Saturday, 15 November 2014

Rubella epidemic during pregnancy increase risk of autism – Mbakwe

By Chioma Umeha

Mrs. Helen Mbakwe, is the President, Keera Autism Foundation, (KAF) in Lagos. In this interview with CHIOMA UMEHA (HEALTH EDITOR) Mbakwe, also a lawyer, who has a daughter living with autism, x-rays challenges of parents and children with the condition. Excerpts: 

Mrs. Helen Mbakwe, is the President, Keera Autism Foundation, (KAF) in Lagos.

Give the overview of autism? 
Autism is a developmental disorder of the brain. It affects children that are less than three years. It is characterised by a problem with social interaction, impairment in verbal and nonverbal communication and a pattern of repetitive behaviour with narrow, restricted interests. Autism is classified as one of a group of disorders known as the pervasive development disorders (PDD) by the American Psychiatric Association. In addition, PDD include Asperger syndrome, which is a childhood disintegrative disorder. This group of disorders is sometimes called the autism spectrum disorders (ASDs). Autism goes without diagnosis until the child enters school. Autism is highly genetic and genetics of autism is complex and unclear about the genes responsible for this disorder. Observable signs can be seen within the first two years of life. Early intervention can help the child regain skills, social behaviour and self-care as there is no cure to this illness. 

Mention factors that can put children at risk of autism? 
Studies suggest that the prevalence of autism is one to two per 1000 globally. The number of reported cases of autism increased dramatically in the 1990s and early 2000s. This rise is contributed by factors like changes in diagnostic practices, referral patterns, availability of services, age at diagnosis and public awareness. Autism is associated with several other conditions like genetic disorders, mental retardation, epilepsy and metabolic defects.Various factors contribute to the causes of autism. Some of them are exposing to infections especially in the rubella epidemic during pregnancy increase the risk of autism in new born among others. A review conducted in 2007 showed that advanced maternal and paternal age, prenatal, perinatal and postnatal infections, exposure to toxic agents, obstetric conditions like low birth weight, decreased gestation period and hypoxia during child birth are the risk factors of autism.         

List signs and symptoms of autism? 
Children with autism may show normal development for the first few months or years. Later they become less responsive. Signs and symptoms widely vary in children. Diagnosis is based on the behaviour; signs and symptoms. After initial identification, specialists like a child psychologist or a developmental pediatrician do assessments. They use a variety of methods like a standardardized rating scale to identify the disorder. 

Discuss treatment and prevention of autism? 
There is no cure for autism. Proper treatment and education can help the child to learn and develop. Treatment depends on the condition and individual needs of the patient. Combination of treatment methods is more effective as autism requires lifelong treatment. Autism can be prevented by avoiding alcoholic beverages and drugs during pregnancy. It can also be prevented through immunization against rubella. 

Discuss challenges of parents with children living with autism? 
It is very difficult to raise a child with autism. The parents experience a lot of stress to meet the demands of the child. Recognizing the problem and preparing one’s self to face the challenges ahead would be helpful and make a tremendous difference. The severity of symptoms varies greatly, but all people with autism have some core symptoms in the areas of: Social interactions and relationships. Symptoms may include:  significant problems developing nonverbal communication skills, such as eye-to-eye gazing, facial expressions, and body posture; failure to establish friendships with children the same age and lack of interest in sharing enjoyment, interests, or achievements with other people. The next is lack of empathy. People with autism may have difficulty understanding another person’s feelings, for instance; pain or sorrow. Another challenge is verbal and nonverbal communication. The symptoms include: delay in, or lack of, learning to talk. About 40 per cent of people with autism don’t speak, while some find it difficult to start a conversation. Also, people with autism have difficulties continuing a conversation after it has begun. They also have problem of stereotyped and repetitive use of language. People with autism often repeat over and over a phrase they have heard previously. They also have difficulty understanding their listener’s perspective. For example, a person with autism may not understand that someone is using humour. They may interpret the communication word for word and fail to catch the implied meaning. Children with autism show limited interests in activities or play. Symptoms may include: an unusual focus on pieces. Younger children with autism often focus on parts of toys, such as the wheels on a car, rather than playing with the entire toy. They are often reoccupied with certain topics. For example, older children and adults may be fascinated by video games, trading cards, or license plates. They show stereotyped behaviours. These may include body rocking and hand flapping. Symptoms of autism are usually noticed first by parents and guardians during the child’s first three years. Although autism is present at birth (congenital), signs of the disorder can be difficult to identify or diagnose during infancy. Parents often become concerned when their toddler does not like to be held; does not seem interested in playing certain games and does not begin to talk. They also may be confused about their child’s hearing abilities. Some children with autism do not hear, sometimes, he may appear to hear a distant background noise, such as the whistle of a train. With early and intensive treatment, most children improve their ability to relate to others, communicate, and help themselves as they grow older. Contrary to popular myths about children with autism, very few are completely socially isolated or “live in a world of their own.” During their teenage years, the patterns of behaviour often change. Many teens gain skills but still lag behind in their ability to relate to and understand others. Puberty and emerging sexuality may be more difficult for teenagers who have autism than for others this age. Teens are at an increased risk for developing problems related to depression, anxiety, and epilepsy. 

Explain your passion for children living with autism and why you set up a foundation? 
KAF was set up as a result of my family’s personal experience and the desire to help others with the same problem. I have a daughter, Keera, living with autism. Keera, my daughter is a 13 and has two brothers. After birth, her life was just like that of millions of Nigerian children and fun, until six months before her third birthday when she was diagnosed with autism. Since then, her learning and communication issues, coupled with difficulties in socializing and repetitive behaviour have made life a roller coaster of sorts. The burden has not been Keera’s alone to bear, as my family constantly sought medical, spiritual and educational solutions. Like my family and Keera, there are countless families out there in need of direction, wholesome solutions and comfort. The condition of my daughter exposed me to the problems of parents with children living with autism. That was why I set up Keera Autism Foundation (KAF).  KAF was set up in honour of Keera. The Keera Autism Foundation, KAF is a not-for-profit organisation set up to provide succour for both children living with the condition and their families. Recently, KAF commenced a campaign to help empower and support children living with autism, their parents and care-givers. The main focus of the campaign for children living with autism is provision of information on the condition, with the aim of making more Nigerians understand and appreciate the stress which children living with the condition faces with their families. In most cases, children living with autism and their families are victims of a poorly understood condition. 

What is the scope of your campaign? 
KAF is embarking on a journey that will enlighten the populace on certain unknown facts and correct many assumptions. It will open up new vistas through which an average Nigerian will understand the challenges associated with autism. The awareness campaign, which will run in phases throughout the year, will make use of the electronic, print, outdoor and social media. Strategic parts of the campaign include educational series in newspapers; docu-drama and Documentary on Television; radio drama; news and features write-ups in the print media. Nigerians love for the Social Media will also be exploited to pass the message along to the public.Our goal is to provide relief for affected children and families while creating an enabling social environment in communities through advocacy and awareness. In line with this belief, the foundation will offer specialized education and care for children living with autism. This includes recreational facilities and supervised play and graded skill acquisition for the children; integration of the children into society and advocacy for employment for adults with autism. KAF also provides relief for parents of children living with autism through guidance on family and social structures for autism and opportunities for interfacing with international and local medical and educational experts versed in autism. Our aim reflects in our slogan: ‘Education, Awareness, Support, Integration, Empowerment, Relief’ which translates to the “EASIER” life we will provide to people living with autism and their families. 

What are symptoms of autism during adulthood? 
Some adults with autism are able to work and live on their own. The degree to which an adult with autism can lead an independent life is related to intelligence and ability to communicate. At least 33 per cent are able to achieve at least partial independence. Some adults with autism need a lot of assistance, especially those with low intelligence who are unable to speak. Part- or full-time supervision can be provided by residential treatment programs. At the other end of the spectrum, adults with high-functioning autism are often successful in their professions and able to live independently, although they typically continue to have some difficulties relating to other people. These individuals usually have average to above-average intelligence. Many people with autism have symptoms similar to attention deficit hyperactivity disorder (ADHD). But these symptoms, especially problems with social relationships, are more severe for people with autism. About 10 per cent of people with autism have some form of special skills and gifts such as memorizing lists, calculating calendar dates, drawing or musical ability. Sleep problems occur in about 40 per cent to 70 per cent of people with autism. 

How early diagnosis and treatment can help children with autism? 
Early diagnosis and treatment helps children with autism develop to their full potential. The primary goal of treatment is to improve the overall ability of the child to function. Symptoms and behaviours of autism can combine in many ways and vary in severity. Also, individual symptoms and behaviours often change over time. For these reasons, treatment strategies are tailored to individual needs and available family resources. But in general children with autism respond best to highly structured and specialized treatment. This includes programmes which focus on helping parents improve communication, social, behavioural, adaptive, and learning aspects of their child’s life. The American Academy of Pediatrics (AAP) recommends the following strategies for helping a child to improve overall function and reach his or her potential.

This story was published in Newswatch Times on June 6, 2013.

Friday, 14 November 2014

WHO certification: No report of new guinea worm infection yet

By: Chioma Umeha

“We are staring history in the face as the public health system of Nigeria is about to make a bold statement of eradicating Guinea worm disease in Nigeria after many years–over two decades of hard fought battle against Guinea worm, we have now succeeded in defeating it.” Thus quipped General Yakubu Gowon, former Head of State, on the verge of the struggle against eradication of guinea worm infection in Nigeria. This remarks of Gowon may come true barely 17 days from today if there is no report of fresh guinea worm infection in the country. 

This is because Nigeria will be officially certified free of the disease by the World Health Organization (WHO), this month. Precisely, the International Certification Team (ICT) for Guinea Worm disease eradication, from the world health body will be in the country between June 24 and July 14, to assess her for certification. Nigeria was the most guinea-worm-endemic country in the world, between 1988 and1989, as it reported more than 650,000 cases in 36 states, according to the first nationwide survey for the disease. In 1988, the disease affected 5,879 persons. Popularly identified in local parlance as “the impoverisher,” between 2002 and 2004, UNICEF spent about US $ 3.8 million (500 million naira) for guinea worm eradication. In the mid-1990s, guinea worm infections in parts of the heavily populated region of southeast Nigeria caused an estimated USD $20 million in lost income to rice farmers alone. 

The Carter Center’s Guinea Worm Eradication Programme confirmed that the disease cost rice farmers an estimated US $20 annually in the late 1980s, in the south-east alone. In collaboration with Nigeria’s Ministry of Health, the strategy for elimination consisted of several components, driven by health education. The goal was to change the behaviour and mobilize communities to improve the safety of their local water sources. Most endemic communities lacked access to quality health education, social and educational facilities among others. The period when the worm normally emerges on the skin of people tends to coincide with the peak farming season, therefore, guinea worm infection not only renders the victim immobile, it causes poverty and hunger. 

Consequently, it is often referred to as ‘masiyaci’ in Hausa, meaning ‘the troublesome one’ and ‘sobia’ in Yoruba meaning ‘poverty’. As most guinea worm endemic communities lacked health clinics, infected school children couldn’t attend classes, either temporarily or sometimes permanently. Infected individuals are unable to attend to their means of livelihoods and to fend for their families. Infected mothers are unable to provide adequate care especially to infants resulting in conditions such as diarrhoea, malnutrition and skin infections. They are unable to walk any great distance to immunise their babies against childhood killer diseases. Nigeria reported its last case in a 58-year-old woman in south-eastern Nigeria in November 2008. Since the past three years, the country has been in surveillance of guinea worm disease in preparation for the official certification by the World Health Organization as free of the disease, experts are focusing on how to repeat Nigeria’s success in the last strongholds of the disease in southern Sudan, northern Ghana, and eastern Mali. 

Meanwhile, Ethiopia is fighting just a few remaining cases. However, some have said that the expected certification programme may be a fluke, insisting that the disease is still occurring in the villages, therefore, the country cannot claim to have eradicated the disease. Those who belong to this school of thought insinuate that those who claim that the disease has been eradicated are living in the city, not in the village where the disease mostly occurs. For instance, Mr. Soni Uwachue, a chartered accountant, an indigene of Nsukka, Enugu, who works in Lagos, said; “nobody can say that guinea worm diseases has been eradicated. You cannot stay in Lagos and be talking about certifying the country free from guinea worm by the World Health body, because the disease is still occurring in the villages.” Similarly, Sam Idiga, a lawyer, practising in Lagos, asked rhetorically; “Is this not one of the government’s gimmicks? That was how the government said that leprosy and polio diseases have been eradicated, yet there are still reports of the disease in some parts of the country. 

However, Tony Ufoma, from Ezza Nkwubor village, Enugu; one of the guinea-worm-endemic states in 1988, said that the thinking that guinea worm has not been contained is the figment of some people’s imagination, especially those who do not appreciate that the world today, including Nigeria is a global village. Ufoma, who spoke to Daily Newswatch, reasoned that if reports of the disease in 1988 came to the public domain before the era of global communication network, then, any report of new infection since the last case in November 2008, would have become public knowledge. Further investigations confirmed that there has not been any report of new infections since 2008 in Izamgbo, Ezza both in Ebonyi State and Ezeagu in Udi Local Government Area, Enugu State, among other areas which were affected by the disease between 1988 and 2008. In a telephone conversation, Joe Nwagbo, from Izamgbo, in Ebonyi State, said there has not been any report of new infections in the state. Nwagbo said he often visits neigbouring cities like, Aba, Onitsha, Enugu, Port Harcourt, even Lagos on business trips. There has been no confirmed case of the disease in the country  since the reported 38 cases in 2008, down from over 653,000 cases at the start of Guinea Worm Disease eradication campaign in 1987. 

Guinea worm eradication efforts have been pushed by the Nigeria Guinea Worm Eradication Programme (NIGEP) focusing on surveillance, integrating guinea worm watch into other immunisation programmes and conscious efforts to improve water and sanitation in the 5,879 affected villages identified by NIGEP in 1998. However, through persistent, leadership from individuals like General Gowon, and Nigeria’s contribution of US $2 million of its own funding to the Carter Center for the campaign. Between 2009 to date there have been 545 rumoured cases of guinea worm out of which 21 were recorded between January and March 2013. Since the country reported its last case in November 2008, there has not been any confirmed report of fresh infection from any part of the country. During a roundtable on media and advocacy for guinea worm disease eradication pre-certification activities, in Lagos, recently, Assistant National Coordinator of the National Steering Committee of NIGEP, Mr. Babatunde Tokoya, highlighted of the criteria for the certification.  

Tokoya explained; “Before Nigeria can be certified guinea worm free, we must meet four distinct criteria. We must have at least 85 per cent timely monthly reporting from all health facilities, public and private primary, secondary and tertiary health facilities in the 774 LGAs across the country. Currently we have attained 57 per cent. Further, he said there must be at least 80 per cent monthly reporting from all 774 LGAs in the states. “Currently we are at 83 per cent completeness but 51 per cent reported timely. “We must have at least 80 per cent  monthly reporting from all 774 LGAs and at least 80 per cent of the general public in rural and urban areas knowing about the reward, and all health facilities staff at national, State, LGA levels must know about the case definition of guinea worm and appropriate response to the cases. Currently we have attained 32 per cent. “All guinea worm disease rumours must be investigated immediately, within 24 hours of receiving the verbal or written report. Currently we are at 82 per cent. Further, Tokoya said adequate safe water supply and management in villages at risk must be maintained. “Currently we are at 97 per cent. The government appears ready to spare no effort in the preparation to be officially certified as a guinea worm disease free country in the next 17 days. Confirming the proposed visit by the ICT recently, the Minister of State for Health, Dr.Ali Mohammad Pate, expressed optimism that the visit will yield positive results, insisting that Nigeria will qualify to be certified free of Guinea worm disease this year. To this end, the country is trying to tighten every loose end to avoid the re-emergence of the disease. 

Already, Nigeria has increased surveillance on border posts to avert new infections in the country, even as experts are focusing on how to repeat her success in the last strongholds of the disease in southern Sudan, northern Ghana, and eastern Mali. The government has also promised a cash reward of N25,000 to any reporter of authentic, new guinea worm cases from any part of the country. In 2011, a N10,000 reward was offered for a similar report. Speaking, recently, in Kaduna, the Communication Officer, NIGEP, Dorcas  Mernyi, elaborated on the measures being adopted to avoid cross-border infections and ensure that Nigeria remains guinea worm free. Ms. Mernyi emphasised on the need to sensitise Nigerians to be more vigilant so as to avert contracting the disease from neighbouring countries where it had not been contained. “We are keeping surveillance over our borders because some countries are still reporting and Nigeria is bordering some of the countries. So our surveillance structure has to be very sensitive so that no case will be imported into Nigeria,” she said. 

According to her, cases of guinea worm diseases were still prevalent in Sudan, Ethiopia, Chad and other border countries, hence the collaboration between the Federal Government and the neighbouring countries, to eradicate the disease. “We are fighting this together; we don’t want any re-bounce of guinea worm case in the country. We are intensifying surveillance at the borders, screening people that come in. It is a collaborative effort; we cannot do it alone. What Nigeria is doing is collaborating with other countries,” she said. She said that villages bordering other countries had been engaged in community participatory surveillance, to assist government in checking the spread of the disease into the country. “People in the communities are helping us to look out. If we see a stranger, we find out who the person is, if we don’t understand, we report immediately. “We are not pursuing them out of the country, but we want to know who they are, where they are coming from and to make sure they are not bringing guinea worm disease into Nigeria,” she said. Guinea worm disease otherwise known as Dracunculiasis is a water-borne disease which affects human beings. It has an incubation period of about 12 months and manifests through the formation of blisters on any part of the body, inflicting pain on its victims who are in most cases, immobilized during the peak period of attack. 

The disease is common in communities with low level of hygiene practice. It is mostly found in very poor communities, hard to access, uninformed and neglected areas with no safe sources of drinking water. Infection occurs when a person drinks water contaminated with water flea or Cyclops which contains the worm larvae. The water flea is digested while the guinea worm larvae is set free; it penetrates the digestive tract and moves through the body between nine to 12 months until it emerges from any part of the body. All age groups are susceptible to guinea worm infection. There is no treatment for Guinea worm disease; the only prevention is to avoid contaminated water.

This story was published in Newswatch Times on June 6, 2013.
Coping with watery eyes

By Chioma Umeha

Tears are essential to the performance and health of the eyes. They keep the surface of the eye moist, help with distribution of nutrients and protective cells, and wash away particles and foreign objects. Watery eyes however, send a different message, especially when accompanied by itching, redness, discharge or puffiness around the eyelids. These signs may indicate an allergic reaction, but they could also be caused by clogged tear ducts, blepharitis (inflammation of the eyelid follicles), airborne irritants like chemicals, cigarette smoke, smog – even aging. Watery, itchy eyes may result in temporary blurriness, but seldom are they a medical emergency or threat to your eyesight. A health professional is usually needed only if the tearing is prolonged and bothersome. 

Here are four of the most common conditions that may cause watery eyes, according to John Hopkin Health Alerts: 

•   Allergic conjunctivitis: For millions of Americans, leaky eyes are a sign of the allergy season, which can extend from early spring to late fall. Seasonal allergies, commonly known as hay fever are touched off by the body’s reaction to allergens in the air, mostly pollens from grasses, trees and ragweed. 

•    Dry eye: Ironically, another cause of watery eyes can be dryness. Dry eye produces an itchy, gritty feeling in your eye, which in turn stimulates the tear glands to overproduce as a protective response. Dry eye is particularly common among people as they age because the tear glands tend to shrink. 

•   Blepharitis: Blepharitis, marked by swelling along the edges of the eyelids, may result in itchy, watery eyes. Caused by recurring or chronic inflammation, blepharitis also results in thickening and scales along the lid margins, crusting, redness and shallow lid ulcers. The inflammation is caused by infection, an allergic reaction or a skin condition. Blepharitis usually does not damage the cornea or result in loss of vision. 

•   Blocked tear duct: Aging may cause narrowing or obstruction of the nasolacrimal ducts (tear ducts), which help drain tears away from the face. When these ducts become constricted as a result of infection, inflammatory disorders, trauma to the eye or face, surgery or changes to hormone levels, they can cause tears to detour to the face instead of following the normal nasolacrimal route. Symptoms of a blocked tear duct may get worse after a cold or sinus infection. Also, symptoms may be more noticeable after exposure to cold, wind or sunlight.

This story was published in Newswatch Times on  June 8, 2013.
Over 110m Nigerians don’t use toilets

‘Reduction saves children’s lives, protects environment’

By: Chioma Umeha

Studies have shown that 90 per cent of diarrhea cases in children under five are related to unsafe water, sanitation and hygiene, and reduction in open defecation can significantly reduce the incidences of diarrhea. A new release from United Nations Children’s Fund (UNICEF) has established a synergy between sanitation, children’s health and protection of the environment. The statement which was to mark the World Environment Day linked sanitation to the health of children and protection of the environment. 

Open defecation causes contamination to water bodies, and is a serious threat to public health, especially during flooding. “We know that by improving sanitation, we can improve child survival as well as the environment,” the UNICEF release said. Research has also shown that it is possible to improve the sanitation situation in the country, especially in rural areas by engaging the communities through a Community Led Total Sanitation (CLTS) approach. Recommending the Community Led Total Sanitation approach, the UNICEF release said it is a process of engaging with the community members ranging from individuals to schools and traditional leaders and empowering them to address their sanitation situation by ending open defecation, and the use of toilets constructed by locally available materials. 

Testimonies to improved public health and a clean environment are common in the Open Defecation Free (ODF) communities. UNICEF partners with relevant government ministries, departments and agencies, NGOs, donors such as European Union and UK Aid to support implementation of CLTS in 30 states of the country. Consequently, there are more than 4,000 ODF claimed communities with over 2.5 million inhabitants now using toilets. Going by Unicef figures, this implies that about 110 million Nigerians do not use modern toilet facilities. 

With continuous support from governments and other partners in scaling up this approach, more Nigerians will live in open defecation free communities. Although current sanitation coverage is low at 31 per cent, successful models like the CLTS approach have already demonstrated that it is possible to achieve quick progress in access to sanitation. Experts believe that the country can still make substantial progress towards attaining the MDG sanitation specific target, with the right prioritization of resources, political will and collective efforts. The country has already demonstrated its commitment by successfully hosting the Presidential Summit on Water in February 2013. “Ending open defecation also means saving the lives of thousands of Nigerian children dying annually from preventable water and sanitation related diseases” says Jean Gough, UNICEF Nigeria Country Representative.

This story was published in Newswatch Times on June 8, 2013.

Wednesday, 12 November 2014

…Students killing dims Nigeria’s future

By: Chioma Umeha & Toyin Adebayo

The United Nations Children’s  Fund (UNICEF) has condemned the cruel attack, Monday, on the Government Science Technical School, Potiskum in Yobe State, which killed dozens of children and injured many more. 
Bemoaning, UNICEF said: “These repeated and relentless attacks on children and schools are attacks on the future of Nigeria, a country that already has the largest number of children out of school in the world. “We call on those with the responsibility and power to bring the perpetrators of this cruel act to justice and to uphold their responsibilities to protect children.” It is recalled that a suspected Boko Haram suicide bomber, disguised in school uniform, killed 47 students in northeast Monday, prompting US and UN condemnation of one of the worst attacks against schools with a so-called Western curriculum.

The explosion ripped through the all-boys school, just as students gathered for morning assembly before classes began, causing panic and chaos. The massacre, described by President Goodluck Jonathan, as a ”dastardly attack”, came just a day after the release of a new Boko Haram video, in which the Islamist group’s leader, Abubakar Shekau, again rejected Nigerian government’s claims of a ceasefire and peace talks.

 This story was published in Newswatch Times on November 12, 2014.
Natural ways to treat diarrhoea

By: Chioma Umeha

Diarrhoea refers to frequent intestinal evacuations of loose and watery stools. It is part of the body’s defence mechanism in getting rid of toxins or poisons out of the body. This medical condition is usually manifested with stomach pain and gas. It may signify an existing problem around the gastrointestinal tract or can be an indication of an underlying disease such as irritable bowel syndrome, dysentery, or ulcerative colitis. Occurrence of diarrhoea can be stopped through taking over-the-counter medications, but it may also interfere with the body’s natural way of draining the toxins out. Here are natural remedies that can to reduce the discomforting effects of diarrhoea without halting the immune system’s normal defence.

Natural Fruit Juice
Drink lots of clear sterilized water to replenish loss fluids, prevent dehydration and to provide ample amounts of electrolytes needed by the body. Stay away from caffeinated and alcoholic drinks.

Apply heat therapy to reduce abdominal or stomach cramps. Diarrhoea is typically paired with stomach pain. To reduce such discomfort, get a heating pad, wrap it with a towel and place it at the lower back area. Avoid placing it directly on top of the stomach or abdomen as it may induce vomiting. Try the lemon juice therapy. Freshly squeezed lemon juice taken three to five times daily will help eliminate diarrhoea-causing pathogens. Taking one to two tablespoons of lemon juice before meals is also excellent in protecting the stomach against viruses that cause diarrhoea. You can also mix ½ teaspoon of lemon juice, ½ teaspoon of ginger juice and ¼ teaspoon of powdered pepper. Drink this mixture two times a day to make stools less watery and relieve diarrhoea.

Sip some hot tea to get rid of diarrhoea. Drinking hot green tea three times a day is a very helpful way in alleviating diarrhoea. Ginger tea is also beneficial in relieving stomach pain or abdominal cramps that goes with diarrhoea. Cure diarrhoea by consuming carrots. Prepare two to three pieces of carrots, slice them and then steam until its soft enough to blend into a soup. This cure is excellent in eliminating E.coli bacteria among individuals with severe diarrhoea.

This story was published in Daily Newswatch on June 15, 2013.
Public-private partnership to end malaria scourge

By: Chioma Umeha

That Malaria has been an endemic disease plaguing the entire sub-Saharan Africa, including Nigeria, definitely will not make headline news now. However, its impact is significant enough to be currently viewed as a global health issue. Concerned stakeholders continue to intensify efforts through more innovative ways to lower malaria prevalence across Nigeria. In view of this, Ogun State Government and Reckitt Benckiser’s Mortein insecticide brand have teamed up to combat the scourge in Ogun state. CHIOMA UMEHA (HEALTH EDITOR) writes.

Officials of the Ogun State and Reckitt Benckiser
As concerned stakeholders intensify efforts to lower malaria prevalence across countries especially in Africa, more innovative ways to strengthen the global campaign against malaria are also unfolding. One of such innovations is the strategic alliance between the Ogun State Government and Reckitt Benckiser’s Mortein insecticide brand in which both parties are partnering to bring down the current malaria prevalence in the country and ultimately, the entire African continent. The partnership between the state government and the company was predicated on the conviction that malaria was preventable, but there was the need for stakeholders to take more proactive steps in order to halt the current trend of avoidable deaths resulting from the disease especially among pregnant mothers and children below five years of age.

In light of the above, both the state and Reckitt Benckiser for the first time jointly commemorated this year’s World Malaria Day in Abeokuta to demonstrate leadership in this advocacy campaign to end malaria scourge thereby offering succour to hundreds of residents of the state, particularly, new and expectant mothers as well as children.

Speaking on the partnership, the Commissioner for Health, Dr. Olaokun Soyinka, said due to the strategic placement of Africa as the new hub for the world’s economy, it was imperative to accord malaria eradication priority and every support needed to overcome the alarming prevalence rate.

To this end, he revealed that his ministry had mapped out six core intervention areas to strengthen the fight against malaria scourge. These interventions, according to him, are Malaria Prevention; Diagnosis and Case Management; Malaria in pregnancy and under-five children; Advocacy, Communication and Social Mobilization (ACSM); Health System Strengthening (HSS) and Information Management (IM).

Soyinka said the focus of the ministry was to scale-up intervention initiatives that include appropriate measures to promote positive behaviour change, strengthen the health system to deliver package of interventions and adequately mobilize for action against malaria through a broad based partnership. The commissioner, who described the partnership with Reckitt Benckiser as timely, commended the company for its Mortein anti-malaria initiative even as he called on other well-meaning corporate organizations and institutions in the country to emulate the company in a bid to make the country malaria-free.

Soyinka added that the initiative was a demonstration of responsible corporate citizenship which he said underpinned the company’s love and commitment not only to the people of the state, but to the country as a whole. He said, ‘‘complementary efforts of this nature are not only needed but deeply appreciated by the Government of Ogun State. This will certainly go a long way in ensuring that our children and mothers are free from the scourge of malaria.’’

The General Manager for Central (West & East) Africa, Reckitt Benckiser, Mr. Ashok Bashin,  said the need to fill what he called the ‘‘deadly gaps’’ in the various malaria eradication programmes informed the intervention initiative being provided by the company. “There are lots of activities and momentum to combat malaria in the country, but deadly gaps still exist. More needs to be done to prevent children from being infected and ensure access to quality malaria treatment”, he declared.

Bashin said further that, ‘‘empowering families and communities through participation – while improving their knowledge about how to prevent, recognize and treat malaria – is an important part of Reckitt Benckiser’s malaria prevention work.

‘’Community workers should try to sensitize the local population about preventing malaria through the use of insecticide-treated nets (ITNs), cleaning their environment on regular basis, avoidance of stagnant water in their surroundings and use of insecticides which is safe on both the mother and child.’’ The theme for this year’s World Malaria Day celebration  is ‘‘Invest in the future: Defeat Malaria’’, and it is aimed at creating awareness at all levels to help people especially at the grassroots to be more responsive to the global effort to combat and overcome the malaria scourge in the country. Malaria is responsible for about 66 per cent of all clinic visits in Nigeria. Health workers are sometimes forced to work overtime, and doctors and nurses can be on duty for over 12 hours a day. Still, women and children have to wait for hours before receiving medical consultation.

The high point of Mortein-supported World Malaria Day celebration was the affirmation to a pledge by representatives of pregnant women and new mothers to join the crusade on malaria prevention and eradication. The pledge-making session was led by Mortein Anti-Malaria Campaign Spokesperson, Omawumi Megbele. The pledge tagged ‘Mortein Mothers Pledge Against Malaria’ reads: ‘I am a Nigerian mother and I promise to wait no longer, to take up the malaria fight. Protecting my child from mosquito bites, I stand firm to protect my own. No stagnant water or dirt in my home. Let’s embrace our countries’ plight; standing as one. One enemy, one fight. ’’

Reckitt Benckiser, is also partnering with the National Association of Nigerian Nurses and Midwives to achieve malaria-free country. The partnership emphasises the synergy in the ability of nurses and midwives to reach mothers and children through the primary health care centres nationwide.

This story was published in Daily Newswatch on June 13, 2013.

Monday, 10 November 2014

Why rape victims, Chibok girls need health package – Experts

Tomorrow is the Global Day of Action for Access to Safe and Legal Abortion. Many girls and women are still going through trauma as victims of rape and incest in Nigeria today. The case of the over 200 Chibok girls abducted last April is unimaginable. Yet, they cannot access the right to safe and legal abortion if they have been abused and are pregnant because of restrictions posed by the 1861 Abortion Law. But, experts have advocated that a total health package recommended by the World Health Organisation (WHO) should be offered to victims of sexual violence, including the abducted girls when they are released. CHIOMA UMEHA (HEALTH EDITOR) writes.

L-R: Toyin Aboh, Appolonia Adeyemi, all members of Network of Reproductive Health Journalists in Nigeria (NRHJN) Dr. Nihinlola Mabogunje, Country Director of Ipas in Nigeria and Yinka Shokunbi, National Secretary, NRHJN, during a meeting of the group in Lagos, last weekend.

Since the beginning of this week, the media have been awash with fresh reports that the Boko Haram Islamic sect has finally agreed to free all the Chibok girls in a swap deal for 18 of its commanders currently in detention.

It would be recalled that less than two weeks ago it was reported that the insurgents had agreed to release only 30 female students abducted in April in exchange for 18 of its members. The decision was allegedly made after government authorities had held secret talks with one of Boko Haram’s seniors identified as Umar.

However, finally, according to latest media reports, the agreement on the release of 219 girls has been reached.

With this news, the hope of welcoming the abducted school girls back into the society has again been renewed. For parents, guardians and relations of the girls, they just can’t wait to welcome their daughters and sisters who had been in the abductors’ den since April 14. As for the girls, being left off the hook promises to be freedom for a new life where they can live a life of dignity that is devoid of the slavery and servitude that their terrorist abductors have subjected them to.

However, as concerned families and rights activists campaigning for their freedom and the society await their return, the issue of how to meet their immediate health needs has come to the fore. There is no doubt that as victims of abduction, the girls may have been subjected to harrowing rape experience and of course, heartless repeated rape which may have resulted in lacerations. What about possible unplanned and unwanted pregnancies? How about the psychological torture the girls would have been subjected to and the lasting impact of such on their psyche?

Narrating the account of one of the three girls who escaped from the camp of the terrorist Boko Haram, a clergy and expert on counter-terrorism, Oladimeji Thompson, of The Omoluabi Network, who has been working with other groups to assist victims of the abduction overcome their pains said: “One of the girls I interviewed was being raped 15 times by 15 men every day.” The girl was traumatised and confused, he said.

In other accounts, media report has quoted some Chibok girls who escaped as being pregnant. During an interview on the Hausa service of the British Broadcasting Corporation (BBC), former President Olusegun Obasanjo said some of the Chiboks girls are pregnant while others may never return again.

For those that have escaped and the more that may ultimately be released, the question that have naturally reoccurred is: what will the affected girls do with such pregnancies?

While the father of one of the pregnant girl was quoted as saying he does not want to have anything to do with the pregnancy, the girl who survived the abduction said if she is delivered of the baby, she would do away with it. This brings to the fore the hard facts and how to address problems resulting from persistent abductions which are now rampant in the North eastern states of Nigeria. Although, these issues have been on the front burner,  the forthcoming  Global Day of Action for Access to Safe and Legal Abortion, makes them very relevant. The day to be marked on Sunday, September 28, has been set aside to demand de-criminalisation of abortion. The day  has its origin in Latin America and the Caribbean where women’s groups have been mobilising towards the  September 28 event  since the last two decades to ask their governments to decriminalise abortion, tprovide access to safe and affordable abortion services and end the stigma and discrimination towards women who choose to have abortion.

Going by the provisions of the 1861 Abortion Law in Nigeria, women in Nigeria can only procure abortion where the life of the mother is in danger.

Hence, the Chibok girls or those representing them cannot even demand to abort pregnancies arising from some of the rape that occurred during their abductions. Even if the victims choose to terminate the pregnancies, legally, they cannot procure them.

Apart from pregnancies, what about those Chibok girls who had been subjected to rape countless times throughout the period that they were held? What about their injuries, pains and the trauma they are facing presently, among others?

Dr. Nihinlola Mabogunje, Country Director of Ipas in Nigeria, said the focus should shift to how to compensate the Chibok girls in terms of meeting their health needs.

According to her, although, the health needs of a rape victim is wide and big, the relevant authorities should agree that rape victims should be compensated.

Based on this plan, the Chibok girls, other abducted girls, rape and incest victims should be given physical, mental and social wellbeing. She said: “You look at her in terms of if she has a vaginal tear which is possible, it will be sutured; if she develops a fistula, she will be cared for; should she be pregnant, there will be need for her to be provided with medications; if she has HIV, she will be provided with prophylaxis.” She added that the problems of these victims must be addressed in a holistic way so as to provide a way out for them.

Therefore,  the responsibility of the state and federal governments and other stakeholders to the Chibok girls and other women who are subjected to rape should be viewed in this light. The World Health Organisation (WHO) defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Based on this recommendation, the health needs of the Chibok girls must be met.

Already, those girls that escaped are already being offered scholarships to pursue their education. It should be noted that if these girls are not healthy, there will be no education to pursue.

“A man who raped a woman should compensate the woman. It is not just enough for the offender to go to one year jail or thereabout. That punishment is not enough. Mobogunje reasoned that in addition to the penalty, the offender should be made to compensate the victim, and that this should be the new trend. It could reduce incidence of rape in this environment, she said.

Speaking in a similar vein, president of the International Federation of Women Lawyers, Hauwa Shekarau, said even the 1861 Abortion Law  criminalises abortion and only makes it possible for a mother whose life is in danger  to terminate a pregnancy in order to save her life. However,  the law did not specify who determines that the life of the mother seeking to procure the abortion is in danger.

Shekarau lamented that due to the restrictive nature of the Abortion Law in the country, women and girls who are victims of rape and incest are left to their own devices regarding what to do whenever rape results in pregnancy.

There have been moves three different times in the past to change the existing abortion law in line with modern trends especially on the need to meet the health needs of female victims of rape and incest but “they were turned down by mostly religious people and some other women who were guided by their religious beliefs,” she said.

Furthermore, the president of the International Federation of Women Lawyers said a more recent attempt to review the Violence Against Persons Prohibition Bill (VAPP) in the House of Representative similarly suffered a setback.

A clause inserted in the VAPP bill to enable victims of rape and incest who get pregnant to have access to safe termination of their pregnancies if they so choose was deleted before passing that bill. She said if that clause had sailed through, it would have provided for victims of rape, incest and women under some health conditions to terminate pregnancy if they choose.

On another front in Imo State where the VAPP bill was successfully passed with the same clause it generated uproar. Consequently, the Imo State Governor, Owelle Rochas Okorocha, abrogated the law on the basis that there was an outcry by the religious community to the effect that the entire VAPP bill passed by the Imo State House of Assembly was an abortion law.

Having gone through the House of Representative, Shekarau said the VAPP Bill is currently in the Senate. “We are advocating and lobbying to ensure that they include that clause,” she said.

The journey to review the 1861 Abortion Law may be slow; but the stakeholders are not relenting, considering that it would ultimately be to the benefit of the entire women folk. A recent WHO report on ‘Trends in Maternal Mortality: 1990-2013’ classifies Nigeria as on of the 10 countries that contribute about 60 per cent of the world’s maternal mortality burden. Though Nigeria currently has a maternal mortality ratio of 560 per 100,000 live births, the ratio improved slightly, moving from the 630 per 100,000 recorded in 2010.

This high mortality rate in Nigeria falls short of the Millennium Development Goals (MDG) targets for 2015. With 2015 in the corner, there are doubts that the goal of eradicating maternal mortality or reducing the ugly trend drastically will be achieved.

Unsafe abortion contributes 13 per cent of maternal mortality. Imagine how the incidence of maternal mortality will be reduced in the country if there is a law that promotes safe abortion.  This is food for thought.

This story was published on September 27, 2014 in Healthy Living Saturday Newswatch.

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