In March 2013, the BellaNaija team asked for your feedback on how to handle the issue of the emails we receive with regards soliciting for financial aid {Click here to read}. We were grateful for your feedback. Over the years, BellaNaija has published various feature stories on Nigerians in difficult situations and we are thankful that our BN Fam has supported in full force. From the man who was wrongly imprisoned for over a decade to and the struggling father suddenly saddled with major financial obligations due to the birth of his triplets.

During this time, we worked to get as much information as we could about different situations that was sent to us. In many cases, the people sending the emails don’t come back to us when we ask for more information. Sometimes they do and we are sceptical about the information given to us and as such we are unable to publish these stories. We will continue to publish these stories, however, we realize this is not enough.

While we are very concerned about the integrity of our brand and are conscious of the fact that there are too many fraudsters out there, we are definitely aware of the major challenges people go through every day.

If you’ve ever had a health-related issue in Nigeria, then you will probably understand that it is extremely difficult to fund your treatment and navigate the healthcare system. Even at the government hospitals (where health care service supposedly subsidized) you find yourself having to pay N50,000 here for something, another N18,000 for something else. Before you know it, you’ve spent hundreds of thousands of Naira. We all know how difficult it is to raise money, even amongst the most ‘comfortable’ people. While many save for a rainy day or have health insurance, most cannot afford to set aside a contingency sum for sudden major illnesses.

In view of this, BellaNaija is launched the BN Community Centre. This online platform will feature “calls for help” as submitted to us. This includes information, photos and account numbers. We are, however, stating categorically that we are doing only basic fact checking, therefore, we will not be held liable in ANY circumstance.

We encourage you to give if you can, however, please ensure you perform independent verification prior to donating any funds.

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Her campaign message is :

Hello my friends how are you all doing? I just want you to know I’m very sick right now the doctor had concluded that I need to do kidney transplant and that will cost 6million Naira but they said for me to be alive before the transplant I need to be doing dialysis every 10,days. I had done it over 18 times. My family had spend all they got on my health. We don’t have money to do another dialysis or even buy my drugs right now. Please I need your help because I don’t want to die. PLEASE all I need right now is your donation for my health anything you can help me with please.

Here are the bank account details: (her mother’s account)

MBONU NDIDI PATIENCE 3021660844 FIRST BANK.
NDIDI PATIENCE MBONU 0055590179 DIAMOND BANK
Her gofundme account is www.gofundme.com/xmcdfs
Facebook: Tochi Mbonu or https://m.facebook.com/mbonutochi?refid=12

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Hale P?maika?i, H?na Community Dialysis Home. Photo courtesy Lehua Cosma.

By Maui Now Staff

The 6th Annual K?kua Fundraiser for the Hale P?maika?i H?na Community Dialysis Home will take place on Saturday, July 25, 2015 on the front lawn of the facility.

The event starts at 9 am. and ends at 4 pm. and admission is free.

The fundraiser includes live music by the Ata Pata Band, Leokani and the Dizon ?Ohana from Lahaina. There will also be food booths, arts and crafts, baked goods, s silent auction, iced coffee, shaved ice, lucky drawings throughout the day, thrift store specials, and a tour of the nation’s first-of-its-kind communal dialysis home.

There will be an information booth by Microcom on cable and internet services.  For each person that signs up, Microcom will donate $50 to $75 to the H?na dialysis home program.

The event is sponsored by the 501 (c) (3) non-profit organization, Hui Laulima O H?na.

All proceeds raised will benefit H?na Dialysis Home.

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Twenty-six people from Malvani in Malad were admitted to Nair hospital from June 18 to 23 for methanol poisoning. All had consumed 150-250ml of liquor six to 24 hours prior to admission. Out of these, seven who were very critical were transferred to the Medical Intensive Care Unit. A majority of them had blurring of vision on admission. All of them had headache, chest discomfort and giddiness, along with severe acidosis (bicarbonate levels ranging from as low as 1 to 7 (normal being 18 to 24).

We treated them with ethyl alcohol (via ryles tube) and sodium bicarbonate intravenously, a standard treatment for methanol poisoning. Thirteen patients received haemodialysis (11 required only one session and two required two sessions each), which is again a standard practice to remove formic acid — a metabolic product of methanol.

All patients also received adequate intravenous fluids and were monitored round the clock. We also subjected them to investigations and ophthalmic examinations to rule out optic nerve damage.

Out of those admitted, 10 died and 13 recovered, with no residual visual deficit. One patient, who is otherwise stable, has suffered from loss of vision, while two are still in critical care unit. None of the patients had any neurological complications. However, late complications, such as rigidity (stiffness of the body) and tremors, which are Parkinsonian features, are known to occur in some patients a couple of months after exposure to methanol.

Hence, patients need to be followed up on for a period of time for these symptoms.

Patients of methanol poisoning should be detected and treated promptly and receive early dialysis, which would be life-saving. This is because if not treated promptly, methanol is metabolised to formic acid which is responsible for the visual symptoms and circulatory collapse, leading to death, and delayed neurological complications in survivors. Prompt dialysis removes the formic acid which is responsible for all the toxic effects of methanol poisoning.

Dr Mala V Kaneria
Prof and unit head, Department of Medicine
Nair Hospital

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Action Points

The overall risk of death and access to arteriovenous fistula (AVF) for patients with kidney disease vary widely depending on geographic location, says a new study.

Researchers looked at more than 460,000 patients and found that the percentage of those with end-stage renal disease (ESRD) who received AVF on first dialysis ranged from 11.1% to 22.2% depending on where the patient lived (P<0.001). New England, Northern Midwest, Northern California, and Southern California had a significantly lower risk of dying among patients when compared with Arkansas, Louisiana, and Oklahoma (hazard ratio 0.99 versus 1.27; P<0.001) at an average follow-up time of 1.6 years.

The study was led by Devin Zarkowsky, MD, at the Dartmouth-Hitchcock Medical Center in Lebanon, N.H., and researchers published their findings on Wednesday in JAMA Surgery.

"If you are a person with kidney failure in Texas, you're in trouble, but if you're in New England you're golden, and that's profoundly troubling because the quality of care shouldn't be predicated on your ZIP code," says one of the authors, Mahmoud Malas, MD, at the Johns Hopkins University School of Medicine, in a press release.

The highest rates of AVF use were found in New England (21.3%) -- which includes all states east of New York -- and in the Pacific Northwest (22.2%). Those percentages were twice what was seen in regions with lower rates like Florida and Texas. Southern California had the lowest rate at 11.1% (P<0.001).

There are 18 different ESRD Network Programs in the U.S. They connect local services with the federal government and monitor the quality of kidney care in the US, according to the website of The National Forum of ESRD Networks. Southern California is its own network, but in others, several states are lumped into the same network.

Previous research has shown that using a fistula at hemodialysis leads to improved outcomes and lower costs, but most patients still receive a catheter. In addition, AVF use has been shown to be associated with age, sex, race, and socioeconomic class. "Findings from our study extend these results and demonstrate that location within the United States affects incident access type and, more important, associated mortality," wrote the authors.

Data for the study were collected from the U.S. Renal Data System. All of the patients received treatment for ESRD at some time from 2006 to 2010. Information about demographics, insurance status, access type, and nephrology care was collected.

The authors also found that several factors predicted access to AVF. Nephrology care was significantly associated with incident AVF use, and New England had the highest frequency of nephrology care at 74.3%. Network three, which includes New Jersey, Puerto Rico, and the U.S. Virgin Islands, had the lowest frequency at 54.0%; they also had among the lowest use of AVF at 13.3%.

"This stark effect suggests that the most expedient intervention to improve pre-hemodialysis AVF creation will come from aggressively directing patients with declining kidney function to nephrologists," wrote Zarkowsky and colleagues.

Congestive heart failure and immobility were negatively correlated with AVF at first dialysis, found the study. Those two factors cut the frequency of AVF in half, according to the authors. The mean frequency of ESRD patients with congestive heart failure was 33.6%, with an AVF frequency of 11.0%. New England had the highest prevalence of patients with ESRD and congestive heart failure, yet still had the highest rate of AVF use.

"These findings suggest that AVF construction is clinically feasible and that the negative bias associated with preoperative congestive heart failure is perhaps unfounded," wrote the authors.

Frequency of AVF still remains low overall according to the researchers; the Fistula First Catheter Last guidelines state that half of all patients should use AVF. "Combined with our study and others quantifying these effects, there is a clear body of evidence for the need to redress regional inequities in ESRD patient care," concluded the researchers.

Limitations of the study included the large size of the database, making it difficult to link cause of death with disease. In addition, those that enter data for Medicare and Medicaid patients include physicians, mid-level staff, and nurses, which could lead to inconsistency and errors.

It's also possible that some variables not recorded, like access to vascular surgery, could affect the findings of the study. Some patients moved between network programs, which could have confounded the results.

Researchers disclosed no relevant relationships with industry.

• Reviewed by F. Perry Wilson, MD, MSCE Assistant Professor, Section of Nephrology, Yale School of Medicine

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