Hidden face behind teenage pregnancy on schoolgirl

Liseli Nyambe, 17

DOREEN NAWA, Lusaka
“THEY all look innocent as they walk to school from Monday to Friday, but surprisingly, a few months later we discover that two or three in that group are pregnant.” These words of Sesheke district commissioner Mihupulo Yumei came following increased cases of schoolgirl  pregnancies and abortions.
As if that is not enough, when schoolgirls discover they are pregnant, they either consult a friend on how to get rid of the pregnancy or they go to elderly women in the communities to help them abort.
Mr Yumei blames the truckers who spend more days than is necessary at Katima Mulilo Border post even after being cleared by immigration to proceed.
“If you look at statistics from the district education office, you will discover that teenage pregnancies are a common feature and these girls always find a way of getting rid of a pregnancy in order to go back to school. Unfortunately, most of these girls go unnoticed once they are pregnant because they have become professionals in procuring abortions,” Mr Yumei said.
Although abortion in Zambia is legal on medical and social grounds, most schoolgirls in Sesheke resort to illegal means because legal services are inaccessible and unacceptable.
The main reason girls resort to abortion is for fear of being expelled from school and their unwillingness to reveal a secret relationship.
For Kezia Sililo of McKillop township in Sesheke, getting pregnant whilst in school was the most humiliating experience she would not wish on anyone else.
Ms Sililo says she had aborted three pregnancies before and she did this because she wanted to continue with school.
“I got pregnant four times and I managed to successfully terminate the three but for this one, I was afraid whether I would be successful or not; I ended up keeping it after I had tried two times to terminate it,” Ms Sililo said.
Her decision to abort was primarily determined by the reaction of the boyfriend and his unwillingness to accept paternity and the associated financial implications.
Asked on how she managed to abort the three pregnancies, Ms Sililo said she used a combination of herbs she bought from one of the women in a village.
“This is the woman who was instrumental in the three abortions I undertook. She would prepare two types of traditional medicines; one type I would insert in my private part while I would drink the other one. After drinking the medicine, I begin bleeding and that is how all the three pregnancies were terminated,” Ms Sililo said.
And a mother of one, Liseli Nyambe, 17, a former pupil of Katima Mulilo Primary School, says she got pregnant after writing her grade 9 examinations.
Asked whether she attempted to abort, Ms Nyambe answered in the affirmative.
“I tried to abort several times and I failed. I used several methods, among them is the most popular method of self-induced abortion by overdosing on chloroquine, I also used some traditional medicines such as various types of roots, as well as more modern methods such as ingesting washing powder,” Ms Nyambe said.
For Ms Nyambe, she tried all possible methods but she failed to terminate the pregnancy.
She says abortion is so emotive but the decision to do so is necessitated by various reasons like denial of the responsibility by the boyfriend, fear of being out of school, and how the family would take the news.
One recommendation that Ms Nyambe would want to see is for policy-makers to concentrate on the improvement of formal, ‘youth friendly’ health services and the development of appropriate outreach education methods which address specific concerns widely held by young women.
And Sesheke district education board secretary Mubonda Katukula says the district records more than 10 cases of pregnancies each term.
He noted that the idea of most girls renting rooms while attending school has contributed to increased cases of teenage pregnancies.
“We have a challenge here, there is an ever increasing cases of teenage pregnancies and the girls resort to abortions so that they can go back to school,” he said.
Mr Katukula said in spite of the challenges mentioned above, the education system should continue with its vision of instilling discipline, upright moral values, and genuine patriotism in children for the good of the nation.
According to health experts, adolescents face higher reproductive risks than older women. Pregnancy is the leading cause of death for young women aged 15-19 worldwide, with complications at childbirth and unsafe abortion being the major risk factors.
Teenage girls who are not physically mature are at greater risk of obstructed labour, pregnancy-induced hypertension and obstetric fistula (the creation of a hole between the birth canal and anal area during prolonged labour).
Young people rank sexual health as their primary issue, because sexual behaviour is integrally-linked to other aspects of their lives.
In Zambia, pregnancies are deemed to be a common occurrence amongst the adolescents, with an estimated two-thirds of unwanted pregnancies ending in unsafe abortions.PUBLISHED IN THE ZAMBIA DAILY MAIL ON APRIL 30, 2015

Strategic power of vaccines

DOREEN NAWA, Lusaka
IN the current global environment of austerity and ever decreasing budgets, immunisations represent one of the pillars of global health that is a cost effective, proven intervention.
Beyond protecting millions of children every year from infectious diseases, vaccines often provide the backbone of the healthcare system.
It is for this reason that April 24 to 30, 2015 will be celebrated as the African Vaccination Week to promote the use of vaccines to protect people of all ages against disease.
This year, African Vaccination Week is under the theme ‘Vaccination a gift for life’ and 47 African countries are expected to participate.
African Vaccination Week provides an opportunity for countries to strengthen immunisation services and systems through advocacy, education and communication tools and activities.
When a mother brings her child in for routine immunisations, it can be an entry point to provide her with other health services - HIV counselling and testing, family planning information and services, and bed nets to protect her children from malaria.
Routine immunisations can help the mother and the rest of the family to access healthcare.
Unfortunately, not every mother and child is able to take advantage of these basic services.
According to the Global Alliance for Vaccines and Immunisations (GAVI), about 1.7 million children die from vaccine-preventable diseases every year globally.
In Zambia, where distances are vast, basic road infrastructure is lacking, and transportation is weak, reaching every child with immunisations can be very challenging.
For Janet Tembo of Libuko village in Chongwe district, she walks for hours under very hot temperatures, often carrying a child on her back with older children in tow, just to reach a healthcare facility for immunisations.
Not every mother is able to travel these distances, or to make multiple journeys when more than one dose of the vaccine is required.
“The African Vaccination Week is a strategic initiative that every mother should take advantage of because it will be like healthcare brought closer. I would like my fellow mothers to turn out in numbers and bring their children under that age of five,” Ms Tembo said.
Countless challenges also exist in delivering the vaccines. Among them, healthcare facilities often do not have sufficient numbers of trained staff to provide basic services, and maintaining the cold chain so the vaccines are kept at the proper temperature is complex.
Despite these obstacles, there is a strong commitment to immunisation programmes in Zambia.
Recognising that not every mother can access these services, healthcare workers often travel for hours to reach children in remote parts of the country.
In fact, it is this dedication on the part of both health workers and mothers, which has helped fuel high rates of immunisation coverage for measles and polio in the districts.
Ministry of Community Development, Mother and Child Health specialist Francis Mwansa says: “Immunisation is the process whereby a child or a person is made immune or resistant to an infectious disease, typically by the administration of a vaccine. Vaccines stimulate the body’s own immune system to protect the person against subsequent infection or disease.”
Dr Mwansa says immunisation is a proven tool for controlling and eliminating life-threatening infectious diseases and is estimated to avert between two to three million deaths each year globally.
It is one of the most cost-effective health investments, with proven strategies that make it accessible to even the most hard-to-reach and vulnerable populations. It has clearly defined target groups; it can be delivered effectively through outreach activities; and vaccination does not require any major lifestyle change.
And Ministry of Community Development, Mother and Child Health chief expanded programme on immunisation officer Elicah Kamiji says the African Vaccination Week is a time when countries in the African region embark on raising public awareness on the benefits of vaccination and conduct different catch-up vaccination activities.
Ms Kamiji says the event is both timely and apt highlighting the role and importance of governments, healthcare workers, parents, families and communities - all doing their part to support immunisation.
“Everybody has a role to play in fighting vaccine-preventable diseases such as polio, whooping cough, measles, tetanus, diphtheria, influenza, diarrhoea, pneumonia and hepatitis,” Ms Kamiji says.
Introduced only three years ago, the African Vaccination Week (AVW) initiative is now known for promoting the benefits of immunisation during a person’s life, and the delivery of life-saving interventions in the African region.
Indeed hundreds of millions of children, adolescents, women, and men were vaccinated and received other health interventions during the last three sessions.
Zambia has made great strides in the control of some of the vaccine-preventable diseases such as measles, epidemic meningococcal type A meningitis, polio, and others.
Currently, Zambia has been declared yellow fever and polio free all because of its commitment to vaccines.
Ongoing efforts by Government in the introduction of new vaccines are injecting momentum to vaccination efforts. This progress is a shining example of what can be done when all stakeholders join hands to improve the health of the people. However, progress can only be sustained if vaccines are provided as part of a comprehensive approach to health services delivery.
By commemorating the African Vaccination Week, Zambia and Africa as a whole are demonstrating an acute awareness of their collective vulnerability to diseases - a vulnerability, which calls for shared responsibility and investment of even more resources in immunisation. PUBLISHED IN THE ZAMBIA DAILY MAIL ON APRIL 26, 2015

Living HIV-positive, nutrition linked

DOREEN NAWA, Lusaka
AS Zambia prospers in managing and increasing access to antiretroviral treatment (ART), will diets for people living with AIDS improve?  Various organizations and researchers have been pondering on this question lately.
Various studies in Zambia have shown that people living with AIDS face increased challenges in maintaining proper nutrition.
Despite developments in medical treatment, nutrition remains a key component in managing this condition.
The challenges those living with AIDS face can be as a result of the viral infection itself or the effects of Anti-AIDS therapy.
“My being HIV-positive made me go through a lot, and it was at this point that I learnt HIV and nutrition are intimately linked,” says Kelly Mulenga of Lusaka’s Kamanga township.
As for Mr Mulenga, living positively has changed his life completely.
“I got sick in mid-2012 and I was rushed to Chelstone Clinic. Whilst there, several medical tests were done and among them was the test for HIV, and the results were positive,” he says.
Mr Mulenga says because of being ill, he lost his job, and life for his family became unbearable as he could not provide for them anymore.
He says from the time he tested positive, one thing he has learnt is that HIV infection can lead to malnutrition.
He said this is because once infected, one’s ability to provide for themselves and their family is affected leading to poor diet, which in turn speeds up the infection progress.
“I saw it myself. I got worse each day because we did not have food at home. My being here is testimony enough,” Mr Mulenga says.
As HIV treatment becomes increasingly available everywhere, critical questions are emerging about how well the drugs work in people if they do not take adequate food.
Mr Mulenga says without food or the right nutrition, taking antiretroviral drugs is such a painful experience, which can be equated to digesting razor blades.
“Given a choice between taking pills with no immediate visible impact, and eating food to survive, food will almost certainly take priority every time.
“Where malnutrition is widespread, taking antiretroviral drugs on an empty stomach is like digesting razor blades. The result is that many simply stop taking them [drugs],” Mr Mulenga said.
AIDS is well known for causing severe weight loss and deterioration. The body changes do not only occur during the AIDS stage but in earlier stages of HIV infection only that they are less visible.
Among young women aged 15-24, HIV prevalence is more than twice that of men in this age category.
The nutritional challenges of HIV-positive people prompted the birth of Food and Nutrition Foundation (FNF), a non-profit organisation working with people living with HIV and AIDS in poor communities in South Africa and Zambia to start up a feeding programme and lessons on how to maintain a balanced diet for people living with AIDS.
FNF runs a feeding programme in Kamanga township.
Foundation executive director Charity Katotobwe Sikazwe says after witnessing the amount of suffering people living with AIDS were going through in accessing nutrition, she decided to form the organisation.
She says her organisation seeks to fight the disease at all levels through the provision of nutritional support and care. 
“What I found was that underprivileged women in the compounds and rural areas did not know or understand the importance of appropriate care, for example feeding their HIV-positive relatives properly.
“This lack of understanding and nutritional knowledge resulted in many people dying from HIV and AIDS when there may have been other alternatives,” Mrs Sikazwe said.
Mrs Sikazwe says economic hardships, lack of education, and poverty dramatically affect mortality rates and increase morbidity among people living with AIDS adding that once people fall ill, they are unable to work and they cannot look after themselves and their families.  
“This economic disparity is amplified within the HIV and AIDS community and results in inadequate food and nutritional options.  Without enough food and proper nutrition, many people begin to react to their medication. This creates a cycle of malnourishment, and a discontinued use of medicine, further depressing immune systems, which results in their death,” Mrs Sikazwe says.
Statistics show that AIDS is most prevalent in the sub-Saharan African region, of which Zambia is part, and most people living with AIDS are undernourished.
Research done by AVERT, an international HIV and AIDS charity based in the United Kingdom (UK), shows that some of the reasons why there is a correlation between malnutrition and the presence of AIDS are the difficulties that some people suffering from AIDS face finding food because the virus increases fatigue, compromising their ability to work in order to provide or prepare food.
The research shows that this impact is greater on those living in poverty in rural areas, where providing food is largely based on farming and other household chores.
The impact of AIDS has gone far beyond the household and community levels. All areas of the public sector and the economy have been weakened, and national development has been silent.
The epidemic is as much likely to affect economic growth as it is affected by it.
The loss of workers due to AIDS can lead to a large reduction in a nation’s economic productivity.
Agriculture, from which the vast majority of Zambians make their living, is particularly affected by the impact of AIDS. A decline in the number of individuals able to work at the crucial periods of planting and harvesting can significantly reduce the size of the harvest.
This further affects food security both at household and national levels, thereby perpetuating malnutrition and worsening the HIV situation. PUBLISHED IN THE ZAMBIA DAILY MAIL ON APRIL 12, 2015