Programme Mwana wins gold, Silver, for UNICEF Zambia

By Meluse Kapatamoyo

Zambia has been awarded a Gold Award in Design for Social Impact and a Silver Award in design Strategy for its UNICEF-Zambia supported mobile health project, Mwana.

Launched on November 17, 2011, Programme Mwana uses Short Message System (SMS) technology to speed up the relaying of HIV test results for infants, allowing for an early start of treatment for those who are found to be with HIV.

UNICEF Zambia Officer-in-Charge Shaya Asindua

“By winning the awards the communities involved as well as staff members from the Zambian government, partners, and UNICEF colleagues have been recognized for the efforts they put into this innovative project.
 Programme Mwana is unique in that it is helping to reduce under-five mortality and deliver services to the hardest to reach populations. The hard work by all involved has brought great honour and pride to all of us,” UNICEF Zambia Officer-in-Charge Shaya Asindua said.

Mwana collaborating partners include; Boston University affiliate, the Zambia Centre for Applied Health Research and Development (ZCHARD), the Clinton Health Access Initiative (CHAI) and the Zambia Prevention, Care and Treatment Partnership.

The programme was first piloted by the Ministry of Health in 13 districts in six provinces from February 2010 with a goal of reaching nationwide coverage by 2014.

The awards to programme Mwana, a Ministry of Health initiative, were bestowed on UNICEF by America’s Designers Society, the world’s oldest and largest member-driven society for product design, industrial design, and interaction design.

According to UNICEF, more than 5, 000 infant HIV results have been relayed with reduced turnaround times of around 50 percent, benefiting rural facilities that previously depended on hard-copy results that were transported by road, significantly delaying the start of treatment for infants living with HIV. PYM

Facing the dangers of high blood pressure (BP)

 By Gershom Ndhlovu



Gershom Ndhlovu

In the year 2000, I was transferred from my base in Ndola where I had worked for just over four years back to Lusaka. My family remained on the Copperbelt while I went to take up my new appointment.

It was while there that one day a team of Rotarians came to my place of work to conduct some medical check-ups.

A Rotarian of Indian origin took my blood pressure. He looked at me and said my Blood Pressure (BP) was very high. As far I was concerned, he was talking to himself because it did not register to me what he meant and especially that he did not mention any thing I should do to control it or to seek further medical advice from a registered clinic.

As far I was concerned, life continued as usual—imbibing the lagers and cheap Zimbabwean spirits of Bols and Chateau and eating michopo in the form of goat meat, T-Bone  and fish roasted at pubs and added to that, the home made stews—and of course other unhealthy life styles.

One day, on my way to Ndola to see my family, I felt very uncomfortable on the bus with one side of my head getting swollen. Because of some pain emanating from the ear, I thought I had an infection in the ear. The following day, my wife suggested we go to the Ndola Central Hospital where she worked as a nurse.

When it was my turn to be examined by the nurse on duty, she, as a matter of routine, took my Blood Pressure. The woman looked at me wide-eyed and took the reading again. Without saying anything, the nurse shot off the room and came tagging a doctor. At this time, it still did not register to me how serious the problem was.

The doctor, straight away, recommended that I be given a bed. At that point, the problem of the ear was all but forgotten. I was taken for ECG (Electrocardiogram) and other related stuff. I spent four days in the Ndola Central Hospital, but that was the beginning of a very long journey with my BP treatment and admissions to hospitals.

An electrocardiogram (ECG) is a medical test that detects cardiac (heart) abnormalities by measuring the electrical activity generated by the heart it contracts. The ECG can help diagnose a range of condition including heart arrhythmiasheart enlargement, heart inflammation (pericarditis or myocarditis) and coronary heart disease.

Fast forward to 2009, living in a European country. One day I went to see my doctor for some minor problem I had. Fortunately or unfortunately, my usual doctor was not there and I was seen by another one who, again as a matter of routine, took my BP. While measuring it, she put the stethoscope on my chest and listened intently. She said: “You have a heart murmer.”

Again, I had no idea what that meant but she explained in simple language saying that as the heart pumped blood away from the heart, some of it was going back into the heart. She referred me to the hospital for a thorough examination. But I was assured that although there would be need for surgery in future, they would be monitoring me and required me to go for an annual check up.

I did not have any notable problems until towards the end of 2010 when I started experiencing pain in the chest, arms and legs particularly after a strenuous chore. This was increasingly getting debilitating almost knocking me out.

One day, after one of these attacks, I decided to go to the hospital. The doctors decided that I should undergo an angiogram (X-ray test that uses a special dye and camera to take pictures of the blood flow in an artery or a vein) to determine if there were any blockages in my coronary arteries. The doctors’ fears were confirmed. One of my arteries had narrowed. But because at that time it had been decided that I need heart surgery because of an anomaly in my heart valves that allowed blood back into the heart, the narrowing would be dealt with at the same time as the heart surgery on a date that had not even set.

Two weeks after the angiogram, i had an emergency. I set out to travel out of town to the university where I was studying for classes, on the way to the bus stop I just felt this pain I had never felt before. I dragged myself back home. I recovered quite alright but later in the evening I experienced the same pain. At that time I was taking some pain killers that had been left over by my daughter but ran out.

I had to go to the surgery the next day to go and get my own pain killers. As luck would have it, I saw the doctor who had diagnosed my heart murmur a couple of years earlier. She quickly ordered an ECG. Because of the ECG result and my presentation of the problem, she called an ambulance which fetched me from the surgery.

At the hospital, they did further tests and they determined that I needed an angioplasty or a stent, to widen the narrowing artery. I spent three days in the hospital. From that time to date, I have not felt that pain again.

Nevertheless, the medical authorities now had to scramble to find a date for my open heart surgery. This came six months later in May 2011. I had been given three choices of what they were going to do with my valve—replace it with an organic one, i.e. from a pig or sheep, replace it with a mechanical one or just repair my natural one. Fortunately for me, my natural one was in reparable state which they did.

The underside to all this is that I have to be on constant medication such as aspirin to “thin” blood and four other types tablets to control blood pressure. I also have to bear the 30 cm scar on my chest where I was opened up for heart surgery to take place.

The recovery process is a story for another day but in writing all this, it is my wish that Zambians should take issues of high blood pressure.

Based in the United Kingdom, Gershom Ndhlovu is a veteran Zambian journalist, a co-host on Crossfire Blogradio (UK) and former Zambia Daily Mail Editor.PYM

Measles Campaign draws thousands

     ...as men get involved

BY MELUSE KAPATAMOYO




Children queue up to receive the measles vaccine

 

With just a day to go, Zambia’s five day countrywide Measles Campaign has received overwhelming response in areas like Chazanga compound where 5025 children were vaccinated at Bwafwano Integrated Services Organisation (BISO) Health Centre during the first three days.

Despite some parents complaining of having to wait in the queue for many hours in the heat, by end of day on Wednesday, a total of 1,470 children had been vaccinated. The campaign runs from 10-15th September 2012 across the country.

A visit to the area by Alliance for Community Action on HIV and AIDS (Alliance Zambia) on Wednesday (September 9, 2012) found hundreds of children in queues accompanied by elders who included mothers, fathers and grandparents.

Siblings older than 15 years of age accompanied their younger brothers and sisters, and "shared" their pain of the measles prick.

Alliance Zambia took the opportunity to sensitise the community through drama on the need to take children to health facilities for a healthy living and also distributed baby caps donated by Save the Children Sweden (SCS).

“The response here has been overwhelming because most of the children in this area are under our programmes. The mothers are under our PMTCT (Prevention of Mother to Child Transmission) programme and as a result they prefer coming here.



BISO Executive Director Beatrice Chola

"We have been urging parents to take their children to other health posts for vaccination but that is not something they want to hear,” explained BISO Executive Director, Beatrice Chola.

She said because of the awareness campaigns on the PMTCT programme held in partnership with Alliance Zambia in 2011, Bwafwano has seen an increase in male involvement on maternal and child health issues.

                                                  
“The programme has really come up with good results. Men in this area are very much involved concerning PMTCT, immunisation of children and escorting their wives for ante-natal clinics,” said Mrs Chola.

For men like Joseph Zulu, father of three year old Naomi, escorting his wife and children to receive medical attention is a non debatable issue.



Naomi receives the measles vaccine

 He said having been raised by a grandmother, being around women and helping with household chores or trips to the clinic were normal to him.

“My wife and I are partners. Anything that involves her involves me. It is my duty to make life easier for her and vice-versa and bringing our child to the clinic while she attends to household chores is my way of supporting her," said Zulu.



Joseph with his niece Alice

 Two of Zulu's nieces were at his house on a visit from Pemba and he made sure that they too got vaccinated.

BISO situated in Chazanga, is a non-governmental organisation, established in 1996 during the time when high levels of Tuberculosis, HIV patients and vulnerable children were at an all time high.

The organisation which houses the health centre and a community school within its premises has a strong stamp in the community, and hence has had to deal with a high number of children turning up for vaccination than any other health centre in the area.

Bwafwano which started as a home based care with only 27 patients now has 15, 000 patients under the home based care programme. Other programmes include PMTCT, Voluntary Counseling and Testing, Sexual Reproductive Health and skills training. 

Chazanga catchment area has a population of 103, 000 people of low income with only one government clinic in the area. PYM

HIV stigma curtailing positive living

By MELUSE KAPATAMOYO

Being found HIV positive and choosing to live positively can be an easy thing to do, what makes it hard is living in a community that constantly reminds you that your health is in danger. 

At five months pregnant, Susan discovered that she was HIV positive and since then life has not been easy for her.

"I am a strong person mentally but the things that people say when I tell them about my status are difficult to take. Sometimes it takes God to get through a day,” says 26 year old Susan of Chiyuni village in Kembe, Chibombo district.

A housewife and mother of one, she started getting sick when she was four months pregnant. She was initially treated for malaria, but her condition continued worsening.

Chitanda Rural Health Center

Nursing staff at Chitanda Rural Health Centre later referred her to Liteta Hospital, 90km from Chitanda, where a pneumonia test came out positive. 

Despite commencing treatment for pneumonia, the discomfort and pain in her entire body persisted.

After the pneumonia treatment, Susan and her husband were then tested for HIV and both were positive.

“I had heard about HIV before but never thought I could get the disease (virus) so yes I was shocked. After counseling, we were put on medication and I got better. I was determined to give birth to a healthy baby so HIV became just like any other disease.”

While some friends and family members have distanced themselves from Susan and her husband, others ask how she contracted the virus, as well as how she intends to live the rest of her life with HIV.

“I have been asked a lot of demeaning questions most of which insinuate that I was promiscuous. But the worst statement I have received and this I have had people say to me more than once was ‘If I were you and I found I was HIV positive, I would kill myself’," explains Susan.

She says while such statements can hurt like a knife to the heart, however she continues to live positively and does not hide her status. For Susan, raising her daughter is much more of a challenge and a concern than what people have to say about her condition.

Although her 14months old baby is HIV negative, her health from birth has been greatly affected by the lack of proper nutrition. She was forced to immediately put her child on supplementary feeding soon after delivery when her breasts failed to produce adequate milk for the baby.

Months later, Susan said she switched to Super Shake (Maheu), a much cheaper option compared to a tin of formulae which costs about K30, 000 and lasts less than a week.

She is worried that her daughter may suffer from malnutrition and is eager to get knowledge on what other options are available for a child who is basically living on Super Shake instead of breast feeding as recommended by the World Health Organisation (WHO) for children upto two years or more.

For Susan and hundreds of mothers in the Kembe area, the sensitization on stigma, nutrition and other health issues that they desperately need may not be too far away.

Alliance for Community Action on HIV and AIDS (Alliance Zambia) with support from Save the Children Sweden (SCS) is looking into starting a project to address issues on Maternal and Child Health. The organisation was recently in Kembe to identify maternal health concerns and also identify key stakeholders that can be engaged on the SCS project. The visiting group also conducted a community mapping exercise of maternal health services in the area which included a visit to Chitanda Rural Health Center.

The SCS project will work towards contributing to Millennium Development Goals (MDGs) 4 and 5; to reduce mortality and morbidity rates for children Under Five years old in Zambia by 2014 by two thirds and to promote safe motherhood, improve maternal health in Zambia by 2014 and reduce maternal mortality by three quarters respectively.

Alliance Zambia Programmes Manager, Shupe Makashinyi, said that one of the many activities of the project which is already underway in the populated area of Mandevu in Lusaka includes sensitization on nutrition which is key to maintaining the good health of a mother and child.

The Smart- Care System may also be strengthened should the project go ahead in the area.

“We have already identified gaps in the Smart Care System. We have discovered that there is only one computer at Chitanda Rural Health Clinic (which has 472 women on ART).

To address this problem we would consider bringing in another computer to hasten the process of filing information. By sorting out this problem, we are not only helping out the healthcare providers but families because when a mother goes for ante-natal she will now not spend too much time at the clinic. She will be attended to in record time and return home quickly to attend to other duties” explained Mrs Makashinyi.

Operating as a non-governmental organisation, Alliance Zambia established in 2008, has been affiliated to the International HIV/AIDS Alliance since 1999. The organisation works in tandem with National AIDS Strategic Framework providing technical and financial support to Community Based Organisations (CBOs) and other Non-Governmental Organisations (NGOs). 

It implements capacity-building activities which strengthen community based HIV/AIDS Prevention, Care and Support responses including Sexual Reproductive Health (SRH), Maternal, Neo-natal and Child Health (MNCH), Orphans and Vulnerable Children (OVC), and anti-stigma and discrimination programmes. 

The organisation, in collaboration with the ministries of Health and Community Development Mother and Child Health, has been implementing healthcare programmes in Lusaka, Eastern, Southern and Copperbelt provinces.

If all goes according to plan, the Maternal and Child Health project will help people like Susan who seek information on nutrition and other services.

The Central Statistical Office puts the Kembe catchment area at 21, 977, but local officials say the number currently stands at 29, 000. PYM

Inadequate staff to hamper Measles Campaign

By Meluse Kapatamoyo

As Zambia’s Fourth National Measles campaign kick-starts from September 10 to 15, 2012, challenges of staff may hamper the K34billion Campaign budget allocated by the government to vaccinate children.

Areas like Ndola have reported having a short-fall of staff by over 50 per cent to carry out the immunisation campaign.

Recently, the Ndola District Medical Office reported that there were only 120 out of the 290 staff needed. The district would fail to meet its target of 240, 000 children if the number of staff was not beefed up.

Measles is a highly contagious viral disease, which affects mostly children. It is transmitted via droplets from the nose, mouth or throat of infected persons. It is one of the major causes of childhood morbidity and mortality in children under the age of five if not well treated.

The ministry of Community Development, Mother and Child Welfare is targeting about seven million children, inclusive of those who had been vaccinated before.  

According to experts, the first dose given to a baby at nine months old does not develop the protective response in some children, hence the need for a second dose which increases the protective response in children and likelihood of immunity.

In its latest report, the World Health Organisation (WHO) revealed that the number of deaths from measles has declined by about three-quarters over a decade, 200-2010. However, most deaths were recorded in India and Africa, where fewchildren are immunised.

More than 9.6 million children were saved from dying from measles between the said period, after big vaccination campaigns were rolled out.PYM.