Abortion: Is it a womans right?

By Meluse Kapatamoyo


Last week the Zambian government suspended Marie Stopes International -Zambia from carrying out abortions in Zambia after investigations revealed that the organisation had carried out numerous abortions without following the right procedure and Law.

Religious groups say do not kill and that life begins at conception while others say for Medical Reasons an abortion may be approved by qualified medical personnel and this is within the laws of Zambia. The modernists say it should be left to the woman to decide whether to abort or not.
What do you say?

Zambia suspends Marie Stopes International from conducting abortions

By Meluse Kapatamoyo

Marie Stopes International has been suspended from conducting abortions in Zambia.

Health minister Dr Joseph Kasonde made the announcement in Zambia’s capital Lusaka today, July 25, 2012, after investigations into allegations that the non-governmental organisation was conducting illegal abortions in Muchinga and Northern provinces.

Although, Marie Stopes International Zambia programme manager Nikile Siamwiza Njovu had earlier in the week denied the allegations, Dr Kasonde said the numerous abortions conducted by the organisation were illegal as they were authorised by one doctor instead of three as stipulated by law.

Dr Kasonde emphasised that any abortions should be conducted within the sanctity of the law.  

However, the organisation will continue to provide other services such as cervical cancer screening, family planning and treatment of sexually transmitted diseases.

In its official report, Marie Stopes International disclosed that it had been conducting medical abortions in Mbala, Chama and Nakonde districts.

In January to May 2012, it conducted 430 abortions in Nakonde and 30 in Kasama.

Abortion is legal in Zambia provided it is done within the laid down conditions of the law.

The Termination of Pregnancy Act is the principle legislative Act on the termination of pregnancy. It was enacted in 1972 with amendments in 1994.

Termination of pregnancy can be done under the following circumstances:

(i) Where the pregnancy constitutes a risk to the life of the pregnant woman or where the pregnancy constitutes a risk to the physical or mental health of the pregnant woman.

(ii) Where the pregnancy constitutes a risk to the physical or mental health of any existing children of the pregnant woman, to such extent that the risk is greater than if the pregnancy were terminated.

(iii) In circumstances where the pregnancy constitutes substantial risk so much that the child to be born would suffer from such physical or mental abnormalities as to be seriously handicapped.

In Zambia, Marie Stopes International provides sexual and reproductive healthcare to thousands of Zambia's vulnerable women and, according to their website, in 2011, the organisation prevented 1, 900 unsafe abortions in the country.

Have your say: Family planning is your choice!.

By Meluse Kapatamoyo

“Women must have the power to choose how many and when to have children” stated David Cameron, the British Prime Minister at the recent summit on Family Planning held in London.

Cameron believes that preventing women from making that choice compromises their chance of a better life in the future.

He added that “fewer children increase chances for better healthcare and better education for children…we know this works because smaller families are healthier and wealthier.”

Cameron’s call came with Britain’s pledge to double its budgetary support for family planning to Africa and other poor nations elsewhere.

While Cameron’s statement may sound empowering to most women, there are still growing concerns that side-effects, costs, ease of use, access and communication between couples often hinder the success of family planning methods.

In most African communities, negotiating for sex and the use of any planning methods remains a man’s prerogative. Only he has the final choice on how many children the couple should have. A woman’s role, unfortunately, still remain, to ensure that his wishes are followed.

Although traditionally women undergo initiation ceremonies where they are taught everything from how to look after a man to how to sexually satisfy him in bed once in marriage, they are not given the voice to negotiate for sex or the use of contraceptives.

Kyapa, an ardent follower on my blog added her voice saying "I strongly feel our culture in Zambia has betrayed the women and sentenced them to silence....!! The tradition tells a woman that they should do what the man says always......in the line of sex it in fact teaches the woman to be so submissive ......as in that is their role to please the opposite sex.

I feel we should then direct our sensitization to these women especially in rural areas were once they reach puberty these teachings are embedded in them. Surely and truly may we all women learn."

Meeting the current need for modern contraception would reduce pregnancy-related deaths by 79,000 in the developing world. Most of this reduction – a drop of 48,000 maternal deaths – would take place in Sub-Saharan Africa, the region with the highest levels of maternal mortality and unmet need for modern contraception.

The good news for Zambian women is that government at the same summit also announced that it had doubled its budgetary allocation in a bid to reach the vulnerable majority who needed these critical services.

Dr Joseph Katema, Zambia’s minister of Community Development, Mother and Child said that funding from government will be complimented by additional contributions from donors' “Family planning and commitments to increase the contraceptive coverage for modern methods have gone up from 33 percent to 58 percent.”

In a statement released by Amos Chanda, press secretary at the Zambian embassy in London, government’s approach to achieving this will be broken into three categories; policy changes, significant increase of financial resources allocation to family planning and improving delivery.

Government further intends to dialogue with stake holders in order to reach  the underserviced populations such as religious populations and traditional leaders, including its other departments in order to increase contraceptive coverage.

Melinda Gates, of the Bill & Melinda Gates Foundation, said the organisation plans to spend one billion dollars of aid money to help advance family planning services in poor countries especially among women and girls.

However, as government and various stakeholders continue to pump money to close gaps hindering family planning, there should be deliberate efforts made to communicate and ensure that women understand why it is important to have a say and control on how many children they should have.

An anonymous contributor wondered "why reproductive health is only taught in clinics and other counselling places. I suggest, churches, places of learning should all learn even at tender age. Imagine thinking its taboo talking about safe sex with your children and they get to learn from friends about unprotected sex, surely it doesn't pay."

"We have got to talk about it openly so that everyone can acquire this knowledge. My biggest problem is the NGOs who make all the noise but do very little in terms of educating men and women, the so called modest in rural areas."

"Their concentration has been on women when they are supposed to concentrate on men. We (men) need the data than our counterparts in skirts."

United Nations Population Fund (UNFPA) executive director, Dr Babatunde Osotimehin noted that “as our numbers keep growing past 7 billion, and so many (people) suffer from poverty, poor health and lack of opportunities, it is more important than ever to ensure that every child is wanted and that everyone has the power and the right to manage their own fertility.”

And a recent study Adding It up: Costs and Benefits of Contraceptive Services- Estimates for 2012 released in June 2012, by the Guttmacher Institute and the United Nations Population Fund (UNFPA) estimates that the number of women with an unmet need for modern contraception increased in sub-Saharan Africa, from 31 million in 2008 to 36 million in 2012.

About 80 million unintended pregnancies will occur in 2012 in the developing world as a result of contraceptive failure and non-use among women who do not want a pregnancy soon.

The unintended pregnancies will result in 30 million unplanned births, 40 million abortions and 10 million miscarriages, the report stated. PYM

Epilepsy: Anytime Anywhere – Be prepared



Chishala Mumba



By Meluse Kapatamoyo

Mental health illnesses remain one of the most misunderstood health conditions among many (African) communities and Zambia is no exception.

A neurological condition, Epilepsy (aka a seizure disorder), which affects the nervous system can be best explained by Chishala Mumba, 20, an Environmental Health Technology student at Lusaka’s Chainama College of Health Sciences who has experienced it firsthand.

“I started having seizures in 2005 and the doctors couldn’t come up with a proper diagnosis. It was irritating because I was limited on how happy or upset i could be because excessive happiness or sadness are said to trigger seizures.

Since then I have experienced a lot of scary moments. One time i was leading worship during fellowship, all of a sudden I felt a sharp pain in my spine, and was rushed to the hospital.  There, i was immediately put on oxygen because i couldn’t breathe. Ten minutes later the tank ran out and the nurses had to go in search of another.

I live in fear. For example, I was scared of having an attack when I went for a boat cruise on Lake Kariba. One of the most disturbing things I heard when I started to have seizures was when a certain doctor told me that I would not be able to get married or live far from home. But here i am living in Lusaka which is hundreds of kilometres from Kitwe where I am from.

Yes i have had challenges here too, like the time i had my first seizure at school and i had to break the news to my roommate. Luckily, she understood because she also had a rheumatic heart condition and we both needed to know what to do in the event that either one of us had an attack.

I am lucky that I have never had a seizure among strangers, during the times i have had the attack, people around me have been amazingly caring. They make sure that i have enough air and if i take long to regain consciousness, they rush me to the clinic.

But i know that people’s perception of the condition can be very negative. Some fear that they may contract epilepsy especially from those who have discharges from the mouth or pass urine when under attack, which fortunately i never do.

However, being a student at Chainama has not only helped me with access good medical services but it has also given me the chance to meet people with the same condition and hear about their challenges, as well as how society reacts to them. I appreciate the support from my family and friends during the times I get sick.”

As can be deduced from this story, the impact of epilepsy is not only on the person with the condition and the family but is also felt by the community because of the unpredictability of the seizures which can occur anytime and anywhere, and without warning.

But according to experts, if the patient is able to identify factors that trigger their seizures, they can help themselves a great deal by trying to avoid those things as much as possible. One way to identify the factors is by keeping a seizure calendar or diary.

In simple terms, Epilepsy can be defined as having recurrent seizures (convulsions) which are unprovoked. These are episodes of disturbed brain activity that cause changes in attention or behaviour.

The World Health Organisation (WHO) estimates that there are over 50 million epilepsy sufferers in the world today, with 85 percent living in developing countries.

In Zambia, although no epidemiology or study has been done to find out the extent of the burden of epilepsy, from hospital records, the prevalence is very high, says Anthony Zimba, who is Epilepsy Association of Zambia president and also International Bureau of Epilepsy (IBE) Africa region vice president.

Just like there are different types of seizures, not all seizures are epileptic.

And according to Mr Zimba, the management of epilepsy can take approximately two years. Only after two years and without experiencing seizures, can doctors recommend a reduction in dosage, which can last up to six months.  And if the condition remains the unchanged, the patient can then be declared free of epilepsy.

He expressed concern that in Zambia, there was a general lack of knowledge on how best to look after epilepsy patients whenever they had an attack because people had the tendency to panic.  The panic, he said, resulted in them using wrong methods of care which put the lives of patients at risk.

Mr Zimba gave the following tips as measures one should take when caring for someone having an epileptic attack, emphasising that the golden rule to remember was ‘You cannot stop someone from having a seizure.’

“Do not shake or hold a person who is having a seizure. Instead, get a soft cloth and place it underneath the patients head to protect them from injuries and then proceed to remove any hazardous objects,” he explained.

Loosen tight clothes such as shirt collars, or if someone wears glasses, remove them. If that person was eating you must open their mouth and remove the food but be very careful because they can bite you.

But while it a common trend to put a stick or spatula in the mouth of the person having a fit to protect them from biting their tongue, Mr Zimba said doing so introduces infection and may lead to the person breaking their teeth, emphasising “People do not swallow their tongues during a seizure. A bitten tongue can heal, but by placing objects you risk breaking their teeth and can even introduce infection.”

He also warned against rolling the person to the side while they were having a seizure. But once the seizure had stopped, the person could be rolled to the side to allow any vomit or saliva to drew down and avoid chocking.

However, in instances where the person having a seizure goes into a kind of altered state of consciousness for a short period of time (the person may look dazed and stare into space), it is enough to stay by the person and wait for the seizure to pass. After they have regained consciousness, he/she may be dazed so it is vital that you remain calm and reassuring. Do not talk in a harsh tone as this can scare them.

“But what in many instances what people do is that the moment they people see a person having a seizure, they lift them, put them into a taxi and rush them to the hospital. That is very unnecessary unless a fit lasts more than 10 minutes. Then it becomes a hospital emergency. One has to be put on IV line or injected with medicine to stop the seizure,” stressed Mr Zimba.



Chishala on a cruise on Lake Kariba



He said only under the following circumstances should a person having a seizure be rushed to the hospital; If the person is pregnant or if they have injured themselves or if that individual is diabetic or suffers from a condition which can worsen the seizure.

And if while having a seizure, the individual fell into a pool or river and had gotten chocked, they should be rushed to the hospital. This also includes anyone who fails to regain consciousness or is not breathing normally.

“Most importantly if that individual is having a seizure for the first time. They need to be taken to the hospital to investigate the cause and also rule out infections or other problems,” said Mr Zimba.





Male circumcision: which way forward?

By Meluse Kapatamoyo

Male medical circumcision: should it be a prerequisite to civic center, church or any other lawfully sanctioned marriage?

Bush aids Zambia's cervical cancer fight.

By Meluse Kapatamoyo

The threat of cervical cancer on Zambian women has reached alarming levels and need urgent and concerted efforts to ensure that awareness, testing and treatment of the disease becomes top priority on government and its cooperating partners agenda.

Zambia has the second highest cervical cancer incidence in the world, despite being one of the few countries in Africa with a Cancer disease hospital. Guinea takes top spot.

For hundreds of women at risk and those with the disease, the recent visit to Zambia by former US president George W. Bush put into the spotlight the importance of creating cervical cancer screening opportunities.

Bush was in Zambia to reinforce the Pink Ribbon Red Ribbon campaign on HIV and cancer which he launched in December 2011.

The campaign is aimed at increasing the availability of cervical cancer screening, treatment and breast care education.

While in the country, Bush spent four days putting his hands to work, renovating a clinic in Kabwe used for cancer screening and emphasizing the message “If women could be saved from HIV/AIDS and yet die from cancer, then life has not been saved.”





He also held talks with President Michael Sata at state house and met with first lady Dr Christine Kaseba for the Pink Ribbon Red Ribbon campaign at the University Teaching Hospital (UTH), Zambia’s only referral hospital.

Cervical Cancer Prevention Programme in Zambia (CCPPIZ) co-director, Dr Mulindi Mwanahamuntu had this to say about Bush’s visit to Zambia; “The women were saved from dying due to AIDS by George W Bush's President's Emergency Plan for AIDS Relief (PEPFAR) initiative which brought ARVs to public health hospitals beginning from the mid 2000s. Sadly, a lot of these women whose lives were being prolonged by costly ARVs were once again beginning to die from cervical cancer which appears to be more serious in women with immunity problems.

For PEPFAR to allow us in Zambia to use some of the ARV budget to screen women and stop deaths from cervical cancer means that an entire loop is getting sealed. I think Bush must have been a happy man to see first hand how Zambia has created health promoting systems initiated by his kindness and that of the American people.”

Since the start of the CCPPIZ programme in 2005, more than 81, 000 women have been screened for cervical cancer. The organisation intends to embark on a vaccination programme on young women between the ages eight and 12 who are not yet sexually active.

Should sexual reproductive health be taught in schools and churches?

By Meluse Kapatamoyo

Should sexual reproductive health be taught in schools and churches? Someone thinks so.

“Meluse, I wonder why reproductive health is only taught in clinics and other counseling places. I suggest, churches, places of learning should all learn even at tender age. Imagine thinking its taboo talking about safe sex with your children and they get to learn from friends about unprotected sex, surely it doesn’t pay. We have got to talk about it openly so that everyone can acquire this knowledge. My biggest problem is the NGO's who make all the noise but doing very little in terms of educating men and women, the so called modest in rural areas. Their concentration has been on women, when they are supposed to concentrate on men too. We men need the data than our counterparts in skirts.”

To view this comment and others follow this link http://pokeyourmind.blogspot.com/2012/07/when-love-becomes-pricy.html#!/2012/07/when-love-becomes-pricy.html

Fibroids: A readers personal account

Today I take a back seat role - let me put aside my writing and be a reader. Great contributions have come on POKEYOURMIND as will be affirmed in the story you are about to read from one lady whose mind was poked and she decided to share her personal story on fibroids. Do we share the same experiences? Here is her story...unedited.

FIBROIDS : A PERSONAL ACCOUNT

To wake up in a foreign country in a hospital is the last thing that anyone would like but that is exactly what happened to me once.

I woke up one morning and felt like the bed was spinning, I thought I was groggy from my sleep. I got out of bed and tried to stand up but fell to the floor. Lucky for me, my house mate then heard the thud, called for me and as there was no answer, she opened the door to my room and found me on the floor. When I opened my eyes, I was in the hospital.

I was found with low blood pressure, my blood levels where very low and thus the weakness. The good news is that I was given medication and treated but it didn’t end there.

After a year of staying in a foreign country, I finally came back home. A few months later, I went for a check- up and the doctor asked me about how my bleeding was during my menses, I told the doctor that they were very heavy. After a thorough examination I was finally given the bad news that I had the dreaded fibroids and that they were still quite small. I was asked all sorts of questions and we came to a conclusion.

The heavy bleeding continued but these came with excruciating violent period pains. I would have diarrhea and vomit and just fail to get out of bed for hours on end.

After two years of ignoring them and hoping a miracle would happen, my stomach started growing such that people would ask me whether I was pregnant. Sleeping became a problem because the fibroids grew so big that even my stomach felt hard to the touch. Eating became a problem too. I would eat small portions of food and feel so full, even drinking water would make me full as if I ate a full meal.

At the end of 2011, I traveled to work outside the country. On the first night I started experiencing this pain that I had never felt before. I went to the toilet and bled like never before. This happened twice and stopped, I prayed that I would just get home and get treated from there.

As soon as I arrived home, I made an appointment to see the doctor, we did the tests all over again, and I was told I needed to undergo surgery almost immediately as the fibroids had grown to sizes larger than my fist and there were three large ones and some small ones.

At this point, it was becoming impossible to do almost anything. I would tired easily, even lifting my hand for less than a minute was like I had done a very heavy job. I almost hated eating and drinking anything but at the same time when I got hungry I had pain in my tummy, basically everything was uncomfortable.

MY D-DAY

My surgery was scheduled for a Thursday so I checked into the hospital on a Wednesday evening as requested so that the nurses could prepare me. Very early in the morning, we (me and other ladies scheduled for various operations) were told to go to the theatre room. My turn came and I lay on the operating bed (or table). The anesthetist then gave me an injection that was shot through my leg and in a few seconds I was numb from my stomach down. Funny thing is I was actually chatting with my doctors. I could hear them pluck out chunks of the fibroids, one team member actually showed me what they were taking out of me.

The surgery was completed in about two hours. I was then wheeled back to the ward to start recuperating. But instead of that happening I started having this excruciating pain and I must have cried for what looked like hours for help from the nurses until one lady doctor (my angel) who personally knows me happened to be doing her rounds and found me. Am assuming because of my screaming, she had a look at me and found that I had started to bleed once again.

The doctor quickly made arrangements to take me back to theatre and made a few calls to some specialists. Apparently I bled so much I turned purple. I was opened and sewn three times in the same place where I was sewn the previous day. My chances, I am told were 50/50. I could have died but the almighty God decided to spare my life.

Oblivious to me and after being opened three times, as I had lost a great deal of blood and was literally on my death bed, I was wheeled to the Intensive Care Unit (ICU) again to recuperate but this time with extra care.

UNCONSCIOUS BUT ON THE MEND

As I lay in my unconscious state in the ICU with blood drips all over my body, my very loving family called everyone in my phone contacts and notified them about my situation, the doctors had said it was 50/50 so you can only imagine how frightened my family members were. People streamed in from everywhere to see me in my unconscious state not knowing whether I would make it or not. As everyone came to see me, I could see and hear all of them but all I could do at the time was shed tears, lots of tears. Now I know not from the movies but from my own experience that when people are unconscious, they can hear everything.

CONCLUSION

Statistics say that eighty percent (80%) of women on the streets have fibroids. They may seem simple because they do not hurt but when they grow very big, in my view, they can be very dangerous. I encourage all ladies to get examined especially if ones menses are heavy.

If I do not thank my God for preserving my life and giving me a second chance at life, then I do not deserve to be walking the earth today. God gave me a second chance. I thank him and only him.

When love becomes pricy

By Meluse Kapatamoyo

For most women, being in love, means throwing caution to the wind. The thought of ever being betrayed by their significant other is implausible.

Like many women, when Martha Ngoma, 28, met Nathan, she thought she had found the love of her life - the man she would spend the rest of her life with. (Real names withheld to protect and respect their privacy)

Martha recounted how they instantly became good friends and in no time started dating. She said that they had so much in common and he was well mannered, educated and blessed with dashing looks.

"But what I loved most was his kind nature. For the first time in my life, I was able to be completely vulnerable with a man and yet still feel safe,” she added.

Although she was quick to point out that the relationship was not perfect, Martha said the differences only seemed to make the relationship stronger.  At least that is what she thought until a year later when she discovered her boyfriend had been cheating.

She was devastated. Not only because her prince had turned into a frog, but she feared that her reluctance to insist on using condoms in their relationship may have left her vulnerable to Sexually Transmitted Infections (STI), especially HIV.

“I think i was more worried about getting pregnant. We only used condoms during my danger days when there was a possibility that I could get pregnant,” said Martha who only shrugged her shoulders and looked rather embarrassed when asked if there was ever a moment she thought about the possibility of contracting HIV.

To clear her conscience, Martha decided to have a complete screening for all STIs.

Fortunately, the results were negative. But just as she was beginning to get on with her life, she received some rather disturbing news - Her ex-boyfriend's other lover was HIV positive. The information came from a credible source who knew the girl well.

The informant advised Martha to get tested so that she could know her status. In denial, she phoned her ex boyfriend so he could refute the claims but his answer shocked her.

A teary Martha said “he straight up told me he knew about her HIV status but insisted he had not slept with her."

Martha narrates how she immediately went numb and then became hysterical. She remembered the nurse insisting that she goes back for another HIV test after 3 months and at that moment it occurred to her that there was a 90 percent chance she could be carrying the virus.

That night, thoughts of how she would tell her family and find the courage to live positively, crowded her mind. Martha was also filled with anger and regret, wishing she had thought of using condoms or  just abstained. Although her ex had denied having sex with his other lover, she wondered at what point in their relationship, the woman had revealed her status to him. Besides, he could not be trusted, he had told so many lies before.

Her only option was to have another HIV test. This time around she knew the results would change her life forever.

“I can’t remember any other time in my life when I have been so scared. Even after counselling, I was still shaking when I took the test. As I waited for the results, I said a prayer asking God to give me the strength to accept what was to come. I knew what the results would be, I just needed confirmation and soon enough it came,” a somewhat relieved but distraught Martha said.

In shock, she asked the nurse if she could run the test again, but was assured that the clinic was very thorough in the way it conducted its tests. She left the clinic dumbfounded, with the counsellor emphasising the importance of abstinence and use of condoms.

“I needed that wake up call. I was leading a very careless life, literally placing my life in someone else’s hands. Had the results been positive, I would have had no one to blame but myself because not once did he force himself on me,” she added.

Martha concluded that "It’s dangerous to think the person you are with only has sex with you alone and not every HIV positive person will reveal his/her status before any sexual contact. Until you someone discloses to you, don't take things for granted in the name of love and trust. In my case, when love comes around, I intend to take charge.”

George Bush back in Zambia

Former US president George W. Bush (l)  being welcomed by Zambia's Vice President Guy Scott (r) upon arrival at Kenneth Kaunda International Airport in Lusaka, on June 30, 2012. Bush is in Zambia to promote his foundation's health initiative to improve cervical cancer prevention and treatment programs in Africa.