the witness unwele oludunwele oludeeing and to support patients in their quest to quit. twelve buses...
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WitnessTHE
PROUDLY BROUGHT TO YOU BY KZN DEPARTMENT OF HEALTH
UNWELE OLUDEUNWELE OLUDEUnited in prayer Page 2
Friday, June 3, 2005
A nurse’s lifePage 3
Health budgetPage 6
Youth suicide linePage 7
On the lookoutfor wormsPage 5
Winter comfort Page 4
MBALI THUSI
DO you smoke? Do youknow someone whosmokes? The chances
are that most people willrespond with a resoundingyes to one or both of thesequestions.
Smoking is one of theleading causes of death andMay 31 was World NoTobacco Day. The big ques-tion is: “What are you doingabout it?”
By quitting smoking youcould be giving yourself asecond chance. You canalso save the life of afriend, a colleague, a rela-tive or a loved one who isaddicted to tobacco byencouraging them to quit.
To create awarenessaround the dangers associ-ated with smoking, theprovincial Department ofHealth will host an event onJune 10 that will focusmainly on educating theyouth about health hazardsthat are often triggered bysmoking.
Peer pressure and theurge to experiment andexplore are some of thereasons that lead youngpeople to use tobacco,drugs and alcohol.
In order to nip the prob-lem in the bud, the depart-ment will take the messageto school children in north-ern KwaZulu-Natal.
“We have identifiedschools, especially highschools, in the Ulundi area,to be part of the event. Byhaving this event, we willbe able to talk to the youth
about the dangers of smok-ing,” said Londa Langafrom the Chronic and Geri-atric Programme.
“We will also educatechildren about diseasessuch as cervical cancer,cancer of the oesophagus
and the fact that tobaccocan also increase thechances of having heartproblems,” says Langa.
“Health ProfessionalsAgainst Tobacco” is thetheme for this year’s WorldNo Tobacco Day. The
emphasis is on profession-als in health care to quit inthe first instance, to createawareness about healthrisks associated with smok-ing and to support patientsin their quest to quit.
Twelve buses will ferry
pupils from the schools inUlundi to Ulundi Stadium,where the event will beheld.
A detailed story on theevent will be published inthe next issue of UnweleOlude.
PASSIVE smoking meansbreathing in other people’ssmoke. If you spend eighthours in a smoke-filledroom, it is as if you havesmoked 36 cigarettes,writes the Cape Town No-Tobacco ForumTask Group.
The non-smokerbreathes insecond-hand(or environmen-tal tobaccosmoke), whichincludes side-stream smoke(emanating fromthe burning endof the cigarette)and mainstreamsmoke (smokeexhaled bysmoker).
Second-handsmoke is themain cause ofindoor air pollu-tion and people are usuallyexposed at home, in theworkplace and in publicplaces.
Immediate and long-termeffects of second-handsmoke• Eye irritation, headache,
nasal discomfort andsneezing, cough and sorethroat, nausea and dizzi-ness, increased heart rateand blood pressure. • A non-smoker working ina smoke-filled room for
eight hourswill breatheas many can-cer-causingchemicals asif he or shehad smoked36 ciga-rettes.• Second-hand smokeis especiallyharmful to
children. Theyare more likelyto get colds,allergies, middleear infections,and “glue ear”,which is themost commoncause of deaf-
ness in children.• Exposure to second-handsmoke and smoking whilepregnant are both linked tomiscarriage, low birthweight and stillborn births.There is also evidence thatpostnatal exposure of
infants to second-handsmoke contributes to therisk of sudden infant deathsyndrome.
What you can do aboutsecond-hand smoke• Strive to make yourhome, workplace and com-munity smoke-free.• Support the new tobacco
legislation, which protectsnon-smokers from the dan-gers of passive smoking.• Ask smokers not tosmoke around you.• Don’t let smokers smokearound your children.• Ask visitors not to smokein your home.
Tips for quitters
• Keep a fresh taste in yourmouth by brushing yourteeth frequently.• Do stretching exercises.• Get plenty of rest.• Engage in activities thatare important to you.• Take deep breaths as adistraction technique torelax. — Health 24.
Campaigntaken toschoolsin KZN
Some people start smokingwhile they are still at school.
Don’tsmoke
around yourchildren.
”“
Passively joining the brigade of smokers
WORLD NO TOBACCO DAY
MESSAGE FROM KZN HEALTH MEC,
MRS PEGGYNKONYENI, ON WORLD
NO TOBACCO DAY
AS WE CELEBRATEWORLD NO TOBACCO
DAY THE KWAZULU-NATALDEPARTMENT OF
HEALTH WOULD LIKETO REMIND YOU OF AFEW FACTS ABOUT
SMOKING ANDENCOURAGE YOU TO
KICK THE HABIT.
Smoking narrows yourblood vessels and enlargesnaturally occurring bloodclots. By smoking you arebasically causing a trafficjam to your heart.
The effects on othersaround you ...Passive smoking is theresult of non-smokersbreathing in smoke produced by a smoker.Non-smokers who breathesecond-hand smoke suffermany of the diseases ofactive smoking.
Poison to the unborn baby ...Babies born to motherswho smoked (or areexposed to second-handsmoke) whilst pregnant are more likely to be underweight, premature orstillborn.
There is no safe level ofsmoking – low tar, mild orlow nicotine products areno healthier or safer. Thesingle most important stepfor smokers to take is toquit smoking.
SO, HOW DO I QUIT?
- 8 out of 10 people find itmost effective to stopsmoking abruptly.
- Plan what to do at thosetimes when you usuallysmoke – something to distract you.
- Stay motivated. The firstfew days are the hardest.
- You might be irritable anddifficult because of thecraving. Ask friends andfamily and colleagues tobear with you – it will getbetter.
- Avoid other smokers andsmoke-filled environments.
- Find support. Refer to astop smoking associationor support group.
- Consider using quit-smoking aids such asnicotine patches, spraysand gums. Nicotinereplacement therapieslike these have beenfound to double successfulsmoking cessation rates.
- Your health care workercan also provide valuablesupport. Contact yournearest clinic for moreinformation.
KZN MEC FOR HEALTHMRS PEGGY NKONYENI
MBALI THUSI
THEY came in their numbers topray for those living with HIVand Aids, and to salute those who
have succumbed to Aids. The community of KwaMbonambi
on the KwaZulu-Natal north coastwere united in prayer at Nzalabantustadium to observe the InternationalCandlelight Memorial Day earlier thismonth.
The event was attended by provin-cial Health MEC Mrs NeliswaNkonyeni, members of the provincialand national Parliament, general man-ager Dr Sandile Buthelezi, officialsfrom the Department of Health,amakhosi and religious leaders as wellas more than 5 000 members of thepublic.
Religious leaders from differentdenominations who are part of theProvincial Aids Religious ExecutiveCommittee (Pareco) each gave mes-sages of support and prayed for thoseliving with HIV and Aids.
People living with HIV and Aidsalso attended the event and some, likeShumi Khumalo, came forward andspoke openly about their status. “I amstill healthy and enjoying life to thefullest, and I am taking anti-retrovirals,” said Khumalo.
The International CandlelightMemorial Day is celebrated by morethan 4 500 communities, in 93 coun-tries around the world. The day ismeant to be a catalyst for people tobegin talking about HIV and Aids intheir community. It is a unique event
that promotes discussion, education,awareness and action against thepandemic. The International Candle-light Memorial day has four mainobjectives: • to honour the memory of those lost toAids;• to show support for those living withHIV and Aids; • to raise community awareness anddecrease stigma related to HIV andAids; and • to mobilise community involvementin the fight against HIV and Aids.
Speaking at the event, the MEChighlighted that HIV/Aids does notonly affect those living with it but italso affects their relatives and chil-dren. “Some children are orphansbecause their parents died of HIV andAids and this affects them,” said theMEC.
She further announced that thedepartment is committed to a compre-hensive approach to the managementof HIV and Aids. Said the MEC,“R507 million has been set aside todeal with HIV and Aids in this finan-cial year alone.”
She saluted those who were braveenough to disclose their HIV status.“We salute people like Gugu Dlamini,Gibson Kente and many others whocame out in the open and created moreawareness around HIV and Aids,” saidthe MEC.
This year will mark the 28th yearthat people around the world havecome together to honour the memoryof those who have died from Aids-related illnesses.
Page 2 — Advertorial supplement to The WitnessSaturday, June 4, 2005
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IN the April issue of Unwele Olude we featured an article on Ms Nelly Mkhize. In the article Ms Mkhize’s job title was given as DeputyManager: KZN Provincial Laboratory Services. She is, in fact, Manager: KZN Provincial Laboratory Services.
‘Turning remembrance into action’ wasthe theme for this year’s InternationalCandlelight Memorial Day, which isobserved internationally on May 16every year. Provincial Health MECMrs Neliswa Nkonyeni lit a candlein memory of those who have diedof Aids and to honour those livingwith HIV.
Photo: THEMBA MNGOMEZULU
KwaMbonambi united inprayer for Aids victims
JOHANNESBURG — It is irresponsi-ble to sell HIV/Aids test kits to thegeneral public, the SA MedicalAssociation, the doctors’ union,has announced.
Sama chairman Dr Kgosi Letlapesaid that self-testing without coun-selling could be disastrous forthose concerned.
Selling the kits in super-markets could also leadto their abuse by employ-ers or insurers.
Letlape was comment-ing on recent reports inthe media that a super-market franchiserecently sold such kitsfor about three weeksbefore deciding to removethem from the shelves.
The Star reported recently thatAndrew Nathaniel, a director ofHomelab, the company that mar-kets the U.S.-developed product inSouth Africa, said it is a screeningtest that is 99,5% accurate.
But he added that “people usingthe product still need to go to adoctor or a laboratory to have adiagnostic test”.
Said Letlape: “We have a historyof employers trying to exploitdomestic workers and testing themagainst their will. [South African]women are disempowered andcould be forcibly tested by their
male partners. We are concernedbecause of the potential harm,namely the absence of counsellingand support.”
He explained that besides wor-ries about whether untrained peo-ple can use the kit properly andwhether the test is always accu-
rate, self-testing has the poten-tial to ruin lives and drive
people to suicide ormurder.
Letlape added that tohis knowledge, the Health
Department is working onguidelines regarding the
issue.“There must be
proper guidance. Thesekits should only be used
in a professional setting where eth-ical guidelines are in place. Thereis nothing wrong with using the kitsbut this must be done so in theproper setting.”
Counselling is vital because ofthe confusion and many miscon-ceptions surrounding HIV/Aids inthis country. “There is the issue ofstigmatisation but also misrepre-sentation about facts, including theidea that proper nutrition is cura-tive and a substitute for therapeu-tic medication.”
The 16 000-strong Sama is affili-ated to the Congress of SA TradeUnions. — Sapa.
APOLOGY
SALE OF HOME HIV/AIDS TESTS INCUR DOCTORS’ WRATH
MBALI THUSI
PICTURE this: you have to wakeup early in the morning andtravel from Umlazi, south of
Durban, to King Edward VIII Hospitalto be on time for work as your shiftstarts at 7 am and ends at 6 pm.
Your job is to look after and providemedical care and assistance to the sickand to those in pain. You spend most ofthe day on your feet and it can bedraining — physically, psychologicallyand spiritually.
This is a typical day in the life of theprovincial Department of Health’s 26 368 nurses, including studentnurses. The department is celebratingInternational Nurses’ Day today, June3, as a way of applauding and givingthanks to all the nurses in KwaZulu-Natal for their hard work.
Many people often wonder whatmotivates health workers to enter acareer which sometimes entails hav-ing to watch a patient die.
Sister Ntombenhle Lillian Nkosi is anurse at King Edward VIII Hospital inDurban. Despite her demanding job,this 54-year-old mother of three andgrandmother of two still finds time tomanage a community project thathelps the poor and the sick.
When did your career in nursingbegin?
I started working as a nurse in 1975at Wentworth Hospital after complet-ing training at Osindisweni. Back inthose days, one was not allowed totake maternity leave for the thirdpregnancy, so when I was pregnantwith my third daughter, I had toresign. I joined King Edward VIIIHospital in 1983 and worked in differ-ent departments, including the gynae-cology department.
In 1993 I worked at the depart-ment’s clinic in Beatrice Street. In1998 I took a break and started a com-munity project and was lucky to jointhe department again in February1999, and I have never looked back.
In 1999 I was doing pre- and post-counselling courses on HIV and Aids.In 2000 I enrolled for a bridgingcourse, which I completed in 2002, andlast year, I completed a NationalHigher Diploma in CommunityNursing from the Durban Institute ofTechnology.
What made you choose nursing as acareer?
It’s an honour to be a nurse. I oftensay nursing was in my fingertips fromwhen I was a baby. My mother was a
domestic worker and ended up gettinga job at a hospital and sometimes Iwould spend time in the hospital withher. That is how my love for nursingand giving assistance to the sick grew.It is indeed a noble profession for me.
What does your job entail? I am currently working in the surgi-
cal ward and I deal with patients onTotal Parental Nutrition. The type of
patients who I work with include thosewho have illnesses like cancer andthose who have serious injuries, suchas gunshot wounds — and as a resultcannot eat or feed themselves — aswell as those with special nutritionalneeds.
What are some of the challengesand how do you think the public canhelp nurses?
There are challenges everyday but Itry to work around them. For example,a patient could be sleeping in a hospi-tal bed without all the required linenbecause the linen has been sent out forcleaning. My job is to explain the situ-ation to the patient and his family thatwe have a shortage of linen and thatthe linen has been sent for cleaning.Sometimes you do find yourself havingto deal with an angry or rude person,but as a nurse I always put my emo-tions aside and try to remedy the situ-ation in the best possible way. I thinkthe public and patients know abouttheir rights and I believe it is impor-tant for the public to know some of theproblems we encounter as nurses inour work and to be understanding.With the long queues and overcrowd-ing in hospitals, we often have toattend to very sick patients first andyou have to explain this to those whohave been waiting for a long time. Ifthey don’t understand our challenges,it can become a problem.
Can anyone be a nurse? The job is not about money. You
need to be a disciplined person, youneed to have a passion for nursing andcaring for the sick. You must haverespect for yourself and others, youhave to persevere and be an honestperson. Nowadays, with our diversecultures, it is also very important tounderstand the cultures of differentpeople. You must be active, your eyesshould not always be looking in onedirection but everywhere at oncebecause you may never know whocould be in need of your assistance.
What do you do when you are notworking?
I run a community project with 18community health workers in Umlazi.We have a soup kitchen for orphansand other vulnerable groups, and runthe Directly Observed TreatmentShort-course (Dots) programme forpeople on TB treatment. We also giveout food parcels. I do this with theassistance of the church.
I get three days off per week and Ispend most of my time doing commu-nity projects.
I would love to continue helpingpeople even after I have retired fromnursing. I would really love to dohome-based care and assist the ill intheir homes.
• The KZN Department of Healthtakes this opportunity to salute all itsnurses, who are the backbone of ser-vice delivery.
— Page 3Advertorial supplement to The Witness Saturday, June 4, 200
Unw
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may work as well, or better, thancommercial remedies for treatingcommon childhood aches and pains.
Dr Kenneth Haller, an assistantprofessor of pediatrics at Saint Louis University School of Medicine,U.S., suggests that you sometimesneed to think outside the medicinebox.
Turn back the clock and listen towhat grandma recommended, hesays in a statement.
Haller offers some of his favouritetreatments:• Dab a bit of roll-on antiperspiranton mosquito bites. The aluminumsalts in the antiperspirant help thebody to reabsorb the fluid in theinsect bite. That reduces the swellingand itching.• Freeze a bagel or washcloth andgive it to your child to gum when heor she is teething.• For swimmer’s ear, mix a solutionof half vinegar and half water. Put thesolution in the ear and then let itdrain out.• Stuffy nose. Mix a quarter of a tea-spoon of salt in half a cup of waterand spray or drop the solution intothe nose. It helps clean out nasalmucus, which washes out pollensand viruses.• Sore throat. Drink plenty of fluids. Adried-out throat is more prone toinfection.
• Pink eye. Massage the bridge ofthe nose a couple of times a day andalternate warm compresses on eacheye.
Pink eye is often caused by ablockage in the ducts that drain tearsaway. If pink eye doesn’t go away intwo days, call your doctor.• Prevent ear wax accumulation byputting a solution of half water andhalf peroxide in the ears once amonth.
Never use cotton swabs to removeear wax. They just push wax deeperinto the ears.• If a child has diarrhoea, feed himor her a lot of starches and the Brat— bananas, rice, applesauce andtoast — diet.
For constipation, avoid starchesand serve plenty of fruit and vegeta-bles, high fibre food and water.
— News24.
A nurse’s working life
OLD-FASHIONED REMEDIES
Clockwise from top left: There areinexpensive remedies for teething,eye and ear infections, and mosquitobites.
PROFILE Sister Ntombenhle Lillian Nkosi
The Red Cross, EastCoast Radio, Rotaryand Gift of theGivers are rollingout their WinterWarmth campaign
for thevulnerable
in oursociety.
MahatmaGandhiHospital getscheck-upfrom KZNHealth MECKWAZULU-NATAL MEC for Health,Peggy Nkonyeni, recently embarked onan unannounced fact-finding missionto Mahatma Gandhi Provincial Hospi-tal in Phoenix.
The MEC visited the hospital toestablish what problems it faced, fol-lowing a string of complaints madeagainst the institution.
Nkonyeni toured the hospital andthen held an impromptu imbizo withthe patients. This gave them a chanceto tell her and a senior managementteam from head office their concernsabout the hospital.
Nkonyeni then held a meeting withhospital management.
For the patients, the most pressingproblem was lengthy waiting times atadmission and at the pharmacy. “Weare usually required to come back thefollowing day for medicines,” said onepatient.
For management, the most pressingissue was staff shortage and a lack of
space. For example, the maternity sec-tion has only 10 delivery beds, yet onaverage it delivers 11 000 babies ayear.
The MEC promised patients thatimmediate remedial action would betaken. She said that within a few daysof her visit, patients coming to collect
their medication would no longer haveto sit at the outpatients departmentwith patients who had come to seedoctors. Staff would also ascertainhow sick each patient was, so that acritically ill patient would not have tosit for hours on a bench waiting fortreatment. She added that recruitment
of staff was ongoing and in the nextthree months, maternity staff num-bers would be beefed up with moreprofessional nurses.
The MEC urged community mem-bers and leaders to report their con-cerns through the relevant channelsprovided by the department.
RIGHT: Banqobile Nzuza and East Coast RadioDJ Daimon Baird (left) atBethesda Hospital during theWinter Warmth Campaign.
Page 4 — Advertorial supplement to The WitnessSaturday, June 4, 2005
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MBALI THUSI
THIRTEEN-YEAR-OLD Banqo-bile Nzuza from Ubombo innorthern KwaZulu-Natal is in
Grade 4 and lives with her grand-mother. Both her parents died lastyear so she lives with her grand-mother. Life can be tough for a 13-year-old living with an elderly personwho is as dependent on her as much asshe is on her.
Banqobile has two uncles who bothwork in Hluhluwe and she and hergrandmother often rely on them tomake ends meet.
Her story is a common one in anarea where many homesteads arechild headed or are full of orphans.
For many of these children, HIV andAids is a reality and as a result theyhave to learn to fend for themselves.
These are some of the stories thathave touched the hearts of manyincluding the South African Red CrossAir Mercy Service, East Coast Radio,Rotary and the Gift of the GiversFoundation. The South African RedCross Air Mercy Service provides aflying doctor service to remote areasin KwaZulu-Natal and they work inpartnership with the provincialdepartment of health.
As the winter season approachesthey are rolling out their WinterWarmth Campaign. The campaignkicked off at Bethesda Hospital in theUbombo area. Orphans and the poor
from around the area were asked togather at the hospital on the day of thecampaign and Banqobile was one ofthose who took the long walk to thehospital.
Not knowing what was in store forher, Banqobile sat quietly as TrishGloss from the Red Cross Air MercyService, together with radio personal-ity DJ Daimon Baird, greeted her.
Baird and Gloss had come bearinggifts — blankets. When she receivedher blanket, Banqobile was beaming.
“I only have one blanket at homeand I always had a problem when Iwashed if because if it there was notenough sunshine when I hung it out todry, I would not be able to sleep withmy blanket.
“Now I have two blankets so I canuse the one when the other is dirty,”said Banqobile.
“This is a moving experience and Isalute the Red Cross Air Mercy Ser-vice for all the work they are doing,”said Daimon. Thanks must also go toEast Coast Radio listeners who gener-ously supported this initiative.
Close to 100 blankets were handedout to the community in the out-patients department and at the ARVclinic at Bethesda Hospital to helpkeep them warm this winter. The blan-kets were also for orphans such asBanqobile. The initiative gave themhope and the comfort of knowing thatsomeone out there cares. The smile ontheir faces said it all.
‘Just me andmy gran’
KwaZulu-Natal MEC for Health NeliswaNkonyeni makes a surprise visit to theMahatma Gandhi Hospital.
Provincial Health MEC NeliswaNkonyeni together with Dr LindiweMakhubalo, Chief Director forHealth Information Research, duringthe World Health Assembly (WHA)in Geneva, Switzerland. NationalHealth Minister Dr MantoTshabalala-Msimang led the high-
level South African delegation tothe WHA, which included Free StateHealth MEC Sakhiwo Balot,KwaZulu-Natal Health MEC NeliswaNkonyeni and other senior officialsfrom the Health Department. TheAssembly was held between May 16and May 25.
Photo: THEMBA MNGOMEZULU
Photo: THEMBA MNGOMEZULU
SA delegation attends the World Health Assembly
— Page 5Advertorial supplement to The Witness Saturday, June 4, 200
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WORMLIKE parasites, calledhelminths, usually live in thegastrointestinal tract (gut).
Some helminths can also infect thebloodstream or tissues. They can blockthe gut, the bile duct in the liver, orthe lymphatic vessels, or they deprivethe body of nutrients. Some wormsalso cause bleeding in the gut.
Helminth life cycles include a stagein the human host and a stageoutside — either in another animal, orfree-living in soil. Common examplesof helminths are roundworm, tape-worm and bilharzia.
RoundwormYou get the worm by ingesting food
or water which contains its eggs.These hatch in your gut. The larvaemove into the bloodstream, reach thelungs, are coughed up and swallowed,and return to the gut. The adult wormslive in the gut and reproduce.
Symptoms are generally mild andvague, and may include abdominalpain, nausea, weight loss and diar-rhoea. Some people develop a coughand mild fever from the larvae movingthrough the lungs. Mebendazole is themost common drug used to treatroundworm. Hygienic disposal offaeces is very important in controllingthis and other worm infections.
TapewormThese worms are flat, ribbon-like
and segmented. They can reach up to10 metres in length with over 1 000segments, each segment capable ofreproducing. Mature segments breakoff and migrate out through the anusinto the soil. The segments, which arefilled with eggs, are eaten by a herbi-vorous host (usually cows and pigs).The eggs hatch to release larvae,which move through the gut wall intothe tissues. The larvae fill with fluidand form a cyst. If a human eatsundercooked meat, these cysts canhatch and a tapeworm can develop inthe gut after two to three months.
In an important variation larvae canreach the tissues in a human host andform cysticerci as well. These tend tomigrate mostly to the brain.
Infections with adult worms nor-mally produce mild symptoms, such asabdominal pain and nausea.
However, cysts in human tissues cancause a variety of problems, such asepilepsy and hydrocephalus (fluid onthe brain).
Many people have no symptoms atall. Eventually the cysticerci die andbecome calcified.
BilharziaAn estimated 200 million people
worldwide are infected with schisto-soma, the parasite that causes bil-harzia. Eggs are excreted in thehuman host’s urine or faeces. If theeggs reach water, they hatch andrelease the larval form. These infectaquatic snails, in which it undergoesvarious developmental changes tobecome a small, free-living parasite,which swims from the snail and canpenetrate human skin.
So, if you’re swimming in waterwhich has infected snails, you maybecome infected. The snails live instill or slowly moving water.
Once the parasites penetrate theskin, they develop into another larvalform in the bloodstream. They movethrough the lungs andeventually reach theblood vessels around theliver. They mate andthen move to the bloodvessels around eitherthe gut or the bladder.The females lay eggs,which pass into the gutor bladder, and areexcreted in the faeces orthe urine. Some peopledevelop an itchyrash wherethe para-site pene-trated theskin,which lastsabout a week.
Symptoms mayinclude fatigue,nausea and diar-rhoea, a burningsensation on passingurine, and blood in theurine. With time there can be liverdamage and enlargement of thespleen, or urinary tract and kidneydamage.
Bilharzia can be treated with thedrug praziquantel. Infected water canbe treated with chemicals to help killthe snail population.
ToxocariasisToxocariasis is caused by infection
with the type of roundworms that nor-mally infect dogs or cats. The animalsshed the eggs of the worms into thesoil where they can remain for weeks.
Infection with these worms cancause a syndrome called visceral larvamigrans. The eggs hatch to release lar-vae into the gut. These larvae burrow
through the intestinal wall andmigrate to various organs in the body.Most infections show no symptoms. Ifpeople do become symptomatic, symp-toms include cough, fever, wheezes,enlarged liver or spleen, skin nodulesand itchiness, seizures (very uncom-mon) and involvement of the eye if alarva becomes trapped there.
To prevent infection, dogs and catsshould be dewormed regularly. Peoplewho have been infected usually ridthemselves of the parasite withouttreatment in six to 18 months. Meben-dazole is sometimes prescribed.
HookwormThe lifecycle of hookworms begins
and ends in the small intestine. Largenumbers of eggs are passed in thefaeces. The eggs need warm, moist,
soil to hatch into larvae,which penetrate the skinand are carried to thelungs. They eventuallyreach the small intestinewhere they develop intoadult worms that areabout one centimetrelong. The worms attachthemselves to theintestinal wall and suckblood.
People are usually infected whenthey walk barefoot on soil that con-tains human faeces. Hookworm cannotbe spread from person to person.
Itching and a rash are usually thefirst signs of infection. Symptoms ofheavy infection include anaemia andabdominal pain, diarrhoea, loss ofappetite and weight loss. Chronicinfections can cause stunted growthand mental development. It can befatal, especially among infants.
PinwormPinworms are small,
white intestinal wormswhich live in the large
intestine or rectum of humans. Whenan affected person sleeps, the wormsmove through the anus and depositeggs on the surrounding skin. Theeggs can survive up to two weeks onclothing, bedding and other objects.
Symptoms include itching aroundthe anus, irritability and restlessness,insomnia, weight loss and poorappetite. The usual method of diagno-sis is to press a bit of sticky tape to theanal area in the morning and examineit for eggs. Treatment consists of atwo-dose course of medication, usuallypyrantel pamoate or mebendazole.The second dose must be given two
weeks after the first. Close familymembers should also be treated.
ThreadwormThreadworms occur mainly in moist
tropical regions, especially in ruralareas, institutional settings and lowersocio-economic groups.
Larvae in the intestine are excretedin faeces and contaminate soil. Somedevelop into adult worms and continueto breed. Others develop into infectivelarvae which may penetrate thehuman skin, usually the feet. Theytravel to the lungs and from there tothe small intestine where they becomeadult female worms. These lay eggswhich become larvae, which onceagain get passed in the faeces. Some-times, however, the larvae mature inthe gut, and can reinfect the same per-son. This can lead to an overwhelminglarval invasion which is often found inpatients with immune defects.
Threadworm infection is frequentlyasymptomatic but symptoms includeitching, urticarial rashes in the but-tocks and waist areas, mild diarrhoeaalternating with constipation, abdomi-nal pains, nausea and vomiting, andcough with bloodstained sputum.
People with massive larval invasionoften have more severe symptoms,including abdominal pain, involve-ment of the lungs and bacterial infec-tions with shock and sepsis, and thisform of the infection can be fatal.
The infection is treated with thedrugs ivermectin or thiabendazole.
WhipwormWhipworm eggs are deposited in the
soil where they mature. Peoplebecome infected when they handlecontaminated soil and touch theirmouths. They can be infected whenthey eat food that contains the eggs.
The larvae hatch in the small intes-tine and move to the large intestine.Female worms lay eggs which areexcreted in the faeces. If the infectionis light, there may be no symptoms.Moderate infection causes abdominalpain, loss of appetite, nausea, vomitingand diarrhoea. Heavy infection causesbleeding from the intestine, abdominalcramps, anaemia and appendicitis.
Infections can be treated with thedrug mebendazole and can be pre-vented by good personal hygiene,cleaning of fruit and vegetables andgood sanitation. — Health24.• Dr Andrew Whitelaw is the seniorregistrar at the Department of Micro-biology, University of Cape Town andGroote Schuur Hospital.
Infection ofhumans with
roundworms iscommon, especially in
developing countries,where sanitation is oftenpoor and access to cleandrinking water limited.
Look out for worms
Over onebillion people
are thought to beinfected with
roundworm.
”“
Look out for worms
DrANDREWWHITELAWlooks at thetypes ofparasiticworms thatafflict us.
Page 6 — Advertorial supplement to The WitnessSaturday, June 4, 2005
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MOKGADI SEABI
PROVIDING a quality health ser-vice for all in the province willbecome a reality after the
provincial Health Budget received anamount of R10 379 billion for the cur-rent financial year.
“The growth in real terms is, for thefirst time since 1998/99, positive andthe department will be able toimprove the quality of their ser-vices,” said MEC for HealthNeliswa Nkonyeni during her pre-sentation of the budget speech inthe provincial legislaturerecently.
She said the budget alloca-tion will assist the departmentto address issues suchas low servicedelivery levelsbut she main-tains that it“remains insuf-ficient to
substantially address certain areas ofconcern”.
These are the provision of healthcare in certain under-served areas;the provision of Emergency Medicaland Rescue services which require a50% increase in funds but only 30%can be solved this year; addressing thepoor state of some health facilities andimproving the quality of services with
additional personnel.However, there are
many benefits to thisyear’s budget.
The staff accommo-dation in various dis-tricts will also beimproved.
The department isplanning on taking
over the run-ning of
Santa(TB)hospi-tals in
July, which will strengthen theprocess of diagnosis and managementof chronic diseases through screeningprogrammes, with queues for theelderly added at all healthfacilities.
More health facilities will be builtand the old ones refurbished.
There will be more relief forHIV/Aids patients and theKhomanani Pro-gramme, andimprovements willbe made to labo-ratory services,information ser-vices, humanresources, drugprocurement anddistribution.
Nkonyeni com-mended those whocare for people livingwith HIV/Aids andmentioned a num-ber of home-
based care facilities that have been setup around the province by people whoare committed to making a difference.
The department has made womenand children their priority.
Nkonyeni added that their challengethis year is to ensure that all hospitals,clinics and community health centresare well equipped to prevent andreduce both maternal and child
deaths.Nutrition has also been made a
priority. Children under five havenow been provided with a pro-gramme for nutritional supple-ments. Nkonyeni also encour-aged people to follow healthylifestyles to beat obesity.
Left: Attending thedinner were (from left)Nozipho Bhengu, SizaNgcobo and KZNHealth MEC NeliswaNkonyeni.inset right: DrZweli Mkhize.
MEC for Health in KwaZulu-Natal, Mrs Neliswa Nkonyeni (seated, centre), with department head Professor Green-Thompson (right) and department staff at the budget speech dinner.
Budget BOOSTPhotos: THEMBA MNGOMEZULU
— Page 7Advertorial supplement to The Witness Saturday, June 4, 200
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PARENTS often try to squeeze “qual-ity time” activities such as sports andreading into their children’s alreadybusy schedules. But in doing so, theycould be robbing their children of theone activity that comes most naturallyand is vital to their development —playing.
Child development experts say free-form playing is every bit as importantto a child’s growth as any structuredactivity.
“Playing is critical to children anytime of the year,” says Joelle Garnick,a child life/recreation therapy man-ager at Temple University Children’sMedical Centre. “Play is importantbecause it’s a child’s way of learningand developing.”
Child psychiatrist Dr ElizabethBerger says one of the main problemsconfronting parents is confusion aboutexactly what constitutes real play.
“Something like baseball or socceris fun and considered playful, but thatrequires skill and very controlledactivity,” Berger says. “But real play-ing is about discovery and being cre-ative with self-generated activity.”
In fact, play uses many of the sameintellectual skills children will need asadults with careers, she says.
“Someone has said: ‘Play is the workof childhood.’ For a child, creativityand intellect are the same thing,”Berger says. “The world presents itsperplexities to a child and it’s throughplay that a child masters thoseperplexities.”
Garnick adds that an essentialaspect of playing is the independenceit offers children.
“When we give children the abilityto interact with other children on anequal level and explore the environ-ment on their own, versus [the dictate]‘here’s the environment, you willexplore it’, it supports their develop-ment,” Garnick says.
Play also lets children release emo-tions in a safe way. It gives them thechance to express feelings or emo-tions, such as pent-up energy or anxi-ety, while giving them pleasure. Whenchildren play, they’re in control. Play-time is free of rules and gives anunlimited number of choices, saysGarnick.
Throughout childhood, play takesmany shapes and forms. Swiss psy-chologist Jean Piaget described thestages of play as including: • sensory-motor play, in which infantsand toddlers experiment with bodilysensations and motor movements; • symbolic play, in which objects takeon a different meaning — wrappingpaper becoming a dress, for example; • mastery, in which children are incontrol of their bodies but still possessimagination — becoming a rocketwhen on a swing, for example; • and finally, games, with their rulesand order. — News24.
SA suicide line savingyounglives
IN South Africa nine percent of allteen deaths are caused by suicide.Only car accidents and homicide
kill more young people between theages of 15 and 24. The suicide helpline helps to save the lives of this vul-nerable group.
Research indicates that althoughmore females attempt suicide, moremales succeed.
This is due to the more violent mea-sures males select. Girls are morelikely to overdose on medication, or totake chemicals, whereas boys oftenhave access to firearms or hangthemselves.
There is a major link betweendepression and suicide. Most of thetime, teen depression is a passingmood. Sadness, loneliness, grief anddisappointment are normal reactionsto life’s struggles. However, undiag-nosed depression can lead to tragedy.Up to one third of all suicide victimshad attempted suicide previously.
“It is not hard to see why seriousdepression and suicide are con-nected,” says Zane Wilson, founder ofthe South African Depression andAnxiety Group (Sadag).
“Depression involves a long-lastingsad mood that doesn’t let up and a loss
of pleasure in things you once enjoyed.It involves thoughts about death, nega-tive thoughts about oneself and a senseof worthlessness. A teenage girl of 15who has been constantly abused byher stepfather, a boy who has lost hiselder brother due to gang violence or achild of 12 whose mother has recentlydied of Aids might feel there is noth-ing to look forward to or that lifewould be less painful if they were toend it.” However, depression is treat-able. With treatment, over 70% of suf-ferers can make a recovery.
Sadag answers the national toll-freesuicide line, which takes a huge num-
ber of calls from teens who are callingfor themselves or on behalf of a friend.This line has already saved thousandsof lives, and over 110 000 children inthe North Western Province and theNorthern Cape have attendedworkshops. This programme not onlyencourages teens to come forward butalso tells them where to go for help intheir own community and how to con-tact the suicide line.
Skilled counsellors answer the lines(0800 567 567) and encourage teens toget professional help, to talk to anadult they trust, to go to a doctor, or totalk to a church leader. — News24.
The national toll-free suicide
line takes a huge number of
calls — and has prevented
thousands of teenagers from
taking their own lives.
Family dinnersmay hinderanorexiaGATHERING around the family din-ner table each evening may helplower risks for eating disorders ingirls, suggests a University of Min-nesota (U.S.) study.
Regular family meal times appearto encourage healthy eating in allchildren, the researchers added.
The study of nearly 4 800 adoles-cents found that teen girls who eatregular family meals in a structuredand positive environment are lesslikely to use extreme weight-controlmeasures such as chronic dieting,vomiting and diet pills.
The researchers found that girlswho join in at least five familymeals per week are at one-fourththe risk of developing an eating dis-order compared to girls without ahistory of regular family mealtimes.
The findings appear in theNovember issue of the Journal ofAdolescent Health.
Boys also benefit from regularfamily meals but not as much asgirls, the study found.
Study author Dianne Neumark-Sztainer said: “Prioritising familymeals that take place in a positiveenvironment can protect girls fromdestructive eating habits.”
Families can be creative about it,Neumark-Sztainer said. For exam-ple, organising a regular familybreakfast may be easier to arrangethan dinner.
– HealthDayNews-News24.com
Let the kids play — it’s their work
‘Real playing is about discovery and being creative.’