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Although early and sudden death from heart attack and complications of hypertension has been raging wild among Nigerians, especially the affluent or middle class, it is surprising that very little seems to be done about it on both the individual and collective levels. Certain factors may explain this rather nonchalant attitude to a situation that has obviously become an object of anxiety and fear from very many people. These factors need to be recognized and addressed if relevant preventive actions are to be effectively taken against this twin monster of death and disability. Four of the factors are particularly important for discussion as follows:
Lack of Knowledge
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While many of the victims of stroke and heart attack may be uneducated and therefore at a disadvantage in obtaining information on these problems, this cannot be said of the many middle class Nigerians who appear to be the more frequent victims. However, the middle class has not shown better knowledge; in fact, the situation presents middle class Nigerians as generally lacking in relevant knowledge for dealing with these conditions. There is no other conclusion anyone can reach why such a group who are generally well educated would be so careless with their health and life. There is no doubt that they all value their lives and quality living. I do not think that anyone, middle class or not, would intentionally engage in a lifestyle that compromises his/her health and life so gravely. We must therefore plead ignorance on the part of the numerous Nigerians who cheaply fall victims to avoidable stroke and heart attack.
For example, the one-time acquaintance of mine who I referred to in the first part of this work as nursing and proudly carrying his bulging abdomen as a badge of honor certainly did not know how much he risked heart attack and/or stroke from hypertension. If I had the time for explanation, the only question that was on my mind for him was: “Why do you do this to yourself?” I am certain he did not know the danger he had put himself although he was a university graduate who occupied the high position of a Sole Administrator of a local government area. I believe that most Nigerians who literally eat themselves to death and disability or engage in other lifestyles that are associated with sudden death from heart attack and stroke are in the same position of ignorance, their attainment of high educational degrees notwithstanding.
Lack of Appropriate Attitudinal Orientation
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It cannot be truly said that all the Nigerians who defy the dangers of stroke and heart attack to engage in lifestyle that predisposes them to these conditions are ignorant. In fact, many of them are adequately knowledgeable about the conditions and their ramifications, yet still handicapped by lack of suitable attitude needed for appropriate action. A very good example was the case of a medical doctor from an adjacent clan to mine. He was trained overseas and was in his mid-thirties when he established his practice shortly after his return in the mid 80’s. He was noted for being particularly sociable, which somehow helped his practice and he was soon economically well off.
Although we were not bosom friends, we were close enough for me to know that he was seriously hypertensive in his mid-forties. That did not stop him from eating anything, frequently drinking and partying almost round the clock, since money was no object, so to say. It was not much of a shock to me that he died suddenly one night, reportedly after collapsing in a night club. I am not sure if he died of massive stroke or heart attack but it must be one of them.
He may not represent the average medical doctor, but no one would say that he did not know the dangers of hypertension or the probability of heart attack associated with the nature of his lifestyle. Irrespective of his knowledge, his attitudinal orientation was not attuned with that knowledge. I would not be surprised if he did not comply with his medication for hypertension. And I will be surprised if as a medical doctor he did not know about the dangers of high cholesterol or if he ever checked his cholesterol level. He died when he was barely over forty years of age. His may be an extreme case but it somehow typifies the attitude of most Nigerians about their health, especially where living the so-called good life is concerned.
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The common mindset of most Nigerians is to live life to the fullest as much as you can. That is good; but must it be in the form of unrestrained eating, drinking and other social excesses? Should momentary pleasure be put before health, life and longevity, especially when we know the negative implications of that lifestyle? I have heard many people philosophically explain the emptiness of life by stating: “Only what you eat is actually yours”. Borrowing the idea from the Bible, we must ask ourselves: “What does it benefit a man to eat, drink and enjoy himself to premature and sudden death?”
Cultural Value for Conspicuous Consumption
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A recent CNN report indicated that a world-wide study found that Nigerians are the happiest people on earth. How nice to know! But what are the criteria for this ranking? I am still trying to lay hands on the specific rating criteria for that study. I believe that the numerous boisterous parties and flamboyant lifestyle of ours was probably major part of the assessment tool. Or more relevantly, the eating and drinking habit of Nigerians, which derives from the general belief in most of the cultures that: “Life is short, only what you eat is actually yours”. Consequently, as much as you can afford it, eating the most and the best foods is like the best thing you can do for yourself. It is therefore not expected that anyone should hold back on eating the good things of life; only if you cannot afford it. Hence one’s socio-economic success should be physically self-evident in the form of the so-called evidence of good living.
|The Body System|
Protruding abdomen, even for women, commands respect. Heavy adipose tissue making the skin full and shining is something you cannot miss in affluent Nigerians. It is amazing to hear how ordinary folks adore this evidence of good living: If you see im skin, you no se im node sofa again! It appears that the worst thing that a Nigerian who “has made it” can do to self is to remain slim as if he or she cannot get enough to eat. If a person who everyone knows to have made it remains slim, that is regarded as painful evidence that the person is very stingy, even to self! Not many people want to put themselves in that embarrassing position. It is not that middle class Nigerians simply want to earn the praise of others by eating and drinking themselves into obesity; they inherently enjoy eating and subscribe to the cultural value of conspicuous consumption.
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Unfortunately, little do the Nigerians with “evidence of good living” know about the harm they do to their health, life and quality of life. Apart from the risk of hypertension and heart attack, overweight or obesity is a primary cause of innumerable health problems. For example, diabetes, arthritis, some types of cancer, and various respiratory diseases are only a few of the health problems associated with obesity. In addition, fat people are more prone to different forms of aches and pains, fractures from accidental falls and premature death from various causes. In fact, a common axiom in health education circles is: “The longer the belt, the shorter the life”.
Unfavorable Attitude toward Maintenance and Preventive Health Care
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One other important contributory factor to stroke and heart attack among Nigerians is our fundamental belief or disbelief about health, illness and health care. Traditionally, most Nigerians believe that they are healthy as long as they suffer no pain or some other obvious evidence of illness. It is therefore difficult for many of us to take such conditions as high blood pressure seriously even when we are told that we have it. In most cases, hypertension does not cause obvious problems, even after being so diagnosed. Very often, for lack of accurate language, high blood pressure is explained to patients as “having too much blood”, which usually does not make sense, unless the person is obese. In that case, the person tends to think that his excess weight is probably due to excessive blood and simply wonders why he cannot just donate some blood periodically and be alright!
When people do not see or feel evidence of being ill, it is difficult for them to take the probable threat from a disease and the treatment process serious. Hence, such people have problems complying with medical check ups and treatment regimen. They are simply not convinced that they are at risk or committed to doing anything to avoid the probable complications of the disease.
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Another common cultural belief is that if you have the right medicine for a disease, it should be cured. When you have the so-called high blood pressure or some heart disease, for which you have to take medicines all your life, there is often some doubt about the reality of the disease and the efficacy of the medical intervention. This too is a common source of noncompliance with medical check-ups and medication regimen. When the person actually feels healthy and probably having good time, his belief in the presence of a disease and commitment to the treatment procedure is usually low. These problems are usually worse when we talk about maintenance and preventive health measures. In health care, preventive measures are generally difficult to sell and this is particularly so with most Nigerians. People simply do not think that they can be affected by the disease in question. They have never been affected and therefore do not consider themselves at risk. Even the conditions of stroke and heart attack, which have been ravaging the population, especially the middle class in recent years, are not considered by many as personal threat, though they may be secretly scarred, having known friends, acquaintances, and even relatives who have been victims. It would appear that the attitude of “not for me” is simply a defense mechanism. Obviously, that attitude is unrealistic and not good enough.
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(From the Book; “Early and Sudden Death; the Price of Affluence among Nigerians”.Read “New Ways to prevent Stroke & Heart Attack” in our next post on Asabeafrika)