Kilmarx returns from Sierra Leone

The Country Director for CDC Zimbabwe has returned from his month long duty in Sierra Leone as the team leader of the CDC Ebola response.
Kilmarx addressed journalists yesterday in the capital courtesy of the Health Journalists Association (HeJaz).
“For the past month I was the team leader for the CDC response to the Ebola outbreak in Sierra Leone. I was there for one month in Free Town leading all our CDC responding to the Ebola outbreak. There has been a 25 percent to 90 percent of mortality rate within several days largely due to the vomiting and diarrhea fluid loss and shock,” Kilmarx said.
Sierra Leone is in West Africa and is a former colony of the British.
According to Kilmarx it has had a very challenging history civil of civil war which went on for a decade, the literacy rate is 40 percent, it does not have very strong health systems, 80 percent of the population lives on less than US$2 dollars per day and it also has the second child mortality rate in the world.
“The Ebola outbreak started in Guinea in December 2013 spread to Liberia and Sierra Leone. The first case in Sierra Leone was in May this year and has spread to very district in the country. There have been10 000 cases in Africa, 3 000 cases in Sierra Leone and it has been 50 -50 male and female with the affected being the reproductive population. The number of children and older people is small but a lot of orphans due to the fact that a lot of adults have been infected and the high mortality rates of the adults.”
Dr Kilmarx also took the time to shower praises on Zimbabwe and the work it has been doing on Ebola preparedness and response.
“I happen to be more complimentary on the work that Zimbabwe is doing on the Ebola response. Just at the baseline there are much better health systems in place already in terms of the Ministry of Health’s education, capacity and work done over the years. The laboratory quality, the communication and transportation in Zimbabwean and the work done in training and developing isolation centres, system screening going on at airports and the good and important policy that Zimbabwe has.”


Find it, Fight it and win the battle

Last Friday women from all walks of life met at the Ster Kinekor 105 (Opposite Eastgate) for October’s Girlfriend’s Getaway.
This was not just for women to have fun, get makeovers, enjoy live performances and eat popcorn watching a really good movie.
The Pink Affair at Ster Kinekor 105 helped women to learn more on about breast cancer and 25 percent of the ticket sales went towards the Cancer Association of Zimbabwe.
“The Pink Affair helped us to increase awareness on breast cancer. It was a joy to see the ladies enjoying themselves and getting information on the condition,” Grace Mtongerwa the Manager of Ster Kinekor 105 explained.
After the serious business ladies enjoyed a movie and got goodie bags.
The theme Find it, Fight it and Win the battle calls for you and I to be equipped with all the knowledge on breast cancer.
The very first thing women need to do is to get screened.
Screening is looking for cancer before you have any symptoms. This is important because it can help find cancer at an early stage. When the cancer is found early it may be easier to treat and by the time the symptoms appear the cancer may have begun to spread so the earlier the better.
“When your doctor suggests that you should be screened remember that screening tests are given when you have no cancer symptoms but if the screening test comes abnormal you may have to get more tests done and this is called diagnostic tests,” Dr Hosea Magwaza explained.

Health talk-Breast Cancer
Dr Magwaza further highlighted that breast cancer can involve a number of different types of examination
“A woman should do a breast self examination. She should check her own breast for any irregularities which may include changes in breast size or shape, lumps, nipple discharge or irregular tissue thickening.”
Step 1: Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips.
Here’s what you should look for:
• Breasts that are their usual size, shape, and color
• Breasts that are evenly shaped without visible distortion or swelling
If you see any of the following changes, bring them to your doctor’s attention:
• Dimpling, puckering, or bulging of the skin
• A nipple that has changed position or an inverted nipple (pushed inward instead of sticking out)
• Redness, soreness, rash, or swelling
Step 2: Now, raise your arms and look for the same changes.
Step 3: While you’re at the mirror, look for any signs of fluid coming out of one or both nipples (this could be a watery, milky, or yellow fluid or blood).
Step 4: Next, feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few finger pads of your hand, keeping the fingers flat and together. Use a circular motion, about the size of a quarter.
Cover the entire breast from top to bottom, side to side — from your collarbone to the top of your abdomen, and from your armpit to your cleavage.
Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically, in rows, as if you were mowing a lawn. This up-and-down approach seems to work best for most women. Be sure to feel all the tissue from the front to the back of your breasts: for the skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your breasts; use firm pressure for the deep tissue in the back. When you’ve reached the deep tissue, you should be able to feel down to your ribcage.

Step 5: Finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Cover your entire breast, using the same hand movements described in step 4
Nobody welcomes the diagnosis of cancer because nobody wants it!
However if you are in a very early stage of the disease you have an extremely good chance of it being cured.
That is why it’s important to do the physical examination.
Major treatment advances have been made in recent years and patients prospects are much more promising than they used to be.
“Treatment for breast cancer is available in several ways. This depends on the kind of breast cancer and how far it has spread. Some have surgery whilst some have chemotherapy.”
According to the Centre for Disease Control and Prevention most breast cancers are found in women who are 50 years old or older but breast cancer also affects younger women
“Some younger women are at a higher risk for getting breast cancer at an early age compared with other women their age. If you are a woman under age 45 you may have higher risk if you have close relatives who were diagnosed with breast or ovarian cancer.”
This article is not just for women only but for men also because men can get breast cancer.
In men breast cancer can happen at any age but it is most common in men who are between 60 and 70 years old. Although it is not very common, less than one percent of breast cancers occur in men.
I hope this article has been of great help to you. If you have story to share or want to give feedback get in touch with me on the following:
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Zimbabwe on Ebola

Zimbabwe has Ebola protective clothing in the event of the epidemic outbreak.
Health and Child Care Minister Dr David Parirenyatwa told H-Metro yesterday that the protective clothing was donated by the World Health Organisation.
“We have a lot of protective clothing donated by the World Health Organisation and it has already been disbursed to different isolation areas across in the country including airports and border posts,” Minister Parirenyatwa said.
Ebola protective clothing runs from goggles and head covering to gloves and boots.
The clothing which is known as Personal Protective Equipment (PPE) protects health workers from the bodily fluids that can transmit the virus from the vomit, blood, sweat and mucus.
It has a 14 step wearing process that health care workers are trained for.
“I know that there is a lot of panic and most of it is genuine because people really want to know what is true and what is not true. There is need for educating people. As a Ministry we are launching a big awareness programme and we will disseminate information on Ebola,” Minister Parirenyatwa added.
Minister Parirenyatwa urged people to remain alert and not panic.
He further added that there s need to correct an consistent information.
“There is also need for people to know the areas affected by Ebola. These are Liberia, Sierra Leone, Senegal, Nigeria, Guinea (Conakry.) Remember there is Guinea Bissau and Equatorial. So Ebola is in Guinea Conakry. Nigeria is doing so well in containing the Ebola cases confirmed there. In DRC the confirmed cases are in a remote area. It is not the whole county that is affected. It’s important to contain the disease. It’s important to keep guard,” Minister Parirenyatwa added.
Recent reports from Sierra Leone reveal that the country confined its six million people to their homes from last week Friday to yesterday (Sunday.)
The West African Country began what it believed to be the most sweeping lockdown against disease since the Middle Ages.
Health officials said they planned to urge the sick to leave their homes and seek treatment.
More than 2 600 people have died in West Africa over the past nine months in the biggest outbreak the virus ever recorded with Sierra Leone accounting for more than 560 of those deaths.

Ebola: What you need to know

A man runs towards the market place screaming Ebola, Ebola, Ebola.
People start screaming, commotion takes the centre stage with men and women running in different directions.
This is the scene of a video that has gone viral on many social networks.
Should people run away when they hear the word Ebola, how careful should we be now that the disease is killing people in West and Central Africa?
What do you know about Ebola? How best can you raise awareness and share the information on Ebola with your family, friends and relatives without causing alarm and despondency.

Certain facts have to be driven correctly in order for people to debunk the myths around the disease.
Firstly, there is NO case of Ebola in the country as some hoaxes have been spread on social networks.
“Ebola is a viral disease which is caused by the Ebola virus commonly found in West and Central Africa. The host of this disease is fly birds that are habitat in thickets and in monkeys which are found in Western and Central Africa. The virus does not cause sickness in its natural host but in people,” Dr Prosper Chonzi the Harare City Director of Health Services explained.
Dr Chonzi also highlighted that the most common feature of the disease is a running temperature of 38.8 degrees and above.
When nearing death by Ebola a person may start bleeding from everywhere.
“The incubation period of someone with Ebola is 21 days so between two to 21 days most patients might show the signs of Ebola. However the most common time in most patients is eight days,” Dr Chonzi added.
Flue like symptoms, weak joints, loss of appetite, vomiting, lesions and diarrhea are some of the symptoms of Ebola as it progresses.
When one starts bleeding from the nose, anal, vagina, eye and ears among other places within a week they will die from shock. That is also why is it’s also called the Ebola hemorrhagic fever.
What exactly are the modes of transmission?
“Direct contact with a person who is infected or symptomatic is one of the modes of transmission. If you are not wearing protective clothing and you get in contact with an infected person’s sweat, saliva, semen or any other bodily flood you can get Ebola. If you also get in contact with the clothes that an infected or a symptomatic person you can get infected. Ebola is unlike cholera where you have to take orally the sickle matter of an infected person. Mukukwazisana, kusvipirwa, kugumana ndipo panobatirana Ebola. The other way it can also be transmitted is when you get in contact with the infected/symptomatic person’s linen, vomit, diarrhea or syringes, kugumana ikoko,” Dr Chonzi further elucidated.
How then can health personnel distinguish that someone has Ebola?
“Firstly the person has to have a positive history travel to West and Central Africa places like Liberia, Sierra Leone, Guinea, Nigeria and Congo. We check if the person has travelled to the worst affected areas in the last 21 days. We also ask the person if they have been in contact with someone who has been to those places. For those that are coming from West Africa when they come here we screen them first at all ports of entry. We check their temperature. We get details of where they are staying and we visit them everyday checking their temperature, checking if they are not sick or showing signs of Ebola. We put them under surveillance. This means that we want to know the places they have visited when they are in the country. We encourage them not to visit too many places but to keep their areas of visits lower so that if they do start showing signs of Ebola, we know where to go and who to take in for testing.”
How is Zimbabwe prepared in the event that we do have a case of Ebola or a suspected case?
“Every case or suspected case of Ebola from Harare is to be handled at Wilkins Hospital. We have a dedicated team of trained health personnel and ambulances dedicated to that. As soon as a case or suspected case is taken there we will seal off Wilkins Hospital. All the patients that collect their drugs or are treated at Wilkins Hospital for TB, or collect their ART will start using the Nazareth Hospital.”
“We have six teams and a rooster that is operational as we speak. Each team is headed by a medical doctor and each team has an infection control nurse, nurses and a nurse aide. There are also environmental health people to disinfect each team. Each team works for four hours.”
“The new Start Centre at Wilkins Hospital is the changing room. They leave their home clothes there and change into gowns like people going into theatre. They then go for the donning process which has 14 step defined steps. They have steps of wearing the gloves, boots, apron, space suit and goggles. An infection control nurse checks the whole process to see that they are wearing the protective clothing properly. They approach the ambulance where patient is wearing protective clothing. When they are done with their shift, the area is disinfected and their protective clothing is disposed off. We are supposed to have a lot of protective clothing but at the moment we only have the clothing given to us by the World Health Organisation.”
In the event that a person infected with Ebola dies, Dr Chonzi said the relatives will only be informed but they will not be allowed to collect the body for burial. Our trained staff will take care of the burial and we have a dedicated spot at Granville Cemetery where we will be burning the Ebola victim. Everything will be supervised. We cannot give families the body for them to do their rituals because it will be contaminated. It’s unfortunate that they will not take part in the burial processes as well but it’s for the better.”
In the event that the outbreaks occurs negatively i.e when people die in homes, the bodies will be taken directly from the homes to the cemetery. A team of trained personnel from Doves and Nyaradzo are already in place for that. We have eight vehicles from both companies that have been set aside. Those cars will not be used to ferry people that have died of any other diseases except for Ebola. The drivers will be wearing protective clothing and we have trained them to disinfect the house before going in and also to disinfect the bodies. Our health personnel will already be at the site by the time the collection of the body is done. Our environmental health team will be at the place to make sure that they also disinfect the whole area and talk to the people and find out who has been taking care of the patient.”
In Liberia they are burning everything that the deceased wore, the bed or mattress and everything that was used when he was sick.
In Zimbabwe Dr Chonzi said they will very radical and destroy whatever the deceased was using.
They will be no funeral; people will not be allowed to meet for the funeral because it would be easy for the disease to be spread easily because the people will not have any idea of who was taking care of the patient.
Many doctors, nurses and others have been trained.
“Health personnel have been trained that if there is a high index of suspicion then the health person should wear protective clothing before they attend to the person. You don’t want to rush into touching them without protecting yourself.”
Dr Chonzi is so highly trained when it comes to these diseases. He has been heading the teams that have been training people on Ebola in the country.
Council Clinic employees have been trained and people in private practice have been trained.
Another local medical doctor has just been in Brazzaville receiving training and will be training trainers who will be dispatched to all provinces in the country.
I hope this article has been of great help to you.
Do get in touch with me on the following
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Twitter: @healthtalkwithmelody

Live, Love, embrace them

She takes off her dark sun glasses and the cloth covering her eyes to reveal her skin that has turned red.
Her left eye is closing; blood comes out from three tiny holes near her ear.
“It’s very painful; and I am in need of help,” Shekeni Ncube says.
The 45-year-old woman is many of the few people affected with albinism that have skin cancers.
The lack of pigment blocking (ultraviolet radiation) increases the risk of melanomas (skin cancers) and other problems in people living with albinism.
“The problem started in 2006 when I was diagnosed with cancer. It started as an open sore which was not healing. I sought medical attention for it and I was referred to Dr George Mukhari Hospital in South Africa where they diagnosed me with cancer of the skin. They told me that the cancer had spread so they had to remove the skin that had been ravaged by the cancer and perform skin grafting afterwards”
Skin grafting is a type of graft surgery involving the transplantation of skin.
The transplanted tissue is called a skin graft.
Specific surgeries that may require skin grafts for healing to occur are most commonly the removal of skin cancers.
In Shekeni’s case the cancer had damaged her left lower eye lid, ear and part of the nose.
The doctors told her that there was a possibility the cancer would re occur.
“It has come back again and I need to go back for treatment. It has affected my eyelids and they need reconstruction. My eye sight has not been affected. Just next to the ear there are three holes which are gushing blood. The holes have an infection and are cancerous.”
Skin cancers are not the only problems that people affected with albinism face.
Besides melanin giving your skin, eyes and hair its colour, melanin protects the skin from the sun.
Without enough melanin the skin won’t be able to protect itself.
Shekeni was born in a family of nine children.
Both her parents were not affected and only one of her siblings was affected with albinism.
People with albinism have little or no melanin, which is a chemical that colors our skin, eyes and hair.
“My parents gave me the same treatment as my siblings. The problem came when I started going to primary school. The teacher who was supposed to teach me flatly refused and she cried saying she did not want to teach an albino. If it wasn’t for my mother’s friend who was a teacher at the same school who offered to teach me, I don’t know what would have happened,” Shekeni added.
That was not the only problem that Shekeni faced.
Some children at the school called her rude names like “nguruve, musukupete, murungudunhu and mungawu.”
“The calling of names reduced my morale. I was psychologically affected by this and was shattered. I only had relief when I came back home to a supportive family.”
Despite all the problems, Shekeni was intelligent and she passed with flying colours.

After excelling in primary school, she was enrolled at an all girls’ boarding school which is known for academic brilliance.
At this school (name provided) she suffered a major lapse.
“We studied a book that talked about the lives of people affected with albinism. It revealed that children born with albinism long long ago were killed while some were hidden in clay pots by their parents only to be killed later by some people.”
This had a negative impact on Shekeni who was teased by her dormitory mates who said, “dai wakazvarwa zvichakadaro wairaswa iwe.”
Shekeni contemplated suicide when she was 16 years old because of that.
Her parents did not have answers on how and why she was born like that.
Most forms of albinism are recessive which means that a child inherits one abnormal gene from each parent.
Most children with albinism are born to parents with normal pigmentation.
These parents like one in 75 people are carriers for albinism.
A carrier is someone who has one abnormal gene and one that functions normally and because the functional gene overrides the normal one, these people do not have albinism themselves; however they are still able to pass the abnormal gene on to their child.
“I was affected a lot by the nasty things that were said to me. I do not want anyone to go through the same stresses I went through. I was depressed when I was in high school,” Shekeni added.
During her adolescence, she was fancied by a boy from her neighborhood.
The boy was not affected by albinism and his family did not like Shekeni.
She ended the relationship.
Later on she was also fancied by a boy who was forced by peer pressure to end the relationship.
“It didn’t affect me because I had experienced it before. The third boy I met is now my husband. I have been with him from the time was 24 and together we have four children of our own and one adopted. My husband and our kids are not affected with albinism. His family did not have a problem with me. I had fears that my children would be affected with albinism,” Shekeni explained.
Albinism affects people of all races and ethnicities and is much more common than most people think. In fact, one out of 17 000 people worldwide has some form of albinism. In some populations, it occurs in one out of every 200 births.
Parents of children with affected with albinism go out of their way to make sure their children are comfortable in every area of their lives.
One such person is Loveness Mainato.
The strong spirited woman was not born with albinism but has two children affected with it.
She has formed an organisation called Albino Charity Organisation of Zimbabwe (ALCOZ).
“People with albinism always have problems with vision, the degree varies greatly. Some are legally blind while others have vision that is good enough to drive a car. Most are able to read without using Braille. However we do encourage learning institutions to be patient with children affected with albinism. When they write on the board they should increase the font size, use white on black or vice versa and not use bright colours/markers and chalks like pink.”
Loveness highlighted that people with albinism are human beings who should be treated fairly.
“Sometimes they have good qualifications for a job and they are assured that the job is theirs but when they met with the employer, the story changes. Some face problems with landlords who do not want to accommodate them.”
Many people who still segregate people are misinformed.
There are certain weird myths around people living with albinism that makes them outcasts.
Let us dispel these myths
It is thought that having sex with a woman with albinism will cure a man of HIV, as a result many women have been raped: THIS IS NOT TRUE. HIV has no cure.
Individuals affected with albinism are sterile. THIS IS NOT TRUE. People with albinism are capable of reproduction
People with albinism are regarded cursed. THIS IS NOT TRUE. They are not cursed.
It is also thought that people with albinism live a short life. THIS IS NOT TRUE. They can live long lives just like people who are not affected with albinism.
I hope this article has been of great help to you.
Do get in touch with me on the following
Facebook: Health Talk with Melody
Twitter: @healthtalkwithmelody
Shekeni is in need of more than US$10 000 for the treatment. If you would like to help Shekeni please contact her on O774 650 883 OR 0772977024 (Both numbers register with Ecocash) OR CBZ Kadoma Branch 61760984120016 or contact Loveness Mainato on 0773468122

Breastfeeding A winning goal for life

I remember vividly the first time I held my baby with the intention of breastfeeding her.
I was a first time mother and I had mixed emotions, excited scared and confused.
I carefully placed the tiny head in my left palm and directed the tiny mouth to latch onto the breast.
The innocent being would not latch.
I rubbed the breast on her soft lips, she still did not budge.
Her eyes were wide open staring at me.
I looked at the nurse my eyes pleading for help.
She squeezed the baby’s cheeks.
For a moment I thought she was hurting my baby.
As soon as the tiny mouth opened, I quickly put the breast into the mouth.
My baby looked at me and started suckling.
I was overjoyed.

You see I had been scared that she would refuse my milk, not for any reason, but I was just scared.
It might sound very petty but most first time mothers experience this.
We all want our babies to breastfeed.
The support I got from the nurse was very crucial.
She came to check on me often to make sure that I was doing well and my baby was breastfeeding.
No one should assume that because you are pregnant, you know how to breastfeed.
That is why the new brochure led by World Health Organisation and UNICEF and developed jointly by Nutrition and Maternal, Newborn and Child Health colleagues on the crucial link between breastfeeding and newborn survival and health clearly emphasizes that the ten steps to successful breastfeeding include the training of doctors, nurses and midwives and community health workers to provide counseling and support within an hour of childbirth.
It is the early initiation to breastfeeding that is key to the survival of our newborn babies. However statistics show that less than 50 percent of newborns are breastfed in the first hour of life
We have had so many times that it helps us in bonding with our offspring.
Is that all? NO.
Breastfeeding is a winning goal that saves lives.
Initiating breastfeeding in the first hour of life lays the foundation for optimal breastfeeding which consists of feeding only breastfeeding (not even water) until a child is six months old and continued breastfeeding along with safe and age appropriate complementary food up to two years or beyond.
And why is it so important that this is followed?
Studies show that a newborn first absorbs colostrum (first milk) that is rich in nutrients and antibodies.
Before we go any further let me debunk a very popular myth I grew up hearing.
Pregnant women are told that when you are breastfeeding for the first time squeeze out the milk on a towel or onto the ground.
“Mukaka iwowo imvura mvura haunakire mwana” (The first milk is too watery and it’s not tasty for the baby).
However the FACT is that that the “first milk is all the baby needs in the first few days of life!”
Feeding that milk will also help the mother to produce more breast milk.
Have you ever wondered why when your baby is not well health care providers tell you to continue breastfeeding the baby at all times?
It’s not only because the baby is hungry but because the milk has antibodies.
When you breastfeed your baby within an hour of birth you also protect yourself your health and reduce the risk of post partum hemorrhage.
Optimal breastfeeding of infants under two years of age has the greatest potential impact on child survival of all preventive interventions, with the potential to prevent over 800,000 deaths (13 per cent of all deaths) in children under five in the developing world (Lancet 2013).
UNICEF says breastfed children have at least six times greater chance of survival in the early months than non-breastfed children.
An exclusively breastfed child is 14 times less likely to die in the first six months than a non-breastfed child, and breastfeeding drastically reduces deaths from acute respiratory infection and diarrhea, two major child killers (Lancet 2008).
“Virtually every mother can breastfeed, if given appropriate support, advice and encouragement, as well as practical assistance to resolve any problems. Studies have shown that early skin to skin contact between mothers and babies, frequent and unrestricted breast feeding to ensure continued production of milk and help with positioning and attaching the baby increase the chances of breast feeding being successful.”
Misinformation and lack of early support can keep mothers from breastfeeding and expose newborns to infections and inadequate nutrition.
Some breastfeeding mothers may need help to improve the way the baby takes the breast into the mouth to ensure good attachment so the baby can suckle effectively.
If the baby does not latch well it may result in the mother’s nipples cracking.
The nipples will be very painful and this may cause discomfort when breastfeeding.
An infection might also come about.
A visit to the nearest health care provider is essential.
Babies need more opportunities to breastfeed. They should breastfeed “on demand” day and night at least eight times during a 24 hour period.
A baby should be allowed to breastfeed until he or she releases the breast and looks away satisfied and sleepy. It shows that the baby has had all they want from the breast and can be offered the other breast and may or may not want it.
For working mothers who travel a lot, you can continue to breastfeed your child when you return.
You should breastfeed as often as possible when you are with your baby and express your breast milk and dispose of it when you are apart.
After six months of age when babies begin to eat foods, breastfeeding should continue for up to two years because it is an important source of nutrition, energy and protection from illnesses.
Enjoy the rest of the World Breastfeeding Week!
Get in touch with me on the following:
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BOTH men and women are affected by sexual problems.
Today I have decided to talk about the sexual dysfunctions in men.
I embark on a journey to talk about an issue that rarely finds itself in discussions.
Many a time talks are centered on additional pressure on men to perform at their zenith.
These talks shut the door on some candid talk that some will be in need of.
Sad but true, many men face problems of sexual dysfunction and cannot present the problems to doctors let alone their friends.

Health Talk-Dr Kavai seated and Dr Mapondera
Men’s sexual health has some stigma attached to it.
In our society men feel they can’t present to a doctor with these problems or feel ashamed to present with these problems because there is a certain stigma attached to it zvinenge zvakunzi murume arikuda kuiita musikanzwa or akasungwa so men are fearful to present with these problems. It’s time that men’s issues be addressed because men are humans just like us and they have real problems.
To remove the stigma attached to it, I spent some time at the newly opened Men’s Clinic in the capital with two medical professionals, Doctors Hosea Mapondera and Advance Kavai who imparted their knowledge of men’s sexual health.
The two doctors who have a strong passion of keeping men alive shared on the subject of sexual dysfunction in men, an issue they deal with at their clinic.
“Men have been neglected in society everything out there from Non Governmental Organisations to donors they cater for women’s issues, from breast and cervical cancer awareness and screenings. Men actually have real problems. Problems that face men are several; things like prostate cancers men don’t have to die from it. There’s not much of it in terms of awareness and screening,” Dr Mapondera clarified.
Men’s sexual health deals mainly with three main issues. The first issue is that of impotence.
Impotence can be split into three can be split into three categories being erectile dysfunction, premature ejaculation and low libido.
“Erectile dysfunction is failure to get an erection or sustain an erection while you have it for satisfactory sexual intercourse while premature ejaculation is when you ejaculate within two to three minutes of penetration,” Dr Mapondera said.
To understand erectile dysfunction it is important to understand the normal mechanism of an erection.
“Men are stimulated by their senses either visually or through the auditory sense when a woman whispers sweet nothings in to their ear,
or through the olfactory sense or the sense of smell nostrils just what a woman cooks has an impact on the libido , the way the food is arranged in the plate also plays a part in the man’s libido,” Dr Kavai added.
Men’s sexual problems have repercussions because if a man is not performing well in the house he might go out believing that he will perform better outside the house.
That guy will go out and have a small house and pick up sexually transmitted diseases or HIV and bring back them in the home.
His wife because she is not satisfied will begin to nag and cause problems which cause stress and worsen the situation.
She might go out to look for sexual satisfaction outside the home and this leads to broken homes, kids being raised without both parents, the impact to society is quite big.
“When a man is aroused the signals meet in the brain where they are integrated and they are transmitted down through the nerves to the male organ. Once at the male organ there is release of neurotransmitters . The neurotransmitters cause the blood vessels in the penis to release a chemical called nitric oxide which is a powerful vasodilator that when released in the body opens blood vessels. This chemical then results in blood vessels in the penis opening up wide, blood rushes into the penis and just like someone blowing air into a balloon it then stands,” Dr Kavai added.
Anything that affects a man’s brain, a man’s nerves or man’s blood vessels will affect sexual function.
If a man is stressed or depressed it means the integration of signals in the mind is not as efficient and if a man has spinal trauma for example a man is involved in an accident and they become quadriplegic or paraplegic the injury disrupts those neuronetworks that go to the penis or is a man has cancer which may spread to the spinal cord and it cause damage to the spinal cord thus affecting their sexual health.
“There are chronic illnesses which are becoming more and more common nowadays and the non communicable diseases like hypertension diabetes mellitus, obesity and cancers they all impact on sexual function for example diabetes destroys the nerves, your nerves don’t work efficiently. Hypertension hardens the blood vessels they don’t open wide enough even the drugs for like HCTs for such men switching them to a different medication will solve it,” Dr Mapondera enlightened.
Dr Mapondera further highlighted that premature ejaculation causes are mainly psychological.
“It can be situational or global. Situational occurs with certain partners for example a man will ejaculate prematurely with his wife. Global means the man will ejaculate prematurely with other sexual partners or with all sexual partners so it’s almost the same causative factors as with erectile dysfunction and the basic is usually have to do with diet, weight and any other chronic illnesses they may have but the major component is psychological so with low libido they are more or less causative mechanism.”
All these problems can be treated.
Counseling is a major part of managing these conditions,
Usually when you know the causes of a problem you rectify, that’s a standard way in which medicine is practiced
They are medical things that can also be done.
Certain medicines can be prescribed and the most common drugs that are given are the phosphodiesterase inhibitors like the Viagra’s, an enzyme involved in the pathway of burning up the blood vessels
“The problem is that these Viagra’s are taken by mouth what they then do is that when they circulate throughout the body they start opening blood vessels everywhere, in the brain nostrils in the circulatory system and cause problems like nasal congestion and headaches. In someone who has had a chronic heart disease if they just open up blood vessels throughout the body it may cause a certain drop in blood pressure which may lead to a heart attack so these are dangerous,” Dr Mapondera added.
Unfortunately this is what you are finding at street corners in the forms of teas and coffees.
These “sex enhancing” teas and coffees contain an analog called sildenafil (the chemical name for Viagra) and can cause serious health problems. It’s a potential medical crisis waiting to happen
“Before you prescribe Viagra you need to do a full physical assessment on a person. They need an ECG. You need to know how their heart is performing. Do they have any problems with their heart?’ Dr Kavai said.
However a safer treatment has been developed.
The Men’s Clinic uses this.
It is called the intracavernous injections.
Intracavernous injections are injections which contain powerful vasodilators which are injected directly into the penis.
A standard diabetic needle is used.
Medicine is filled into the injection depending on the dose and put into the injector device.
It is then injected into the penis.
The medicine flows throughout the penis and opens blood vessels and the man can get an erection in ten minutes
The erection goes down within an hour or two.
Once they are at home if they are sexually stimulated their blood vessels are now hypersensitive they respond much better to their internal hormones.
“Research has shown that men who are injected every third day for six months 90 percent of men are cured of erectile dysfunction,” said Dr Kavai.
These medications are not an overnight thing.
For years some men believed that sexual problems were a normal part of growing older or an evil spell cast on them
Fortunately changing attitudes and medicine have debunked this myth.
As a man you should be comfortable in talking about sexual problems to your partner or health care provider.
There is no reason for you not to remain sexually active well into your 70s and beyond.
Till next week seek help, support and enjoy your life!
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Planning families, saves, lives and money

Family planning currently saves the lives of 4 300 children every year by allowing couples to time pregnancies better and avoid high risk pregnancies.
A research done by the Futures International Group also indicated that the uptake of family planning services can increase the number of children’s lives saved to 6 900 annually by 2020 or 2 600 more per year than in 2014.
“The bottom line is, the economic and health analysis we did indicates that family planning saves lives. Through increased use of family planning that promotes birth spacing fewer children die before the their fifth birthday, fewer women die because of pregnancy and delivery related causes at the same time family planning contributes to savings in the health sector because women and children don’t need to use health services as often because they are healthy,” explained Dr James Gribble from Futures International.
The key background indicates that Zimbabwe has committed to increasing its Contraceptive Prevalence rate (CPR) to 68 percent as well as decreasing its unmet need to 6.5 percent by the year 2020, the last observation (Zimbabwe Demographic Health Survey 2010-11) measured CPR at 59 percent and unmet need at 13 percent.
Increasing the uptake of contraceptives and adding long acting permanent methods to the mix of available contraceptive options will save the lives of 15 000 mothers between 2014-2010.
In addition to that family planning also saves money due to the fact that every pregnancy in which the mother seeks healthcare has associated costs.

These costs can escalate quickly if the mother experiences complications.
As a result of family planning, Zimbabwe saves US$14.2 million per year in the cost of providing maternal and child healthcare.
Expanding access to and uptake of family planning services could see these savings rise to US$22.8 million for a cumulative savings of US$128 million between now and 2020.
Currently every US$1 spent on family planning saves US$1.52 in direct healthcare costs in Zimbabwe.
Increasing uptake of long acting permanent methods can increase these savings to US$1.85 per dollar spent.
According to a new booklet titled “How Family Planning Saves the Lives of Mothers and Children and Promotes Economic Development,” Zimbabwe’s Contraceptive Prevalence rate (CPR) is one of the highest in Africa at 59 percent. However from 2006 to 2011, the percentage of married women using contraceptive declined, while the number of children per woman (the total fertility rate) increased from 3.8 to 4.1.
Currently, family planning averts approximately 310 000 unintended pregnancies in Zimbabwe each year.
By investing in family planning now, the country can increase this number to almost 500 000 per year by 2020.
According to the World Bank Development Indicators, In Zimbabwe 1 in 53 women will die from maternal causes.
Pregnancy and delivery can be a dangerous time for mothers. By extending the interval between and reducing the number of pregnancies and births a woman experiences over her lifetime, family planning helps women avoid health complications.
According to the World Bank Development Indicators, 8 in 100 children die before their fifth birthday.
When a woman and her partner can control the amount of time between a birth and subsequent pregnancy “spacing” they are better able to take care for their unborn child.
Family planning is a cross cutting human rights issue that allows women and couples to take control of their reproductive health and choose the family that’s right for them.
Women are free to participate more fully in the workforce and parents can invest in better food for their families and education for their children.
Government’s commitment to increase awareness and access to affordable, accessibility and quality Family Planning services in the country is best demonstrated by the setting of the Zimbabwe National Family Planning Council (ZNFPC) a parastatal under the Ministry of Health and Child Care established by an act of Parliament in 1985.
“Despite the economic and social challenges currently bedeviling the country, the ZNFPC has committed to lead and coordinate efforts that have registered notable achievements in Family Planning. With support from donors such as DFID and USAID access to family planning has been further strengthened by the availability of family planning commodities in all health facilities through the Delivery Team Top Up System. This procurement and logistics infrastructure has reduced the stock out rate of all Family Planning commodities and condoms to below five percent. It has become a best practices example which other countries have come to learn from,” Minister David Parirenyatwa said recently.
With Technical and financial support from UNFPA, the country’s long term partner in reproductive health and family planning, ZNFPC is in the process of developing a new Family Planning Strategy (2014-2010) to revitalize government’s efforts and help achieve the ambitious 2020 targets.
If Zimbabwe manages its population growth it will have more resources to invest in education, water and sanitation, preventing communicable diseases and for maternal and child healthcare.
Investing in family planning use can save Zimbabwe nearly half a billion dollars in development costs.
As Minister Parirenyatwa put it,
“Investing in family planning is investing for the future.”
Let us plan our families until next week, stay blessed.
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Depression after delivery

Chenai arrived at the hospital and started the pre birth check in process.
She was alone and had no one to help her with her heavy bag.
A nurse aid was called in to help her as the hospital clerk saw that Chenai seemed overwhelmed.
She seemed too have forgotten her personal details and was frantically taking things out of her handbag.
After the process she was admitted and was attended to by a nurse who saw that she was teary.
“I can’t do this. It’s too difficult. Why is life so difficult? What am I going to do, how will I look after the bay?’ Chenai asked herself.
From the time that she found out that she was pregnant Chenai did not receive any support from her family. Her boyfriend refused to take responsibility of the pregnancy while her family disowned her.
After prolonged labour Chenai finally gave birth to a baby boy that weighed two kilograms.
When she was taken from the labour room to the ward, Chenai refused to breastfeed her baby.
The baby cried until nurses came to see what was troubling him.
They saw him lying in the cot bed with Chenai sobbing her face buried in her hands.
Chenai is one of the many mothers who are faced with depression after pregnancy.
The depression has serious potential risks for mother and fetus.
In Chenai’s case it led to prolonged labor and low birth weight.
“Stressful situations unplanned pregnancies, pregnancies without support depending either how the partner is responding to the pregnancy or how other family members are responding to it can lead to the woman having serious anxiety problems which can lead to depression. Fears can trigger serious mental problems but if there is a supportive partner, family environment these are transit problems that the woman can cope with,” explains Doctor Mugove Gerald Madziyire a Gynecologist and Obstetrician.
Almost every woman goes through lots of anxiety more so in the first pregnancy considering first the liability to carry the pregnancy successfully and delivering successfully.
It’s basically fear of the known, some women have heard many stories about labor. They have heard many frightening stories about labor.
Some have heard of other women who have died due to the process of child birth or babies that have come out abnormal.
All the things cause anxiety and varyingly in the absence of a supportive environment can make someone to go through pregnancy in a state of anxiety disorder where they are very unsettled and once people are unsettled they have sleep disturbances sometimes they have tension headaches
The majority of mental problems are happening after delivery which is called the post partum period.
“In the ante partum period there are some disturbances related to the hormonal changes happening. The hormones are coming from the placenta and affect the brain. This is what we call hypothalamus of the woman. They are minor moody disturbances they get swinging emotions. They are sometimes depressed sometimes they are happy and they can react in unpredictable ways but this is never so serious in women who have never had mental illnesses but for women who have heard existing mental problems or with a known psychiatric history, pregnancy can trigger even episodes which may require psychiatric evaluation or psychiatric admission.” Dr Madziyire elucidated.
If someone has been depressed before and they are now pregnant they have to be followed more closely.
With post partum blows most women start getting episodes of either anxiety depression for many its transit, it goes away with the support they are getting from family members in the minority of women it progresses to severe depression which requires the attention of psychologists and psychiatrists.
Its more predictable in women who have had history of depression before .Those need to be watched out if they have progressive depression.

They can commit suicide or infanticide and health workers need to see the responses.
Is she tearful always tearful?
Some have suicidal thoughts like, “life is not worth it.”
Some are psychotic and lose their minds
They start shouting and hallucinating.
They identify the baby to some strange object. They may want to harm the baby or refuse to feed the baby.
Those who have had mental problems have a dire chance of having severe problems.
“Even without a history of mental problems you do have get a number of women who have mental problems after delivery and almost 30percent post delivery are going to have varying degrees of mental disorders. Post partum psychosis is rare as opposed to depression. Some women can start saying statements like people don’t understand me, claiming that somebody is coming to snatch my baby the worst thing they can do is they can harm themselves or their baby so immediately a psychiatrist needs to be involved. However with some when they get anti-depressants they eventually come out of it after sometime. With some it is so severe that they need to go to the psychiatric unit where they are given special treatment and sometimes when it doesn’t work they are put on work electro convulsive therapy. Electro convulsive therapy is for the severe cases.”
Mood swings affect relationships.
Relationships can deteriorate severely.
Some people go on separation while some women fail to tolerate their partners.
They shout at them using crude language.
If the partner is not able to appreciate that its mood swings moods they might fight a lot and it might affect the relationship
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