Health

ZAMBIA: Pregnant women ignore killer malaria

1. Posted on Friday 6 May 2011 - 10:17
   Doreen Nawa, AfricaNews reporter in Lusaka, Zambia

   For her first pregnancy, Kezia Banda did not like the idea of taking sulfdoxine pyremethanine, known by the brand name Fansidar, the recommended drug to protect her against malaria. The longer time she needs to complete a full dose of the malaria course puts her off. Banda always dribbled the nurse saying she will take it home with a fruit.

   

   In all Government clinics, it is mandatory that every pregnant woman who attends antenatal clinic takes an anti-malarial drug three times before giving birth.
   
   And to make sure that mothers to-be take the prescribed anti-malaria drug, the nurses will ensure that it is taken in their presence at the clinic, a thing that most pregnant women abhor.
   
   But for Mrs Banda, the truth was she never took the medication and instead threw it away on her way back home from the antenatal clinic.
   
   Little did she know that the malaria attack was closer than ever and the results were severe. At four months she started experiencing fever, chills, vomiting and other flu-like symptoms, and traditionally she thought her body was getting accustomed to the pregnancy changes.
   
   The situation got serious and when she was taken to the hospital, she had a miscarriage.
   
   Miscarriage rate
   
   According to the World Health Organization (WHO), pregnant women who acquire malaria have a highly elevated rate of miscarriage. The miscarriage rate for pregnant women with malaria may be as high as 60%.
   
   While malaria is both treatable and preventable, if left untreated it can cause severe complications and even death.
   
   From a medical point of view, malaria can also increase the risk of stillbirth and neonatal death. Malaria is one of the main causes of miscarriage in developing countries including Zambia.
   
   Malaria is especially dangerous for pregnant women and their unborn children. It is caused by a parasite that attacks and kills the blood cells of humans, which can lead to anemia. If a pregnant woman is infected with malaria, the disease can be transmitted through her blood to the fetus, leading to stunting at birth and stillbirth.
   
   When a woman becomes pregnant especially for the first time, they lose their built-up immunity to the disease and once they have an attack, if not treated early, women have miscarriages.
   
   A reduced level of healthy red blood cells leads to anemia which leads to death or various internal-organ health problems. It is associated with retarding the growth of a fetus and lower child-survival rates.
   
   Currently, Mrs Banda is pregnant again and this time she makes sure that she takes her medication at the clinic in the presence of the nurse whenever she goes for the antenatal at Lusaka’s Chelstone Clinic.
   
   She needs to take it three times before giving birth to protect herself and the unborn baby from malaria which caused a miscarriage during her first pregnancy.
   
   Ms Banda is one of the many women in malaria-endemic countries like Zambia where the Ministry of Health has made it mandatory for every pregnant woman to take a malarial drugs three times prior to giving birth.
   
   During her previous pregnancy, Mrs Banda was never protected against malaria which meant that she was at risk contracting to malaria. Surely she did have malaria and lost her pregnancy.
   
   She is now remaining with only a dose of fansidar during her pregnancy. Since she receives her treatment at the health clinic during her pregnancy care visits, she does not throw away the medicine and has never had a fever or contracted malaria.
   
   Malaria, by its complexity of involving health as well as environmental and socioeconomic determinants and consequences, relates virtually to all the Millennium Development Goals (MDGs)
   
   In a bid to reduce the country’s malaria burden, health workers at all centres countrywide do carryout malaria education, diagnosis and treatment to would-be mothers that visit the health centre for route antenatal check ups.
   
   Ending death
   
   Ending death from malaria is a goal of Zambia’s Ministry of Health as well as WHO and it is up to the mothers to heed and take the recommended drugs to prevent death and of their unborn babies.
   
   Approximately 40 percent of the world’s population, mostly those living in developing countries are at risk of malaria. In Zambia about 6, 000 people died of malaria each year among the population of about 13.5 million.
   
   The World Health Organisation estimates that malaria causes nearly a million deaths a year, mostly among African children. The disease is a major cause of lost work productivity in endemic countries.
   
   Such strategies used to fight malaria are something women ought to go for. Health experts say pregnant women are more susceptible to the disease than other adults, especially women who are pregnant for the first time.
   
   Up to 30 million African women become pregnant each year in areas where malaria is prevalent, and more than 200,000 newborns die each of the disease.
   
   The goals include making sure that the quality of the work at health facilities is optimal, that women are receiving education, [and that] new doctors, nurses and midwives are all learning new policies to practice in health facility settings.
   
   More than 1 million of the 300-500 million cases of malaria each year result in death. Malaria is the leading cause of death for children under age five in sub-Saharan Africa, and a predominant killer of pregnant women and their unborn children.
   
   Malaria costs Africa an estimated $12 billion in lost productivity each year.

Education

NIE: Inculcating a reading culture in schools

By DOREEN NAWA
HAVE you ever asked your child to circle in the newspaper the letters that make up the alphabet?
What about asking your child to identify nouns, pronouns, verbs, proverbs or adjectives in the newspaper?
Maybe you have gone to the sports page of the newspaper and asked your child to identify in the football league table Odd numbers, Prime number or the difference between the top team and the one at the bottom of the table.  
One of the worrisome challenges in the Zambian education system is the poor reading culture in most schools.
This problem is compounded mainly by the shortage of reading and learning materials in schools.
The lack of access to reading and learning materials has largely contributed to the poor reading culture and poor performance of the school going children.
In an effort to bridge the gap, the Zambia Institute of Mass Communication (ZAMCOM) recently launched the Newspaper In Education (NIE) project in Lusaka.
The NIE project is a ZAMCOM initiative with the assistance from the American International Health (AIHA), the University of Kentucky School of Journalism and Telecommunications with support from USAID.
The main objective of the Newspaper In Education is to promote the reading culture of pupils in schools countrywide.
Generally, the contents of the NIE will range from environment, gender to education.
Following a partnership ZAMCOM entered into with USAID, and other co-operating partners like Zambia Daily Mail, the NIE project will provide access to quality reading relevant to the primary and basic school curriculum.
The NIE project will provide inexpensive, relevant teaching materials and ready-to-use lesson plans to Zambian schools.
At the launch, Minister of Education John Phiri said the NIE project will not only improve the reading culture among pupils but also alleviate the shortage of teaching and learning materials in schools.
“We welcome this gesture because we realise such help will assist restocking the much needed reading materials in our schools,” Dr Phiri said.
At the same function, USAID Education team leader Wick Powers said the USAID supported NIE programme will encourage more Zambian school children to read.
“Reading is the single most critical foundational skill in early education and is the basis for future learning,” Mr Powers said.
With the NIE in every school at no cost at all, it is hoped that the passion for reading will become a cultural habit for students in Zambia.
Marble Sakuwaha, a teacher at one of Government schools in Lusaka says most private schools produce quality pupils because of the reading culture they have cultivated among the students.
She says students in most Government schools lack reading and learning materials, which makes the reading culture non-existence.
“Reading is not merely a hobby, it is a culture. This culture is usually cultivated in the early stages of a child’s life. For private schools, you will find that their pupils perform better than ours because of their capacity to introduce the students early to reading. Our colleagues have enough reading materials and I believe the NIE will complement on the lack of reading material mostly in government schools,” she said.
Reading is a very important language skill because of the benefits an individual or community derives.
The availability of the NIE in every school where people can read is also a major factor that will lead students in the country become avid readers.
It is undisputable that good reading skills lead students to become successful learners.
Most of the time, a student learns from written language learning materials, such as textbooks, handouts, posters and other publications like newspapers and magazines.
Reading also encourages people to become successful lifelong learners, as books can be enjoyed throughout a lifetime.
“The NIE is a good initiative because it will provide a platform for them to read. Reading can stimulate someone to be creative and innovative. Innovation results from the combination of ideas and concepts. The more we read, the more ideas and concepts come to mind. Take Japan as an example: the high level of reading in Japan has made it one of the most innovative nations,” according to Henry Muntanga, a former head teacher at Muyoma Basic school in Lusaka.
Mr Muntanga suggests that policy makers should seriously promote reading in the country by redesigning the literacy education curriculum so that it stipulates reading books in classrooms is compulsory.
“This means schools have to be equipped and enriched with a variety of reading materials. Students should be allowed to read all books, both fiction and non-fiction, based on their age and reading skills,” says Mr Muntanga.
A reading culture is an important ingredient for any society to become developed.
Although it is a challenging journey, with willingness and commitment a sustained reading culture can definitely be achieved.
When there were no televisions or computers, reading was a primary leisure activity.
People would spend hours reading books and travel to lands far away-in their minds.
However, with modern technology, most people have lost their skill and passion to read and this has also been transferred to students.
It has however been observed that children and teenagers who love reading have comparatively higher degree of intelligence.
They are more creative and do better in school and college. It is recommended that parents inculcate the importance of reading in their children in the early years.
Reading is said to significantly help in developing vocabulary, and doing it aloud helps to build a strong emotional bond between parents and children.
The children who start reading at an early age seem to have good language skills, and they grasp the variances in phonics much better.
Reading helps in mental development and is known to stimulate the muscles of the eyes.
Reading is an activity that involves greater levels of concentration and adds to the conversational skills of the reader.
It is an indulgence that enhances the knowledge acquired, consistently. The habit of reading also helps readers to decipher new words and phrases that they come across in everyday conversations.
Once in cooperated in the students’ life and with the NIE readily available, the habit of reading can become a healthy addiction to students.
So the next time you buy the Zambia Daily Mail, know that it can be used to teach gramma, civic, geography, mathematics, science, history and many other subjects.

Environment

Climate change should take centre stage

By DOREEN NAWA IN THE face of climate change, the fate of the remaining natural resources in Zambia largely depends on how the land around it is managed. Indeed, it is no exaggeration to say that the economic, social and environmental future of this country depends on the wise use of its land resources. In view of this, stakeholders from various organisations including government ministries recently met in Chisamba to find a way forward in mitigating climate change through land use. It is generally agreed that land resources such as water, forests and land itself can be a powerful agent of change and as such climate change will have strong effects if the issues of land use are not addressed. During the meeting, it was resolved that it is possible to make choices with land resources that will mitigate what seems likely to be the effects of climate change. In Zambia, land resource management has become a critical issue because of the role it plays in contributing to the well-being of many whose lives are dependant on land and forests. It is with this background that community participation in local land use and management becomes paramount to any long-term success of mitigating the effects of climate change. “The issues of climate change threaten Government’s efforts in achieving development objectives including the attainment of the Millennium Development Goals and poverty reduction, But Government alone cannot succeed without community participation,” Ministry of Tourism, Environment and Natural Resources permanent secretary Peter Mumba said at the Chisamba meeting. The need to engage forest dependent communities in addressing issues of climate change and land resources management is vital because the livelihood of most communities in Zambia is inextricably tied to land and forests. Mr Mumba said in efforts to reduce gas emissions, initiatives that tend to give a solution to the issues of gas emissions and climate change should not ignore the plight of the local communities. He said the land resource sector is a significant source of greenhouse gas emissions both globally and countrywide. “It is estimated that land use accounts for up to 30 percent of the global greenhouse gas emissions and in the case of Zambia emissions from the land use sector area much larger fraction due to deforestation, now estimated to be between 250,000 to 300,000 hectares per annum,” Mr Mumba said. A prevailing notion is that community-based approaches to planning tend to be more effective because they incorporate the relevant knowledge and experience of those affected by land resource decisions. In this way, participation can help to mitigate potential and existing conflicts and empower communities to take a more active role in exploring management issues and initiating possible responses. Community empowerment in land resources is both desirable and critical to the adaption and mitigation of climate change. According to Climate Change Facilitation Unit technical co-ordinator in the Ministry of Tourism, Environment and Natural Resources, Professor Prem Jain, community participation serves several purposes including increasing economic and technical efficiency because resource users have more clearly defined responsibilities for their actions. Of late, climate change has become a serious challenge to sustainable development and if no action is taken to mitigate it, the effects of climate change will become unbearable. Prof Jain said land resource management is a key factor in the mitigation of climate change adding that Zambia contributes more that 38million tonnes of green houses gases due to poor land resource management. “The effects of land resource management have also contributed to reduced yields annually because of poor land. That is how crucial it is and therefore we need to address this challenge now,” Prof Jain said. Sustainable development and benefits to the protected area and surrounding communities are possible only to the extent that local people are involved. Community participation in land resource management is seen as an important enforcement check and balance mechanism to control natural-resource depletion. Notably, community bargaining power is generally less than that of the management agency, the education and training offered to communities is often biased toward the perceptions and goals of the management agency rather than the needs of the community. According to Zambia Land Alliance, one of the participating organisations to the meeting, a partnership must be created in which rights, aspirations, knowledge, and skills are respected and enhanced, and the importance of human-nature relationships is recognised and valued. “In addition to traditional natural-resource questions, relevant social issues raised by the community may include traditional land-use patterns or methods, territorial rights, or the right to self-determination,” the Zambia Land Alliance said in their presentation at the meeting. Besides these social aspects of environmental management, the economic side of integrated development planning is also important, and experience has shown that it may be particularly important in tourism planning where cultures and environmental quality are central concerns. Not all communities, however, are equipped to participate fully at the co-management level; they may need additional education to build experience and to strengthen confidence that problems can be confronted and solved locally. Effective participation by communities may require improving technical knowledge within the community and improving communications between the community and other institutions with an aim towards collaboration and institutional strengthening. Through these different modes of education, communities may be empowered to participate in management as partners with established management agencies. However, it is not only the community that needs additional training and education. Government agencies, non-governmental organisations, and assistance agencies also may need training and education to foster collaboration and co-management. Clearly, how such training is planned and implemented will determine its chances for success. Land resource planning is a centrally important government function, directly affecting the lives of all people. It is therefore particularly important that it is characterised by fairness and transparency and that people are afforded a meaningful right to participate in decisions. When public authorities formulate new plans, they must be put in place. Also, where land development projects are initiated by the private and non-governmental sectors, there must be procedures that ensure that interested parties have an opportunity to express their views or to object. Although the idea of co-management may appear basic to land resource planning, achieving it in a real-world setting is often more complex. Real-life limitations of politics, history, economic forces, and cultural traditions determine to a large extent not only what is needed but the range of possibilities.

Governance

Peaceful elections cementing Zambia’s democracy

By DOREEN NAWA WITH the September 20 elections passing as one of the most peaceful transitions of power in Zambia’s political history, every fear of post-election violence should now be duly consigned to the dustbins of history. Zambians last month allowed history to repeat itself by ensuring the country’s fifth general election, since the 1991 return of multi-party politics, passed without major incidents. Even though there were some pockets of violence following the slow transmission of the elections results, it is still nothing compared to the large-scale violence that was initially projected to rock the country. Several international and local poll observers have since hailed the recent elections as having been free and fair. According to Zimbabwe Election Support Network (ZESN), the recent elections were held in a peaceful and conducive environment, with all security forces and political parties respecting the will of the Zambian people. ZESN deployed a 15-member delegation covering all the nine provinces of Zambia. “The country’s 2011 general elections have been held in a peaceful and conducive environment because of the way the Electoral Commission of Zambia (ECZ), Government and all security wings have managed it,” the ZESN said in its report. “Despite a few violent acts in Lilanda, Kanyama and Nakatindi Hall owing to the delay in delivering of voting materials, the rest were peaceful.” The peaceful nature of the recent elections reinforced yet again the country’s ever blossoming democracy. Zambia has never had a life-threatening authority transition since the 1991 return of multiparty democracy. In 2001, late second republican President Frederick Chiluba peacefully handed over power to his successor, Levy Mwanawasa, whom he had handpicked to contest the general election on the former ruling party’s ticket, following the expiry of Dr Chiluba’s second and final five-year term. And after the 2008 death of Dr Mwanawasa in office, former President Rupiah Banda peacefully ascended to power after winning the presidential by-election. Mr Banda would later become Zambia’s shortest-serving republican President, having been in office only for less than three years before last month’s elections, which he lost to President Michael Sata. Ahead of the September 20 tripartite election, many people and even international organisations, predicted large-scale violence because of what they perceived to be a brewing conflict between the people’s desire to change government and the ruling party’s determination to hold on to power. As months turned to weeks and eventually days and hours before the opening of polling stations, ordinary people across the country started panicking. They flooded shopping malls to panic-buy and stock-pile whatever foodstuff they could as a shield against the ‘clashes’ that could have prevented them from going outside their homes. It is now over a week after the new President was announced and subsequently inaugurated. And all predictions of post-election violence have since died out, thereby adding impetus to the status of Zambia as a peaceful country. As in the words of Forum for Democracy and Development (FDD) president Edith Nawakwi – the only woman contestant in the presidential race – time is ripe for Zambia to start focusing on development, not violence. “We need peace, we need stability and we need our people to start thinking about creating wealth at household level. Zambia is the heart of Central Africa. Anything that goes wrong here during or after the elections will affect our brothers and sisters in the region,” Ms Nawakwi commented. “Zambians must understand that in the region, everybody is busy with the development agenda; no one in southern Africa wants to start dealing with a horde of refugees that arise out of post-election conflict.” Marvin Walumba, a Lusaka resident, supports neither the ruling party nor any opposition political party in Zambia. But he is still able to acknowledge the peaceful nature of the recent election and gives credit to all the political players. “I am neither a PF nor an MMD supporter but I would like to give credit to the losing party (MMD) for staging a peaceful and transparent election. They had all the powers to manipulate the results but for the sake of peace and tranquillity, (which) our beloved country has enjoyed since independence, MMD for once put the people’s desire on top of theirs,” Mr Walumba said. “To the winner, I say ‘congratulations, you fought battles, cried foul but never gave up and in the end people jubilated over your triumph. In every story, there is the beginning and the ending. I will live to see where your story ends’.” United States President Barack Obama commended Zambia for holding peaceful elections and said it has helped the country to build on its commitment to multi-party democracy. “The hard work of a living democracy does not end when the votes are tallied and the winners announced. Instead, it offers the chance to reconcile and to advance greater security and prosperity for its people,” President Obama said. Zambia, southern Africa’s oldest democracy, has set an example for the rest of Africa and the world on how power should be transferred without incidents of violence. Former President Banda graciously conceded defeat barely few hours after President Sata had been announced winner. In his televised national address, Mr Banda called on all Zambians to rally behind the new President and ensure that the country continues on its path to economic development. United Nations secretary-general Ban Ki-moon praised the smooth transition of power and commended the country for holding elections and upholding democratic principles in an environment that was overall peaceful and orderly. Mr Ban has also extended his praises to the ECZ for the critical role it professionally played in ensuring a credible and transparent election process. “(I) am pleased that Zambians have today shown Africa and the world that change can be brought about peacefully when democracy is allowed to flourish,” Mr Ban said. And many more people still continue speaking highly of Zambia’s recent free and fair elections that have effectively consigned all fears of violence to the dustbins of history.

Health

Giving birth a nightmare for women in Chief Kalindawalo’s area in Petauke

By DOREEN NAWA BRINGING forth life in form of a baby is a source of joy for many women and brings about fulfillment in a marriage. It is a moment when families unite to celebrate the arrival of a new family member. But this is not the case for most women in Mulimbu Village in senior Chief Kalindawalo’s area in Petauke district in Eastern Province where giving birth has not only become a burden but a nightmare. Women dread falling pregnant due to high costs and risks associated with giving birth in this area. Despite only having one clinical officer and no midwife, the nearest and only rural health centre called Luamphande has introduced child delivery charges which are beyond the reach of most rural women due to high poverty levels in these areas. This has left no option for most pregnant women who instead deliver their babies at home with the help of untrained traditional birth attendants. Giving birth at home, as cheap and convenient as it may seem, comes with its own risks and complications. According to Royce Nyaradzi Banda, a retired midwife at the University Teaching Hospital (UTH), apart from the risk of complications and even death that women face when giving birth on their own, home births often result in non-repair of perinea sensitive tissues, delayed clamping of the umbilical cord which can result in infections, and the non-use of routine examinations during labour.  Mrs Banda pointed out the need for strengthening community midwifery care to rural women. “I think the best way to handle this is to strengthen community midwifery in order to bring professional midwifery care to rural women thereby facilitating access in the face of inadequate infrastructure and inadequate resources,” she says. According to Mrs Banda, most rural women in Zambia are still fond of traditional antidotes and that when pregnant, the practice of using traditional herbs against Western style medicine is common amongst pregnant women and that this has increased the risk in child birth. “Rural women here in Zambia still strongly adhere to traditional practices and beliefs during labour and this is a trend that has proven to be difficult to fight,” she said. Mrs Banda says some of the concoctions that women take to expedite child birth could be the cause of some of the complications and that giving birth at home with the help of untrained birth attendants may pose even a greater risk because the birth attendants may fail to recognise or even alleviate these complications as they lack medical expertise. However, most women in Mulimbu Village still contend that it is not their wish to give birth at home but prevailing circumstances at the only health centre force them to. Most women complain of ill treatment by the medical personnel and the high child birth charges as some of the hindrances to accessing maternal health services.  She says the clinical officer is never there to monitor the process and that they are left to be attended to by cleaners. According to Agness Tembo, a mother of four, most rural women cannot afford transport when labour starts and other necessities like decent clothes for the unborn child due to high poverty levels in the area. She says the child-bearing charges are therefore farfetched.  “We are charged K50, 000 when you take a child that has been born at home to Luamphande Clinic to get an under-five card.  We also pay K15, 000 to the traditional birth attendants commonly known as Anya mwinu, failure to pay the said amount will land you in problems. It’s either you do not get the under-five card for the baby or the traditional birth attendant takes the matter to the induna and later to the headman,” she says. She further says besides paying child-bearing charges every pregnant woman must secure baby clothes before giving birth. Mrs Tembo says it is a prerequisite for any pregnant woman be it in rural or urban to have a towel, a complete baby suit which includes a hat, socks, a vest or dress, nappies and baby blanket. But just finding all these requirements is a nightmare for many families in Mulimbu Village.  “Money is very difficult to come by here in the village and just to be charged K65, 000 here in the village it’s unacceptable and cruel. We need government to intervene in this matter.  “Whenever I fall pregnant. I fear for myself thinking I might die any time when giving birth because I do not know what the future holds for me since we do not have a midwife at Luamphande Clinic and we also do not have trained traditional birth attendants,” Mrs Tembo said. According to Mrs Tembo, every pregnant woman hires a traditional birth attendant at their own expense to accompany them to the clinic or home once the labour pains begin. Luamphande Clinic has no midwife and is manned by one person, the clinical officer only identified as Mr Banda and has only two cleaners who also work as nurses but are not trained.  “We have a big problem here, the only medical personnel, Mr Banda who is in charge of the clinic is always out of the station and whenever you ask his children you will be told that he has gone to the Boma (Petauke). He is never there for us and that is the reason why most women end up delivering in their homes,” another resident of Mulimbu Village Dainess Zulu said. Asked why the charges were introduced, Mrs Zulu said it is a penalty fee to those that give birth at home. She said the charge is meant to discourage women from giving birth at home. “We were told that it is a penalty fee but it is not helping anyone because it is too high and mothers have continued to give birth at home and not take their babies for under-five,” Mrs Zulu said. Then giving birth at home and not taking a baby for under-five clinic becomes the preference for most women because it is cheaper. Another reason is the fact that a large proportion of pregnant women deliberately opt to give birth at home because they find hospitals to be very uncomfortable because of the unavailability of medical personnel. There are often situations where some women fail to deliver safely due to complications like the case of Temwani Njovu of the same area. Mrs Njovu says she is lucky that she is alive today. Most of her friends, she says, gave birth at their homes without any complications. The 34-year-old resident of Mulimbu Village about 24 kilometres from Petauke says her experience is different from others. Mrs Njovu says she owes her life to a good ‘Samaritan’ who gave her a lift from the junction to her village to Petauke District Hospital because her baby lay across and could not be delivered using the normal birth canal. “My baby was breech and could not be delivered using the normal birth canal. I went to the clinic and found a cleaner but Mr Banda (Clinical officer) was not there. After a few minutes, the baby came out first using the hand and my husband was told to rush me to Petauke using a bicycle. “Just when we were about to join the Great East Road, my husband stopped a vehicle. Thank God the driver accepted to give us a lift up to Petauke District Hospital. Unfortunately my baby died of suffocation, I was on the verge of death,” Mrs Njovu said. Apart from the general lack of adequate medical staff at Luamphande Clinic, rural women in this area continue to be faced with challenges such as long distances to the nearest health centres and high cost of public transport .

Last Updated ( Thursday, 19 January 2012 12:46 )