Address youth myths on Voluntary Medical Male Circumcision

By Meluse Kapatamoyo

Nkonde speaking at the Third National HIV Prevention Convention.
Pic by Unicef Zambia.
 

In Zambia, it is estimated that every three hours, a young person gets infected with HIV. To counter this, the country has committed itself to reducing the rate of new infections by 50 percent by 2015, using a combination of prevention strategies such as male circumcision.  

However, according to 18 year old Solomon Nkonde “adolescents have the lowest levels of male circumcision amongst all the age groups in Zambia. There are a lot of reasons as to why our fellow brothers do not want to get circumcised, among them; fear of severe pain, fear of losing sensitivity and lack of information on the benefits and how the circumcision process is performed.”

Nkonde who represented voices of the young people at the just ended Third National HIV Prevention Convention, added that “while other young people felt it was not part of their culture, others wanted to know what was done with their prepuce after it got removed. In addition, there were also misconceptions on the motives of the sensitisers and the donors supporting male circumcision.”

To rebattle these myths, the youths shared various interventions that would help scale-up male circumcision among the youth.

“Parents should be sensitised on the importance of male circumcision so that they can take their children for circumcision as early as birth and massive sensitisation should be done in both rural and urban areas with young people as role models too,” urged Nkonde.

In addition to creating more centres for male circumcision in rural areas, the youths called on government to train more male doctors to conduct operations as most boys were shy to be cut by females.

UNICEF in collaboration with the Zambian government brought together 50 adolescents from 10 provinces for a Pre-HIV Prevention Convention workshop where they shared issues on HIV.

Nkonde also spoke on behalf of more than 15, 000 young U-Reporters aged between 10-24 years who participated in real-time via SMS from all the 10 provinces.

U-ReportZambia is an innovative SMS platform designed by the National AIDS Council and UNICEF to accelerate HIV response for adolescents and young people towards an HIV-free generation in Zambia.

It provides to adolescents and young people an opportunity to access comprehensive information on HIV and any other sexually transmitted infections by SMS. PYM

 

Nominate your PEPFAR Zambia hero

By Meluse Kapatamoyo

 

The United States Presidents Emergency  Plan for AIDS Relief (PEPFAR) this year celebrates 10 years of tackling HIV in Zambia by celebrating heroes in the fight against the disease.

According to a statement from PEPFAR's Development Outreach and Communications Specialist, Kathryn Koonce, heroes do not need to be associated with PEPFAR-Funded programs.

"We would like to honour those who made small and large contributions to creating an AIDS-free generation in Zambia. Tell us about someone who cares tirelessly for orphans, or someone who endured stigma and discrimination to encourage others to test for HIV and obtain anti-retroviral treatment (ART), or someone who has not stopped leading by example in Zambia’s fight against HIV for the past 10 years.  Or someone who has done something else to end this scourge, " she explained.

 

PEPFAR will then select 12 heroes to honor by giving a cash prize to the community that supports each winner such as a chiefdom, an orphanage or a clinic.  In addition, three heroes will be selected to travel to Lusaka for a World AIDS Day event in December 2013.

 

To nominate your PEPFAR Zambia Hero, submit a written explanation of why the nominee is your hero.  The deadline is October 15, 2013. 

 

Send your nomination by email to PEPFARZambia@state.gov or by mail to PEPFAR Coordination Office, RE: PEPFAR Hero Award, American Embassy, Ibex Hill, P.O. Box 31617, Lusaka, Zambia.  Include specific information about your hero’s work, success, and relevant background information.  Please also include a photo of your PEPFAR Zambia Hero and photos that demonstrate the impact your nominee has made in the fight against HIV in Zambia.

 

For your inspiration, PEPFAR Zambia Country Coordinator Kristie Mikus gave the following as examples of heroes the organisation is looking.

"Elizabeth has been living with HIV for 20 years. Through the PEPFAR-supported organization Needs Care, she visits people’s homes in the N’gombe Compound in Lusaka to identify their needs and then links them to available resources.

 

Recently Elizabeth visited the home of an extremely ill woman.  The woman’s legs were severely swollen and covered with sores.  She was tested for HIV, but she denied the results.  With compassion, Elizabeth told the woman about her own experience living with HIV.  By the end of the visit, the woman agreed to test for HIV again.  The result of the HIV test was positive, but this time the woman accepted the results.  Today she is receiving counseling and HIV treatment, thanks to Elizabeth’s care and support.

 

Glenda was pregnant and walked five kilometers to the local clinic in Nalube to receive prenatal services. During her first visit, she tested positive for HIV.  Glenda was referred to an ART clinic 20KM from her home, but she could not afford to travel there.

 

Glenda enrolled in a PEPFAR-funded mobile program closer to her home.  There, she received HIV treatment during her pregnancy to prevent transmission of the virus to her baby.  Thanks to ART, Glenda gave birth to a healthy boy.  Glenda’s son continued treatment for six weeks after his birth and was breastfed until he was 18 months old, never contracting the HIV virus along the way." PYM

Wear it Pink for Cancer

By Meluse Kapatamoyo

You have got to love my line of work - meeting with amazing people, everyday. Each day, I am assured of talking to a stranger. Some I never get to see again, others become friends, mentors, comforters and heroes.

 

ZCS Executive Director Udie Soko

Udie Soko, is one of those strangers that has now become my hero. She is a Hodgkin’s Lymphoma cancer survivor and Zambian Cancer Society (ZCS) Executive Director. I met Udie through a friend and colleague, Christine Ngwisha, who invited me to a meeting that was being hosted by ZCS.

 

As I listened to Udie share her experience with cancer that day, my mind drifted to Susan Musukuma and Maureen Lewanika, two very strong women that lost their lives to Cervical and Breast cancer respectively. So, I have some idea of the damage the disease causes when it manifests in the body, regardless of what type of cancer it is. 

 

For a moment I was drowning in sadness, but when I looked at Udie, she spoke with so much enthusiasm about her life now; her struggles; and her triumphs with Hodgkin’s lymphoma which surfaced 24 years ago. She got my attention even more when she spoke about the work that ZCS is involved in. I knew right then that this was not a woman who should be pitied but celebrated. Since then I have been a fan of Udie and I have made it my mission to follow up on ZCS activities.

Despite the fact that Udie has survived cancer, she is my hero amidst her health struggles she is determined to ensure that no other person goes through what she has and that if unfortunately they do, she is right there to give moral and financial support through ZCS.

On September 7, 2013, the Zambian Cancer Society organised 'Cancer Relay for Life' which I and my family proudly attended at Olympic Youth Development Centre (OYDC). Being in the midst of so many people who had lost their loved ones to different forms of cancer as well as meeting survivors renewed my determination to contribute to the causes being championed by ZCS.

The great causes include the distribution of pamphlets and talks on different forms of cancer with emphasis on Cervical, Breast and Children’s cancers; Making regular donations to the Children’s Cancer ward at the University Teaching Hospital (UTH).

This October, ZCS will be holding various awareness activities starting with the Pink Golf tournament on Sunday October 6, 2013 to be graced by Zambia’s first lady, Dr Christine Kaseba.

But if you are not a fan of golf like me, then you too will be particularly excited with the activities that will take place at Mandahill on Saturdays of 19 and 26 October. According to ZCS, in support of their activities, the mall will literally be painted pink.

October 19 is dubbed ‘Cancer Awareness Day.’ Manda Hill Shopping Mall has already printed brochures which will be distributed to the public by ZCS members. In addition, booths will be set up where those interested can chat with experts and survivors to better understand the importance of early detection and available options. The focus will be on Breast, Cervical and Children’s Cancers.

There are also various prizes to be won, all donated by Mandahill Mall tenants. Large boxes will be stationed throughout the mall for donations of books, toys, sweets and clothes for the Children’s Cancer Ward at UTH.

ZCS, through a medical officer, will provide Mandahill female tenants with a talk on breast and cervical cancer at the Mr Price Store.

On October 26, which is ‘Wear it Pink’ Cancer fundraising and Awareness Day at the mall, all Mandahill fashion stores will dress their windows in pink. On that day, members of the public are encouraged to wear pink as they go to the mall. 

In honour of those that have survived cancer like Udie, those that lost their battle to cancer, those still fighting, and those just finding out they have the disease, let us show our support and let us make these events a success.

Make sure you bring your families as there will be lots of fun things to do - from getting temporary tattoos to having your hair sprayed pink in support of cancer awareness.  And to spice it all up, the lively Barefeet Theatre group will offer entertainment. PYM.

Meluse's HIV test experience

By Meluse Kapatamoyo

For most people testing for HIV can be a scary experience and it was for me too but i did it anyway.Okay, maybe i did it to encourage a friend who needed to take the test, so i thought why not, besides its something i had been considering.



Meluse getting tested

I had read a lot about HIV, the many ways it's transmitted, the importance of knowing ones status, how to stay healthy when found positive etc. So the counseling bit was not that scary. What threw me off a little was being asked what i would do if my results came were positive. After thinking about it, i realised, one can never predict what their reaction would be if given such news, so my answer was an honest 'i don't know'.

Funny, before my blood was taken, i was so confident of getting a negative result, but immediately after the prick, the nerves did get the better of me. The question, 'What if' begun to ring in my head. I thought of the changes i would have to make to my diet (must admit i am not a healthy eater), who i would tell first and the type of medication i would need to take. In those few minutes, i even thought about all the people i know who are living positively, the likes of Clementine Mumba. Somehow and almost immediately my fears were eased, and by the time the results were revealed to me, i was calm.

Since then i have learned so much about HIV and AIDS and know that as a woman i made the best decision to get tested. I know my status and can better protect myself.PYM

Vasectomy sieves sperm NOT Semen

By Meluse Kapatamoyo

When i raised the issue of Vasectomy as an alternative family planning measure, i got emails from men who said they would never consider this simple but effective operation. Reasons cited were: loss of libido, interference when urinating, lack of sexual satisfaction etc.

So i asked Dr Mulindi Mwanahamuntu, a gynaecology consultant at the University Teaching Hospital (UTH), to hopefuly put the minds of our men at ease.

This is what the doctor had to say;

"All these questions are because people confuse or do not understand the difference between sperm and semen. Sperms are small cells that can't be seen by the naked eye but contain DNA (Deoxyribonucleic acid) that when lodged into an egg, a baby is formed. Semen on the other hand is the fluid or whitish liquid that comes mainly from the prostrate. This fluid is confused with sperms.

Even men who do not have sperms or who have dead or malformed impotent sperms do release this fluid since it is released during climax. Vasectomy does not disturb this fluid called semen. Vasectomy only closes the tubes that bring sperm to be carried by  the semen.

Think of it like this: A river is the semen, some dirt, silt or small branches of trees in the river water is the sperm. If you put a wire mesh to remove or sieve out the dirt, branches or some stony silt, does the river stop flowing? Not at all. But only crops down the river will suffer because the silt which fertilizes them has been removed. When a man is vasectomized, the only thing that suffers is the egg in the womb because the cell (sperm) is not there to fertilize!" PYM

HPV vaccine, still your choice!

By Meluse Kapatamoyo

Thought about keeping this to myself but on second thought decided i need to make this very CLEAR. My posts on the HPV Vaccine  on my Facebook Page  are not meant to FORCE any of you to have your children vaccinated. I got a call from one angry parent who accused me of being USED to advocate for a vaccine whose efficacy is yet to be proven. She said i should be ready to take responsibility when the side-effects of the vaccine begin to show on the vaccinated children.

On the page, we have had several debates on the HPV vaccine with parents in support and those against, and i have shared information gathered from experts and in some cases added names of some of the experts spear heading this campaign. Now if you as a parent feel the vaccine is not for your child, then, by all means, do not allow her to be vaccinated. It is your right! But what i will continue to do is share whatever information i come across to allow parents make informed decisions.


Her last question to me was, 'If you had a child, would you allow her to get the vaccine?' My answer was YES. And i came to this conclusion after much research 'online and interviews with Cancer experts and parents in and outside Zambia who have had their children vaccinated.'

Dr Mulindi Mwanahamuntu chats with girls at the HPV vaccine Launch

In addition, i personally know people who had cervical cancer and the damage the disease can use. So, let me make this clear again, i am not forcing and neither is the government forcing parents to get their children vaccinated. That final decision is yours as a PARENT. It was not a nice call but i understand, even in my old age, my 'guardian' still worries about me, and here we are talking about the lives of little girls.  Stay blessed all and stay healthy. PYM

Your facts on blood donation

June 14 is WORLD BLOOD DONOR DAY. Here is what you need to know;

1. It takes about 30 minutes to complete the blood donation process.

2. Persons in good health can donate blood every 12 weeks (3 weeks) without posing any risks to their lives.

3. To be a blood donor , you should be between 16 and 65 years old and weight at least 45kg.

4. Prospective blood donors first have to pass a brief medical examination before they can be allowed to donate. Pre-donation counseling is given to every prospective donor to inform them about the tests to be done on their blood and the need to discuss test results with ZNBTS donor counselor.

 

5. Blood donation could either be arranged through an appointment at a place of work, school or by going to any Provincial Blood Transfusion Centre.

6. The tools used for blood collection are sterile and disposable and each kit is used only once, for one donor and thereafter disposed off safely. therefore giving blood does not put a donor at risk of getting any infection such as HIV, Hepatitis or syphylis.

-Information courtesy of the Zambia National Blood Transfusion Service

Become a blood donor

By Meluse Kapatamoyo

I was coming from the Zambia National Blood Transfusion Services (ZNBTS) located at the University Teaching Hospital (UTH) yesterday when the bus i was on got involved in an accident. Fortunately, there were no serious injuries recorded. But had the accident been fatal, its most likely that we would have needed blood transfusions to survive.



Donate blood and save a life

 In that bus was your mother, father, sister, brother, auntie, nephew, cousin etc but saving our lives would not have been that easy because the availability of BLOOD at ZNBTS cannot always be guranteed. Blood donation in Zambia is very low and lives are being lost because of it. I say thank you to all the BLOOD DONORS and if you are not one, please think about becoming one. You never know whose life you will save, it just might even be yours.

HPV Vaccine for Zambian girls

By Meluse Kapatamoyo

The statistics are alarming. Zambia’s cervical cancer burden ranks second in the world next to Guinea. Over 1,400 women die annually from the disease, according to Zambia’s Cancer National Registry.

“Cervical cancer is the most common cancer in Zambia.  It accounts for approximately 30 percent of new cancer cases seen in Zambia every year.  The incidence rate as at the last IARC report is 52.8 percent per 100,000 women,” says Dr Sharon Kapambwe, Program Head at the Cervical Cancer Prevention programme.

But as the country grapples with this disease, vaccines worth US$11 million were recently acquired by the Zambian government in a desperate attempt to save the next generation of women from Cervical Cancer, caused by the Human Papilloma virus (HPV), found in men and transmitted through sexual contact.

The HPV Vaccine, Gardasil, which prevents against HPV types 16 and 18, responsible for 70 percent of cervical cancer cases, will be rolled out in three districts of Lusaka province;  Lusaka, Kafue and Chongwe and shall be given to girls between the ages 10 and 13. 

The vaccination will reduce the prevalence of cervical cancer in years to come through protecting girls from not getting HPV, though the reduction will not be overnight but in many years to come when the girls get exposed to HPV.

“The HPV vaccination will definitely reduce the prevalence of cervical cancer in years to come through the protecting of girls. The girls we are looking at are in fourth grade and 90 percent of them are between ages 9 and 13. And because HPV is predominantly sexually transmitted, it will have to wait until these girls get sexually active for us to see the benefits. The girls have to grow into women for us to see the benefits, the impact and reduction of cervical cancer,” Dr Kapambwe explained.

And while, she says the vaccine will prevent adolescent girls from getting HPV infections and developing cervical cancer later in life, she is quick to point out that HPV vaccination will not replace screening and treatment but compliment  screening.

“Since 30 percent of the cancer cases will not be protected by the vaccine, girls who will not be vaccinated will need to be screened in future,” she explained, “Currently, Zambia does not have any means of making a diagnosis of whether a man has HPV or that a woman has contracted the virus hence leaving screening as the only option once a woman is exposed.”

For some Zambians however, despite the alarming statistics of cervical cancer, they are not keen to allow their daughters have the vaccine. Unfortunately, many have not forgotten the Mazabuka Microbicide Clinical trials which failed and left women infected with HIV.

Delphine Hampande, remains unconvinced that the vaccine is safe for her daughter and questions government commitment to taking responsibility in case of any adverse side effects from the vaccine. 

“Yes, while government has gone on record to say the vaccine is safe, it has done that before, a very good example is the case in Mazabuka. Even when there was evidence, that women were infected with HIV, government backed off. To date they do not want to take responsibility. So how can a parent be sure that this time they can be trusted to stick around in case of serious side effects? For my daughter, I will teach her the importance of screening,” Hampande emphasised.

And Like Hampande, Chela Chisulo, a father of two, wants trial tests conducted in Zambia even though the vaccine has been tried and tested in other countries.

 “Zambia and other countries are two different places. We need to do our own tests here, if it is a vaccine, clinical tests must be done. And it must be proven safe to be used in Zambia,” Chisulo says.

Addressing these concerns, Dr Penelope Kalesha, Acting Deputy Director-Child Health, Ministry of Community Development mother and child health said the HPV vaccine launched over 10 years is safe and has recorded a safety profile which has continued to be excellent.

“There is no controversy to warrant comparison of HPV to the Mazabuka trial. What was being undertaken in the Mazabuka trial was to test and see whether the microbicide was effective or not. They were testing the drug itself, which is not the case for HPV vaccine. They were testing to see whether the drug will work in women where as in the case of the HPV it has been proven that the vaccine contributes to preventing 70 percent of cervical cancers,” she clarified.

The vaccine is given as an injection in the upper arm. For a girl to be fully protected, she must receive 3 doses of HPV vaccine. The 2^nd dose should be given 2 months after the 1^st dose, and 3^rd dose should be given 4 months after the 2^nd dose.

Currently the HPV vaccine, manufactured by MERC, a USA pharmaceutical company, is being administered in several other African countries such as Rwanda and Uganda, which have already incorporated the vaccine as part of their routine vaccination country wide.

Other countries also on their way to introducing the vaccine and exploring how to reach eligible girls are Ghana, Kenya, Malawi, Mali, Nigeria, Niger, Sierra Leon and Tanzania.

Dr Kalesha says like any drug, following immunization, the vaccine has adverse side effects. The common ones include pain, discomfort, headache and swelling at the site of injection.

She adds that the HPV vaccine is not the first anti cancer vaccine being provided in the country. Zambia has been providing Pentavalent vaccine, a five in one vaccine which is provided in the first year of life which targets to reduce cancer of the liver and prevents infection of Hepatitis B.

“Like any other vaccination service all the country does is provide the service and encourage clients to seek these services. It is not compulsory. But using the Public Health Act, we are mandated to provide health services that are meant to protect and prevent diseases from the populations, so addition of the HPV is being carried out under such a mandate. We strongly encourage that people make use of these intervention."

The vaccine was provided through a donation that Zambia applied for amongst many other nations.

To address misconceptions, government has been carrying out massive sensitization in communities and has produced materials explaining not only the benefits, but who is eligible and where the vaccine is to be administered.

Working with various partners like the World Health Organisation (WHO), UNICEF, Centres for Infectious Diseases Research in Zambia (CIDRZ), PATH, Catholic Medical Mission Board (CMMB) and the American Cancer Society, the vaccine is expected to launch on May 15, 2013.

“Apart from administering the vaccine, part of the orientation include how to handle the vaccine, how to store and how to dispose of the waste that remains, that is the used, syringe and needle,” she explained.

On a positive note however, some people like Shamaoma Musonda are urging parents to take advantage of the vaccine aimed at saving their daughter’s lives.

“I know the HPV vaccine has passed the clinical stage, which is encouraging. Most fears come when things are at trial stage because you do not know the side effects seeing that Zambia has had a case of a clinical trial gone wrong. But this vaccine has been approved and is doing well in other countries, therefore, it is safe and the initiative has to be supported by all Zambia,” says Musonda.PYM

Zambia hosts African Scientific symposium on Blood Transfusion

By Meluse Kapatamoyo

Zambia is tomorrow expected to host the Second International African Scientific Symposium on Blood Transfusion Services.

The two-day event to be held at Radisson Blu Hotel will bring together 50 blood transfusion practitioners and experts from various Francophone and Anglophone African Countries with the objective to discuss blood safety, and laboratory strategies that would contribute towards promotion of safety of blood and blood products.

According to a statement released by the Zambian National Blood Transfusion Service (ZNBTS), the symposium will be held under the auspices of the African Society for Blood Transfusion, SADC Region and spearheaded this year by ZNBTS.

Topics will come from various regions of the Africa Society for Blood Transfusion (AfSBT), namely East African Community (EAC); Economic Grouping of West African States (ECOWAS); North African States (MAGREB); and Southern African Development Community (SADC).

The inaugural symposium was held in Abidjan, Ivory Coast in April of 2012.

Zambia was chosen to host this second Symposium. The Africa Society for Blood Transfusion (AfSBT) plans to make this as an annual event, alternating between Anglophone and Francophone countries.

It is expected that at the end of the symposium on Wednesday, participants would have shared information on improvement of blood safety on the African continent.

This is to facilitate contribution towards attainment of the Millennium Development Goals (MDGs) on health, particularly those related to combating HIV and AIDS, and those focusing on reducing maternal and child mortalities.  PYM

 

Nurses win pay rise

ZUNO STATEMENT

Nurses and midwives have earned a graded salary increase that improved their take home pay by 21 per cent during the salary negotiations between Zambia Union of Nurses Organisation (ZUNO) and the government that ended on Tuesday April, 2 2013.

Nurses

The salary increment will be based on the results of the Job Evaluation and Re-grading (JERG) exercise that government has embarked on and will be effective on 1^st September, 2013.

The negotiations saw nurses and midwives being awarded a new exclusive duty facilitating allowance called Health Personnel Shift Differential, and an increase in the Commuted Night Duty allowance.

And speaking in a statement, ZUNO described the just ended negotiations for salaries and other conditions of service for nurses and midwives in the civil service as progressive.

ZUNO President Thom Yung'ana said that this year’s negotiations were meant to correct distortions that existed in the different medical salary scales and were a firm foundation for overhauling the pay system for the civil service.

Mr Yung'ana said that the civil servants’ pay structure was riddled with distortions among the salary scales that tended to favour certain sectors giving rise to the distortions.

“Currently, the pay structure is such that certain cadres were getting different salaries though doing the same job. And this structure does not recognise the qualifications of the incumbents nor the intensity of the jobs involved. And this year’s negotiations were meant to address such concerns,” he said.

He said that the union and the government were working together to bring about reforms in the way nurses and midwives were remunerated and that this process would take time to be fully implemented.

 “This year we are implementing the JERG which will also involve the validation and re-evaluation of certain jobs in the medical scales. This will be done by the incumbents and this process shall go on up to August 2013,” Mr Yung'ana said.

During this period, the union and the government would also review and develop staff structures in the Ministry of Health and the Ministry of Community Development, Mother and Child Health to accommodate health professionals who are degree holders in the clinical area in addition to administration and nursing education.

“Further, this period between March and August will also be used for other consultations and appeals from the job incumbents before the JERG results can be implemented on 1^st September, 2013,” he said.

Mr Yung'ana called the nurses and midwives to continue being professional in all their conduct and assured them that the results of the 2013 would only be effective for four months before the union engages government for the 2014 improved salaries and other conditions of service.PYM

A closer look at Celebral Palsy in Zambia

By Meluse Kapatamoyo

The joy of bringing a healthy baby into the world is every mother's wish. When Mbachi Mtonga was ushered into the labour ward at the University Teaching Hospital back in 2000, she could not contain her excitement. The excitement of getting to look and hold her baby overshadowed the labour pains.

What Mbachi didn’t anticipate was just how complicated her labour would be and much worse, how drastic her life would change.

“I had prolonged labour which lasted almost two days. I really thought I was going to die and that my child would die too. The doctors had to use a vacuum to suck out my baby. When she was taken out, she never cried like other children do. They said she had Asphyxia, her brain was starved of oxygen,” explained Mbachi.

Little did Mbachi know that the lack of oxygen to her baby’s brain had caused irreparable brain damage leading to a condition known as Cerebral Palsy (CP). The damage is sometimes caused by injury or abnormal development of the brain that occurs while a child’s brain is still developing. This can happen before, during, or immediately after birth.

Despite the severity of the condition, not many cases are diagnosed at birth like Mbachi’s daughter, Kaseba, now aged 13. CP affects among other things, body movement, muscle control, muscle coordination, muscle tone, reflex, posture and balance.

Kaseba relaxing at home  in Kafue

“Four months after her birth, we realised that she had no head control. But when we took her to the hospital, we were told to wait until she was six months old. Because she was chubby, doctors thought she was just being lazy. Only later were we informed that she had CP,” said Mbachi, who is also Chairperson of the Zambia Association of Parents for Children with Disabilities (ZAPCD).

Kaseba is now totally dependent on her mother and 9 year old brother, Wongani. She lacks the sense of speech and only communicates by way of mumbling, smiling and crying. Without support she cannot sit on her own as her muscles are stiff and she rarely moves her hands. She therefore does not know how to feed herself nor chew.

Her menu consists of soft foods which do not require chewing, such as mashed potatoes.

Although life is limited to the bed and sometimes the wheelchair, Kaseba is high-spirited and very much alive to her surroundings as she has a good sense of hearing. She demands attention and expects to be first to be greeted whenever the household
receives visitors.

According to her mother, when First Lady Dr. Christine Kaseba is on TV, you are guaranteed to see a wide smile and hear a lot of mumblings from young Kaseba.

Despite Kaseba’s disabilities, Mbachi strives to make her daughter’s life as normal as possible. Whenever possible, Kaseba accompanies her mother for shopping. She has taken her daughter swimming at Dream Valley, looking at the photos, happy is not the word one would describe to express the expression on the girl’s face.

Kaseba in a pool with her mum and brother

Zambian-Italian Orthopaedic Hospital Administrator Sister Margaret Mweshi explained that if a mother has had German measles, severe cerebral malaria,

Jondis or Sexually Transmitted Infections (STIs), it is possible for the child to develop CP before birth. In addition, complications arising from HIV can also ultimately affect the growing baby.

In certain cases if a pregnant woman is involved in an accident, the severe movement that takes place, could damage the unborn child’s brain which is still developing. The severity of the problem is almost always directly connected to the amount of damage.If the damage is extensive then (you expect) the signs and symptoms will be predominant. If the right side of the brain has been damaged extensively, the left side of the body will be showing certain signs and symptoms which are not expected in a normal child.

However, it is possible for the health personnel to miss the presence of CP after delivery in cases where the problem is mild, or in events where the health centre lacks diagnostic facilities.

“CP comes in different types. For instance, here is a child who wants to greet, but he or she fails to because they cannot coordinate. Why, because there is damage in a portion of the brain called Cerebellum, which controls coordination. Other children will present stiffness that can be compared to a hard log. Even if you wanted to bend their elbows, you will not succeed. This is how muscles work, if one group contracts, the other group should relax so that there is movement taking place. However you will find that coordination lacking in a child with CP,” explained Sr Mweshi, who is also a lecturer at the University of Zambia (UNZA) School of medicine.

“But in circumstances where one part of the brain called the internal capsule is damaged, you expect children to sometimes exhibit spasticity (severe contraction of muscles).”    

The prevalence of Cerebral Palsy in Zambia is unknown due to lack of research and documentation, but to help prevent the condition, experts advise parents to take their children to hospital in case of raised temperature that may arise from other diseases, such as malaria.

Nevertheless, what many may consider as a dilapidating condition, CP is not life threatening neither is it progressive. Children may die from other complications such as epilepsy which is common among children living with CP.

Sr Mweshi says, “Some children die at the age of 20 or 25 years old, although it’s very rare in Zambia to find somebody with CP live up to the age of 30 or 40 years old, because we do not have structures and facilities that can give them proper livelihood in terms of those that need to be independent. In short, we neglect them. There is stigma and so many other things that are connected to the problem.”

When a child has been diagnosed with CP and there are no indicators of another problem, physiotherapy is highly recommended. Medications, surgery, therapy, and assistive technology can also help maximize independence, reduce barriers, and increase inclusion, therefore lead to an enhanced quality of life of the child.

Sr Mweshi says the country has enough physiotherapists to meet the needs of CP patients. However, what is lacking and hindering the process of administering treatments is perhaps the long distance to hospitals that patients have to take. Although children never completely recover, some improvements are often recorded after extensive therapy and physiotherapy.

“When you look at CP and physiotherapy, you need a lot of patience. This is a very difficult process for the child. Other mothers get affected mentally and because they overdo certain things in order to see their children get better. Others get fed-up and become depressed, what I may see (as a physiotherapist) as an improvement may not seem such to them.”

One person who sees improvement is Clementine Muteteli, a resident of Kanyama. Her 10 year old daughter, Lillian Iradukunda has been in and out of the Zambian-Italian Orthopaedic Hospital since 2011 and has had several surgeries. Clementine does not remember how many surgeries her daughter has had, but she keeps track of the little progress that her daughter makes, such as how far she can stretch her leg now.

“Soon she will be able to stand on her own. Tomorrow she has another operation to straighten the bones in the hip area,” says Clementine with a smile while she unfastens the straps of her daughters Calipers to release her legs.

As I look at Lillian who was re-admitted to hospital two days ago, sitting on her mother’s lap and wearing a diaper, my eyes drift to the hip area, where I notice several scars. It’s evident that she has had several surgeries on the same area. I imagine just how hard life has been for both mother and child but when I lift my eyes up at Lillian, she gives me a huge smile and with much struggle, she says ‘I want yoghurt.’

Lillian’s mother, a Rwandese national does not speak English but is fluent in Nyanja. I ask if her daughter has been attending school, to my surprise, I am told Lillian learnt English at the hospital from doctors and nurses. In 2011, she spent five months in hospital.

Clementine looks exhausted but still optimistic and looks forward to being discharged and returning home to attend to her son who is currently in the care of her husband, but is often looked after by neighbours and church members while he goes out to look for odd jobs. The couple has no relatives in Zambia.

As I say my goodbye’s, Lillian’s list of demands grows from yoghurt, to the famous Chicco biscuit and chocolate, another huge smile appears when I promise to bring her special order the next time I visit. PYM