2018 landmark surgeries highlighted

PART of the team that operating on Mapalo and Bupe.

DOREEN NAWA, Lusaka
THE year 2018 will go down in history as one in which some memorable milestones in Zambia’s medical history have been made.
All these milestones were recorded at the University Teaching Hospital (UTH) in Lusaka.
The hospital, which until recently was segmented into five hospitals, is the country’s largest and oldest health facility.
The five hospitals created are the Women and New Born hospital, the Eye hospital, the Emergency Hospital, Paediatrics and the Adult hospital.
The year 2018 began on a challenging note when the country was expectant of the scheduled surgery of the conjoined twins, Bupe and Mapalo.
After a month into the New Year, Bupe and Mapalo, born in Kawambwa, Luapula Province, were transferred to Lusaka for further attention.
A surgery was scheduled on February 2, 2018.
And on this day a team of about 30 medical staff successfully separated the seven-month-old conjoined twins in a landmark operation done at UTH in Lusaka. The surgery was done at the Women and New Born Hospital. On this day, at about 17:00 hours, renowned Zambian neurosurgeon Kachinga Sichizya announced on his Facebook page that the operation was successful and completed at 16:58 hours.
“Zambia has new heroes! The much-anticipated first separation of Siamese twins has ended successfully after close to 7 hours of surgery. We give God the glory. Please receive our new champions,” he said, referring to the team of surgeons and supporting staff.
The team was led by Dr Bvulani Bruce and Dr Robert Zulu and the anaesthetic team led by Dr Christopher Chanda, the nursing team led by Josephine Chimpinde and Peggy Mashikati and paediatricians Sylvia Machona and Kunda Mupesu Kapembwa.
It was an operation that sent Zambians to cheers considering that the hospital had never carried out such an operation.
Updating journalists on the operation, UTH Mother and Newborn Hospital senior medical superintendent Maureen Chisembele said the twins were successfully separated.
And there was jubilation among doctors who were monitoring the operation from another room after the successful separation of the twins.
The doctors started operating on the twins at 11:00 hours on February 2, 2018.
The girls, Bupe and Mapalo, who shared a liver, were conjoined at the abdomen.
Zambian top surgeons Professor Lupando Munkonge, Dr Tackson Lambert, Dr Chadwick Ngwisha and Professor Sultanov led the team of surgeons who operated on the twins.
A few months later, another milestone was reached.
On September 14, 2018, UTH operated and successfully removed a tumour from the middle of the brain through the nose, a complex operation called Transnasal Trans-sphenoidal approach.
Dr Sichizya, who was part of the team of doctors that conducted the operations, confirmed the development.
Dr Sichizya said the operation took eight hours, describing it as a major score for Zambia’s biggest hospital.
“It is the first time such a procedure is done in Zambia as patients have been referred to India. A team of neurosurgeons and surgeons combined efforts to successfully remove a tumour from the middle of the brain through the nose, a complex operation called Transnasal Trans-sphenoidal approach. The operation, which began at 14:00hrs, only ended at 21:30hrs,” Dr Sichizya said
The operation had been conducted by a group of indigenous Zambian surgeons.
October was not just a month of freedom to the nation. It was also a month to remember for Job Kasweshi, 30, who successfully received a kidney from his brother, Tinashe.
This, again, was another successful surgery conducted at UTH.
On October 25, 2018, UTH scored another milestone by conducting a first-ever kidney transplant surgery.
With the success UTH recorded in 2018, it could ease the pressure on patients being referred to India, which is not only distant but very expensive.
Visiting donor and recipient of the first-ever kidney transplant surgery conducted at UTH, President Edgar Lungu expressed confidence that the successful kidney transplant surgery will help cut down on monies Government spends on sending people abroad for treatment.
The kidney donor, Tinashe Kasweshi, 25, a lawyer and the recipient, Job Kasweshi, 30, are siblings.
The team of doctors led by Zambian surgeon Michael Mbambiko and an expert from India successfully conducted the kidney transplant operation.
Like most professionals in many developing countries, the doctors at UTH are not exempt from some of the difficulties that are peculiar to their work.
Considering the staffing level challenges and many other challenges that the health sector faces not only in Zambia but worldwide, such surgeries being conducted locally are worthy the celebration.
According to the World Health Organisation (WHO), Zambia has only 1,500 medical practitioners, and faces a shortfall of 3,000 doctors.
The WHO recommends that for every one doctor there should be 5,000 patients. In Zambia, one doctor attends to 12,000 patients.
The above ratio points to consequences such as work overload due to the shortfall of physicians.
As all is done for 2018, a puzzle is yet to be solved on a three-year-old boy of Chipata who was found with 44 needles and wires and only 24 were removed and 18 remain in the body.
The boy is waiting to undergo surgery and is currently admitted to UTH.
Doctors at Chipata Central Hospital removed 24 needles from the boy’s body before evacuating him to Lusaka.
Now all eyes are on the UTH surgeons.
Giving an update on the anticipated surgery, UTH head of clinical care. At the Children’s Hospital, Musaku Mwenechanya, said the boy still has 18 needles in his body which need to be removed.
Further, Dr Mwenechanya said the hospital is still making preparations for the surgical operation as it requires specialised doctors and equipment to conduct the surgery.PUBLISHED IN THE ZAMBIA DAILY MAIL ON JANUARY 4, 2019. LINK: http://www.daily-mail.co.zm/2018-landmark-surgeries-highlighted/

Agriculture diversification: Missing link

CHILANGA ward councillor Misheck Mweemba applying manure in a field in Shimabala, Kafue district. PICTURE: DOREEN NAWA

DOREEN NAWA, Kafue
IN the Seventh National Development Plan (7NDP), agriculture development is considered the engine for economic growth in Zambia, and a key determinant in the country’s efforts to reduce poverty.
However, productivity in the agriculture sector lags considerably behind mainly because the rural populace, which accounts for 70 percent of the country’s agricultural production, seems not to produce enough to tackle poverty at household level.
Government has been implementing a number of development programmes and strategies aimed at improving agricultural productivity, though they have often generated weak responses.
For example, the dependency on maize production alone has been identified as one of the many contributors to high poverty levels and food insecurity among rural farmers.
In February last year, President Edgar Lungu advised Zambians to rethink dependency on maize.
“It is time farmers reconsidered their dependency on maize as a staple food and sought other alternatives. Going by what we have experienced [drought], it is time we took stock, whether maize should be the ultimate crop for survival as a people,” President Lungu said.
For almost every Zambian, maize means food.
Many homes, whether in the rural or urban areas, depend on nshima for their main meals.
It is not an understatement that in some homes, it is the only food available for all the three meals in a day - breakfast, lunch and supper.
But maize production is facing a bleak future as Zambia’s staple food not only because of the erratic rainfall that the country is experiencing, but also the high cost of producing it.
Take last farming season, for instance, when the country witnessed a long dry spell, which left some maize fields scorched.
Farmers in Zambia depend on rain to grow their crops and times like these leave them desperate and hopeless.
Zambia has other alternative crops like cassava, sorghum, millet and rice, which can be developed to constitute main meals.
But why is farmer response to diversification weak?
Evaristo Banda, 66, a small-scale farmer in Rufunsa district, says the main problem farmers face in adjusting from maize to other cereals is the lack of technical advice and knowledge on how to go about the production of alternative crops.
Mr Banda attributes the lack of knowledge to the absence of response from agricultural extension and advisory services in his area.
“I know [about] the advice from President Lungu early last year, but farmers have no guidance on how to go about it because of the absence of technical advice from extension officers. For this, I blame the extension officers for their failure to address the diverse farmers’ needs and demands,” Mr Banda says.
Mr Banda knows that farmers countrywide have not adapted to climatic and other risks, hence the urgent need for diversifying their farming activities.
“We know the need to diversify but we cannot explore it on our own. We need assistance through research and surveys to determine what crop to grow and at what time. Such information is missing and is the major setback to our graduation from maize to other cereal crops,” Mr Banda says.
He says the relationship between farming diversity and food security has potential to change the current face of agriculture in the country.
Another small-scale farmer, Christine Singoyi, 46 of Shimabala area in Kafue knows that crop diversification has potential to grow agricultural productivity.
Mrs Singoyi says the missing link between small-scale farmers and agriculture extension officers is a drawback in the progress of farming systems in Zambia.
“We know of the cost of just growing one crop like maize both in nutrition and monetary terms but as small scale farmers. We need programmes that promote sustainable land use management practices in order to nurture our soils, but people to give us this information are not there,” Mrs Banda says.
Studies indicate that agricultural diversification increases resilience, helps farmers to reduce climatic and economic risks, enhances productivity and creates food and nutrition security.
The International Institute for Environment and Development (IIED) recently conducted a research in Zambia on the need for small-scale farmers to diversify crop production as opposed to depending on maize alone.
IIED senior researcher Seth Cook notes that diversity is a key element not only to food production but also of healthy, high-quality diets.
According to the research findings, diverse agricultural production will contribute to dietary diversity in farm households in Zambia.
“In addition, studies have found stronger links between agricultural biodiversity and dietary diversity in female-headed households than those headed by males. There is also evidence that when women have control over resources such as land and money, it leads to greater allocations of household resources for food. Empowering women is clearly key,” Mr Cook says.
Mr Cook says failure to diversify threatens food production and dietary patterns in Zambia. He notes that food diversity is at risk because of various factors, among them the diminishing number of crops on farms.
He is hopeful that one day diversity on the farm will lead to diversity on the plate.
Mr Cook says the way forward to diversity is to protect and strengthen the knowledge and cultural practices that support diverse food systems, adding that a multi-stakeholder approach can help to achieve diversity and build upon citizens’ knowledge and practices. PUBLISHED ON JANUARY 9, 2019. LINK: http://www.daily-mail.co.zm/agriculture-diversification-missing-link/