Showing posts with label Shadrack Egbonimali. Show all posts
Showing posts with label Shadrack Egbonimali. Show all posts

Thursday, 15 March 2012

Menarche and our parent’s role



  
Puberty is a time of many changes. For young girls a defining event during this developmental process is menarche, which is defined as “the beginning of the menstrual function.”

Menarche according to Wikipedia, is the first menstrual cycle, or first menstrual bleeding, in female human beings. From both social and medical perspectives it is often considered the central event of female puberty, as it signals the possibility of fertility.

Menarche can be a stressful time for young girls, and the event is often met with mixed emotions. Like many other changes associated with puberty, it can be confusing. Many girls experience fear and anxiety related to their first menstrual cycle, largely because of misinformation or, more frequently, lack of information.

Girls who are prepared for menarche often have a more positive initial experience with menstruation. However, studies show that many girls are not prepared. In Delta women’s survey in involving 10 participants each from 25 local government in Delta State Nigeria, nearly one third of the respondents reported that they had not been told about menarche prior to its occurrence. Being caught unawares, the girls did not know what to do when it came.

Some of the most negative experiences have been reported by women who had no education about menstruation or menarche. In one study, when describing their menarche, women used words such as “panic,” traumatic,” embarrassed,” and “ scared” to recount their experience.

The sight of blood generally frightens people, since bleeding is usually associated with pain or injury. Thus, it is not difficult to see that when proper explanation or preparation is lacking, cultural stereotypes, myths, or even plain ignorance can cause one wrongly to associate menstruation with disease or injury or to view it as something of which to be ashamed. Young girls needs to know that menstrual bleeding is a normal process that all healthy girls experience.

There are many sources of information on menstruation, such as school teachers, health-care practitioners, printed material, and even educational films. Many parents find that these sources often provide valuable information on the biology of menstruation as well as menstrual hygiene. Still, girls may have questions and needs that these sources do not address. Even if they know what to do when their period comes. Girls are often uncertain about how to deal with the varied emotions and feelings associated with menstruation.

Mothers, older sister, and particularly grand mothers can help to provide the additional information and emotional support that young girls need. Most often, girls consider their mother to be most important sources of information about menstruation.

What about fathers? Many girls feel embarrassed to talk to them about menstruation. Some want their father to play an indirect role by offering support and understanding, while others prefer that he not be involved.

In some countries the number of single father households has increased over the past few decades.* Thus, more and more fathers will need to rise to the challenge of educating their daughters about menstruation. These fathers will need to be familiar with the basics of menstruation as well as with the other physical and emotional changes their daughters are facing. Fathers may choose to turn to their own mothers or sisters for practical advice and help in this regard.

Globally, the average age for menarche is generally between 12 and 13 years, although it can occur as early as 8 and as late as 16 or 17. In parts of Africa and Asia, the average age for menarche tends to be higher. For example, in Nigeria the average age is 15. Several factors, such as genetics, economic status, nutrition, physical activity, and altitude, can affect the timing of menarche.

It is best to start sharing information with your daughter before she has her first period. Hence conversations regarding body changes and menstruation should begin early, perhaps when your daughter is about eight years of age. You may feel that this is too early, but if your daughter is between the ages of eight and ten, it is likely that her body is already beginning to mature internally in response to surges of hormones. You will notice external physical changes associated with puberty, such as breast development and an increase in body hair. Most girls experience a growth spurt (rapid increase in height and weight) right before menarche.

Girls who are approaching menarche are often curious about what to expect. Likely they have heard other their peers at school discussing the subject. They have questions, but many have difficulty formulating exactly how to ask about it. They may be embarrassed about the subject.

The same is true for parents. Although mothers are usually the primary sources of information about menstruation, they often feel ill-prepared and awkward when discussing the subject.

Pre-teen girls who are approaching menarche are likely to understand simple, concrete information. Such information might include how often a period occurs, how long it lasts, or how much blood is lost. Thus, in the early stages of menstrual education, it may be best to focus on the more immediate and practical aspects of how to deal with menstruation.

You may wish to discuss details of the biology of menstruation. Oftentimes, you can get educational materials from health –care practitioners or from the library or book-store. Such reference works may be helpful in explaining the details. Some girls may prefer to read this material themselves. Others may feel comfortable if you read the material to gather with them.

Pick a quit place to start the conversation. Begin with a simple discussion about growing up and maturing. Perhaps you could says:

“Someday soon you are going to experience something very normal that happens to all girls. Do you know what it is?” Or a mother might start with a personal comment, such as:

“When i was your age, I started to wonder about what it was like to have a period. My friends and I talked about it in school. Have your friends started talking about it yet?” find out what she already knows about menstruation and clears up any misunderstandings. Be prepared for the fact that in your Initial conversations, you may need to do most if not the talking.

As a woman who no doubt experienced your own anxieties and concerns about menarche, you can draw upon your personal experience when discussing this subject. What did you need to know? What did you want to know? What information was helpful? Endeavor to provide a balanced view of the positive and negative aspects of menstruation. Be open to questions.

Menstrual education should be viewed as a continuing process rather than as a one-time discussion. You do not need to cover all the details in one sitting. Too much information all at once be overwhelming for a young girls. Children learn things in stages. Also, repetition of information on different occasions may be necessary. As young girls grow older, they are more able to understand additional details.

Another factor is that girl’s attitudes toward menstruation change throughout adolescence. After young girls gain more experience with their periods, they will likely face new concerns and questions. Hence, you need to continue to share information with them and answer their questions. Focus on what is most meaningful and appropriate for their age and ability to understand.


References
4.      ^ Anderson SE, Dallal GE, Must A (April 2003). "Relative weight and race influence average age at menarche: results from two nationally representative surveys of US girls studied 25 years apart". Pediatrics 111 (4 Pt 1): 844–50.doi:10.1542/peds.111.4.844PMID 12671122
7.      ^ Magnússon, T.E. (May 1978). "Age at menarche in Iceland.". American journal of physical anthropology 48 (4): 511–4. doi:10.1002/ajpa.1330480410ISSN 0002-9483PMID 655271
9.      ^ Frisch RE (August 1987). "Body fat, menarche, fitness and fertility"Human Reproduction 2 (6): 521–33. PMID 3117838http://humrep.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=3117838
10 Field work 2012(delta state)

11 Wikipedia.


Written by
Agboje Okwualefe Peace, Egbonimali Shadrack and Kirthi Gita Jayakumar

Wednesday, 22 February 2012

Development

Development as a concept has no universally accepted definition. It is often used by various people of different backgrounds to mean different things. In some quarters, it connotes the number of vehicles,
calories-intake, TV sets per head, industries, roads, including fly-overs, educational institutions, health institutions etc, that are made available. It has also been erroneously equated with economic development, growth, modernization or even westernization. 



While the above constitute indices of growth or what the radical school call "checklist of artifacts" they may not have contributed to development. Equally too, economic development, industrialization or westernization
is not the same thing as development. These are so, for the fact that an infrastructural transformation may not at the end contribute meaningfully to real transformation(development of the living being in that setting). Hence, it is possible to see a twelve year old child growing so tall, but has not developed intellectually to help 

the society through new discoveries.


From the above premise we want to identify ourselves with the school of thought in development studies which sees development as multi-dimensional rather than unilineal. Walter Rodney, a well acclaimed
scholar of this school sees development from three broad perspectives, the individual level(the crux of our work), the social group level, and the state level. Development at the individual level implies increased
skill and capacity, greater freedom, creativity, self discipline, responsibility and material well-being. Development at the social group level refers to the capacity of a social group to regulate its internal
and external relationships. At the state level it entails both quantitative and qualitative growth in the economic, political and social aspects of human and material resources from a lower to a higher stage. These are what constitute National Development. 


We may ask; "what are the universal aims and objectives of development, and that of Nigeria in particular?". The aims and objectives of development in Nigeria may be summarized from its various national development plans as: 
(1) a free and democratic society; 
(2) a just and egalitarian society; 

(3) a united, strong and self-reliant nation; 
(4) a great and dynamic economy; and 
(5) a land of full bright opportunities for all citizens. (Second National Development Plan, 1970-1974). 


A critical analysis of the aforementioned objectives no doubt centres on freedom for the individuals to attain survival goals, restriction notwithstanding. The state as an institution was created to cater for the individual by channelling state wealth into providing amenities which will aid the common goal.  According to Seers, the universal aim of development is the realization of the potentials of human personality(Seer, 1972). By
extension, development should always be people-oriented rather than economy-oriented. This must be so because a people-oriented program helps to uplift the living condition of the individual and this helps
him/her further to contribute his/her quota to further development. This makes him/her to prevent oppression from the system and its leaders. Thus, a government policy that increased housing units and a progressive
tax policy will uplift the individual and he/she will be ready to defend the nation anywhere, anytime. However, a policy that is singly geared towards fantastic industrialization may benefit the government and contractors, but may in turn affect the individual negatively. This makes the leaders to maintain their status quo. The bottomline of this is that social plagues like hunger, unemployment, criminality becomes imminent in the society.  



In other words, the development of human person is an important ingredient. National development is not complete without the moral elements. Societies must imbued of ethics and moral values. Through the inculcation of ethics and moral values, there will be development in the society. This brings into sharp focus the development of the human personality. It is, put in other words, the moral development of the citizens that constitute one aspect of national development. There are other aspects of national development, for a country is like a living organism with many parts or organs, each of which needs development. If any of its parts remain undeveloped, the whole organism suffers. Each part has its own distinctive contribution towards the growth and well-being of the whole organism.

Monday, 6 February 2012

The Damaged Womb

There is no gain saying that the health delivery system, especially in developing countries such as Nigeria, has ceased to be threatened by the activities of pseudo medical practitioners who often claim to have exhaustive knowledge of all dimensions of medical practice. The result of the activities of these charlatans, otherwise known as quacks, has
over the years been visibly detrimental to the nation's health status and this phenomenon has lately assumed an alarming and uncompromising proportion and so calls for a proactive and urgent attention, if the image of this nation must be redeemed and made to have a recognition in this regard in the world community.

Regrettably, the activities of such people apparently find expression among other things, in the administration of fake and expired drugs believed to aid the termination of pregnancy, insertion of unsterilized instrument such as foetus evacuation tubes and cutters, and the use of some locally made concoctions also believed to be efficient in the termination of pregnancy. A number of reasons have been advanced for the patronage of such quack medical practitioners. Such reasons range from the low cost of it to ignorance. However plausible these reasons might seem, the incontestable truth 
remains that the adverse effect of such act far out-weighs its purported good side, as it often results in either deformation of the unborn baby(that is if it is not successful) or termination of life. Such was the case of a pretty and promising young girl of 16 years of age(Named Onyero) in early 1993 in Alisimie community, Ika South Local Government Area of Delta State who had a recourse to such act.


According to her, the so called medical practitioner she went to see with her problem of unwanted pregnancy was a well known patient medicine dealer within the locality. The man(Mr. Abaye), middle aged, claimed to have got expert knowledge of the business. He had attended to countless number of persons before she became a victim. She was attended to and shortly after that, there arose some complications within her uterus. She began to bleed ceasely. This made her to go back to the man(Mr. Abaye) for remedy and she was given some medications which heightened the situation. She was left with no option other than to seek medical attention in the Central Hospital, Agbor where she was told that her womb had been damaged and all that was needed to be done to save her life was to cut off her womb. Till date, she remains without a womb and this has cost her two marriages as she could not bear a for her husbands. Today, she lives in regret, in pain and dejection as she has become a laughing stock within her community

Wednesday, 11 January 2012

Playing with Fire


Hi Mommy,

I'm your baby. You don't know me yet, I'm only a few weeks old. You're going to find out about me soon, though, I promise. Let me tell you some things about me. I've got beautiful brown eyes and black hair. Well, I don't have it yet, but I will when I'm born. I'm going to grow up without a daddy mostly, but we have each other. We'll help each other, and love each other. I want to be a doctor when I grow up.

You found out about me today, Mommy! You were so excited, you couldn't wait to tell everyone. All you could do all day was smile, and life was perfect. You have a beautiful smile, Mommy. It will be the first face I will see in my life, and it will be the best thing I see in my life. I know it already. ... Today was the day you told Daddy. You were so excited to tell him about me! ...He wasn't happy, Mommy. He kind of got angry. I don't think that you noticed, but he did. He started to talk about something called wedlock, and money, and bills, and stuff I don't think I understand yet. You were still happy, though, so it was okay. Then he did something scary, Mommy. He hit you. I could feel you fall backward, and your hands flying up to protect me. I was okay... but I was very sad for you. You were crying then, Mommy. That's a sound I don't like. It doesn't make me feel good. It made me cry, too. He said sorry after, and he hugged you again. You forgave him, Mommy, but I'm not sure if I do. It wasn't right. You say he loves you... why would he hurt you? I don't like it, Mommy.

Finally, you can see me! Your stomach is a little bit bigger, and you're so proud of me! You went out with your mommy to buy new clothes, and you were so so so happy. You sing to me, too. You have the most beautiful voice in the whole wide world. When you sing is when I'm happiest. And you talk to me, and I feel safe. So safe. You just wait and see, Mommy. When I am born I will be perfect just for you. I will make you proud, and I will love you with all of my heart.

I can move my hands and feet now, Mommy. I do it because you put your hands on your belly to feel me, and I giggle. You giggle, too. I love you, Mommy.

Daddy came to see you today, Mommy. I got really scared. He was acting funny and he wasn't talking right. He said he didn't want you. I don't know why, but that's what he said. And he hit you again. I got angry, Mommy. When I grow up I promise I won't let you get hurt! I promise to protect you. Daddy is bad. I don't care if you think that he is a good person, I think he's bad. But he hit you, and he said he didn't want us. He doesn't like me. Why doesn't he like me, Mommy?

You didn't talk to me tonight, Mommy. Is everything okay?

It's been three days since you saw Daddy. You haven't talked to me or touched me or anything since that. Don't you still love me, Mommy? I still love you. I think you feel sad. The only time I feel you is when you sleep. You sleep funny, kind of curled up on your side. And you hug me with your arms, and I feel safe and warm again. Why don't you do that when you're awake, any more?

I'm 21 weeks old today, Mommy. Aren't you proud of me? We're going somewhere today, and it's somewhere new. I'm excited. It looks like a hospital, too. I want to be a doctor when I grow up, Mommy. Did I tell you that? I hope you're as excited as I am. I can't wait.

Mommy, I'm getting scared. Your heart is still beating, but I don't know what you are thinking. The doctor is talking to you. I think something's going to happen soon. I'm really, really, really scared, Mommy. Please tell me you love me. Then I will feel safe again. I love you!

Mommy, what are they doing to me!? It hurts! Please make them stop! It feels bad! Please, Mommy, please please help me! Make them stop!

Don't worry Mommy, I'm safe. I'm in heaven with the angels now. They told me what you did, and they said it's called an abortion.

Why, Mommy? Why did you do it? Don't you love me any more? Why did you get rid of me? I'm really, really, really sorry if I did something wrong, Mommy. I love you, Mommy! I love you with all of my heart. Why don't you love me? What did I do to deserve what they did to me? I want to live, Mommy! Please! It really, really hurts to see you not care about me, and not talk to me. Didn't I love you enough? Please say you'll keep me, Mommy! I want to live smile and watch the clouds and see your face and grow up and be a doctor. I don't want to be here, I want you to love me again! I'm really really really sorry if I did something wrong. I love you!

I love you, Mommy.
Mommy, I am sorry, but something went wrong and you are here with me. What happened, mommy? I see you wonder at the amazing sight of these angels around us, I see you look at them in awe. You, like me, have been sent back, to heaven. They told me that because there wasn’t anything right about the method you used, you wound up dying.

~A modified version of an original story by Robert Stamm~

Although the substance of this article is neitherto deal with the propriety of abortion, nor as to whether it has any sanction in religion or morality, the aforesaid story is a necessary introduction to the reality that surrounds us. The fact that abortion is outlawed on certain grounds while permitted on certain others warrants that there must be some modality of regulation on the manner and the basis on which it is carried out. Owing to the fact that certain grounds do not fulfil the criteria of becoming the basis on which an abortion may be carried out. There are plenty of instances wherein women seek recourse to unsafe and illegal methods of abortion. The end result is hardly anything to appreciate.

In the words of a renowned member of the medical profession based out of Nigeria who wishes to remain anonymous, an abortion in medical speak is called a termination or “planned miscarriage”. “Abortion is understood to be the Healthcare Professional used to describe the premature conclusion of a pregnancy whether planned or of natural causes… before it can be called a miscarriage.” He says. An unsafe abortion, as the very same doctor puts it, refers to “An abortion done by unskilled persons including the lady herself, or done by Professionals with insufficient experience or skill, or done by persons with skill but poor after care, or done to people who have additional risks like very late twins or may be susceptible due to other medical conditions in which infection or blood loss would be poorly tolerated.” In the doctor’s opinion, usually young girls with little access to money or other means coupled with the ignorance of the avoidable dangers of the procedure fall victim to the unsafe abortions in order to cut costs. 

The consequences are plenty:
  •  Death
  • Infection
  • Anaemia from blood loss
  • Damage to Bowel Bladder  and reproductive organs           
  • Difficulty in getting pregnant or carrying pregnancy neck of womb called cervix may be damaged           
  • Chronic pain from botched procedures including incomplete termination in which half of the fetus is left behind 
  • Psychological issues of regret, guilt and depression


In Nigeria, abortion, as the law stands, is permissible on limited grounds which are enumerated as below:
Basis
Status under Law
To save the life of the woman
Allowed
To preserve mental health
Allowed
In cases of conception being a consequence of rape
No
In cases of foetal ill-health, impairment or disability
No
Economic and Social considerations
No
On request by the woman herself
No
Familial pressure
No

Evaluating the statistical side, there is plenty of evidence that suggest that women rely on unsafe methods of abortion in a bid to side-step the law, and to avail a series of back-alley mechanisms to bring their pregnancies to an abrupt halt. From the statistical resource pool collected by  AllAfrica.com, “From statistics, an estimated 46 million pregnancies worldwide end in induced abortions each year and 20 million of these are unsafe. About 13 per cent of pregnancy related deaths have been attributed to unsafe abortions and 80,000 deaths annually.”

The legal system governing abortion in Nigeria predominantly comprises two different laws. In the generally Muslim states in the North, the Penal Code, Law No. 18 of 1959 is in force. In the south, which is largely Christian, the Criminal Code of 1916 is in effect. Although both codes prohibit abortion, the differences in the wording of the Codes, as well as in their  interpretation, that have resulted in two slightly different treatments of the offence of abortion.

In general under the Penal Code, an abortion may be legally performed only to save the life of the pregnant woman. Save for this one explicit permission, any person who voluntarily causes a woman with a child to miscarry, can be subjected to a penalty that could range up to fourteen years’ imprisonment with, or without the payment of a fine. This punishment holds good even for a woman who causes her own miscarriage, although harsher penalties are awarded if the woman dies owing to the miscarriage. Under the Criminal Code, abortions are legally permitted only in the event that the life of a woman is to be saved. At the same time, any person who, with intent to procure the miscarriage of a woman, unlawfully administers to her any noxious thing or uses any other means is subject to fourteen years’ imprisonment.  A woman who undertakes the same act with respect to herself or consents to it is subject to seven years’ imprisonment. Any person who supplies anything knowing that it is intended to be unlawfully used to procure a miscarriage is subject to three years’ imprisonment.

One slight deviation in the context of the Criminal Code is that by interpretation, abortions have been allowed in the wake of broader circumstances. The English decision in Rex v. Bourneushered in an era where the element of necessity was read into situations to determine whether it was ripe for a legal authorization of abortion or otherwise. Besides these developments, in 1982, there was an attempt made to liberalize abortion law, but the same was nipped in the bud before it attained fruition.

In Nigeria, induced abortion using unsafe methods is considered to be a rather major cause of maternal mortality, which is considerably high in Nigeria. Delta Women conducted a survey amongst women in Nigeria, and the resultant data suggested a considerably shocking trend. 

Out of a survey pool of 20 sample respondents between the ages 25 and 50, 22% had undergone an abortion. Of these respondents, one of them stated, “Yes, I had an abortion. It was done in a clinic by a Certified Doctor, I will say. I had to do it because my parents wouldn't hear that I am pregnant outside wedlock.”As for considering abortion as an option, 22% of the women answered that they would, while another 22% were unsure, and the remainder were vociferously expressive of their antagonism to choosing abortions. 

About 80% of our respondents expressed that they were aware of the consequences of an unsafe abortion on their bodies, and also 90% of the respondents are aware of the legal standpoints on abortion in Nigeria. While as many as 80% of the respondents did not know of others who had undergone unsafe abortions, one of the remaining 20% explained, “A school mate of mine underwent an unsafe abortion, and she died. However, when one other friend of mine did the same, she didn’t face any such bad luck.”

20% of the respondents did not know what unsafe abortions were, while the predominant answers in the survey so far as their knowledge was concerned, most perceived unsafe abortions to be:
  • a significant cause of maternal mortality
  • the termination of an unwanted pregnancy by persons lacking the necessary skills, or in an environment lacking minimal medical standards, or both
  • the absence of proper and clean/safe facilities and equipment
  • an abortion at a late stage of pregnancy
  • an abortion in a non sterile environment, with unsterilized tools and performed by unqualified personnel
  • an abortion by self-medication


A Nigerian doctor (who wishes to remain anonymous) feels that rates of unsafe abortions can be reduced by making contraception easily accessible, along with offering awareness as to its usage. “Unfortunately some ladies use termination as “contraceptive” with disastrous consequences. The government should see a termination as a woman right, the deep religious, cultural and social stigmatisation of a terminationwill need to be addressed. 


Opposing it forces it underground. It doesn’t stop it and “No sex” is practically impossible to advocate. Safe protected sex and condoms help with STDs, and will also cut down the need for termination but combined with the pill even more effective as it is unlikely that both methods would fail simultaneously         .” He further adds that there should be laws to protect qualified practitioners of safe abortions, should contraception fail. The procedure should be subsidised in order to make them affordable. “Unfortunately it has been a non-issue and unless there are statistics to make the people and government agencies aware that it is a major source of loss of women’s life and future fertility, unsafe abortions will continue as there is a market for it.”

There is evidently a cause for practical implementation of the legal system that exists on paper. Although in principle, abortions are banned except for certain grounds, there are plenty of clinics that thrive on the business of quick, unsafe and illegal abortions. At best, the solution does not lie in legalizing abortions, but rather, in legally regulating abortion. Simple means of doing this would be mandating the registration of medical practitioners under the law. There should be a compulsory rule that without a license, a practitioner cannot conduct any means of abortion. Furthermore, it would be wise to mandate that every case of abortion be a registered case, with the patient’s right to privacy being retained by allowing them to be unnamed.


Written by Elsie Reed, Kirthi Jayakumar and Shadrack Egbonimali