Neglected Health and Osteoporosis

By Aastha Kapoor

Mothers keep running after their kids with food plate in a hand and a glass of milk in the other. After all, healthy diet is important for the well being and growth of the child. Wives are the ones who buy low cholesterol oil for food cooking so their husbands live long and healthy. The only ones women tend to ignore are themselves. They work and run and cook and clean but still there is no special intake of vitamins or calcium that their bodies require. Such neglect in later days is a cause of diseases such as Osteoporosis.

Osteoporosis refers to the weakening of bones that tremendously raises the chance of bone fractures. In most cases, it is the women post menopause who are at maximum risk to it. It is because post menopause, the BMD (bone mineral density) in women tends to decrease as estrogens levels drop. Deficiency of calcium and Vitamin D in body further aggravates the condition. More than often, the disease goes undiagnosed until late as there are no clear symptoms-just minor ones like loss of height due to curvature of spine that are mostly ignored. The most accurate medical test available to diagnose the disease is the DEXA (Dual Energy X-Ray absorptiometry). It is painless, takes only 10 minutes and is carried out on hip/spine.

One good news is that it is possible to prevent the disease if more attention is given to some parameters. Young women can right away begin taking measures to averse the risk. The steps are simple

·         Intake of well balanced diet that includes milk, eggs,  green vegetables like spinach to maintain appropriate levels of calcium and vitamins

·          Some form of physical exercise like walking, jogging or running

·         Smoking?? No way!

·         Moderate or no drinking

So, it is not really a difficult task to prevent the disease and weakness that comes with it-all that is needed is a little more attention to our own bodies. Only when we ourselves are healthy can we take care of those who matter so much to us, isn’t it?

Source: wellbeing.com.au

Mental stress among women

Women are soft hearted beings. They are gentle and kind. They face loads of strain cum tension of varying magnitude during their journey of life out of which mental stress and its related disorders are amongst the prominent after effects. In their conviction to keep everyone happy, they lose their mental integrity. According to the facts and statistics given by WHO, Depressive disorders account for close to 41.9% of the disability from neuropsychiatric disorders among women compared to 29.3% among men. The leading mental health problems of the elderly people are depression, organic brain syndromes and dementias. Shocking yet significant result is that amongst these people, majority are women.

An estimated 80% of 50 million people affected by violent conflicts, civil wars, disasters, and displacement are women and children.

Lifetime prevalence rate of violence against women ranges from 16% to 50%. At least one in five women suffers from rape/attempted rape/molestation in their lifetime. These are the horrifying results which draw our attention towards this grave issue.

Mental stress is induced among women owing to her environment at personal and professional front. By her qualities of heal and hearty, mostly she is able to manage both fronts efficiently and effectively; at times there occurs a conflict of situations which imbalance her integrity. There are many reasons for depression or psychological stress; mainly it could be due to violence- sexual or domestic (which could be physical), gender discrimination at every turn, while coping up to be an efficient daughter/wife/mother/friend simultaneously where at one point of time she forgets to live herself and last but not the least are other associated socioeconomic factors affecting her mental health secondarily... like over-exhaustion due to household chores, peer pressure, poverty, health related issues viz. malnutrition etc. Associated factors could be seen affecting the mental health of men but women are affected more severely comparatively in terms of frequency and severity. Women are more emotionally inclined hence are trapped in emotional bouts leading to excessive strain. Women have been fed with the disease of inferiority complex; no matter how high they reach… deep inside they know they are lesser. Lack of self confidence affects them even harder. These patients are not recognized and therefore not treated. As per the research, Unipolar depression, predicted to be the second leading cause of global disability burden by 2020, is twice as common in women.

Now the question which rises is that what can be done to prevent the present scenario from deteriorating or what measures can be taken to improve the situation. There’s a need to formulate health related policies that directly target the mental illnesses of all ages. General population should be taught about basics of mental health and ways to distress oneself. Meditation definitely helps. Women who have been abused should be handled with TLC (tender love & care). We all should try to help women who have been ill treated or abused; they need our assistance so as to cope up with their stresses. In this gizmo-tech world, every individual is fighting along with his inner conscious to curb down the stress. Point is that together we can resolve the underlying cause but alone we only get stuck. This is especially true for women who are taken for granted and presumed to be better listeners; their problems remain unsung… Hence, devise ways to smile in pain…

Let’s take steps towards a stress free healthy life for women!

By Aakshi Kalra

An HIV-AIDS Project in East Africa

                         

Today, I would like to introduce you to my good friend and colleague, Dr Connie Chung, who graduated with a doctorate and two master's degrees in Human Development and Psychology  from Harvard University, USA. In the year 2009, Connie won the Harvard Committee on African Studies project that funded her study on gender and HIV in East Africa and this brought her into close contact with the small town of Iringa, in Tanzania, Africa. She met with Anthropologist Joseph Lugalla, who was part of the Iringa Development of Youth, Development and Children Care and after a thorough research of Iringa and the project’s objectives, began working with the project. I had a conversation recently with Dr Connie Chung regarding her experiences in Iringa and regarding her opinion about women and HIV-AIDS in East Africa. Connie provided me with a keleidoscope of myriad experiences coupled with her inferences from the project and her views. The following is an excerpt of my chat with her………

AB: It is really wonderful chatting with you regarding your experience with the gender and HIV-AIDS project in East Africa. I have been thinking about it and the first thought that comes to my mind is ‘this is such enriching and rewarding experience’. What drew you to this project, Connie?
CC: I was drawn to gender since I had previously worked with young girls who were forced or pressured into prostitution and had volunteered with Aids Project Los Angeles. Some of the girls that I had worked with had contracted STDs during their sex work, and females are more likely to contract HIV through heterosexual intercourse than males.

AB: And what research prep did you do before you left for Africa? What were your expectations?
CC: I wrote a proposal that I sent to my advisor, the Harvard Committee on African Studies, a draft which was sent to an anthropologist who focuses on HIV in Africa and also spoke to an Anthropologist who worked with street youth. I did an extensive literature review prior to coming to Africa.
I was expecting to see a profound level of poverty, given that I was focusing on street children and AIDS orphans. I also expected to have difficulty adjusting to the living conditions and culture.

AB: And did you ? Was it how you thought it would be? How difficult was it?
CC: ……I would say that there are layers to the experience, sometimes painful and at other times joyous.  I had difficulty with the physical conditions of my experience, but over time I grew accustomed to it.  

My exposure to Africa prior to my arrival was very much based on Western media-and sometimes in a way that blended paternalism, sympathy, and/or condescension.  Prior to going to Africa, all I heard about Africans was civil unrest, hunger, apartheid, and memories of commercials showing a destitute or forlorn African child.  These snapshots of Africa are actually very myopic, and often streamed to the West en masse without sufficient education of the complexities of African geopolitics and their culture.  Instead, we lump Africa as some foreign, exotic other,without recognizing its significant internal diversity and the complexities of economic development in the aftermath of colonial rule.  I wouldn't say my experience was as difficult with respect to adjusting to the cultural shock and difference, but I did have individual experiences that were very hard. I was robbed in Kenya, and I remember crying because I woke up in a bed covered with lizards.  The latter story is not typical of what it is like to live in East Africa, but I ended up staying in one house that had a problem with lizard infestation.  I still vividly remember the lizards, and crying because I had never been surrounded by lizards before and thought they would attack me.  Being robbed was an emotional experience too.  I had to grow a thicker skin, and recognize that I was very fortunate to have regular access to basic resources. Over time, I adjusted to the rhythm of meeting my practical needs.  You can be robbed anywhere, so this isn't a statement that if you come to Africa, you'll get robbed.  I know plenty of foreigners who lived in Africa for years on end and have never been robbed.  But those two memories were very difficult for me.

The people were very kind to me.  Many people went out of their way to welcome me to their home, sharing whatever resources they had.  There was a warmth and kindness that permeated my social networks, and I also welcomed the different pace of life and how in tune I felt with my core values.  I did a lot of soul searching in Africa, and I think it offered me a breath of healing. I grew up in Los Angeles, a concrete jungle ripe with the entertainment industry.  Then I moved to Boston, a city with a high proportion of academics who are intensely ambitious and/or competitive.  In East Africa, I lived in a house with chickens, boiled water to sanitize it regularly, bathed in a plastic tub, and sometimes didn't have a toilet, running water, electricity, or a shower.  I passed chickens on the way to work, and sometimes saw monkeys cross my path.  My mom grew up in a similar way, having been raised on a farm.  But I wasn’t.  I loved my new life.  

AB: It sounds like a bittersweet experience in some ways Connie. But considering that you were for a project, let us talk about the project a little. Tell me about the condition of women in general and those afflicted with HIV in Africa. How did the project identify those requiring help? Who were you focussing on?
CC: Tanzania, Africa is a complicated place. I specialized in Iringa, Tanzania which is a major travelling center for migrant workers going to Zambia and other countries. There was a high proportion of men migrating for seasonal labor and contracting HIV and then spreading it along migratory transit routes where sex work was common. Tanzania, Africa also allows polygamy so a man could infect multiple wives at a time. So, the magnitude of the problem is colossal. Education and socio-economic status were big barriers. Most of the cohort lived on less than a dollar a day and condoms were very expensive. Cultural beliefs were sometimes at odds with utilizing condoms and there was still a lot of cultural stigma about HIV and a very high prevalence. HIV/AIDS afflicts a high percentage of various regions in Africa, an anecdotal figure of 16% of Iringa residents has HIV.
From what I understand, the organization had social workers who found street-based children (female and males) who were living in destitute conditions outdoors. Many of whom had been orphaned by AIDS, and sometimes contracted HIV on the streets or from birth. In terms of adult women, we often worked with Masaai women who were semi-nomad tribal women. However, I am unclear as to their HIV status: this was more in the context of  microfinance aspects of the organization with business development models.

AB: What did the project hope to achieve ? And was this feasible?
CC: I think this project was excellent at providing support for AIDS orphans through housing, educational supports and also provided microfinance/business loans and small business developmental training to impoverished women and youth. Once you contract HIV, consistency and availability of ARVs is critical. Some of these people seemed to be able to access ARVS but were not always consistent in taking their prescriptions. However, I personally believe that enriching people's lives by poverty reduction efforts, educational outreach, and social support, the project was able to provide some degree of support and help to the women and children afflicted with HIV-AIDS.

AB: Was anything done at all in terms of medical aid to these women and children? How were the resources and facilities medically? Did these women have access to them?
CC: In terms of medical care, IDYDC provided care and support to HIV positive people across age and gender groups. It partners with Family health International, Football for Hope movements, USAID, Engender Health-CHAMPION project, International Youth Foundation, GrassrootSoccer, and FHI-Tunajali project for more resources that are health-specific.

AB:  What is the understanding of the people and particularly the women afflicted with HIV-AIDS and their knowledge about HIV?
CC: I think that when you are dealing with functionally illiterate women who may be highly intelligent but didn't have the resources to attend school, understanding Western conceptualizations about medical diseases can be very foreign and different. Also, these women are dealing with life stressors that are so intense: 5 or 6 children, living in severe poverty, without clean water, etc. that more information that does not align with their indigenous beliefs can be difficult to adopt or practically enact

AB: Did they volunteer for the HIV test? Did the project offer incentives for these tests?
CC: I do not know.I am not sure if there were incentives for taking HIV tests through this organization. I think testing centers are prolific, but many people are reticent to actually get tested and know their status. There is still much cultural stigma related to HIV status, and sometimes people claim to have malaria instead.

AB: How do you think gender inequality affects a woman with HIV status in Africa?
CC: I think gender inequality affects women's access to health care, education, social support, and making empowered decisions about their sexual health. Encouraging condom use actually
assumes that women have egalitarian stakes and choice in the elective use of a condom.
Sometimes men may forgo or refuse condoms on the basis that it numbs their pleasure, and some women who do not have the resources to survive on their own may simply go along with what their partner says. 80% of HIV infections in Tanzania are via heterosexual sex.
Saying no to sex, using condoms, or limiting sexual partner exposure (such as a man who sleeps with multiple women, or accumulating one's own partners) are contingent on other variables related to power, access, status, and gendered ways of being where women are often in a position of less power yet the irony is that women are more likely to be infected with HIV from heterosexual penetration than men. But sexual decision making is undergirded by so many cultural ways of relating and understanding gendered norms that women may sometimes be put at a disadvantage and then subsequently have less resources once they contract the disease ,even if contracted in a situation of oppression or forced assault.

Gender inequality isn't so always so concrete, or black and white.  The preceding example of not being in a position of reciprocal power in negotiating sexual health precautions, such as condom use should not be exaggerated that African men are mysogynistic or that African women are just victims of gendered and other forms of structural/personal oppression.  That would be an over-reduction of a complex issue, and not the case in many relationships between partners.  However, there are still some deep seated cultural norms about gendered roles, gendered separation of labor, and ways of negotiating relationships-particularly for such a delicate topic as sexual intimacy-that I myself am not privy to, or do not fully understand.  I never dated an African man, and many cultural ways of family/gendered life are still very alien to me.  However, some ways of relating that I did observe, as a cultural outsider, not from a rigorous form of study or investigative research-is that many of the women that I dealt with (which does not represent all Africans, of course)-and who are predominantly very poor and have low education/literacy levels, is that they were often highly reliant on men for basic survival, and sometimes that changes the tenor of how sexual and other personal decisions are negotiated in a way where the women were less advantaged, or in a position of elevated risk for HIV.  

AB: From what you have just mentioned, it sounds like these women have very few choices with regards to their life. Did you have the opportunity to speak to any of these women personally?
CC: Yes I spoke to them personally when I was there. I think that choice and opportunity are not only personal, but structural in nature.  So I do want to underscore that many hard working, highly intelligent African men also confronted significant limitation in their occupational or educational trajectory.  In the areas I visited, the levels of poverty could be very severe.  Poverty is a compounding risk factor-it permeates everything from health care, to education, to literacy, to risk for HIV, to family dynamics, sexuality and gendered norms, family dynamics, and engagement with civil society.  So the range of choices that many (not all) of these women confronted may be very limited in comparison to an African of better economic resources and education, and extremely limited in comparison to many middle class Westerners-however, they still aren't victims.  They still exercise choice, even if these choices are made in extreme challenge, hardship, or duress.  

AB: Do you think you were making any difference to them particularly if they were HIV affected?
CC: Population movement among young men in Tanzania is extraordinarily high and this is also a barrier to health care, medication compliance, and maintaining care. My own feeling is that the biggest difference is when you empower people to empower themselves on a grassroots level. IDYDC staff are primarily composed of local Tanzanians or people who permanently relocated to Tanzania to help out. So any effort that I put in should ultimately be about facilitating indigenous populations to access resources, and thereby build their own networks that heighten social capital to help their own people. If anything, they made a greater difference in my life. They changed my perspective about life and love, what poverty looks like, and how resilient the human vessel is when faced with horrific poverty and abuse

AB: Do you feel considering the multitude of problems we have just discussed, the project was a success? What would you call a success ?

CC: The aim of the organisation is to decreased incidence rate of new cases of HIV infection over a 5-10 year span and to create a greater awareness of HIV/AIDS, destigmatization of the illness and people who are infected and strengthening social support and quality of life for HIV-infected persons. ARVs have changed the quality of life for people with HIV. Encouraging patient compliance, targeting dimensions of health, education and poverty reduction, all strong protective factors for HIV are important goals. If you live without access to clean water, you're functionally illiterate living on less than a dollar a day, if you live on one meal a day, then you have to address success as a whole person-their socio-emotional needs,  improving the health care access and consistency of client use of available medical care in already infected persons, nutrition, clean water, essentials for good health when immune functioning is already suppressed from the virus, and educational needs.

Me: Would you like to share what you learnt from this experience and how it changed you to be a better person?
CC: I learned many personal and spiritual lessons from this experience. I learned the power of human resilience in the face of atrocious adversity. Many of these girls/women still laughed, had families, had friends, tried to do the best with what little resources they had: fighting for a bit of food with whatever skills they could muster. I also learned that by virtue of being born in the United States, I was shielded from many assaults such as starvation that afflict many persons in developing nations.I learnt that I was lucky to have clean water, access to a doctor and was fortunate to be able to read and have an education. Hope takes many disparate forms
and tenacity is often built in the mires of deep and insufferable anguish. In terms of what I learned about women, I will say that I learned that gender inequality is reified and reproduced in a culture of silence and shaming.  When women don't have access to clean water, regular access to food, proper health care, who cannot read, and who are sometimes reliant on sex work to survive-it may be difficult for them to fully embrace, or practically institute changes, that reflect Western medical notions about health care and safer sexual health practices.  I really believe in the power of communities advocating for themselves on a grassroots level-African women advocating for African women, Africans advocating for Africans, and this should be done in a climate where basic resources and sheer physical survival are not the most pressing concerns of the day.Then as women grow economically, they can charter a different course in how they conduct themselves in sexual/romantic relationships, and how they negotiate sexual decision making.
and make choices about their bodies, their health, their voice, their opinions, and decide on their fundamental core values in a climate of safety, respect, and understanding. I am not claiming that African culture is anti-women, or that I understand the sophisticated, complex and subtle dynamics that subsume gender relations but that gender and how women empower themselves are still issues that need to be debated, voiced, and loudly heard. It is then that HIV/AIDS, poverty, rape, sex trafficking, abuse, (all of these conditions which also affect boys and men) will have less of a chance to thrive in such an environment of openness, destigamatization, and personal empowerment.

Thank you Dr Connie Chung. We thank you for sharing your experience and wish you all the best for future endeavours.


Dr Anusmita Baruah

Obstetric Fistulae

While much attention has been paid to the socio-economic plight of women in developing countries, the media often neglects to highlight the physical ramifications of such environments, especially regarding women’s health. Poverty and low status are not only psychologically debilitating, but can have severe medical consequences. While an unsexy issue, and therefore one that is difficult to publicize, a lack of adequate medical care is a dangerous (and potentially fatal) problem for women worldwide.

One such issue, remarkably simple and yet devastating, is a birth complication known as obstetric fistula. In regions such as sub-Saharan Africa and parts of Asia, where many women do not receive pre-natal care, this easily preventable and treatable condition affects up to 50,000 women each year.

Obstetric fistula occurs during obstructed labour, when the baby’s head pushes against the pelvic bone, cutting off blood supply to the surrounding tissue.  This creates a ‘fistula’, or a hole, between the birth canal and the nearby internal organs. Among these are the bladder and bowel, which, when affected, can rob the woman the ability to hold her urine or her faeces, an embarrassing and debilitating condition. The physical pain and psychological effects are profound enough, but even worse is the stigma attached to it. Because of the physical incapacitation and foul smell, many individuals are shunned by their communities or exiled from their families. In some cultures, it is not seen as a medical problem, but divine punishment for misbehaviour and in others, women lose their worth when unable to bear children.

In pain and alone without the resources for treatment, women can suffer for years in physical and psychological agony. Relating her story, a Ugandan woman, Sifa, explains how she endured days of labour and a miscarriage after her family refused to take her to a hospital for delivery. “I started leaking urine like tap water after that. I suffered a lot during that time. My husband left me. My mother hated me. I couldn’t fit in with people.” Sifa eventually managed to find herself at a hospital, where she made a full recovery after treatment. However, not all women are as lucky as Sifa.

The treatment for fistula is surgery – estimated at a cost of USD $450 for an individual, it is a relatively low cost procedure that can make or break a life. Recognized as one of the most widespread problems in women’s health, treatment of obstetric fistula was included in the Millennium Development Goals established in 2000, and the UNFPA has begun a campaign directly geared towards ending obstetric fistula.

While the direct cause of fistula is indeed a prolonged labour, an indirect cause is the poverty in many of these countries. The condition has been practically eliminated in the developed world, because of the availability of C-sections and high level of prenatal care. In poorer countries, however, a variety of factors contribute to this growing problem. Malnourishment during growth causes many women to be ill-equipped for childbirth, as their bodies are stunted and pelvises tend to be underdeveloped. Lack of education means many women are unaware of the risks of a prolonged labour. Inability to access adequate healthcare because of cost, distance or in some cases, a woman’s lack of agency over her own body, are all obstacles in caring for high-risk individuals.

Currently, there are a variety of organizations established to educate and eradicate obstetric fitula. You can learn more or how to help at the websites below:http://www.fistulafoundation.org
http://www.engenderhealth.org/our-work/maternal/digital-stories-uganda-fistula.php
http://www.unfpa.org/public/home/mothers/pid/4386
http://www.who.int/features/factfiles/obstetric_fistula/en/


Farahnaz Mohammed

The toilet

The sanitation and health condition of the marginalized section of the society is very acute in the Third World Countries. A case in point is the ability to enroll woman for education and primary education. it is true that for any development to be long lasting requires the participation of the woman of the society . In case their participation cannot be ensured then any development is not going to be deep rooted as half the intended beneficiaries have not been made party to the development process. It is in this context that the issue of sanitation assumes importance.

It is true that female enrollment in schools is low and gradually tapers down by the time the girl acquires puberty. One of the most functional problem that a female in third world country faces is the lack of adequate toilets  for them in any public place and in particular the schools. The aspect of cleanliness is not being touched upon as it is less said the better. However it is pertinent to note that separate toilet for girls in schools are next to nonexistent. Now in the absence of toilets the functional problems that the girl faces is simply phenomenal. In fact it is worth imagining that you are suppose to apply yourself to gain knowledge and when it comes to performing the most basic function you are left high and dry. 

At what cost? Going behind the bushes or behind a wall under the prying eyes of all antisocial elements. Thus the basic incentive to go to school is defeated. Even in the schools were the toilets are there they are common and are mostly dominated by the boys. As the girl grows the problem magnifies and as a result they find it better to leave the formal schooling and contribute to the family labour on farms or as labourer.

Thus the sanitation program of the third world country ought to have a very strong input of provisioning of toilets for females in schools and places of education. This is going to give a boost to the education level of females thereby imparting huge push to the various welfare measures being run concurrently.

By Rajiv Tewari

Breast Cancer Awareness

Cancer has always been a dreadful name for common man especially. Cancer in any form signifies pain, mental torture and finally succumbing to end. But its real definition is unknown to many. According to WHO, Cancer is a generic term for a large group of diseases that can affect any part of the body. One defining feature of cancer is the rapid division of abnormal cells that grow beyond their defined limits, and which can then invade adjoining parts of the body and spread to other organs. This process is referred to as metastasis. Metastases are the major cause of death from cancer. Breast cancer is currently the top cancer in women worldwide, both in the developed and the developing world. The majority of breast cancer deaths occur in low- and middle-income countries, where most of the women are diagnosed in late stages due mainly to lack of awareness and barriers to access to health services.

Breast cancer is the most common cancer in women worldwide, comprising 16% of all female cancers. It is estimated that 5,19 000 women died in 2004 due to breast cancer, and although breast cancer is thought to be a disease of the developed world, a majority (69%) of all breast cancer deaths occurs in developing countries (WHO Global Burden of Disease, 2004).

Incidence rates vary greatly worldwide, with age standardized rates as high as 99.4 per 100 000 in North America. Eastern Europe, South America, Southern Africa, and western Asia have moderate incidence rates, but these are increasing. The lowest incidence rates are found in most African countries but here breast cancer incidence rates are also increasing. The statistics are indeed disheartening and provoke us to initiate a strong fight against it. In fact, many women remain ignorant of the symptoms of the disease and tend to ignore them. This has been especially seen in underdeveloped countries. 

Reproductive factors associated with prolonged exposure to endogenous estrogens, such as early menarche, late menopause, late age at first childbirth are among the most important risk factors for breast cancer. The causal factors have been associated with familial history of the patient and rarely with mutations of genes. We need to address such grave familial tendencies effectively as it would aid in early detection and henceforth early treatment of cancer. 

Woman get scared of telling the changes in them and suffer the end term consequences. Few steps towards prevention can bring about long term results. Women in underdeveloped and developing nations are unaware of simple points. Control of specific modifiable breast cancer risk factors as well as effective integrated prevention of non-communicable diseases which promotes healthy diet, physical activity and control of alcohol intake, overweight and obesity, could eventually have an impact in reducing the incidence. The effect of cancer is more of psychological than physical. 

There are two early detection methods; one could be early diagnosis or awareness of early signs and symptoms in symptomatic populations in order to facilitate diagnosis and early treatment and second could be screening that is the systematic application of a screening test in a presumably asymptomatic population. It aims to identify individuals with an abnormality suggestive of cancer.

As far as treatment is concerned, Breast cancer is usually treated with surgery and then possibly with chemotherapy or radiation, or both. A multidisciplinary approach is preferable. Hormone positive cancers are treated with long term hormone blocking therapy. Treatments are given with increasing aggressiveness according to the prognosis and risk of recurrence.

We all can read books over breast cancer or simply search on net but if we do not take necessary steps what is the point… Sometimes, we need someone who can tell us few points in a different manner which insists us to rethink over the issue. Hopefully, this does the same.

Hence jist is as per incidence level we need to educate women through every possible way. As  

“Prevention is better than cure”

• 
  

• Written by Dr. Aakshi Kalra

ALCOHOL: AN ADDICTION CLAIMING LIVES OF MANY WOMEN

Alcohol is an intoxicating constituent of many hard/alcoholic drinks. Alcoholism is lifelong and it can be both progressive and life threatening. Alcohol consumption has increased manifold in the recent years especially among women. Men and women under the age of 21 are strictly prohibited from drinking. Woman who are or planning to become pregnant should avoid drinking as well but no one really cares about the after effects. Alcoholic drinks can interfere with certain medicines and cause side effects. 

In spite of knowing the ill effects of alcoholism, women are increasingly getting indulged into this addiction. It is a potent source of depression contrary to what people normally think - that it makes them forget worries. 

Women are at greater risk than men for developing alcohol-related problems. Research suggests that as little as one drink per day can slightly raise the risk of breast cancer in some women, especially those who are postmenopausal or have a family history of breast cancer.

Women who are facing troubles in their career, close relationships, unmarried, divorced or separated are prone to alcoholism. Assaulted or sexually abused women face the same. They feel they have been rejected by society and it seems that alcohol keeps them away from troublesome worldly situations. Unfortunately, over drinking deteriorates their health and mental thinking and reacting abilities.

Stress coping is a daily phenomenon in a woman’s life. One of another reasons for drinking is stress coping.

Drinking too much often leads to impaired judgement, slurring of the speech, a tendency to violent behaviour and loss of short-term memory. As alcohol also irritates the stomach, heavy drinking can cause sickness and nausea, and sometimes diarrhoea. Alcohol also has a dehydrating effect, which is the main reason why excessive drinking can lead to a hangover. 

In the long term, alcohol can contribute to a variety of problems, including damage to an unborn child, liver disease, osteoporosis (thinning of the bones), pancreatitis, stomach ulcers, infertility, heart disease, raised blood pressure, stroke, dementia and brain damage. 

It can also lead to an increased risk of a variety of cancers, particularly breast cancer and cancer of the gullet. All these are adverse reactions of over drinking as it is well said, “Excess of everything is bad”

Let us try to make life better for womanhood so that worse situations do not drive her towards such addictions. There are numerous ways of coping up with this addiction but it is often a difficult path and requires full support and patience of the family along with the sufferer. Rehabilitation centers offer solutions to such problems. Peer and family care can make anyone overcome alcoholism in span of time. One day we all have to die, so why not die with a smile with nurturing family beside instead of dying with poisonous addictions and that too lonely!

By Dr. Aakshi Kalra

Malnutrition among women and adolescent girls

Adequate nutrition, a fundamental cornerstone of any individual's health, is especially critical for women because inadequate nutrition wreaks havoc not only on their health but also on the health of their children. Children of malnourished women are more likely to face cognitive impairments, short stature, lower resistance to infections, and a higher risk of disease and death throughout their lives.

Although malnutrition's effects have been recognized for decades, there has been little measurable progress in addressing the specific nutritional problems of women and adolescent girls. Ignorance about the symptoms of malnutrition, such as the lethargy and depression caused by iron deficiency, may be dismissed as "normal" or unimportant, further exacerbating the problem.

Malnutrition poses a variety of threats to women. It weakens their ability to survive childbirth, makes them more susceptible to infections, and leaves them with fewer reserves to recover from illness. HIV-infected mothers who are malnourished may be more likely to transmit the virus to their infants and to experience a more rapid transition from HIV to full-blown AIDS. Malnutrition undermines women's productivity, capacity to generate income, and ability to care for their families.

Certain conditions and phases of a woman’s life need special attention in terms of nutritional value. The onset of menstruation in which lot of iron is lost each month during menstruation making teenage girls and women very prone to iron deficiency anaemia. One should ensure that they are getting adequate amounts of iron and vitamin C (which aids iron absorption) during this period, Pregnancy in which a well balanced diet will help a mother-to-be to stay healthy and supply sufficient nutrition to growing foetus. A good intake of all vitamins and minerals is essential during pregnancy. Calcium helps baby’s teeth and bone formation. Vitamin D helps the body to absorb calcium and folic acid reduces the risk of congenital neural tube defect in baby. Iron is required for making baby’s blood as well as for maintaining mothers own iron levels, Menopause in which women tend to lose more calcium and bone density making them prone to osteoporosis. At this age, one should eat plenty of dairy products, green leafy vegetables and avoid excessive caffeine and alcohol.

Addressing women's malnutrition has a range of positive effects because healthy women can fulfill their multiple roles like generating income, ensuring their families' nutrition, and having healthy children more effectively and thereby help advance countries' socioeconomic development. Women are often responsible for producing and preparing food for the household, so their knowledge or lack thereof about nutrition can affect the health and nutritional status of the entire family. Improving women's nutrition can also help nations achieve three of the Millennium Development Goals, which are commonly accepted as a framework for measuring development progress.

By Aakshi Kalra

The Heavy Threat

Being overweight and obese are conditions consequent to excessive fat accumulation that presents a risk to health. In fact, anything that is over or above accepted norms is not favorable for the body.

It is a bitter irony that as developing countries continue their efforts to reduce hunger, some are also facing the opposing problem of obesity.  "Unfortunately, food doesn't always get to the people who need it most." Hunger is one result. Obesity is another. Though data on obesity in the developing world are limited, preliminary studies indicate that some of the same nutrient deficiencies in the underfed also afflict the overfed. Two of the most common are iron deficiency - anemia and vitamin-A deficiency, which continues to cause widespread blindness in children under five.

In the WHO Region for Europe, Eastern Mediterranean and for the Americas over 50% of the women were overweight. For all three of these regions, roughly half of overweight women are obese (23% in Europe, 24% in the Eastern Mediterranean, 29% in the Americas). In all WHO regions, women were more likely to be obese than men. In the WHO regions for Africa, Eastern Mediterranean and South East Asia, women had roughly doubled the obesity prevalence of men.

Being overweight has become a serious health threat for women at every stage of life. It is deemed a serious factor in over 30 conditions that effect women. As the prevalence of obesity has grown significantly, it has become the second largest cause of preventable death in the United States, following tobacco. Recent research is clarifying the relationship of obesity to breast cancer. "The percentage of postmenopausal breast cancer accounted for by weight gain alone was approximately 16% and by hormone replacement therapy alone was 5% but when the interaction between these variables was considered, together they accounted for about one-third of postmenopausal breast cancers."

Excess body fat is related to menstrual abnormality, infertility, miscarriage and difficulties in performing assisted reproduction. High pre-pregnancy weight is associated with an increased risk in pregnancy of hypertension, toxemia, gestational diabetes, urinary infection, macrosomia and cesarean sections. Obesity was found to be a strong risk factor for several urinary symptoms after pregnancy and delivery or as long as 6-18 months postpartum. Raised body mass index (BMI- measure of weight relative to height) also increases the risk of cancer of the breast, colon, prostate, endometrium, kidney and gall bladder. The prevalence of raised body mass index increases with income level of countries up to upper middle income levels.

Obesity affects the psychology of a woman as well. A sense of inferiority and feebleness gather importance in life. Hence, obesity not only has physical bearing but also mental and psychological after effects. After all,

A healthy mind always resides in a healthy body

To achieve optimum health, the median body mass index for an adult population should be in the range of 21 to 23 kg/m², while the goal for individuals should be to maintain body mass index in the range 18.5 to 24.9 kg/m². The main treatment for obesity consists of dieting and physical exercises. Diet programs may produce weight loss over the short term but maintaining this weight loss is frequently difficult and often requires making exercise and a lower food energy diet a permanent part of a person's lifestyle. Weight reduction of even a kilogram boosts up confidence level. The most effective treatment for obesity is bariatric surgery (weight loss surgery). Surgery for severe obesity is associated with long-term weight loss and decreased overall mortality.

Still it’s always better to opt for prevention than cure.

Written by Dr. Aakshi Kalra

World Hepatitis Day 2012: Is Enough Being Done to Help Women

In 2010, it was decided that every July 28th would be known as World Hepatitis Day. As one of four diseases to be granted a specific day (the other three being Malaria, HIV/AIDS, and TB), Hepatitis is known as a ‘silent disease’. Across the world some countries are tackling Hepatitis head on, but many are failing to give the disease the recognition it needs in order for it to be prevented. As a result of this, millions of women across the world are suffering.

For women, the lack of attention paid to Hepatitis can come with serious health implications. Unfortunately, it is women who are more at risk, and women who are less likely to access life-saving treatment. Hepatitis E, which is spread via the fecal oral route, is usually contracted as a result of poor hygiene practices and unsafe drinking water. Women who are pregnant are particularly susceptible to the disease; once they have caught it, there is no specific cure, and they are at risk of liver failure. In addition to this, the disease can spread to the fetus, and increase the risk of miscarriage and stillbirth.

Other more lethal forms of Hepatitis, such as B and C, are spread through the exchange of bodily fluids. Both types are on the rise among drug users and sex workers, and with many sex workers in the developing world experiencing poor access to barrier contraceptives, routine vaccinations, and sexual health screening, women are naturally at risk of catching the disease. As many female sex workers do not carry condoms due to the stigma attached, cannot afford costly Hepatitis B vaccinations, and are not aware of this silent disease, they often only recognize the signs of Hepatitis when it is too late.

Although 2012’s World Hepatitis Day highlighted successes in Australasia and the Far East, there are many areas of the world that are failing to meet the demands of this silent disease. For example, in Ghana a vaccination program is available, but at the cost of 60Cedi--a price that many Ghanians cannot afford. The same pattern is repeated across many African countries. However, the governments of such countries could learn from Nigeria, as its health service has made significant attempts to combat the disease.

It is now the case that a hotline is available in Nigeria to those who feel they may be at risk of, or have developed, hepatitis. This hotline allows Nigerians to access advice on treatment, symptoms, and prevention. In addition to this, it can direct those who call towards doctors who can treat the disease, as well as vaccination programs. This could be the way forward for women who otherwise would not be able to access vaccinations. Ultimately, what benefits women will also benefit their husbands and children. In addition to this, over 10,000 children were issued toothbrushes to combat Hepatitis types A and E, which are spread due to poor hygiene. This is a great example of how it is possible to combine prevention and education en-masse.

Although these measures are great, they should not be seen as silver bullets in the battle against this deadly disease. All governments, not just Nigeria’s, should make it their mission to educate those who are at risk. Sexual health programs across Nigerian schools would alert both men and women to the ways that Hepatitis is spread, and how to prevent it. Similarly, routine vaccinations for types A and B would significantly reduce the disease’s prevalence. As it stands, only 9% of Nigerian people are vaccinated against the disease, despite it being 50 x more infectious than HIV, and 19 million people having it. Finally, the stigma that surrounds the use of barrier contraceptives needs to be eliminated. This is particularly the case for female sex workers, who often fail to use them for fear of being persecuted.

In 2012, Hepatitis continues to be known as the ‘silent disease’. The World Health Organization have taken a big step by introducing World Hepatitis Day, and now governments across the world need to take a strong stance in order to prevent the disease. If each country were to honour this day by introducing educational programs, greater access to barrier contraceptives, and free vaccination programs, the prevalence of this disease could be reduced drastically.

08058206916 - Nigerian Hepatitis Helpline


By Laura McKeever

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

1.      ^ http://www.emro.who.int/publications/emhj/0601/06.htm

2.      ^ http://rmohamed.kau.edu.sa/Files/140/Researches/59054_29400.pdf

3.      ^ http://indox.org.uk/node/34

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.111.4.844. PMID 12671122. 

5.      ^ http://www.ncbi.nlm.nih.gov/pubmed/21110899

6.      ^ http://vstudentworld.yolasite.com/resources/final_yr/gynae_obs/Hamilton%20Fairley%20Obstetrics%20and%20Gynaecology%20Lecture%20Notes%202%20Ed.pdf

7.      ^ Magnússon, T.E. (May 1978). "Age at menarche in Iceland.". American journal of physical anthropology 48 (4): 511–4. doi:10.1002/ajpa.1330480410. ISSN 0002-9483. PMID 655271. 

8.      ^ http://pediatrics.aappublications.org/content/early/2011/06/08/peds.2010-2267.abstract

9.      ^ Frisch RE (August 1987). "Body fat, menarche, fitness and fertility". Human Reproduction 2 (6): 521–33. PMID 3117838. http://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