Pneumonia still poses great threat to children in Nigeria -Dr Adamu

At an interactive session organised for media practitioners from Lagos, Jigawa and the FCT recently, Dr Adamu Isah, chief of party for Save the Children International says pneumonia remains a major killer disease in Nigeria. BAYO MUHAMMED ALABIRA was there.
Give us an overview of the INSPIRING Project.
The overview of the INSPIRING Project is to raise awareness to the killer disease called pneumonia. The awareness has brought knowledge to policy makers and stakeholders about pneumonia. It is also the ability to adapt to the situation where we have found ourselves especially the Covid19 in the middle of the our programme and how to adjust over the intervention to enable us take into consideration the prevailing situation we found ourselves. This was why we designed our Covid19 code called ‘Covid19 Adaptation or Covid 19 Response’. That was why we got involved in supplying oxygen to hospitals that are both in Lagos and Jigawa states.
What do you have to say about mysterious sicknesses?
To some of us in the public health, it is not mysterious but to some, it is. People don’t know about it and again, those who are dying  are very little children mostly in the first year of their times. These are not powerful people, they don’t speak, they don’t vote, they don’t protest, so they may not be a great worry to the public, those who are worry are their parents.
Had it been these are powerful people that are dying, just take the case of Covid19 when we lost senators, former governors, super stars, it would have become an issue, but we are losing so many children everyday just because they are not active politically. That is why their plight is not recognized. There this poor attitude about seeking healthcare by which parents don’t want to take their children for immunisation. If you don’t immunise your child, you are exposing that child to so many diseases, including pneumonia. If you don’t provide good nutrion, you are exposing your child to another bad behaviour.Another thing is you need to have good clothing for your child against cold, especially during harmattan. In the northern parts of the country, its get cold and gets dusty.
What are the smptoms of pneumonia?
 It is good to use the plaint language our mothers in the villages can understand and it is importance to agree on these symptoms. It is not easy to start with in any of the Nigerian languages to define pneumonia in one word. So, when mothers see a child with cold, cough or a combination of cold, fever, fast breathing and difficulty in breathing, these are symptoms that are very common in children with pneumonia. Some children are malnurished and their immunity is somehow so poor. You may not see these symptoms classically, that is why it requires a lot of training to be able to recognise that, but our mothers can recognise them.Those caregivers, our sisters and our brothers in the village that spend their times with the children. They are the primary target, if you want to make improvement before you even go to the policy makers, you need to make those mothers recognize the symptom of the pneumonia because they are always there with the children in the villages and most of our focus are on the cities and elites, but don’t have to focus on urban centres only. So, if you want to role out a programme, you have to do Social Behaviour Communication Change. And I am happy to say that is the big component of our project. We have to include the understanding of this problem from the grassroot as we empower them to make decision.
How would policy makers know about this?
Once you are done with the community caregivers, then you target the policy makers. Tell them that pneumonia is something they should think about. It make sense to policy makers to spend money on pneumonia because it is a killer disease of the children under the ages of five year. And if you want to make data with under five mortality, you need to address the biggest killer first. At the end  your figures are not going to improve remarkably. That is why we need people like you, the journalists, you say you are not medical professionals, you are not nurses and doctors, but you have the voice. You can make a change, you can falicitate improvement. How many under five children are lost in Nigeria? The figures are changing over the years.  Pneumonia has been contributing between 16% to 20% under five mortality. 
Give us the exact range in figure.
When it comes to figure, it ranges from 80,000 to 120,000 deaths of children. Some years, it gets higher; some years, it gets lower. Why we need to be cautioned about it is that it depends on which survey. Under every five years, the country carries out a National Demographic Survey (NDS) which covers most parts of the country. Figures from these are much more reliable, but also some states do other surveys where they comes up with their figures. So it depends on who you are listening to. All I am going to say is that none of the above is giving us any impressive figure because we are not getting the kind of figures we want to know.
What are the losses?
Back to the question, we are losing let’s say 120,000 every year. For us to achieve the target set up by WHO their Global Action for Prevention of Pneumonia and Diarrhea (GAPPD), we have to reduce that deaths by 71,000 deaths every year. For us to follow that call and reach the target, we have to slow down the deaths. So, the statistics may not make much sense, but in reality, it going to need a lot of hard work, engagement, change in attitude,  change in practice and change in financing many things. We are however not considering this as an insurmountable task. You may see some things have changed in the area of HIV/AIDS. When we started the HIV/AIDS in the 80s and 90s, it was like a death sentence. As you know today, it is no longer a death sentence; It is reducing.
Is Nigeria winning the war against pneumonia?
The war is not just a Nigerian war; the case in Nigeria is the samething found in other parts of the world. Although there desparity between the developed and the countries that are still developing. Countries like Pakistan, DRC, Nigeria and another two are contributing more than half of the world problem of pneumonia. The fight against  pneumonia involves everybody on the plannet, especially those who have power to do the fight, power to allocate fund and power to make change. Nigeria on its own side is doing its best. First of all, you better recognize the enemy before you attack him. If we don’t realise pneumonia as an issue, there is no how we can tackle it or allocate funding to it. It is true that a representative of Jigawa state government said government don’t know much about this issue as dangerous as it is. Not only policy makers but most of the people think malaria kills more than the pneumonia, but data is suggesting otherwise. So you have to accept what the data is saying. If you trust the data from the UNICEF, NATO, from the Global World Health Organisation, you have no option than to believe that this pneumonia is an issue. Nigeria is the first in the whole world to develop the National Pneumonia Control Emergency (NPCE).
What are the challenges?
On our side, I cannot say we have a lot of challenges like you said. What we have presently is not an improved situation anyway, that is why I said we want the government or policy makers to do more than what they are doing today. I told you, I  don’t easily or quickly blame government because they are dealing with a thousand and one other cases.
If you are from the North-west or North-east, the priority of every governor is to provide security. If any money comes in, the security agents request for money and we too go and request money for pneumonia, the money would going to security. So, don’t blame anybody because you don’t known what they are passing through, but all the same, you have to be preserved and you have to be persistent in your request. Don’t always present problem but present solution; that is exactly what we are doing. We are inviting them to come here with us and sit here with us to see the solution and raise awareness.