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Health Reporting: Winner - Bamuturaki Musinguzi, Daily Monitor
Health Reporting: Winner - Bamuturaki Musinguzi, Daily Monitor
BY BAMUTURAKI MUSINGUZI
Battling elephantiasis
The Minsitry of Health
says more than 11 million
Ugandans are suffering from
Neglected Tropical Diseases
(NTD). Starting today,
Healthy Living will run a
series of stories on NTDs. We
begin with elephantiasis, a
disease that leads to massive
swelling of body parts.
BY BAMUTURAKI MUSINGUZI
editorial@ug.nationmedia.com
Prevalence rate
According to the Drugs for Neglected Diseases Initiative (DNDI),
elephantiasis affects an estimated
120 million people living in tropical
areas. The ministry reports that elephantiasis mostly affects the poorest
Ugandans. It is a major public health
and socio economic problem with 4.7
million people in 54 districts out of
the 112 suffering from the disease.
Another 14.5 million are at a risk of
being infected.
In some communities in eastern
and northern Uganda, up to 25 per
cent of adults show chronic signs of
LF; mainly hydroceles.
54
12
Peter Oyuki has lived with elephantiasis for 31 years. PHOTO BY PAUL MENYA
Treatment coverage
The NTD Control Programme
provides annual drug treatments to
nearly 13 million people in affected
areas under its Mass Drug Administration (MDA) activity.
MDAs occur annually in districts
endemic with NTDs that can be controlled with medicine. The first MDA
with Ivermectin and Albendazole
against elephantiasis was carried
out in 2002 in two districts (Katakwi
and Lira), reaching coverage rates of
about 75 per cent.
The MDA has been scaled up to
cover all the 54 affected districts.
Health workers also conduct hydrocele surgeries. There are plans
to scale up the number of surgeries
conducted by implementing surgical
camps.
Those with elephantiasis get health
education to control secondary infections and alleviate pain. Health officials refute claims that elephantiasis
is caused by witchcraft and hydroceles are hereditary. Matwale says
treating elephantiasis in Uganda is
not clear-cut like treating malaria.
This is chronic infection where
obvious signs (elephantiasis and
hydrocele) appear later in life. Our
strategy is to interrupt transmission
where by people are given medicines
(Mectizan and Albendazole) despite
their infection status. By doing that,
those who have it will have reduced
the worm load, which cant be picked
by the mosquito.
The major challenge is to convince those without the signs to take
the medicine. Also, there is little focus or help for those already infected
because the medicine has little effect.
Lastly, we lack transport and operation funds to intensify supervision
of village health team members who
are our frontline service providers,
Matwale adds.
According to the ministry more
than 11 million Ugandans are suffering from NTDs. Uganda has 12 NTDs.
World Health Organisation says NTDs
such as leprosy, elephantiasis and
leishmaniasis (kala-azar) are feared
and the source of strong social stigma
and prejudice. As a result, these diseases are often hidden out of sight,
poorly documented and silent.
Daily Monitor
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TEETH
CARING FOR AN
EXTRACTED TOOTH
Have you ever had a painful
cavity and all you can do is
go for extraction to relieve
yourself of the pain? The
next few days before healing
might have been so bad that
you questioned what went
wrong because the wound
was as painful as the cavity.
Dr Victoria Nanziri, a dental
administrator at Nakasero
Hospital says: The pain
only comes either because
the person who extracted
the tooth did not give
proper instructions or you
simply never followed the
instructions.
After the tooth has been
extracted, you must not
brush immediately because
the toothbrush may
accidentally hit the gum
causing it to bleed.
Dr Nanziri also warns
against immediate rinsing
because it washes away the
platelet clotting responsible
for quicker healing of the
wound.
The pain comes due to
infections because you did
not follow instructions and
proper medication. The area
must be healed within four
days, adds Dr Nanziri. The
medication given includes
painkillers to reduce pain
and antibiotics to kill the
bacteria.
If the pain persists, you
must see a dentist who
will make it bleed and
dress it again and give you
medication that will help
you heal.
Dos
Eat soft foods
Take lukewarm fluids
Take the medicine as
instructed by the dentist.
Rinse the mouth with
lukewarm water and salt the
following day.
Donts
Take a lot of fluids on day
one
Eat hard foods
Roll your tongue on the
area
Brush or rinse immediately
after the extraction.
After a day, you may brush
but be careful not to hit
the affected area to avoid
bleeding.
By Beatrice Nakibuuka
BY BAMUTURAKI MUSINGUZI
editorial@ug.nationmedia.com
A number of
people have
resisted taking
the drugs
because some
politicians
claim that if
they do, they
will not have
children in
future,
GODFREY NSEREKO
KATOSI VILLAGE
HEALTH TEAM
MEMEBER
240
74
THE NUMBER OF DISTRICTS IN
UGANDA AFFECTED BY BILHARZIA
200,000
Fishermen at Katosi
landing site prepare
to go fishing. Wading
through fresh lake
water puts people
at risk of Bilharzia
infection.
PHOTO BY PAUL MENYA
Daily Monitor
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HEART
BURN
GETTING RID OF THE
IRRITATING FEELING
Raymond Kabenge
(above) admits
he does not know
what causes
intestinal worms.
(left) hookworms
are one of the
common types
of worms that
Ugandans suffer
from.
PHOTO BY PAUL MENYA/
NET PHOTO
FACTS WE SHOULD
KNOW ABOUT WORMS
According to the Ministry of Health,
hookworm is the most common of all
worm infections, and it is homogenously
distributed in the country exceeding 60
per cent prevalence in 85 per cent of the
schools surveyed.
On the other hand, roundworm
and whipworm are concentrated in
southwestern Uganda, where up to 9 out of
10 people are said to be infected.
The health ministry estimates that
about 17 million Ugandans are infected
with worms and 33 million are at risk of
becoming infected.
The latest estimates from WHO indicate
that worldwide, more than 880 million
children are in need of treatment for these
parasites.
serves.
Intestinal worms include roundworm (ascaris lumbricoides), whipworm (trichuris trichiura) and
hookworm (necator americanus and
ancylostoma duodenale). They are
commonly transmitted through poor
hygiene and sanitation.
The worms enter the body through
bare feet or ingestion of contaminated foods.
Their eggs are released through
the faeces of infected individuals into
the environment, hence the collective
name of Soil Transmitted Helminthes
(STH). They are also one of the neglected tropical diseases.
According to the World Health Organisation, STH live in the intestine
of infected individuals where they
produce thousands of eggs each day,
which are then passed out in faeces.
Humans become infected when
ingesting infected roundworm and
whipworm eggs or hookworm larvae
in contaminated food (for example,
vegetables that are not thoroughly
cooked, washed or peeled), hands or
utensils or through penetration of the
skin by infective hookworm larvae in
contaminated soil.
There is no direct person-to-person
transmission or infection from fresh
faeces because eggs passed in faeces
need about three weeks in the soil before they become infectious.
According to WHO, the more the
number of worms an infected person
has, the greater the severity of disease.
The worms impair the nutritional
status of those infected in many
ways, including causing intestinal
bleeding, loss of appetite, diarrhoea
or dysentery and sometimes causing
complications that require surgical
intervention.
Hookworms for instance can cause
chronic intestinal blood loss that may
result in anaemia.
According to the Ministry of Health,
worm infection in pregnant women
can lead to underweight babies and
complications for the mother.
WHO notes that worm infections
are among the most common infections worldwide, and affect mainly
deprived communities.
Pregnant women at risk
According to WHO, pre and schoolgoing children and women of childbearing age (including pregnant
women in the second and third trimesters, and those who are breastfeeding face higher risk of suffering
from worms.
Infections are common in tropical
and subtropical areas and, since they
are linked to lack of sanitation, they
occur wherever there is poverty.
The parasitologist in the Vector
Control Division at the Ministry of
Health, David Oguttu attributes the
high burden of intestinal worms in
Uganda to the ignorance about transmission and prevention.
There is poor sanitation especially if somebody infected with
hookworms openly defecates in the
gardens, other people will also be infected. We also have poor food handling and hand-washing culture and
hygiene, Oguttu says.
The Mayuge District Vector Control Officer, Juma Nabonge notes that
containing the disease that is spread
across the district requires a combination of interventions including
construction of latrines. As far as
sanitation is concerned we emphasise wearing of shoes to reduce the
transmission rate and continued usage of drugs, Nabonge says.
Interventions
WHOs control interventions are
based on the periodic administration
of anthelminthics to groups of people
at risk, supported by the need for improvement in sanitation and health
education.
The health ministry treats all children aged one to 15 years twice a year,
under the Mass Drug Administration
(MDA) programme with medicine
(Albendazole and Mebendazole) donated by WHO.
The government and its partners
observe that school-based MDA to
treat bilharzia and STH has proven
to be a cost-effective intervention.
Reasons for this include the reduced
price of the drug and the use of nonhealth volunteers to distribute the
medicines.
Government admits in the National
Master Plan for Neglected Tropical
Diseases Programme 2013-2017 that
sanitation management remains dismal, with latrine coverage still below
the expected level.
As a result, after successful treatment of worms, majority of the people quickly get re-infected, thus compromising the impact of Mass Drug
Administration. It is therefore vital to
undertake sanitation improvement,
behaviour change among communities and snail (the vector for bilharzia) control, all of which are currently
not being given adequate attention
due to limited funding.
Latrine construction especially in
public places such as landing sites,
schools, health facilities, worship
places and markets should be made
priority.
Daily Monitor
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FUN TIME
ARE YOU WATCHING
TOO MUCH TV?
Are you watching too much
television? Well, in the long
run, it could have negative
consequences for your eyes.
According to Charles
Mainga, an optician at
Eye-to-Eye Optical Centre,
watching television generally
does not damage the eyes,
but rather strains it over a
period of time.
He explains that there is no
defined distance from which
either adults or children
should be while watching TV,
but generally, being four to
five metres away from the
set is recommended.
Children have the ability to
focus very well at close range
because they have a shorter
distance between their eyes
than adults, hence they
prefer sitting closer, Mainga
says.
He, however, adds that
if a child has the habit of
watching TV while sitting
closer to the set, the parents
should consider undertaking
tests to eliminate possible
refractive error, especially
shortsightedness.
What happens is when
people are watching
television, the muscles
around the eyes get worked
up and the longer the person
watches the screen, the
more tired the eyes get,
explains Mainga.
Other activities that cause
eye strain may include sitting
behind computers over long
periods of time.
It is not advisable to watch
television in a dark room
where it acts as the only
source of light because
eyes quickly get fatigued.
The sitting posture should
be upright and not on the
bed or lying on ones back
because it can lead to severe
backache and neck pain,
says Mainga.
Dr Ronald Kiweewa of Kadic
Hospital Bukoto, explains
that when light enters the
eye, it has to be refracted
or reflected, which involves
sending impulses to the
brain thus affecting the
eye nerves. And when a
person consistently watches
television over a long period
of time, say four to five
years, the cornea and iris
(parts of the eye) tire out
and therefore cause damage
to the eyes.
By Roland Nasasira
BY BAMUTURAKI MUSINGUZI
editorial@ug.nationmedia.com
2m
UGANDANS AT
RISK OF INFECTION.
3m
NUMBER OF UGANDANS WHO
ARE BLIND BECAUSE OF THE
DISEASE.
20,000
AFFECTED DISTRICTS.
35
Tereza Akulu speaks during the interview. (Below) She has developed a patchy skin
infection on her legs as a result of living with river blindness for several years.
PHOTOS BY PAUL MENYA
Daily Monitor
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GOOD DIET
WHY YOU SHOULD EAT
A BALANCED DIET
Nutritionists encourage
us to eat a well-balanced
diet. But how many of us
know what exactly entails a
balanced diet? According to
nutritionist Jamiru Mpiima
of Family Nutritionist
Uganda, people usually
misunderstand what a
balanced diet is and what it
should contain.
It is sometimes referred
to as a coloured plate. This
means your plate of food
should have more than three
colours of food, he says.
He explains that for a
meal to be balanced, it
should have at least five
food groups, each taken
differently, depending on the
requirement for the body.
These comprise starch
from grains such as cereals,
cassava, sweet potatoes and
plantains. It can also contain
proteins as a source of body
building. The proteins can
come from plant and animal
sources. Animal proteins can
be got from fish, eggs and
milk, while plant proteins
include soy beans and
ground nuts.
Therefore, a balanced diet
should include both animal
and plant proteins.
Fruits such as pineapples,
paw paws, oranges and green
vegetables should also be
included in ones meal. Fatty
oils are also recommended,
although they should always
be taken in moderation.
Mpiima notes that a
balanced diet is important
because one type of food
cannot have all nutrients
needed for the proper
functioning of the body.
Whereas fish and eggs have
particular nutrients, they
may not be able to cater for
fibres found in vegetables
and minerals, he explains.
Without a balanced diet, a
person risks being either
over or under malnourished.
You can see a person having
matooke and beans every day
and when they check with
the doctor, they are told that
they are malnourished. This
is not the best way to keep
healthy, he notes. He adds
that eating a balanced meal
everyday also helps to reduce
the chance of developing
constipation and contributes
to better brain growth in
children.
By Sandra Janet Birungi
Daily Monitor
www.monitor.co.ug
Monika Nandego
(Left) has lived
with trachoma
since she was 10
years old. She says
the disease has
severely affected
her left eye and
causes her pain.
PHOTOS BY PAUL MENYA
Trachoma is a preventable
disease which continues to
blind people in Uganda. In our
series on neglected tropical
diseases, today we look at
how it can be managed.
BY BAMUTURAKI MUSINGUZI
editorial@ug.nationmedia.com
GOOD DIET
WHY YOU SHOULD
NOT SKIP BREAKFAST
Nutritionists encourage
us to eat a well-balanced
diet. But how many of us
know what exactly entails a
balanced diet? According to
nutritionist Jamiru Mpiima
of Family Nutritionist
Uganda, people usually
misunderstand what a
balanced diet is and what it
should contain.
It is sometimes referred
to as a coloured plate. This
means your plate of food
should have more than three
colours of food, he says.
He explains that for a
meal to be balanced, it
should have at least five
food groups, each taken
differently, depending on the
requirement for the body.
These comprise starch
from grains such as cereals,
cassava, sweet potatoes and
plantains. It can also contain
proteins as a source of body
building. The proteins can
come from plant and animal
sources. Animal proteins can
be got from fish, eggs and
milk, while plant proteins
include soy beans and
ground nuts.
Therefore, a balanced diet
should include both animal
and plant proteins.
Fruits such as pineapples,
paw paws, oranges and green
vegetables should also be
included in ones meal. Fatty
oils are also recommended,
although they should always
be taken in moderation.
Mpiima notes that a
balanced diet is important
because one type of food
cannot have all nutrients
needed for the proper
functioning of the body.
Whereas fish and eggs have
particular nutrients, they
may not be able to cater for
fibres found in vegetables
and minerals, he explains.
Without a balanced diet, a
person risks being either
over or under malnourished.
You can see a person having
matooke and beans every day
and when they check with
the doctor, they are told that
they are malnourished. This
is not the best way to keep
healthy, he notes. He adds
that eating a balanced meal
everyday also helps to reduce
the chance of developing
constipation and contributes
to better brain growth in
children.
By Sandra Janet Birungi
Sleeping sickness
still thrives in
poor communities
Although many countries have
eliminated sleeping sickness,
it continues to affect several
communities in Uganda,
especially those who are poor,
with limited access to health
care services.
BY BAMUTURAKI MUSINGUZI
editorial@ug.nationmedia.com
Late-stage disease
Charles Elamu, the Kaberamaido
District vector control officer says in
Ocungs case, the disease was already
at an advanced stage. It had therefore
affected his central nervous system.
During this stage, patients develop
visual problems, they feel sleepy
most of the time and their speech
becomes incoherent.
Like Ocung, Moses Eryengu initially relied on malaria drugs which
he got from his drug shop in Soroti
Town to treat his illness. Little did he
know, at the time, that it was sleeping sickness that was keeping him ill
most of the time.
I was weak and could not even
stand up. I was admitted to hospital.
Tests confirmed I had sleeping sickness and not malaria. I felt relieved
because at least I now knew what it
was. I even thought I had been bewitched because of the on-and-off
Control efforts
However, WHO says continuous
prevention control efforts over the
years have reduced the number of
new cases. In 2009, there were 9,878
new cases of the disease reported in
Uganda. This was also the first time
in 50 years that less than 10,000 cases
were reported.
And in 2012, this figure dropped
further to 7,216 cases.
Sleeping sickness is prevalent in
about 40 districts, with 10 million
more people at risk. Because of concerted control efforts, we have been
reporting just a third of cases in the
past five years ago, says Dr Charles
Wamboga, the programme manager
in-charge of sleeping sickness control
at the Ministry of Health.
The ministry notes that Uganda is
affected by mainly two types of the
diseases-trypanosoma brucei gambiense and trypanosoma brucei rhodesiense.
Trypanosoma brucei gambiense
predominantly occurs in the West
Nile region, which is bordered by the
Democratic Republic of Congo and
South Sudan- countries also known to
Daily Monitor
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DIAPERS
WHEN YOUR BABY
DEVELOPS RASHES
John Ocung (above) speaks during the interview. (Below) A campaign poster against
sleeping sickness hangs in a ward at Lwala Hospital PHOTOS BY PAUL MENYA
muscles and joints, headaches and
irritability. When left untreated, the
disease attacks the central nervous
system and can cause death.
According to WHO, sleeping sickness occurs only in 36 sub-Saharan
Africa countries where there is a high
prevalence of tsetse flies.
The population most exposed to
tsetse fly and affected by sleeping
sickness live in remote areas with
limited access to adequate health
services, which complicates the surveillance and therefore the diagnosis
and treatment of cases.
In addition, displacement of populations, war and poverty are common
factors that facilitate transmission, as
poor people with no access to health
services cannot be diagnosed early
enough and put on treatment.
Daily Monitor
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districts. Mapping is important to establish the extent of the disease, however, we need to know where the vector is more prevalent. We also need to
have good diagnosis and treatment,
Prof. Olobo notes.
Illiteracy
A poor health seeking behaviour
and low literacy levels are some of the
challenges that make it easy for kalaazar disease to thrive in Amudat.
When people in these areas fall
sick, they do not seek medical care
from hospital immediately. Their first
call is usually the traditional healers and when this fails, they come
to hospital, says Lawrence Okello,
the medical officer in charge of the
management of kala-azar patients at
Amudat Hospital.
According to WHO, kala-azar is
most prevalent in the Indian subcontinent and in East Africa. An
estimated 200,000 to 400,000 new
cases of kala-azar occur worldwide
each year. Over 90 per cent of the new
cases occur in six countries of Bangladesh, Brazil, Ethiopia, India, South
Sudan, and Sudan.
Treatment
Following a kala-azar disease assessment, Medecins Sans Frontiers
(MSF), which has been offering technical assistance to Amudat Hospital,
initiated a control programme in
2000, focusing on case detection and
treatment.
Treatment of kala-azar usually involves the use of antimonial drugs
such as sodium stibogluconate (SSB),
which has also been included on the
essential drugs list of Uganda.
Research has also been conducted
in the past three years to see if drug
combinations are effective.
The health ministry admits there
is no established control programme
for kala-azar, with current diagnosis
and treatment largely supported by
the Drugs for Neglected Disease initiative (DNDi).
GOOD DIET
LIMIT YOUR DAILY
SALT INTAKE
Salt (sodium chloride) is
essential for our bodies.
However, if consumed in
high quantities, it can cause
high blood pressure and also
damage the kidneys.
When there is too much salt
in the body, the kidneys pass
it through urine. However,
because of the high salt
level, the kidneys cannot
keep up with the salt level,
and most of it ends up in the
bloodstream.
Salt also attracts water. And
as it draws more water into
the blood, this increases
the volume of blood, which
thereby raises blood
pressure.
That is why eating salty food
tends to make us thirsty,
as we end up drinking and
retaining excess. With this,
the blood pressure also
continues to build as water
is consumed several hours
after salt is ingested.
The result can be a
temporary increase in blood
pressure, which persists
until the kidneys eliminate
both salt and water.
Foods that are high in salt
will increase blood pressure
over time. Fortunately,
limiting salt intake in the
diet can reverse these
effects. Discuss with your
nutritionist, the alternatives
you can use to reduce your
salt intake. These could
include adding lemons and
spices to your daily diet.
Also, some people are more
sensitive to salt than others
including the elderly, women
and people with diabetes.
These groups of people
need to control how much
salt they consume. Most of
the sodium we consume is
in the form of salt, and the
vast majority of it is found in
processed foods.
It is also recommended
that you consume more
potassium containing foods
because it is the balance
of the two minerals that
matter. A potassium-rich
diet includes a wide variety
of fruits, vegetables, and
legumes.
Alternatively, discuss with
your nutritionist how to cook
delicious food without or
with limited salt.
By Jamiru Mpiima
The writer is a nutritionist
How rodents
are spreading
bubonic plague
Plague outbreaks are largely
unheard of in most parts of
the world. But in Uganda,
many communities are still
affected by this problem,
largely because prevention
programmes remain weak.
BY BAMUTURAKI MUSINGUZI
editorial@ug.nationmedia.com
Daily Monitor
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FIRST AID
TIPS FOR BURNS
IN CHILDREN
Jesila Ngoloru shows the swollen lymph nodes caused by the plague. Below, Maturu
Ruzalia who lost her granddaughter to the the plague recently. PHOTOS BY PAUL MENYA
ported in the last 20 years.
And in the past 10 years alone,
more than 2,000 cases of plague have
been diagnosed in Arua and Zombo
districts. The health ministry has reported an average of 200 plague cases
per year from this region, with 30 per
cent resulting in death. Uganda accounts for 50 per cent of all plague
cases worldwide.
The flea species responsible for
transmission of the disease are Xenopsylla cheopis and Xenopsylla brasiliensis. If a person is infected with any
of these flea species, they experience
symptoms such as fever, headache,
body weakness and swollen lymph
nodes.
Control plans
Plague outbreaks in Uganda typically occur as a result of cultivation of
grain crops, deforestation and poor
sanitation. The Ministry of Health,
Uganda Virus Research Institute and
the US Centres for Disease Control
and Prevention are collaborating
on plague research and control programmes in Arua and Zombo districts, as a result, have set up a test
laboratory in the area.
Beside laboratory testing programmes, the ministry also carries
out flea control programmes by
spraying affected areas during outbreaks and administering treatment
such as prophylaxis against those
who are infected.
Community Medicine Distributors (CMDs) or VHTs have also been
trained to identify cases and refer
them to health facilities.
Anguyo says seeking medical care
in time is crucial.
Rapid diagnostic kits and facilities
for diagnosis have been established
in the affected areas. Clinicians have
also been trained to manage cases in
Daily Monitor
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FIRST AID
RELIEVING
CONSTIPATION FAST
Martin Tako (inset) shows his scarred left leg which is healing after a buruli ulcer operation. His biggest complaint is that the leg still swells. Dr Dominic Drametu (R) says the disease
is very common during the rainy season. PHOTOS BY PAUL MENYA
Constipation is such a
common uncomfortable
condition that occurs
when one gets a problem
with their digestion. Dr
Alex Kakoraki, a general
practitioner at Murchison
Bay Hospital in Luzira
says that the condition
is also caused when the
muscle contractions in
the intestines are too slow
to push the stool out of
the body and sometimes,
it is lack of enough water
to soften the stool so as
to move it through the
intestines to the anus. Other
causes of constipation
include; cancer of the
intestines, local swelling
of the walls of the large
intestines, failure to drink
a lot of water, over eating
of fast foods like chips,
chapatis, and chicken,
among others.
Kakoraki further mentions
some of the ways one can do
to relieve the constipation.
Take a soap enema with
warm water
Take a lot of warm water.
As a start, try just drinking
a glass of water 3-4 times a
day in addition to what you
normally drink. after a heavy
meal
Take laxative tablets
Aim to eat at least five
portions of a variety of fruit
and vegetables each day.
One portion is: one large fruit
such as an apple, pear.
Keeping your body active
helps to keep your gut
moving. It is well known that
disabled people, and bedbound people (even if just
temporarily while admitted
to hospital) are more likely to
get constipated.
In children, the doctor
advises that one should rub
vaseline or oil on the middle
finger, push it into his or her
anus to remove the stool.
One can use gloves in this
case or rush the child to a
nearby hospital.
The doctor also cautions,
you may notice an increase
in wind (flatulence) and
tummy (abdominal) bloating.
This is normal and tends
to settle down after a few
weeks as the gut becomes
used to the increase in fibre
(or bulk-forming laxative).
By Christine Katende
always comes with burning and itching of my legs and feet. Once the pain
intensifies and I am eating, I have to
put the food aside and concentrate on
scratching my legs and feet, Bukoma
laments.
The father of 10, thought he had
been bewitched, but quickly adds
that he has not tried traditional
medicine and is pinning all his hopes
of ever healing on modern medicine.
I have now given up on getting cured
because I have suffered for so long.
I wish a cure could be got and the
drugs brought nearer to us, he bitterly says.
What its all about
According to the World Health Organisation (WHO), podoconiosis is a
type of tropical lymphoedema clinically distinguished from elephantiasis (lymphatic filariasis) by being
ascending and commonly bilateral
but asymmetric. Research suggests
that podoconiosis is the result of a
genetically determined abnormal inflammatory reaction to mineral particles in irritant red clay soils derived
from volcanic deposits.
Podoconiosis is found in high-
William Bukoma
has lived with
Podoconiosis for
54 years. Below
is his left foot
with signs of
elephantiasis of
the lower limbs.
PHOTOS BY PAUL MENYA
Kapchorwa District revealed a prevalence of 4.5 per cent in all age groups.
Another survey carried out by the
Programme to Eliminate Lymphatic
Filariasis in 2012 showed a prevalence of 7.2 per cent in the badly hit
sub-counties of Busiriba and Ntara
of Kamwenge District in western
Uganda.
The health ministry observes that
the socio-economic impact of the disease is high: Out of 10 patients, seven
to nine tend to belong to the economically active age group population.
The ministry further admits to
National Master Plan for Neglected
Tropical Diseases Programme 20132017, that despite the high prevalence,
high morbidity and enormous socioeconomic impact, little information
about the disease burden is available
in most parts of Uganda.
Consequently, little effort has been
made at national, district and community levels to control podoconiosis.
Prevention
According to WHO, primary prevention consists minimising exposure
to irritant soils by wearing shoes or
boots and by covering floor surfaces
inside traditional huts.
Secondary prevention includes
daily foot-washing with soap, water
and antiseptic, use of a simple emollient, bandaging in selected patients,
elevation of the leg, controlled exercises, and use of socks and shoes.
Compression bandaging is highly effective in reducing the size of the soft
type of swelling.
Tertiary prevention encompasses
secondary prevention measures,
elevation and compression of the
affected leg, and, in some cases, removal of prominent nodules.
More radical surgery is no longer
recommended since patients unable
to avoid contact with soil experience
recurrent swelling which is more
painful because of scarring. Social
rehabilitation is vital, and includes
training treated patients in skills
that enable them to generate income
without contact to irritant soil.
According to the Action on Podoconiosis Association (APA) based
in Ethiopia, as a result of stigmatisation the sufferers are frequently
ostracised from their families and
communities, lonely and treated as
lepers.
They are typically in constant
pain and discomfort from the condition and can smell offensively
through chronic infection. Only the
fortunate receive family support.
Some die early through starvation or
infection although, without help, all
are destined to a miserable, deprived
existence.
However, Bukoma says he has not
been shunned in his community. I
have not been stigmatised by my
community because I always associate with them. I share my problem
with them and they always advise
me to go to Mbale Regional Referral
Hospital.
Daily Monitor
www.monitor.co.ug
FIRST AID
HOME REMEDIES FOR
MIGRAINES
A migraine is a severe
headache which is
characterizsed by throbbing
or pulsating on the fore
head, on either side of
the head. Dr Umar Rashid
Gulooba of Makerere
University Business school
health centre says when
serotonin, a chemical in the
brain, reduces, the blood
vessels first contract and
then they dilate which
triggers the initial stages
of a migraine before severe
pain set in. He also says a
migraine is triggered by
emotional, physical, dietary,
environmental and medical
circumstances.
Under emotional situations,
Gulooba says, anxiety,
panic, stress from work
and depression triggers
a migraine; and physical
circumstances like
tiredness, fatigue and failure
to have enough sleep also
brings about migraines.
Poor dietary conditions
like dehydration, alcohol
and taking much tea or
coffee which has caffeines
that affect the serotonin
chemical in the brain and
environmental conditions
like bright light from
television and computer
and loud sound also triggers
migraines. Medically,
taking sleeping pills and
contraceptives frequently
act as triggers.
When one side of ones
vision is not clear and also
when there is an experience
of flash lights and blind
spots in the eyes, are all
symptoms of migraines.
Similarly, when someone
also smells weird things
when they actually arent
there is also a symptom
of migraines, Gulooba
says. He adds that when
you put a person in a dark
quiet room and give them
sedative pills to rest for
some time, by the time they
wake up, the migraine pain
will have reduced. Using
pain killers and medicine
to stop vomiting also cures
migraines.
As anyone who gets
headaches knows, certain
smells can trigger the pain.
But peppermint in particular
seems to have pain-reducing
effects. Its very individual,
he says, and may not work
for everyone. Or, it could just
mask less pleasant smells.
By Roland Nasasira
Rabies management
in humans still
inadequate
Rabies is a fatal disease
among humans with survivors
being only those who have
received vaccines before the
onset of the disease.
BY BAMUTURAKI MUSINGUZI
editorial@ug.nationmedia.com
Loopholes
The Health ministry says the actual
prevalence of both human and animal rabies in Uganda is currently not
known because of inadequate surveillance system.
Therefore, there is a need to carry
out the surveillance to actually determine the magnitude of the disease in
the country.
www.monitor.co.ug
Bulima Muwada (above) was attacked by a dog while chasing a cow from their potato
garden. (Below) His right hand healing from a dog bite PHOTOS BY PAUL MENYA
Expert analysis
According to the president of the
Uganda Veterinary Association, Dr
Dominic Lali Mundrugo-Ogo, rabies
is the only viral disease among the 12
Neglected Tropical Diseases (NTDs)
in Uganda, adding that it is not curable.
Death is rapid once clinical signs
including encephalitis (madness),
abnormal behaviour, difficulties in
swallowing, staggering, paralysis, altered vocalisation, and seizures have
manifested, Lali Mundrugo-Ogo observes.
With exception of buruli ulcer,
plague and trachoma which are bacterial, the rest (NTDs) are parasitic
and run a chronic course.
It is estimated that the population
of dogs in Uganda stands at three
million while that of cats is about
640,000.
With the poor veterinary care given
to these animals, these pets pose a
big risk factor in rabies transmission,
health officials warn.
They add that the current dog vaccination coverage in Uganda is less
than 20 per cent and there is no regular centrally planned mass vaccination programme for dogs and cats
countrywide.
Daily Monitor
MEDI CARE
Interventions in place
The Ministry of Health has put in
place a rabies control programme
that aims at improving the prevention and control of human rabies
in Uganda. This is to be achieved
through improvement of rabies surveillance in animals and humans,
diagnosis, creation of awareness,
regular vaccination of dogs and cats,
improvement of animal welfare and
treatment of people exposed to the
disease.
In the National Master Plan for Neglected Tropical Diseases Programme
2013-2017, this strategy is usually
successful if the vaccination of dogs
is carried out at least once a year and
with vaccination coverage of at least
75 per cent of the dog population.
The Ministry of Health together
with health education and community sensitisation on rabies control is
responsible for the execution of this
mandate.
But already there are hiccups,
the health ministry admits, However, the vaccination of dogs and
cats in Uganda and sensitisation
programmes are not regularly carried out because of lack of funds to
purchase rabies vaccines and other
logistics and carry out sustained sensitisation campaigns.
BY BAMUTURAKI MUSINGUZI
editorial@ug.nationmedia.com
MENYA
Daily Monitor
www.monitor.co.ug
BABY CARE
HEALTHY BABY
FEEDING TIPS
Should you worry about
baby fat? Not so much.
While some recent studies
have found a link between
fattening up too fast during
infancy and childhood
obesity, your number one job
as a parent is to help your
baby gain weight. Indeed,
cutting calories during the
first year could interfere
with both your babys
physical growth and its brain
development. Instead, just
keep these guidelines in mind
so your little cherub develops
healthy eating habits:
You will need to feed
a newborn often and on
demand. But an older baby
who fusses between meals or
not long after it has emptied
its mums breasts or finished
off a bottle does not always
need more food to feel better.
First try offering them a
pacifier, or help him relax
with rocking.
During the first year, a
childs primary source of
calories and nutrition should
be breast milk or formula.
Even though babies typically
start solids around six
months, the main function of
eating food at this point is to
get a child used to having it in
her mouth and to provide her
with a chance to practice
eating.
Babies should double their
birth weight by about four
months, and triple it by their
first birthday. Talk to your
pediatrician if your baby is
exceeding these guidelines.
First foods first!
Village Health Teams have been engaged in helping with mass drug administration to
help adrress the problem of human resource shortage. FILE PHOTO
Daily Monitor
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NUTRITION
EATING HALF-COOKED
MEAT MAKES YOU ILL
Due to different reasons,
people at times do not eat
well-done animal products.
This, health experts cautions
could cause brucellosis.
Dr Sam Thembo, a general
medical practitioner and the
director of Community Clinic
and Laboratories Limited,
says brucellosis is an
infectious disease caused by
bacteria of genus brucella.
He says humans get infected
with brucellosis when
they get into contact with
infected animals or when
they consume products from
infected animals like goats,
sheep and cattle.
Dr Gloria Akampa of Kairos
Hospital in Seeta, Mukono
District, further adds
that brucella abortus is
the commonest type of
brucellosis that human
beings suffer from.
She says, Infants can also
be infected with brucellosis
through breastfeeding,
especially when the mother
has the disease and is not
on treatment. it can also
be spread through sexual
contact.
Signs and symptoms
According to Dr Akampa,
brucellosis can show
symptoms like fever, joint
pain, loss of appetite, back
pain and general body
weakness.
She adds that vomiting,
fever, nausea, backache,
chest pain, abdominal pain,
headache, heart palpitations,
burning sensation in the
legs and feet, sweat and
dizziness are soime of the
warning signs.
Other signs may include
sexual dysfunction,
miscarriages and severe
infection of the central
nervous systems.
Treatment
Dr Thembo recommends
to fully cook all animal
products. For herdsmen and
hunters, it is advised to use
rubber gloves when handling
bowels of animals.
By Joseph Kato