The social responsibility theory of the media mandates the media to put the societal wellbeing at the centre of its activities.

This theory says that the media has a responsibility to the society and should always work in the interest of the society. While a media outfit may be a business organization that must make returns to its shareholders, the operators of the business must realize that they will only continue in business if the society survives. If the society is destroyed, the business outfits operating in it will also go down. The easiest way to destroy a society is to destroy its youths.

If the media understands this responsibility and upholds it, it will be clear that the future of the youth who are being exposed to substance abuse is of more importance than the immediate pecuniary gain they will make by pushing out deleterious contents that will push the youth into seeking substances that would make them high.

The media is a major factor in the wellbeing of the society because it plays a major role in what is permissible or prohibited. This is done through what it promotes or refrains from promoting.
As part of its social responsibility, the media should embark on sensitization of the public on the dangers inherent in substance abuse. This should be continuous and sustained as the media’s contribution to the wellbeing of society.

**The government is the most important factor in curbing substance abuse because government is a change agent. Whatever the government permits gains prominence and whatever it prohibits is frowned at.

Government can curb substance abuse through orientation and reorientation. By deploying its massive resources, the government can get across to all strata of the society on the ills of substance abuse and why it is pertinent for it to be spurned by the youth. By making use of all channels of communication and all media outlets, the government can drive home the point on why substance abuse should not be embraced by the youth.
Another means the government deploys to curb the spread of substance abuse is regulation. The Federal Government has, over the years, come up with various regulations to reduce substance abuse in the country. These include:
The Indian Hemp Decree No. 19 of 1966.
The Indian Hemp (Amendment) Decree No. 34 of 1979.
The Indian Hemp (Amendment) Decree, and the Special Tribunal (Miscellaneous Offences) Decree No. 20 of 1984.
The Special Tribunal (Miscellaneous Offences) (Amendment) Decree of 1986 and the National Drug Law Enforcement Agency Decree No. 48 of 1989 (as amended by Decree No.33 of 1990, Decree No 15 of 1992 and Decree No. 62 of 1999). These laws were harmonized as an Act of the parliament, CAP N30 Laws of the Federation of Nigeria (LFN) 2004. This Act established the NDLEA.
The government also fights substance abuse through Enforcement.
The National Drug Law Enforcement Agency (NDLEA) is the agency of government primarily saddled with the enforcement of substance abuse laws. The agency, which is under the Federal Ministry of Justice, is charged with eliminating the growing, processing, manufacturing, selling, exporting, and trafficking of hard drugs. The agency was established by Decree Number 48 of 1989.[1] The NDLEA is present in international airports, seaports, and border crossings.

The last leg is prosecution.
Section 11 (a) of NDLEA Act makes it an offence for a person, who having no lawful authority to do so, to engage in the importation, production, manufacturing, processing, growing and planting of cocaine, heroin, LSD or any other drugs of similar nature. The offence is punishable on conviction with life imprisonment. Section 11(b) and (c) also spell out punishments for those who contravene NDLEA laws. The import is that NDLEA is the primary agency with prosecutorial powers on substance abuse. The Nigeria Police Force can also prosecute.

Of the four legs to combating substance abuse, it is only orientation and reorientation that involve the three tiers of government. The remaining three, regulation, enforcement and prosecution are within the ambits of the federal government. How can NDLEA be on top of the situation of those smoking igbo at Igbo Ora or those sniffing Kushy at Kishi?

The point here is that substance abuse among Nigerian youths is on the rise because the strategy is wrong. Every criminality is local. Therefore, criminality is best fought or combated at the local level. Nigeria cannot successfully overcome the challenge of substance abuse among the youth unless the states and local government authorities are fully involved in it. That brings us again to the issue of the elephant in the room: restructuring.

**We need to restructure the policing system as well as the substance abuse regulation and enforcement systems to defeat substance abuse among the nation’s youth.

The media and the government have critical roles to play in reducing substance abuse among the youth. The media needs to take its social responsibilities seriously and ensures that it projects values that would make the society better and stronger.

The government needs to take its sensitization and orientation responsibilities very seriously. Then, the system of government that makes the fight against substance abuse more of a matter of the federal government needs to be tinkered with so that all tiers of government can own the battle and deliver our youths from the jaws of substance.

Sulaimon Olanrewaju
Olanrewaju is Special Adviser (Media)/Chief Press Secretary to Oyo State Governor,

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