A tribute to two great advocates, story tellers and mentors to many

By Esther Nakkazi

It is not possible to honor all the health workers, advocates, and media personnel who have died of COVID-19 but telling the story of Dr. Charles Kiggundu and Patrick Luganda may serve as a tribute to them and others.

Both Dr. Charles Kiggundu and Patrick Luganda were consultants in their fields, advocates of difficult topics, mentors, passionate with their jobs, high achievers, great communicators, and storytellers. They also, unfortunately, lost their lives to COVID-19.

Dr. Charles Kiggundu, a consultant obstetrician and gynecologist was born in Kasiso, Kasana in Luwero district and died on 29th December 2020, aged 55 years.

I last talked to him on 26th September 2020, when the Health Journalists Network in Uganda (HEJNU) in partnership with the Association of Obstetricians and Gynaecologists of Uganda (AOGU) held a science media Café on safe abortion in health care.

Dr. Kiggundu was one of the speakers at this Café and he had been a speaker on many more and others which were in commemoration of International safe abortion day of September 28th.

I was the moderator but it was initiated by one of the HEJNU members and it was Saturday so I was a bundle of nerves about timekeeping, speakers, and HEJNU members showing up. Dr. Kiggundu was already at the venue. He had arrived over 30 minutes early.

He was his usual self talking about how COVID-19 had affected reproductive health, giving insight about different topics as the questions were flowing from whoever came before the function started, and giving story ideas about his favorite topic; access to safe abortion. He was brilliant, easy to talk and he liked to tell stories to illustrate a point.

Many words have been used to describe Dr. Kiggundu; CEHURD where he was a board member described him as an advocate for post-abortion care, health justice, and reproductive health rights. Asia Russell an advocate for health justice and access to treatment for all tweeted;

From a media perspective, he was a devoted, unselfish individual always ready to share his knowledge and a fierce advocate for maternal health rights and for his patients. Due to personal values, religion, beliefs, and how society will judge most people will steer clear of discussions around topics like abortion, GMOs especially with the media.

Dr. Kiggundu was never afraid to speak about access to safe abortion. He was friendly with everyone and thrived in leadership roles with a down-to-earth style that made us in the media comfortable asking about anything in his specialty.

Vivian Agaba a journalist and member of HEJNU described Dr. Kiggundu as very knowledgeable and passionate about maternal and child health. “Most of the times when I was writing health-related articles regarding maternal and child health for the New Vision, he was always willing to share information.”

“Some times, I would interview him from Kawempe hospital many times sparing about 30 minutes of his precious time with his patients. He became a good friend, says Agaba.

Losing Dr. Kiggundu causes direct and indirect harms that are impossible to overstate said Rusell.

“His death is a blow not just to us but to everyone who has drunk from his wealth of wisdom, including several civil society organizations, Sexual and Reproductive Health Rights, and women's movements. That he will be greatly missed is an understatement,” said a statement from CEHURD.

In the world scientists like Dr. Kiggundu are gems, hard to come by so losing him is going to create a void in that space that is very hard to fill. He delivered on his promises, served above self and we shall greatly miss him.

Dr. Kiggundu's last post on his Linkedin account says; “Let us work to leave a mark. Work to be well remembered ever. Leave society better. Don’t just do what people will quickly applaud. Do good.” #RIPCharlesKiggundu

Patrick Nkono Luganda: “Many agree Patrick Luganda, will be remembered as the father of agriculture journalism in Uganda, climate journalism in greater horn of Africa and mentor of many senior journalists,” said an article published in the Sunday Vision.

Patrick Luganda was a science journalist, consultant, trainer, farmer, and co-founder of many media organizations including Network of Climate Change journalists in the Greater Horn of Africa (NECJOGHA).

He was the Executive director of EBAFOSA /UNEP that seeks to combat food insecurity, climate change, ecosystems degradation, and poverty in Africa using an innovative approach. He was born on 8th October 1957 and died on 16th December 2020.

I first met Patrick in 2006 in Nairobi at a training workshop organized by the World Federation of Science Journalists (WFSJ). We were both mentees and paired with mentors. I had almost just started out and didn't know much about science journalism but ready to learn, to be mentored, most of us were and so was Patrick even if he already was a seasoned, award-winning journalist.

In 1999, Patrick co-won the A.H. Boerma Award worth $10,000 and an all-expenses-paid visit to Rome to receive the Award with his spouse. He reported extensively on the cassava mosaic viral attack causing food insecurity for thousands of people and his efforts also resulted in a rapid technology transfer that restored the food production of cassava.

“Mr. Luganda's concrete and descriptive way of featuring policy and decision-makers, research and beneficiaries on an equal basis, makes him a journalist of outstanding caliber. His weekly programs on Radio Uganda intended for rural communities, have encouraged this sector to apprehend and implement improved agronomy methods.”

During the WFSJ mentoring program, Patrick was never assuming, as much as he knew so much and was willing to share his knowledge he also pretty much followed through with the program that lasted for four years.

I have already talked about difficult topics in the media and climate change is one of those but Patrick easily trained, advocated, and simplified it to a level that even those who did not care listened.

He was passionate about innovations in agriculture and trained, preached, and lived them practically. He loved to tell stories, use illustrations as he was training, and speak in different languages that simplified science and technology.

Patrick was such a great speaker on climate change he received the loudest applause on any panel I have participated in at a conference. So in 2009, we both were panelists on a roundtable about climate change at the 7th World Conference of Science Journalists in London. I had just returned from a year-long fellowship in the USA and was very confident and pleased with my submissions.

When I listened to Patrick on that panel there was no doubt about the passion, energy, knowledge, and ability to deliver and the audience, of course, reacted with a big applause. As we stood outside after the panel he was flooded for contacts. When I reminded him about that experience he encouraged me - ‘you will get there’ and laughed off.

Patrick loved his family. I don’t remember ever having a conversation that did not meander to the kids, his parents, or family. Losing him is going to create a void that is pretty hard to fill in the science journalism profession. #RIPPAtrickLuganda

http://hejnu.ug/a-tribute-to-two-great-advocates-story-tellers-and-mentors-to-many/

Triplets born during the pandemic

By Patricia Nakyalu and Esther Nakkazi

On the 28th May 2020 during the pandemic, Brown, named after its color, started to show signs that she was going to give birth. She was crying endlessly in low tones, looked weak and exhausted, and was breathing heavily.

Brown and Black were both adopted by Marcel. One evening he heard crying puppies in a nearby bush. He checked to find two puppies. They were dirty and infested with fleas but they were well fed.

He picked them up and brought them to the house. We gave them a clean bath and he arranged to have a veterinary doctor come and immunize them. The following evening a fatty, big dog came around and we knew that was the mother.

Brown and Black were domesticated so they were not wild anymore. Marcel made a house for them and we would cook for them - mostly posho, rice with silverfish (Mukene), chicken legs, or beef bones.

Their mother who we named mother dog was still a bit of a wild dog so she would go in and out of the compound as she wished. She came back every evening and slept on the verandah. Although mother dog’s movements were not restricted we realized that she enjoyed staying near her children. So we started feeding her too. She would come to the compound during meal times. We then added her to the pack.

Mother dog and her puppies now grown-up dogs have been living with us for four years. During this time she had triplets but we gave them away. Her daughter Brown also got pregnant and on 28th May she downloaded six beautiful puppies.

The first signs of the puppies coming were after the dog walk in the morning. Brown was very exhausted. She started making funny noises so Uncle Marcel decided to carry her to the dog house where we had prepared some clean old clothes in a comfortable bed to deliver her puppies.

At exactly 2: 48 pm, 28th May, Brown started giving birth, we all watched in awe and pity because she seemed to be in pain breathing fast and crying. After what seemed like an eternity to her but just two hours all the six puppies were born.

She was a protective mother. If someone got near her puppies she would let out a warning low bark as if to say back off. We started feeding her two meals a day because she was a mother and needed extra food to produce milk for her puppies. In the morning rice and silverfish (Mukene) and the usual posho and fish in the evening.

The puppies were cute and lovely. Their eyes were closed all the time. They had a variety of colors - two were pure black, one looked like Brown, another one had no resemblance to her at all. We think the father of the puppies is Black because they all have a white tip on the tail like Black except for one of them.

A week after they were born I went to check on them in the morning. Three of the puppies were dead. It was a very despondent moment for me because it was like losing family members. Uncle Marcel thought that the puppies might have died because they were not vaccinated.

So the surviving three were vaccinated immediately. We also gave them names - ‘booze’ names. The triplets who are all female were named; Miller Lite, Brandy, and Vodka. After a month they started going for dog walks. They were afraid of everything.

When they saw a bodaboda they would stop walking, they were afraid of humans and they would get tired. They would freeze and not move when a bicycle was passing by. Just stare at it until it disappeared at the end of the road.

On many occasions, Marcel had to carry at least two of them back home because they were just tired and could not walk back to the house. The puppies and Brown continue to have a breakfast meal - rice and Mukene so that they grow healthy and Brown has to rebuild her body. They also eat an evening meal with the rest - Black and Mother dog now ‘Oma’ - grandma in Dutch.

They have grown big so fast. It was just months back that they could not even open their eyes and only cried when they were hungry. Now they understand Marcel and play some tricks. They all look different and have personal characters.

Miller is the ‘blonde’ gal both in looks and brains. She has greenish eyes, has white, brown color fur. She has a lot of fur on her outer coat which makes her look like a typical crossbreed. She is the cutest by far, the friendliest but the most stubborn and a 'crying baby'.

Miller loves food but has no brains to fight for it. When you save a bone for her and quietly call her to eat she will abandon it and follow you thinking that you have an even bigger bone. That way she loses her bone to Black who is fierce while fighting for food and anything.

Miller is the one everyone comments about that she looks ‘exotic’ on the dog walks and they ask Uncle Marcel to give her to them. Too bad she does not hear what they say she would walk over her sisters. Miller loves playing with Vodka but then she will start crying like they are killing her until we intervene.

Vodka looks exactly like her Mother Brown. She has grown so big sometimes it is difficult to know who is mother or daughter. Vodka is peaceful. She is scared of everything which makes her insecure but that means she can also snap and bite you because she thinks you want to hurt her. Vodka is also the most destructive, she hides in a corner, stays quiet, and will chew at your shoes or slippers until she shreds them to pieces.

In a dog pack, there has to be a leader. In this case the only male, Black is the head. Black is the one who will attack anyone who gets into the compound. He is so fierce he will attempt to jump and bite if you don’t hold his chain tight during the dog walk. He is also the most obedient dog to his master.

When Marcel leaves the house, Black sits by the gate and peeps at every car driving by. He sometimes refuses to eat until he comes home. When he gets home, Black usually licks his beard and shakes his tail so hard running around him as if to say I am so happy you are back.

Brandy on the other hand loves to be the one in charge and sometimes tries to take Black’s position in terms of rank and has been badly been bitten a few times by Black. Brandy has a dark brown color that almost looks like her granny (Oma) but not exactly. She resembles black too. She loves to play and will be the one to dare steal a bone from Black who will fight her. She also loves fighting over food with her sisters during the morning meal. She will try to chase and bite Vodka and Miller so that she eats everything. They are clearly afraid of her at mealtimes.

Brandy loves climbing up on the chairs on the verandah ‘playing king of the jungle’ and looking down at Vodka and Miller who then fight to try to climb up too but never get a chance. She is playful but hates water. When the dogs are taking a shower and you hear the loudest cry that will be Brandy. Even when we smear them with lotion after bathing, Brandy screams like it is so unpleasant.

So which of the triplet puppy gals do you pick; Brandy - 'queen of the jungle', Miller -' the blonde gal', or Vodka 'the mischievous'?

ends

First medical training school to be opened in Sudan rebel-held territory next year

By Esther Nakkazi 

Last week Dr. Tom Catena the only surgeon for approximately 1.3 million people in the Nuba Mountains of South Kordofan, Sudan announced the opening of a medical training school next year in the rebel-held territory.

“There has been a tremendous upgrade in medical capacity over these past 13 years but despite these efforts, there remains a huge deficit in medical personnel in Nuba. We now believe that the only way to address that huge shortfall is to open a training school here, and train our own, nurses, midwives and clinical officers,” said Dr. Catena during a virtual World Innovation Summit for Health (WISH), a global healthcare community dedicated to capturing and disseminating the best evidence-based ideas and practices. 

“We are now in the early planning stages of this school, and hope to have it up and running within the next year.” 

The medical school will be attached to the Gidel Mother of Mercy Hospital, which he helped establish and open in 2008 and remains the only major provider of medical care in the Nuba mountains region. The hospital has been relying on heroic on-the-job trained staff but now wants to have fully trained professionals. 

‘Dr. Tom’ as he is affectionately known, has served in Africa for more than 20 years and works and lives in rebel-held territory, around the size of Austria, which has known civil war, starvation, and genocide ever since the founding of the Sudan republic in 1956. 

Funds to run the Gidel Mother of Mercy Hospital mostly come from individual donors, well-wishers, except for donations of food, vaccines, and TB drugs but they don’t receive anything from the International donor community which has made them rather frugal in their operating expenses. 

It will require about USD $800,000 to run the 435-bed hospital and the training school for a year and they would provide most of the basic services and low cost. By way of comparison, a similar-sized hospital in Dr. Catena’s home area in the US would have an annual operating budget of 400 times this amount of money annually which if availed to the Gidel Mother of Mercy Hospital and training school would be sufficient for the next 400 years. 

“Good health care, education, do not need to be prohibitively expensive. We feel that we can provide a good number of services at a very low cost …. perhaps, the problem isn’t lack of money, but just a gross maldistribution of resources,” said Dr. Catena. 

Although life in Nuba has improved due to a cessation of hostilities however the Nuba are people deeply traumatized due to centuries of oppression and marginalization at the hand of cards emulate. 

The training it is believed will uplift the respect of the Nuba people who have proven themselves as tough warriors over the years but have been humiliated, degraded, and grown accustomed to being treated as second class citizens in their own country with little hope that they will be treated as the equals be the Northerners. 

“We encourage our staff, that as a way to get respect, will be by using their intellect and skill to show their detractors that they are the equal of anyone,” said Dr. Catena. “It is our sincere hope that our initiatives to train our staff will put them on an equal footing with health practitioners anywhere in the world.” 

The hospital is already receiving patients from as far as Khartoum. “We hope that with our clinical school will become a training center for all of Sudan, both students and patients will come to us seeking care. It is much more difficult to despise someone if he or she is the one performing your surgery or diagnosing your complex medical problems,” he said. 

“It is our dream that one of the dividends of a first-grade hospital and training program will bring peace in our troubled region,” concluded Dr. Catena at the WISH conference. WISH is an initiative of Qatar Foundation for Education, Science and Community Development (QF) and is under the patronage of Her Highness Sheikha Moza bint Nasser, its Chairperson. 

https://www.virtualwish2020.com/conference/keynote-speaker-dr-tom-catena

Women and Water: Collecting water causes serious injuries says study

By Esther Nakkazi

Collecting water can cause serious injuries like falls, traffic accidents, animal attacks, and fights, which can result in broken bones, spinal injuries, lacerations, and other physical injuries, particularly for women living in low and middle-income countries according to new research from the University of East Anglia (UEA).

The research titled ‘In pursuit of ‘safe’ water: The burden of personal injury from water fetching in 21 low-income and middle-income countries’ published in the journal BMJ Global Health also says women are also most likely to sustain such injuries – highlighting the social and gender inequities of a hidden global health challenge. 

“Millions of people don’t have the luxury of clean drinking water at their home, and they face many dangers before the water even touches their lips. We wanted to better understand the true burden of water insecurity," says Dr Jo-Anne Geere, from UEA’s School of Health Sciences.

Dr. Geere says most of the global research on water has largely focused on scarcity and health issues related to what is in the water, but the burden and risks of how water is retrieved and carried has been overlooked until now.

The new study was led by Northwestern University in the US, in collaboration with UEA, the University of Miami, and the Household Water Insecurity Experiences Research Coordination Network (HWISE RCN).
 

The research team used a large global dataset to understand what factors might predict water-fetching injuries. The work draws on a survey of 6,291 randomly selected households across 24 sites in 21 low- and middle-income countries in Asia, Africa, Latin America, and the Caribbean.

They found that 13 per cent of the respondents reported some sort of injury while collecting water, and that women were twice as likely to be hurt as men.

 “Thirteen percent is a big number, but it is probably an underestimate. It’s highly likely that more people would have reported injuries if the survey had more detailed questions," says Dr. Sera Young, from Northwestern University.

“This reinforces how the burden of water scarcity disproportionately falls on women, on rural populations, and on those who do not have water sources close to home. It highlights the importance of safe interventions that prioritise personal physical safety alongside traditional global indicators of water, sanitation, and hygiene,” says Prof Paul Hunter, from UEA’s Norwich Medical School.

The researchers say that keeping track of such safety measures — in addition to the usual measures of water quality and access — could help better assess progress towards the United Nations’ Sustainable Development Goal 6.1, which sets out “to achieve universal and equitable access to safe and affordable drinking water for all” by 2030.

“It seems likely that water-fetching can contribute considerably to the global Water, Sanitation, and Hygiene (WaSH) burden, but it usually goes unmeasured because we typically think about access and water quality. It is, therefore, a greatly underappreciated, nearly invisible public health challenge," Dr. Vidya Venkataramanan, also from Northwestern University.

“It’s really important that data on water-fetching injuries are systematically collected so that we can know the true burden of water insecurity. Currently, all of the broken bones, spinal injuries, lacerations, and other physical injuries are not accounted for in calculations about the burden of water insecurity.”

Ref: https://gh.bmj.com/content/5/10/e003328

 

Study uncovers ‘enormous burden of dengue’ among Kenyan children

Researchers uncovered what they called “an enormous burden of dengue fever among children with undifferentiated febrile illness in Kenya.”

Specifically, out of more than 1,000 children ill with fever, more than 40% were infected with the dengue virus. Many children with dengue and without malaria were treated with antimalarial drugs, antimicrobial drugs, or both, according to a report in Emerging Infectious Diseases.

Dengue, which is endemic in more than 100 countries, “is an important cause of illness among children in Kenya, and clinicians should consider dengue as a cause of unlocalized fever,” Melisa M. Shah, MD, MPH, an endowed postdoctoral fellow at Stanford Medicine, told Healio.

“Often, fever is considered to be malaria and empiric treatment is given,” Shah said. “The lack of awareness about dengue as a cause of febrile illness is one factor causing the overdiagnosis and overtreatment of malaria.”

Shah and colleagues tested blood samples from 1,022 Kenyan children with ongoing febrile illness from 2014 to 2017. Of the 862 viable samples, dengue viremia was detected in 361 (41.9%). Of those 361 samples, 333 were classified as primary infections (92.2%), 14 were secondary infections (3.9%) and the remaining 14 samples lacked dengue virus immunoglobulin G data.

Of the 1,022 study participants, 419 (41%) received antimalarial drugs, Shah and colleagues reported. Antimalarial drugs were more likely to be administered to patients with dengue virus viremia — 48.8% vs. 36.8%. Among 141 study participants who had confirmed dengue without malaria, 29 (20.6%) received an antimalarial drug (20.6%), 75 received an antimicrobial drug (53.2%) and 12 received both (8.5%).

“The unnecessary use of antimalarials and antibiotics exposes children to known medication side effects and may contribute to the development of drug resistance,” Shah said. Participants with dengue virus viremia with febrile illness reported headaches (49.6%), poor appetite (46.8%), cough (45.7%) and joint pain (36.8%).

“An accurate, reliable, and affordable point-of-care diagnostic for dengue is urgently needed for health practitioners in outpatient settings in endemic areas,” Shah said. “Such a diagnostic could quickly identify whether dengue may be the cause of febrile illness.”

According to a CDC summary of the study, genetic testing revealed that some of the strains of dengue virus were not typical to Africa and may have been imported by travelers from other continents.

“The paucity of dengue surveillance studies and sequence data from Africa is striking,” Shah and colleagues wrote in their paper. WHO estimates that around half of the world’s population is currently at risk for dengue, which is typically found in urban and semi-urban areas in tropical and sub-tropical climates.

Researchers predicted last year that the geographical range of dengue would place 60% of the world’s population at risk by 2080. Right now, an estimated 100 million to 400 million dengue infections occur each year, according to WHO.

There is no specific treatment, although there is an approved dengue vaccine.“Dengue activity will likely continue to spread in Africa because of rapid land-use change, climate change, urbanization, increased human travel and international trade,” Shah and colleagues wrote.

“Knowledge of the spatial-temporal dynamics of dengue circulation throughout Africa is critically needed to inform a coordinated public health response in an increasingly interconnected world.”

Source: https://www.healio.com/news/primary-care/20201030/study-uncovers-enormous-burden-of-dengue-among-kenyan-children?utm_source=selligent&utm_medium=email&utm_campaign=news&m_bt=421806888584

Cerebral Palsy in Uganda: still very difficult to diagnose

By Esther Nakkazi

Six-year-old Rahmah Kiiza is a special guest at World Cerebral Palsy day. 

She is in a wheelchair, on the front speakers’ row, seemingly attentive, sometimes making random noises during ongoing speeches and testimonies. 

Rahmah is one of 900 persons with cerebral palsy registered by the Uganda National Association of Persons with Cerebral Palsy (UNAC). The estimated crude cerebral palsy prevalence for children aged 2–17 years is 2·9 per 1000 children in sub-Saharan Africa. (1) 

This year, UNAC has a theme ‘Make your Mark; break barriers for persons with cerebral palsy in Uganda’. 

Rahmah is the only girl, third and last child of three born by Latifah Muzaki. She follows a set of twins. When Latifah was pregnant with Rahmah she experienced high blood pressure in the second trimester. The child was born with jaundice but the midwife assured the mother all would be well. 

Latifah just had to expose the baby to the sun for a few minutes and that is what was done. But a few months into her growth, it was evident that something was wrong. 

Rahmah had slow growth, floppy muscles, joint problems, and speech issues. Latifah spent many hours in the hospital looking for solutions. The diagnosis did not come until six months later. 

“Our disability is difficult to identify just as the data of people affected by cerebral palsy,” says Rashid Kalule the chairperson for UNAC. The database of who is infected is almost entirely absent. Even if the categories of the condition vary all are lumped in one group - as persons with cerebral palsy. 

Cerebral palsy is a result of damage to the cerebrum which is part of the brain responsible for body movement due to environmental and natural causes. It affects muscle tone, movement, and motor skills hence, hindering the body's ability to move in a coordinated way. 

By virtue of their disability, persons with cerebral palsy face significant mobility-related barriers that limit their full participation in activities of daily living as well as access to services and other opportunities. Such barriers place them in a vulnerable position of all kinds of abuse, ignorance, and poverty says Kalule.

He says they are among the most marginalized persons with disabilities in Uganda since Cerebral palsy is not largely recognized by mainstream National Development programs.

Ambrose Asiimwe, senior Physiotherapist, Capital Centre Medical Clinic says in Uganda about 80 percent of cerebral palsy happens during pregnancy caused by urinary tract infections, STDs, smoking, alcoholism of the mother, pregnancy stress or assisted reproductive technology. 20 percent happens during birth due to labor complications, shortage of oxygen to the baby.

Preterm birth, sickle cell anemia, obstetric complications, birth asphyxia, neonatal jaundice are high-risk factors. Some children get cerebral palsy after birth caused by episodes of cerebral infections, high fevers, convulsions, brain infections such as bacterial meningitis.

“Cerebral palsy has no cure. It requires patience and consistency,” advises Asiimwe.

After the diagnosis, it was full time looking after Rahmah. Latifah lost a job. Her husband ran away. 

“He said he cannot be the father of such a child,” says Latifah with all the sadness in her eyes. 

“Fathers quit easily due to stigma. At UNAC we are trying to bring fathers on board,” says Christine Kirungi, the executive director of UNAC. 

The community turned against her. She was isolated and called names - witch, the mother of a child with a disability, bad luck. “My relatives told me to go back to where I got these problems. I thought the child was not mine. She was given to me by mistake.” Kirungi says there is limited knowledge on Cerebral palsy in communities and increased abuse of persons with cerebral palsy by their family members and surrounding communities. 

Another challenge for caretakers of children with cerebral palsy is feeding. Many of the children with cerebral palsy are malnourished which makes them susceptible to infection. These children eat special food - ‘soft and porridge-like’ and have low appetites so they suffer a lot from malnutrition. 

Change of mindset:

After losing her job as a secretary at the Ministry of defense, her husband running away, Latifah turned to her talent and what she loves to do best - decoration. She now decorates for weddings, parties, and even conferences.

She has learned to ignore the abuses, live with the stigma, and focus her energy on creating awareness about cerebral palsy in communities. She also started appreciating all the milestones Rahmah achieved and now calls her a miracle child renamed ‘Mukiisa’.

She learned new local innovations. One such tip that she says has improved Rahmah’s life is the soil or sandpit technique. In Uganda, some parents dig a hole in the ground put the child with cerebral palsy in a standing position, and cover with clean sand or soil up to the neck. It can be for minutes or hours - for as long as the child can endure.

It is the equivalent of a standing frame that costs about $100 or UGX 360,000. Since a child will need a new standing frame at every stage, parents of children with cerebral palsy said they are costly and unaffordable. Moreover, children also require essential drugs for life.

“At first she stood in the hole for about 30 minutes but she cried a lot even when I was sited by her side and assuring her,” says Latifah. Gradually, the duration was increased to 45 minutes and now she stands in it for an hour.

Rahmah is not bothered by standing in the sandpit anymore. While in it her twin brothers keep her company and the watchful eyes of her mother are always close by. “Rahmah was floppy but now the backbone is firmer, she is more stable. It has helped her backbone and joints,” says Latifah. On top of that, she attends physiotherapy. 

Stephen Muhumuza attests to benefiting from this local innovation. “My mother died when I was only a day old. I lived with my grandmother a natural therapist. I could not walk until I was 10 years old. My grandmother put me in the soil pit and it helped,” says Muhumuza now 45 years old and with a family.

Kalule who also says his condition improved due to the pit and soil innovation explains the three models of disability in Uganda as thus.

“In Uganda, we have three models of disability; the belief that disability is a charity and you have to depend on begging to go survive that is why most parents do not take their children to school. The second model is medical where they take you to the hospital or rehabilitation and forget about you,” says Kalule.

He urges all Ugandans to embrace the third model. “With the social model, we can break the barriers and work together.” “

“I may be with a disability today but if we work together we can break the barriers,” says Kalule.

    

Appeal from UNAC

As we celebrate World Cerebral palsy day 2020, it’s important to note that persons with cerebral palsy raise critical concerns for redress:

We appeal to the stakeholders in the mainstream government programs and development partners:

To popularize awareness of Cerebral palsy and provide attention to additional reasonable accommodation needs of persons with cerebral palsy to enable inclusive and equal participation in the mainstream development programs.

Rebalance the combination of COVID-19 interventions to minimize the impact of standard physical distance and lockdown strategies on persons with severe disabilities in communities (like CP).

Extend social protection programs, inclusive education, and health services to reach persons with cerebral palsy at Zero cost.

Make public services accessible to make society a better place for all.

The Community stakeholders to collaborate with UNAC in protecting the rights of persons with Cerebral palsy particularly children who are at increased risk of abuse, neglect, and murder. (UNAC statement)

(This blog story is especially for awareness creation on Cerebral palsy. I salute all the mothers like Latifah who have taken time off to look after their children and not abandon them. God bless the mothers. EN) 

WHO records show a steady decline of COVID-19 cases in Africa

By Esther Nakkazi

The African region has seen a steady decline in new COVID-19 cases over the past two months, the World Health Organisation reports. 

Starting 20 July to September 20th, 77,147 new cases were reported, down from 131,647 recorded from May 20th to mid-July. Deaths attributed to COVID-19 have also remained low in the region.

The cases are also mostly among people below 60 years of age who contribute to about 91% of COVID-19 infections in sub-Saharan Africa and over 80% of cases are asymptomatic, the WHO has observed. 

The pandemic has largely been in a younger age group and has been more pronounced in a few countries, suggesting country-specific aspects are driving the pattern of disease and death.

“The downward trend that we have seen in Africa over the past two months is undoubtedly a positive development and speaks to the robust and decisive public health measures taken by governments across the region,” said Dr. Matshidiso Moeti, WHO Regional Director for Africa.

The decline over the past two months have been attributed to a variety of socio-ecological factors such as low population density and mobility, hot and humid climate, lower age group as well as early and strong public health measures taken by governments across the region. 

Even in the most-affected countries including Algeria, Cameroon, Cote d’Ivoire, Ethiopia, Ghana, Kenya, Madagascar, Nigeria, and Senegal infections are dropping every week over the past two months.

By 20th September, twenty-nine countries recorded a decrease in new cases, with 20 of them registering a decrease of more than 20%; Sao Tome and Principe (89%), Mauritius (75%), Botswana (69%), Seychelles (67%), Lesotho (61%), Senegal (55%), Malawi (47%), Mauritania (46%), Liberia (44%), Gambia (39%), Rwanda (38%), Ghana (37%), Zambia (34%), Burundi (33%), Burkina Faso (30%), Côte d'Ivoire (30%), Zimbabwe (28%), Namibia (27%), Sierra Leone (23%) and Eswatini (20%). Only Eritrea and the United Republic of Tanzania did not officially submit any report.

As of 22 September 2020, a cumulative total of 1,149 940 COVID-19 cases was reported in the region, including 1,149, 939 confirmed, with one probable case reported in the Democratic Republic of the Congo. South Africa has consistently registered more than half, 58% (663,282) of all, reported confirmed cases in the region.

The other countries that have reported large numbers of cases are Ethiopia (70,422), Nigeria (57 613), Algeria (50,214), Ghana (46,062), Kenya (37,218), Cameroon (20,690), Côte d’Ivoire (19,327), Madagascar (16,136) and Senegal (14,759). These 10 countries collectively account for 87% (995 723) of all reported cases.

However, WHO has warned Africa against complacency as other regions of the world that have experienced similar trends find that as social and public health measures are relaxed, cases start ramping up again. 

In recent weeks, Cameroon and Cote d’Ivoire which are among the countries that have recorded a decline in infections since mid-July, have seen a slight increase in cases. In most African countries schools are beginning to open and lockdowns have been lifted which could see a resurge in cases.

“Africa has not witnessed an exponential spread of COVID-19 as many initially feared,” said Dr. Moeti. “But the slower spread of infection in the region means we expect the pandemic to continue to smolder for some time, with occasional flare-ups.”

WHO still cautions that It is crucial that countries maintain public health measures that have helped curb the spread of COVID-19 to limit further infections and deaths.

“The response in African countries needs to be tailored to each country’s situation moving forward as we see different patterns of infection even within a country. Targeted and localized responses that are informed by what works best in a given region of a country will be most crucial as countries ease restrictions and open up their economies. Blanket approaches to the region or countries are not feasible,” Dr. Moeti said.

References: A virtual press conference on 23 September organized by APO Group.

https://apps.who.int/iris/bitstream/handle/10665/334399/SITREP_COVID-19_WHOAFRO_20200923-eng.pdf