Background: The first stand-alone sexually transmitted diseases (STDs) clinic developed in Nigeria in 1974 from the Endemic Diseases Clinic of the referral consultants’ Medical Out-Patients’ (MOP) Clinic of the University College Hospital, Ibadan. At that time, a good number of patients seen there included subjects with complications of the STDs, in both males and females. Young people were hardly seen at that clinic then. By the 1980s young people began to be seen there. Because of this, a purely preventative extra-curricular health education programme was started for secondary schools in Ibadan. The need for the programme to be value-based also evolved and all the community values in the locality were included in a values clarification component of the programme.

Progression: Over time, some teachers of the adolescents as well as some of their parents showed interest in the programme and together joined the youth programme as well as developed the expanded programme for the adults, families and leadership audiences. The basis of these expansions were the participants further needs identified along the previous programme as existed. This article is a review of the programme and the in-course researches conducted on it over the 37 year old programme in this June 2023.

Current programme: As of today, a full programme of 46 lecture and seminar-workshop topics has developed as well as subsidiaries thereof, run as individual lecture-seminars or as adolescents, adults, family, or advanced follow-up community leadership programmes. This article is a summary presentation of the development and contents of the programme as well as some of the within-service research products thereof.

Conclusion: It is hoped that the nature and importance of this programme may be appreciated as a complement to the “value-free” ones already well known; for a truly socially healthy, free and mutually respectful world.

Keywords: value-based, human love, sexuality, family life education

The University College Hospital (UCH), Ibadan, was developed in 1957 as the first university medical school teaching hospital in Ibadan, Nigeria, for all the British West African countries of the University of London College Medical School in Ibadan. In 1974, the stand alone Special Treatment Clinic (STC) was developed from the referral consultants’ Endemic Diseases Clinic of the Medical Out-patients’ Clinic of the hospital, as was becoming the pattern around the world then. At that time, virtually all the clients seen at the clinic were adults, mostly young and middle aged; and a sizeable proportion of these were people with the chronic complications of the STDs. These ranged from penile amputation from Chancroid, to urethral strictures and watering can perineum in the males; to vesico-vaginal and recto-vaginal fistulae,¹ and pelvic inflammatory diseases in the females. Infertility secondary to STD in both males and female clients were also seen. The clinic was jointly run by specialists in medical microbiology, obstetrics and gynaecology, as well as the original preventive and social medicine (as the modern community medicine department that ran the Endemic Diseases Clinic was called then).

However, by the 1980s, young people began to be seen at the clinic also, including secondary school students. As the counselling services in the clinic were not particularly adequate at that time, some of the community medicine staff decided to start an entirely preventative educational service programme for the Ibadan secondary schools, right in their very schools in this regard, in 1986. As the initial knowledge gaps, confusions or problems that the youths seemed to be having in this regard, as experienced from the UCH STC centred around three issues, the first one-day-only programme for this extra-curricular voluntary participatory Saturday programme started with a 3-lecture and seminar (questions and answers) exercise. These three subjects of need were: first, on the nature, problems and promise of adolescence and the need and possibility to get the best out of it, irrespective of one’s original family background. The others were on the nature and functions of human love and friendship as the second issue, and on the nature, causation, complications and management (including prevention) of the sexually transmitted diseases as the third. The questions and answers segment of that first activity resulted in the splitting of the 3 original topics to a total of 6 that constituted the programme of the next year in another secondary school in another socio-economic geographical area of Ibadan. By the time that we ran the 4^th annual programme in 1989, the Ibadan Adolescent Youth Congress programme had developed into a 15 lecture programme over a 3 consecutive Saturday period, with 5 short lectures and a seminar for each day. All these further topics were based on the further areas for more knowledge from the adolescent participants from the exercise as arose from the question and answer segments of these days’ seminars.

The realization that knowledge by itself does not necessarily lead to the good applications thereof; and depended on the value bases upon which the subject applies the knowledge, persuaded us to invite the various leaders in the locally prevalent value systems to attend the programmes to give the opening and brief key-note address at each of the programmes. The youths were encouraged to personally clarify and own the value basis from which they decide to apply the simple biological and pscho-social knowledge shared in the programme as these value leaders are required to emphasize, with the liberty to explain some of their own on a free value (but obviously not value-free or value-less) basis. The free, varied but value-rich basis for human behaviours that were covered in this educational service programme include the Secular Humanist one that is already creeping into the Nigerian societies as the participants may more fully explore by themselves in their very own documents.² The rest of the other values covered include the Traditional African values, the Christian (Catholic, Protestant and Pentecostal) as well as the Islamic (local Sunni, Shiite and Ahmadiyya) values. This review article aims to share this programme and the in-course researches conducted therein over these 37 years for international awareness as well as possible collaboration by any interested persons, institutions and associations.

Progression

By 1992 some parents and teachers who had become aware of this programme showed much interest in expanding the programme for adults as well as parents, teachers and others who may be interested in it. Thereafter, 15 more topics were added to the adolescent programme from the identified further subject areas by these parents and teachers; and began to be held for various communities of adults as they may request it – army barrack communities and various other faith communities. Some religious leadership groups also requested for this Ibadan Adult Programme on Family Life Education and Services; and beyond the basic 30 lecture programme, and the further 10 lecture-seminar topics were added for this follow up programme. This adolescent 15 lecture-seminar (A to C) programme as well as the full 30 lecture-seminar workshop for adults or entire parents, teachers and whole family educational service programme (A to F) are shown in Table 1 below then evolved based on this progression. The Table 2 shows the follow up programme especially for religious leadership formation houses where the entire programme of the Adult Family Life Education and Services has been provided since 1993.

Some details of the Ibadan adolescent youth congress topic and programmes

It is neither possible to go through the entire 15 lecture-seminar, A to C sections, of this programme that constitute the adolescent youth programme, nor the entire 30, sections A to F, that constitute the basic adult programme. It will also not be possible to overview the 10 further lecture-seminars of the follow-up adult leadership programme. However, it is easy to see the comprehensive nature of the programme and their covering all that any normal person may know and be able to provide for himself in relation with all healthy living in relation with family life until a natural death; especially in the present modern age of primary health care and health for all. The questions and answers and the further need to add such subjects as entirely different topic, to assign as separate topic, during the seminar question and answer segment of the seminars resulted in the development of all the new topics until this comprehensive programme was arrived at. Some of the researches done in the furtherance of the topics covered here resulted in the further articles indicated below;^3–6 while some of the textbooks or monograph developed for the clients or in relation thereof are shown similarly shown below also^7-10; and the programme of continuing to produce such further books and booklets is part of this Ibadan programme of human love, sexuality and family life education and services.

The summary of the lecture-seminar A1. The Ibadan Adolescent Youth Congress programme on the nature of adolescence alone will be provided here; namely on the physical developmental milestones of adolescence. This is to be as the only example of how the rest of the programme goes; as the report of all of them will not be reasonable for a journal article as intended herein:

Adolescence is the period of rapid human growth and development between late childhood and the attainment of all the basic essences of adulthood – physically, sexually, emotionally, intellectually, morally, socially, spiritually, economically and legally. The first trimester thereof, usually referred to as pubescence, is marked by the rapid growth sport, the appearance of hair on the pubes (pubarche) and all the other physical growths and developments until the first seminal emission in males or menstruation in the girls. Emotional, social, spiritual and moral maturation largely takes place during the second trimester, while economic and legal maturation and attainment occurs largely in the third trimester. During this interval, the young person naturally answers the FOUR fundamental questions of the adult human life, mainly: i. Who am I? (viz, gender, parentage, family of birth and/or orientation, race, societal class and valuation of self, etc.); ii. What shall I live for? (viz, my values, spirituality, religion, friends, etc.); iii. What work or profession will I have in order to be able to maintain my adult life independent of my family of birth as it must be? (viz, trade, profession, occupation, career, etc.); and finally, iv. With whom shall I live my life in the essential family of procreation in order to fulfil the purposes and values which I have created for myself? (viz, marriage – ordinary or vocational - the single life or the consecrated/covenantal community life). Every one of these developmental milestones in the human growth and development has challenges which in the stable and healthy family life may progress without any problem. However, otherwise, these may pose serious problems for the adolescent. However, nature endows the adolescent with so much energy, idealism and inquisition that will enable them to be able to pass through this stage in life well, even if they lack such balanced and healthy family. They may do so by finding a healthy surrogate family of their self-chosen values to do so healthily.

The physical development issues start with the rapid physical growth spurt. The other physical developments in their relative sequences and order will be the appearance of hair on the pubes (the pubarche) at first and then on the jaw (face and chest in the males), thickening of the breasts’ areola (differentially in both males and females) and of the entire breasts in the women, and growth of the muscles relatively more in the males. The others are the maturation of the sebaceous (fat/skin oil) glands of the skin and its smoothening of the skin especially of the girls (with possibility of developing pimples), growth of the hip bones in the girls, with the differential greater deposition of fat around the females’ hip areas to change the shape and contours of the girls unto lady-like ones. The maturation of the primary and secondary sex organs of penis, womb, vagina, girls’ breasts, testes and ovaries to their adult sizes and functions; including the deepening or “breaking” of the voice of the male adolescents. By this time the ovaries and testes have learnt to produce the female eggs or ova and the testes the spermatozoa or male seeds which with the prostate organ secretions and those of the seminal vesicles are released to the ejaculatory duct in the males. From these events, the terminally pubescent adolescent males may experience their first seminal emission (or ejaculation, usually in so-called wet dreams in the night); and the girls, their first menses (menarche) to technically mark the end of the pubarche. The hormonal levels (testosterone in males and oestrogen and progesterone in females) would have attained adult levels now, with all the capabilities to stimulate the heterosexual attractions as part of their natural functions.⁶ All these milestones may cause undue problems in adolescents who subject themselves to gossips and inappropriate sources of guidance or assistance with their adolescent growth and development.

Some details of the second part (sections D to F) of the basic adult family life education programme

The second half of the full 30-lecture basic family life education that constitute the Association for Family Life Education and Services programme has the 15 topics after the original 15 topics of the Adolescent Youth Congress Programme of Sections A to C. Within the adult programme the very essential issues of adolescence with which unprepared parents may get into trouble with external interferences with the healthy growth and development of these adolescents are treated and then continues with giving an entire overview of the entire human life from conception to a natural death in the first topic of the Section D1. Its purpose is to be able to prepare such adults for the full and proper understanding and care of the human life as an informed and well educated persons – whether of themselves, their own children or of their very own parents as these get older. The emphasis is, of course, on their self-care and then of their own children’s proper parenting. It covers the modern understanding of the conception of the human person, to the uterine implantation and the rest of pregnancy within which later stages the child’s sensation of filial love of the parents (especially of their mothers) are becoming better understood. Then early infancy and childhood of the stepwise growth in Filia, Platony and Agape up to the age of reason and commencement of the formal elementary school education. Then comes the primary school age, the adolescence, early adult life, middle age (with their middle age and executive stresses), then peri-menopause, old age and its associated retirement from formal work, possible senility, dying and death. The privileges and functions as well as the principal physical and psycho-social and health challenges of these periods are explored. Their self- and other caring services are examined – including all the preventive health behaviours that are important to note.

The values clarification and respecting aspects of the programme

As is normally accessible to all human persons by mere common sense properly applied, all human thinking and living are value-based; and no human knowledge by itself is useful except from the point of view of the value-base from where it is used. Knowledge does not produce any good behaviour except from the positive value basis within which it is lived out. In the situation of the modern world’s so very many value basis and their apparently growing failure to promote harmony between all of these it has become rather obvious that for the true health and happiness of the entire universe, all these prevailing values should now become unravelled and taught in a free value atmosphere of mutual love and respect. None of these value basis, theistic or atheistic, may be allowed to be masquerading itself in the modern world, nor allowed to be attempting to undermine or to supress any of the others. Such attempts are not only humanly impossible to any properly thinking person nor are they reasonable or healthy to do. Authentic values clarifications would be based on learning of all the value basis in the world where one lives and evaluating them with one’s own; and so, thereafter, coming to a moral decision on how to act towards such people. Any value system, culture, ideology or religion that believes that it is the only one that everybody must accept and live by in ANY country or place is obviously the culture, value system, ideology or religion that must be seen as one to be collegially proscribe in ANY human society; as it will most easily be seen that it is not a natural situation of man to be. Such a culture or notion will be prone to community chaos in the place. All these value basis or religions must be charged with learning the spirit of self-identification and self-ownership in all its dimensions and manifestations as well as their responsibility for mutual respect and ecumenism with all the other value systems in the world.

As is accessible to the knowledge of every human person and especially a biological scientist, since the beginning of the pursuit of human knowledge, all living things are assigned some Latin-based identification nomenclature. These names are usually two, such as to indicate the phylum as well as the species respectively of such a living thing and so, to completely identify all living things, one from each other. Their genetic and other more molecular research all eventually indicated the same without fail! Only the human person was given the name of Homo sapiens - for his phylum as Homo and sapiens for his species. The meaning of sapiens indicated that the human person as the only living thing that lives (or should live) principally by reasoning, by wisdom; and not mainly or exclusively by instincts as all other living things (plants and animals) do. The most important aspect of man’s reasoning for the actions that he ought to take following the various instincts come from experiences of the past and the usual products they yield. These experiences gathered in human populations lead to the cultural norms of the different human societies all over the world. Apart from the human instincts as biological stimulus that brought the possible human needs of such instincts to the human consciousness, thinking thereafter, analysis or reasoning and wisdom in order to determine what actions to take about such feelings or instincts are brought to bear on the decision making thereof by any normal human person or communities as Homo sapiens.

In addition, the past human experiences of the result of actions taken in such regards and the results thereof (good or bad) assist in such decision making. The articulated metaphysical understandings of the persons or the established societal metaphysical norms in those regards are also brought to bear in deciding the actions to take thereof. It is these accumulation of past human experience(s) and metaphysical realities that produce the individual or community values (to pursue the good, safety and reasonable self-preservation) that people have, as such individuals and communities. No proper human actions happen except within these value constructs. It is such values that make a person to do even difficult things with all happiness and joy. The same will make them not do anything even under the threat of death. Values are therefore the most important factors in ANY human life, actions and entire existence, for the health, happiness and THE COMMON GOOD of the individual and the society that he lives in. It is therefore self-evident to us as we progressed in developing and giving these services discussed here that no human education or services may be given outside the value constructs of the individuals concerned or their communities. These communities may possibly be largely vertical in some multicultural communities or largely horizontal in the less metropolitan communities.

Hence, when the apparent epidemiology of the STDs began to change in Ibadan, in this area of a disease of human behaviour so laden with personal and community values, it was obvious to us that the fundamentally scientifically based biological education on the STDs and on adolescence should be given within the prevailing community values in the locality as well as their authentic, non-manipulative values clarification for each individual participant. This article discusses this programme and the intra-service researches thereof that has been carried out over the last 37 years. It is being produced here in June 2023 to be published internationally so that people may become more aware of it beyond Ibadan and Nigeria. In that way, any individuals, organizations and institutions interested thereof may be able to partner with us in its better understanding further research and community services.

The rising pandemic of STDs, old and new, would seem to us to be as a result of the spreading of sex or rather eroticism revolution without a healthy human value base within which to apply it as basic common sense would make every human person to appreciate. As is also all well known in the common adage that knowledge does not necessarily produce good action or wisdom or the healthy applications thereof. However, the conclusive facts of such universal intuition needs to be researched by modern solid social epidemiological methodologies. While the results of those further aetiological studies are awaited or being pursued, the various aspects of the pandemic identified in Ibadan in the early and mid-1980s that resulted in the onset of the services of the Ibadan Adolescent Youth Congress (AYCON) programme and the subsequent Association for Family Life Education and Services (AFFLES) must continue to provide the easily understandable healthy approach to solving the many problems that they are already causing in our communities here. The process of further educational individual and community needs identification in these regards from the people, freely, and of meeting them from already existing knowledge and especially of promoting valid human values of mutual love, health, mutual respect and ecumenism can neither wait nor be undermined in any ways. It is our expectation that other people may learn of these services and the results of the intra-service researches that go along with it enough as to apply the same to their own local settings or to seek collaboration with us in those regards.

None.

The author declares there is no conflict of interest.

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