Improper waste disposal such as domestic and medical waste has been identified as a major cause of environmental degradation and spread of the Human Immunodeficiency Virus (HIV).

This much was revealed at a training workshop for health workers on medical waste management organized by Action Family Foundation in Lagos recently to sensitize the public on the best way to properly dispose of waste to avoid the spread of various disease conditions.

Speaking at the workshop, the Medical Director/CEO of the foundation Dr. Emmanuel Okechuckwu explained that improper disposal of domestic and medical waste is one salient factor that has been contributing to the spread of HIV.

According to him, people need to know the importance of separating their waste before disposing them off, saying that co-mingling of medical waste with domestic waste is dangerous.

Expatiating, Dr. Okechukwu observed that medical waste which is a total waste stream from health facility is made up of 75-90% and 10-25% of waste. He later classified medical waste into infectious waste, sharps waste, anatomic waste, pharmaceutical waste and genotoxic waste which he said dispose off differently.

He further stated that medical waste management in Nigeria has not been given a recognised priority though the Lagos State Waste Management Authority is doing something in that regard but could still do better.

Medical waste according to Dr. Okechukwu contains infectious agents, genotoxic, radioactive among others which endanger health workers, waste handlers, patients and the general public.

The best way to get over this problem, Okechukwu said is for medical waste to be segregated into various components, safe storage in appropriate containers, transported to waste treatment and disposal sites and final disposal of such.

The highpoint of the workshop was the enlisting of new members into the Healthcare quality and Patient Safety Association of Nigeria, a new advocacy group.

Dr. Fowobi Gbadebo, a US-based neuropsychiatrist, is a partner and a shareholder at the Marshfield Clinic, a multi-specialty clinic with over 800 physicians located in Wisconsin in the United States. In this interview with Tosin Makinde, he gives useful suggestions on how to tackle the problem of brain drain,among other issues




The health system in Nigeria is one sector that has suffered from the brain drain syndrome as some of it best brains are plying their trade abroad. Can you give an estimate of Nigerian Medical personnel practicing over there?

You are right, brain drain is a major problem with huge financial and social implications. As we speak, our president is in Saudi Arabia receiving medical care. That is truly a shame! What does that say about us as a country? The sad truth however is that the president cannot trust his life with the health care system as we currently have it in Nigeria because of faulty policies that are in place. Yet, there are Nigerian physicians performing wonders in foreign countries. I can guarantee you that some of the doctors that would be taking care of our president in Saudi Arabia are Nigerians. I have had the opportunity to meet and work with some of them. Brain drain is a major problem. The Association of Nigerian Physicians in the Americas estimates that about 40,000 Nigerian Doctors practice in North America. I have seen numbers as high as 20,000 Nigerian Doctors in the US alone. That is almost 2.5% of the total physician workforce in the US. There are factors in Nigeria that "push" physicians away such as low wages, poor job satisfaction, infrastructural decays, lack of security, pandemic corruption, harsh economic situation etc.. There are factors that "pull" people away; generally better wages, good work environment, and security. The United States strategically offers H1 visas to highly skilled professionals to draw them into the USA.

What do you think can be done to address the situation?

Brain drain is a universal issue, not unique to Nigeria, and has huge financial and social implications. It is very unfortunate that highly skilled doctors that could be contributing to the development and growth of our dear country are working as expatriates and "aliens" in Europe and North America. Many of us would love to return home, including my humble self, and contribute our quota. First, there should be an accurate record of this phenomenon, which government could use to develop effective policies and strategies. Hard work and skill should be valued and appropriately rewarded. Doctors wages should be revised so it could be reasonably competitive with other countries. Medical technologies that can assist with diagnosis and treatment should be readily available. There should be an exchange program that allows Nigerian physicians to travel abroad; and western physicians to come to Nigeria. We should be able to tap into foreign assistance and grants that could be used to conduct more local research on issues that are peculiar to our population. Government cannot do this alone. There should be support from organized private sector. Above all there should be a sincere effort to improve the security in the land. A country where people vanish for no reasons and the value of human life is worth less than that of a chicken, is not attractive to most people.

In this time of credit crunch brought about by drastic reduction in income there have been rising cases of suicide attempts in some parts of the world, as a neuropsychiatrist how can individuals curtail this tendency?

The world wide recession has been particularly hard on developing countries like Nigeria where average family income is low, and stress of daily living is high. There is not much of financial cushions to absorb the shock created by the financial earthquake that we are seeing. The increase in stress level, brings despair, hopelessness, depression and unfortunately in some cases suicide. We as a people need to face the reality. We need to live within our means, cut our cloths according to our sizes and stop chasing after the Jonesses. The history would tell us that recession is temporary and almost always followed by economic rebound. This happened after World war II, and it will happen again. It is a time to reflect and review what is really important in life, which is really the family. Material things will come and go and what we always have is family and friends. We need to make deliberate efforts to take good care of our health. Exercise is a good way to relieve stress and unfortunately this simple task is often ignored by many of us. If you are feeling depressed and overwhelmed, talk to someone and get professional help. You don’t have to do it alone.

Upwardly mobile executives have become prone to all kinds of debilitating ailments like stroke, diabetes, distress amongst others, how can they overcome this problem?

Professional jobs these days are rigorous and could be very demanding. We are all working long hours and spending less time to replenish our energy. I know of a bank executive that once told me he had not taken vacation in 5 years. That is absolutely insane. There is a reason why an average person in Europe or America takes 2-4 weeks of vacation every year.

There are medical studies out there that suggest people who take regular vacations are generally more productive and efficient. Men aged 40 and above should have regular medical and physical check up, including prostate examination at least once a year. Women should have regular medical check up including mammogram and pap smears. These simple tests can detect early cancers and other problems that could potentially be amenable to treatment. Regular exercise is the single most important activity an individual can do to reduce stress, lower blood pressure, improve respiratory function, lower blood cholesterol, lower blood sugar and improve a sense of well being.

How much percentage of income should individuals invest in their health especially where the state does not provide for them in a country like Nigeria?

The amount an individual spends on his/her health could be very variable. A healthy 20 year old healthy lady would spend way less than a 70 year old man with cardiac failure. The question should be what percentage of the national GDP should Nigeria spend on her citizens’ health? I have not seen the 2010 budget but the total expenditure on health as a percentage of the GDP in Nigeria in the last 10 years has been less than 5%. Compare that to 6.2 % in Ghana, 10% in Canada, and 15% in the United States of America. Good health is priceless and no amount of money is too much to spend on your health. In Nigeria, the cost of living is very high. Most people are trying to cover the basic necessities of life like food and housing that they have very little left to spend on anything else including their health.

Do you think investing in the healthcare business in developing countries like Nigeria, is worthwhile?

There is no country in the world that has been able to develop its economy with a weak health system. A healthy nation is a happy and productive nation. Investing in health and education is crucial as our future as a nation depends on this. Chief Obafemi Awolowo had the foresight and understood this.

You are a part owner of a clinic in Wisconsin, how has that helped you as an investor?

One of the beauties of America is the recognition and reward of hard work. It is a system that promotes entrepreneurship and small businesses. There is no better feeling in the world than knowing you control your own fate and you are your own boss. I am a partner and a shareholder at the Marshfield Clinic, a multi-specialty clinic with over 800 physicians located in Wisconsin USA. I am a board member and a director in this organization, and that gives me a unique opportunity to be directly involved in both the administrative and business aspects of the Clinic. This has given me a better appreciation of the business aspects of medicine. Doctors generally are not business oriented but this is changing very quickly. There are many doctors now that have MBA. We need to be more comfortable with the business aspect of medicine as more people go into private practice.

Considering that healthcare has to do with saving lives , how can we align the practice with life and profit?

The primary goal of a good physician is to help the patient, provide good care and do no harm. People are willing to pay for good care even in Nigeria where the income is low. There should not be a conflict about practicing good medicine and charging for the care you provide. A medical doctor spends between 6 and 15 years after high school pursuing additional training. His/her time and expertise is worth something. A good doctor has the moral obligation of stabilizing an accident victim and not necessarily turns them away because they could not make the initial deposit. On the other hand, I know people that can pay N20000 to see D’Banj, pay N50000 to have dinner with their friends but find it difficult to pay N5000 for a doctor’s visit. People don’t blink an eye to pay N30000 per night for a hotel room but would complain if they get a bill of N20000 for a 3-day stay in a hospital where they get tender care round the clock. That is wrong. Some people just don’t feel they should pay for health care. They forget it costs a lot to pay the staff, run generators 24/7 and keep the practice alive. Medicine is a noble, humane profession but also a business.

Less privileged and homeless children have been identified as integral parts of the society and gifts from God that must be accepted wholeheartedly by all members of the society.

This was the focus of the seventh edition of the Best Spring International Christmas musical concert and competition for Orphans, Motherless and the physically challenge children from five different orphanages homes penultimate Saturday with the theme "Joy to the world".

Speaking at the event the Managing Director/CEO DN Meyer Plc Mr. Bola Olayinka, said the army of the less privileged in the society should have a sense of belonging despite their status. "We need to incorporate the needs of the physically challenged to our programme and every segment of the society must be involved; it should not be left alone to the public sector, we have to join hands together to help them"

According to Honourable Mrs. Lola Akande represented by Mr. Fasanmi, children should realise that God has a purpose for their lives. "Believe in yourself and God is your strength, the sky is not the limit irrespective of your circumstances God has a plan for your life," he said.

The event, which witnessed the different orphanages showcasing their musical and dance talents, also had the presence of a Nigeria- born International Dancer and Choreographer resident in America for over thirty years shared some word of encouragement with the youths. He praised the organisation for putting up such a programme promising to start his own charity in Nigeria soon.

Speaking on the reason for organising the event, the Director of Best Spring International Mrs. Aramide Oikelome, said these children have talents and gift but they feel they are not part of the society because of the discrimination they are subjected to.

"We want them to know that they are an integral part of the society," she said explaining that they intend to organise an essay competition by middle of next year where they will be asked them to write on issues of interest.

Orphanage homes that participated in the competition are Heritage Homes Orphanage, Redemption, SOS Village, Ijebu-Owu, Ogun State, Light of Hope Orphanage, Akute, Christ Light Special School for the Deaf, Idimu, Ijamido Orphanage Home, Ota. SOS Village came first and carted home a 21 -inch Plasma TV while Christ Light Special School for the Deaf came second and went home with a DVD player. The third and fourth position went to Ijamido Orphanage Home and Heritage Home respectively.

Mr. Paul Oyeleye is a 60-year old retired Industrial engineer living in Olorunishola Village, Ayobo, Ipaja, Lagos with interest in Interior design. His love for design and engineering work has taken him to places. He comes across as a retired civil servant with a difference in an age where retired civil servant are wont to queue at government offices for collection of pensions.

As early as 12, he started experimenting with different gadgets and drawing it was not surprising that after leaving primary school at The Apostolic Church Ebute Metta, Lagos in 1963, he proceeded to St. Finbarrs College, Bariga, Lagos where he studied Technical Study specialising in wood work.

On completing college, he was employed by Thermocool for three years before moving to Federated Motors in 1973, and later to the Nigerian port Authority (NPA) where he was sponsored to England to study Industrial Engineering. While there, he did his apprenticeship at Thermocool majoring in manufacturing process in refrigerator.

"I like design and inventing things just like Dunlop did for car tyres, The Wright brother for airplane and Henry Ford for car," said the British trained engineer. According to him, if he gets sponsor, he can invent machines that would be cost effective and reduce manpower hour. "If I get some help, I can help people in the agricultural sector by designing and building machine that can help in all areas of planting and harvesting thereby reducing the fatigue farmers go through," the Ondo born engineer stated.

After he was retired prematurely from the Nigerian Printing and Minting company in 2005 as an Industrial Engineer with 17 years of service to his credit, he decided to set up Pauloye Design and Décor Centre in 2005 to train and equip people with vocational skills for empowerment as his own way of contributing to the development of the society.

Some of his works include a grass mower, which he designed and built after weeds started taking over his compound. ‘I think of what to do that rather than give some people money to clear the weeds for me, I decided to build this electric mower and it has really helped as you can see,’ pointing to the mower and the neat compound.

He explained that Design and craft governs all that one has to do which was evident in the way he designs his house with different colour separation. All parts of his house have a touch of his design and craft ingenuity.

For this interior designer, Nigeria is backward because unlike in Europe, we have not devised ways of saving manpower hour. "We need to first study the people, note the delays and things which are hindrance then move from there by eliminating them he said.

To him the vocation training centre he set up early this year is a way of impacting lives. "I give vocational trainings aimed at equipping people with the necessary foundation to become professionals in any of these areas such as graphic art, ceramic, architecture, printing, signs, interior decorator, jewelleries, metal work, wood work and many others," he explained.

One might think that after retirement he should be resting but he disagrees "Many people think that retired people are tired and should be resting. "I have worked for many years and have varied knowledge, so I can’t be tried of doing what I love doing best," he said.

Speaking on his inspiration he recounted, "I have an uncle who inspires me through his work of art such as drawings. He is a graphic artiste and having gotten a technical background. I noticed that interior decoration has an overlapping place in Industrial Engineering, so I plunged into that as well"

For him the problem with Nigeria when it comes to vocational work is that "a lot of people learn trade which they do not practice largely because they lack the equipments needed to put those knowledge into practice. Many of the factories we have now are using old machines. You can’t expect to use dilapidated machines for the kind of production needed now."

Oyeleye works span plain machines, saws, potters, ceramic cup and plates, drilling machines used for sharpening metals, lamp, paintings, toys, and jewelleries amongst others. The training, which he started this year, and hopes to continue with a two weeks foundation class before a six month specialisation class where participants are expected to know there area of expertise and work on it.

He has been a fellow member of Institute of Quality Management service, London since 1975 and was qualified in 1982, as member of Nigerian Institute of Management; member Nigerian Institute of Industrial engineer; associate member, American institute of Industrial Engineer; Technician Member and British Institute of Interior design.

The world of investment is made up of varied channels of investments, from capital market investments, to trust funds, among others.

But in this period of financial hardship brought about by the global economic meltdown, going back to the village to invest in agriculture could be a panacea to solving the problem in Nigeria, a country that has long abandoned her first love and first source of national income-agriculture. Investing in villages present to us a good opportunity to make lot of money which can be used for both personal and national development.

In a large market in Ipao, Ekiti sitting on the bench facing a large Yam Market in the bristling Friday afternoon sun with market men and women moving up and down the market, Alhaji Isiaka Ibrahim is in a upbeat mood, as he points towards the market.

"We have the land for development and farming here is very profitable. But we prefer to have private investors and private organisations in our midst to help us than government because they have failed us several times", Ibrahim said, in reference to the viability of investing in his village yam business.

Expatiating, the village head of Ipao village in Ikole Ekiti local government in Ekiti state said: "We have so many lands that if the government have been more responsible we should be more developed than this."

While noting that Oja Isu Owode, located in Ipao is one of the biggest in the state, he fell short of blaming the state government for criminal negligence.

The situation is not any different in other parts of South West Nigeria, where several farm holdings exist.

In the palmoil rich Alabidun village in Ona-Ara Local Government Area of Oyo State, the community boast of being a thriving belt for the production of palm kernel, cocoa plantation, plantains, oranges, mango just as many other plants and fruits abound in this solitary and remote village.

"In this place we have a lot of cash crop waiting to be tapped. Take for example the palm kernel seed, you can extract a lot of things from the single seed. Apart from palm oil you can also make soap from the waste. In fact, there are lots of ways money can be made from investing in palm kernel seed", said Evangelist Jeremiah Williams, a missionary in the village.

Lending credence to Williams’ submission, another clergy, Pastor Samuel Adebayo gave a freskh perspective.

According to him: "The palm oil industry in this village is been operated by old women who daily swerve and toil on the field everyday come rain. Often times than not, the locals complain about the lean profit and are calling on people in urban centres like Lagos to come down there and invest not only in their palm oil business but in all the other agricultural products they have."

Other villages in the same local government with similar compalints like Alabidun include Eleta village and Eleserin village. Others are Elere-Adeogun, Agbemo village, and Onifufu village all in Idi-odo local government in Oyo State.

Further away in the cassava producing village of Adebiopon village in Obafemi-Owode Local Government area in Ogun State, the farmers there continue to bemoan their fate over what they described as their unfair treatment from land developers.

They said instead of investing in their rich farms and building agriculture industries, various estate developers scattered across the village are busy buying the lands and fencing it round to be used as residential estates, which will add no values to their lives as villagers.

"They have brought our lands including the ones we used to cultivate cassava which has led us to increase the price of a basket of garri to as much as N1,500 from less than the N200-N500 price we were selling it before. Still at that we are not getting the desired profit", said a woman, who simply gave her name as Iya Niyi.

"One thing they don’t know is that they can make a lot of money from here", another farmer offered.

Experts however note that before venturing into windows of investments like agricultural produce, it is necessary for investors to carry out a feasibility study to ascertain what produce are the investments havens. One agric produce that holds a lot of promise to investors, analysts said, is yam produce.

Alabi Saliu, a farm manager in Ekiti said: "The diversity of opportunities in yam marketing and cultivating allows you to opt for the type of investment you find most suitable. For example in Ipao village, one of the market women explained that with an initial investment of around N100, 000 one can be sure of getting over N800, 000 in return."

Continuing, he said: "To ascertain this, a visit to the yam market shows that 10 tubers of yam go for as low as N450–N500 which ordinarily will cost around N300 per yam in big cities like Lagos. A wheel barrow of yam goes for N1,000 to N1,500 you know how much that will go for in Lagos? No doubt investing in yams in places like Ipao in Ekiti will give big time return as the villagers have always shown their readiness to give land to whoever wishes to invest in the yams and at the same time help to develop their village."

Cassava, Saliu said, which is processed into garri is the staple food of millions of Nigerians.

"Investment in cassava is a huge investment that one should not miss. But the cultivation of these staple foods of millions of Nigerian is however been threaten as a result of encroachment on the land by various estate developers who bought the lands at cheap prices and sold it off at exorbitant prices",he lamented.

Cassava as we know can be used for a variety of purpose of investment in such can be likening to a gold mine.

Palm Oil which Nigeria is vastly blessed in is one big investment area that will continue to be so for a very long period of time. Not only does the palm represent a pillar of a nation like Nigeria but it is a catalyst for rural development and political stability.

Many social initiatives use profits from palm oil to finance poverty alleviation strategies. Palm oil is a very common cooking ingredient in Nigeria and other Africa countries.

Its increasing use in the commercial food industry in other parts of the world is buoyed by its cheaper pricing, the high oxidative stability of the refined product and high levels of natural antioxidants.

Cocoa was the main stay of the Nigeria economy before the advent of oil. The advent of oil brought about the collapse of the Agricultural sector and ultimately led to the death of cocoa farm in Nigeria. Nigeria was formally the world largest cocoa producer but now the story has changed.

But still at that thousands of cocoa plantations are scattered across the country waiting to be harvested. From the west to the east to the south they abound, like a gold mine waiting to be tapped.

There are boundless opportunities in investing in cocoa production. In most cocoa areas, the main harvest lasts several months. Another harvest – the mid-crop - lasts for several additional months. Changes in weather can dramatically affect harvest times, causing fluctuations from year to year, even on the same farm.

Many cocoa farms are lying fallow across the country with nobody to come and invest in them. Beverage companies and even health companies are the biggest customer for cocoa produce.

It is estimated that the number of cocoa farmers worldwide is between 5-6 million but the number in Nigeria has dwindled.

Annual cocoa production worldwide is 3 million tons, with Nigeria accounting for less than 1 percent of this figure. The annual increase in the demand for cocoa is rising every year, it is 3 percent per year, for the past 100 years.

The current global market value of annual cocoa crop $5.1 billion and it could be more if countries like Nigeria are investing heavily in the crop. The percentage of cocoa that comes from West Africa stood at 70 percent while the length of time required for a cocoa tree to produce its first beans (pods) five years. The duration of "peak growing period" for the average cocoa tree is 10 years.

Cocoa is one of the most significant crops in West and Central Africa occupying between 5 and 6 million hectares in the coastal humid zone. Investing in cocoa might look long and uncertain but the waiting that an investor will have to endure is worth it considering the huge returns that will come after the harvest and marketing of the crop.

Other produce that are good investment any time any day are fruits. Fruits such as bananas are widely consumed. Yet, they represent a wide variety of interrelated issues, from environmental, economic, social, and political.

Nations and regions, such as the US and EU have in the past battled in a trade war over how bananas are exported and imported, affected the poorest in the producing countries the most.

So many resources are poured into the banana industry. Planting starts in April and can be extended to October.

Plantains, carrot, orange, cashew, palm kernel seed, and kolanuts are other good examples of fruits that one can invest in these villages.

One important factor to consider when attempting to invest in these villages is to observe the principles of fair trade. When investing in these villages, the principle of fair trade should come to play. The villagers of the villages mentioned earlier are few of the cases of the seller getting poorer and the buyer getting richer.

Fair trade is an organized social movement and market-based approach that aims to help producers in developing countries and promote sustainability. The movement advocates the payment of a higher price to producers as well as social and environmental standards in areas related to the production of a wide variety of goods.

It focuses in particular on exports from developing countries to developed countries, most notably handcrafts, coffee, cocoa, sugar, tea, bananas, honey, cotton, wine, fresh fruit, chocolate and flowers.

The principle is a trading partnership, based on dialogue, transparency and respect, that seek greater equity in international trade. It contributes to sustainable development by offering better trading conditions to, and securing the rights of, marginalized producers and workers – especially in the South. Fair trade’s strategic intent is to work with marginalized producers and workers in order to help them move towards economic self-sufficiency and stability.

It proponents include organization such as Christian Aid, SERRV International, Oxfam, Amnesty International, Catholic Relief Services, and Caritas International.