Neighbourhood health committees out to reduce maternal mortality

By MELUSE KAPATAMOYO

The day is September 25, 2012 and I am at Chaisa Health Centre to be part of a Focus Group Discussion (FGD) on Maternal and Child Health being held by Alliance for Community Action on HIV and AIDS in Zambia (Alliance Zambia), with Neighbourhood Health Committees (NHCs).

Despite it being a windy day, as soon as I step out of the vehicle, am greeted by a strong stench emanating from a nearby sewer. Fortunately my attention immediately shifts to a large crowd of women and children attending an Under-Five Clinic. What is even more striking is that the majority of these mothers are still children themselves.

Before my brain can process the situation and begin to ask the necessary questions, my focus is drawn to a screaming baby. I curiously watch as the young mother struggles to calm the child down.  Looking somewhat embarrassed and irritated by the child’s screaming, she starts to remove the baby’s clothing, signaling that perhaps the September heat could be the reason for her Childs discomfort.

But that doesn’t calm the child down, forcing one elderly woman to ask if the child is sick. Her response, ‘This is the way she cries. She will stop on her own. I am used to it.’  The woman suggests that she should perhaps try and breast feed the baby. Having drawn everyone’s attention already, the young mother reluctantly gets ready to feed but the young mother lamentably struggles to hold on to the breast and at the same time hold on to the child. It is clear that she is yet to grasp the art of breast feeding. 

Luckily for her, she gets a free lesson from the elderly woman who teaches her how to hold the baby’s head comfortably, while holding on to the breast to prevent chocking. In just a few minutes, the child’s screaming is replaced by the normal noise of other children, running around the clinic compound as the crying baby falls asleep.

“That is a daily occurrence around here. We have children, having children. And when these children have children, they have no idea of what it takes to be a mother. The situation is made worse because most of them miss out on ante-natal where they can be taught some of these things such as the importance of nutrition. Instead of attending ante-natal the girls try by all means to conceal their pregnancies,” says one NHC member when I shared the story of the young mother and her breast-feeding dilemma during the Focus Group Discussion. 

“About two months ago, an 18 year old girl gave birth just outside the clinic. She had kept the pregnancy hidden until she went into labour, by the time they got here, it was too late. They couldn’t get her inside the clinic. It’s a difficult situation, we are dealing with mothers who not long after delivery start to live the child in the care of younger siblings or old grandparents, depriving the baby of breast milk and motherly care,” added another NHC member. 

According to the NHCs, as high as the turn-up of mothers who bring their children for under-five clinic at Chaisa Health Centre may seem, the number of women that stay away was equally high.  The clinic covers three catchment areas; Marapodi, Chaisa and Mandevu.

Some of the reasons they absconded from accessing health care services at the clinic included; long queues caused by lack of adequate staff at the health centre and lack of family planning knowledge, which often leads to some mothers getting pregnant soon after delivery, making it difficult for them to live home and take all their children for under-five clinic. 

However, some women find taking a malnourished child to the clinic embarrassing. Instead they choose to keep the child hidden even from neighbours than admit they are unable to provide a proper diet for it. This is despite having knowing that through NHCs the clinic offers free nutritional supplements for malnourished children and also free cooking lessons.

While some of these challenges are being addressed by NHC’s in the area, others are beyond the committee’s capabilities and can only be handled by relevant authorities such as councilors, Member of Parliament (MPs), Ministers/Ministries.

Realising the important roles that NHC’s play in communities and the urgent need for these maternal health challenges to be addressed by authorities, a suggestion was born by Alliance Zambia, with support from Save the Children Sweden (SCS), to hold an  Advocacy training on Maternal and Child Health for Mungule and Chaisa NHCs. 

Together, and in collaboration with health centres in Mungule (Chibombo) and Mandevu (Lusaka) the two organisations are implementing a project that will see a two third reduction in morbidity rates for children under five years old in Zambia by 2014. The project is also promoting safe motherhood and is contributing towards improving maternal health in Zambia by 2014 and reducing maternal mortality by three quarters, thereby contributing to Millennium Development Goals (MDGs) 4 and 5.  

The two day training was held in Lusaka and attended by 10 participants from Chaisa and Mungule, an area where maternal health challenges are rampant and where two Focus Group Discussions were held prior to the training.  Each NHC was represented at the training by five participants.

Key points in the training included brainstorming major health challenges affecting women and under five children in Mungule and Chaisa and then depending on the particular issue, identifying targets they could advocate their problem to.

Although both areas faced similar problems, they chose different issues as the ones needing advocacy.



NHC Members Stanely Banda (R) and Leonard Mwewa during the
Alliance Zambia training.



“For a long time we have had major issues in our communities needing urgent and serious attention from our leaders, but didn’t know how to approach them. It was difficult to find ways of tackling these issues. The training has indeed opened my eyes to the many different methods we can use to air our views and most importantly get the attention of our leaders,” said Chaisa NHC member, Stanley Banda, enthusiastically, at the end of the training.

And Mungule’s Catherine Himoonga said, “Advocacy used to be such a strange and complicated word to me, now I understand it and how to go about it. I can’t claim to be an expert but it’s good that the team from Alliance Zambia have committed themselves to be available when we need help. We have always been silent and do nothing when things go wrong in our community but with this training, we now have an idea of how to go about it.” PYM. 

Be a good neighbour, stop GBV

By MELUSE KAPATAMOYO

At only 12, the life of Brilliant Muyuwa was brought to an abrupt and brutal end when she was defiled and strangled early this year.

Brilliant's death made headlines in the media and also attracted the attention of high profile people like First lady Dr Christine Kaseba, who travelled to Masupelo village in Chibombo to attend her funeral.

Since then Chibombo has remained in the spotlight and many more cases of Gender Based Violence (GBV) have surfaced. However, civil society organisations are keen to see a reduction and eradication of GBV cases in the area.

Recently, the Zambia Social Forum (ZAMSOF) and its partners; Alliance for Community Action on HIV and AIDS in Zambia (Alliance Zambia), Action Aid, Sight Savers and Oxfam in Zambia held a National Forum aimed at making known the new Anti- Gender Based Violence Act  and raising awareness on GBV to people in Chibombo and neighbouring areas.

ZAMSOF is a network of civil society organisations which is part of the World Social Forum of Civil Society Organisations (CSOs), an open space for reflective thinking, democratic debate of ideas, free exchange of experiences and interests for effective action.

The national forum was flagged off with a march past led by the vice-presidents wife, Charlotte Scott, ministers spouses, representatives from the first lady’s office, members from various civil society organisations and community members. It was held under the theme ‘Gender Based Violence, Child Rights and Abuses.’

Issues on the agenda included, HIV & AIDS, maternal neonatal, children health and voluntary medical male circumcision, climate and environment, youth and labour, governance, human rights, including the right to land and women’s rights.

Mrs Scott said it was impossible to achieve any meaningful development amid a society which experiences injustice and violation of human rights due to GBV

“More police posts should therefore be equipped with facilities to ensure this is a reality. Distance should not be a barrier to the course of justice and recourse in our communities so that women and children are adequately protected. As Zambia celebrates its 49^th year of independence, the commemorations need to move the country to another level of social justice and wellbeing should lead to reduced GBV cases,” said Mrs Scott.

For children who are victims of abuse and violence, which includes witnessing violence that is inflicted on other members of the household, this affects their mental, physical, and emotional development. It also affects their capacity to realise their aspirations and contribute to the development of the country.

Mrs Scott added that, “We know the role that women play in the country, not only in social but also economic development and if we are taking the people who are leading that process and we put them into lives of anxiety, of fear, of pain, of rights abuse then the country can’t go anywhere.”

Recent statistics from the Young Women Christian Association (YWCA) indicate that cases of GBV are still on the upswing. About 3, 733 cases were reported between January and June 2012.

NGOCC Executive Director, Engwase Mwale noted that “It is an undeniable fact that GBV reinforces the inequalities and iniquities between women and men and therefore compromises, not just the health of the victims, but also the dignity, the security and autonomy of the victims.”

She said because women and children had continued to be victims of brutal killings, rape, defilement, incest and other forms of abuse, the fight against the vice needed commitment and concerted efforts from different stakeholders if Zambia was to see a reduction in such cases.

“We are here (Chibombo) to be able to commit to work with the traditional leaders that their voice is important to end the negative cultural practices if we are to win the fight against GBV. And as a women’s movement, we are requesting the traditional leadership to ban early marriages in their chiefdoms. Early marriages have repurcations on the girl-children because it keeps them away from schooling,” pleaded Mwale.

She called on government to allocate adequate resources in the 2013 national budget so as to address the issue of shelter for survivors of GBV and also resources that will go towards putting together a gender based violence fund that will cushion the survivors of GBV.

And Alliance for Community Action on HIV and AIDS in Zambia (Alliance Zambia) Policy and Advocacy Manager, Reverand Malawo Matyola directly called on women not to live in fear but report cases of Gender Based Violence to relevant authorities.



Charlotte Scott folds the Maternal and Child Health Poster presented to her by Alliance for Community Action on HIV and AIDS in Zambia (Alliance Zambia) Policy and Advocacy Manager, Reverand Malawo Matyola, as ZAMSOF chairperson, Mary Tembo-Mhango looks on/Picture by Nkandu Chikonde from Alliance Zambia



“In our African setting, your neighbour’s child is yours too. Because that is your child too, if you notice that child is showing signs of abuse, it is your duty to report the case to authorities and if possible take the victim to the hospital,” Matyola advised.

However, he also urged health workers to be tolerant and patient with victims of GBV.

Matyola condemned an incidence where a young girl was harassed by police on her way to the hospital to collect Ante-retro viral drugs (ARVs) when she was accused of promiscuity.

“Because of the long distance to the centre, this young girl started off to the clinic as early as 04:00 but was stopped by police who accused her of being promiscuous. Such situations should not be allowed to happen. The girls’ only response was ‘I wish I was the causer of this disease, but I was born with it.’ Colleagues in the police force and clinics, let’s be friendly and render the help these victims need,” he added.

Recognising the importance for Civil Society to address GBV, Child Rights and abuses in communities, Alliance Zambia places great importance on the rights of pregnant women and children under the age of 5, to ensure they are not abused.

With support from Save the Children Sweden (SCS) the organisation is currently contributing to Millennium Development Goals (MDGs) 4 and 5; to reduce mortality and morbidity rates for children under five years old in Zambia by 2014 by two thirds and to promote safe motherhood and improve maternal health in Zambia by 2014 and reduce maternal mortality by three quarters respectively. This project is being implemented in Mungule (Chibombo) and Mandevu (Lusaka) through close collaboration with the healthcentres in the respective sites.

In Zambia, cases of mothers miscarrying due to GBV and others who die while pregnant due to the same vice are common.

The National forum which was organised by Zambia Social Forum, under the secretariat of NGOCC, Women for Change (WfC) and Zambia Council for Social Development (ZCSD) also provided eye screening checkups, Voluntary Counseling and Testing (VCT) and testing, Sexually Transmitted Infections (STIs), Male Medical Circumcision and information on Economic Empowerment.

ZAMSOF has been successfully organizing the annual National Social fora in towns and communities of Lusaka, Choma, Kapiri-Mposhi, Monze, Mansa and Chipata since 2003.

One of its many objectives includes improving participation of the general citizenry in the policy making processes of the area Members of Parliament by ensuring those peoples’ voices are registered at the national, regional and continental levels.

“Our mission is to promote and facilitate sustainable, socio-economic Development through collaboration and networking among NGOs, Community Based Organisations (CBO’s) and other stakeholders,” explained ZAMSOF chairperson, Mary-Tembo Mhango. PYM

 

Male involvement in ante-natal care equals healthy babies

By MELUSE KAPATAMOYO

Enedi Malambo, 38, is a mother of seven and is currently carrying another pregnancy due in three months.

Enedi

During all the previous seven pregnancies, her husband has never accompanied her to the Ante-Natal Care (ANC) clinic. But the eighth one is exceptional in more ways than one.

“Since my first ante-natal appointment (during this pregnancy), my husband has been coming with me to the clinic. Before, he used to refuse,” says Enedi of Kembe area, some 70km off the Great North Road in Chibombo district.

She smiles and adds that “not once did he escort me to the clinic when I was pregnant with my other (seven) children. But now that nurses insist on pregnant women coming with their husbands, he had no choice but to come with me to the clinic.”

Enedi is happy over the involvement of her husband in her current pregnancy. She says it has given him extra insight into the intricacies of pregnancy care and as such they  are now able to communicate better about her health needs.

In the past men were not obliged to accompany their pregnant wives for ante-natal check-ups. Currently most public health institutions are asking men to be fully involved in the affairs of their expecting wives. 

Pregnant women and their husbands undergo couple HIV Counseling and Testing services. In the event of both or either of them being found HIV positive, the couple can then be counseled on how to manage the infection and ensure they protect themselves from re-infection.

Where both of them are HIV negative, they are still encouraged to discuss their status and ways of ensuring they remain free from HIV infection and other sexually transmitted infections. PYM

Programme Mwana wins gold, Silver, for UNICEF Zambia

By Meluse Kapatamoyo

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

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

UNICEF Zambia Officer-in-Charge Shaya Asindua

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

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

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

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

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

Facing the dangers of high blood pressure (BP)

 By Gershom Ndhlovu



Gershom Ndhlovu

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Measles Campaign draws thousands

     ...as men get involved

BY MELUSE KAPATAMOYO




Children queue up to receive the measles vaccine

 

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

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

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

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

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

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



BISO Executive Director Beatrice Chola

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

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

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

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



Naomi receives the measles vaccine

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

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



Joseph with his niece Alice

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

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

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

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

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

HIV stigma curtailing positive living

By MELUSE KAPATAMOYO

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

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

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

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

Chitanda Rural Health Center

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Inadequate staff to hamper Measles Campaign

By Meluse Kapatamoyo

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

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

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

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

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

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

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

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

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

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

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