FISTULA

Fistula also Known as vesico vaginal fistula is a destructive condition that affects women and girls across Africa. It is a hole between the birth canal and bladder/rectum caused by prolonged , obstructed labor without access to timely and quality medical treatment which results to uncontrolled  leakage of urine. Leading to social isolation, skin infections,skin disorders and death if untreated.

Causes Of Fistula.

  • Sexual violence
  • early marriages and child-birth
  • harmful traditional practices
  • Lack of access to maternity care (financial catastrophe, geographical and culture)
  • poverty

Ways in Which Fistula can be avoided

  • timely access to quality obstetric care especially cesarean section
  • Delaying the age of first pregnancy
  • Cessation of harmful traditional practices

Some of the challenges faced mostly is lack of awareness and lack of commitment to address and resolve the issue. Kenya being a developing country face this challenges, however through donations and government funds they have improved in terms of awareness for instance, they had free fistula treatment to all women across the country at Kenyatta National Hospital from 16/June/2017 to 30/June/2017, also the number of  health centres offering fistula treatment has increased so as to reach women allover the country.  This institutions include:-

Kenyatta National Hospital- Nairobi

Jaman Mission Hospital-Nairobi

Isiolo Development Project- Isiolo

Daraja MbiliVision volunteers-Kisii

Gynocare Fistula Center- Eldoret

Bomu Hospital-Mombasa

Wamba catholic Hosp-Samburu

Women and Development Against Distress In Africa-(WADADIA)

Cherangany Nursing Home-Kitale

Jaramogi Oginga Odinga Teaching and Referral Hospital-Kisumu

 

Universal access to safe delivery care and Maternal health care are assured ways of reducing or getting away with Fistula in our country.

 

“Women with obstetric Fistula are indicators of the failure of health systems to deliver accessible, timely and quality care”

 

 

Orofacial Cleft

Is a group of condition that includes cleft lip ,cleft palate or both (CFP). Cleft lip is a physical split of the two sides of the upper lip and appears as a narrow opening in the skin of upper lip which extends beyond the base of the nose while cleft palate is an opening in the roof of the mouth, can involve the hard palate and or the soft palate.

This is how it occurs.

While a baby develops during pregnancy, body tissue and specific cells from both side of the head  grow toward the centre of the face joining together to make the face.The orofacial cleft is as a result of tissues of the face not joining properly during development.

Children with orofacial cleft might develop some other problems like: Not able to speak clearly, hearing infections and feeding problems.

Causes

In most cases the causes are unknown . Although the said risk factors include:

  • Smoking during pregnancy.
  • Obesity
  • Diabetes
  • Acne drugs containing accutane.
  • Genetic and environment- There is a probability of clefting  in a newborn if a parent, sibling or relative has had the problem.

Cleft lip, cleft palate or both can be treated through a surgery.

In Kenya,the condition incidences are high in central regions and least in coastal regions.

 

 

 

 

Malaria

Is a preventive and curable infection caused by parasitic protozoans belonging to the plasmodium parasite which is transmitted to people through bites of infected female anopheles mosquito.

Mode of transmission

Anopheles mosquitoes lay their eggs in water, which hatch into larvae which later grows into adult mosquitoes, The female mosquitoes seek a blood meal to nurture their eggs thus introducing the parasites into human blood (host) through bites. The parasites travel to the liver where they mature and produce affecting the cells in the liver. Malaria incubates and later presents itself with initial flu-like symptoms that include:- fever, headache and vomiting it is always fever like illness.

Malaria can progress to severe illness which could lead to death or serious brain damage especially in children and pregnant women.

Environmental and host factors that favor transmission.

climatic conditions.

Temperature There being different types of plasmodium species , the development cycle of malaria also varies differently in differently in different temperature degree.

Development of the mosquito larva depend on temperature,High temperatures increases the no. of blood meals taken and the number of eggs laid by the mosquitoes, increasing the number of mosquitoes in a given area.

Minimum temperature for mosquito development is between 8-10 degree Celsius , optimum temp is 25-40 degree Celsius and the maximum temperature is 40 degree Celsius.

Attitude:– Influences the distribution and transmission of malaria indirectly, through its effect on temperature where the higher you go the lower the temperature and the lower you go the higher the temperature.

rainfall

Mosquitoes breed in water therefore right amount increases their breeding , however too much rainfall can flush away breeding habitats temporary, that’s why mosquitoes start breeding as soon as the rain stops.

Malaria vectors mainly breed in stagnant water collections, rarely in slightly moving water and not in rapidly flowing rivers and streams.

Relative humidity

This refers to the percentage of moisture in the air. Relative humidity affects malaria transmission through its effect on the activity and survival of mosquitoes.

Non-climatic factors

Malaria vectors

Female anopheles mosquito is the only one responsible for malaria transmission and different plasmodium species vary in terms of their favorable conditions for development.

Water development projects.

This include:- dams, ponds and irrigation challenges  which can increase malaria in areas near such projects.

Travelling and migration.

If one is moving from a place that is vulnerable to malaria he/she might have malaria parasites which can be transmitted to their place of destiny. It is always advisable that if one is travelling to  a place where malaria cases are intense, one should take antimalarial early in advance to increase resistance against malria.

Urbanization

Rural areas are said to have more malaria cases compared to urban places. This is due to bigger space in rural areas than in towns where there is high population. However construction projects in urban areas can also increase the breeding areas for mosquitoes.

Host immunity.

People with high immunity are less likely to get malaria infection while people with low immunity are highly likely to get malaria infection.

People are asked to manage their environment by clearing bushy areas and draining stagnant water, insect repellents and insecticides spray are also encouraged not forgetting sleeping under treated mosquito net as prevention measures for malaria.

Interventions for malaria.

 

Endometrial cancer

Cancer 

Cancer is the third highest cause of morbidity in Kenya, Endometrium cancer is the sixth most common cancer  worldwide according to  http://www.wcrf.org/int/cancer-facts-figures/data-specific-cancers/endometrial-cancer-cancer-lining-womb-statistics.

Endometrial cancer.

  • Endometrium/uterus.

Uterus is where a fetus grows and develops when a woman is pregnant,endometrium is the inner layer of uterus which prevent adhesion between the opposed wall of the outer layer (myometrium) thereby maintaining the degree of openness of the tube of the outlet in the cavity (patency). During a woman’s menstrual cycle hormones cause the endometrium to change during the early stage of the cycle, before ovulation oestrogen (hormone) is produced by the ovaries which make the endometrium thicken so as to nourish an embryo if pregnancy occurs, if no pregnancy, estrogen is produced in low amount and more of progesterone is made after ovulation , preparing the endometrium to shade as menstrual period this cycle repeats until the woman’s’ is post menopause.

Endometrial cancer begins when  cells in the lining of the uterus start to multiply out of control and these cells are capable of spreading to other parts of the body , it can be detected early enough for treatment. It is influenced by the following factors:-

  • Age
  • Use of intrauterine device
  • hormonal change
  • birth control pills
  • Diabetes
  • Family history
  • Obesity
  • Having been diagnosed with other types of cancer such as ovarian cancer, breast cancer. data shows that in every 30 cases of cervical cancer there is one case of endometrial cancer.

Causes of endometrial cancer

Body fatness and glycemic are the well-known causes of this type of cancer, therefore people are asked to engage in physical activities and drink coffee.

Endometrial cancer like any other cancer can be treated through surgery, radiation therapy , hormonal therapy and chemotherapy.

 

Guinea worm diseases.

Guinea worm

Is a large nematode (roundworm) which is ingested through drinking contaminated water.The condition is known as guinea worm disease.Guinea worm is 1.2 m long and causes debilitating and painful infection that begins with a blister. It is not easily detected until it pierces the skin rearing it’s threadlike body.

One experiences itching, fever, swelling ,severe pain and a  burning sensation.

How one gets Guinea worm disease..

  • Human drinks dirty water with water fleas which have the young guinea worms.
  • The young worm passes through the stomach and the intestines.
  • Adult worms move towards the skin surface and to  other parts of the body
  • One year after, the adult worm causes a painful watery swelling, that sends out young worms after coming into contact with water.
  • The water fleas swallow the young ones and the cycle continues.

 People suffering from Guinea worm disease should not enter into water that the community drinks and humans are encouraged to drink treated/filtered/boiled water.

Removal of the worm MUST be done in a health facility.

Eradication of Guinea worm disease Kenya

Kenya is said to be certified free of guinea worm disease before this year(2017) ends however this can only be done if there are zero cases reported of the disease before then.

Dr. Oigara WHO public adviser promised a reward of KSH 100,000 to any Kenyan who will report any suspected case of guinea worm disease within the country.Reports can be done through cont: 0732353535/0729471414 or at any public health facility.

Importance of Guinea worm disease free certificate.

Once Kenya will be declared free from this disease, it will have joined 198 other countries in the world and 40 in Africa in that league.