GlobalHealthAfrica

Posts Tagged ‘Sophie Okolo’

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Albinism: The Intersection between Health, Melanin, and Vision

In Albinism, Healthcare on May 10, 2014 at 4:32 pm

Global Health Africa blogger, Sophie Okolo, provides an overview of albinism in Africa. Her goal is to focus and raise awareness on the health issues affecting albinos.

Photo by Gustavo Lacerda

Photo by Gustavo Lacerda

My recent fascination with Lupita Nyongo, a 2014 Academy Award winner among other prestigious film awards, is nothing out of the ordinary. Some of us admire certain celebrities for their work especially when they tackle an issue that is of great importance. In 2009, Lupita wrote, directed, and produced the documentary In My Genes, about the treatment of Kenya’s albino population, which played at several film festivals and won first prize at the 2008 Five College Film Festival. While In My Genes delves into the prejudices that surround albinism, my goal is to focus and raise awareness on the health issues affecting albinos in Africa.

Albinism is a defect of melanin production that results in little or no color (pigment) in the skin, hair, and eyes. Growing up in Nigeria, I noticed a number of people with albinism but was oblivious to the many health challenges they faced as a result of their skin pigmentation. Like the people in Lupita’s documentary, they always had problems with vision (not correctable with eyeglasses) because albinism affects eyesight. With no melanin in the eyes to sieve light, people with albinism struggle to sieve light which leads to astigmatism, an optical defect caused by the abnormal patterns of nerve connections between the eye and the brain; and the struggle to see in bright light. In Kenya, people with albinism are grouped with the blind and the visually impaired although many people with albinism are legally blind.

Africa is the hottest continent on earth therefore people living with albinism are prone to skin cancer due to the sun’s harmful rays. Agnes Muthakye, the main protagonist of In My Genes, always covered the top half of her face to protect her skin from the sun’s harmful rays. Unlike other populations, the skin of an albino does not acquire a tan when exposed to sunlight. Instead, it remains light which poses a greater risk of skin cancer. In tropical countries like Kenya and Tanzania, those who do not use skin protection may develop life-threatening skin cancers which reduce their life spans considerably. Sunscreens are a much needed commodity in regions that have any number of people living with albinism. Unfortunately, the lack of sunscreens and availability of low quality sunscreens only worsen the health conditions of albinos especially since skin cancer is a leading cause of death among albinos.

Despite these issues, organizations such as the Albino Foundation (TAF) is doing great work to improve the health and social well-being of people with albinism (PWA) in Nigeria and the world. Among other ongoing programs and initiatives, TAF provides free treatment and rehabilitation to poor and indigent albinos who cannot afford the high cost of preventive skin care management and treatment. Also, the Regional Dermatology Training Center housed at Kilimanjaro Christian Medical Center (KCMC) became the first facility to produce a Tanzanian-made sunscreen. The low cost of manufacture allows the operation, which is supported by donations and supplied with raw materials by the chemical company BASF, to distribute sunscreen for free.

African societies need to prioritize the needs of people with albinism. In the United States, most people with albinism live normal life spans and have the same types of general medical problems as the rest of the population. Increasing the use of sunscreen lotions rated 20 SPF or higher, optical aids, sun hats and sun-protective clothing will improve the quality of life of people with albinism. Moreover, the continent needs to train and retain more optometrists or ophthalmologists with experience in low vision. Hospitals with specialization in dermatology and ophthalmic health should also be a goal for African societies. Ultimately, albinism is not preventable but quality of life can be improved for people with albinism especially if everyone does their part.

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Tackling the Health and Economic Risks of Child Marriage

In Healthcare, Youth on March 29, 2014 at 3:52 pm

What will it take to end child marriage? GHA blogger, Sophie Okolo, points out the recent change in dialogue and highlights the health and economic risks of child marriage in Africa.

Early this year, the conversation about child marriage shifted from human rights to that of health and education. Child marriage is still a hot button issue in many African countries hence this change was significant. By shifting the conversation, public health professionals can address this issue in a tactful way since cultural beliefs are difficult to change. Like any important issue of our time, finding creative ways to address such issues can lead to a change of heart and eventually, cultural transformation.

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Despite recent condemnation of child marriage in many African countries, tradition and beliefs continue to ruin young lives in remote regions. For example, child marriage is prohibited under Nigeria’s Child Rights Act (enacted in 23 of 36 Nigeria’s 36 states), which bans marriage or betrothal before the age of 18. But federal laws compete with age-old customs, as well as a decade of state-level sharia law in Muslim states. Last year, the Nigerian Senate came under attack for failing to include the age at which girls can get married thereby condoning child marriages. These customs and laws should be challenged although health information can go a long way in addressing this critical issue. For instance, girls who marry too young are denied the educational opportunities of their peers and are put at greater health risks, such as HIV and teen pregnancy. Teen pregnancy may lead to a difficult and prolonged labor which can result in a fistula, an abnormal connection between an organ, vessel, or intestine and another structure that causes uncontrolled urination or defecation. According to Dr Mutia, one of two practicing fistula surgeons in Zamfara, Nigeria, “fistulas can happen to anyone, but are most common among young women whose pelvises aren’t at full capacity to accommodate the passage of a child.” In the development community, studies have shown that child marriage is also linked to poverty. Rachel Vogelstein, a Fellow for Women and Foreign Policy at the Council on Foreign Relations, states that “Recent research suggests that families in crisis situations are more likely to marry their daughters early, either to preserve resources by offloading economic responsibility for their girl children or in an attempt to ensure their daughters’ safety from conflict-related sexual violence.” Clearly, child marriage is a complex issue.

Although the number of global child marriages is declining, rates are staggering in countries like Chad, Niger and the Central African Republic. More than two out of every three girls are married before eighteen. Roughly half of the girls married early in Niger do so before turning fifteen. Since there is no magical solution to child marriage, combined efforts may help women and girls lead healthy and successful lives. The goal is to help African societies fully comprehend the seriousness of the issue.

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The Millennium Development Goals: Positioning Boys For The Future

In MDGs, Youth on March 10, 2014 at 6:43 pm

Global Health Africa blogger, Sophie Okolo, highlights the lack of emphasis on the development of boys in the Millennium Development Goals. She argues that public health programs need to engage both girls and boys to promote cultural change.

I’d like to see where boys and girls end up if they get equal encouragement – I think we might have some differences in how leadership is done – Sheryl Sandberg

Last month, I had an interview with an organization that enables young girls to excel in school, and young women to defeat the causes of what they endured in life. As the interview continued, I asked about the inclusion of boys in their agenda since these girls would grow up in a society that may not value them as equal contributors. It is well-known that boys are preferred over girls in lots of countries hence public health programs do not see a need to include boys. Even the Millennium Development Goals (MDGs) have a main focus on women and girls which poses a significant problem in the future. Such one-dimensional focus sets a stage where girls aspire to impact society but do not receive support from the boys/men in their lives. The MDGs need to encourage programs that co-educate and expand opportunities for both girls and boys in order to achieve cultural change in African nations.

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When we educate and empower girls, who are we leaving as spouses when they want to marry? In my opinion, we are doing girls a disservice if we do not prepare boys to become supportive husbands as well as brothers, sons, and leaders in society. I believe that when organizations see the importance of boys, the discourse will start to shift and it is encouraging to know that some organizations are starting to educate boys to bring out cultural change. Like girls, boys have substantial energy, resilience and the power to induce change. When boys are educated and empowered, there are gains on various levels such as challenging a culture that condones child marriage, violence against women, and much more. In fact, a report by IRIN, award-winning humanitarian news and analysis service, highlighted Zimbabwean men who have become increasingly involved in caring for AIDS patients, challenging the stereotype that caring for the terminally ill is women’s work. Since boys and girls are part of society, I believe they can achieve more success together than separate. Neither boys nor girls run the world and society will suffer if one decides to run the world alone.

Currently, Africa is the most youthful continent in the world. At least 35 per cent of its more than one billion population is between the ages of 15 and 35. This number will continue to increase as Africa’s population grows. Therefore, investing in children, which includes boys should also be top priority for cultural transformation. As Chimamanda Ngozi Adichie, a writer from Nigeria, states “Culture does not make people. People make culture.”

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Improving Preventive Care Training in African Medical Schools

In Healthcare, Medicine on December 3, 2013 at 3:53 am

Two years ago, the Medical Education Partnership Initiative (MEPI) was launched to increase the quality, quantity and retention of health care workers and the faculty needed to train them. The program is investing about $130 million over five years through direct awards to African institutions in a dozen countries. Within this initiative is the emphasis of preventive care training at medical schools. In Africa, the correlation between preventive care training and non-communicable diseases is particularly important.

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Unhealthy diets and physical inactivity are key risk factors for the major non communicable diseases such as cardiovascular diseases, cancer, and diabetes. While Africa faces a double burden of infectious and chronic diseases, infectious diseases still account for at least 69% of deaths on the continent. If there is to be a shift in focus from curative to preventive care, the medical school curriculum must include nutrition and physical activity education. So far, MEPI has led to a fundamental change in the way African institutions and government leaders approach medical education.  Institutions are changing curricula content and expanding the breadth and depth of subject matter that emphasize the importance of preventive care.

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In Durban, South Africa, the University of Kwa-Zulu Natal (UKZN) is expanding its approach to the HIV/AIDS epidemic. The university has packaged a series of workshops called “Me and HIV,” to enhance sensitivity about HIV/AIDS among health workers. These workshops examine the myths, realities, attitudes and perceptions of HIV/AIDS, prevention strategies and how to help people learn to live with their condition. Emphasizing the importance of preventive care through medical school is crucial in creating sustainable prevention-oriented physician practices. The role of the physician is vital since patients cite their physician most often as the one who influenced them most to make a health behavior change. If MEPI remains successful, medical education in Africa will have a positive impact on people’s health in the continent.


Quality of Life for Elders: Lessons from South Africa and Bolivia

In Elderly, Health Policies, Healthcare on November 10, 2013 at 5:45 am

Last month, the Global AgeWatch Index issued a report on the quality of life of older people in 91 nations. The report included several factors such as income security, health and well-being, employment and education. African nations did not fare well. South Africa was the highest ranked African nation at number 65 while Ghana, Morocco, Nigeria, Malawi, Rwanda and Tanzania came in at numbers 69, 81, 85, 86, 87 and 90 respectively. Other African nations were not included in the report because there was not sufficient data. With South Africa leading the pack in elderly well-being, it helps to decipher the various ways it deals with its senior citizens.
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In addition to having the largest and most developed economy in Africa, the old age pension reaches 72% of the older population in South Africa. South Africa’s pension system is the second most distributed of the African countries that are in the Index. Namibia is the first at a whopping 167.3% although there was not enough data in other areas to include the nation in the report. While South Africa performed moderately well in income security, they ranked low in elderly’s health status. There are only eight registered geriatric doctors to serve an older population of 4 million. Since 1994, dramatic changes have taken place in the structure of health services. The government prioritized maternal and child healthcare because of the HIV/AIDS pandemic in the 90’s.

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Although South Africa was ranked at number 65, Bolivia, one of the poorest countries on the list was ranked at number 46. This shows that higher-income does not always correlate with better quality of life. In fact, some lower-income countries that invested in aging saw positive impacts. Bolivia, for instance, implemented a national plan on aging and free health care for older people, which vastly improved quality of life. The rankings illustrate that limited resources need not be a barrier to countries providing for their older citizens, that a history of progressive social welfare policies makes a difference, and that it is never too soon to prepare for population aging. This is important for other African nations because the elderly are a significant boon. As African nations, we can do better by learning from each other as well as other non-African nations. Our collective goal is to improve the elderly’s quality of life for present and future generations.

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Safe vs. Cheap: The Dangerous Cost of Street Medicines

In Street Medicines on August 30, 2013 at 8:24 pm

Are cheap medicines harmful to population health? Like thrift stores, flea markets and fast food restaurants, cheap medicines pose a potential health risk to communities. In Africa, the word cheap is synonymous with counterfeit medicines. Cheap medicines are commonly sold on the streets where traders in counterfeit drugs have thriving businesses, sometimes at the cost of human lives. The concern for counterfeit drugs is crucial because these trades target Africa’s poor. If safe medicines are not accessible and cost effective, poor people are at risk of obtaining counterfeit drugs. According to the UN Office of Drugs and Crime (UNODC), counterfeit drugs are a multi-billion dollar business accounting for 30 percent of the pharmaceutical market in parts of Africa. When we imagine the market saturation of counterfeit anti-malarial drugs, painkillers and antibiotics, it is not difficult to fathom the rampant growth of these businesses. Below is a summary of the counterfeit drugs landscape in Africa:

•Fraudulent medicines have become an increasingly lucrative area for organized criminal networks, according to the UN Office of Drugs and Crime.
•In Kenya, 30 percent of drugs sold in 2012 were either fake or counterfeit, according to the Pharmacy and Poisons Board of Kenya.
•Between 20 and 25 percent of the drug market in Ivory Coast are fake drugs, according to Parfait Kouassi, chair of the National Order of Pharmacists in Ivory Coast from 2005 to 2012.
•In Nigeria, phony drugs and real ones that had passed their expiry date made up 70 percent of sales in 2002, according to the World Health Organization.
•Nigeria imports more than 50 percent of fake drugs from China and India, according to Abubakar Jimoh, spokesman of the National Agency for Food and Drug Administration and Control (NAFDAC)
•South Africa has a strictly enforced licensing system to fight the illicit drug trade, according to Griffith Molewa, head of law enforcement at the Medicines Control Council.

While these counterfeit drugs may seem to work at first, they ultimately cause serious complications that may not be reversible. African countries like Nigeria and South Africa should continue to fight the illicit drug trade in addition to keeping drugs accessible and cost-effective. The video below highlights the fight against counterfeits drugs in Nigeria.

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Mandela’s Health: A platform to discuss the treatment of the elderly in South Africa

In Elderly, Healthcare on July 6, 2013 at 2:11 am

This past month South Africans have been on edge. Nelson Mandela has spent four weeks in a Pretoria hospital with a recurring lung infection. While we hope that Mandela’s health improves, there are at present senior citizens who cannot afford sufficient medical care in South Africa. The situation is more problematic because advocates for the elderly state that the services for senior citizens have dramatically decreased in the last two decades.

According to Anita Powell, Southern Africa reporter for Voice of America, few among South Africa’s rapidly growing elderly population are faring well, health wise, due to economic insecurity which is linked with better health outcomes. Elderly advocates insist that Mandela is not the standard by which South Africa’s treatment of its weakest members should be judged because the nation’s growing elderly population is increasingly marginalized by a government that has focused its health care on the young. While child health is very important, the health care needs of the elderly should not be overlooked especially in a nation with only eight registered geriatric doctors (International Longevity Center-South Africa). This video portrays the work of the Ikaheng Daycare Centre for the Aged in the South African Township of Ikaheng.

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The Role of Fathers in Maternal and Child Health

In Maternal and Child Health on May 20, 2013 at 2:50 pm

Family

The emerging issue of father involvement in maternal and child health (MCH) programs is important. Fathers have always played a significant role and the time for organizations to stop overlooking the father role and include them in their programmatic work is now. According to UNICEF, Nigeria loses about 2,300 under-five year olds and 145 women of childbearing age every single day. This makes the country the second largest contributor to the under-five and maternal mortality rate in the world. Although recent research provides essential interventions that can avert most of these deaths, father involvement is rarely addressed.

Research on father involvement in Africa is not prevalent, but evidence has shown that father involvement has positive effects on MCH outcomes. Father involvement increases the likelihood that a woman will receive prenatal care in her first trimester by 40 percent and reduces a pregnant woman’s cigarette consumption by 36 percent (Martin, McNamara, Milot, Halle, Hair, 2007). Expectant fathers can be influential advocates for breastfeeding by playing a critical role in encouraging a mother to breastfeed the newborn infant (Wolfberg et al. 2004). Fathers who also accompanied the mother on a prenatal visit were more likely to engage in father-child activities later in the child’s life (Vogel, Boller, Faerber, Shannon, Tamis-LeMonda, 2003).

In order to engage fathers in MCH programs and services, public health organizations need to focus on the family as a whole. Families are the building blocks of society hence excluding fathers from initiatives can negatively impact children. In addition to further research on father involvement in Africa, social inequalities that prevent fathers from being present in the home have to be challenged. Public health professionals can help promote father engagement within family systems to support an atmosphere of paternal inclusion. Fathers are an important part of the family system and their contributions (or omissions) have a lasting impact on the overall welfare of the mother and child.

References

1. Martin, L., McNamara., M., Milot, A., Halle, T., Hair, E. (2007). The Effects of Father Involvement during Pregnancy on Receipt of Prenatal Care and Maternal Smoking. Maternal Child Health Journal, 11, 595–602.

2. Wolfberg, A., Michels, K., Shields, W., O’Campo,P., Bronner,Y.,Bienstock,J. (2004) Dads as Breastfeeding Advocates: Results from a Randomized Controlled Trial of Educational Intervention. American Journal of Obstetrics and Gynecology. 191(3), 708-12.

3. Vogel, C., Boller, K., Faerber, J., Shannon, J., Tamis-LeMonda, C. (2003). Understanding Fathering: The Early Head Start Study of Fathers of Newborns. Mathematica Policy Research, Inc. Available at: http://www.mathematica-mpr.com/earlycare/fatheroverview.asp.


Introducing Post Abortion Stress Syndrome (PASS)

In Health Policies, Mental Health on February 16, 2013 at 3:36 am

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The topic of Post Abortion Stress Syndrome (PASS) brings up great controversy among pro-life and pro-choice groups everywhere. In fact, there is much debate about the existence of this problem because some fear that pro-life groups invented PASS in an attempt to hinder further abortions. However, other groups of people recognize PASS as a problem. This article is not about the controversy, but a highlight on PASS especially since it is present in Southern Africa (Boulind & Edward, 2008).

The term Post Abortion Stress Syndrome is not known by a lot of people and there is little research from the African continent. Post-Abortion Stress Syndrome, abbreviated as PAS or PASS is a form of trauma that can occur in women after an abortion (Speckhard & Rue, 1992). It has also been called post traumatic abortion syndrome. According to a South African study published in the journal BMC Psychiatry, women who have experienced abortion have high levels of post-traumatic stress disorder (PTSD), which follow findings from earlier studies linking abortion and PTSD (Suliman et al. 2007). Moreover, the study states that high rates of PTSD characterize women who have undergone voluntary pregnancy termination. Believing that PASS exists means that health professionals should provide supportive and constructive counseling around the trauma symptoms African women experience. What are your thoughts on PASS?

References

1. A. C. Speckjhard and V. M. Rue, “Postabortion Syndrome: An Emerging Public Health Concern,” Journal of Social Issues 48 (1992):95-119.

2. M. Boulind and D. Edward, “The Assessment and Treatment of Post-Abortion Syndrome: A Systematic Case Study From Southern Africa,” Journal of Psychology in Africa 18 (2008): 539-548.

3. S. Suliman, T. Ericksen, P. Labuschgne, R. de Wit, D.J. Stein and S. Seedat, “Comparison of Pain, Cortisol Levels, and Psychological Distress in Women Undergoing Surgical Termination of Pregnancy under Local Anaesthesia versus Intravenous Sedation,” BMC Psychiatry 7 (2007):1-9.

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Poverty and Neglected Tropical Diseases (NTDs)

In NTDs on January 19, 2013 at 5:04 am

Two years ago, the Global Health Council organized the 4th Annual Beth Waters Memorial Lecture in Philadelphia, PA. I had the opportunity to attend the lecture after my participation in the American Society of Tropical Medicine and Hygiene Annual Meeting. The featured speaker, Dr. Peter Hotez, President of the Sabin Vaccine Institute, delivered an engaging and passionate lecture on neglected tropical diseases (NTDs), poverty and drug availability.

According to Dr. Hotez, NTDs are the common infections of the world’s poorest people. He emphasized the availability of drugs to reduce burden of disease for 50 cents a person per year. This is considered one of the very best buys of global public health, said Dr. Hotez. He stated that this network was launched at the Clinton Global Initiative because President Clinton decided that NTDs needed attention. Moreover, Dr. Hotez stressed that nobody is really dying from NTDs which is a difficult message to convey to global health policy makers and get NTDs more attention.

Since NTDs affect the world’s poorest people, they subsequently keep these people trapped in a cycle of poverty. In addition to providing treatment and prevention drugs to millions affected by NTDs, poverty needs to be confronted in these communities. There is no reason why a person should not have access to clean drinking water or inexpensive medications. I am always amazed at the lives of two people from different socioeconomic backgrounds in the same country. Both people contact the same disease but one dies from it due to inadequate resources. While vaccine development is important, organizations should find ways to alleviate poverty from these communities. You can watch the lecture here:

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