Imagine Fabrice Muamba’s fate if he was playing in Rwanda

Imagine this scenario: a packed Stade Amahoro, screaming football fans and a pulsating match pitting arch-rivals APR FC and Rayon Sport. Now picture this; as the extremely fit young men run, jump, tackle and shoot in frantic gusto, all of a sudden, an APR FC player kneels over and collapses on the pitch, with no one closer than ten metres from him. The game continues for a few seconds as the players, referee and coaching staff look at the prone figure in bewilderment. Then all of a sudden the stadium becomes as quiet as a morgue as the medical staff of the football club rush over to the player, the other 21 watching the unfolding events in horror.

As the APR FC football club doctors, more used to dealing with sprained ankles and bruised ligaments, attempt to revive the fallen player it dawns on the watching crowd that they might be watching a man die right in front of them. Belatedly, an ambulance appears on the scene and he’s driven to King Faisal Hospital and the game is called off. It’s taken about thirty minutes, from the time he collapsed to the time he was bundled into an ambulance.

This scenario, give or take a few major differences, occurred in England a week or two ago. In a FA Cup quarter-final match pitting Bolton Wanderers and Tottenham Hotspurs on 17, March, Fabrice Muamba, a Bolton player collapsed on the turf during the first half, suffering cardiac failure.

After receiving lengthy attention on the pitch from medical personnel including a consultant cardiologist who was at the game as a fan, he was taken to the specialist coronary care unit at the London Chest Hospital. Bolton’s club doctor later told the press that that Muamba’s heart had stopped for 78 minutes.

 

By 19 March, his heart was beating without medication and he was able to move his limbs, and later that day his condition was described as “serious” rather than “critical” and he was able to recognise family members and respond appropriately to questions. By 21 March, his consultant suggested that Muamba’s progress had “exceeded our expectations” and that although he faced a “lengthy recovery period”, “normal life [was] within the spectrum of possibility”. The latest news from London is that he has been able to sit up, eat by himself and watch his team-mates play on television.

Stories like that gladden the heart; he was obviously popular and everyone is wishing him a quick recovery. But for every miraculous ‘Muamba’, we have a ‘Marc-Vivien Foé. The Cameroonian international collapsed and died during a FIFA Confederations Cup semifinal on 26th June, 2003, suffering cardiac arrest.

Now back to Rwanda, would the APR FC player have made it? I’m sure that the medical staff would have worked extremely hard, but he would have died. Not because the King Faisal Hospital staff weren’t good enough, but rather because the first aid care he received at the stadium was inadequate.

Let’s imagine this had happened during one of the Friday Sports Day that civil servants indulge in. An almost certain fatality would ensure, simply because no one is ever trained in emergency first aid. How would you, a parent, react to the sight of your child’s face turning blue as he/she chocked on their food? Would you know what to do to save their live?

In North America, basic first aid and ‘what to do in case of emergency’ is taught to children in school. Children are taught what to do in case of tornadoes, earthquakes, floods, electric shock and yes, chocking. This kind of knowledge is often the difference between life and death and sadly, this knowledge isnt imparted either to the young ones or their parents. This is something that is simply unacceptable and the Ministry of Education, working with the disaster and health ministries, should include this in their curriculum.

So, back to the question, “what would have been Mr. Muamba’s fate”? He’d have been dead and buried by now, and that is the honest truth.

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We must do all we can to protect expectant mothers

I read a story in today’s issue of The New Times that left me gasping for breath in horror. Titled ‘Medic held over suspected rape of pregnant woman’, it recounts the shenanigans of an unnamed senior nurse who was arrested last week for sexually assaulting a woman who had gone to Kimonyi Health Centre for antenatal care.  While the attack itself was vile, and the arrogance of the nurse bloodcurdling, (he told the unfortunate woman that “all the nurses were his friends, and no one from her family will get treatment if you report me to the Police”), what really outraged me was the fact that this suspected predator had left two other medical facilities under a dark cloud. He had been dismissed from Ruhengeri Central Hospital over accusations of sexual harassment, indiscipline and neglect of duty before he was transferred to Kimonyi. And, in 2004, he was similarly dismissed from Kirambo Health centre after allegedly defiling a young girl.

While I must allow the court system to find him guilty of innocent, and not try him in the court of public opinion, I can’t understand why, or how, he kept his job. While the spokesperson for the Ministry of Health, and my fellow columnist, Arthur Asiimwe, ably defended his institution for accusations of a lack of oversight saying “public service regulations stipulate that he had to be referred to District officials his file (after his dismissal from Ruhengeri Hospital)… it from the District that he was re-deployed to the health centre”, I feel that simply referring this case to the Police and moving on, is wrong.

The Catholic Church is currently being hammered for its inaction over paedophile priests. In Europe and North America, priests who did horrendous things to children under their care were, instead of being defrocked and thrown into the penitentiary (or at least investigated), were simply transferred to different dioceses. The Diocese leadership were simply playing musical chairs with these errant clergymen, making these evil men another person’s problem. It was only after the victims started speaking out and naming names did the Church do something about these predators; the problem was that many of these men were already deceased. Rome is now paying millions of dollars in damages and I wonder whether it will ever live down this scandal, I doubt it.

I’m not saying that there is widespread rape in our medical profession; that would be disingenuous to all the hard work that’s been put in by our nurses, doctors, pharmacists and other medical staff. What I’m saying is that perhaps the system of oversight can be improved. Maybe it isn’t a good idea to give the District authorities oversight of medical officers or perhaps the Ministry of Health can have a representative on these District Boards. I feel that, if there was improved oversight, the nurse could have been stopped in 2004, and not in 2012.

I feel extremely sad for all the women who weren’t able to seek proper medical treatment in Kimonyi because they feared sexual assault. Rwanda is attempting to make sure that as many women give birth in health centres in order to reduce deaths during labour. This strategy, which has been extremely successful so far, can only remain so if women, first of all, feel safe enough to go to the health centre, and if they are confident enough in the professionalism of male staff. In the aforementioned case, the victim said, and I quote, “pregnant women had stopped coming here (to the Kimonyi Health Centre) for fear of this man”. Simply for this reason, the Ministry needs to make sure that this scandal is never repeated again.

RBS bares it teeth, don’t expect any cheese on your hamburger

I have a huge culinary weakness; it’s a North American staple and if overindulged in, will lead to obesity, high-blood pressure, diabetes, gout and early death. It’s a slab of grilled mincemeat topped with lettuce, tomatoes, dill pickles and gooey cheese and encased in a bun a.k.a a ‘cheeseburger’. On Monday I drove to my favourite fast food place, ‘Mr. Chips’ in Kicukiro, expecting my weekly dose of a ‘heart-attack in a bun’. Imagine my ire when I found that the cheeseburger didn’t have cheese. I thought the proprietor was being a bit of a cheapskate so I put him to task. That’s when I found that Mr. Chips’s burgers didn’t have cheese because almost all locally made cheese was removed from store shelves by the Rwanda Bureau of Standards (RBS).

I thought he was just making excuses (and trying to make an extra few coins) and this feeling continued when I called a friend of mine who works at the Ministry of Health, who denied all knowledge about the cheese issue. He however suggested that I talk to the good people at RBS, something I did (although I must admit that I didn’t expect to get any information; very few organisations have a pro-media stance. I was pleasantly surprised to find discover that RBS is one of the good ones).

Mr. Philip Nzaire, the RBS Director of Quality Assurance, confirmed Mr. Chips’s story. He informed me, in a cordial telephone interview, that various brands of local cheese had been removed off shop shelves, during a February exercise, because they were, and I quote, “contaminated with bacteria, resulting from poor processing and handling”. So, if you are planning a wine and cheese tasting party, you will be forced to buy imported fromage for a while. The RBS will simply not allow bacteria-infested cheese unto our plates; and all I can say is, “good for them”.

Mr. Nzaire complained that many cheese producers didn’t only lack high-tech, modern machinery but also failed to do some of the simple things, such as use clean water and boiled milk when making the cheese.  When I asked him when we would be able to eat some locally made Gouda cheese, he had this to say, “as long as they [the cheese producers] are ready to improve their practices and call us to inspect them, we shall allow them to sell their produce”.

What really shocks me is this, why did RBS act so late? The mere fact that they had to remove each and every slab of cheese from our local stores and supermarkets, though commendable, is also regrettable. It means that the issues of standards weren’t drummed into the heads of the cheese producers in the first place. How could they not have been able to make sure the producers were making good products? The real issue I think is professional standards in the cheese-making industry.

Thank god no one has complained about food-poisoning caused by unhygienic cheese producers because if it had happened, the local cheese industry could have been damaged irrevocably. I mean, if E-coli or Salmonella had been found you could rest assured that no hotel or restaurant would have trusted local cheese. And neither would I.

I think that RBS should work with the Ministry of Trade to make sure that our local industries produce hygienic, quality goods. We cannot afford to handicap ourselves; local industries already have enough issues dealing with cheaper imports. They mustn’t make life harder for themselves. We must do everything to make sure that the ‘Made in Rwanda’ label signifies quality. There is no two ways about it.