Wednesday 27 January 2016

Joining the fight against Vesico Vaginal Fistula (VVF)

She would not let any of the visitors who had come to condole with her over the death of her baby see her. She did not want to see the shocking expression on people's faces and their difficult effort to withstand the stench coming from her body, a stench even she found difficult to withstand. Her husband has been caring the much he could but she could see the exasperation in his eyes while he attended to her. She felt suicidal. The whole pain and shame would have been a tad bit bearable if she had not lost her baby. The local midwife said she must have incurred the wrath of the gods hence the fate that befell her. The enlightened female teacher at the government-owned primary school in the neighbourhood had mentioned something like VVF and advised her to seek medical attention in the hospital few miles away. There was no way they could afford hospital bills now, her husband's crops failed and harvest was poor. The teacher came around again and insisted she visit the hospital even volunteering to accompany her. She also paid their transport fares to the hospital. One look at her, the gynecologist diagnosed VVF and referred her to another hospital where she was treated for free. Halima remembered almost taking her own life while the ordeal lasted. She has taken it upon herself to teach women around her about VVF and how to prevent it. She also tells sufferers that treatment is free.

Vesico Vaginal fistula (VVF) is said to be an abnormal tear that occurs between the bladder, Vesico and the vagina leading to uncontrolled discharge of urine and feces. It is usually caused by prolonged labour when the baby's head squashes the tissues of the mum's pelvis, cutting the blood flow and causing the affected tissue to die, leading to the development of a hole. Nigeria is said to have the highest occurrence in the world with about twelve thousand women developing it every year.

VVF seems more prevalent around ignorance and poverty. It is linked to prolonged labour, fear of Caesarean sections, violent rape and under-age pregnancy.Treatment which often involves surgery is free in designated hospitals spread around the country. Symptoms include severe abdominal pain and irritability of the bladder, urinary incontinence as well as a very strong smell 2 to 4 days after a traumatic childbirth.

No woman deserves to go through this heartbreaking and devastating condition. Wherever you see someone with a condition similar to that described, please direct the person to the nearest hospital, they would know the nearest VVF treatment center to direct the patient to. Twelve thousand sufferers every year may be a statistic, but behind every such statistic are humans; daughters, mothers, wives, sisters and friends.

Choosing to appreciate my post-pregnancy body

Being pregnant is hard, giving birth could be harder, getting your pre-pregnancy body back could also be challenging and sometimes impossible. Some of us find it challenging to look at our mum-bodies. We compare it with that of others who seem to have the perfect body even after childbirth.

Hello!!! No two people are the same. You didn't go through the same things and definitely did not find yourselves in the same situations. So while you admire Beyounce, Mercy Johnson and Tiwa Savage and all those mums who look great few weeks after childbirth, you should not unduly stress yourself into being like them because YOU ARE NOT THEM. You should not be pressured into fitting into some post-pregnancy body ideal. The most important thing is that you were part of the miracle of creating another human being and should not trade that for anything else in the world.

So mums please embrace your post-pregnancy bodies; embrace the stretch marks that have refused to clear, embrace the post-pregnancy belly that has refused to tone. Be confident in the fact that your are a mum, trim body or not. Someone called them "mummy-scars" and I agree. So long as they do not interfere with your being a good mother to your little one(s) , then you should not loose sleep over them. You should learn to love your post-pregnancy self.

Whenever you look longingly at your cloths which you can't fit into anymore as well as at pictures of your fit and trim pre-pregnancy self, you should look at your baby with utmost gratitude to God for the great privilege of having gone through pregnancy, childbirth and having tell-tale signs of motherhood on your body. You should always remind yourself that you did not become part of the saddening maternal mortality statistics in Nigeria.

Monday 25 January 2016

Memoirs of a Nigerian mum 3

I had taken my baby to one of his immunization rounds and in my usual maternal and child health advocacy/outreach duties I was reaching out to fellow mums and striking up conversations when I noticed a particularly tiny baby, I guessed she was just a few days old. The baby’s mum said she was actually a month old. She explained her baby had what she called “Nza” that she claimed makes newborns sick and wasted. She said orthodox medicine doesn’t treat the condition so the baby was being treated the trado-medical way. I remember imagining how this very tender and weak-looking baby is made to drink concoctions of herbs and roots. She weighed 2.3kg.

As if that wasn’t enough shock for the day, I noticed another girl of about 2-3 years old who had marks on her forehead and cheeks. Deep, straight marks like the ones seen on Benin masks. Her mum said she (the girl) is always sick so they figured out she was an Ogbanje and had to give her those scars to cut her ties with the spirit world. At that moment I wished there was a child welfare policy in our country which allows children to be taken from their incapable parents, as I heard exists in the West.  On a second thought, I believe these mums were simply uninformed. They didn’t know any better. Most mums do what they think is best for their children. If only they knew how much harm they were exposing them to.

The sad thing is some of these harmful beliefs and practices have gone on for too long and are steadfastly held unto by many rural-dwelling mums. These mums often refuse being followed-up by health workers for fear of God-knows-what. They always claim to be on top of the situation. I often imagine how challenging it is for the nurses and doctors in rural areas. They must have really seen it all.

I remember imagining how a child gets disadvantaged simply by being born by a particular person or in a particular environment. At that moment, the meaning of “Social Determinants of Health” sunk in. 

Saturday 9 January 2016

Promoting the first 1000-days cause

Life begins at conception. That is also the point when nutrition starts to matter. What a pregnant mum consumes right from the time of conception is said to influence her baby’s health. Beyond conception, the first two years of a child’s life is also said to make or mar so many things in the child’s later life. Thus different child health and nutrition advocates champion the first 1000-days cause.

The first 1000-days of a child’s life in this context means from conception to the child’s second birthday.  It is said to influence so many things in the child’s later life; height, strength of the child’s immune system, IQ, risk of diseases like diabetes and cardiovascular diseases as well as a country’s GDP.  Investing in a child’s health should begin from conception.

During pregnancy, the baby depends on its mother for nutrients to fuel its rapidly growing and developing body system. Thus pregnant mothers are advised to consume foods rich in folic acid and iron which are important for the baby’s rapidly growing brain. A pregnant mother’s diet is also believed to influence a baby’s food preferences as taste buds and sense of smell are said to develop in the first trimester. A child’s lifelong health can be influenced by what its mother eats.   Pregnant mums are advised to eat more of green vegetables, beans, cereals, red meat, poultry and fruits.  

After nutrition in pregnancy comes that of the first six months in a child’s life. Experts strongly recommend exclusive breastfeeding, that is feeding the baby on breast milk ALONE. At this point in a child’s life, breast milk provides all the hydration a child needs, water is therefore NOT NEEDED. The importance of giving a baby breast milk alone, part of which is discussed here, cannot be overemphasized; the duration of which experts suggest between 4 to 6 months after which breast milk alone cannot supply all the nutrients needed;  Cereals, vegetables and some fruits can then be introduced.

Research suggests children can take adult foods from about 12 months upwards. The emphasis is more on wholesome, fresh foods which we are so blessed to have in abundance in our part of the world. We need to cut down on the sugary snacks and drinks we give toddlers and teach them to snack on fruits. We are lucky to be blessed with a wide variety of fruits.

Children who get the right nutrition in their first 1000 days are said to be ten times more likely to overcome life-threatening diseases, fare better in school and live healthy adult lives. Poor nutrition is reported to be responsible for about half of all childhood deaths worldwide. Let us therefore make conscious effort to give our children a shot at healthy, fulfilling adult lives.

Wednesday 6 January 2016

Memoirs of a Nigerian mum 2

The day I returned home from the hospital with my baby was a day like no other. I returned home a mother. Oh! How I was celebrated. The Igbo tradition celebrates every new birth with pomp and pageantry. Other mums danced and sang to the successful birth and newborn.  I was very happy and also very appreciative of the goodwill of all women who gathered that day. Then began another phase of my journey to motherhood.

I had an amazing aunt-in-law take care of me during puerperium. She cooked and served my meals, took care of my newborn, washed our cloths, gave me the traditional hot water massage on my stomach. In fact, she treated me like a princess. All I did was sleep and breastfeed my baby. God bless her. She taught me a whole lot.  I remember spoiling several diapers before I learnt the proper way to change a diaper.

There were several challenges hubby and I faced the first few weeks of parenthood. We were not sure which advice to take and which to discard. There were several unsolicited albeit well-meaning advises. Our decision not to let the baby’s umbilical stump be massaged with hot water was fiercely criticized, so also was our decision to practice exclusive breastfeeding. I remember several mums telling us we are making mistakes and reminding us how experienced in child birth and rearing they are. One even asked if our mums gave us breast milk alone. They said our baby will suffer from dehydration Oh! How much information they need.

 We didn’t know how to handle certain challenges that came with the newborn. Our little one cried so much at nights for the first few weeks; he would be so inconsolable for hours till he is tired and would sleep off. I used to get scared once night comes. Till now, we both have not figured out why he cried those nights.  About two weeks after birth, I noticed our baby writhing in pain; this was explained to be gas and also normal but I couldn’t really stand it. Prescriptions ranged from gripe water to bitter kola. I noticed the pain had a pattern. It happened anytime I consumed any dairy product; I also noticed it the day I ate food containing cabbage; these I ruled off my diet till he was about three months old after which I gradually re-introduced them. Nursing mums are made to believe drinking tea increases their milk supply; I am yet to see any research that backs that up.
Baby developed diaper rash few days after birth, at our first immunization appointment I was told it was caused by my using talcum powder when changing his diaper. I started using petroleum jelly and that took care of the rash.

Looking back now, I realize a lot of misinformation exists. We unknowingly expose our babies to risks. Why would we give our baby’s umbilical stump hot water massage? Why would we let our babies be thrown up and down in a kind of acrobatic display they claim makes them fearless? Why would we be giving our babies bitter-kola water to reduce gas? Why would we add steroid-containing creams to baby lotion to make their skins smoother? What exactly is Jedi Jedi and why do we believe only alternative medicine treats it? Why should we be restricted to certain types of food during the puerperium?  I had (and still have) too many questions.