|Year : 2019 | Volume
| Issue : 1 | Page : 1-2
Audacity and perseverance under prodigious adversities
Dr. Joe Nwiloh Heart Center, St. Joseph's Hospital, Adazi Nnukwu, Anambra State, Nigeria
|Date of Web Publication||1-Oct-2019|
Dr. Jonathan Nwiloh
Dr. Joe Nwiloh Heart Center, St. Joseph's Hospital, Adazi Nnukwu, Anambra State
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Nwiloh J. Audacity and perseverance under prodigious adversities. Niger J Cardiovasc Thorac Surg 2019;4:1-2
This issue contains the last of a three part series of the awe inspiring story of pioneer African-American surgeons. Their cumulative individual and collective struggles laid the foundation that ultimately dismantled the entrenched racial inequalities, liberating the black physician from professional isolation into the mainstream of American medicine.
The historical struggle which predated the Civil War (1861–1865) starting with the admission of the first blacks to Harvard the 3rd oldest Medical School founded 1782, namely Marin R. Delany in 1849, Daniel Laing Jnr in 1850, and Isaac Humphrey Snowden in 1851. Subsequently, Nathan Francis Mossell undaunted by the prevailing racial bigotry applied and became the first black admitted in 1878 to the University of Pennsylvania the oldest Medical School founded 1765. After the 2nd World War, the exigencies of the time and workforce shortages forced a more open-door policy with integration of the black physician into white establishments. A major milestone occurred in 1945 with admission of blacks into fellowship of the prestigious American College of Surgeons (ACS), a cardinal event and high point for the black physicians in American medicine. Sequel to this epoch-making event was the shattering of the glass ceiling 50 years later and 83 years after the establishment of ACS when Dr. Lasalle L. Leffall, the Charles R. Drew Professor of Surgery at Howard University, made history by being elected the first African-American President of the ACS 1995–1996. Less than a decade later, another giant African-American surgeon Dr. Claude Organ, Jnr appointed in 1971 the 1st black Chairman of Surgery at a predominantly white Medical School Creighton University, Omaha, Nebraska, was elected the 2nd black ACS President 2003–2004. Last but not least Dr. L. D. Britt a medical graduate of Harvard, the 1st African-American to be awarded an endowed Chair in Surgery at a major American Medical School, the Eastern Virginia Medical School in 1994 was elected the 3rd black ACS President 2010–2011. In summary, the profound life lessons learnt from the struggles for integration following emancipation from slavery of these pioneer black surgeons and the generation after, exemplified by the past 3 African American ACS Presidents is a testimony to the adage that “There is no height to which the human spirit cannot rise, the only limitations been the ones we set for ourselves.” They all by their audacity and perseverance under prodigious adversities overcame what initially seemed an impossible mission.
Obstructive sleep apnea (OSA) is often unrecognized and rarely diagnosed in most of Africa. The reasons clearly include the lack of physician knowledge in the relatively young specialty of sleep medicine and the nonexistent diagnostic tools in most of these low resource nations. Kimani  in his excellent review shows a staggering global OSA prevalence in 936 million people, a figure significantly higher than the previously reported 100 million by the WHO in 2017. Shockingly, the estimated prevalence in Africa ranks among the highest with, for example, Algeria (54%), Nigeria (60%), and Mali (65%) in the age group of 30–69 years. To the best of our knowledge, there is only one sleep laboratory (SleepMedix, Lagos) in Nigeria with an estimated population of 200 million. From personal communications and data obtained from SleepMedix Director Dr. Don Ogu, 145 patients were evaluated for OSA in their sleep laboratory over 6 years. 80% were male and 93% were in the age group of 31–70 years. 84% (122/145) were diagnosed with OSA [Table 1]. Patients with moderate-to-severe OSA were treated with continuous positive airway pressure (CPAP) with subsequent significant improvement in symptomatology and other comordities such as hypertension and diabetes mellitus during follow-up. Their patient referrals included neighboring West African countries such as Ghana, Ivory Coast, and Burkina Faso. There are certainly many more patients with unrecognized OSA in the general population, heralding the need to increase physicians and patients' education on OSA and its deleterious systemic effects. Hopefully, the update by Kimani  will aide our readers in recognizing potential OSA patients and initiating referral to sleep laboratories like SleepMedix for evaluation and treatment for patients who can afford it.
| References|| |
Maynard DA, Lee AB, Walker M, Nwiloh J. History of pioneer black surgeons in American medicine conclusion. Niger J Cardiovasc Thorac Surg 2019;1:3.
Kimani A. Obstructive sleep apnea: 2019 update. Niger J Cardiovasc Thorac Surg 2019;4:1. [Full text]