Health e News

Surgery backlog growing by the day at Bara

Bara surgery backlog: Father at a loss for words

  A 17-year-old boy is one of just over 11 000 patients on the surgery waiting list at Chris Hani Baragwanath Academic Hospital, known as Bara, in Soweto after his appointment was postponed several times. The father of Sanele Qwabe* said that his son had developed tissues on his nipples due to side effects from his treatment. His doctors then transferred him to Bara for surgery. Back and forth Dad Xolani expressed his frustrations from all the unreasonable ups and downs at the hospital. “Sanele was in the Harriet Shezi ward before being transferred to plastics in January 2022, which upon their assessment, gave us another date for two months later,” said the father. “When we arrived on the 24th of March for him to be admitted, we were told that they were only attending to emergencies. They gave us yet another date, the 14th of July,” he said. Once

Pregnancy itself is a potential mental health stressor, even for older women. Generally, women are twice as likely to experience mental health challenges as their male counterparts. According to a research article published in 2022, although research on maternal mental health in Africa is sparse, some studies estimate the prevalence of postpartum depression in Africa to range between 15 to 25%.30,31. The prevalence of postpartum depression among adolescent mothers ranges from 14% to 53%. This is more than double that observed in older mothers (7–17%). The article also states that teenage mothers with untreated depression have a far greater likelihood of having a second pregnancy within two years. According to the South African Medical Journal, the number of births to young teenagers aged 10 - 14 years increased by 48.7% (from a baseline of 2 726, which is very high by developed-country standards) and the birth rate per 1 000 girls in this age category increased from 1.1 to 1.5. SAMJ analysed the data available in the public sector database, the District Health Information System, from 2017 to 2021. In adolescent girls aged 15 - 19, the number of births increased by 17.9% (from a baseline of 114 329) and the birth rate per 1 000 girls in this age category increased from 49.6 to 55.6. These increases also occurred year on year in a continuous upward trend as well as in all provinces, but at different rates. Generally, rates were higher in the more rural provinces such as Limpopo, Mpumalanga and Eastern Cape than in more urban provinces such as Gauteng and Western Cape. Londeka and Patience are both mothers who fell pregnant whilst teens. They shared their mental health struggles as well as what being pregnant whilst still a teenager is like. Londeka Ngcongo, is a 17 year old mother of a 1 year 4 months old girl. She fell pregnant in August 2020 and I gave birth in May 2021. “I was nervous; I thought that I will be kicked out at home but I didn't think of having an abortion. I first told my boyfriend that I was pregnant. He was shocked but he gave me a lot of support and took care of me. I was 3 months pregnant at the time when he told his family. They gave me much support, love as well and they love the baby too. Our relationship is good”, she says. The teen mum who is from Inanda, Durban, lives with her mother’s family. “At home everything is bad, I’m being insulted, they are talking behind my back, gossiping. I feel like a prisoner. Everything that I do is not appreciated, I feel like I am useless and I am not a member of the family, I feel like an outcast, life is difficult”, she says. Ngcongo says that her father’s side of the family is a bit more supportive. “My father’s family is okay, they are supporting me they understand that I am a child and I also do mistake as other teenagers, I even wished if I could live with them but I can’t because they live in rural area northern KZN plus I am still studying I can’t just go and live in rural area”, she says. Ngcongo had to skip school last year because her baby was very sick. “We stayed at the hospital for 2 months, and even this year my baby is still in and out of the hospital, which is a difficult thing for me as a young mother”. She says that she is grateful that her boyfriend's family is still supporting them, which she is not experiencing from her family. “In my family, it seems as if they don’t even care about my suffering; they don’t ask me anything regarding myself and or the child’s wellbeing. Ngcongo says being in school, as a young mother is not easy. “Not because I have a child but because of the depression and trauma I have. My high school life has been difficult since Grade 9 because I had no support from home, even the school uniform that I had was not in a good condition. It became worse when they found out that I was pregnant, even my mother she didn’t support me not to mention my friends as well who also turned their backs on me which is the thing I didn’t expect honestly, but I told myself that life goes on I have to be strong for myself and for my child”, she says. During the week, Ngcongo’s child stays with her grandmother (her boyfriend's mother) because she is still at school but during the weekends, holidays and school holidays, she makes sure that she fetches her child. Though Ngcongo does receive a social grant, she says it is not enough for a child who is always sick because most of the time she needs to see a doctor or be sent to hospital. “Life is tough but I try by all means to take it one step at a time”, she says. Ngcongo gets her income from hair braiding, hair styling and manicures. “My dream one day is to have my own salon in town, because to tell you the truth I don’t see myself as a career woman but I see myself as a business woman one day”, she says. 21 year-old mother to twins, Patience Mentoor, also gets income through manicures. Mentoor, who lives in Delft, Cape Town fell pregnant in Grade 11 and felt like her life was over. “It wasn’t easy at all, but I love my children. Finding out that you are pregnant at 17 isn’t easy but now finding out that it was twins was even worse. The first thing that crossed my mind was my parents, I knew that they were going to be disappointed. I gave birth in June (matric year) and dropped out of school, so I don’t even have matric”, she says. Mentoor says that the pregnancy was not easy and she was depressed throughout it. “Getting through the day was hard. Both of our parents agreed that I should stay at home until the babies were born but the environment at home wasn’t nice, especially with my father. There was also a time when suicide crossed my mind because I felt like a burden and unworthy.”, she says. I was lucky that I fell pregnant towards the end of Grade 11 so I didn’t really have to face people’s comments and stares at school but I knew that when matric started I’d have to face it eventually because my bump was growing”, she says. Mentoor says that a social worker in the community encouraged her to join a support group for teen mothers, because she could see how it was affecting her mental health. “Aunty Lydia (social worker) was actually more supportive than my family, in terms of emotional support, so that did help in a way. She really guided me and told me that I need to speak about how I am feeling and not keep it inside. I am grateful to her because it really helped with the mental health struggles I was having and still have sometimes”, she says. Mentoor started doing people’s nails as a way to make income. “My boyfriend’s and his family do help financially but I just wanted to make sure that I am making money of my own, so I started with something simple. It’s not a lot but it’s a start. I really hope to study someday. I didn’t finish matric but I still hope that I can do something to secure my future.” she says. A 2020 study explores the intersection between mental health and sexual and reproductive health amongst adolescent girls and young women in South Africa. In South Africa, adolescent girls and young women (AGYW) are at risk of poor mental health, HIV infection and early pregnancy. Poor mental health in AGYW is associated with increased sexual risk behaviours, and impeded HIV testing and care. Using in-depth interviews and focus group discussions, the study explored subjective experiences of mental health and sexual and reproductive health (SRH) amongst 237 AGYW aged 15–24 years in five South African districts. Respondents shared narratives of stress, emotional isolation, feelings of depression, and suicidal ideation, interconnected with HIV, pregnancy and violence in relationships. In the South African context, pregnancy may exacerbate existing social and contextual stressors, adding additional stressors such as interpersonal relationship challenges, regret around ‘unintended’ pregnancies, and depression. Respondents suggested that due to social stigma attached to teenage pregnancy, pregnant AGYW fear being judged and gossiped about: “Pregnant girls feel sad, some even contemplate suicide (azive efuna ukuzibulala) because of hearing unpleasant things about their life being spoken by other people”. (15–18 years, WC, isiXhosa) “Pregnant girls are teased, and then they drop out of school, they don't finish; here at school, we gossip about each other in the toilets.” (15–18 years, WC). The emotional ‘burden’ of teenage pregnancy was described as a key contributing factor to poor mental health: “They say having a child is a good thing, but as a teenager it is a burden, it’s difficult to cope” (15–18 years, EC). The study also revealed that a lack of emotional support from partners/fathers of children also contributed to stress and depression amongst young mothers. Lacking a supportive social environment negatively impacted on mental health and self-esteem. Suggestions from this study include addressing the burden of unplanned teenage pregnancy. Sex education needs to be incorporated into discussions at school, home, and health facilities. Further, safe, stigma-free access to contraceptives needs to be provided for adolescents. Authors from the study also suggest that the sociocultural stigma and taboo associated with discussions about sex at school and within the community needs to be mitigated to provide a safe environment for teens to engage. Community health workers, who are typically lay members of the community who work either for pay or as volunteers with the local health care system, can be trained to provide sex education community members (including teenagers and their families). “Teens are more comfortable learning from teens. Trained peer counsellors and support groups have been used to provide safe environment for adolescents to have healthy conversations on sexual and reproductive health”. There are several organisations throughout South Africa that provide support for teenage mothers and their families. A few include: Mamkhulu.org in Mpumalanga, Teen Moms Youth Development run by Options Care Centre in George, The Parent Centre in Wynberg, Cape Town, Lifeline Pregnancy Support and Girl Pride Africa . - Health-e News

Teen pregnancies: Heavy burdens for young shoulders

The number of teenage pregnancies is rising rapidly in South Africa and the mental burden is taking its toll as children as young as 10 are falling pregnant. According to the South African Medical Journal (SAMJ), the number of births among children aged 10 – 14 years increased by 48.7% and the birth rate per 1 000 girls in this age category increased from 1.1 to 1.5. Frightening figures Up to half of the adolescent mothers experience postpartum depression in Africa and if left untreated, they are far more likely to fall pregnant again within two years. According to a research article published in 2022, although research on maternal mental health in Africa is sparse, some studies estimate the prevalence of postpartum depression in Africa to range between 15 to 25%.30,31. The prevalence of postpartum depression among adolescent mothers ranges from 14% to 53%. This is more than double than

KZN floods: Healthcare services take a battering

Climate crisis: Health must be front and centre at COP27

On the eve of the pivotal climate talks at COP27, the World Health Organisation issued a grim reminder the health impacts of the climate crisis must be at the core of these critical negotiations. The climate crisis increasingly makes people sick and jeopardises lives. The organisation said climate change is already affecting people’s health, and urgent action is needed to stop this. The WHO said COP 27 must end with progress on mitigation, adaptation, financing and collaboration to tackle the climate crisis. “Climate change is making millions of people sick or more vulnerable to disease worldwide. The increasing destructiveness of extreme weather events disproportionately affects poor and marginalised communities,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. Climate crisis to health will cost billions He said the ecosystems on which the global population’s health is threatened more than ever by deforestation, agriculture and other changes in land use and rapid urban

COP27 explained by experts: what is it and why should I care?

COP27 is the 27th Conference of the Parties (countries) that signed up to the United Nations Framework Convention on Climate Change. The convention was established at the Rio Earth Summit in 1992, and has been ratified by 198 countries. They agreed to stabilise the production of greenhouse gases in order to prevent dangerous climate change. Since then, the Conference of the Parties has been hosted in a different country each year. These conferences broadly provide a platform for the negotiation of international climate change treaties. The very first treaty acknowledged that the responsibility for action was different for developed and developing countries, because developed countries were responsible for most greenhouse gas emissions. Despite some gains, commitment to these treaties has not translated into the action necessary to shift the course of global climate change. The recent Intergovernmental Panel on Climate Change report states that global average temperatures have already reached

Booster does may not be able to put up a good fight against Omicron variant.

Africa Health Congress kicks off

After a 2-year hiatus due to COVID-19, Africa’s healthcare community has gathered in Midrand for the Africa Health Congress, which brings together leading healthcare professionals from across the continent. “Healthcare professionals from multiple disciplines are meeting to promote discussion and thought leadership on the advancement of healthcare in the region,” said Solenne Singer, Group Director (Healthcare) at Informa Markets Healthcare. Infection control under the spotlight The congress addresses the needs of African healthcare professionals. These shares strategies are transforming the future of medicine and examine the latest disruptions in healthcare driving the continent’s transformation. Key conference highlights include Imaging and Diagnostics, Quality Management and Patient Safety, CSSD, and Emergency Medicine. The Transformation Talks and Techquity Talksunveil future predictions, new technologies and innovations that would change how diseases are treated and diagnosed. Public health; nursing; and infection control are also key topics. – Health-e News

national cancer survivors day

Breast cancer: Five tips from an expert on catching it early and keeping safe

Breast cancer is the most common cancer in the world. Every year it claims more than 650,000 lives. Breast cancer affects more women in high-income countries like the US and the UK. But people in low- and middle-income countries, such as Nigeria, are most vulnerable. This is mainly because people in these countries seek medical help at a late stage when the disease is advanced. When breast cancer is at an advanced stage, it is harder to treat, and people are more likely to die. Nigeria, for example, has one of the highest breast cancer fatality rates. The country has seen a significant increase in the number of cases over the past four decades. It’s currently the most commonly diagnosed cancer and one of the leading causes of cancer deaths in the country. The deficiencies in the Nigerian healthcare system – which requires that most patients pay out-of-pocket for their

Centre breastfeeding support on mothers and not the mechanics

Government should lead the march to support breastfeeding

South Africa celebrated World Breastfeeding Week (WBW) earlier this year when South Africa was coming to terms with the devastating news of children in the Eastern Cape and KwaZulu-Natal dying from severe acute malnutrition. Most shockingly, in January and February alone, 199 children succumbed to malnutrition in hospitals across the country. This national nutrition crisis compels South Africans to reflect on the importance of breastmilk in not only helping children survive but also helping them thrive. Breastmilk is the most important source of nutrition after a child is born – and the only food source they need for the first six months. Yet in South Africa, the number of exclusively breastfed infants is just 32%, among the lowest rates in the World. Exclusive breastfeeding is the practice of feeding children breastmilk only and no solid food or water in their first six months of life. Make breastfeeding the norm Government

Clinical research plays critical role in health system

Some coronaviruses kill, while others cause a common cold. We are getting closer to knowing why

It’s hard to imagine a time when “coronavirus” wasn’t a household word. But for a long time, this family of viruses had merited very little attention. Believed to be ubiquitous among animals and avian species, the first coronavirus to infect and cause disease in humans was only isolated and identified in the 1960s. Seven human coronaviruses have been identified since then. Most cause only relatively minor health concerns: the common cold and seasonal respiratory infections that come around every year. But the 2003 outbreak in China and other parts of Asia of the severe acute respiratory syndrome (SARS), caused by SARS-CoV (now renamed as SARS-CoV-1), propelled the virus onto the global stage. Coronaviruses gained further infamy when, in 2012, cases of the much more severe Middle East respiratory syndrome (MERS) were identified in Saudi Arabia. Both outbreaks were relatively contained. Not surprisingly, the concern over coronavirus diseases largely faded from

Turning a blind eye to eye health services

World Sight Day: Eyes closed to increasing number of avoidably blind

South Africa runs the risk of an added barrier to achieving its national goals if it continues to close its eyes to the increasing number of people who are avoidably blind. Cataracts and uncorrected refractive errors continue to be an under-reported barrier to education, employment, and health. In a world where we depend on sight for productivity, safety and mobility, the increasing numbers of avoidably blind people remain a significant challenge.  In 2020 the International Agency for the Prevention of Blindness (IAPB) estimated that 11 million people in South Africa were living with vision loss. Of these 370, 000 were blind. South Africa remains one of the most unequal countries in the world, with gender inequity having a far-reaching impact, extending to eye health service delivery. Approximately 58% of people living with vision loss are females. South Africa has been a signatory to sight-saving programmes like Vision 2020, amongst others,

Mental health: Most of SA's kids don't seek help

World Mental Health Day: Most kids don’t get the help they need

Almost two-thirds of South Africa’s children are facing their mental health problems alone; avoiding help or treatment when they need it most. And experts believe the only way to address this worrying trend is to become more vigilant about their children’s behaviour. Bongani Ndlovu, a 15-year-old from Soweto, knows what it’s like to feel all alone. “What breaks me is the fact that no one in my family noticed that I wasn’t okay. This means that I’m alone and have no one to turn to during this time,” said the teen. He said he never healed after he was mugged and his cellphone taken away for months. Michel’le Donnelly, Project Leader for Advocacy & Awareness at the South African Federation for Mental Health (SAFMH), said that 10% of children and adolescents worldwide experience a mental disorder, but most don’t seek help or the care that they require. Promoting children’s mental

University students cry for help as load shedding harms their mental and emotional states

South African students have been “bracing themselves” through the country’s escalating energy crisis, and they are exhausted and frustrated. This is according to Mmusi Thema, a student at Wits University in Johannesburg. Thema is a member of the Student Representative Council. “We have built a high propensity for dealing with pressure, and we can withstand so much,” says Thema. “But that’s a problem because we shouldn’t have to.” Although most universities already have protocols to deal with load shedding – given that this has been going on since 2008 – the increased blackouts this year have delivered a blow to the wellbeing and safety of the student population. Read in Daily Maverick: Load shedding is adding to the anxiety, depression and mental health toll among South Africans It is a pervasive issue that impacts all students, staff and faculties, but it disproportionately harms students. Load shedding is an inconvenience at

HIV treatment in South Africa: how to help people stay on ARVs when life gets in the way

Antiretroviral therapy (ART) has turned HIV into a manageable chronic condition. When ART is working effectively, HIV cannot be transmitted. This allows people with HIV to live fuller lives without the fear of infecting others. It’s also led global HIV control efforts to focus on increasing ART coverage. The aim is to improve the health of people living with HIV, and to decrease and eventually halt the spread of the virus. UNAIDS set 90-90-90 targets to measure global progress by 2020: 90% of people with HIV know their status, 90% of those with a known status are on treatment, and 90% of those on treatment are virally suppressed (a blood test result that means ART is working effectively). These targets have now been increased to 95-95-95, to be reached by 2030. South Africa has achieved the first 90 target but it falls short on the second 90. Despite having more

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