Passionate Nigerian Nurses, Giant Snails and Scottish Butterflies

I spent last week in Lagos, Nigeria. Despite the noise, mega traffic congestion, possible risk of kidnap, humid heat, the high price of a glass of wine, and malaria, it was an absolutely fantastic experience  I was part of a trip organised by the University in response to an invitation to attend the West Africa Student Nurse Association (WASNA) Conference.  And it was the students, who came from all over West Africa, that made my time there fantastic. I have never seen so much passion and enthusiasm for taking the profession of nursing forward. The delegates literally all ensured they had a voice as did the more politically minded and experienced members of the WANSA Executive Committee.

At the end of the first afternoon of the conference we met with the Executive – average age 25 years old. They were full of energy, angst, and determination to bring about change. They were frustrated about the lack of opportunity there is for developing the nursing profession in Nigeria, a lack of opportunity that came from poor investment in health care and universities. Indeed, academic staff had been on strike for some 2 months. They were seeking more money to be spent on salaries and infrastructure. On the very last day there seemed to be a breakthrough and more investment was promised to ‘rejuvenate’ the University system.

Nigeria has Africa’s 2nd largest economy, but has long relied upon oil revenues as a source of foreign reserves. The World Bank has estimated that as a result of corruption, 80% of the energy revenues benefit only 1% of the population.   Nigeria is the most populous country in the African continent. But despite thier oil wealth, 45% of Nigeria’s population live in poverty and 70% of the population lives on less than £0.65 a day, and 43% have no access to clean water. The extent of the poverty was plainly evident everywhere I went. 

So the students and their lecturers, the doctors and nurses I met really did have something to fight for. Amidst papers on politics and nursing power, global employability, I was privileged to be asked to present some work I had done on nurse leadership as a key note paper. It was a very different experience to those I have enjoyed before. The audience were very respectful, but also very interactive. I am now known as Professor Tony. There were some 300 students in the auditorium, all of whom wanted to know how they could change nursing practice, education and research for the better.

In the session I talked about the power of social media, to both capture the nursing voice and as very powerful tool to making sure this voice was heard internationally. As a School we can help. One of the great things about our School is the number of people who are far more adept and expert in using Twitter and Facebook than I am, they will ensure that West African nurses are fully part of or international community of practice. But there are other ways we can help.  Maybe we could persuade the organising committee of the NET/NEP international nursing conference to think about how to get some of these West African nurses to the conference in the Netherlands next year! As a School we might choose to sponsor places rather than conference bags. 

Nursing and Midwifery colleagues, I will be asking you to clear out some of those text books you have  on your shelves, books that you may not have opened in years. We can send them and fill the empty library shelves in the University of Lagos School of Nursing. Like our library, the University of Lagos is moving to buying e-books, but whilst many of the students have smart phones, very few had tablets or e-readers. And the electricity and internet supplies can and disappear on very regular basis. Among many other things our students perhaps take for granted within the School, they need books on their shelves!

I was also able to meet with the Dean of Medicine and Health and the University Provost both of whom want to take discussions forward to consider taught postgraduate programmes, doctoral studies and research collaborations. I think that the fact I was able to meet these people was due in part to the clear power of the student voice. So apart from the daily dices with death on the roads, giant snails and gizzards on the menu, being mobbed by crowds of young ladies wanting photos of themselves standing next to Professor Tony, and the constant touching of my hair by male and female admirers, it felt like a very successful trip. 

It also felt like a great start to what I hope will become a long term relationship. 3 hours after landing at Manchester Airport I was up in my home in Scotland. One of the first things I saw was this butterfly on my neighbours garden wall. It made me think of the wonderful people I had met in Nigeria, people full of vibrant colour, boundless energy and graceful movement, but who, like the butterfly, were vulnerable too. 

Zombie Hoover Attacks Professor, Agile Working and Freud’s Couch

I'm looking forward to whizzing across to Leeds later today to see my twin grandson and granddaughter. Leeds City (population 757,700) is the 3rd largest city in the UK. The twins were born there just 12 weeks ago adding 2 to the population of urban Leeds (474,632). Their births also contributed to the continued rise in births in the UK that has occurred since 1972. The Office of National Statistics (ONS) hasn't yet published the birth-rate for 2013, but they have for 2011-12. They report that the UK population grew by 419,900 to 63.7m over this period. There were also 254,000 more births than deaths over the year.

People do appear to be living longer; there are 26% more men now aged over 75 in the UK than there were in 2001, the increase for women was only 6%, which appears to be down to male jobs becoming less physical and safer, men choosing to give up smoking and advances in treatments for circulatory illness. Personally I also think it has something to do with men not getting to use the hoover so often. Last week I had an  encounter with a hoover that can only be described as vicious and sustained. It was an attack of the Zombie Hoover. That I survived the encounter is, I think, down to a superb physique and finely honed reflexes.

I won’t mention the name of the hoover's manufacturer, but Jim boy has a lot to answer for in my book. It took me ages to work out how to get the thing to stop standing upright, to turn it on and getting the hose, and hose attachments out was difficult, but more so getting them back in. Billy my parrot shrieked with amusement and anxiety as I wrestled with various bits of equipment in trying to clean his cage. And in a  last minute attempt to win the battle, the container that holds the dirt and dust and so on leapt from the hoover's main body and landed on my bare toes – lightening reflexes couldn't save me, I simply was not agile enough to escape injury.

And agility was in the NHS news last week. It appears that across the land, agile working practices are being adopted to make our doctors and nurses more efficient in the way they work and improve the quality of patient care. For the uninformed, agile working is different from flexible working, something most NHS HR Departments have dreamt up in an attempt to emulate a Tescoesque approach to employment. In other contexts, agile working approaches explore how to maximise individual performance and productivity by changing the overall working practices. Staff are given more choices as to where and when they undertake their roles, whether this be at a central location, a community site, at home, or hot-desking.

This approach does rely upon technological support that allows access to information and support programmes anywhere. In a NHS context this might relate to providing access to clinical / patient data on smart phones, tablets and so on, anywhere and at any time. There are some obvious problems with this approach around confidentiality and data security, but these are probably surmountable. More importantly, will be the task of resolving the people issues as the work / home divide risks becoming even more blurred.

Freud may have the answer. I got word last week that his iconic couch is finally to receive some TLC in the form of a 2 week restoration project. The work will be carried out at number 20 Maresfield Gardens, Freud’s home in London during the last years of his life. The conservation work will start in  early September, and will be undertaken by one Poppy Singer. She will do the work in public (well Freud's old dinning room) and anyone can go and watch. Once complete the couch will be fully restored to its original fine condition. It will be once again a place to contemplate, and we all need a place to sit down and ponder the world, and perhaps, we all need to think about becoming less agile! 

The Naked Food Anthropologist Rediscovers a Clockwork Orange

Occasionally when writing this blog I have worried about the number of observations I make about food. When thinking about this week's post, I couldn't help but notice the number of food story's there were last week. So when thinking about once again writing about food I found myself experiencing little spikes of anxiety, and thought I had better check out the legitimacy of such story telling. I needn't have worried. The International Commission on the Anthropology of Food and Nutrition (ICAF) have it covered.

The ICAF co-ordinates the work of anthropologists interested in applied research into food. Biological and social anthropologists are interested in the way food supplies may be affected by changes in energy systems, market structures, public policies, family composition (particularly women's roles) and technological change. My academic colleagues in Finland had long ago made me an honorary anthropologist so despite my ICAF membership needing renewing, I felt happier about sorting out this week's post.

I doubt anyone could have missed the so called £250k ‘Frankenburger’ story - an artificial beef burger, made from 1000s of cow stem cells in a laboratory. The new food product is called ‘in vitro meat’. I first heard the news on Farming Today as I travelled into work. As one might imagine the farmers interviewed were less than enamoured by the news. However, in the interests of fairness, shifting meat production from farms to laboratories would help cut down on the billions of tonnes of greenhouse gases released by livestock and of course requires 99% less land than beef farming. The World Health Organisation predicts that meat consumption will double by 2050.  I'm glad I'm a vegetarian. 

Last week included Black Wednesday, so called because it’s the first Wednesday in August that the majority of UK doctors in training change their clinical posts. International evidence shows a 6% increase in mortality over the Wednesday and the next few days. Anyway, last Wednesday there was a bit of good news from researchers at Harvard Medical School who advised that drinking 2 cups of hot chocolate a day will help improve blood flow, which has been linked to healthier brains, improved cognition and memory.

Those of you who read my comments in last week's blog about coffee will also be pleased to hear of the research undertaken by researchers at the Tel Aviv University who reported last week that eating a larger breakfast can help you lose weight. Arguing that it's not just what you eat but when you eat that makes the difference. The researchers, who gave women most of their calories either at breakfast or dinner, found that those on the breakfast plan lost an average of 19lbs and 3.3 inches from their waistlines over the trial, compared to only 7lbs and 1.5 inches for those on the dinner diet.

So there was a lot to contemplate as I finally got home on Friday. The something to look forward to over a large glass of red was the BBC Proms. On Friday evening the concert music featured was Beethoven's 5^th. Not only is this a fabulous soul stirring piece of music, but along with Beethoven’s 9^th symphony, it featured in the film soundtrack for ‘A Clockwork Orange’. Against claims that the film incited violence and rape, it was withdrawn from public release by Stanley Kubrick, the film’s Producer and Director in 1973. For 27 years it was extremely difficult to see the film in the UK. It was only after Kubrick’s death in 1999 that the film re-appeared in cinemas and was reproduced as a DVD. I first saw the film in 1972, and then again in 2000, on DVD. Hearing the music on Friday took me back all those years to a very different place and sense of the importance of being able to defend the exercising of free will in a culturally very different society. But I never did drink 'milk plus'!

Caffeine, Cannabis and Jane Austen’s Caroline

I usually get to my desk at about 06.00 every morning. In order, I switch on my lap-top, turn on the shared photocopy/printer, and make a cup of coffee. Possibly before other people begin to arrive I will have made and drunk another cup of coffee. For the rest of the day I tend to drink fruit teas, ginger and lemon being my favourite.  In the evening I go back to coffee, possibly drinking 2 or 3 cups before going off to bed. All of which, perhaps explains my growing midriff.  

According to a paper published last week in the Journal of Agricultural and Food Chemistry, research carried out by Australian and Malaysian academics, reported that 5 cups of coffee a day could cause obesity. However, the study involved mice and not people, and the chemicals found in coffee, not coffee itself. Their assertion appeared to the consequence of a little over enthusiastic discussion of the potential implications of the research. Still a medium latte with whole milk weighs in at 290 calories, more than 10% of the daily recommended calorie intake. It is also true that drinking 5 or more cups of caffeinated coffee a day can lead to symptoms such as irritability and insomnia.

Whilst coffee might be the ‘drug’ of choice for many people, so it seems is cannabis. 2m people in the UK smoke cannabis, and 50% of all 16 – 29 year olds have tried it at least once. There are about 400 different chemical compounds in the average cannabis plant. When cannabis is smoked, it is these compounds that rapidly enter the bloodstream and are transported directly to the brain, particularly to the brains receptors that influence pleasure, memory, thought, concentration and time perception. The National Institute of Drug Abuse in the US has ranked the relative addictiveness of 6 substances (cannabis, caffeine, cocaine, alcohol, heroin and nicotine). Cannabis was ranked the least additive, closely followed by caffeine, and nicotine the most addictive. The United Nations claims that cannabis is the most used illicit drug in the world.

Regular use of the drug appears to double the risk of a psychotic episode and or long-term schizophrenia and depression. Long term studies from Australia, on school children aged 14 – 15 years have found that adolescents who used cannabis daily were 5 times more likely to develop depression and anxiety in later life, and they started smoking before the age of 15, they were 4 times more likely to develop a psychotic disorder by the time they were 26 years old.

Interesting then that last week Uruguay took another step closer to legalizing the sale and use of cannabis. The illegal cannabis market is estimated to be about £48m a year. It is this money that feeds widespread organised drug trafficking crime, and a 7% rise in murders in the last 12 months. Whilst 63% of the population is opposed to the proposed changes, Uruguay is no stranger to early adoption of sometimes controversial new legislation. In 1913 it became the first country in the region to grant divorces to women who requested them. In the UK, up until 1923, women had to prove that their husband had committed adultery and also his cruelty, incest or rape!

Women, murder, rape and money were also in the news for other reasons last week. Caroline Criado-Perez received rape and death threats from Twitter users after she successfully campaigned for a woman’s picture to be used on the new £10 note when it is introduced in 2017. She organised an on-line campaign to persuade the Bank of England to use a picture of Jane Austen on the new note. However, according to the Guardian newspaper last week, she may need to continue the campaign to make sure the quote to be used is a little less ironic. The quote is from Pride and Prejudice; ‘I declare after all there is no enjoyment like reading!’. Unfortunately this quote is uttered by Caroline Bingley as she tries to impress Mr Darcy. She has been described as one of Jane Austen’s most deceitful characters who had no interest in books at all. It’s not known if she had any interest in coffee or cannabis.