Thursday, August 30, 2012

Global fund approves US$28 million grant for Zambia

By Meluse Kapatamoyo

Zambia has received US$28 million for its Malaria and Tuberculosis (TB) fight from the Global Fund. The grant is part of the US$419.2 million to fund prevention, treatment and care services of people affected by AIDS, Malaria and TB in 37 countries worldwide.

According to a statement from PartnersZambia, the proposals, approved on August 30, 2012 were part of the Transitional Mechanism.

The mechanism was established by the Global Fund Board in November 2011 on an exceptional basis to ensure that essential programs are not disrupted, at a time when there was uncertainty on the availability of resources.

The approved funding will bridge the financing of essential interventions until the next opportunity to apply for grants.

Gabriel Jaramillo, General Manager of the Global Fund said, "We are proud that this investment can assure continuation of live-saving services to countless patients."

From the US$ 419. 2 million grant, a total of US$111.7 million is to be spent on HIV activities in 16 countries, while TB is set to gobble US$103.8 million in 18 countries, with a further US$ 202.2 million going to Malaria in 11 countries.

About 48 applicants presented 61 proposals but 11 proposals worth US$ 91.2 million from 10 countries were sent back for revision.Unlike regular grant proposals, which can last five years, the requests were limited to a two-year period.

Other African countries to benefit from the fund include Angola, Benin, Botswana, Burkina Faso, Burundi, Chad, Central African Republic, Ethiopia, Guinea Bissau, Malawi, Mozambique, Niger, Sierra Leone, Swaziland, Tanzania, Togo and Abidjan-Lagos Corridor organisation, Djibouti and Egypt. PYM

Wednesday, August 29, 2012

Your Male Circumcision Q and A

                                                                       By Meluse Kapatamoyo

A discussion on Male Circumcision (MC) posted on this blog a few weeks ago ignited a fierce debate. Centred on whether or not it would be a move in the right direction for MC to be considered a prerequisite to civic centre, church or any other lawfully sanctioned marriages in Zambia, readers, especially the male folk, had a lot to say on the topic.

MC also known as ‘The cut’  is the removal of the foreskin from the head of the penis. The ministry of Health is currently on a drive to circumcise 198,000 men in the country this year. Scientific evidence shows that MC reduces HIV transmission by at about 60 percent.

However, doubts surrounding the surgical procedure and the benefits of MC have seen more men shunning the operation. Circumcision is mainly traditionally practiced by the Luvales, Lundas and Kaondes in North-Western Zambia.

In a bid to find answers to questions sent to Pokeyourmind by readers, I came across three small easy to read booklets being distributed by the Health ministry and its partners- Marie Stopes International, USAID and Partnership For Integrated Social Marketing (PRISM). 

The booklets give a low down on circumcision, from its benefits, the surgical procedure and healing process.

Benefits of MC

MC improves hygiene and can reduce a man’s chance of getting some sexually transmitted infections (STIs) including HIV, syphilis, chancroid and human papilloma virus (HPV). HPV is a virus that can cause penile cancer in men and cervical cancer in women. And because MC keeps the penis clean and dry, baby boys who are circumcised are less likely to get urinary tract infections.

Appropriate age for MC

MC can be done very safely for baby boys below the age of 90 days old. Healing takes less than one week. Note that MC is not offered to children between the age of two months and seven years because children in this age group are very active and do not follow instructions. After seven years old, the procedure can be done on boys and men at any age.

Safety

MC is a very safe procedure if done by a trained health provider. But as with all surgical procedures there are some risks, including pain, bleeding, swelling, infection or reaction to the medicine. It is therefore important to speak with the MC provider about the possible risks and follow instructions to the latter.

Surgical Procedure

A clinical assessment is done before each procedure. This includes an examination of the genital area to rule out the presence of any genital diseases. If any are found, they must be treated before the procedure can take place.

You will be given a few small injections to numb the pain at the base of the penis. This will ensure that the person feels no pain when the foreskin is being removed. After the foreskin is removed you will be stitched and bandaged.

Healing period

You should be able to return to work or school within 2-7 days but the patient will need to return to the MC centre after two days to have the bandage removed and again after one week so that the provider can access if the wound is healing properly.

Sexual performance after MC

MC does not change sexual pleasure and it does not affect a man’s ability to have children. However, there is a six week healing period, and during this time the man is expected to completely abstain from sex or masturbation.  A man is actually more at risk of contracting HIV and some other STIs if he has any sexual contact during the six week healing period.

How to tell a circumcised man from one who is not

A man is circumcised if the head of his penis is fully exposed all the time. A man is not circumcised if there is a bit of skin that folds over and covers the head of the penis while the penis is not erect.

Protection

MC only provides about 60 percent protection and not 100 percent. Thus, after the procedure, always use a condom or abstain from sex and be faithful to one partner who is faithful and know your status. PYM

Wednesday, August 15, 2012

QUAD PILL: The HIV adherence booster


By Meluse Kapatamoyo

Adherence to medication is critical for people living with HIV. However, the number of tablets a patient is required to take on a daily basis makes it difficult to stick to a regular time-table, a situation which can lead to drug resistance.


Clemetine Mumba
For people like Clementine Mumba, who has been on anti-retroviral therapy (ART) for the last 12years, she soon may no longer have to worry about the number of pills she would have to take on a daily basis.

A recent US study has revealed “Quad pill” tablet which combines four HIV drugs into a single daily treatment. The four in one pill is intended to make it easier for patients to stick to their medication, improving the effects of their treatment.

Mumba was diagnosed with Tuberculosis in 1998 and immediately commenced treatment but tested HIV positive eight months later.

In the year 2000, she started the antiretroviral therapy (ART) but had to discontinue due to prohibitive cost of Antiretroviral (ARVs) drugs at the time. The drugs cost K1.5 million per month (U$300).

“The stress of taking so many drugs was too much and as if that was not enough, storage of (Kaletra) was also difficult for me, especially when I was travelling.  I used to move with a small cooler box all the time when I was travelling out of my base.

I remember one time, my friend lost her father in Mpulungu (Northern Zambia) and I escorted her for a funeral in the village where there was no electricity and no refrigerator.  I would buy ice water at the market and put it in the small cooler box just to keep my drugs cool.”

Though Mumba restarted her treatment two years later, she had already developed resistance to the drugs.

In 2005 after becoming resistant to first-line treatment, Mumba was put on 2nd line drugs and started taking Aluvia and Truvada which she says require her to take fewer tablets daily.

Instead of the earlier 7 tablets, she now only takes 5 (2 Aluvia tablets, twice daily and 1 Truvada tablet daily)

The Quad pill is said to be the first multi-pill to include a type of anti-HIV drug known as an integrase inhibitor, which stops the virus from replicating.

Researchers say the solitary once a day pill was found to be faster acting and had fewer side-effects compared to two widely used drug regimes.

Mumba says “for me taking one pill a day would make a great difference in my life, it will christmax, especially that it has fewer side effects.  Some of the drugs that I have taken have left me with fatal side effects which are physically irreversible.

So the news of one pill, once per day and fewer side effects, will be truly good news for a woman like me, who has come a long way from taking so many TB drugs, so many ARV drugs to one tablet only once per day.”

According to the World Health Organisation (WHO), standard ART consists of the combination of at least three ARV drugs to maximally suppress the HIV virus and stop the progression of HIV disease.

An estimated 34 million people are currently living with HIV worldwide. At the end of 2011, over 8 million people living in low- and middle-income countries had access to ART, reported the WHO and UNAIDS organisations.

While access of ARVs by infected people remains vital, finding a lasting solution to drug resistance, that would ensure patients take their medication daily and on time is equally important.PYM

Monday, August 6, 2012

Breastfeeding- the healthier choice for babies

By Meluse Kapatamoyo

With an upsurge of various diseases and pressures of daily living affecting most women, some mothers are being forced to reduce or stop breast feeding altogether before the
recommended six months, denying their infants the much needed nutrients from breast milk.

From August 1 to 7, mothers in more than 170 countries celebrate World Breastfeeding week, a period meant to encourage breast feeding and the improvement of the health of babies.

The week commemorates the Innocenti Declaration made by World Health Organisation (WHO) and UNICEF policy-makers in August 1990 to protect, promote and support breastfeeding.

WHO recommends excluse breastfeeding until a baby is six months old, and continued breastfeeding with the addition of nutritious complementary foods for up to two years or beyond.

Eliva Mwewa Mwansa, a mother of one,  said, “I went back to work after 3months but wish I could have spent more time exclusively feeding my baby for the recommended months. Unfortunately, my baby refused formulae so I started giving her light cereal at 3 months. I am still breast feeding and she now eats solid foods, so I only breastfeed her when I get home, mostly in the night. Luckily she is a very healthy child.”

According to UNICEF, despite compelling evidence that exclusive breastfeeding prevents diseases like diarrhea and pneumonia that kill millions of children every year, global rates of breastfeeding have remained relatively stagnant in developing countries, recording a minimal growth from 32 percent in 1995 to 39 in 2010.

“If breastfeeding were promoted more effectively and women were protected from aggressive marketing of breast milk substitutes, we would see more children survive and thrive, with lower rates of disease and lower rates of malnutrition and stunting,” said UNICEF executive director Anthony Lake.

He believes that strong national policies supporting breastfeeding could prevent the deaths of around 1 million children under five in the developing world each year.

In 2008, the Lancet Nutrition series revealed that a non-breastfed child is 14 times more likely to die in the first six months than an exclusively breastfed child.

“Breastfeeding needs to be valued as a benefit which is not only good for babies, mothers, and families, but also as a saving for governments in the long run,” said Lake.

In June, world leaders meeting in Washington, DC, pledged as part of the “committing to Child Survival: A promise Renewed” movement to work toward ending preventable child deaths.
PYM

Tuesday, July 31, 2012

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?

Wednesday, July 25, 2012

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.

Saturday, July 21, 2012

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

Monday, July 16, 2012

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.







Thursday, July 12, 2012

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.

Wednesday, July 11, 2012

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

Thursday, July 5, 2012

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.

Tuesday, July 3, 2012

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.”

Monday, July 2, 2012

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.

Tuesday, June 19, 2012

Kenya to host first African Epilepsy Conference

By Meluse Kapatamoyo
Come June 21 to 23, 2012, The International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE) will host the first African Epilepsy Congress in Nairobi, Kenya.
More than 40 speakers will present a range of topics over the three day period on recent scientific and clinical developments in epilepsy.

The conference is a firm commitment by African countries to improve the quality of life of people with epilepsy through support of education, research, knowledge dissemination and patient care.

The conference, among others, will focus on diagnosis, management and special epilepsy populations, as well as addressing management gap and research in Africa. The way forward in the African Region and primary healthcare will also be tackled.

Zambia will be represented by Anthony Zimba, Epilepsy Association of Zambia President who is also the IBE Africa region vice president.
Epilepsy is one of the most prevalent neurological disorders worldwide with no age, racial, social class, national nor geographical boundaries says the World Health Organisation (WHO).
It estimates that there over 50 million sufferers in the world today and of that number, 85 percent live in developing countries. Globally, an estimated 2.4 million new cases occur each year.

Zambia: The untold agonies of Care-givers



Picture by Miyon Kautz, World Vision Zambia


By MELUSE KAPATAMOYO
Nursing a loved one during an illness comes as a family responsibility to some people and part of the marriage vows to others. But whatever the case, it is an obligation that requires individual sacrifice to save a life.
While it is understandable that a patient receives undivided attention, great care and support should also be given to care-givers, also known as ‘bed-siders’ in most Zambian hospitals.
Care-givers spend countless hours attending to sick family members who may either be in hospital or at home. Their duties are mainly physical and include washing, bathing and feeding the patient.
Depending on the willingness of family members, these duties can be alternated. Unfortunately, some care-givers spend weeks and sometimes months without getting any relief.
Not too long ago, I was hospitalised at Zambia’s highest referral health facility, the University Teaching Hospital (UTH) and I got to see first-hand the emotional and physical stress it takes to take care of a sick person.
My diagnosis, a brain infection, which triggered on and off mild seizures, usually lasted a few seconds and meant I was very much aware of my surrounding.
I was admitted in the heavily-congested ‘Filter Clinic’ for the first night, with more than 15 other patients, each with one or two people by the bedside looking after them. I had my sister spending the night in a chair next to my bed.
We both did not sleep much and we did not talk much either. I felt as if by talking I was being disrespectful to care-givers whose relatives mourned and screamed in pain. I even felt guilty getting out of bed because they had to struggle to put their loved ones in wheel chairs before wheeling them to the bathroom.
Although I did not hear a single one of them complain, the troubled faces of worry and sometimes frustration told all that needed to be said.
The woman next to me was on life-support. A man and woman watched helplessly over her. In a conversation with my sister, the woman explained that her cousin had collapsed the day before. Diagnosis was a stroke. The elderly man who never left her side was her husband.
I also observed a man some few beds from mine. He was the only one in the room who seemed to have had as much energy as I did. He walked unaided to the gents but I was shocked when he died in the early hours of that morning. His bed-sider collapsed. I heard that she was his wife.
The boy opposite my bed had clearly been sick for a while. His body was frail. While his mother made conversations with him and smiled, I caught her in tears when the boy fell asleep.
I could not see the faces of all the patients but I was able to get a clear picture of the care-givers' desperation as they struggled to feed, clothe and make bed changes. It was at this point that I realised the impact of Zambia’s shortfall in health-care personnel.
The ministry of Health estimates that Zambia’s public health institutions, including the UTH are operating at 50 percent capacity; with the doctor to patient ratios standing at around one to 12,000. 
This shortfall means that care-givers have to help-out the few nurses in dealing with the patient needs. Regrettably, due to lack of training and perhaps emotional involvements, the process can be frustrating.
The next day, I was moved to what was to be my home for the next nine days. I felt relieved. Unlike the filter clinic, things at the High Cost wing seemed calm. Perhaps it was because 90 percent of the ward remained unoccupied. In total, it had four patients, inclusive of myself. I was relieved for my sisters who were already taking turns in taking care of me.
The sanitary conditions were better and the over-worked nurses were more attentive.
However, it was there where I witnessed the strength and patience it takes to look after a sick person. Opposite my bed was a woman in her 40s. She was in a state of confusion. The emotional and physical abuse she inflicted on her sister, who she accused of wanting to kill her, shocked me.
Surprisingly though, she developed a liking for one of my sisters who took over the responsibility of feeding her and making sure she took the medication.
Her sister was not allowed to touch her food, not even water. If she did, it had to be discarded. She was forced to sleep under the bed, pretending to have left. One day, I witnessed her bend over and empty a bottle of water on her blanket. The sister took walks to calm herself down.
I also remember Tina, a young lady suffering from malaria who had a lumbar puncture. Her guardian was a heavily-pregnant young lady. Despite her condition, which made it difficult for her to attend to all of Tina’s needs, none of the woman’s relatives came to help her out.
She struggled to feed and bath her knowing that a call for assistance to the nurses meant an extra charge. One evening, after she had tucked Tina into bed, exhausted, she tried to leave and spend the night home, only to be called back by the nurses.
I realised that whether in high-cost or low cost wards, most nurses go to sleep soon after midnight. Their duties, it seems, mainly involve checking the patients’ temperature and blood pressure as well as delivering medication. It was the bed-sider's responsibility to watch over the patient during the remainder of the night.
Two days before I was discharged, I was awakened by someone wailing. The woman in the side ward had died. I never got to see her but had watched her mother trek to the bathroom every so often.
All I knew was that she did not want to die. For two days she screamed, saying she wanted to live and raise her children. Her mother was inconsolable.
Six hours later I was awakened by another cry. Tina had died and we found out that she had been an employee of the pregnant woman who had only worked for a month before she got sick.
Wailing, the lady asked how she would explain Tina’s death to her relatives who lived in another province. She also wondered how she would manage to transport the body and meet the funeral expenses.
Three hours later, the elderly woman who had been brought in two days before, also passed-on. She was the same woman who had been next to me in the filter clinic. Her husband and cousin were witnesses as she took her last breath, both were grief-stricken.
In a country where people do not culturally accept professional counselling and still consider it a trend synonymous to white people, I often wondered where one gets the emotional strength to continue giving support and love to their loved ones during such times even when they are exhausted.
Months later, my siblings and I suddenly became care-givers to my mother who suffered from dementia. The encouragement I got was “be strong, now is not the time to break-down, take it one day at a time”.
I guess this is how bed-siders do it; they take each day it as it comes, watching helplessly and hoping for the best. I realised then that one has to dig deep within themselves to find the strength and patience to care for a person who is ill, especially those suffering from terminal illnesses because love alone is not enough.
Care-givers go beyond relatives and friends. Most of them take the time to nurse even total strangers because of their desire and passion to save a life. We should all salute care-givers, as even in death, they are life-savers indeed.
 Ends…/