Caring for children
Published On July 26, 2014 » 2012 Views» By Administrator Times » Latest News
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Little SecretsI  BECAME a doctor quite by accident. My introduction to health services when I was just about six years old was an unhappy one. So I had determined, early, not to have anything to do with the career of medicine.
In 1972, I had the misfortune  to be admitted to Kitwe Central hospital. The story was that I had knocked my head against the bed post in my bedroom, while playing, acting cowboys and Indians with my younger brother one school-day morning.
I felt slightly drowsy, but unwilling to draw attention to my mischief, my brother and I, had agreed to keep quiet about the event and go to school.
What followed was nothing less than drama. A few hours into the morning classes, at my school , which was called Fredrick Knapp primary school in Nkana West.
I became quite unwell, it started with a bit of a headache, some vomiting and when I was taken to the school sick bay, I lost consciousness. When I came round, I found myself in Kitwe Central hospital. The place had a distinct smell of disinfectants and everything looked white. The beds, the nurses and the doctors were all clad in different versions of white.
Everyone tiptoed about and spoke in whispers. The place was morbid. There was an overwhelming sense of gloom that was wholly disheartening. I came round as I was about to be wheeled into the operating room to have surgery.
I was told later that I had developed a blood clot on the surface of my brain, which needed to be removed. I opened my eyes just at the nick of time. Fortunately, the bleeding had stopped and the clot gradually resolved itself.
I knew that whatever  was going on was serious when my mum and dad, sat round the bed and were being very nice to me. In those days being chatty with children was just not an in thing.
Besides, I had expected, a very thorough telling off and a very good hiding to top it off. I escaped the operation, but spent a very uncomfortable number of nights in the hospital.
I recall that the nurses were reasonably unkind and that I received not a few unpleasant injections on my backside. This experience alienated me from the hospital for a good portion of my life.
I have learnt over the years that children are among the group of people in the community who are most at risk of disease.
This is so both because their internal body defences are not fully-developed and also because they are externally dependent on others for their nutrition  and general welfare.
Among children, the most vulnerable are those below 5 years of age. When your children cross this bridge you should really breath a sigh of relief, because from this point on their susceptibility to disease is markedly less.
There are three things that put children below 5 years most at risk from disease these are:
1.The parents
2. The home
3.The community
The Parents
This sounds odd at first, but in fact good healthy parents will give birth to good healthy babies. The baby is quite vulnerable to its environment. However, this is made worse if the child has also a birth defect.
The most common defects are those that result either from infection into the womb, while the baby is developing or is inherited as a family disease. Infection or disease during the period of pregnancy can be prevented by the mother being regular with antenatal attendances.
By doing this, any disease the mother may have will be detected early and treated. Inherited family diseases are perhaps less easy to prevent.
However, when choosing a spouse, try if it is possible, to chose someone from as different a geographical cultural background from yours as possible.
If you are from the north marry from the south for example. This simple advise is medically sound, because the information that is inherited comes from two sources.
There are the woman’s genes and the man’s genes (the genes carry information about the characteristics of each individual which are then passed on to their children).
The body chooses the best of the two genes and passes on the best from each parent. If you both have the same genes, you don’t give the body much of a choice.
By marrying widely you give your baby a better chance of good health. This is why  traditionally the elders in the family would decide who a young man may marry, they will ask not only the tribe, but the clan and the family. This was meant to assess if the genetic pool was of a good stock or not, and, therefore, to secure the health of the next generation.
The next piece of useful advise is, marry and have children early. If the man is older than 45 years and the woman older than 35 years, there is an increased risk of the children being abnormal.
The genetic information deteriorates with age. The most common congenital defects are those of the limbs, the heart (and the blood), the abdomen and the brain.
Some of them are not compartible with life or make the child severely incapacitated and dependent on others.
Under parents, I add the all-important area of food or nutrition.
Mothers should breast-feed their children, they should start early and breast feed them as long as possible. This helps to boast the immunity of the children and also bonds the mother to the child. Not to add its protective effect against breast cancer.
The breast-feeding technique is not easy and should be learnt with the help of an older and more experienced mother. Do not allow your child to be breast-fed by any one else apart from yourself.
Bottle-feeding increases the risk of diarrhoeal diseases and is more expensive. One of the biggest threats to the health of children in Zambia is malnutrition.
A good deal of malnutrition can be attributed to ignorance of the parents. Children who have poor nutrition will not have a normal development of their brain and other body systems.
This may impair their health for life. Most of all before having children, both parents should know their health status, particularly their HIV status, in order to give their child the best chance of a good health.
The Home
Physical injury poses a major threat to children under 5. This is the time when children are very active and want to explore. They have a tendency to want to touch things and put them in their mouths.
My own experience when I was five, was of putting live electricity cables that were hanging in the kitchen into my mouth. I was thrown across the room and nearly roasted. I have feared electricity ever since.
One of the biggest threats to children under five are domestic burns. This is mostly from hot water in the bath tub. Typically a baby is left by a maid or young sister in a tub or a baby basin of boiling hot water while she continues other house hold chores.
The best advise is to bath your children yourself, or in your presence. This disastrous outcome is purely the result of parental neglect. Many children are burned by hot fluids while trying to see what’s cooking on the stove.
They pull the handle of the pot and the contents spill onto the child. Always keep the handle of the pot face away from where children can reach them.
Occasionally, children are run down in the streets by motor vehicles or bicycles, because of playing near the road. If you stay near a busy road, if you have children under five, it is a good idea to keep your gate locked or have them supervised by some one older.
Never leave brightly coloured pills where they can be reached by children, they will think these are sweets and try to swallow them. A few years ago coins were re-introduced in Zambia, these are sparkly objects and many children will try to eat and swallow them.
The number of cases of swallowed coins had reduced remarkably in the 1990s and early 2000s when they were no coins in circulation. Now we are seeing increasingly the return of this problem. Do not keep a box of loose coins in your car, or in the house where children can reach them.
Children are prone to insect bites with spiders, ants, dogs and even snakes. If you keep the grass short, spray the home regularly you will save yourself a lot of heartache.
If you have ferocious dogs, keep them chained, and make sure you have a lockable Dog house. With children under five around the home, you need to keep a first aid kit in the home.
This should contain some painkiller syrups, a supply of antipyretics (drugs that suppress fever), cotton wool, small band aid strips, antispetics for sore, some antifungal creams, bacterial cream and some anti insect bite cream.
Often the bite itself is innocuous, but many times the children have an allergic response which may worsen matters. Some children become breathless, have a puffy face and begin to wheeze after an insect bite.
The community
Children under-five are very prone to all types of allergies. In Zambia now with a lot of cars and industries, the air is becoming heavily polluted. Children in this age group are prone to coughs, sneezing and even Asthma like attacks.
Spend some time if you can visiting parents and grandparents during holiday time away from the city. This will help keep the children in touch with their family, but also give an additional boost to the health of their respiratory system.
Many children start school early now, and the school environment though good also poses some threats to the health of young children. One common one is fungal scalp infections called ring worms.
These are passed on from one child to the next, particularly as teachers hold the head of one child and then the next. Cut children’s hair frequently and shampoo them regularly with antifungal shampoos and treat their scalp with anti ring worm creams.
Children like to pick up and put all sorts of things in their mouth. It is called the oral phase. They explore the environment mostly with their mouth. This means that they may get infections with soil parasites such as worms.
These parasites will grow in the tummy and cause pain and malnutrition in children. It is good advise to give children deworming medicine regularly to clear these infections.
The greatest threat to children below five years in Zambia is malaria. More children die from malaria then any other disease worldwide. Keep the home clean, ensure that you have no stagnant pools of water around your house.
Most houses have had indoor residual sprays by the local council, make sure you have it as well. Mosquito treated bed nets are available and distributed freely.
These reduce the number of bites that a child may be exposed to particularly at night. If these are inconvenient, spray the vents and curtains in your home with insecticide, to keep away mosquitoes.
Malaria infections tend to be particularly severe in young children, and is a leading cause of death in Zambia in particular and Africa in general.
Conclusion
Children are the greatest assets we all have, and young children below five years are at a special risk to diseases. This is from parents, the home and the community.
We prevent our children being  born unhealthy by being healthy ourselves and choosing healthy marriage partners.
We must take advantage of all the provisions for good health of children provided by the health services around us including antenatal clinic visits, under five clinic visits, following all the vaccination schedules for our children, regular deworming, vitamin A supplementation and making the home safe for children.
If we have male children let us have them circumcised early. This prevents diseases of the foreskin in childhood such as phimosis and urinary tract infection.
What do we mean by men’s sexual health? This is where the male organs are free of disease and are able to perform their normal reproductive function.
The male chemical (hormone) testosterone plays a big part in the normal function of these organs and their performance. This chemical increases over a man’s life span, peaks at around 35 years and declines gradually reaching its lowest levels after 60 years. Natural foods can increase the levels of the male hormone including nuts such as almonds, avacado, and milk products such as cheese.
This decline in the male hormone can be accelerated by the health choices that a man makes. So that if men need to preserve their sexual health they need not look for solutions outside of themselves. They need only to do a check list of their own attitude towards their;
1.Habits
2.Hobbies
3.Holidays
4.Happiness
Habits-many men have pot bellies. This is the result of excessive deposition of fat under the skin. This fat, especially around the trunk, breaks down and reduces the level of the male hormone testosterone, which shifts the natural decline of sexual function a few years earlier than normal. So when you see any man with a pot belly, you can be sure their sexual health is not as good as it should be.
A person who eats lots of bread, cakes, pastries, chips, eggs and pork will quickly earn a handsome pot belly. One very quick measure is what is called the body mass index.
This is an attempt to measure the density of fat an individual has. How is this parameter measured.Take your weight for example an average man may be say 90kgs in weight.
Then divide that by the height squared(your height X your height). For an average man say  1.70metres (1.70X1.70m =2.89m2) . Then take  90kgs and divide it by 2.89 the answer you get which is  31.1 is the body mass index(BMI).The normal range of BMI is  18.5 to 25. If this ratio is greater than 30 then a person is obese(too fat).
So our average male in this case is obese. What is the importance of this self evaluation? Well, if your BMI is high, you are at risk of three cousins of disease that together worsen your sexual health. These are diabetes mellitus (sugar disease), hypertension(BP) and renal disease(kidney failure).
The diabetes comes first because you will outstrip your body’s capacity to feed itself adequately. Even when you eat more the body chemical (Insulin) that distributes the food you eat to the body will be outstretched.
This results in excess sugar in the blood. The body will start converting this to fat for storage. Some of this fat will be stored in the lining of the blood vessels, which leads to narrowing and high blood pressure(Hypertnsion).
One of the first organs to suffer from narrowing of blood vessels and excessive sugar in the body is the kidneys. The kidneys will be stressed and begin to suffer damage and deterioration. These diseases will all worsen further your sexual health.
Hobbies– I asked a group of men recently what there hobbies were and most were not quite sure what a hobby is. So I said how do you spend your free time. Most said I watch ……. So its either I watch Television, or I watch football, or I watch Golf or I watch movies. Many of us are increasingly more and more inactive.
The other month RTSA released the figures of the number of cars imported in Zambia in the first quarter of the year and it was amazing. There are in excess of 200 cars coming into the country everyday.
Car importations are a major source of tax revenue to ZRA. The numbers already in Zambia are close to a million. We see this all the time trying to get to working in the morning. Most cars are driven by men by the way.
So more and more men are living a sedentary lifestyle. We are simply spending more and more time sitting down and doing very little exercise. It has been shown that exercise raises the levels of the male hormone testosterone. Regular exercise maintains this level high for longer and will generally improve sexual health.
Holidays-how do you spend your holiday.I am too busy for holidays. I go and build at my site.I go and work on my kantemba.I spend time with friends discussing politics and how bad the economy is.
These are the typical responses from most men when you talk about holidays. The thing is, that just like your cell phone battery will lose its energy if it is not recharged periodically, so too the body loses its health more rapidly if it is not given an opportunity to rest.
A holiday does not necessarily mean going out of your town or city. It simply means a period of rest from your daily routine of work. If you can do this daily or weekly this is even better still.
How about choosing to spend one day a week with the family. Have you been to the special sites in your town with the family, have you taken them to a museum, have you been with them to your local recreational club. Allocate sometime to developing a life outside your work, it will improve your health and well as your work performance.
Happiness– how much do we invest in your own happiness. Mostly men invest in the happiness of others. They spend a lot of time being bitter with other people. Bitter with the boss, with the wife, with the children.
Why is it when we arrive from work there is a lot of laughter and it suddenly disappears when a husband comes in to the home. So what is happiness? Many men mistake happiness for richness.
Richness is abundance of wealth. It may not always bring happiness in fact sometimes quite the opposite. We clearly see many rich people who are unhappy. Happiness is an inner richness, it is richness of the heart. It is to be content with what you are and what you have.
How can men be happier? Many men consider happiness a soft emotion. The only happiness they know of is the feeling when their
favourite team schools a goal.
In fact some men consider a little bit of latent anger makes you hungry for success. Someone once said to me, I built my success around my anger at the poverty I had in my childhood. It may work, but it definitely burns you out more quickly.
Happiness leads to better health. What if we all tried to experiment with trying to be happier and see what it does for our health. Perhaps that is worth a try. So how can men be happier. They can begin by reviving their old hobbies.
How about picking up that old guitar and playing your old favourite songs. How about trying to write poetry again. How about picking up your camera again and taking those photos. If men were happier the world would be a better and safer place for women and children.
What are the things that men whisper to men. They whisper about their hopes for better sexual health. They share experiences about what they have tried that appeared promising but fizzled out.
They talk about the next big thing that will make their sexual health better. What talk a lot more about habits, hobbies, holidays and happiness. like how the waist line can be trimmed. How to quit smoking using the electric cigarettes. If men did this a lot more our sexual health would be a lot better and everyone would, I think, be happier.
It justifies inactivity. It also results in the release of unhealthy body chemicals that overtime destroy the blood vessel system.People who are religious or spend time in church are said to be healthier and to live longer.
This is because their stress levels are lower. They have learnt to forgive themselves and others, to accept that they are not perfect, and they can make mistakes too. to say sorry, to forgive their spouses.
These small or effeminate sounding things make a great difference to health.This is why worldwide women live at least 10 years longer then men. They are more concerned about pursuing happiness rather than wealth. They are more concerned about companionship rather than competition.
Conclusion
Clean the body (habits and hobbies), clean the heart (happiness) and clean the mind (holidays). Sweep the blood vessels everyday and they will sweep out the poisions from your body and keep you young and healthy.
[The author is Professor of Urology at the Copperbelt University. He is also the Dean of the Copperbelt University School of Medicine. kbowa@yahoo.com
He is the Author of the popular motivational book “Making the Cut”]

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