Monday, April 15, 2013

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


Monday, April 8, 2013

Nurses win pay rise


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.

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 1st 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 1st 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

Friday, April 5, 2013

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.

Thursday, April 4, 2013

Ladies and Booze

By Meluse Kapatamoyo

People who consume alcohol will give you different reasons as to why they drink. But while those reasons may differ, the ultimate purpose is to get relaxation, not only of the body but also the mind.

It is therefore common to see colleagues and friends alike meeting for alcoholic beverages at their favorite drinking spots after working hours.

Although a few years back, this trend seemed to be a reserve for men, the bar is no longer a domain for men alone. For some women, a trip to the bar after a stressful day at the office for a few bottles of beer or glasses of wine is now the normal. It is for this reason that it is now believed that women are drinking more than they did a few years ago, an assertion that Tsute Mwale refutes.

“The only difference now is that women are more independent and don’t mind as much what men think. They see themselves to be at par with their male counterparts.  People will say women are drinking more now, I disagree, it’s only that in the past they were secretive about it and now they are not. It’s a liberation process,” Tsute said.

For Tsute, it is wrong for people to brand women who drink from bars as being loose and irresponsible as most are decent and are just out to have a good time and on many occasions with their female friends.
Tsute Mwale

“A woman has many roles, not only is she a career woman, she has to be a wife and mother among many other things and all these things can be very exhausting. Some choose to have a few drinks to unwind before going home to another hectic environment. I see nothing wrong with that unless she begins to neglect her family in preference for alcohol and hanging out with her friends.”

Tsute who herself is an occasional drinker and a mother of one girl says she prefers to invite friends over with their children. She says that way not only do the parents get to spend time and watch over their children, the mothers too can enjoy some downtime with adult company while drinking moderately.

It's difficult to obtain the actual statistics in Zambia as very few research has been done with regards to alcohol but what is considered moderate drinking?

The United States Department ofAgriculture (USDA) defines moderate drinking as up to one drink per day for women and up to two drinks per day for men. For women who drink above average, the health risks are many; Liver damage, heart disease, breast cancer among many others.

Dr Francis Mupeta, the Secretary General of the Resident Doctors Association Of Zambia adds that "an individual who is dis-inhibited will engage in activities they would not normally do if they were sober such as unprotected sex, a public nuisance and disorderly conduct.

"Alcohol can also disturb the menstrual cycle and eventually infertility. Alcohol also exposes a woman to physical and sexual abuse."

And while chronic heavy drinking is a leading cause of heart disease, women are more susceptible to alcohol-related heart disease than men, even though women drink less alcohol over a lifetime than men.

"It should be noted that women are more susceptible to the effects of alcohol than men. This is because they have more body fat than men," Dr Mupeta emphasized.

The USDA also notes that “there is an association between drinking alcohol and developing breast cancer. Women who consume about one drink per day have a 10 percent higher chance of developing breast cancer than women who do not drink at all."

For pregnancies, any drinking during pregnancy is risky. A pregnant woman who drinks heavily puts her fetus at risk for learning and behavioral problems and abnormal facial features. Even moderate drinking during pregnancy can cause problems.

And SABMiller, the main distributor of popular alcoholic beverages in Zambia in its 2011 Position Paper on Pregnancy and Alcohol states that pregnant women should either not drink alcohol or seek medical advice before they do.

Though we recognise that consumers are ultimately responsible for their own drinking decisions, our advertising does not suggest that drinking during pregnancy is acceptable behaviour,” reads part of the company’s position statement on alcohol and pregnancy.

The paper further states that a cluster of genetic anomalies, classified as FoetalAlcohol Syndrome (FAS) or Foetal Alcohol Spectrum Disorder (FASD) has been found in some children born to women who are either dependent on or abuse alcohol during pregnancy.

FASD is a birth defect that has its primary effect on the brain. The anomalies include pre and postnatal growth deficiency, distinctive facial features and central nervous system dysfunction.  

“Other foetal conditions associated with drinking during pregnancy are heart and kidney defects, hearing and sight impairment, cleft lip, and other brain and central nervous system dysfunction. But in women who are light or infrequent drinkers, there is no conclusive evidence of increased risk of foetal harm or miscarriage,” says SABMiller.

Dr Mupeta counters SABMiller warning that "alcohol crosses the placenta and can affect the baby. It is teratogenic meaning it has the ability to form 'cancers' in fetuses. A baby can also be born with a condition known as fetal alcohol syndrome which leads to physical, mental and behavioral disorders in children."

"The effects of alcohol on an infant can be as disastrous as that of unborn one. Some of the pronounced ones are brain damage. The infant would have delayed development milestones such as sitting, walking and speech. These children end up with learning disabilities in school."

While understandably there is a justified scorn towards women who drink whilst pregnant, Pastor Isaac Makashinyi of Emmasdale Baptist Church says alcohol has a negative impact on marriages and families.

Pastor Makashinyi says ”alcohol breeds suspicion and tension in the marriage. Husbands of spouses who drink away from home naturally begin to suspect their wives of extramarital affairs with other men. Furthermore, the tension builds up due to the negative feelings that begin to develop toward the alcoholic wife because of the smell of stale alcohol on their breath.”

Such acts open the door for infidelity in the marriage by one spouse or both. The non- alcoholic husband may turn to someone else for comfort, while the alcoholic wife may betray the marriage as a result of a wrong decision made while under the influence of the alcohol.

The hurt felt from this betrayal of trust in a marriage often times causes the end of the marriage. Alcohol causes the drinker to have strange and adulterous thoughts, produces willfulness, and prevents reformation because it makes one unstable.

Dr Mupeta explains that "alcohol increases sexual arousal and desire by psychologically dishibiting them! This makes them (women) more vulnerable to unwanted sexual advances from men. Women who drink were more likely to have unprotected sex and therefore more likely to contract sexually transmitted infections.

On the other hand, alcohol is a suppressant therefore it tends to cause latency in achieving orgasm and less intense orgasmic experiences. Alcohol also affects the ability of an individual to relax, therefore affecting the 'coming' of a woman during intercourse."

Pastor Makashinyi also warned that “in situations where alcohol is present, differences between spouses become more frequent and intense. And because the marital quality is decreased, these differences increase the likelihood of divorce. Drinking has an impact on the amount of time that partners spend together, especially if the alcoholic frequently drinks away from home. The more time spent apart, the less satisfied the nonalcoholic spouse becomes and the greater the potential for divorce, “

He added that alcohol also increases irrational behaviour such as anger and because marital satisfaction is related strongly to a couple's ability to communicate effectively, heavy alcohol use is associated with more negative and hostile communication, more expressions of anger, and less warmth and unity in the relationship.

These factors, he says decrease a couple’s satisfaction in their marriage and create greater tension and violent behaviour. In Proverbs 4:17, the Bible refers to alcoholic drink as “the wine of violence.”

In the clergy’s view children who grow up in an alcoholic home environment may develop emotional problems, such as anxiety and behavioral outburst. Such children who rarely have quality time with their mother in a sober state begin to feel unloved and lonely and hence develop serious emotional and developmental problems.

According to Pastor Makashinyi, “Drinking mothers simply don't have the time for effective and responsible parenting.”

Besides the many problems already said, alcohol affects medications such as oral contraceptives and makes them less potent. This results in a woman falling pregnant despite being on the pill.

There are some ARV’s which are hepatogenic (capable of affecting the liver). When these are combined with alcohol, they can accelerate liver damage or they may be made less potent by alcohol. PYM.