We spent today shadowing the nurses and doctors at Maternal
Child Health center (MCH). Claire and I
were placed in the Ante-Natal Care Clinic with Everlyne, the supervisor and
head nurse at MCH, and wow, what an incredible job to have. Each pregnant woman
brings a check-up book in which the nurses track important information such as
HIV status, appointment reminders, and other information. These books are also
used to monitor the newborns vaccines and weight changes after birth. Everlyne uses these books to make sure all
tests, records, and counseling sessions are done prior to delivery and that patients
receive all necessary information. Women
are scheduled for four visits with the overall focus on birth preparedness and
readiness to handle complications. Below
is a breakdown of what happens at each visit.
Many important conversations fall under the counseling and
education portion of the visits. During
this time, Everlyne makes sure to teach the expecting mothers exactly what is
happening inside of them, why certain things are and are not ok to do, and rid
them of any false beliefs they may have.
Other topics include breastfeeding, malaria prevention, and the importance
of having a skilled delivery attendant present for the birth. There are also
many rumors and false stigmas that Everlyne tries to explain to the soon-to-be
mothers. One specific rumor Everlyne
told us about is the rumor that some babies have white on them when they are
born because their parents had sex while the mother was pregnant. Everlyne explained however, that this white
film is made by the mother’s body in order to keep the baby warm inside the
womb.
The first patient Claire and I saw was 21; one year older
than me, one year younger than Claire.
She had a section on her belly that was bubbled up, but not where the
baby was, which concerned Everlyne. For
this reason, Everlyne suggested the mother go to the hospital in Kakamega to
receive an ultra sound. Unfortunately,
Kakamega is about an hour bus ride away, and transportation costs may make this
difficult for the patient. This
challenge is very common, and instances like this make it clear why WOPLAH’s
income generation projects are so needed in order to improve health standards. While this young lady had an unresolved issue,
and highlighted a struggle in local healthcare, the rest of the appointments
went smoothly and were very exciting to be a part of. By the end of the morning, we had seen women
at every stage of pregnancy and had felt the small heads of several babies in
the womb! Everlyne is unbelievable. She is so knowledgeable and can find and
identify every part of the baby within just a few seconds of touching the woman’s
stomach. One of the babies twitched when
we touched its knee, which was very cool.
The best part though, was the heartbeat of the babies. I almost started crying it was so beautiful.
It took me a few tries before I finally heard it, but once I did I was overwhelmed
with joy. The pitter-patter sound was so pure. I think I could do that for the
rest of my life.
Following the Ante-Natal Care Clinic we stepped into a whole
new portion of life. Watching the
beginnings of life changed to the beginnings of manhood as we each took turns
watching a male circumcision at MCH. Winter
break just started here meaning it is time for circumcisions. This is the case as USAID provides free
circumcisions in health facilities during all holidays to ensure boys have time
to recover before the school year starts again. The little boy I watched was 11 and he was so
brave! Many of the boys were nervous
after hearing stories from their friends who had been circumcised the
traditional way, while others watched the entire thing (which was pretty
crazy). The traditional
circumcisions are also taking place right now as evidenced by the many joyous
parades we have seen marching down streets collecting funds for the boys’
recoveries.
In these practices, boys are usually taken into the countryside and
numbed in cold rivers, after which they use knives to perform the act. The boys then stay in the countryside for one
month to recover. However without
sterile equipment or the knowledge of health facility employees, it can be a
dangerous practice, which is why many people are now being encouraged to go to
health facilities. Not to mention that
the health facilities use local anesthesia where as in the traditional practice
they only have the coldness of the river to help numb before the procedure
takes place. I really appreciate and
honor traditions in general, but seeing the caution used at MCH when performing
the circumcisions, made it difficult for me to disregard my concern for the health
and safety of the young boys going the traditional route.
- Libby Alvin '16 Molecular and Cellular Biology Major
Would you say an 11-year-old girl was "brave" for her response to female genital surgery, or would you question why it was happening?
ReplyDeleteThe sooner this outdated tradition dies out, the better. It makes no sense to be promoting male circumcision to prevent HIV.
From a USAID report:
"There appears no clear pattern of association between male circumcision and HIV prevalence—in 8 of 18 countries with data, HIV prevalence is lower among circumcised men, while in the remaining 10 countries it is higher."
It seems highly unrealistic to expect that there will be no risk compensation. The South African National Communication Survey on HIV/AIDS, 2009 found that 15% of adults across age groups "believe that circumcised men do not need to use condoms".
It is unclear if circumcised men are more likely to infect women. The only ever randomized controlled trial into male-to-female transmission showed a 54% higher rate in the group where the men had been circumcised:
ABC (Abstinence, Being faithful, and especially Condoms) is the way forward. Promoting genital surgery seems likely to cost African lives rather than save them.
Europeans don't circumcise, South Americans don't circumcise, Australians and New Zealanders used to circumcise but stopped, and less than half of North Americans circumcise. Why should Africans circumcise?
Recent news from Botswana:
"There is an upsurge of cases of people who got infected with HIV following circumcision."
and from Zimbabwe:
"SOME circumcised men are contracting HIV and Aids after ditching the use of condoms, under a misguided belief that male circumcision (MC) would prevent them from getting infected"
and from Kenya:
"Push for male circumcision in Nyanza fails to reduce infections"
Google "ulwaluko" for horrific photos of what can go wrong with traditional circumcision btw.
Was the eleven year old boy able to give informed consent? Was he told about the irreversible nerve damage? Was he told about the functions of the prepuce? Was he told how common it is for men to regret getting circumcised?
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