February 5, 2012

The World’s best diet

Uglai and cabbage. Ugali (also sometimes calle...

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A few months ago I watched a TV programme entitled the world’s best diet. The show featured presenter Jonathan Maitland and  a celebrity spread of made up of Linda Robson, Cheryl Baker, Darren Gough and Carole Malone. Whilst I wouldn’t argue that some of the destinations, for instance, Japan, offered the worlds healthiest lifestyles, I was somewhat disappointed that nowhere in the programme was any part of Africa featured. I cannot blame anyone for this, as much as we would like, Africa in terms of its food still presents itself as the dark continent, where no light has been shed on some of the best recipes it can offer.

Additionally, for those recipes that have emerged as familiar, they do not exactly come across as the healthiest, even to people of African origin. I remember having a conversation with another African lady at a recent ethical fashion event about presenting an afro centric diet as a healthy living way of life. Her immediate comment was, “well, African food does not strike me as healthy.” In today’s post I wish to challenge this idea. The only way to do this is through educating readers out there and letting them know that if we examine African staples and tweak them here and there, we are actually in the running to provide one of the world’s healthiest diets.

Let us examine a very popular dish which one would find easily across east and southern africa. ‘Ugali, irio na nyama’ in other words solids made of maize, millet or sorghum meal, green vegetables such as spinach or the truly divine covo and meat or fish. With the ugali rich in fibre, greens rich in iron and grilled river tilapia rich in healthy protein and some omega 3, you are well on your way to a healthy diet. Take another recipe which is made up of our popular stew. Stews are normally tomato based, with onions, garlic and ginger. Why this comes across as vastly different to pasta sauce, an Italian staple, (Italy ”Mediterranean” featured as healthiest diet destination) is beyond me. We only fall short in the preparation of stew, where too much oil used is not uncommon.

Apart from all of this, the afro centric diet abounds with fresh or naturally preserved ingredients. You seldom hear of a diet rich in fast or highly processed foods. And even better is our use of indigenous plants and herbs as natural remedies. There are remedies for controlling diabetes and high blood pressure (dawadawa), cholesterol and even malaria treatment. All of these could benefit from additional research but they have been used for 100′s of years and need not be suddenly “discovered” by some witty Oxbridge scholar, we already know about them.

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HIV Transmission Through Medical Procedures in Africa

Main symptoms of acute HIV infection. Sources ...

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Even back in the 1980s, not long after HIV was identified as the virus that caused AIDS, medical transmission was recognised as one of the possible modes of transmission.

[http://sites.google.com/site/davidgisselquist/pointstoconsider] Some important research went into establishing the extent of unsafe medical practices and the results suggested that these practices could transmit HIV very rapidly.

As a result of this research the possibility of medical transmission was all but eliminated in Western countries. But virtually no research was carried out to establish the contribution of this kind of transmission in African countries.

WHO, various UN agencies, leaders of all descriptions, professionals of all descriptions, various globally represented organisations, institutions, universities and others flew the flag for heterosexual transmission of HIV in developing countries (though not in developed countries).

The few exceptions to this were considered to be denialists or trouble makers. There are still few exceptions and they are still quickly branded and dismissed by the HIV industry elite. [http://ijsa.rsmjournals.com/cgi/content/abstract/20/12/812]

Well, maybe medical transmission of HIV is not very high; maybe it is lower than heterosexual transmission. Maybe all the fuss is about nothing and maybe I’m just one more person poking his nose in where it doesn’t belong.

But we are entitled to know why medical transmission of HIV has not been properly investigated, why it is still dismissed as being almost non-existent. The recently published (though based on out of date data) Modes of Transmission Survey for Kenya suggests that medical transmission accounts for 0.6% of all transmission, based on an assumption that seems to have been pulled out of thin air. [http://www.unaidsrstesa.org/files/MoT_0.pdf]

The same survey notes a finding that puts the rate at 2%, over three times higher. But this is still dwarfed by most of the other modes of transmission, especially heterosexual transmission. And even 2% sounds ridiculously low.

But those who are still being branded as mavericks for questioning the received view point to many bodies of data that have managed to investigate medical transmission rates of HIV. [http://sites.google.com/site/davidgisselquist/pointstoconsider]

Those bodies of data show that medical transmission is extremely significant, perhaps even more significant than any other mode of transmission, including heterosexual transmission.

All the dissenters are asking is that these results be taken seriously and subjected to rigorous testing. [http://ijsa.rsmjournals.com/cgi/content/citation/20/1/69r] If medical transmission of HIV even stands at 5%, this would still account for millions of people currently living with HIV and hundreds of thousands of people who have died of HIV.

One of the most heartrending things about people dying of HIV, as opposed to other diseases, is that they are, because of the unexamined and long held assumptions of so many ‘brilliant minds’, vilified, ridiculed, shunned, persecuted, sneered at and humiliated just when they are in most need of sympathy, love and basic humanity.

If it is even remotely possible that we as people are guilty of such terrible injustice to fellow human beings, surely that is in urgent need of investigation? Far from dying because they have engaged in what may or may not be risky sexual activity, people may be dying because they have followed the advice of well educated professionals.

It’s almost unthinkable that many, or even any recent cases of HIV have been transmitted by the very professionals that are supposed to be preventing and treating the disease. But it is even more unthinkable that we could suspect such a thing is happening and do nothing about it.

Maybe there is a danger that people will stop going to health professionals and stop seeking medical treatment, even vital vaccinations and life saving treatment, because of a complete lack of confidence in the profession. But that is something the profession will have to deal with because they certainly don’t deserve any confidence or respect until they have fulfilled obligations that have so long been outstanding.

It is possible that in some countries, going to the doctor may curently be a significant health hazard, carrying risks of infection with HIV and many other blood borne diseases. In the field of HIV, nothing is more important right now than establishing the extent of HIV transmission through medical treatment.

 

Guesst Post from Simon Collery: I am campaigning for the recognition of non-sexually transmitted HIV, which may be a significant contributor to some of the most serious epidemics, which are all in sub-Saharan Africa. The extent of non-sexual HIV transmission is unknown because no comprehensive investigations have been carried out. But there is a lot of evidence against the view that sexual behavior alone can explain the massive epidemics found in countries such as Swaziland, Botswana and South Africa. While I do blog about other subjects relating to Africa, this is my main concern.

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Once bitten twice shy: malaria and disease in our time

Abuja City Gate

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“My twin daughters died when they were only two years old. I didn’t know what was wrong with them, they were both very ill and I was weak with a fever. So I carried them for two days to the nearest health centre, walking as fast as I could. It was hot and dry and my babies just kept getting worse. When I was a few hours away from the health centre they both stopped crying. When I arrived, the nurse told me that it was too late to treat their malaria.”

Hasena lives in Kodae village in the remote desert region of Afar, 40 miles from the nearest health centre. Sadly, her story is not uncommon. But AMREF refuses to accept this situation. Just because people live in remote rural areas of Africa doesn’t mean they should struggle to find basic health care and die of easily preventable and treatable diseases (http://www.amref.org/personal-stories/hasenas-story/).

AMREF (African Medical and Research Foundation) represents one of a number of institutions that have taken up the gauntlet of taking responsibility for finding solutions to the health and social challenges of our communities.  With the advent of HIV/AIDS, there has been a greater focus on coordinating international aid and funding efforts, however, that coordination does not necessarily translate into better health outcomes.

The experiences of this mother who lost two children are not a rare occurrence in poor countries that that are also heavily reliant on donor funding. In many instances donor funding, which also funds institutions such as AMREF, represents over a quarter of countries health care funding- particularly in low to middle income countries across Africa and around the world.  The truth of the matter is that no matter what context we speak across, there are fundamental issues that have not yet been adequately resolved.  These are issues which centre around weak governance structures, poor accountability of the state to its electorate(s) and shifting focus between democracy and development. They impact all levels of society and ultimately result in poor economic, social and health outcomes.

Ultimately what we should be asking is to what extent do our governments prioritize health and treat it as a public good as opposed to a brokered commodity? Does the health expenditure in our countries approximate the target of 15% of total government expenditure as agreed by the African Heads of State in Abuja in 2001? The status quo determines that it is inevitably the poor and vulnerable (particularly women and children) that are the greatest affected and marginalised.

Secondly, what is the real and lasting legacy that external funding and solutions will leave with us?  The HIV/AIDS and TB pandemics have received major inputs as a result of international pressure and attention and in the same vein, so have other diseases of poverty been placed under the spotlight and been given significant focus through cash injections into health systems strengthening, drug and vaccine development, research, advocacy and social mobilisation.  One does not dispute these facts and indeed it is important to give credit where credit is due, however, does the link between the issues and agendas of governance, democracy, development and health care not beg the fundamental question of what the definitive conclusion of external funding is?  Between the cracks of our own structures of government falls the security of stewardship and this is what determines the capacity of countries to create autonomous, sustainable and effective interventions against health crises.  It is an open secret that aligning our health priorities with international imperatives and subsequent reliance on external funding is a compromise and there is a real risk of falling into a situation of perpetual subservience to agendas that are not locally developed.  These external priorities unequivocally come with the peril of conditionality in spheres that matter most such as in health and at economic policy and trade levels.

The challenge of malaria is illustrative of a disease that causes untold suffering yet despite this, home brewed solutions have not received the necessary capacity nor momentum that they warrant.  I challenge local communities, researchers and activists at home and abroad to manoeuvre to create new power bases that will result in the collection and creation of knowledge for local use.  Change must happen from within our communities and countries of impoverishment first before it can be relevant to the international community, yet so often we are so obsessed with reverse.  The gauntlet to be taken up is to develop lasting solutions which women like “Hosae” in partnership with the health care workers of “Kodae village” can implement, because ultimately the death of her children is the death of our children and our brothers and sisters and no life, no matter how brief can be replaced.

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The “f” in feminism

I’ve often been asked which side of the coin I fall on pertaining to the feminist movement and I have to say I’ve always not been sure.  I believe in mutual respect of persons as well as accepting that there are certain things which I would prefer to have a man do for me without having to be taxed to doing them myself to the equal setting.  The feminist movement as I first got educated about seems to be at odds with some of the persons who claim the label and are quick to virtually silence anybody that is male to the point that I at times pity the male child.  Female bosses from experience have been worse than their male counterparts – some citing the difficulties they had to undergo to get to top.  I would be of the school of thought that would have thought that the experiences they went through at being badly treated by males would have given them a head start in correcting and indeed showing that the alternative is better as opposed to becoming the abuser!  The drive for equality which the feminist brigade appears to be about has to me done more harm than good.  It focussed so much on educating us the females about how to get our rights to equality but spared little thought in educating the males with whom we had to share this new found access to equality.  As a result, you get some of us females working twice as hard in all areas, in order to maintain the equality badge!  From experience, it seems to be the case that feminism as played out here in developed countries by “girl power is all about gender battles if not fame at any cost,  to put down men at whichever opportunity arises – not about co-existence or supportive roles for genders.  This is partly why I am hesitant to support girl child programmes in Africa in their present format as most often they alienate the boy-child leaving me wondering what is to become of these secluded generations of young ladies/men or how they will benefit their communities in a balanced way.

Having started off on a rant, I will now give due respect to Annie Lennox, a feminist.  To mark International Women’s day, I have been moved by the works of Annie Lennox in spear-heading in this year’s events which kicked off in London on the 6th of March whereby she gave an interview on what she and five other high profile females had to say on feminism as it is seen today (http://www.eurythmics.me.uk/2011/03/06/annie-lennox-in-todays-observer/).  I am a fan of Annie Lennox’s music from way back in my early twenties alongside her bold move to come across as beautiful short-haired woman that opted to market her voice as opposed to shedding her clothes to market herself.  I admired the resilience and spirit she has continued to show in coping with her private challenges alongside her activism in global social issues especially pertaining to the female gender.

The interview Annie and the other ladies raised questions which as a female with female children offspring, have further heightened my concern about how feminism is perceived in our society both here in the developed world and in the developing world – namely Africa.

“For me the anomaly is that the western countries are so resourced. I can identify with a woman losing a child. This happened to me, I lost a baby. But I’m living in a place where I can get medical treatment. A woman in Rwanda or Uganda or Bangladesh will deliver a baby on the floor and probably it won’t survive and there’s a good chance the mother won’t either. Being conscious of this vast disparity between our experiences, I’m appalled the word feminism has been denigrated to a place of almost ridicule and I very passionately believe the word needs to be revalued and reintroduced with power and understanding that this is a global picture. It isn’t about us and them.” Annie Lennox.

“Uganda’s maternal mortality rate continues at an unacceptably high level. While maternal mortality figures vary widely by source and are highly controversial, the best estimates for Uganda suggest that roughly between 6,500 and 13,500 women and girls die each year due to pregnancy-related complications. Additionally, another 130,000 to 405,000 women and girls will suffer from disabilities caused by complications during pregnancy and childbirth each year.” USAID.

Ironically in Uganda, given the state of the healthcare system, the female vote at virtually 90% is what endorsed to sustain the status-quo of Ugandan governance.  We definitely need to revisit what feminism is or should be about.

Brain Drain, Not IMF Policies Main Obstacle to Sustainable Health Care in Poor Countries

Oxford University-led study has established that poor countries that borrow money from the International Monetary Fund (IMF) spends only one percent of aid money on health and medical care while countries without IMF loans were said to use 45 percent of aid money on medical and health care. The purpose of the study was to explain why many countries are unlikely to meet Millennium Development Goals (MDGs) for health despite increased aid on health sector.

The authors have attributed the situation to the fact that countries that mostly seek IMF support are the ones facing economic problems. Such economic constraint means that countries seeking IMF assistance also have other areas, beside the health sector, needing urgent economic attention.

Masindi

“Nonetheless, even in such circumstances, it is reasonable to expect aid from donors to have at least some positive impact on health funding, especially given that health needs are often greatest at such times… A change in loan policies is needed to lift the existing restrictions on finance ministers so they are no longer prevented from spending health aid on the people that urgently need medical help.”

This is correct, and diversion of aid money has been, and it is fair to say it will always be there. It’s easier for governments to get aid on premise of improving health sector, especially at a when international community is hell-bent on making sure that poor countries meet MDGs by 2015. ‘A change in loan policies’, is ideal if not a necessary move. Apart from meeting the MDGs in hope of attracting more aid money, most leaders of the global south have no real incentive to improve expensive health sector. Presidents, former presidents, ministers, MPs and their inner circle always seek medical health outside their own countries. If not then can afford to pay for expensive private clinics with their boarders.

This leaves governments with less incentive to improve medical care. Take Malawi, for example. With nearly 14 million people, the country has a doctor to patient ratio of 2: 100,000; it has only 43 doctors and 3, 456 nurses. Yet its former president, Bakili Muluzi has spent a big chunk of his retirement in London and South African hospitals. All this is paid for by Malawi taxpayers who can hardly afford medical care for themselves and their families. The lack of political-will is by no means the only reason why poor countries are unlikely to meet MDGs for health.

The study’s emphasis on the need to reform IMF loan policies neglects a very important area: brain drain. There is a high migration rate of already inadequate heath workers trained in and by the poor countries to the rich countries, particularly from Africa and Asia. Statistics indicates that 23% of doctors trained in sub-Saharan Africa are working in economically developed countries. “Canada and the United States, with only 10% of the global burden of diseases, have 37% of the world’s health workers.” Africa and Asia have fewer than ‘2.3 nurses, doctors and midwives for every 1,000 people.

The situation is unlikely to be reversed anytime soon given the shortage of health workers in rich countries. Rich countries are too attractive for most health workers from the poor countries due to its comparatively higher wages and better life prospects for the health workers and their families. There are more Malawian doctors in the UK than there are in Malawi. At a time of economic uncertainty, many rich nations have resorted to protectionism and stiffened their immigration policies but health worker have been exception.

IMF loans however effective or ineffective they may will not and would address the problem of health care in the poor countries. “A lack of skilled personnel has health systems in developing countries ‘on the brink of collapse.’” In order to improve health care systems, poor countries must use meager resources they have to train health workers, only to lose them to rich nations upon qualifying. How are the poor countries expected to improve without qualified personnel? The problem is much more than ineffective IMF loan policies; it is also about injustices: rich nations exploiting poor countries.

Religious addiction

What is religious addiction?
I have been pre-occupied with this issue for the past few years, not because I am a highly religious person, but because I have seen a good friend of mine developing into a religious addict. Most people want to restrict the topic addiction to the normal cliques – alcohol, drugs etc. But this is not true, we have seen addictions ranging from computer, gambling, sex (?), the range is quite big.

I want to look at the definition of the word “addiction”. According to the dictionary Addiction is an uncontrollable compulsion to repeat a behavior regardless of its negative consequences. A person who is addicted is sometimes called an addict.

Most addicts that have successfully received therapy say that they found themselves in a depression stage (their moods, low spirits) and sought a solution. Theyfound refuge in what turned out to be addiction be it drugs, alcohol, in this case religion.

I know that the topic religious addiction should be treated with great caution; particularly as most people consider that those who are extremely religious are humble in front of God, good to their mankind etc., however nobody considers the ill health in which some of these people are in.

I am currently reading some interesting websites where I actually found more information http://www.spiritualabuse.com/?page_id=46 and would like to share it with those who are interested in blogging with me on this topic.

I would like us to discuss more on this issue and I hope that I’m not the only one who have seen people getting religious addictions and we are not able to help as this is a totally unknown area for us.
Please feel free to comment and let me have your views.

Big is beautiful in Africa- but should a person’s size matter?

They are things in our way of life or culture that we do not question even if we know that they do not serve us or that they are outdated but we do not question them.

I am one of those people that lose weight when I have something bothering me emotionally, my appetite just goes and food isn’t appealing to me at all  when I am that state of mind.  I am currently in that state of mind and consequently I have lost some weight, but not too much to be described as skinny and in fact could lose a little more to get to the ideal weight for my height, but this is possibly a topic for another blog.

The realisation of this unintended weight loss has brought a new set of worries which may lead to further weight loss- my upcoming trip home to Uganda. The last time I was there was May this year. My mother and aunties were beaming with the biggest smiles at my appearance. I had gone up a dress size!

Oooh! You look well they cooed!

At the back of my mind I was concerned about having to get a whole new summer wardrobe and how I could afford it as nothing from the previous season would fit!

Well I didn’t have to worry for much longer as one thing led to another on my return and off went the weight and a new summer wardrobe was not an issue anymore.

I am due back to Uganda in 3 months time and although I am a grown woman I am worried about the matriarchs’ reaction if I don’t regain the weight before I go.

There will be questions, lots of them!

See in most African communities being fat is a sign of

  • good health
  • for men in particular it is a sign of wealth
  • feeding well (this translates as having  good quality food as well as having plenty of food)
  • And in the case of a woman, “your husband must be taking good care of you” which translates as having a well stocked kitchen amongst other things.

This has left me wondering about the origin of this way of thinking and whether is serves us as a continent. We know much more about health implications of being over weight but in  some quotas this doesn’t make a bit of difference!

Take the example of Mauritania women/girls have to be fattened like cows due for sale at the slaughter house before their wedding

What is that all about?

Is being that obese really sexy? What about the health problems associated with being obese?

Is it possible to be thin and healthy or even happy in an African society?

What are the current trends? Are the new generation still obsessed with being fat or have they caught up with their western counterparts and prefer to be a size zero?

Please share your views on the matter.

Nursing – saving Grace

Returning back from the warm embrace of Uganda to the cold grey reception of Gatwick airport in March ’86, found me a very irritable 17yr old lady – as most people, I’m not at my best when deprived of sleep.  My ticket back to the UK had been an award from a family member who worked as a minister in Education after checking to ensure I was truly a student and resident in the UK. Other than getting my travel itinerary sorted out, I had not looked much further than this although given the state of our relationship with my mum who had now opted to officially state that she was my paternal aunt.  It made a pig’s ear of the whole situation and according to rumours that went rife amongst the family members; it almost cost her residence here!  As usual, the blame was placed squarely at my feet.

I recall the immigration officials asking me who was meeting me and where I was going to stay. My response that I was going to strike out on my own and rent my own place whilst I finish my A-levels didn’t somehow wash – so I was placed in detention. You see I’d been working Saturdays at Littlewoods since getting my NI card and managed to save up quite a fair sum alongside my baby-sitting jobs. Relations between myself and mom had hit a low so I’d figured, once I had enough for a deposit on a bedsit, I’d move out and finish my studies before applying for a place a university.  Contrary to what mom had thought of my teenage rebellion, I really hadn’t gone off the rails; I simply didn’t agree with her perspectives on how I should pursue my life along the culture lines here in London.  She had opted to believe my rebellion was a preliquiste for getting myself a boyfriend and basically not respecting her wishes. There had been a lot of external influences from the extended paternal family members on who had long-term issues with my place in mum’s life – namely my paternal grandmother. Over the years, I’d witnessed a fair number of unfair acts that in the end, I’d given up trying to point them out and opted to bite my lip and bid my time instead.  As it were, my mum had given in to possible pressure and had opted to follow through advice given her and send me back to Uganda – perhaps to teach me a lesson in humility or reminder of my position in the family hierarchy. Whichever it were, the gods were on my side and truth always triumphs no matter how much one tries to hide it.

So there I was the youngest detainee in a detention place some place in Gatwick or thereabouts.  After repeated conversations with various immigration officers, one of them asked me if there was anybody here in the UK who could come and lay claim as my guardian. Going through my little tatty address book making calls to various family friends, relatives – all refusing to come to my rescue, I resigned myself to being returned on the next flight back to Uganda.  At least it was warm there and my biological mum had appeared to be so welcoming and loving in addition to my biological siblings.  I was missing them already.  The poverty and hardships I’d witnessed in my three months stay didn’t sway my love for the country. I’d seen persons who even in the very little they had, being willing and generous in all they shared. But as I was about to hang up, I remembered I’d not called my school friend who’d been in touch with me throughout my short stay in Uganda. I’d not even called her to tell her I’d arrived!  So I asked the immigration officer if I could just make one final call just to let her know I’d arrived but would have to return back. This was the turning point. When I called her, she was so overjoyed to hear my voice that we chatted about everything silly that I almost forgot to tell her I’d be returning back! It was the immigration officer who tapped me on the back and reminded me to bid her goodbye that when I did and she asked why that saw my whole situation change. Claudia, my friend, alerted our headmistress, Mrs Martin, who by the crack of dawn was in the detention office like a lieutenant demanding to know why they had kept a minor in an adult detention centre – it was somewhat comical to see were it not serious.  What transpired between her and the immigration officers after her arrival I was not privy to, but all I remember was being escorted out and being driven to my friend’s house whilst a permanent solution was reached.

In the three months that followed, I attended school from Claudia’s house to finish my A-levels. Unfortunately, I’d missed some of the critical exams and this meant University entrance was to be postponed.  Instead, I opted to attend Croydon College to at least get the grades I needed as advised by my headmistress in order to try and gain entrance to nursing school.  I couldn’t stay with Claudia’s family for long, she had decided to elope to marry her school sweetheart and relocate to Hong-Kong. Besides, her family aside from her mother, all spoke Spanish – having been posted here on diplomatic duties from Chile. Whilst I made good use of free Spanish lessons from Claudia’s grandmother, long-term stay was out of the question.  I initially stayed at a refuge hostel before acquiring my own bedsit.  Throughout this time, I’d attend courses in-between jobs in order to raise the capital I needed to send to back to my biological mother for a proper building to call home.  With the help and advice of Mrs Martin again, I attended my first interview at Ealing School of Nursing after finishing a volunteer’s nursing assistant course at Mayday Hospital in December ‘86 and commenced my student general nursing course in March of ‘87.  Nursing as Mrs Martin had advised me would provide me with a residential in addition to an earning whilst gaining the training that could help me towards any course later on in life should I opt to not to stay within its’ discipline.  She was so right, nursing was my saving grace and an eye opener to a childhood echo of mine when I recall way back at primary answering saying I wanted to work for the Red Cross.  Well I’ve not exactly worked for the Red Cross, but I’ve ended up working within the medical profession and learning all there is about the health of the human body.