Monday, September 25, 2017

Five things you should know if your loved one is battling cancer

 

By Dr Chris Peterson

There are lots of stereotypes and misconceptions about how cancer patients look like, act and feel like. This article aims to dispel these myths.

Everyone’s experience with cancer may be different. For someone who has just been diagnosed, it can be scary to not know what to expect. Will it be like what you see in the movies, or will it be completely different? It isn’t until we start treatment and the process of beating cancer that we really understand all the misconceptions that exist.

For those who haven’t been affected by the disease, it can be hard to know what to say and how to say it. And for those who are dealing with a diagnosis, it can be incredibly frustrating to be stereotyped into certain categories that are not reflective of what you are going through. I set out to dispel these myths.

1. Cancer doesn’t always end when treatment does

The “new normal” is always a hard and scary place to be for many. Not only are they still dealing with lingering physical side effects of a cancer diagnosis, fear of recurrence, survivor’s guilt, the list goes on. It’s hard for them to explain to their loved ones that just because treatment is over doesn’t mean they are “over it” if they tell you that they are not okay, please take it just as serious as you did when they still had cancer.

2. Cancer doesn’t look the same on everyone

There is no one “image” of someone with cancer that they all need to adhere to in order to be acknowledged as a patient. Some lose weight from chemo, others gain weight from steroids. Some lose their hair and others do not. They are all different and their experiences are always not the same. All experiences with cancer may be different.

3. Some days are just hard

Some days are better than others, but when it comes down to it, some days are just hard. There is no inspirational quote or uplifting book that is going to change that. They appreciate it when you try, but sometimes all they just need is a supportive hand to hold, and an understanding that sometimes it’s just going to be hard, but that it won’t stay that way forever.

4. Just because they don’t look sick doesn’t mean they are not

For some cancer patients, thinning hair and weight loss is the norm. But for others, there are no outwardly signs of suffering, which can make it very difficult when people say things like: “but you don’t look sick….. “those who don’t look sick” are often in a lot of pain on the side and it can be hard when others don’t see that.

5. They are so much more than their disease

When they get grouped and labeled as a “cancer patient” sometimes it seems like all of their other identifying factors no longer matter. It doesn’t matter that they are professionals, parents, significant others, friends, activitists. All that people seem to see or acknowledge is the cancer. please remember that, they are still themselves, they just happen to have cancer now.

Email: sonchrispeter@gmail.com

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Monday, September 25, 2017

Things you need to know about anaemia



Ali   Khatau

Ali   Khatau 

By Ali Khatau

Today I want to say something about a person’s blood, more so, what happens when the person’s body does not have the right level or amount of blood. I will also explain why your blood level may change and how.

Firstly, there is this fact to note—that if your blood has a few or abnormal Red Blood Cells (RBCs), then, your body won’t receive enough oxygen.

When the body is in such a state, we say, medically that a person has anaemia—the most common blood disease worldwide. It’s a disorder that develops when your blood lacks enough and healthy RBCs or the blood pigment known as hemoglobin. Hemoglobin is a main part of the RBCs and carries oxygen to other parts of the body.

How prevalent is the problem

According to the World Health Organisation (WHO), anaemia affects a staggering 24.8 per cent of the global population which amounts to a massive 1.62 billion people.

A study published in the US-based National Library of Medicine in 2015 showed that the overall prevalence of anemia in Tanzania, Kenya and South Africa was between 71 and 79 per cent, with a significant percent being caused by malaria and Sickle Cell Disease (SCD).

Yet, among pregnant women, the prevalence of anaemia in 2011 in Tanzania was 50 per cent, according to a report by the World Bank (WB) which clearly reflects the extent of this condition.

What causes the problem

Mainly, anaemia can be caused by three things—blood loss (such as when one bleeds heavily), when the body does not produce enough blood cells or when the red blood cells are being destroyed in the body.

The anaemia that is caused by blood loss can be due to a problem in the food canal (Gastrointestinal problems). These problems include ulcers and swollen veins that sometimes protrude from the anus (Hemorrhoids).

It may as well be caused by menstruation and childbirth and here, I am specifically talking about women.

The anaemia which is caused by decreased production of RBCs can be due to deficiency of iron or vitamins in the body.

At times, there could be a problem with the bone marrow or even sickle cell anemia.

Anaemia can also be caused by increased destruction of the RBC’s. This happens among people with inherited conditions such as thalassemia and sickle cell anemia, toxins from the liver or kidney disease, various infections, drugs or snake venom.

How to know someone has anaemia

I have talked about the various forms of anaemia and certainly, when a person is suffering from any of the different types, he/she may report for medical assistance with varying signs and symptoms.

But on a general note, someone with anaemia will typically experience fatigue, tiredness, rapid heartbeats, and shortness of breath, headache and difficulty concentrating.

The patient may complain of dizziness, insomnia and leg cramps. On physical examination, this patient will be found to have a pale skin.

Specifically, the anaemia due to RBC destruction usually includes signs like jaundice, brown/red urine and leg ulcers. The patient may experience abdominal pains and possibly seizures.

What people can do about anaemia

In order to prevent anaemia, it’s vital to eat a healthy balanced diet which is rich in iron and other vitamins.

These include foods like beef, lentils, green vegetables and plenty of fruits. Vitamin C rich foods may help increase the absorption of iron in the body.

You may also want to reduce your tea and coffee intake as they make it difficult for the body to absorb iron.

If you’re concerned whether you get enough vitamins from your diet or not, you should consider consulting your doctor who may advise on the use of multivitamin pills.

You might be able to prevent repeat episodes of some types of anemia, especially those caused by lack of iron or vitamins. Dietary changes or supplements can prevent these types of anemia from occurring again.

Treating anaemia’s underlying cause may prevent the condition. For example, if medicine is causing your anaemia, your doctor may prescribe another type of medicine.

To prevent anaemia from getting worse, tell your doctor about all of your signs and symptoms. Talk with your doctor about the tests you may need and follow your treatment plan.

If you have an inherited anemia, talk with your doctor about treatment and ongoing care.

The author is a Medical Student at Hubert Kairuki Memorial University.

Email:Alikhatau@hotmail.com

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Monday, September 25, 2017

Worrying reproductive health state in Kigoma

A senior midwife at Mwakizega Dispensary in

A senior midwife at Mwakizega Dispensary in Uvinza District, Kigoma Region, Ms Mary Tuakazi, explains to the Deputy Health Minister, Dr Hamis Kigwangalla during the handover ceremony of 26 dispensaries built by EngenderHealth and financed by Bloomberg Philanthropies at a cost of Sh 2.7 billion. PHOTO | SYRIACUS BUGUZI. 

By Syriacus Buguzi @buguzi

The state of reproductive health services in Tanzania’s western region of Kigoma leaves much to be desired, despite the huge investment by the government and donor agencies.

Among women of the reproductive age (15-49 years), in the region, only 17 per cent received ante-natal care during their first three months of pregnancy, according to a latest survey carried out by the US Department for Health and Human Services.

The survey, done under the auspices of the Centre for Diseases Control and Prevention (CDC), revealed further that only 13 percent of the women attended post-natal check-up for their health.

The findings disseminated in 2015 paint a gloomy picture of the state of reproductive health services especially in reference to the high infant mortality rates in the region and the entire country.

The government and donor agencies believe that time is now to scale up more investment in the Kigoma’s reproductive health services in order to reverse the trend of maternal and child deaths.

The country’s ‘National Road Map Strategic Plan to Accelerate Reduction of Maternal, Newborn and Child Deaths in Tanzania (2008-2015) is explicit on what should be done. However, there is something to note in the plan, despite the achievements that have already been documented as efforts by stakeholders.

In the plan, it can be noted that although significant progress has been made in reducing child mortality, neonatal mortality remains high at 32 per 1,000 live births, which accounts for 47 per cent of infant mortality rate, estimated at 68 per 1,000 live births.

Things to address

It has been found in the survey that reproductive health situation is exacerbated by health system factors such as inadequate implementation of pro-poor policies, weak health infrastructure, limited access to quality health services, inadequate human resource, and shortage of skilled health providers.

The weak referral systems have also been a critical factor, in addition to low utilization of modern family planning services, lack of equipment and supplies, weak health management at all levels and inadequate coordination between public and private facilities.

But there are non-health system factors like inadequate community involvement and participation in planning, implementation, monitoring and evaluation of health services, some social cultural beliefs and practices, gender inequality, weak educational sector and poor health seeking behaviour.

What’s being done to rescue the situation

This month, EngenderHealth Tanzania, through Bloomberg Philanthropies & Fondation H&B Agerup support, handed over 26 health facilities that they had built and renovated in Kigoma Region.

This was aimed at boosting the access to quality family planning and other reproductive health services in Kigoma region through expanding availability of comprehensive emergency obstetric and neonatal care.

The broader aim was also to increase comprehensive post abortion care and family planning services, with emphasis on long acting reversible contraception and permanent methods in the region.

This involved constructing and equipping of maternity buildings that include labour wards, antenatal and postnatal clinics, rooms to provide service to women with post abortion complications and family planning as well as maternity wards in 24 dispensaries.

The total cost for the support is worth $1,342,144 in which $ 1,138,244 was used for construction and renovation, and $203,900 for procurement of equipment.

These were collaborative efforts of the Ministry of Health, Community Development, Gender, Elderly and Children (MoHCGEC), Thamini Uhai, the U.S. Centre for Disease Control and Prevention (CDC), Engender Health and local government authorities.

According to Deputy Minister for Health, Community Development, Gender, Elderly and Children, Dr Hamisi Kigwangalla the need to expand the services in Kigoma now requires the support of more stakeholders. “We call upon other stakeholders and well-wishers to come up and offer similar support in other regions,’’ said Dr Kigwangala during the handover event in the region.

There are still some gaps that the government can fill in an effort to improve the services, said the Bloomberg Philanthropies Representative Dr Godson Maro.

“We urge the government to put more efforts on the anesthesiology cadre that is highly needed in every facility that is providing surgical services. The number available in Kigoma is very inadequate,’’ said Dr Maro.

He said, “We have been working in the country since 2006. During that time, we have managed to achieve a lot including upgrading of a total 17 health centres that are now offering labour/maternal and neonatal services and thus contributing to reduce the number of maternal deaths.

Email: sbuguzi@tz.nationmedia.com

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Monday, September 25, 2017

WHAT'S UP DOC : Govt’s control of private health sector is risky



Dr Syriacus Buguzi

Dr Syriacus Buguzi 

By Dr Syriacus Buguzi six.buguzi@gmail.com

The government is now working towards ensuring Tanzanians access quality healthcare without suffering financial hardship when paying for health services, through promoting Universal Health Coverage (UHC).

However, this has come with one key challenge. The government wants to achieve the UHC strategy through means that might leave the private health sector ‘crippled.’

In September last year, the government announced it was scaling down the hospital billing rates to harmonize the cost of treatment in public and private health facilities.

While the aim is to ensure reliable and quality health services to Tanzanians, one thing that boggles the mind is: How fair is it for the government to set up healthcare prices for private health facilities?

Well, recent studies have shown that about 40 percent of the population is served by private health facilities.

Some people argue that private health facilities offer better health services compared to public facilities. There are those who don’t agree with this assertion. We are yet to see a study that would conclude which is one is better. But, going back to my main question on the government’s decision to dictate prices for the private health sector, I recently came across people who argue that the government is right to do so.

The argument is that the government should step in because private health facilities have been largely found to work ‘haphazardly’ meaning that the owners of these facilities set high prices irrespective of what the situation is in the market.

They say, private health facilities are profit-oriented and at times over-treat or rather engage in disease-mongering, failing to stick to medical ethos.

However, there are healthcare planners who argue that the government should keep its hands off because the healthcare prices are set by market forces.

They argue that private health facilities don’t get subsidies from the government to run, just as public health facilities do. Private ones rely solely on cost-sharing for sustainability.

It is therefore important to set a ground for a level playing field that will not compromise any sector, over the other, they argue.

So, to keep the public health facilities running without being compromised, there are calls for the government to stick to an effective public-private partnership (PPP). Who will create a good ground for this? Both sectors need a serious round-table talk.

During this year’s East Africa Health Federation in Dar es Salaam, one stakeholder was of the opinion that if the government manages to control the private health sector to that extent, young medical entrepreneurs with ambitions of investing in private health practice might be discouraged.

If the private health sector is weakened, it means that 40 percent of people who seek healthcare in those facilities might be deprived of the care they deserve.

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Monday, September 25, 2017

A 10 minute workout is all you need

 

The benefits of physical activity are numerous, and in fact, getting regular exercise is one of the best things you can do for your health. But when you live a busy life (which we all do), setting aside an hour a day seems impossible. Sometimes even a 30 minute workout just isn’t feasible.

If you’re incredibly short on time, here’s some incredible news: There is overwhelming evidence that exercising for even 10 minutes a day can make a huge difference in your health and fitness level.

The evolution of exercise

If it seems like you’ve been given different exercise advice throughout your life, you’re not wrong. Determining the minimal dose of exercise to recommend to the public is no easy task, especially since we are all so different. But there was a time when no one ever would have believed that a 10 minute workout could make a difference.

Short workouts vs. long workouts

There is an ongoing debate on the effectiveness of short workouts and whether or not longer is better. We do know that short bursts of high intensity interval training can be more effective than 45 minutes of moderate cardio, but longer workouts can help us build endurance. Ideally, we could do both — a couple of lengthy sweat sessions every week mixed in with a couple of short workouts leads to long-term fitness.

But many of us simply don’t have the time for long gym sessions.

The study

A team of researchers published the results of their study in the Journal of the American Medical Association. For the study, 464 postmenopausal women participated, none of whom were exercising beforehand. The women were assigned to four groups: the control group that stayed sedentary, a light exercise group that averaged 72 minutes of exercise per week, a moderate exercise group, and a high exercise group.

The researchers were pleased to see that the women in the light exercise group increased their peak oxygen consumption levels by 4.2%. They also reported feeling better and breathing easier.

The 10 minute transformation: While the study indicates that a 10 minute workout is good for our health, there’s still the matter of our waistlines. After all, the majority of us workout so that we’ll look good, not just feel good.

Luckily, it seems that 10 minutes of daily exercise can also help you lose weight or maintain a healthy BMI. Prevention magazine even crafted a program called Fit in 10 that offers 10 minute workouts and healthy 10 minute recipes, and it has proven to be very effective.

Proof that 10 minutes is all you need

Despite the mounting evidence, it can be difficult to believe that anyone could get into shape in just 10 minutes a day. But it happens. Renata Zajac lost 12 pounds and 17 inches in a mere eight weeks just by cleaning up her diet and doing 10 minute workouts. In addition to dropping weight quickly, Zajac noticed she was able to run up the subway stairs faster and felt more confident walking into work meetings.

Make the most of those 10 minutes: While it’s true that any exercise is better than none, if you’re hoping to lose a few pounds or get into better shape, you’ve got to make the most of your time.

A 10 minute workout you can do anywhere: Not only are 10 minute workouts effective, but in some cases, you don’t need any equipment or room to complete them. Ben Greenfield, fitness and triathlon expert, recommends completing these moves three times:

• 50 jumping jacks

• 15 body weight squats

• 15 push-ups (on your knees is fine)

• 15 reverse lunges per side

• 15 tricep dips (using a chair or bench)

Try doing this workout every morning and see if you notice a difference in a couple of weeks. Your results might surprise you.

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Monday, September 18, 2017

Schooling your children in dental hygiene

Improper brushing may lead to gum

Improper brushing may lead to gum diseases,tooth decay or bad smell,which is why parents or gurdian need to supervise their children's teeth brushing.PHOTO|AFP 

By Gadiosa Lamtey @gadiosa2

How often do you assist your children to brush their teeth? If you have never considered this, you are not alone. Most of us never thought it was important. Since you are reading this now, you should start helping your childen with oral hygiene.

Did you know that an infant’s gums also need to be cleaned from time to time? They say even a day-old child’s mouth smells if not cleaned.

Dentists say that good oral care begins when children are babies. As your child grows, you are supposed to start helping them with teeth brushing as it not only helps protect your child’s teeth but also cultivates a child’s oral hygiene culture.

A resident of Tabata-Segerea, Irene Kipendi who is a mother of two says she did not know that young children should have their teeth brushed. Irene says when her children were young, she never cleaned their mouths let alone brush their teeth. She never thought it was necessary.

It was during a visit to the dentists one day when her six-year-old had a tooth problem that she learnt she had to help her children with teeth brushing.

“The doctor’s first question after he examined my child was how often I helped her brush her teeth. He advised me to always help her do it the right way,” says Irene.

Importance of oral hygiene

A mother of five, Aimtonga Ndemasa, who lives in Mbezi Louis says a majority of mothers have no idea how important oral hygiene is in children.

“They don’t know that you have to help your child until she reaches the age of six,” Aimtonga shares.

She thinks dentists should continue educating the public, especially mothers on the subject.

“I know about teeth brushing for children because I am a nurse, but besides this, I used to help them until they turned three. After that I would let them brush their teeth on their owm, which I now know was wrong,” she says.

Professor Febronia Kahabuka, a paediatric dentist from Muhimbili University of Health and Allied Sciences (MUHAS)’s School of Dentistry, says children’s teeth should be brushed by parents or guardians up to the age of six.

The professor says an infant’s gums should be gently cleaned using a clean soft cloth at least three times a week. This helps remove milk residue from the mouth so that the baby feels good but also protects it from bad smell.

The dental expert says executing mouth hygiene for an infant is important because it helps the mother develop a routine hygiene practice and is likely to help maintain the practice for the child in future.

When the baby cuts his first tooth, which normally occurs from six to eight months, the parents or guardians should continue to clean it with a clean cloth, the professor advises. She says the use of a toothbrush should start when several teeth have appeared in the mouth. As soon as the first molar appears, it is advisble to start regular tooth brushing using a soft toothbrush.

Parents have a role to play

According to the dentist, parents or guardians should not let children below six years brush teeth on their own. Normally children under the age of six are unable to grasp the toothbrush and properly clean their teeth.

“That’s why we recommend that parents or guardians should perform the brushing,” says Prof Kahabuka.

Allowing children under six years to brush teeth on their own is accompanied with a risk of leaving behind dental plaque and food residues that can lead to oral diseases.

Children aged between seven and nine years can brush their teeth but they too should do so under the supervision of parents or caregivers. In this age group children have acquired self-awareness and are able to follow instructions on tooth brushing, Prof Kahabuka says.

Although statistics show that nearly all children brush their teeth at least once per day, about 80 percent of them do not brush in accordance to professional recommendations namely; frequency of brushing and parental supervision.

Improper brushing may lead to gum diseases, tooth decay or bad smell according to the oral health expert.

Tooth decay is caused by several factors such as frequent intake of sugary foods and drinks, poor oral hygiene and insufficient use of fluoride.

In the previous five years, about 90 per cent of the children attending the MUHAS paediatric dental clinic had complaints related to tooth decay but the problem has since gone down.

Currently the number of children attending the clinic are those with malaligned teeth problems but again, there are a number of specialists dealing with that. Doctors at the clinic are confident that in coming years, this also will no longer be a problem.

“It is important for parents to recognise their role in taking care of their children’s oral and dental health. They should do away with beliefs that milk teeth are not important because they will shed anyway. This is a fantasy concept as tooth decay or any other oral health problem knows no age. Anyone who does not brush their teeth properly will suffer the consequences,” notes the dentist.

Amount of toothpaste to use

With children up to nine years old, parents are advised to use a small amount of fluoride toothpaste in form of a pea size.

This is because young children are unable to spit out the toothpaste or some of them may swallow the paste that is why it is important to consider the size. Habitual swallowing of fluoride toothpaste may cause dental fluorosis, which is a defect of tooth enamel caused by too much fluoride intake during the first eight years of life.

Although fluorosis can be cosmetically treated, the damage to the enamel is permanent.

Recommended toothbrush

The toothbrush should have a small head with a big handle; the small head size helps to access the hard to reach baby’s molar teeth in the back of your toddler’s mouth thus clean the teeth properly.

The big handle facilitates grasping of a toothbrush by a child whose dexterity is not well developed. Tooth brushing should be done twice a day; in the morning and at night before retiring to bed.

Oral hygiene culture

In order to ensure that children are educated about the importance of brushing their teeth, MUHAS, through the school of dentistry regularly visits primary schools in Dar es Salaam to educate children on the importance of oral health, how to take care of their teeth and teach them how to properly brush their teeth.

The dental school, through training activities, conducts various researches with the ultimate goal of finding solutions and making recommendations to the government on how to address oral health related problems in children.

Preliminary findings of a research conducted among preschool children in Tandale revealed that 70 per cent of the children surveyed had one or more decayed teeth.

Another study conducted at Magomeni Primary School shows that most children are not supervised during teeth brushing and the result is tooth decay and bad smell.

The school of dentistry will continue to educate expectant and nursing mothers through brochures and mass media to ensure children are safe in respect of oral and dental health.

Email: glamtey@tz.nationmedia.com

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Monday, September 18, 2017

These are major cancers you can ward off with body fitness

 

By Dr Chris Peterson

A cancers cancer diagnosis is devastating but some cancers may also be preventable. In fact, an estimated half of all cancer deaths are avoidable by practicing healthy lifestyles.

In my article I wrote just a few months ago in this column titled “want to cut your cancer risk? Then reduce that extra body fat”, I tried to shed some light on how being overweight can trigger some cancers as well as their complications.

One of the most potent cancer fighting weapons is exercise. While the benefits of a regular fitness programme are many including keeping the pounds off, improving blood pressure and mental outlook, exercise can also halt the onset of some diseases. Several studies have shown that physical activity is linked with decreased risk of some cancers particularly colon cancer.

Body fitness matters! And it’s never too late to begin a fitness programme. Here are major cancers that scientific researches have shown can be stalled by exercise:

Endometrial cancer. Women who exercise for 150 minutes a week or more had a 34 percent of stalling endometrial cancer (a cancer that begins in the lining of the uterus) than those who are not active. According to recent data by WHO, women with a body mass index (BMI) below 25-73 percent have a reduced risk compared with inactive women whose BMI is above 25. People with a BMI of over 25 are considered overweight.

Prostate cancer. Though several studies have been inconclusive, some findings suggest a link between physical activity and a reduced risk of aggressive prostate cancer. Men who have regular recreational exercise show a lower risk of developing advanced prostate cancer or dying from the disease, compared to those who with no physical activity.

Personalising an exercise routine is therefore important. Pick an activity that you enjoy doing, and then focus on intensity. It is not so much what you are doing but how intense you are doing it. You can do some vigorous gardening, and you are out there working really hard, digging. Alternatively you could be going out running so slowly you never even get your heart rate up.

Breast cancer. Women who have a family history of breast cancer, may successfully reduce their risk by doing at least 20 minutes of moderate or vigorous physical activity at least five times a week along with maintaining a healthy life style in other ways. Post menopausal women who give up their sedentary ways and engage in a moderate-to-vigorous-intensity exercise programme may show changes in hormone and protein levels consistent with a reduced risk of breast cancer. Some studies even suggest that starting an exercise programme during adolescence may delay the onset of breast cancer for women who may carry the mutation in their BRCA genes but it doesn’t prevent the disease from developing.

Ovarian cancer. Some evidence suggests a link between exercise and a reduced risk of epithelial ovarian cancer. Women who engage in high-intensity activity most often, tend to have a reduced risk of invasive ovarian cancer compared to women who report no regular physical activity.

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Monday, September 18, 2017

Best way to introduce solid foods

The World Health Organisation estimates that 2

The World Health Organisation estimates that 2 out of 5 children are stunted in low income countries,Tanzania included.PHOTO|FILE 

By John Mbilinyi

There comes a time when breast milk alone can no longer be sufficient to meet the nutritional requirements of your baby. In this case, other foods and liquids are given to the child, alongside breast milk.

This type of feeding is important when the child is aged 6 to 24 months and it’s a transition period, meaning that at this time, the child is being oriented to foods other than breast milk.

It’s during this period when malnutrition is most likely to affect many children. Malnutrition is a big problem in Tanzania and beyond.

The World Health Organisation (WHO) estimates that 2 out of 5 children are stunted in low-income countries, including Tanzania.

Here are guiding principles for parents to follow to boost children’s health when they are ready for solids.

First is the age when complementary feeding is introduced

WHO recommends that infants start receiving complementary foods at 6 months of age in addition to breast milk. The parent must bear in mind that initially the food is given 2-3 times a day between 6-8 months, increasing to 3-4 times daily between 9-11 months and 12-24 months; with additional nutritious snacks offered 1-2 times per day, depending on the child’s desire.

Then comes the maintenance of breastfeeding.

It’s advisable to continue breastfeeding on demand until 2 years. This helps when the child’s appetite for other foods decreases but breast milk intake is maintained during illness. Frequent breastfeeding protects a child’s health by delaying maternal fertility during the period after delivery.

The third is responsive feeding. This means feeding the child patiently. Experts advise against forcing the child to eat if he refuses to. They instead recommend trying different food combinations, tastes and texture or talking to the child during feeding by maintaining eye contact. Also, minimise distractions during meals.

Fourth is safe preparation and storage of the complementary foods. Good hygiene should be maintained by the care giver and proper food handling such as washing caregiver’s and a child’s hands before preparing, handling and eating foods.

Storing the food safely must go along with serving the food shortly after being prepared. Use clean utensils to prepare and serve food. Use clean bowls and cups when feeding the child. But also, avoid feeding using a bottle which is hard to clean.

Then, let’s look at the amount of complementary foods needed. Start with a small amount, and then proceed by adding the amount of energy food while still giving breast milk 200 kcal/day at 6-8 months, 300 kcal/day at 9-11 month and 550 kcal/day at 12-23 months.

Food consistency also matters. Gradually, this increases food consistency and variety as the infant gets older, adapting to the infant’s requirements and abilities.

Seventh, is meal frequency and energy density. Thisincreases the number of times that a child is fed on complementary foods as he/she gets older. Feeding frequency at the age of 6-12 months give complementary feeds 3 times a day, even if breastfed and 5 times day if not breast fed. At age 12 month- 2 years, complementary feeds are given 5 times a day even if breastfed and at the age of 2 years and older, give family foods at 3 meals each day; also twice daily give nutritious food between meals.

The eighth is about nutrients content of complementary foods. Feed the infant on a variety of foods to ensure that nutritional needs are met such as proteins, vitamins and adequate fats but avoid giving drinks with low nutrient value such as tea, coffee and sugary drinks such as soda.

Then, the use of vitamin/mineral supplements or fortified products is very vital. In some populations, breastfeeding mothers may also need vitamin-mineral supplements or fortified products or both for their own health and to ensure normal concentrations of certain nutrients (particularly vitamins) in their breast milk.

Tenth and last is feeding during and after an illness.

According to the principles of feeding a sick child, this involves continued breast feeding; Do not withhold food at this point. Give frequent small feeds every 2-3 hours. Encourage the child and be patient but also, you can take the child to a health facility where feeding by what we call a nasogastric tube can be started. This is, if the child severely loses appetite (anorexic).

After an illness, give food more often than usual, encourage child to eat more.

But always remember that inadequate feeding of the baby can result to under nutrition syndromes such as kwashiokor, marasmus, marasmic-kwashiorkor and underweight while over-nutrition can result into obesity and type 2 diabetes mellitus. Hence, it’s important to maintain a balanced diet.

Email: johnsalum26@gmail.com

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Monday, September 18, 2017

WHAT'S UP DOC : Wisdom is key as healthcare goes digital



Dr Syriacus Buguzi

Dr Syriacus Buguzi 

By Dr Syriacus Buguzi six.buguzi@gmail.com

The digital era is here, and it’s impacting our lives immensely. Today, I want to show why it’s time to make the most of this digital era to make informed health choices.

First and foremost, the digital space has brought people, communities closer than it was ever before—much to the level of some health experts leveraging on it to promote healthcare.

This also comes at a time when we are seeing a lot of misleading health information circulating on social media, moreover from questionable sources. Luckily, healthcare workers are on the frontline to fight this. The last time I checked there was this: www.saratani.info, where a group of radiotherapists have vowed to spread the right information about cancer through cross-sharing platformWhatsApp.

That’s only a single case of how healthcare is going digital. Each day, I come across lots of health related information on Facebook, twitter and other social networks.

A study done by a US-based mediabistro, found that over 40 per cent of patients agree that information found through social media influences their health choices. We are yet to see such a study done in Tanzania, where millions of people are known to use social media.

The increasing social media audience can be used in health campaigns against things such as cigarette smoking, encouraging the public to go for screening and spreading health warnings.

In the past, running such campaigns meant fueling vehicles and going around the streets, making announcements to sensitise people to go for screening.

But as health professionals share information among themselves on social media groups, it comes with challenges.

My worry is on the risks associated with this. I see a possibility of cases where patients’ privacy might be breached. Already, I am aware of such cases here in Tanzania where healthcare workers, unknowingly or knowingly shared clients’ information in social media.

If we want to maximise healthcare delivery, it’s now time we looked into how to mitigate the risks associated with it. Such matters may damage the healthcare profession altogether.

But also, there is need for the healthcare professionals to scrutinise what they share and how it might influence the end users. I know social media users who make self-diagnosis of the illnesses they don’t know and self-medicate.

For the end users, it’s key that you seek professional advice apart from the useful information you get on social media.

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Monday, September 18, 2017

Myths and realities through an oral health window - 4

Dr Emeria Mugonzibwa  is a lecturer of

Dr Emeria Mugonzibwa  is a lecturer of Dentistry at Muhimbili University of health and Allied Sciences 

By Dr Emeria Mugonzibwa

This is the fourth of the oral health myths series and their related facts.

Myth 1: Smoking can make one’s teeth discoloured and that is all.

Fact: Smokers have more tooth decay than nonsmokers, more problems with periodontal (gum) disease and more risk of oral cancer.

Myth 2: If both parents lose their teeth in their 50s, children too will lose teeth at the same age.

Fact: It is not predictable. Just maintain your oral health, get regular dental care, follow a healthy diet and practice good oral hygiene.

Myths 3: It is not possible to catch the bacteria that causes tooth decay from another person.

Fact: It is possible. In fact, transmission of the bacteria that causes tooth decay routinely occurs from mothers to infants.

Myth 4: Tooth loss is a part of aging.

Fact: Tooth loss is NOT unavoidable.

Tooth loss during adulthood is often caused by Periodontal Disease, which is caused by serious infection of the gums that damages the soft tissue and bone which supports the teeth.

Microorganisms, such as bacteria stick to the surface of the tooth and multiply producing toxins, which provoke the immune system to react and cause inflammation (gum swelling and/or bleeding). Gums become swollen, reddish and bleed frequently, especially with brushing and flossing. The affected gums, if unattended sooner or later lead to loosening of teeth as well as falling out of the gums.

Causes of periodontal disease include:

Poor oral hygiene practices especially not brushing teeth at least once a day with fluoridated toothpaste

Not visiting an oral health professional at least once every 12 months for checkup

Smoking

Inherited or familial situations

Some diseases like diabetes

Some medications

Myth 5: Bleeding gums is a normal condition.

Fact: As your body does not bleed when you wash, it is not normal for your gums to bleed either. In fact, bleeding gums on casual brushing is the first sign of inflammation and/or infection.

Gums will bleed because soft white dirty deposits (plaque) have stayed for too long on the gums or accumulated where toothbrushes cannot reach to clean them. This is why daily complementary flossing is so important! Flossing will help reach these plaque-ridden areas, which add up to about more than one third (35%) of the tooth surface. Consistently brushing and flossing gently twice a day will cure bleeding gums. If bleeding continues, one has to visit an oral health professional for further evaluation of the gums for possible gum disease or other conditions.

Myth 5: Mouth wash will solve one’s bad breath (halitosis) problem

Fact: There can be many causes for bad breath and mouthwash alone is not the solution. Bad breath can be caused by certain medications, illnesses, foods, and poor oral hygiene practices. The most effective way to fight bad breath is through regular brushing, daily flossing, and especially tongue cleaning or scraping. Tongue cleaning gets rid of any remaining bacteria on one’s tongue, which are the real offenders behind bad breath.

Myth 6: Brushing bleeding gums is bad

Fact: Brushing with fluoridated toothpaste is not only good for the teeth, but also for the gums and the tongue.

Brushing these oral areas helps get rid of soft deposits (plaque) containing bacteria which is what causes inflammation, gingivitis, and ultimately gum disease. Plaque causes gums inflammation and bleeding if it not removed/brushed regularly.

Myth 7: Flossing is not important

Fact: Flossing is an extra step that should not be skipped after brushing the teeth. Skipping flossing usually leads to the build-up of bacteria in hard to reach places between the teeth.

If one does not floss such areas, he/she is not cleaning almost one third (33%) of his/her teeth surfaces that regular brushing does not reach. Bacteria in between teeth areas often cause gum disease, tooth decay, and/or pain. Flossing is cheap, easy, and essential for recommended good oral health. Flossing is an easy way to maintain good oral health.

The author is a lecturer of Dentistry at Muhimbili University of health and Allied Sciences,

Email:mugonzibwamwanga@gmail.com

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Monday, September 18, 2017

Eating street food isn’t a bad idea

It is advisable to always ensure street food is

It is advisable to always ensure street food is prepared in hygienic conditions.PHOTO|FILE 

By Devotha John

In modern days where everyone leaves the house early in the morning and returns sometimes very late in the evening, consuming homemade food for all the main meals can be a big challenge.

According to Neema Shosho, a nutrition advisor at the Embassy of Ireland, consuming street food and snacks isn’t a bad idea but many people normally don’t factor in the health aspect of the food. For many, as long as the food is affordable and tasty then other issues are not of big concern and this is where we go wrong.

She named street foods ranging from wali maharage (rice withbeans) ugali nyama (Hard porridge with beef) sold by mama ntilie, chips mayai (chips with eggs) from a nearby food kiosk to mahindi choma (roasted maize) from the guy standing beside the main road as foods that come to rescue the situation not forgetting cassava used by some people as a snack for breakfast.

Gone are the days when every food we consumed was prepared at home, says Neema.

One might wonder why many people go for street food and snacks. They are simply affordable, accessible and of course ready made so one doesn’t have to wait for long to be served. Some people also believe that street foods are yummier than homemade.

Piece of advice

Neema says it’s about time we Tanzanians use our locally available foods to produce healthy street food. It is also about time we learnt to make the right choices when it comes to food. The time to act is now, she says.

“In Tanzania for instance, we do have both healthy and unhealthy street foods. However in urban settings, most of us consume unhealthy ones,” she says.

It is common to see many going for deep fried foods like chips, maandazi, samosas, cassava, high sugar and salty snacks. As a result, there is a tremendous increase in overweight and obese people, people with diabetes, hypertension, cancers and other diet related non- communicable diseases.

Before consuming street food

Check the sanitary conditions of the vending site. Is hygiene well observed? Is the food well handled? You do not want to consume contaminated food and get diarrhoea or vomiting

“Check if the food is fresh. Remember that depending on how busy a street food vendor is, food may be sitting around for a while before you come along to buy it.”

Neema adds that people should check the method of cooking used. She insists that people should avoid excessive consumption of deep fried, high sugar and salty foods.

“Ensure you consume nutritious street foods. Fruits and vegetables should also be prioritised when making food choices,” advises Neema.

Remember one can consume street food and still make healthy choices. She says the benefits of eating healthy are many including protection against the above-mentioned non- communicable diseases that cost families and the country a lot of money for treatment and may also lower your life expectancy.

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Monday, September 18, 2017

My reflection on the top 10 killers



Ali   Khatau

Ali   Khatau 

By Ali Khatau

We all want to be part of a society where we live long and as healthy as we possibly can. But as humans, at some point every one of us will die.

But why do people die?

Together, the following 10 diseases account for around 62 per cent of the deaths in Tanzania. The list is sourced from the Centers for Disease Control and Prevention of the US.

HIV/AIDS- 17%

HIV/AIDS is one of the most prevalent diseases in the world and number 1 on our list. HIV causes 17 per cent of the deaths and has already caused around 35 million deaths worldwide. In Tanzania, more than 630,000 people are currently receiving HIV treatment. Although there is no cure for this condition currently, certain medications can reduce the speed of progression of the disease.

Lower respiratory infections- 11%

These are infections that affect the lower part of the airways which include the trachea, bronchi and lungs. The term ‘Lower Respiratory Infections’ is often used as a synonym for pneumonia, but can also be applied to other types of infection including lung abscess and acute bronchitis. It is common in infants who are not exclusively breastfed during the first half of infancy.

Malaria- 7%

Malaria is a life-threatening mosquito-borne blood disease caused by a plasmodium parasite and spread by mosquitoes. It kills millions every year especially on the African continent. Malaria is responsible for 7% of the deaths in Tanzania and stands in third position.

Diarrheal Disease- 6%

It is the second leading cause of death worldwide in children under 5 years of age.

The disease can be prevented through safe-drinking water and adequate hygiene and sanitation. Globally, there are an estimated 2 billion cases of diarrheal diseases every year which is an extremely huge number.

Tuberculosis- 5%

TB is an infectious bacterial disease. Classic symptoms include chronic cough with bloody sputum, fever, weight loss and night sweats. Smokers and HIV positive patients are at higher risk of contracting TB. According to a report by the World Health Organisation, the condition affected around 10.4 million worldwide and caused 1.8 million deaths in 2015.

Cancer- 5%

Cancer is basically the abnormal growth of cells. A variety of factors can cause cancers and include tobacco use, smoking, alcohol use, obesity, poor diet and lack of physical exercise. Tobacco is estimated to cause about 22% of cancer deaths so make sure you keep away from cigarettes, alcohol and maintain a healthy lifestyle. Early detection of cancer can greatly reduce your chances of survival against it while if detected late, there is not much that can be done against it.

Ischemic heart disease- 3%

Also known as Coronary Artery Diseases, it is the most common type of heart disease. A common symptom is chest pain which radiates to the jaw, shoulder, arm, neck or back. Another symptom includes shortness of breath. Smokers, alcohol users and people with high cholesterol levels, high blood pressure and obese people are at higher risk of developing the disease.

Stroke- 3%

A stroke occurs when the blood supply to the brain is interrupted or reduced.

Thus, the brain is deprived of nutrients and oxygen which leads to death of brain cells. Strokes are usually caused by a blocked artery in the brain or the leaking of blood from an artery in the brain. They usually occur in patients with high cholesterol levels and smokers and can lead to paralysis and even death.

Sexually Transmitted Diseases- 3%: Also known as Sexually Transmitted Infections, they are infections which are commonly spread by sexual intercourse. Most STD’s don’t usually cause symptoms which results into a greater risk of spread to others since the individual is unaware that he is infected. Symptoms and signs may include genital discharge, genital ulcers and pelvic pain. Examples include gonorrhea, syphilis and Chlamydia among others.

Sepsis- 2%: Sepsis is basically the presence of harmful bacteria and their toxins in body tissues, usually through wound infections. Common signs include fever, increased heart rate and breathing, confusion and the condition is usually life threatening. The young, elderly as well as cancer and diabetic patients are at increased risk of developing the condition.

The author is a Medical Student at Hubert Kairuki Memorial University.

Email:Alikhatau@hotmail.com

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Monday, September 11, 2017

Gov’t must act on this ‘cigarette-dilemma’



Dr Syriacus Buguzi

Dr Syriacus Buguzi 

By Dr Syriacus Buguzi six.buguzi@gmail.com

Experience shows that the youth usually dominate playing fields; whether in football or any other outdoor games. Games are refreshing and healthy.

However, there comes a time when the same youth are lured into believing that there is something more refreshing than the games and physical exercises—and that’s cigarette smoking.

They end up in a dilemma, entrapped into the belief that smoking cigarettes is more refreshing. Quite often, they are the soft target of companies that promote the cigarettes.

You will hear the young people say, “Smoking relieves a feeling of stress.” However, if they knew the chilling statistics that cigarette smoking comes with, none of them would dare take up the habit.

Roughly 11 percent of young people aged 13 to 15 around the world use tobacco products like cigarettes and cigars, according to a 2015 report by the U.S. Center for Disease Control and Prevention (CDC). The report was a result of a global survey of students.

Now, here is the bad news: There are more than 4000 chemicals in tobacco smoke, of which at least 250 are known to be harmful and more than 50 are known to cause cancer, according to The World Health Organization (WHO).

Yet, the CDC says smokers are more likely to develop heart disease, stroke, and lung cancer; than nonsmokers.

CDC says smoking increases the risk of coronary heart disease by 2 to 4 times, stroke by 2 to 4 times. It shows men increase risk of developing lung cancer by 25 times. For women, women the risk of developing lung cancer increases by 25.7 times.

This situation slows down development because smoking diminished overall health, increased absenteeism from work, and increased health care utilization and cost.

In Tanzania, where the youth form over 60 percent of the population and constitute the country’s major workforce, you would have expected swift action. But, much is left to be desired. We now need stricter laws that would curb smoking cigarettes and control tobacco business.

Actually, more than half of the world’s population lives in the 39 countries that have aired at least 1 strong anti-tobacco mass media campaign within the last 2 years, WHO says.

Only 42 countries, representing 19 per cent of the world’s population meet the best practice for pictorial warnings against cigarettes. Most of these are low- or middle-income countries.

I really believe it’s high time the Tanzanian government looked at this data keenly and solve this problem.

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Monday, September 11, 2017

Things you must never do to your vagina

If you have sensitive skin or an allergy, check

If you have sensitive skin or an allergy, check with your doctor about the best way to approach your vaginal hygiene.PHOTO | COURTESY 

By Christine Katende

According to health experts, the vagina is self cleansing through production of vaginal secretions and the normal vaginal flora (helpful bacteria). Victoria, a former prostitute, always used soda every after intercourse saying it helped to refresh her vagina thus enticing customers.

She says after prolonged use, she started getting infections and when she visited a doctor, he advised her to stop immediately.

Apart from infections that may arise from using dirty toilets and infections (STDs) from sexual intercourse, Dr Alex Kakoraki, a general physician at Murchison Bay Hospital in Luzira, says using herbs, wearing non-cotton underwear, among other habits may be harmful to the vagina.

Wiping incorrectly

Dr Kakoraki says it is vital for feminine intimate hygiene that you dry yourself properly after using the toilet.

“Because the anus is very close to the vagina, it can transfer bacteria from one part to the other. This bacterium can mix with vaginal mucosa, which is highly susceptible to infections,” he says adding, “The correct way to clean yourself after using the toilet is to start from the vagina and move backwards to the anus. In other words, from front to back.

Foreign objects

Dr Kakoraki says foreign objects such as test tubes, carrots and egg plants can cause infection if inserted into the vagina. Apart from carrots and egg plants that may be dirty, other materials such as tubes can accidently break and remain in the canal which puts the woman’s life in danger. Women who use such things for masturbation get infections and one can only tell by having an abnormal discharge that comes with an unpleasant smell, according to Dr Kakoraki.

Tight underwear

Kakoraki says the underwear or trouser should not be too tight but rather comfortably fitting. Very tight panties can cause moisture in the vaginal area. This creates a favourable environment for bacteria to build up thus causing infection.

Steaming

Jonathan Kabasa, a clinical officer at Mengo Hospital, says although steaming the vagina seems to be quite popular nowadays, steam treatments have resulted in burns and irritation in the intimate area.

Douching

Kabasa says excessively cleaning your vagina is also not good for its health. He says that using vaginal douches can disrupt the balance of healthy bacteria inside the vagina.

Some gynecologists consider douching to be the cause of pelvic inflammatory disease and bacterial vaginosis. “The best thing you can do for your vagina is to wash it with water and a pH-neutral soap when you take a bath or shower. Clean it with a clean towel, but do not rub too hard,” he says.

Vaseline as lubricant

Dr Kakoraki says vaseline and any other products that contain petroleum can cause vaginal infections if used as a lubricant. If you want to use something as a lubricant, use a high-quality professional oil with a neutral pH.

Wearing panty liners

According to gurl.com, an online platform, panty liners were created to absorb vaginal discharge experienced at the beginning and end of every period. Therefore, using them everyday can harm your intimate health, because its daily use makes the groin area more hot and humid.

As a result, the vagina transforms into a perfect area for breeding bacteria. This causes vaginal infections and increases the amount of vaginal discharge.

“If you use these products regularly, then we recommend that you reduce the amount of times you use them or change them more frequently. Ideally, you should be changing them every four hours,” the page recommends.

Popping pubic acne

According to Dr Herman Sewagudde, no matter how painful or uncomfortable your pubic acne may be, puncturing or breaking the pimples is never a good idea. When you puncture the pimple’s outer skin, the pus oozes out with all the bacteria in it.

If this harmful bacteria reaches other skin pores, it can lead to more pimples.

“Breaking the acne can even force the debris and bacteria deeper into your skin, causing more redness, inflammation and swelling on the affected area. This may even lead to permanent scarring. Also, if the acne-prone area itches, try not to scratch. It can cause serious irritation. It is best to allow the acne to run its course,” he says.

Caution

Kabasa cautions women to always clean or wash the vagina after having sex and also go for routine screening of STIs, cervical cancer and vaccination. In case of any odour, Kakoraki also advises a visit to a health professional for help.

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Monday, September 11, 2017

She delivered her baby in a moving canoe in the lake

Scolastica Abednego holding her baby as she

Scolastica Abednego holding her baby as she narrates her story and call on authorities to set up health care facciliities in rural areas.  PHOTO | JONATHAN MUSA 

By Jonathan Musa @TheCitizen jonathanmusa54@gmail.com

Mwanza. Time has gone but still she has the memory. With her face full of tears following painful labour and the shame she had to bear while giving birth aboard a canoe in Lake Victoria.

Scolastica Abednego is among few people who have escaped death narrowly.

The young woman from Chitandele Island, Chifumfu ward in Sengerema district is a woman of her own; do we say she is unique?

She gave birth in a locally made canoe on her way to Mwanza regional hospital, Sekou Toure for health checkup as she had complications.

Considering the number of people on the canoe, she was hoping she would arrive in Mwanza on time.

She has decided to share her story with the public to express her frustrations on how she would have easily died if the labour pains had started in the middle of the night or late in the evening when there is no means of transport available.

She is one amongst a few women who have managed to give birth successfully despite not attending prenatal care.

“The labour pains hit me hard,” Scolastica said.

She says in the Island, there is no health facility and anyone who falls sick is either taken to Sengerema District Hospital or Mwanza if the conditions persist.

The woman says, she stays with her mother-in-law who is extremely old, her husband Juma Lucas who is a casual labourer at Nyarugusu mining site in Geita region.

On April 27, this year she had very severe labour pains, which she says were weird as it was her first time.

Back in the house, whatever she had was only food, which had been sent to her the previous weekend by her husband.

“My husband usually come home after every two weeks, so at this time I was not expecting him because he had recently left and happened to send us some food and a few clothes,” she explained.

The Island has only two moving canoes plying to and from Mwanza city.

She says from Chitandele to Mwanza which is about three hours and they pay Sh7000 per trip using the old canoes and one has to book for a day or two.

On this particular day, they were only three ladies who were travelling in the vessel, out of nineteen passengers.

“The ladies covered me with their ‘vitenge’ while the vessel continued moving, but this does not mean that the rest of passengers who were men did not see the exercise, but was there any option?” she posed.

By the moment they docked at Kamanga ferry, Mwanza city, the child was already born.

She was taken to Sekou Toure Hospital. She stayed for four days and was later discharged.

She named her baby ‘Baraka’ meaning blessings bearing in mind her painful ordeal.

Chitandele with approximately 2800 households, according to the ward councilor Robert Madaha is among six Islands making up Chifumfu ward.

According to Mr Madaha the island does not have any health facility.

“There are high numbers of mothers and child mortality cases here, some are unreported,” he said.

Despite several ferries plying in Lake Victoria, no route has been formalized for the destination. The only possible means to Chitandele is by the use of canoes.

One of the speed boats owners who sought anonymity at Kamanga told Your Health that, Chitandele has very few passengers and therefore setting a route to the place will lead to a total loss of fuel, energy and time.

“People there are poor and no one wishes to make lose plying that route So it’s up to the government to improve the infrastructure and save lives of women,” he said.

In 2012, twelve pupils died from the same island when the canoe capsized.

During a random interview at Chitandele Island, many residents lamented that politicians have forgotten the area.

“I wonder why there is no school here and even a single health facility yet we vote in the leaders,” said Mr Thomas Mlimi, a resident of Chitendele.

But on his parte, Mwanza Regional Medical Officer, Leonard Subi, said in most cases, women from such areas with difficulties have to move closer to where they can easily access health care services.

He added that some of these women or mothers do not get the balance diet during pregnancy and also miss the prenatal care, which is so important.

“In the region for example, 78 women and children have died since January to May this year due to lack of various services including untimely health attendance,” Mr Subi said.

Meanwhile, economic experts say poor healthcare services in Sengerema rural areas is hurting the region’s efforts to attract new jobs and investment.

In late June 24h, 2017, deputy secretary in the Office of the President, Regional and Local Administration, Zainab Chagula, in a result based financing (RBF) seminar that attracted political leaders and health experts from eight regions in Mwanza, said a total death toll of 454 mothers with children under five years were reported in 2010/11 and that the number increased to 556 in 2015/16 in the whole country.

This was due to various reasons including lack of sufficient education and knowledge in the health sector.

“What is required is change, a change that begins with me and you, people are the workforce of every nation and the whole world. Let us strive to eliminate these cases amongst ourselves,” she stated.

According to Word Health Organization WHO, severe shortage of qualified health workers and geographical imbalances in the workforce in many low-income countries require the national health sector management to closely monitor and address issues related to the distribution of health workers across various types of health facilities.

In addition to the rural-urban movement in Tanzania, there is growing interest in the movement of health workers between the public and the church-run health sector. Church-run health services have been particularly important for health service delivery and run almost one-third of the health services especially in rural areas.

Some local politicians have promised to construct health centres in several places including Chitandele.

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Monday, September 11, 2017

Myths and realities through an oral health window - 3

Did you know that not following the recommended

Did you know that not following the recommended two-minute brushing twice daily will make the gums red, swollen and bleed easily. PHOTO | COURTESY 

By Dr Emeria Mugonzibwa

An oral health myth is a collectively held oral health information and/or belief that have no basis in fact.

This is the third of the oral health myths series and their related realities/facts.

Myth 1: Women lose a tooth for each child they have given birth to.

Fact: More of an ‘old wives tale’ than a myth, this is untrue. Hormonal changes while pregnant can exaggerate bacteria in the mouth that can cause bleeding gums or gingivitis. Tooth loss is unlikely with a thorough and regular cleaning regimen.

Myth 2: Dental treatment should be avoided during pregnancy

Fact: A dental check-up is recommended during pregnancy for regular dental check-up, cleaning and fillings. Local anesthetics and X-rays are okay although they are to be done only when necessary. The dentist should be informed of the pregnancy before any procedure since some dental treatments are to be avoided entirely during pregnancy – amalgam removal and taking of antibiotics.

Myth 3: Brushing before the dental appointment will make the dentist not notice that regular brushing is not done since the last dental visit.

Fact: Not following the recommended two-minute brushing twice daily will make the gums red, swollen and bleed easily, making it obvious to the dentist. There’s no way the dentist will not know that the patient is not brushing regularly.

Myth 4: Fluoride is an artificial substance added to toothpaste and water.

Fact: Fluoride is a naturally occurring substance that helps protect teeth from decay by strengthening the teeth layers.

Myth 5:A child not having a dental cavity, guarantees a child not getting dental cavities as an adult.

Fact: While past experience is an indicator for future dental cavities, many things can change one’s dental cavities risk such as a dry mouth because of medication or a change in diet

Myth 6: It is okay to drink soda as long as it is diet soda because diet soda does not contain sugar

Fact: Diet soda is highly acidic and can eat into the surface of the tooth wall: enamel. After that has happened, the enamel is weaker and more at risk for cavities

Myth 7: Spit tobacco is safer for one’s health than smoking because it’s not inhaled and doesn’t cause lung cancer

Fact: Spit tobacco is a primary risk factor for oral cancer, for which the five-year relative survival rate is much lower than for breast or prostate cancer.

Myth 8: If Gums Bleed One Should Stop Flossing

Fact: No, bleeding gums are a sign that oral hygiene is lacking. Hence, brushing and flossing need to be performed more often and more effectively.

Bleeding gums are often the first sign of gum disease and if left undiagnosed and treated can develop to become periodontal disease, a more aggressive and damaging oral tissue disease.

So if gums are bleeding; pick up a toothbrush, floss and take time cleaning the teeth and gums. In addition, plan for dental cleaning, as a buildup of plaque and calculus (tartar) cause gums to become inflamed and bleed easily.

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Monday, September 11, 2017

Here’s how you can stop cancer from hurting you psychologically

Dr. Christopher

Dr. Christopher Peterson sonchrispeter@gmail.com 

By Dr Chris Peterson

From the moment you find out you have cancer; a wide range of emotions can wash over you. You might afraid, angry, and sad or have some other difficult-to name emotion. It’s normal to struggle, but if these emotions go unchecked, they can spiral into depression, anxiety or even post-traumatic depression disorders.

How can tell you coping well emotionally or not? Be aware of signs of deeper problems and know what to expect during treatment. These can help you take control of your mental health. And that, in turn, can have a positive effect in your cancer treatment.

If you think you have mental health problem related to having cancer or its treatment, there are professionally trained people who can help. Talk to your doctor can ask him or her to refer you to psychiatrist or therapist. It is important to ask for mental health professional that specializes in cancer patients.

A psychiatrist will discuss your feelings and symptoms and suggest the best skills for coping. He or she can also help you prescribing antidepressants or medications of anxiety or to help you sleep.

A therapist will likely treat you with cognitive-behavioral therapy, a practice that helps you focus on relationships among your thoughts, actions and emotions. It can work well to help you control your depression and anxiety.

Watch for signs of serious depression

It’s normal to feel down during cancer treatment. Your body is probably changing in unpleasant ways. Sometimes you are not able to do the things you are used to doing. You may have to cut back on your work hours or stop working altogether. Some of your relationships may feel strained. All of these things can take a toll of your mental health and lead to low moods. But if you are feeling persistently down, depression is a possible culprit.

Watch out for these symptoms: persistent feelings of sadness, emptiness or hopelessness, loss of interest and enjoyment in usual activities, reduced self esteem and confidence, feelings of guilt and unworthiness, difficult concentrating, or making decisions as well as thoughts of suicide.

Don’t let anxiety rule your life

Nobody gets through cancer treatment without worry: will I be OK?, can I keep up with my bills? Is my family able to handle this? Will my life ever go back to normal? You may find, however, that your worry has tipped over into full-blown anxiety. And that makes a bad situation even worse.

If you are frequently worried or have feelings of panic and can’t control worrying thoughts, you may have anxiety. Anxiety can also make you feel restless, keyed up or on edge even though you might also feel fatigued. Other symptoms include: difficult concentrating or your mind going blank, irritability, muscle tension, difficulty falling asleep or staying asleep, or restless, unsatisfying sleep.

You may also experience panic attacks, with increased heart rate, racing thoughts, hyperventilation, dizziness or woozness, sweating and feelings of impending doom. You should seek help to keep these overwhelming feelings and worries in check.

•How post-traumatic stress disorders fits in.

Most people associate post-traumatic stress disorders (PTSD) wit combat veterans. But you can develop PTSD after any kind of trauma, including medical trauma. If you have completed cancer treatment, but you are still feeling haunted by the experience, PTSD could be the reason why.

PTSD can cause you to have intrusive thoughts pop up out of nowhere whether you want to think about them or not. You might have nightmares about the event or flashbacks-feelings that you are experiencing the event. You also might have difficulty falling or staying asleep.

As a result, you might avoid thoughts, feelings, or situations connected to the event or have memory problems related to it.

Watch for these other symptoms:

• Being stacked in severe emotions related to the trauma (e.g. horror, shame or sadness)

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Monday, September 11, 2017

Pregnancy and physical fitness

You should maintain a healthy weight, before

You should maintain a healthy weight, before and after pregnancy. PHOTOS | FILE 

By Dr Omary Chillo

During pregnancy, women develop several changes in their body functioning (physiology) due to the significant amount of hormones they release to their unborn offspring (foetuses).

In connection with this, researchers have, since 1990s, found the benefit of regular physical exercises in pregnant women and suggested light to moderate physical workouts.

However, this is advisable for those pregnant women whose medical records do not show they have specific adverse conditions.

The best explanation to this lies in how the hormones work during pregnancy. What actually happens is that for about 40 weeks of pregnancy, especially during the last three months, these hormones cause several changes.

Firstly, the hormones influence the woman’s desire for food, thus increasing her body weight (by an average of 11 kg).

This also entails an increase in blood volume, demand for more food nutrients and the rate at which she respires and her minimal rate of energy expenditure—the Basal metabolic rate (BMR).

In that case, physical activity is very vital because it can help her use up the energy generated but also balance the weight control process.

This also comes with significant benefit on her general wellbeing and goes long to improve the physical and mental health aspects.

What kind of physical exercise matter?

The physical activities are categorized by the level of intensity, ranging from inactive, light, and moderate to vigorous activity.

Studies have shown that moderate and vigorous activity is better for the heart and reduces the risk of developing cardiovascular diseases and other chronic diseases such as diabetes.

Such activities make your heart, lungs, and muscles work harder. However, light activities can have a more remarkable health effect if done for longer and sustained period.

The good thing about light exercises is that they are part of the normal duties performed at home.

World Health Organization says about 3.2 million deaths globally can be attributed to insufficient physical activity annually.

In America, studies I have read show that physical inactivity contributes to about half (48.5 per cent) of all risk factors that lead up to the development chronic diseases in women of reproductive age.

So, this suffices to say that women who exercise regularly and those who perform light to moderate exercises within the first six months of pregnancy have lower risk of developing maternal complications during pregnancy.

Various studies point out that physical activity reduces blood glucose, blood pressure and trims off body fat. In addition, it reduces the risk of colon and breast cancers in women.

Regular physical exercises also reduce the rate of weight gain; lower the risk of premature delivery, postpartum depression and boost self-esteem.

Here is what I recommend for women to do

Start doing recommended physical exercises before pregnancy. Discuss with your doctor about screening for high blood pressure, blood sugar and cholesterol levels before and when considering becoming pregnancy.

Make changes in your life style

Be physically active regularly. Healthy women should get at least 150 minutes per week of moderate-intensity aerobic activity, such as brisk walking before, during and after pregnancy.

If you have other health conditions, discuss with your doctor about the level and type of physical activities to perform.

Maintain a healthy weight, before and after pregnancy.

Maintain a healthy diet that includes fruits, vegetables, whole grains and lean meet (meet with little or no fat). Try to limit foods high in fat, added sugars or salt.

The author is the President of Tanzania Health Summit (THS).This article first appeared in MedicoPRESS.

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Wednesday, September 6, 2017

Ambulance crisis: when taxis fill in the gaps

A taxi arrives at the emergency medicine

A taxi arrives at the emergency medicine department.PHOTO|SYRIACUS BUGUZI 

By Syriacus Buguzi @buguzi sbuguzi@tz.nationmedia.com

It’s a cool sunny afternoon at the Muhimbili National Hospital (MNH). Many people are flocking in for health services but my attention is quickly drawn to a taxicab that arrives in haste at the facility’s emergency centre—Tanzania’s first full capacity Emergency Medicine Department(EMD).

When the taxi finally comes to a stop, Mr Said Bakari, the driver, hurriedly steps out to open the hind door. No passenger alights off. The door is left ajar.

When I get closer to the taxi and peep through, my eyes land on an old man in his 70s, seated like any other passenger. He’s mute, motionless and breathless. He is very ill, yet there is no one inside the taxi to assist him.

I later learn that he’s suffering from chronic kidney failure and his condition had suddenly changed while at his home in Mbagala suburb. Bakari is still wandering around at the EMD for about 15 minutes, not knowing what to do with the patient.

Two sides of the coin

Bakari picked the patient about 12.8 km away from MNH, which is supposed to be about 39 minutes drive away, according to estimates from Google Map. But he drove for about 3 hours.

“I was called on phone to drive this Mzee from Mbagala. Thank God we’ve arrived here. I had to rush him. His relatives will be arriving soon in another vehicle,’’ he explains, when I enquire.

Soon, one of the EMD crews arrives and quickly assesses the patient, instructs Bakari to drive the taxi closer to what I came to learn later, was the right place—the ambulance bay. This is where all critically ill patients must be taken to, says the EMD crew member, Mr Jella Omary.

“Quite often, drivers of taxicabs or other private vehicles bring critically ill patients or accident victims and don’t know what to do on arrival,’’ says Mr Omary who is a nurse at EMD.

“There are cases where some drivers simply dump the patients outside the EMD and leave. This creates unnecessary delays and at times a patient may lose life before being attended to,’’ says Omary.

But Bakari, the taxi driver, has his side of the story too, as he vents off his frustrations. He says what mattered most at that time was the timely arrival and handing over the patient to the EMD.

“It has been a tough three hours on the road,’’ he says. “I have taken several detours to avoid traffic jams but it wasn’t easy, we still got stuck on the roads,’’ says Bakari.

Not a lone case

The story of taxicabs or private vehicles being used to transfer patients to Muhimbili’s EMD is not limited to Bakari’s case alone.

More than 50 per cent of emergency patients arriving at the EMD get there in private vehicles, mostly taxicabs, says the EMD’s Head of Department, Dr Juma Mfinanga.

“You see, in our country’s ambulance system, a patient who is in an emergency situation is transferred from a health facility to another. It’s called inter-facility transfer,’’ explains Dr Mfinanga.

“Outside this system, it means that people arrive at EMD in private vehicles, mostly those taxicabs you are talking about. This poses many challenges and increases the risk of mortality due to delays and lack of pre-hospital care,’’ he says further.

Taxicabs can’t substitute ambulances

Currently, the EMD receives between 200-300 emergency patients per day, data obtained from the facility authorities show. Taxis and private vehicles are the order of the day at the EMD. I camped there for over 6 hours and counted 40 arrivals. But 30 cases arrived in taxis and private vehicles.

At the EMD ambulance bay, the nurse, Mr Jella Omary further explains that certain emergency patients such as those diagnosed with high heart disease must be positioned in such a way that their breathing is not compromised.

“I know several cases where heart patients, who were supposed to be placed in what we call a prop up position, were instead brought in a taxi while seated wrongly. In certain cases, the patients died on the way. Their death could be attributed to wrong positions,’’ explains Mr Omary.

“If such patients came in ambulances, it means that a nurse(s) on board would help position them properly, give the necessary first aid resuscitate the patients where necessary,” he says in an interview with Your Health.

But for this to be achieved, Omary says, there is need for the country to increase access to ambulance services so that more lives are saved through early interventions. “We know our government has invested in emergency services but I think this requires more attention now,’’ he suggests.

A study done in Tanzania two years ago revealed that the health system lacks adequate public resources in the transportation and other infrastructure for first-responder Emergency Medicine Systems (EMS).

Published in the British Medical Journal (BMJ), the study, titled: The Tanzanian trauma patients’ prehospital experience: a qualitative interview-based study, it detailed cases of patients, exposing the current gaps in health delivery that exist with the existing referral system and what should be done.

There were cases of missed diagnoses, delays in care and transfer, and poor patient outcomes which could have been avoided, due to limited capabilities at pre-referral centres, the study shows.

It’s here that the EMD Head, Dr Mfinanga suggests, “In the long-term, it will reach a point where the country needs a centralised system of public ambulances, meaning that a person somewhere in an emergency can call an ambulance by simply dialing a number,’’ he suggests.

Currently, Tanzania’s referral system for emergency patients ideally includes free ambulance services from peripheral to higher level facilities. But, practically, this system is challenged by delays that may occur due to the limited number of ambulances and the cost of fuel.

What researchers say

An Emergency Medicine expert who has been researching on the state of emergency services in Tanzania, Dr Hendry Sawe, says the government has invested resources in ensuring that the emergency services are improved but, there are still big gaps to bridge.

“There is need to strengthen pre-hospital services. This is very crucial’’ says Dr Sawe who is also lecturer at the Muhimbili University of Health and Allied Sciences.

Increasing the number of ambulances in hospitals may not be the perfect idea. He says, “You can have a large number of ambulances but that’s not enough. They should be manned by trained drivers, installed with the necessary equipment.”

But, Dr Sawe says, the most important area of investment that we now need to look into is on ensuring that the public is well informed about how they can be good first responders. This should be complemented with having good pre-hospital services, away from the referral facilities, he says.

“There is a belief among the people that when a person is injured in an accident, he/she must be rushed to a referral hospital immediately,’’ he points out.

“In fact, the nearest facility—however small it may be—is more useful in saving lives,’’ says Dr Sawe who is also the Head of the Emergency Medicine Residency and Research Program Head at Muhas.

Importance of first aid

The Medical Officer in Charge of Amana Regional Hospital, Dr Mesha Shimwela believes that many lives would have been saved if the public understood the importance of first aid.

“Saving a life of an accident victim relies very much on how the first responders will intervene,’’ points out Dr Shimwela during an interview with Your Health.

“I know a case of a person who was hit by a motorcycle somewhere in Vingunguti but instead of being rushed to a nearby health centre for first aid, he was put on a tricycle and brought to Amana Hospital,’’ he recalls.

“All the way to Amana, he was bleeding profusely. By the time he arrived at our casualty department, he had already lost a lot of blood and his kidneys had been acutely affected,’’ he says.

“He died, despite efforts to resuscitate him. This can be attributed to the delays in getting first aid., although there could be other factors. You can see here that this didn’t require sophisticated health infrastructures; he simply needed first aid to stop the bleeding. This could be handled at the nearby facility,’’ says Dr Shimwela.

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Monday, September 4, 2017

Debunking the preconceived notions on diabetes



Dr Syriacus Buguzi

Dr Syriacus Buguzi 

By Dr Syriacus Buguzi six.buguzi@gmail.com

For the number of patients living with diabetes in Tanzania and the rest of the world, the big question now is how to live with it or rather, face it.

The disease is known to affect many organs—the blood vessels, the eyes, the kidneys and nerves. That’s why we tend to call it a multi-organs disease.

Right now, an estimated 9 per cent of adults aged 18 and above have diabetes globally. The disease contributed directly to 1.5 million of deaths about three years ago, data from the Word Health Organisation (WHO) show.

Yet, not many people in Tanzanian societies perceive the disease in the right way.

One aspect is when diabetic people suffer inability to control their blood sugar levels and this makes some to believe that a victim of diabetes cannot live a normal life. It’s not true.

Actually, maintaining a healthy diet and doing regular physical exercises can control their blood sugar levels by 50 per cent, it would help them minimize complications of diabetes.

Then, there are these myths about the foods for the diabetic patients. Some people believe that diabetic patients should eat proteins only. Others think that their food should be overcooked to reduce sugar.

Others discourage diabetic patients from some sweet fruits. Some have reached an extent of cooking the food for the diabetic patients separately from other family members.

When it comes to the food for a diabetic patient, here are the most important things to consider:

Eat three times a day and avoid skipping meals. Each meal should include carbohydrate food, for instance bread, porridge, chapati, potatoes, yams, or rice.

But, reduce the fat intake, example olive oil, groundnut oil. Eat more fruits and vegetables, aim for at least five portion per day and eat more beans. Eat at least two portions of oily fish a week.

Reduce salt intake to at least 6gm per day.

Be cautious with diabetic foods and sweeteners. They have low-calorie and sugar-free drinks useful for patients with diabetes. But these drinks are junks. They usually contain non-nutritive sweeteners.

Many ‘diabetic foods’ contain sorbitol which are expensive and high in calories, and may cause side-effects in the alimentary canal. As a result, these foods are not recommended as part of the diabetic diet.

Then, when it comes to drinking alcohol, this should be taken in moderation.

Stay safe and make informed healthy choices.

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Wednesday, September 6, 2017

An insight into lactose intolerance condition



Milk is a good source of calcium.PHOTO|FILE

Milk is a good source of calcium.PHOTO|FILE 

By Dr Frederick Haraka fharaka@ihi.or.tz

The Tanzania Dairy board estimates a per capita milk consumption at about 47 litres per year. This means that one person consumes about 47 litres in a year.

One among the strategy is to increase per capita consumption to 100 liters per year by 2025. Alongside is to establish and promote milk feeding programs in schools.

These are very good plans which will see increase in awareness on milk and dairy product consumption, a good source of calcium. Calcium is highly needed for bone development, particularly among pregnant women, small children and teenagers.

What is lactose intolerance?

The 2025 target will lead to increase in awareness and consumption of milk among the general population.

From medical point of view, we expect a lot of health benefits which are linked to milk consumption but also medical conditions associated to milk consumption will increase. These are not limited to allergy and lactose intolerance.

Lactose intolerance is a medical condition, which is caused by the inability to digest a form of sugar known as lactose, found in milk. This problem is most common among adults.

Lactose is digested by an enzyme known as lactase which is produced in the small intestine. The production of lactase enzyme is reduced as a baby grows and significant reduction continues after the first year of life.

It is estimated that approximately 65 per cent of people have reduced the ability to digest lactose after the first year of life due to reduced production of lactase enzyme. However, for communities which have long depended on milk as a source of food, the prevalence of lactose intolerance is as low as 5 per cent.

Lactose intolerance is a condition which commonly runs in families. It rarely occurs as a congenital disorder where babies are born without lactase enzyme.

Apart from the mechanism described above, lactose intolerance can also occur as secondary problem, for example, post-surgery, diseases of the intestine such as celiac disease.

What are the signs and cure?

Normally a person with lactose intolerance will present with abdominal bloating, pain, diarrhoea and flatulence 30 to 2 hours after ingestion of milk.

It is presumably easy to detect lactose intolerance among children even at home. Repeated presentation of symptoms should raise suspicion of lactose intolerance.

There is unfortunately no cure of lactose intolerance, however, the good news is that even people with lactose intolerance can tolerate a small amount milk, example, one glass and fermented milk.

People with lactose intolerance should learn to avoid ingesting a lot of milk, increase the intake of other sources of calcium such as green vegetables like broccoli and okra.

Parents must continue to provide milk to their children after infancy through teenage.

As much as this will reduce the risk of developing lactose intolerance, it will increase nutritional availability of calcium which is crucial for the growth and development.

Milk consumption at school will provide another opportunity to ensure children get enough of the benefits. Furthermore, a need to increase awareness on milk consumption among the general public, investment in production of milk and affordability to the majority will remain relevant to realise the 2025 goal of increasing per capita consumption to 100 liters per year.

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Wednesday, September 6, 2017

Do I need to eat breakfast?

By Devotha John djohn@tz.nationmedia.com

Breakfast is the first meal of the day, most often eaten early in the morning before undertaking the day’s work.

According to a Dar es Salaam based nutritionist, Neema Shosho, the wise named breakfast as the ‘most important meal of the day’ for many reasons. It kick-starts your metabolism, gives the energy you need to get things done and helps you to focus at work or school.

“It also helps you burn calories throughout the day. In addition, studies have linked eating breakfast to good health, including better memory and concentration, lower levels of ‘bad’ cholesterol, lower chances of getting diabetes or heart disease,” Ms Shosho adds.

The first meal also helps control being overweight and obese. It is therefore very important to start a day with a healthy breakfast, the nutritionist emphasises.

A big ‘no’

We often hear people say, ‘I’m not a breakfast person’, or ‘I will compensate with a heavy lunch’.

This, Ms Shosho says is a ‘No No’ and regards it as unhealthy habits. Skipping the morning meal can throw off your body’s rhythm of fasting and eating, she explains.

When you wake up, the blood sugar your body needs to make your muscles and brain work their best, is usually low. Breakfast helps replenish it.

The good and the bad

Neema said most Tanzanians fall under light Breakfast, heavy lunch and filling dinner category. This can be due to many reasons; we grew up eating heavy lunch and dinner while breakfast is always not a very big deal. We also all rush in the morning to work or we get carried away with many things in the morning, hence no time for proper breakfast.

Most of us end with a cup of tea/coffee with chapatti, kitumbua, bread or andazi and wait for heavy lunch. Most choices we make for breakfast are high sugar, high fat and high salt choices, which is not healthy.

How to make the right choice

Ms Shosho tells Your Health that a healthy breakfast should be well balanced-with a source of protein, vitamin and minerals and small portion of carbohydrate.

One should avoid high sugar, high salt and high fat breakfast. We normally recommend healthy foods like diary, grains and fruits as they are good source of vitamins and nutrients.

“As Tanzanians we should also make sure that we maximize our local foods for a healthy breakfast. Get a cup of milk, a piece of sweet potato, a bowl of seasonal fruits and an egg, preferably boiled. This is an example of a healthy breakfast which is affordable and locally available,” Ms Shosho advises.

We should all know that eating a light, unhealthy breakfast or skipping it may increase your risk of obesity or make it harder to lose weight because if you eat breakfast you are less likely to overeat throughout the rest of the day.

Skipping the morning meal

Ms Shosho informs that skipping breakfast may also trigger bad eating habits throughout the day, as cravings ensue and quick-fix fast foods are often sought out.

Furthermore, skipping breakfast increases your risk of hypoglycemia or low-blood sugar.

This condition can bring on physical discomfort such as shakiness, dizziness, weakness, headaches, tingling and a rapid heart rate. These are just very few effects of skipping breakfast.

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Wednesday, September 6, 2017

Case of a young girl with kidney disorder

Illustration of a doctor examining the young

Illustration of a doctor examining the young girl.PHOTO|YOUR HEALTH 

By Wilson Lugano lugano_wilson@yahoo.com

Last week a beautiful and a confident 14-year-old girl walked into the hospital I work at with complaints of swollen face and swollen limbs. She was a form two secondary school student from Kondoa.

The young girl narrated that the swelling was a gradual process, where it initially began as puffiness around the eyes with decreased urine output. Upon examination at the hospital, she looked weak and her lower limbs were swollen [edema]. Actually doctors use the term ‘edema’ when they are referring to swelling due to accumulation of excessive fluid in tissues.

On systemic examination nothing significant was revealed.

Then a battery of tests was ordered, including but not limited to a full blood count. The patient was then admitted in the female medical ward, awaiting diagnosis.

The provisional diagnosis was a kidney disease known as ‘nephrotic syndrome.’ Have you ever heard of the disease before?

Her eagerness to know what she had

I always like to interact with my patients without prejudice to my professional ethics, hearing their stories and walking in their shoes, which helps me to serve them with integrity.

I remember asking my young patient if she knew what she was suffering from. She responded, “Ndio, nimeambiwa naumwa figo”. (Yes I do, I have been informed that I am suffering from kidney disease.)

She was right but I had to explain to her the kind of kidney disease that she was diagnosed with.

ou know in bongo, you must be able to translate what you know in English or any other language into Swahili. Thus the challenge was how could I translate the condition of “Nephrotic Syndrome” in Swahili or a vernacular language familiar to her?

Then I had to find a simple and brief explanation, I confidently interpreted, “The nature of this kidney disease leads to proteins spillage and kidney damage”.

She was taken aback but I kept her calm by assuring her that we could treat the disease. I was avoiding to say that we are going to cure the disease since I knew that the disease is incurable, but you better tell someone the truth without causing psychological trauma as I eventually did.

According to Mayo Clinic, nephrotic syndrome is a kidney disorder that causes your body to excrete too much proteins in your urine.

Normally doctors classify the syndrome as either primary or secondary depending on the nature and cause but due to diagnostic challenges in most parts of Tanzania, doctors end up treating the disease without knowing the cause. Mind you, they treat it not cure it.

If it’s incurable then why should we look for the cause?

To determine the nature or the cause, you may be required to do some rather complex, expensive and at times not readily available tests such as renal biopsy among others.

So simply put, nephrotioc syndrome is a group of signs and symptoms that altogether indicate that your kidneys are not working properly as they should.

Some signs and symptoms include swelling of your leg, feet, ankles, face and sometimes the whole body, a condition medically known as “anasarca.”

On top of that there will be too much proteins in your urine, too little proteins in your body, too much cholesterol in your body and high level of triglycerides in your body.

When her lab results came out, it showed that she had proteins in urine, what we initially also claimed.

On top of that, we also did an ultrasound of the abdomen whereby it showed that the kidney was damaged.

Thus we concluded that the patient had “nephrotic syndrome with renal failure.”

What you should know

• Risk group; people of all ages can get this disease, though it is said to be more common in men than women, though in this case it was a young girl.

• Causes of nephrotic syndrome include all diseases that damage the kidneys (primary type), and other secondary causes which are systemic disease like diabetes, Systemic Lupus Erythmatus (S.L.E). so you have to seek treatment at the earliest for any disease that damages your kidneys or that might cause nephrotic syndrome.

How was the girl treated ?

Whilst in the ward, the girl was given relevant medication and she was counseled to strictly limit fluid intake and to take low salt diet.

This young girl was just concerned about being at a boarding school with such arrangements for special diet, a diet with good fats/ unsaturated fats and low salt.

My honest advice to all other victims

A word of encouragement is that for those who are still struggling with nephrotic syndrome, there is a silver lining at the end of the tunnel. With a doctor’s support, things do get better; do not ever think that your life is shattered just because of this syndrome.

The author is a medical doctor based in Dodoma.

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Wednesday, September 6, 2017

Don’t let diabetes ruin your quality of life

An elderly woman getting her eyes checked

An elderly woman getting her eyes checked during an eye camp by a specialist.PHOTO|CHRISTOPHER LILA 

By Dr Dilawar Padhani

Diabetes mellitus, one of the non-communicable diseases (NCDs) leading to the body’s failure to control blood sugar levels, mounts to complications that affect quality of life.

The cost of the disease to an individual and society is enormous. But also, the onset of complications has an impact on longevity.

The life expectancy of individuals with diabetes mellitus is reduced by 5-10 percent.

Diabetes, also known to be the commonest reason for heart disease, kidney complications and amputation, has been found to cause blindness among people of the working age group.

Now that the disease is associated with such devastating complications, the main focus should be on the prevention, early detection and initial management of complications of in adult diabetic patients.

Yet the cost of the disease is predicted to rise in our settings. A recent report in the Lancet Diabetes and Endocrinology Commission on Diabetes in sub-Saharan Africa, the cost associated with the disease could more than double and may reach up to $59.3 billion per year by 2030.

According to the report, the cost of curbing diabetes will increase from $3.8 billion in 2015 to up to $16.2 billion in 2030 in Eastern Africa, namely Tanzania, Kenya and Ethiopia.

Who develops complications?

The risk of developing complications is not uniform for everyone with diabetes.

For kidney complications in particular, there is a strong genetic influence. Duration of diabetes, glucose control, hypertension and smoking are the strongest risk factors.

Diabetes and blindness

The World Health Organization (WHO) estimates that a condition known as Diabetic Retinopathy [diabetes complication that affects eyes], is the cause of blindness in approximately 5 per cent of individuals globally.

It’s caused by damage to the blood vessels of the light-sensitive tissue at the back of the eye (retina). At first, diabetic retinopathy may cause no symptoms or only mild vision problems, medical sources show.

The condition is common in Blacks and Hispanics compared to Whites. In Type 2 Diabetes mellitus and it is present in about one third of individuals who are diagnosed by diabetes.

What to do to prevent complications?

Glucose control: Better the glucose control, lower the risk of complications

Blood pressure: Tight control of blood pressure lowers the risk of complications too.

Lipids: Lowering lipids level also lowers the risk of complications

Smoking: Smokers have high chances of getting complications

Early detection and treatment

It is important that you should plan your visit to see your eye specialist as soon as you have been diagnosed as a diabetic patient, so that your assessment for diabetic retinopathy can be performed.

If you have a complaint of poor vision in one or both eyes the also you should plan and visit your eye specialist immediately.

Your eye specialist will undertake a few tests such checking your vision and your glass presciption if any. The specialist may also put some drops in your eyes and take some photographs and other tests to find out whether you have any changes in your eyes due to diabetes. Depending upon the changes, the eye specialist may advise you to come back after six months or advise you to go for the treatment.

Laser is the mainstay of treatment in diabetic retinopathy, the benefits of laser treatment greatly overweigh the risks.

The aim of the treatment is to stabilise the changes caused in your eyes by your diabetes.

In practice, the medication is injected into the eye. The main effect of the medication is to absorb the blood and decrease the swelling caused by diabetic retinopathy.

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Wednesday, September 6, 2017

Myths and realities through an oral health window - 2

Did you know that decay can also occur when

Did you know that decay can also occur when teeth look and feel normally fine. PHOTO | FILE 

By Dr Emeria Mugonzibwa mugonzibwamwanga@gmail.com

Getting to know the right information and acting upon those choices can keep you healthy for a lifetime, such as your oral health.

Oral health involves diagnosis, prevention and treatment of diseases, disorders and conditions of your teeth and gums.

There are commonly held myths among different age groups who share the same mindset regarding dental health. Let’s debunk some of them in the second part of the ‘oral health myths and realities’ series.

Myth 1: Everyone should have a dental check-up every six months.

Fact

For many people, every six months is appropriate. Some people require more frequent check-ups and others less frequent check-ups.

It depends on one’s oral health and risk for oral disease(s). Your oral health provider can determine how often you should visit.

Myth 2: If there is no pain, the teeth are fine.

Fact

Not always the case!

Dental decay, infection and fractured teeth are often associated with dental pain and discomfort. But that isn’t the case for every case.

Sometimes dental decay penetrates through the hard layer of enamel and the softer inner dentin layer, before any discomfort occurs.

Decay that has gone through the harder tissues of a tooth to the delicate pulp will require root canal therapy if the tooth has to be saved.

However, if the decay is diagnosed in its early stage, a small filling would have stopped the decay.

Not being in pain does not mean the teeth are healthy: that’s why regular oral health checkups and x-rays are important for detecting dental concerns without symptoms.

Myth 3: Spaces or gaps in teeth lead to cavities.

Fact

Bigger spaces or gaps are easier to keep clean as long as food doesn’t get stuck in the gap when one eats and deposit bacteria, wide spaces are less likely to decay.

Keep an eye on small gaps, though. Food may get stuck there and lead to cavities if it’s not cleaned out.

Myth 4: Only children are prone to dental decay and cavities.

Fact

Dental decay and cavities are not determined by age; they will affect the teeth at any age or stage of life.

Children may have more cavities due to lack of dexterity in brushing their teeth – but cavities can be diagnosed in a 50-year-old or 35-year-old person, especially if they have slacked-off their oral hygiene practices.

Effective brushing and flossing is the best cavity prevention – and an understanding that certain medications and life-style choices increase the risk of developing cavities.

Strong relationship with a tooth brush, dental floss and low frequency of sugary snacks are number one defense against tooth decay.

Myth 5: Brush teeth immediately after eating.

Fact

This thought should be dropped from the routine.

As tempting as it may be to grab the toothbrush and scrub away at the teeth straight after a meal to get rid of any food particles, this can only be detrimental to the dental health as it can do more harm than good.

Brushing within 30 minutes of finishing a meal can weaken tooth enamel, especially if one has consumed anything acidic such as oranges, grapefruit and lemons or even if one drank anything acidic.

Instead, one may chew sugar-free gum because it stimulates saliva flow, cleans the mouth of food debris and neutralises plaque acids.

When cleaning the teeth a little later, try not to be too aggressive with the brushing.

Far better to invest in an electrical toothbrush that scientists have proved is a better, kinder option for the teeth.

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Wednesday, September 6, 2017

Keep your heart healthy to prevent attacks

 

By Ali Khatau alikhatau@hotmail.com

A heart attack is serious medical emergency which occurs when blood flow to a part of the heart reduces or stops, causing damage to the heart muscle.

The heart muscle is supplied by the coronary arteries and blockage of these arteries by plaque leads to a heart attack.

According to the World Health Organisation (WHO), around 17.5 million people die from heart disease worldwide and 80 per cent of them are caused by heart attacks and strokes.

Coronary heart disease causes more than 11,000 deaths a year and is the fourth most common cause of death in Tanzania.

Heart diseases are more common in men than in women.

Causes

A variety of things can cause heart attacks ranging from unmodifiable factors like age, family history and gender to modifiable factors like lifestyle and diet.

The most common risk factors for heart attacks include old age, cigarette smoking, diabetes mellitus, high cholesterol levels and high blood pressure.

Other risk factors include male sex, lack of physical activity, a family history of heart disease, alcohol use and obesity.

Smoking is regarded as the most common cause responsible for around 36 per cent of heart diseases cases followed by obesity which is responsible for close to 20 per cent of heart diseases.

Less common causes include low socioeconomic status and chronic high stress levels, so make sure you always keep your stress levels in check.

Symptoms

The most common symptom of a heart attack is usually chest pain.

Most patients describe the pain as a sensation of tightness, squeezing or pressure. This pain, in most cases, radiates to the left arm but may also be felt in the lower jaw, neck, back, right arm and shoulder.

The pain often lasts for more than 20 minutes.

Other symptoms of heart attacks include sweating, fainting, nausea and vomiting. Most women report shortness of breath, fatigue and weakness as their symptoms.

Lesser common symptoms of heart attacks include palpitations and abnormal heart rate and blood pressure. The sooner you recognise the signs and symptoms of a heart attack and seek help, the better.

Prevention

There are major changes one can make to their lifestyle in order to avoid being a victim of heart attacks. Such as:

• Physical activity including sports like football and gym sessions can greatly reduce your chances of having a heart attack.

• Maintaining a healthy balanced diet and refraining from smoking and excessive alcohol use also greatly reduce your risk for heart disease.

• Dietary changes such as substituting olive oil in place of normal cooking oil, reducing sugar consumption and regular adequate consumption of fruits and vegetables.

• There are various medication which lower blood cholesterol levels and reduce the risk of heart disease. These drugs should never be self prescribed but should rather be prescribed by a medical professional.

The author is a medical student at Hubert Kairuki Memorial University.

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Wednesday, September 6, 2017

Dear government, here’s my advice to you on beating cancer

 

By Dr Chris Petterson sonchrispeter@gmail.com

Last week I came across the former US President, Barack Obama’s speech when he declared an initiative called “Cancer moonshot 2020.”

The initiative is aimed at accelerating the fight against cancer, especially in countries where the disease seems to threaten more lives. Here, Sub-Saharan Africa is the case on point.

As a medic, I strongly applaud this initiative. The timing is ideal for renewed attention in our quest to control cancer.

Over the past decade, our knowledge of the genetic aspects of cancer has dramatically grown. There are now new forms of more targeted remedies that are leading to clinical progress for thousands of patients with cancer.

Additionally, our knowledge of the complexities of cancer treatment has dramatically increased, and new immunological therapies for cancer are generating surprisingly strong results for many patients.

As we continue expanding our knowledge, the opportunities for translating research into cancer practice and doing more and clinical research swell. Yet the resources to execute these opportunities are limited.

I strongly believe that more resources will lead to new scientific knowledge, which will lead to realistic treatment advances for cancer patients worldwide.

So what should we do to embrace the cancer moonshot 2020 initiative?

1. Increase funding for cancer research:

I remember about five years ago, 25 to 30 per cent of medical investigator-generated grant applications were funded but today that number is less than 10 per cent.

Renewed emphasis on funding for comprehensive cancer centers is appropriate. Not only does much of the research occur in comprehensive cancer centers, a great deal of population based-medicine and community outreach programs happen too.

2. Fund cancer screening for early detection:

Resources should be added to insure that all Tanzanians receive appropriate cancer screening. Far too many people, frequently of lower socio-economic status, do not receive basic cancer screening. Early detection is the key to improving cure rates.

3. Improve access to state-of-the-art cancer care:

We must give patients better and more access to clinical care and to clinical research. Only five per cent of cancer patients are treated in clinical trials. This rate clearly needs to rise.

All cancer patients should have access to sophisticated genetic-level treatment for certain tumours and it should be covered by the health insurance industry.

4. Rationalise the cost of cancer treatment

One of the biggest challenges in clinical cancer care, especially in Tanzania, is the cost of new drugs. Over the past 10 years, the cost of cancer therapy has dramatically risen.

Dr Syriacus Buguzi, shows vividly how the cost of cancer treatment is a burden to low income earners in his article published in The Citizen: “Cancer patients dig deeper to pay for treatment at the ORCI.”

Dr Buguzi points out in his article that 75 per cent of cancer patients at the ORCI [ocean road cancer institue] reported in the advanced stages of their disease condition, and more are frustrated by high cost of cancer treatment.

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Monday, August 28, 2017

Health risks of not washing your hands

Hand shaking is considered an unhealthy

Hand shaking is considered an unhealthy behaviour among many healthy experts.PHOTO|FILE 

By Khalifa Said @RealKhalifax ksaid@tz.nationmedia.com

Jake Dismas* gave up handshaking and sharing his working tools in the office after observing a colleague going out of the bathroom without having his hands washed. The 28-year-old Dismas described the act as “awkward.”

“This is a very close person to me,” Dismas, a sales officer in one of the country’s soft drinks company speaks of his co-worker. “I was taken aback with the act. From thereon, I decided to have the disinfectant spray with me all the time.”

Is it because Dismas had suffered anything from what he’s saying? “No, but as the old saying goes prevention is better than cure,” responds Dismas.

Not a lone case

If you thought that Dismas’s friend is a lone case, you might’ve gotten it wrong.

According to the Health Minister Ummy Mwalimu, only 35 per cent of Tanzanians do wash their hands after using the bathroom. What does this translate to our public health system? The minister responds:

“No wonder that almost 80 per cent of patients admitted to the country’s hospitals suffer from diseases which have something to do with poor cleanliness and sanitation issues,” noted Ms Mwalimu in a recent press conference.

The health implication

Dismas is doing what an environmental health expert from the Muhimbili University of Allied Sciences (Muhas) would exactly advice.

Dr Simon Mamuya, senior lecturer at Muhas attests that any person who will touch a particular place or object with their naked hands is more likely to be infected with bacteria only if the place or object was previously touched with dirty and infectious hands.

“And by disease, we don’t mean that a person should be sick as there are numerous diseases one may have inside them unconsciously,” offers Dr Mamuya, who also heads the Department of Environmental and Occupational Health at Muhas. “These people are known as reservoirs, that is, they have the disease and aren’t sick but they can transmit them to others.”

The implication of Dr Mamuya’s insight is that once a person is infected with any infectious dieses and touches a place with their insanitary hands, it’s more likely that another person who will touch the same place with disinfectant-free hands will take the bacteria and become infected with the disease.

A hand as a conveyer

But does a hand have any problem? A 2011 study report on ‘Bacterial hand contamination among Tanzanian mothers varies temporally and following household activities’ published in the journal of Tropical Medicine and International Health puts it this way: food handling, exiting the household premises and longer time since last handwashing with soap are positively associated with bacterial levels on hands.

Dr Mamuya, who appeared to co-author the study, highlights that in most cases, a hand is considered as a conveyer, meaning, it the key transmitter of diseases. Many people don’t know the best and proper way to wash their hands, he says from his experience from other studies he has co-authored.

Bunch of diseases

The diseases that can be transmitted through touching, according to Dr Kilawa Shindo, a medical doctor based on Kigoma Ujiji Hospital, can range from those caused by virus to bacterial. “These include, but not limited to, worms, tuberculosis, hepatitis, leprosy, scabies, fungal infection and other diarrhoeic related diseases.”

Even doctors, Dr Shindo shares, are required to wash their hands with sanitary soap after attending each patient. “Though in practice, this isn’t the case as you know the working environment of our hospitals,” adds Dr Shindo from Kigoma during a recent interview with Your Health. “Instead, we rub our hands with an anti-bacteria liquid [sanitiser] as an alternative.”

The spreading of a particular disease doesn’t need ‘a lot of hours’ to occur, even a second is enough to transmit a particular disease from one person to another, debunks Dr Mamuya.

“The spreading of any disease depends on something called viral infection, that is, how fast it can be transmitted. For example, if one will eat something infected with vibrio cholera-insects, which cause cholera-within a few moments, it can bring problems in one’s body like diarrhoea or vomiting,” he points out.

Dr Mamuya says there is a great need for people to cultivate the behaviour of washing hands. He says there are people who spread the bacteria in their hands thinking that they wash them away. Many people don’t use sanitary liquid in washing their hands, he offers.

“Even handshaking isn’t a good healthy behaviour. Can one be able to know where the hand had touched before they handshake it? Personally, I don’t prefer handshaking,” says Dr Mamuya.

Dr Mamuya advices that people should stop the behaviour of handshake. When touching something is unnecessary, people should restrain from touching them.

Behavioural problem

In expressing his view why most people do not have a culture of washing hands, despite being aware of its consequences, Dr Mamuya calls the problem “behavioural.”

He says everyone has his/her own upbringing and things that he/she deems casual as they have been with them since childhood. “Someone will tell you that ‘my father died at 99 and never washed his hands.” To change this behaviour, Dr Mamuya advices it would be a good idea that these people are built with the culture since their childhood.

“Once we stress this matter in a family level and in schools, it’ll go a great mile towards changing the persisting behaviour,” he says.

Ingredients for change

While Dr Mamuya calls for an emphasis at the family level, Dr Deodatus Kakoko, a senior lecturer in health psychology at the Behavioural Sciences Department at Muhas indicates that there are several reasons why people don’t wash their hands.

On one hand, he says, the reasons relate to an individual person but on the other, they relate on the supportive nature of the environment surrounding that person.

“Knowledge, skills and attitude is key to making someone adapts a particular behaviour. Through knowledge, a person will understand the benefits which come with washing hands, skill will teach them how to wash while attitude will make them perceive the act of washing hands as ‘a good and positive’ thing,” offers Dr Kakoko.

Dr Kakoko’s views concede with a 2011 study which found out that mothers in Dar es Salaam, the target of the study, were aware and knowledgeable of the risks of certain household practices and understood safer alternatives.

However, the study titled ‘Understanding Household Behavioural Risk Factors for Diarrhoeal Disease in Dar es Salaam: A Photovoice Community Assessment’ published in the Journal of Environmental and Public Health notes that the mothers were restricted by the perceived impracticality and financial constraints to make changes.

The ‘reminding’ factors

In workplaces, where everything is in place from safe and clean water to soap and other sanitary equipment, what’s needed is what Dr Kakoko calls ‘cue factors.’

“These are actually reminding factors, for example, in developed countries they have alarm which will ring once a person has not washed his/her hands.”

Alternatively, he urges, you can have a banner with a ‘disgraceful message’ reminding a person to wash their hands. These will trigger people to take actions, which is to wash their hands.

Another important factor in behaviour changing according to Dr Kakoko, is what they call ‘motivating factor’ which can provoke one to adapt a particular behaviour. This includes award or punishment.

“Moshi, Kilimanjaro for example, enacted a law based on that basis and anyone can see how far they have gone in the cleanliness issue. Simply because the law clearly stipulated the punishment,” he says.

Ms Mwalimu says that every year the government loses almost Sh300 billion due to poor hygiene.

It starts with you

In order to avoid this ‘unbearable loss’ to the government and prevent ourselves from any infection associated with poor hygiene, there is a dire need to stress the matter of personal hygiene.

This, experts say, involves washing our hands with sanitary soaps and apply disinfectant spray/liquid.

This, according to Dr Mamuya, and Dr Kakoko concurs, “It starts with you.”

*Not his real name

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Monday, August 28, 2017

WHAT'S UP DOC : Are white spots on my finger-nails harmful?



Dr Syriacus Buguzi

Dr Syriacus Buguzi 

By Dr Syriacus Buguzi six.buguzi@gmail.com

I became friends with James* from Mabibo suburb in Dar es Salaam recently and when he learnt that I am a medic, the expected happened—he threw in a question.

“Doctor, good enough you are here,” he began. “My nails have white spots and I don’t know what causes them. By the way, is this dangerous?”

I had to reassure him first—that having white spots on finger nails is a harmless condition and it’s common. In medicine, we call it “leukonychia.”

However, I had to mention it—quite frankly to him that having those white spots could signify that he has an underlying health problem. This, he has to find out with a doctor.

John was keen on asking what really causes the spots. He is not the first person to have asked me this question, but most times it came up, people associated the spots with certain myths.

Well, the spots could have occurred due to injury on nails. That was the second thing I told him—and this is the most common reason.

Perhaps James banged something on to the finger nails or the injury was caused by nail biting.

The injury may have occurred at the base of the fingernail leading to dots on the nails as they grew.

Usually, people tend to forget that they may have had an injury to their nails until after weeks have gone by—and in the end they wonder what might have happened to their nails.

But the condition could have been caused by an allergic reaction—from nail polish or certain gels.

Certain fungi infection too, can cause the white spots. The first sign of the infection may be a few small white dots on the nails. The infection can grow and spread to the nail bed. The nails may appear flaky and then become thick and brittle.

If you are deficient of certain minerals, vitamins and proteins, the white spots can appear on the finger nails.

The mineral deficiencies most commonly linked to this condition are zinc, iron and calcium.

When white spot on the nails is caused by injury, the marks will disappear as the nail grows outwards, however a dietary deficiency will make the problem recur.

There are other causes but they are not common. Here, we are talking of things such as, arsenic poisoning, pneumonia, heart disease, kidney diseases, liver diseases such as cirrhosis and another condition known as psoriasis as well as eczema.

Stay safe and make informed healthy choices!

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Monday, August 28, 2017

The role of community in the fight against TB

 

By Dr Frederick Haraka fharaha@ihi.or.tz

I have encountered a common question during my discussions on tuberculosis (TB) with ordinary people [not in the medical field], ‘Is TB still a problem?’ This has always left me puzzled. I keep asking myself how could it be possible that people in one of the very high TB burdened country know little about the disease.

Well, there are two possible assumptions, one could be that I always encounter a biased group, but it is quite unlikely because such encounters occur randomly and sometimes begin from unrelated conversations. Second, TB is not popular among non-medics. In my opinion, the second assumption is potentially the most reasonable one that needs some reflection.

The link between poverty and TB

Let us begin by asking ourselves, who gets TB? I will not focus on biological and clinical factors, rather talk about socioeconomic factors which have been linked to the disease.

TB commonly affects the poor people in the society. They are those who specifically have material poverty. Those who can hardly afford good housing and end up in slums with poor ventilation and congestion, those who can hardly afford a balanced diet and end up being victims of malnutrition and those with low income who generally have unstable employment.

This means that there’s a strong association between poverty and risk of getting TB. Of course there are other risk factors such as being immunocompromised with HIV.

Community engagement

My concern is on how many of our people actively engage in the fight against TB. We have not fully engaged as a community to seriously not just talk about it but develop interventions which originate from the community to address this disease. There is a general feeling that TB is no longer a problem or less of a concern.

The World Health Organisation (WHO) recommends community engagement in reducing TB transmission. This is well reflected by the National TB and Leprosy Programme through the adaptation of the engage community TB model. These efforts are highly commendable but until the community feel they are part of this struggle, we are yet to fully realise impact of all these proposed interventions.

The fight must start at the family level, schools, local government as well as media. In all these levels, TB must be discussed in terms of risk of transmission, symptoms, early health seeking behaviour, treatment adherence and prevention.

The community should be well educated on all aspects but also motivated to fully engage in seeking healthcare when TB is suspected. At schools, students should form educative clubs such as TB-awareness clubs, which will play a role in bringing awareness to not only within the school environment but also back in the community. The media has a very strategic role to play but also having regular sessions on TB should be planned, which are geared to bring more awareness to the community.

The world has set up ambitious goals of ending TB by 2030. This reflected in our national TB strategic plan. The National TB programme wants to increase TB detection. Our country is still highly burdened by TB. As we head towards the ‘end TB 2030’, our efforts in the fight must double and be above the average.

A healthy society stands a better chance of socio and economic prosperity. As much as we reform our country to a better future, the need to fight chronic diseases such as TB cannot be overemphasised enough.

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Monday, August 28, 2017

When it comes to breast cancer, men are the forgotten victims

 

By Dr Chris Peterson

John’s* medical documents made me pause. As I read over his answers from the patient questionnaire form he had filled in, I found out that this 51-year-old man had not seen a doctor since his childhood-not until last month when his new primary care physician referred him to me after finding a large breast mass.

I walked into the examination room where John, who had an athletic built, sat expectantly in a hospital gown. After a light conversation to help him relax, I examined him. I asked typical questions, such as ‘when did you first notice this lump? Does it hurt when I touch it?’

Under my fingers, I could feel enlarged lymph nodes in both of his armpits, a frequent symptom of unaddressed breast cancer that has spread beyond the breast. Based on what I knew beyond this man’s history, this didn’t surprise me. This didn’t mean cancer, not yet, we’d only know after the results came back from a breast biopsy.

Hundreds of men are diagnosed with breast cancer every year. Some reports even suggest that over the last 25 years, the frequency of new male breast cancers has gone up by about 25 per cent.

With male patients, which seem to be a growing population, we really have to consider their unique needs. Just because it’s less common for men to experience breast cancer, it doesn’t mean men don’t have particular concerns that could surprise and challenge us.

A week later when John returned, I was able to give him some news. His breast biopsy showed high concerns for cancer. I started discussing with him the treatment plan for male breast cancer, including the one I most often recommend as it offers the best outcome, a mastectomy [the removal of the whole breast].

Then, John said something I didn’t expect, “No doctor. I have always said that I would rather die than have a visible part of my body like my nipple, removed.” He blinked back at me as I swallowed my surprise. He seemed to have a strong stance about his decision.

Saving his breast was the last thing I’d expect a physically powerful man to be concerned about. But I always respect my patients’ wishes, as long as they are safe. So we agreed to remove the lump only, allowing us to be absolutely sure of a cancer diagnosis. Once we confirmed it was cancer, then, and only then, did john agree to remove the remaining cancer in his breast. John is now cancer free, after completion of his planned treatments.

A colleague of mine who is a clinical oncologist at the Ocean Road Cancer Institute, recently presented a research about male breast cancer at the medical training fellowship conference. In his research, he found that over the last five years, the percentage of male patients who showed an interest in conserving their breasts went up from 2 per cent to 28 per cent. However, each of these patients did require a mastectomy. To my knowledge, this was the first study evaluating whether to desire to preserve the breast is a concern for male breast cancer patients.

John’s story reminds me of one thing. Men are indeed the forgotten victims when it comes to breast cancer. I therefore recommend people in their societies to be given massive awareness lessons on the disease itself and it also should be known that “breast cancer for men is real.” This will help men draw more awareness, get regular breast cancer screening and abstaining themselves from risk factors.

* The name has been altered to protect the patient’s identity.

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Monday, August 28, 2017

Migraine: more than ‘just a headache’

Migraine is more common in females than males.

Migraine is more common in females than males. PHOTO | FILE 

By Ali Khatau AliKhatau@hotmail.com

A migraine is a very common and distressing disorder. It isn’t usually fatal but can adversely affect the quality of life of the sufferer. If you suffer from migraine headaches, you’re not alone. According to the Migraine Research Foundation (MRF) of the US, migraine is the 3rd most prevalent illness in the world.

A migraine is a primary headache disorder characterised by recurrent headaches. They can be moderate to severe and usually affects one half of the head. The headaches are pulsating in nature and last from 2 to 72 hours. Other symptoms associated with migraines include vomiting, nausea and increased sensitivity to light, sound or smell. Physical activity generally makes the pain worse.

Migraines are more common in females than males and often linked with family history. 85 per cent of chronic migraine sufferers are women mostly due to hormonal causes, suggests MRF. The underlying mechanisms of migraines are not well understood but are believed to involve blood vessels and nerves of the brain.

Symptoms

A migraine is generally divided into 4 phases with different symptoms and signs, although not all phases are necessarily experienced.

The first phase occurs hours to days before the headache. Its symptoms and signs include mood changes, irritability, fatigue, euphoria, diarrhoea or constipation and muscle stiffness.

The second phase occurs immediately before the headache. Its symptoms can be visual, sensory or motor in nature and many people experience multiple symptoms. Visual symptoms occur in almost 99 per cent of cases and include alteration in field of vision and blurring.

The third phase is known as the pain or headache phase in which the headache is throbbing and moderate to severe in intensity.

The final phase which is at the end of a migraine attack presents with fatigue, head pain, weakness and gastrointestinal symptoms like constipation and diarrhoea.

Causes

The underlying causes of migraines are not very well known but are associated with genetics and environmental factors. According to the MRF, about 90 per cent of migraine sufferers have a family history of migraines.

A number of psychological conditions may also cause migraines including depression, anxiety, stress, and bipolar disorder. Other implicated causes include pregnancy, oral contraceptive use, sleep deprivation, alcohol use.

Preventative measures

This includes keeping stress levels in check and taking regular breaks from your busy schedule to de-stress, getting enough sleep and regularly doing physical exercise.

If your migraine attacks persist despite of taking these measures, your best option would be to consult a medical professional for professional advice.

The author is a Medical Student at Hubert Kairuki Memorial University

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Monday, August 28, 2017

Alcohol can ruin a good night’s sleep

 

By Devotha John djohn@tz.nationmedia.com

Finishing off a long day at work with a visit to the local pub is not uncommon for many Tanzanians. Alcohol is used as a relaxant after stressful working weeks, and is often used as a “sweetdream-cap” for particularly distressing days.

While alcohol sometimes helps to induce sleep, drinking alcohol is actually one of the causes of sleep problems.

Alcohol contains a substantial amount of ethanol causing unstable dynamic functions such as unclear speech, unstable movement, troubled perception and inability to react quickly, explains Dr Wema Ngowi, a medical doctor at Buguruni Health Centre.

“Alcohol messes with sleep rotations, resulting in more awakenings, and causing people to spend less time in the important deep sleep stages,” explains Dr Ngowi in an interview with Your Health. Due to this, people who consume alcohol would want to be extra careful with their drinking pattern.

According to Global Status Report on alcohol and health, in 2012, about 3.3 million deaths, or 5.9 per cent of all global deaths, were attributable to alcohol consumption.

Alcohol also results in extra breathing difficulties, it can increase the symptoms or effects of parasomnia, sleepwalking and restless legs syndrome.

“Most people drink for the stimulant effect, such as beer or glass of wine. But if a person consumes more than the body can handle, they then experience alcohol’s side effects. They start to feel “thoughtless” or lose coordination and control,” Dr Ngowi cautions.

Dr Ngowi said on top of this, alcohol suppresses the anti-diuretic hormone in your body, which can contribute to even more bathroom trips. And when you’re going to the bathroom regularly, you tend to lose the essential electrolytes.

All these factors can add up to the fact that when one is drunk, one becomes intolerant to light, frequently interrupted sleep and an exhausted, dehydrated you in the morning. But it doesn’t have to be this way.

Measures

Cautioning the regular drinkers, Dr Ngowi advises consumption of two glasses of water right after a single alcohol drink (glass or a pint). This will help their system to flush out the alcohol.

Drink even more water if you’re having wine, beer or a sugary drink, since your body will need to flush out the alcohol and the sugar.

Excessive bubbles due to carbon dioxide in the drinks can cause gas and bloating of your stomach, providing more surface area for alcohol to be absorbed and mess with your sleep. Similarly, think twice about drinks with bubbly, carbonated mixers.

“Drink with food, and pay attention to your alcohol intake. Doing your drinking and eating at the same time is a good idea because you’re typically munching on meals a few hours before bed, which allows more time for your body to metabolise and more time for you to squeeze in those crucial glasses of water,” Dr Ngowi advises.

Eating will slow the hit of the alcohol, so you might actually end up drinking more to feel the buzz. Allow three to four hours between drinking and hitting the bed.

For example, if you plan to sleep by 10pm, be sure to finish that glass of wine or beer by 6pm or 7pm. It takes your body about three hours to metabolise 8 ounces of wine or beer, depending on your size, weight, gender and the type of alcohol you are consuming.

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Monday, August 28, 2017

Myths and realities through an oral health window - 1

 

By Dr. Emeria A. Mugonzibwa

Oral health consist of dentistry, a branch of medicine involving diagnosis, prevention, and treatment of diseases, disorders and conditions of the oral cavity, commonly in the dentition.

Oral diseases, disorders and conditions are among the most prevalent among children, adults and the elderly across the globe.

The heavy burden of oral disease and conditions in Tanzania like in many developing countries and in communities disadvantaged by poverty, remoteness, and cultural barriers to accessing oral health care put emphasis on the need to share oral health information through various media.

An oral health myth is a collectively held oral health information and/or belief that have no basis in fact. This is the first of the oral health myths series and their related realities/facts.

Myth 1: Rinsing the mouth with water after brushing the teeth.

Fact

Many years ago, this was the advice for many probably also heard from parents, but the current information or basic tip is ‘Spit not rinse.’

The toothpaste contains lots of useful ingredients and that includes fluoride, which helps to protect the teeth against dental decay, strengthens the tooth enamel and reduces the amount of acid that the bacteria on the teeth produce.

So, after brushing, spit out any excess toothpaste by all means, but do not rinse the mouth with water or even mouthwash. One really does not want to remove any left-behind fluoride that can continue to look after the teeth long after the two-minute-or-more brushing regime!

Myth 2: Fruit juice and diet drinks are far healthier than the sugary option

Fact

Fruit juices and diet drinks are just as bad for the teeth as their ‘evil’ sugary counterparts!

They cause ‘acid attacks’ on teeth and even pure fruit juices can contain large amounts of naturally occurring sugars that also have a negative effect.

In fact, some fruit juice may contain more sugar than other soft drinks. Over a period of time and if consumed excessively, fruit juices and diet drinks can wear down tooth enamel, leading to cavities, sensitive teeth and, possibly leading to tooth loss.

Their intake should be limited and better stick with normal clear water as it is by far the healthiest option!

Myth 3: As long as one visits the oral health provider every six months, the teeth will be fine.

Fact

Regardless of how often one visits the oral health provider; he/she must look after his/her teeth.

One should practice good oral hygiene, consume a healthy diet (with as less often sugar snacks and beverages as possible), and follow his/her oral health provider’s recommendations.

Myth 4: A woman should not have any dental work done during pregnancy.

Fact:

It is important to have regular check-ups and necessary recommended treatment during pregnancy to help prevent problems. A woman should inform her oral health provider that she is pregnant before check-ups and appointments.

Myth 5: Using a hard toothbrush will clean one’s teeth better than a soft toothbrush.

Fact:

Using a hard toothbrush can result in abrasion and removal of surface area of the tooth leading disturbing tooth sensitivity.

A soft toothbrush used properly will clean the teeth with less risk of tooth white cover (Enamel) loss.

mugonzibwamwanga@gmail.com

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Monday, August 21, 2017

Engaging youth in making right choices

Teenagers are the most vulnarable to

Teenagers are the most vulnarable to understanding and realising their sexual and reproductive health rights.PHOTO|FILE 

By Halima Lila halima.lila@hopecentre.or.tz

Tanzania has signed the road map to harnessing the Demographic Dividend (DD) through investing in the youth. The country is also well known for its favourable policy with respect to adolescent and youth Sexual and Reproductive Health and Rights (SRHR).

However, with the current statistics on access to family planning services and comprehensive life skills, it means concerted efforts are still required if we want to achieve the ultimate goal.

It’s not a matter to ignore

In Tanzania 64 per cent of the population is below 25. This means one out of every three Tanzanians is a youth between the ages of 10-24. Also over one quarter of young women ages 15 to 19 have begun childbearing in Tanzania.

Against this backdrop, teenage pregnancy rates have risen from 23 per cent in 2010 to the current 27 per cent, yet the use of modern contraceptives among youth aged 15-19 years remains low—at 13 per cent.

This is, even though one in every four young married women aged 15-19 years have a desire to use contraception but are now not using any of them.

The above data indicates that the Sexual and Reproductive Health needs of youth cannot be ignored and overlooked, because young people are the now and future of the nation.

The challenge and solutions

Adolescent and Youth Friendly Reproductive Health (AFRHS) and Family Planning services is still a challenge in the country. Studies show that only 30 per cent of service delivery points in the country meet the national standards for AFRHS.

AFRHS is very vital in Tanzania because young people can better access the information and services they need to stay healthy, avoid unwanted pregnancy and childbearing, complete more years of school, and obtain the skills necessary to be economically productive.

With the statistics above, young people in Tanzania need centres which offer friendly services all over the country especially the regions which teenage pregnancy is above the national average. This will help in contributing to household finances and eventually to the local and national economies.

The reproductive health needs of young people have been largely ignored by existing reproductive health services. Healthcare facilities can play an important role in supporting the sexual and reproductive health of young people.

This can be accomplished by improving the quality and range of services provided to adolescent and youth, in particular, by health care providers maintaining a friendly and open attitude as they impart accurate information and impartial advice.

Further, the guidelines for youth friendly services should be improved and training packages for service providers to ensure young people get the full information and the contraceptive methods tailored to their needs at all primary health care service delivery points should also be enriched and sustained.

Education is the key

Age appropriate comprehensive life skills curriculum in and out of schools in Tanzania is required so as adolescent and young people can know their bodies and make informed choices, for example, when and how they can access, choose and use Family Planning when they need them.

As many researchers have suggested, the age appropriate comprehensive life skills curriculum will help the adolescent and young people delay in pregnancies, unsafe abortions, prevent maternal mortality rate, prevent themselves from STI’s and HIV and hence the girls will continue with their education.

If we still have a 27 per cent teenage pregnancies, this indicate that the age appropriate comprehensive life skills curriculum is necessary and needed now and not tomorrow in and out of schools in Tanzania.

Girls need to have the opportunity to finish school and prevention towards pregnancies can help them to complete their education. With the current situation teen mothers not allowed back to school. Prevention should be the priority if Tanzania is rapidly transforming to a middle income economy.

And as many researchers have suggested, when we invest in girl’s education, we are investing in the economy of a nation hence development will be inevitable.

When girls are denied the opportunity to education, it limits their access to other opportunities including decent employment, leadership and access to information and to make informed choices. Girls who drop out of schools are also likely to end up in child marriages.

The outcome

During the 2017 Family Planning London Summit this year, our government committed to increase modern contraceptive prevalence rate to 45 per cent by 2020 and scale-up the number of health facilities providing youth-friendly reproductive health services from 30 per cent in 2017 to 80 per cent in 2020.

During the summit, over 600 policymakers, donors, youth and advocates from around the world gathered in London, United Kingdom, to discuss efforts to reach our Family Planning 2020 goals and ensure that more women and girls around the world are able to plan their families and their futures.

There was a collective announcement of over $2.5 billion in new funding to deliver rights-based family planning with focus on better serving the largest generation of adolescents in history and the hardest-to-reach women and girls.

I got the opportunities to speak in different plenaries, sessions sharing my work on Family Planning and young people in Tanzania, and one of the key things I heard, is when our government said it would also commit to increasing family planning budget to 35 per cent by 2020.

As one among 15-member YAG for the Summit, we developed an accountability framework which as young people we have a critical role to play in holding our selves, governments and donors to account for the commitments.

The YAG developed an accountability framework to mobilise young people and youth networks at the country level to advocate for the full implementation of the commitments made by our governments.

The framework calls for ensuring that country commitments and policies are responsive to adolescent health needs, mobilizing political and public support for implementation, and strengthening the capacity of youth led organisations and networks to engage in advocacy and accountability.

The author is Founder and Managing Director of Hope Centre for Children, Girls and Women Tanzania.

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Monday, August 21, 2017

The link between aging and back pain

A young adult with back pain. If you overdo

A young adult with back pain. If you overdo activities, back pain in younger age is also common. PHOTO | FILE 

By Dr Mugisha Clement

As we age, our spines age with us. Aging causes degenerative changes in the spine. These changes can start in 40’s or above.

In some, it may occur at a younger age and can make them prone to back pain, especially if they overdo activities.

In females, degenerative changes occur earlier than in males. One of the most common causes of lower back pain is from over-activity. Muscles and ligament fibres can be overstretched or injured.

The ‘disc’

Some people get lower back pain which arises from the disc [the spongy cushions that separate the block-like bones (vertebrae) of the spine], due to small tears in the outer part of it.

This does not mean that all people who have disc tear have lower back pain. It’s also important to note that the pain may last for few weeks, months or even longer.

A small number of people may develop constant pain that lasts for years and is quite disabling. As to why some people have pain and others do not is not well understood.

Also, a disc may herniate and bulge out the spinal cord and this may compress or irritate the nearby nerves hence causing pain on the back and to the regions where the nerve extends (leg and foot).

This type of pain is described as ‘sciatica’ in the medical language. Majority of the individuals get disc herniation during lifting, pulling, bending or twisting movements.

During adolescence, more than 75 per cent of the disc content is water. As we age, the water content decreases and disc begins to wear and tear, causing disc degeneration (aging).

Pain may vary

If you haven’t started experiencing the lower back pain, bear in mind that almost everyone will experience lower back pain at some point in their lives.

This pain can vary from mild to severe. It can be short-lived or long-lasting. However, lower back pain can make everyday activities difficult to execute.

There are many causes of back pain as aforementioned in the article, which may arise from the spine itself but others may be due to nearby structures or organs.

For the purpose of easy understanding, we are going to focus on causes of lower back pain, which results from the spine and spinal cord.

What is the make up of the lower spine and spinal cord?

Spine is made up of small bones, called vertebrae, which are stacked on top of one another. Muscles, ligaments, nerves, and intervertebral discs are additional parts of your spine.

Whether age or other causes, no matter what you think that caused your lower back pain, if it doesn’t get better within a few weeks, or is associated with fever, chills, or significant weight loss, then you need to see a doctor immediately.

Prevention

It may not be possible to prevent lower back pain. We cannot avoid the normal wear and tear on our spines that goes along with aging.

But there are things we can do to lessen the impact of lower back pain problems. Having a healthy lifestyle is a good start.

• Exercise: Combine aerobic exercise, like walking or swimming, with specific exercises to keep the muscles in your back and abdomen strong and flexible.

• Proper lifting: Be sure to lift heavy items with your legs, not your back. Do not bend over to pick something up. Keep your back straight and bend at your knees.

• Weight: Maintain a healthy weight. Being overweight puts added stress on your lower back.

• Proper posture: Good posture is important to avoid future problems. A therapist can teach you how to safely stand, sit and lift.

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Monday, August 21, 2017

Rise in use of contraception reflects hope

 

By Nuzulack Dausen @nuzulack ndausen@thecitizen.co.tz

The use of modern methods of family planning among women has increased nearly fivefold in two decades pushing fertility rate down by one child per woman in the country.

Official data shows that most of this growth has occurred in the last decade a sign that majority now appreciates the benefit of controlling childbearing.

According to the recent Tanzania Demographic and Health Survey (TDHS) 2015/16, the use of modern method of family planning has increased from seven per cent in 1991/1992 to 32 per cent in 2015/16.

In the same period of 24 years, fertility rate, according to the report by National Bureau of Statistics (NBS), has declined from six children per woman to five children.

The report which surveyed 13,266 women and 3,514 men across the country with ages between 15-49 years, says the use of family planning methods is higher among sexually active women with more than half using any method of controlling childbearing.

“The male condoms and injectables are popular methods among this group with 15 per cent of each using it followed by implants at eight per cent and pills at six per cent,” reads a part of the report.

Despite that success, the report reveals that the use of family planning methods by married women increases with economic status.

The United Nations Population Fund (UNFPA) says the use of family planning methods including contraception, benefit women and families throughout the world.

“Contraceptives prevent unintended pregnancies, reduces the number of abortions, and lowers the incidence of death and disability related to complications of pregnancy and childbirth,” says UNFPA.

According to family planning open data published on Hurumap website, in 2013, there were 4.68 million women aged between 15 and 49 years who were using family planning methods.

In July this year, the Minister of Health, Community development, Gender, Elderly and Children, Ummy Mwalimu said to reduce maternal and child deaths, the government plans to extend access to life saving family planning methods to 4.2 million more women and girls by 2020.

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Monday, August 21, 2017

How I prepared my aunt’s mind for chemo

A prep-talk between a cancer patient and a

A prep-talk between a cancer patient and a counsellor on side effects of chemo is important . PHOTO | INTERNET 

By Piamaria Ngole ngolespiamaria@gmail.com

Two months ago, my 60-year-old aunt was diagnosed with stage one breast cancer and as luck would have it, she was scheduled for chemotherapy just a few weeks after the diagnosis.

I particularly stress on the word “luck” because over 70 per cent of cancer cases are diagnosed at very late stages in Tanzania, yet there are only two available cancer facilities in the country—the Ocean Road Cancer Institute and Bugando Medical Centre.

These institutions serve only 5,000 of the country’s estimated 35,000 new cancer cases each year. None of this, however, makes enough sense to consider oneself lucky when one has been diagnosed with one of the leading causes of mortality globally.

So, when my aunt sat on the waiting benches for her first chemo cycle, fear, depression and some serious clinical changes had long crept into her life. As much as her family would have loved to help, they barely knew how to.

Coping with chemotherapy

Now, cancer causes more deaths in developing countries than anywhere else in the world and this puts our societies in a dire need for information regarding - well- anything and everything to do with cancer. This article sheds light on how to cope with chemotherapy.

So if you are on chemo, scheduled for chemo or taking care of a patient on chemo, then you would benefit from knowing what to expect and different ways to cope with it.

It is very important to first and foremost understand that chemotherapeutic drugs are chemicals that target to destroy dividing cells for curative, control or palliative purposes and that it is normal and almost natural to go through an array of changes that may challenge one’s physical, emotional and mental health while on chemotherapy.

Reason why these changes are bound to take place is largely attributed to the fact that chemotherapeutic drugs for cancer are very strong medications, which in the process of killing fast growing cancer cells end up destroying some normal and pretty useful cells of the body hence some side effects.

Not to overwhelm the body with these side effects, chemotherapy is given in cycles, allowing rest periods between doses for the body to regain. The length of these rest periods varies and it depends on types of medication used.

Some people may have little or no experience of these side effects and even among those experiencing side effects, the variation of intensity could be wild.

Fatigue is the most common and probably one of the most distressing side effects of chemo and people find it particularly difficult to cope with because it does not always resolve with rest/sleep.

Pushing ones physical limits may have always been a good idea but at this point it is wiser to conserve as much energy as possible. Try not to overwhelm your daily plan with activities and whenever possible, let your loved ones give you a hand.

Most people will also go through periods of feeling very nauseous few hours after chemo with vomiting (sometimes so severe to points of dehydration). If your doctor has prescribed medication for this, make sure you take them and avoid foods that would make you even more nauseous (example: too oily or too sweet).

One would also benefit from taking small sips of fluids as frequently as possible rather than trying to gulp down a large amount all at once.

Due to its effects on the production of blood cells, chemotherapy increases susceptibility to anaemia, excessive bleeding and infections.

Vulnerability to infections necessitates the adoption to a more hygienic lifestyle making sure that one’s environment, food, water, clothes and other things you make contact with are clean and safe for use.

It’s important to also avoid physical injuries as even minor cuts could bleed excessively.

Chemo may change some aspects of one’s sex life by interfering with both one’s ability and readiness to have sex. Talking to your partner about this should go a long way in easing things out here.

Some people may continue to have a normal sex life but it is strongly adviced to avoid pregnancies because chemotherapy affects both male and female reproductive cells and this could be detrimental to the unborn baby.

Likewise, breastfeeding is strongly advised against.

It is also normal to experience a fogged mind “chemo brain”. Don’t stress so much when you keep forgetting where you left your phone or when you take longer to catch a joke, it’s normal and should resolve after chemo though sometimes it may take longer.

Keep a record of important things you need to remember and let a trusted family member know where you keep this record ( just incase you forget).

The side effects are temporary

Chemo may have debilitating effects on one’s nutrition. Maybe you have lost your appetite and your favourite meal does not taste the same anymore, remember this is only temporary and you may find new ways to prepare your food to make it more palatable.

Don’t force yourself to finish your food if it does not appeal to your taste, instead have as much of the foods you enjoy as possible (unless of course you have another medical condition contraindicating the consumption of such foods).

And just like with fluids, a lot of little portions is better than one big meal.

Like I mentioned before, chemo affects some useful body cells too. Rapidly dividing cells of the hair, nails mouth and stomach are mostly affected. This is why people on chemo will have hair falling off and mouth sores and “not so good looking” nails.

Now this coupled with a pale anaemic look, gives one a very sick physical appearance. This could be very distressing to patients and also to their loved ones.

Unfortunately, there is no way around these side effects but preparing for it before it happens makes the whole experience a whole lot bearable.

One can talk to loved ones about the expected physical changes and maybe explore alternatives to better looks like a low hair cut before chemo, turbans, hats or other head wraps if needed.

I’v had the chance to communicate this information to my aunt before she goes for her second cycle and as she waits for the date, she is stronger and feels more included in the loop.

So viewing this from a brighter side, being on chemo is a grace in disguise, once you have learned how to properly cope with it. This period requires you to pay closer attention to your needs and make the effort to take extra care of your healing body.

Though it may be one of the hardest periods you may ever have to go through, it has the unbeatable joy of really taking good care of oneself.

The author is a pharmacist based at Muhimbili National Hospital(MNH)

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Monday, August 21, 2017

WHAT'S UP DOC : Dear doctor, how do I ease this painful period?



Dr Syriacus Buguzi

Dr Syriacus Buguzi 

By Dr Syriacus Buguzi six.buguzi@gmail.com

Now, this message dropped on my email last week and since then, I have been longing for this time to arrive so that, through this column, I tell Ann*, 32, the sender from Mwanza who asked:

“Doc, I want to ask you one thing. Since I celebrated by 28th birthday, I have been experiencing severe pains in my abdomen during my period and this has been affecting me for a long time. What does this pain mean and how can I deal with it?

Dear Ann*

Under normal circumstances, periods should become less painful as you age—not worse.

In case you have been experiencing painful menses and this seems to be getting worse, you need to pay attention and schedule an appointment with your doctor.

Usually, the pain occurs a few days before or during menstruation and may continue for two to three days.

This pain can be sharp or dull aching and sometimes tends to come and go. It may also associate with back pain. Have you been experiencing this kind of pain, Ann?

If it’s severe and that it affects your quality of life, such as it interferes with your daily routine, then you need to arrange an appointment with a gynaecologist in Mwanza. You could begin by visiting a general physician at your nearest hospital.

Studies show that 1 in 3 women experience painful periods and which sometimes the make it hard for them to do normal household, job, or school-related activities during each menstrual cycle.

Women who are likely to experience this pain are those who started their first period at an early age (younger than 11 years) or have family members with the condition.

If you are overweight or obese, smoke cigarettes or you don’t do regular exercises you are at risk.

How to deal with the situation?

These are suggested tips if you want to ease the pain.

• Apply a heating pad below your belly button.

• Do light circular massage with your fingertips around your lower belly area.

• Drink warm beverages.

• Keep your legs raised while lying down, or lie on your side with your knees bent.

• Take warm showers or baths.

• Exercise regularly.

• You can take over-the-counter pain medication, such as ibuprofen. Start taking it the day before your period is expected to start, and continue taking it regularly for the first few days of your period.

However, make sure you communicate with your doctor for evaluation.

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Monday, August 21, 2017

Here are three ways you can detect cancer in its early stage

 

By Dr chris sonchrispeter@gmail.com

Here is the truth: we could save countless lives affected by cancer, if we simply detected the disease in its early stages.

Take colon cancer, for example. Polyps take as long as 10 years to turn cancerous. Detecting them earlier can literary prevent the disease from developing.

I recently passed through a certain study and noted that colonoscopy [a test that allows your doctor to look at the inner lining of your large intestine] could prevent colon cancer in about 40 per cent of cases. Yet up to 70 per cent of people aged 50 and older have not done a colnoscopy.

The same is true for other forms of diseases. When it comes to cancer, early detection is the absolute best form of prevention.

What steps can you take?

1. Get (regular) screening done:

For example, I recommend colonoscopy for both men and women starting at age 50. In some cases, such as when you have genetic risk factors, you should start even earlier.

To prevent prostate cancer, I always recommend baseline PSA screening for men aged 35 to 70, every one to two years. Have a conversation about the pros and cons of prostate screening with your doctor. For those with a family history of prostate cancer, ask if screening should begin even earlier.

For women I recommend yearly mammograms after age 30 to help prevent breast cancer. In addition, schedule a ‘pap smear’ every three years from 20s to 60s; it’s highly effective way to screening for cervical cancer.

Start the process by having a yearly check-up with your doctor. Ask about what screenings matter most for you.

2. Know your family history and act accordingly:

Your doctor can help you gather your family health history. Family history is much more than a trip down memory lane. Your genes play a major role in many types of cancer. If cancer runs in the family, genetic counseling, and often early screening, can make a major difference in detection and prevention.

For example, the genetic condition, so called Lynch syndrome, raises the lifetime risk of colon cancer to more than 80 per cent for men and more than 40 per cent for women. If this condition runs in your family, you need to start colonoscopy at 20s.

Breast cancer offers another example. If you have mutations in genes such as BRCA1 or BRCA2, your doctor will want to monitor you more closely and discuss possible options such as preventive mastectomy.

3. Take control of what you can:

Lifestyle changes and choices make a proven difference in preventing cancer. For example;

· Lower your risk of lung, throat, and other cancers by quitting smoking.

· Avoid skin cancer by opting out of tanning beds or excessive sun-bathing.

· Minimise your risk of liver cancer by drinking only in moderation or quitting it all.

· Reduce the likelyhood of breast cancer, and other cancers, by engaging in regular exercise and a smarter diet to keep your weight in a healthy range.

Prevention and early detection depend largely on you, the patient. Control what you can and start a lifelong habit of regular checkups.

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Monday, August 14, 2017

Willingness to pay for treated bed nets

A mother and child resting under the mosquito

A mother and child resting under the mosquito net. PHOTO | FILE 

By Syriacus Buguzi sbuguzi@tz.nationmedia.com

Tanzanian policymakers could increase the coverage of Insecticide Treated bed Nets (ITNs) in malaria-endemic areas by capitalising on the people’s willingness-to-pay for them, a study says.

Researchers in the study published last month in the Malaria Journal say this can be done in conjunction with other public sector distribution channels.

Findings from a study published July in the journal, involving 800 households in Ruvuma and Mwanza regions suggested that there is a private demand for nets in Tanzania which could potentially supplement future campaigns to increase the coverage of ITNs in the country.

Since 2008, the World Health Organisation (WHO) has recommended universal coverage with ITNs in Sub-Saharan Africa, in the effort to reduce malaria morbidity and mortality. The aim is to provide one ITN for every two people in regions of high malaria transmission.

When people are willing to pay for the nets

In Tanzania, there have been campaigns to ensure free access to ITNs to children under the age of five from 2008 and 2010 and free universal coverage campaigns in 2010, 2011 and 2015.

However, during the recent study, titled: Demand and willingness-to-pay for bed nets in Tanzania: results from a choice experiment, Prof Chris Gingrich from Eastern Mennonite University and a team of researchers from Tanzania found that households in the two regions studied preferred ITNs with certain market characteristics, such as size of the ITNs, shape and whether they were treated with insecticides or not.

The study targeted parents of school children. Out of those who were interviewed, 40 per cent chose to buy a net across all seven combinations of net prices and characteristics such as size, shape, and insecticide treatment which were selected for the study. Only 8 per cent of all participants chose not to buy a single net, said the study.

A key factor influencing demand was whether a participant’s household currently owned sufficient nets for all members. People in rural areas showed lower net coverage and greater demand than urban participants, the study found.

The study concluded, “Net manufacturers and retailers should advertise and promote consumers’ preferred net attributes to improve sales and further expand net access and coverage.”

Gingrich, who is Economics Professor, said free distribution of ITNs should no longer be the sole means of ensuring the coverage of ITNs.

He said,“… mass distribution campaigns of free nets need not be the sole means of dissemination since most households also show a willingness to pay for supplementary nets where needed.”

“To encourage purchases, private net sellers should promote those characteristics the study found that households value most, namely square shapes, large sizes, and pretreatment with insecticide.

Consequently, net coverage and use should increase, thereby reducing malaria incidence.”

The challenge

During a study funded by United States Agency for International Development (USAID) and the US President’s Malaria Initiative (PMI), the researchers preferred to interview households in Manyara and Ruvuma.

“…because these regions had had been recently involved in bed net programmes under the national subsidised voucher scheme for pregnant women and infants from 2004 to 2014,’’ said Dr Amos Kahwa, a researcher from the National Institute for Medical Research(NIMR); who co-authored the study.

“We had an assumption that the recipient households would show little interest in buying additional nets. But we realized there was a class of people who valued the nets to an extent that they were ready to purchase them as long as they had marketable attributes,’’ Dr Kahwa said.

Dr Kahwa said that it was important to do the study now because the bed net coverage in Tanzania was facing challenges. “There are people who were given free bed nets and they chose to use them for other purposes such as turning them into fishing nets. There was need to reassess the demand characteristics for the nets and find out whether people value them.”

Experts’ take

But, a Tanzanian Epidemiologist based in Dar es Salaam who did not take part in the study, Dr Frederick Haraka, said the idea to increase ITNs coverage is indeed logical, but, he suggested it needs to be tested before it could be circulated widely.

Another researcher who didn’t participate in the study, Dr Peter Asilia from Ifakara Health Institute (IHI), believes that when it comes to malaria prevention through ITNs, it’s high time people were empowered to decide on what works best for them.

“We, as stakeholders just need to improve from the angles where they [the people] can’t go above, instead of using the vertical approach in any intervention that touches the community well-being,’’ Dr Asilia told Your Health.

Currently in Tanzania, 90 per cent of the population live in areas that carry a high risk of malaria transmission, the National Malaria Control Program reports.

Tanzania has the third largest population at risk of malaria in Africa, says malariaspot.org and each year, 10 to 12 million people contract malaria in the country and 80,000 die from the disease, most of them children.

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Monday, August 14, 2017

Here are basics you need to know about cancer of the blood

 

By Dr Chris sonchrispeter@gmail.com

Cancer vary, some are fatal, some have little impact on your quality of life and some can rapidly change your outlook towards life.

With this, treating cancer is changing rapidly-the outlook has never been better.

Speaking about cancer of the blood, there are three main types of it.

1. Leukaemia

Although leukaemia is a cancer of white blood cells, other white blood cells are affected because the bone marrow is too busy making these abnormal cells to make red blood cells or plateletes, which help your blood clot properly. That means symptoms include:

• Tiredness, breathlessness or dizziness due to anaemia.

• Abnormal bleeding (such as bruising without an injury) because of low platelet levels.

• Serious infection because the cancerous white blood cells don’t work properly in fighting off infection.

Most childhood leukaemias can be cured, and treatment for chronic leukaemia can slow down progression for years.

Remember!

Certain medication especialy tablets like asprin can also make you more prone to bleeding. Do get abnormal bleeding checked.

2. Lymphoma

The most common symptom of lymphoma is swollen lymph glands that do not disappear. They can also cause sweating (especially at night), tiredness , fever, weightloss and itching all-over the body.

There are two main types of lymphoma.Hodgkin’s lymphoma can occur at any age but it is in its peak at 20s and over 70s. Most people with Hodgkin’s lymphoma can be completely cured with chemotherapy and sometimes radiotherapy too.

Non-hodgkin’s lymphoma, most commonly affect people of over 60 and although actual data are yet to be collected, thousands of people are diagnosed every year in Tanzania. The outlook and the treatments vary with how fast-progressing the lymphoma is. Fast growing lymphomas can often be cured with chemotherapy. Slow-growing lymphomas are less likely to be cured but treatment can reduce your symptoms and they may not progress for years.

Remember!

A few raised, tender glands in one part of your body are much more likely to be due to an infection than due to lymphoma. If you have other symptoms or they don’t settle, see your doctor, but remember, most swollen glands are not caused by cancer.