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Lower Income Surgery patients may die 3x faster – Research

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  • US, EU frustrating efforts to repatriate stolen fund

A new research has shown that patients undergoing emergency surgery in lower income countries have a three times greater chance of dying than in higher income countries.

The study, published in the British Journal of Surgery, monitored post-surgery death rates and mapped them against the Human Development Index (HDI) of each country.

10,745 patients were monitored up to 30 days after undergoing emergency abdominal surgery, at hospitals in 58 participating countries.

The study showed that death rates were three times higher in low income countries than in high income countries, even after adjustment for prognostic factors such as fitness for surgery, diabetes history and smoking status.

The team behind the research, from the Universities of Birmingham, Edinburgh and Sheffield, believe that the study demonstrates a need to improve patient safety in low income countries, and revisit the use of the surgical safety checklists – the standard global marker of hospital safety.

Dr Aneel Bhangu, from the University of Birmingham, explained: “The association between increasingly mortality and lower income countries might be explained by differences in prognosis, in treatment, or maybe both. What we can say is that our study highlights the significant disparity between countries, and an urgent need to address it.”

It is believed that less than a third of the world’s population have access to safe, timely and affordable surgery. Only 6% of the 300 million surgical procedures performed each year take place in low or middle income countries, despite a third of the world’s population living there.

Surgical death rates are routinely collected in high income countries, such as the United Kingdom and United States, but there is little to no surveillance in as many as 70% of low and middle income countries.

Mr Ewen Harrison, from the University of Edinburgh, described the importance of collecting this data in order to understand what influences surgical outcomes: “Improving surgical access and safety can only be achieved if we really understand what influences surgical outcomes on a global scale.”

The team behind the research have developed a novel model of data collection, forming an international collaboration of doctors known as ‘GlobalSurg’.

This network was created largely using social media, and data capture during the study was improved by use of a novel platform accessible from mobile internet devices.

Dr Edward Fitzgerald, from the GlobalSurg committee, added: “By creating an international network of surgeons it has been possible to collect data on real patients, at the bedside. To measure surgical outcomes we reversed the traditional research model and recruited study collaborators via social media and other avenues. This established a data-sharing platform that is accessible from smartphones.”

The team also analysed the types of surgery being conducted. Regardless of income setting, the most commonly performed emergency abdominal operation was removal of appendix.

The GlobalSurg team hopes that their ongoing research will build on the findings and look to identify targets to help improve the safety of operations for surgical patients around the world.

The Birmingham University it must be noted, is ranked amongst the world’s top 100 institutions. Its work brings people from across the world to Birmingham, including researchers and teachers and more than 5,000 international students from over 150 countries.

In the meantime, President Muhammadu Buhari yesterday expressed frustration over the inability of Nigeria to repatriate stolen funds stashed abroad by corrupt politicians and government officials.The President specifically urged the United Nations Office for Drugs and Crime, UNODC, to facilitate faster recovery of the money. Buhari spoke when he received Executive Secretary of UNODC, Mr. Yury Fedotov at the Presidential Villa. According to a statement issued by his Senior Special Assistant on Media and Publicity, Mallam Garba Shehu, Buhari said the process of recovering the stolen assets had “become tedious” to the consternation of many Nigerians.

“We are looking for more cooperation from the European Union, United States, other countries and international institutions to recover the nation’s stolen assets, particularly proceeds from the stolen crude oil. “It is taking very long and Nigerians are becoming impatient,” the President said. Buhari told Mr. Fedotov that his government had worked very hard in the past 11 months to reverse the negative global perception of Nigeria on corruption.

“Our genuine efforts to deal with corruption and drugs have earned us international respect and this has encouraged us to do more. “We know that by fighting the scourge of drugs and corruption and rebuilding trustworthiness, integrity, good business practices, and imposing discipline on youths to avoid drugs, we are not doing a favour to the international community, we are doing a favour to ourselves,” he added.

Buhari also promised that his administration would work with the UN agency to rehabilitate young Nigerians, who have been misled into consumption of illicit drugs and drug trafficking. In his remarks, Fedotov told the President that UNODC has chosen Nigerian as a pilot country for support and strategic cooperation in the fight against drugs and corruption.

Additional report from National Mirror

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WAIVER CESSATION: Igbokwe urges NIMASA to evolve stronger collaboration with Ships owners

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…Stresses the need for timely disbursement of N44.6billion CVFF***

Highly revered Nigerian Maritime Lawyer, and Senior Advocate of Nigeria (SAN), Mike Igbokwe has urged the Nigeria Maritime Administration and safety Agency (NIMASA) to partner with ship owners and relevant association in the industry to evolving a more vibrant merchant shipping and cabotage trade regime.

Igbokwe gave the counsel during his paper presentation at the just concluded two-day stakeholders’ meeting on Cabotage waiver restrictions, organized by NIMASA.

“NIMASA and shipowners should develop merchant shipping including cabotage trade. A good start is to partner with the relevant associations in this field, such as the Nigeria Indigenous Shipowners Association (NISA), Shipowners Association of Nigeria (SOAN), Oil Trade Group & Maritime Trade Group of the Nigerian Association of Chambers of Commerce, Industry, Mines and Agriculture (NACCIMA).

“A cursory look at their vision, mission and objectives, show that they are willing to improve the maritime sector, not just for their members but for stakeholders in the maritime economy and the country”.

Adding that it is of utmost importance for NIMASA to have a through briefing and regular consultation with ships owners, in other to have insight on the challenges facing the ship owners.

“It is of utmost importance for NIMASA to have a thorough briefing and regular consultations with shipowners, to receive insight on the challenges they face, and how the Agency can assist in solving them and encouraging them to invest and participate in the maritime sector, for its development. 

“NIMASA should see them as partners in progress because, if they do not invest in buying ships and registering them in Nigeria, there would be no Nigerian-owned ships in its Register and NIMASA would be unable to discharge its main objective.

The Maritime lawyer also urged NIMASA  to disburse the Cabotage Vessel Financing Fund (CVFF)that currently stands at about N44.6 billion.

“Lest it be forgotten, what is on the lips of almost every shipowner, is the need to disburse the Cabotage Vessel Financing Fund (the CVFF’), which was established by the Coastal and Inland Shipping Act, 2003. It was established to promote the development of indigenous ship acquisition capacity, by providing financial assistance to Nigerian citizens and shipping companies wholly owned by Nigerian operating in the domestic coastal shipping, to purchase and maintain vessels and build shipping capacity. 

“Research shows that this fund has grown to about N44.6billion; and that due to its non-disbursement, financial institutions have repossessed some vessels, resulting in a 43% reduction of the number of operational indigenous shipping companies in Nigeria, in the past few years. 

“Without beating around the bush, to promote indigenous maritime development, prompt action must be taken by NIMASA to commence the disbursement of this Fund to qualified shipowners pursuant to the extant Cabotage Vessel Financing Fund (“CVFF”) Regulations.

Mike Igbokwe (SAN)

“Indeed, as part of its statutory functions, NIMASA is to enforce and administer the provisions of the Cabotage Act 2003 and develop and implement policies and programmes which will facilitate the growth of local capacity in ownership, manning and construction of ships and other maritime infrastructure. Disbursing the CVFF is one of the ways NIMASA can fulfill this mandate.

“To assist in this task, there must be collaboration between NIMASA, financial institutions, the Minister of Transportation, as contained in the CVFF Regulations that are yet to be implemented”, the legal guru highlighted further. 

He urged the agency to create the right environment for its stakeholders to build on and engender the needed capacities to fill the gaps; and ensure that steps are being taken to solve the challenges being faced by stakeholders.

“Lastly, which is the main reason why we are all here, cessation of ministerial waivers on some cabotage requirements, which I believe is worth applause in favour of NIMASA. 

“This is because it appears that the readiness to obtain/grant waivers had made some of the vessels and their owners engaged in cabotage trade, to become complacent and indifferent in quickly ensuring that they updated their capacities, so as not to require the waivers. 

“The cessation of waivers is a way of forcing the relevant stakeholders of the maritime sector, to find workable solutions within, for maritime development and fill the gaps in the local capacities in 100% Nigerian crewing, ship ownership, and ship building, that had necessitated the existence of the waivers since about 15 years ago, when the Cabotage Act came into being. 

“However, NIMASA must ensure that the right environment is provided for its stakeholders to build and possess the needed capacities to fill the gaps; and ensure that steps are being taken to solve the challenges being faced by stakeholders. Or better still, that they are solved within the next 5 years of its intention to stop granting waivers”, he further explained. 

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Breaking News: The Funeral Rites of Matriarch C. Ogbeifun is Live

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The Burial Ceremony of Engr. Greg Ogbeifun’s mother is live. Watch on the website: www.maritimefirstnewspaper.com and on Youtube: Maritimefirst Newspaper.

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Wind Farm Vessel Collision Leaves 15 Injured

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…As Valles Steamship Orders 112,000 dwt Tanker from South Korea***

A wind farm supply vessel and a cargo ship collided in the Baltic Sea on Tuesday leaving 15 injured.

The Cyprus-flagged 80-meter general cargo ship Raba collided with Denmark-flagged 31-meter wind farm supply vessel World Bora near Rügen Island, about three nautical miles off the coast of Hamburg. 

Many of those injured were service engineers on the wind farm vessel, and 10 were seriously hurt. 

They were headed to Iberdrola’s 350MW Wikinger wind farm. Nine of the people on board the World Bora were employees of Siemens Gamesa, two were employees of Iberdrola and four were crew.

The cause of the incident is not yet known, and no pollution has been reported.

After the collision, the two ships were able to proceed to Rügen under their own power, and the injured were then taken to hospital. 

Lifeboat crews from the German Maritime Search and Rescue Service tended to them prior to their transport to hospital via ambulance and helicopter.

“Iberdrola wishes to thank the rescue services for their diligence and professionalism,” the company said in a statement.

In the meantime, the Hong Kong-based shipowner Valles Steamship has ordered a new 112,000 dwt crude oil tanker from South Korea’s Sumitomo Heavy Industries Marine & Engineering.

Sumitomo is to deliver the Aframax to Valles Steamship by the end of 2020, according to data provided by Asiasis.

The newbuild Aframax will join seven other Aframaxes in Valles Steamship’s fleet. Other ships operated by the company include Panamax bulkers and medium and long range product tankers.

The company’s most-recently delivered unit is the 114,426 dwt Aframax tanker Seagalaxy. The naming and delivery of the tanker took place in February 2019, at Namura Shipbuilding’s yard in Japan.

Maritime Executive with additional report from World Maritime News

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