IMPORTANCE OF CERVICAL CANCER SCREENING

Cervical-cancer-awareness-support-image9

Kisumu City is the third largest city in Kenya with a population of 968,909 with 50.1% being women population. Even though there have been concerted efforts by both the private sector and the government to raise awareness on the benefits of early cervical cancer screening, studies show that a paltry one third of the women have ever heard of cervical cancer.

Early cervical cancer screening averts cases of full blown and complex cancer by identifying the disease at its early stages. When identified early, cervical cancer can be treated in a simple procedure known as cryotherapy.

Cryotherapy is medical procedure that destroys abnormal tissue on the cervix by freezing it. It destroys some normal tissue along with the abnormal tissue. During cryotherapy, liquid carbon dioxide (CO2), which is very cold, circulates through a probe placed next to the abnormal tissue. This freezes the tissue for 2 to 3 minutes.

Should one be diagnosed with cancer at advanced stages, more complex treatment procedures will be required which is not only expensive but also slow.

For example in  Kisumu, cancer patients seeking treatment at the Jaramogi Oginga Odinga Teaching and Referral Hospital have to wait for one week for admission to undergo chemotherapy as the hospital lacks enough staff to carry out the treatment even though there is enough equipment. It is reported that one clinician serves about 30 patients. Most of them are treatment of cervical cancer.

A clinician should handle at least five patients, but due to many women not going for regular screening many of them turn  up for cervical cancer  treatment when it is full blown hence many patients to be attended to.

It is proven that early and regular cervical cancer screening reduces incidences of maternal mortality.  Studies show that the late stage at which women get diagnosed reduces their chances of survival.

Diagnosis of cervical cancer requires visual inspection of the cervix, this  is a screening tool for low resource setting and it’s economical and it provides immediate results and do not require any Laboratory support. This can be performed with acetic acid (VIA) or Lugol’s iodine (VILI). The procedures are also known as Visual Inspection with Acetic Acid (VIA) or Visual Inspection with Lugol’s Iodine (VILI).

Another method is a Pap test  which  is performed by opening the vaginal canal with a speculum,  then collect cells from the surface of the cervix and vagina ,a sample of cervical tissue (called a biopsy) is  then taken and analyzed under a microscope to find out if they are abnormal. It’s also called a Pap smear.

It’s advisable to have screening in the middle of your menstrual cycle, halfway between one period and the next; this enables the cytologist to examine the best possible specimen to achieve the best possible report, when going for screening do not have sexual intercourse 24 hours before your screening, do not use a tampon for at least two days, wear a skirt, be relaxed to avoid discomfort.

Call:  (0800724500) from 8am-8pm free of charge should you want a VIA and VILI or for more information.

Tom Mboya Estate, off Kondele-Airport Ring road

P.O Box 6805-40103. Kisumu

Website: www.kmet.co.ke

Email: info@kmet.co.ke

You can also visit our clinic: Kmet Health Complex Headquarters for quality but affordable preventive and curative services.

Sexual and gender based violence: The Kenyan situation

 

Stopping sexual and gender based violence is a multi-sectoral approach

Stopping sexual and gender based violence is a multi-sectoral approach

In Kenyan communities, wife beating was a common occurrence. The women suffered at the hands of men because this was considered a disciplinary measure. Since the menfolk were dominant they were supposed to inflict pain and cause emotional turmoil to women to control them. In modern times such acts disregard the law particularly on human rights. The constitution of Kenya spells out the rights of each person alongside 

Hiding behind this veil has contributed to these modern times abuse on women. Every day a woman somewhere suffers abuse, is violated adding to the alarming statistics of gender based violence incidences. 

In 1993, the first attempts to clearly define sexual and gender based violence was made at the UN Declaration on the Elimination of Violence against Women.

It’s defined: Any harmful act that is perpetrated against one person’s will and that is based on socially ascribed (gender) differences between males and females.  It includes acts that inflict physical, mental, or sexual harm or suffering, threats of such acts, coercion and other deprivations of liberty, whether occurring in public or in private life. 

SGBV entails widespread human rights violations, and is often linked to unequal gender relations within communities and abuses of power.  According to Human Rights Activists, violence against women is rooted in gender inequality.   It arises from the unequal power relationships between men and women.

 It can take the form of sexual violence or persecution by the authorities, or can be the result of discrimination embedded in legislation or prevailing societal norms and practices. It can be both a cause of forced displacement and an intolerable part of the displacement experience.

Women’s subordinate status to men in many societies, coupled with a general acceptance of interpersonal violence as a means of resolving conflict, renders women disproportionately vulnerable to violence from all levels of society: individual men, within the family and community, and by the state.

According to statistics from the Gender Violence Recovery Centre (GVRC) 45% of women between ages 15 – 49 in Kenya have experienced either physical or sexual violence with women and girls accounting for 90% of the gender based violence (GBV) cases reported. One in five Kenyan women (21%) has experienced sexual violence

The impact of SGBV is devastating. The individual women who are victims of such violence often experience life-long emotional distress, mental health problems and poor reproductive health, as well as being at higher risk of acquiring HIV and intensive long-term users of health services.

In addition, the cost to women, their children, families and communities is a significant obstacle to reducing poverty, achieving gender equality and ensuring a peaceful transition for post-conflict societies.

 This, in conjunction with the mental and physical health implications of gender-based violence, impacts on a state or region’s ability to develop and construct a stable, productive society, or reconstruct a country in the wake of conflict.

Culture has been cited as the leading cause of violence against women. Some men it seems still subscribe to outdated traditions e.g. that battering a woman is seen as a way of discipline and is acceptable.

Financial insecurity has also been said to be a factor. The role of a man has been established as that of a leader and a provider and in some cases where a man fails to establish his authority in these areas, he ends up resorting to physical abuse.

Alcohol and drugs have also led many men, unfortunately, into violence against women. Cases of men coming home drunk and mercilessly beating and defiling their spouses and children have made news.

By Don King

The next article will handle the legal framework and challenges on SGBV.

 

HIV/AIDS AND CONDOM AVERSION: ENGINEERING THE “COOL” CONDOM

rolled cdChoosing the wrong condom size is common among teenagers and young adults. The wrong size can be so constricting cutting off the blood flow and as a consequence becomes rather restrictive during intercourse. This occurrence has also largely made the youth stay away from condoms. However, this needs one to be a bit more informed since condoms in the market come in three categories, the small condoms, regular size condoms and large condoms. Click here
to read more of this  guest article on our website.

Defaulting TB medication puts you & your loved ones at risk

Jedida and her family together with KMET TB Reach Program Officer, Adriano Ngaywa (far right, white shirt) when he made contact tracing.

Jedida(blue tshirt, second right) and her family  when we made contact tracing at he house.

Jedida Atieno lives a modest life in Malunga village, Siaya County with her husband and seven children. The grass thatched house is evidently too crowded for the children- the eldest 8 and youngest 4 years old.  She and her husband are subsistence farmers.
In 2013, Jedida started feeling unwell a little more often. The persistent cough and night sweat continued even after buying over the counter medication for a while. She still experienced the on and off signs prompting her to seek further medical attention.
In June, she went to Siaya County Hospital where a sputum test turned positive for TB. She was then put on medication which was to run for six months. However, she defaulted having taken her medication for June, July, and August.
She had gone to a funeral and had overstayed for two months failing to take her medication as prescribed.
In December, Jedida gathered courage and went to Ngiya Mission Hospital where a sputum microscopy was done same for HIV test. Both tests turned positive.
She was initiated to second line treatment of TB from the month of December to August 2014. During this period Jedida  became pregnant.

KMET TB Reach Quality Assurance Officer, Dennis Nyaoko talks to Jedida Atieno when she visited one of the Huduma Poa facilities for assessmentWhen the baby was born she was started on isoniazid prophylaxis for six months to prevent her from getting TB from the mother.
The child kept on getting sick with persistent fever, night sweats and did not respond to Paracetamol. The little girl was frequently admitted to Siaya County Hospital between the months of June and September continuously losing weight.
Luckily in November, a Community Health Worker (TB agent) working in the KMET TB reach program visited Jedida’s house where she revealed her predicament. She told the CHW about the babies’ situation.

When the KMET Tb reach team visited the area the CHW led them to Jedida’s residence. From there they made an assessment for the child recommending contact tracing for the husband and the children. The child was then taken to the paedtrics at Ngiya Mission Hospital where she scored nine above the normal range that is seven on the Paedtrics TB score chart.
She was immediately put on TB treatment. With time her condition has improved, she has gained weight, the fever has subsided and she is now active like any other child at her age.

“Thank you KMET for coming to my aide, my condition is getting better. I would like to advice others they need to adhere to medication so as to fight the disease” Jedida says.

In 2005, its estimated 7.6 per cent of patients in Kenya defaulted from TB treatment.

KMET SCOOPS AWARD FOR CHAMPIONING SRHR IN COUNTIES

Mama KMET, Monica Oguttu displays the award to the KMET family

Mama KMET, Monica Oguttu displays the award to the KMET family

KMET Kenya has been recognized and awarded by Kenya Obstetrical and Gynecological Society (KOGS) for being a champion in Sexual Reproductive Health Rights (SRHR) in the 47 counties in Kenya.

KMET was congratulated for distinguishing itself in policy advancement, practice and providing stewarded networking with partners locally, regionally and internationally.

As she presented the award to a delighted KMET family, KMET CEO Monica Oguttu noted that the call the organization has had in reducing maternal mortality, especially those that arise from preventable causes would not be achieved if not for the team work and commitment of the staff members.

The organization has been training providers in Post Abortion Care (PAC) services, improving access to quality PAC services in underserved communities, improving access to contraceptives as well as cervical cancer screening to underserved communities since 1995.

KMET received the award at Safari Park Hotel in Nairobi during a KOGS conference where the African chapter was started for the first time.

Why opt for the services of unskilled midwives?

The Fort Ternan community during a community conversation forum

The Fort Ternan community during a community conversation forum

Every day, about 800 women die worldwide from preventable pregnancy or child related complications with most of these deaths occurring in low resource settings.

Poverty set aside, what else could be causing high maternal mortality rates in such settings?

Amongst the Fort Ternan community in Muhoroni Sub County, it is alleged that a number of expecting women would seek delivery services from old unskilled midwives and only go to the facility in case of complications.

Surprisingly enough, the midwives offer their services at a fee yet quality services at the nearby dispensary are free of charge. What could be the reason?

‘I conceived four months after my last delivery. I was ashamed to go to the facility because it was too soon so I opted to seek the services of a midwife. I developed complications and I can’t tell what could have happened if I never went to the hospital. I swear I will never seek the services of a midwife again’, revealed Beth Onyango, a woman in her late 30s.

According to Jane (name altered) who is a young mother of two, she chose the services of an old unskilled midwife during her first delivery out of fear after she heard that nurses beat up mothers in the hospital.

Her experience was not any better since the midwife too beat her when she could not follow instructions due to the labor pains.

The community members who were speaking during a community conversation forum introduced by KMET also disclosed that those expecting twins more often lose one of their babies in the hands of these midwives.

The men who had turned up in large numbers for this forum were shocked when they heard these revelations.

Despite their involvement in taking the women to the hospital during complications, they were not aware of the risks the women faced by first seeking services from the unskilled old midwives.

When all was said, the community members decided to start sensitization sessions that would emphasize on the importance of expecting women seeking all the services from the health facility.

The men even agreed to influence the others and prohibit their wives from seeing unskilled midwives for whatever reason.

KMET has been introducing community conversation forums so that communities and especially men take maternal health issues as their responsibility.

Mageta community to adopt community conversation approach in curbing teenage pregnancy

Mageta is a small cosmopolitan island of about 6.6km2 located in Lake Victoria with most of its residents engaged in fishing and fishing related activities.

A community conversation forum going on

A community conversation forum going on

Just like many other beaches around Lake Victoria, Mageta Island too records high numbers of people living with HIV, maternal health issues and teenage pregnancies despite the many interventions set to curb such issues in the area.
KMET arrived in the island to introduce community conversation as an approach involving the whole community in handling maternal health issues.
Though they found the concept of community conversation new, they embraced the idea and immediately opened up to deliberate on teenage pregnancy which they said is quite prominent.
As the discussion was underway, one community member walked in and after listening for a short while, she broke the latest news of teenage pregnancy in one of the primary schools that left everyone shocked.
She disclosed that she was just from Mitundu Primary school where she had been called to discuss what should be done to the girls who had apparently reported to school pregnant.
The community members led by their chairman Mr.Samuel Otieno noted that in the last three consecutive years, the school has been reporting high numbers of teenage pregnancy with 7 cases recorded in 2014.
This concern led them to discuss the possible causes of high teenage pregnancy and two major factors were identified.
First, they realized that most mothers sent their daughters to the market without money. The girls are then lured by fishermen who give them over ksh.1000 in exchange for sex.
The other major issue is that most of the teenagers sleep homesteads away from their parents and out of peer pressure, some engage in unhealthy relationships during the night.
They finally decided to visit the affected school as a community and talk to the pupils and teachers to find a way forward.
In their next community conversation forum, they intended to encourage parents to find ways of ensuring their children slept closer to avoid peer pressure.
They were so grateful to KMET for introducing community conversation since they realized they have been sitting back in silence as their children’s future slowly got blurred.
‘This idea of community conversation is so timely. We shall first use it to ensure our girls complete their education by reducing teenage pregnancies’, said the community chairman, Samuel Otieno.