Health

Kidney patients receiving haemodialysis treatment at the Yaounde University Teaching Hospital are praying for their lives following the continuous breakdown of haemodialysis machines at the centre.

The situation has become so preoccupying following the death of 4 patients in the past two weeks. Cameroon Concord's source, a patient who opted for anonymity confirms their death saying the breakdown of the machines has made treatment difficult for the over 100 patients who visit the centre,since they can't be treated properly. Most of them are scared for their lives.

This follows a situation in November when patients of the Yaounde General Hospital staged a demonstration to demand for better treatment. Machines at the hospital had broken down causing many to travel to Ebolowa twice a week for treatment. The protest pulled out the Minister of Public Health, Andre Mama Fouda who promised a quick fix of the machines.

A team of technicians from Morocco were at the centre for repairs, but not so much has changed as patients continue to carry dialysis treatment amidst repeated breakdowns.There are over 2000 haemodialysis patients in the country exposed to this disturbing situation .

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Rita Akana

24.Feb.2017

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The National Inter-sector Technical Committee in charge of providing Cameroon with a universal healthcare coverage system, just presented the organisational and technical aspects of the possible set-ups for said system whose development plan will be development and produced during the first half of 2017. Its legal framework will also be submitted this year.

The operation of this system, according to the Committee, rests on the establishment of a single national structure in charge of the technical and financial management of the healthcare coverage. This structure will have to make the proposals on the range of care and health services available to all. To access it, every Cameroonian citizen will need to have a national healthcare system card with a unique ID number. They will be able to access healthcare and services throughout the country. This implies a biometric registration for all. The registration will be carried out at registration points. On this topic, André Mama Fouda, Minister of Health who heads this technical Committee, believes that the current system for Elections Cameroon (organisation in charge of the elections) may be solicited to carry out this operation.

With regards to financial contributions, they would be automatically deducted from the pension by the relevant units in the Finance Ministry and Public Treasury for retired civil servants. While for those retired from the private sector, the deductions would be made on the pension by the Caisse Nationale de Prévoyance Sociale (CNPS – Social Security Fund). For workers in the informal and agricultural sectors, the idea would be to raise taxes by the amount of the national healthcare insurance contribution. For poor and vulnerable people, their membership would be undertaken by decentralised regional governments, based on a methodology and criteria set out at the national level.

As a reminder, based on official statistics, 37% of the Cameroonian population lives under the monetary poverty line. This situation prevents most from accessing healthcare.

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Rita Akana

12.Feb.2017

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Surgical department of the regional hospital Bamenda on strike link to marginalization of Anglophones in Cameroon. Reports says the major surgical equipment in the Hospital got bad and since the surgeons and theatre attendants complained over and again.
The Administrator in the name of Director of the hospital claimed much money is needed to maintain the machines and this has lead to a shutdown of the theatre at Regional Hospital in Bamenda.

All patients in need of surgical attention in this socalled “reference Hospital” are stranded.

A source who is a victim is reported to have said“My sister suffered from difficult labour on the 29 of December,2016 in this Hospital and needed operation which could not be done until 11:00am that I forcefully took her to St Mary where immediate surgical attention was paid and my sister and the baby are safe.”It is worth mentioning that at press time this publication still could not could confirm or deny the news.

Cameroontoday

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Rita Akana

30.Dec.2016

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Diet is a corner stone to the management of diabetes. People with Diabetes have to take extra care to make sure that their food intake is balance with their diabetes medications. A well balanced meal should help improve blood glucose, which is the main sugar found in high amounts in the blood of people with diabetes. Blood glucose is the main source of energy for our bodies. People with diabetes usually have problems with the utilization of the sugars and carbohydrates (starch) that they consume with meals. This is due to the fact that they do not produce enough insulin and/ or their cells do not respond to insulin as they should (insulin resistance).

Every time we eat food, we consume calories. If the amounts of calories we consume are higher than the amount of calories we use during the day, the extra is converted to fat and stored. This leads to weight gain. On the other hand, if we consume fewer calories, the stored fat is converted to energy that is used and we lose weight.

People with certain medical conditions are unable to appropriately break down and use some food types. People with diabetes are unable to appropriately use sugars and carbohydrates (starch) to transform them into energy. If foods rich in sugars or starch are consumed, they can lead to high levels of sugar in the blood.

High blood sugars damage blood vessels leading to stroke, heart disease, eye problems, kidney disease and nerve problem. The effects of persistent high blood glucose can also cause problems with the teeth, gums, feet and skin. Keeping blood sugars, blood pressure and bad cholesterol levels close to normal can help prevent or delay heart disease and some cancers. Eating healthy will improve your overall health and can prevent these harmful complications of diabetes.

The main goal of a healthy diet in people with diabetes is the consumption of an adequate amount of calories for each person’s life style. Foods have to be broken down when consumed, and what they are broken down into is the main key to making diet choices.  People with diabetes should make the maximum effort to substitute foods that are broken down into sugars and carbohydrates with food rich in fiber like vegetables.

The main food items consumed in sub-Sahara African countries like Cameroon include high carbohydrate foods like plantains, corn, corn flower (corn fufu) flour, cocoyam, white rice, yellow yam, cassava and gary. Kidney beans which are rich in protein, soya beans, cow peas, egusi and groundnuts are also widely consumed. Major vegetables are amaranth leaves (also known as green), cabbage, eru leaves, water leaf, solanum scabrum (njama njama) and carrots. Major fruits include, avocado (pear), orange, paw-paw (papaya), banana, mango, and passion fruit (adam fruit). Beef, fish, egg and milk are also highly consumed in Cameroon.  Palm oil, groundnut oils and sunflower oils are some of the most commonly used oils.

Most foods contain more than one type of nutrient. One food type could contain a high amount of one nutrient and a smaller amount of another nutrient. For example, Mangos or bananas are very high in fiber, but they are also high in sugars, so people with diabetes should consume moderate amounts of sweet fruits like mango, bananas or oranges because of the high sugar contents.  

A balanced meal should contain fibers, proteins, carbohydrates and fat. Not every type of sugar or fat is the same.

Note that carbohydrates and sugars are interchangeable as carbohydrates are converted into sugars.

People with diabetes should avoid simple sugars like honey, jam, fruit juice with added sugars or sweet drinks.  These types of foods usually cause a rapid rise in blood sugars which could be very damaging to the blood vessel, and lead to severe complications. Sugars from foods like sweet potatoes, yam, and even fruits like paw-paw (papaya) are a better option, but should be consumed in very moderate amounts.The sugars in these foods take a longer time (about 20 minutes) to reach the blood system.

As with sugars/carbohydrates or starch, unsaturated fats such as fat found in fish, pear(avocado) and nuts are much better than saturated fats. Saturated fats are found in red palm oil, fried vegetable oils, fired foods generally, fatty meat, butter, and even milk. Note that most delicacies like cake or sweet bread are not only very rich in sugars/carbohydrates but they are notably very rich in butter (saturated fats). These foods should be completely avoided.

Proteins also need to be consumed as they are a great source of energy and they are good at making you feel full.

Several people tend to eat foods or some sort of foods from their roots or where they come from, and so it is more difficult to use the standard calorie counters available. It is important to pay attention to what you eat, the portions and possibly write down what you eat in a day.

(see the food composition link below for African foods)

Good to know

.    Every food consumed is some form of calorie. Do not overconsume anything. Eating 6 mangoes a day is a bad nutrition choice. Too much of a good thing can become a bad thing.
.    Trade off!  Trade off!  Trade off! Substitute one food item with a better one from the nutrition stand point.
.    Substitute fried food with grilled or baked food (not cakes)
.    Serve food in small plates
.    Put all the food you have to eat in front of you and actually pay attention to portions and nutrition continents before you start eating
.    Never go for a second or third round
.    Avoid over snacking, that is where most of the un needed calories and poor food choices come from
.    Schedule you meals and fast in-between your scheduled meals
.    Avoid any over processed food or foods you cannot visibly tell what is inside because they have been processed
.    Avoid alcohol
.    Washing your rice well after partially boiling will cut down the amount of carbohydrates
.    Eat 3 balanced meals a day about 4 to 6 hours apart
.    Eat your calories instead of drinking them
.    Eat your fruits rather than drinking fruit juice
.    Drink water instead of juices, low calorie soft drinks tea, coffee…
.    Avoid adding margarine , butter or sugars (jam) to your foods
.    Exercise! Move around! Walk each day!
.    If you are overweight, try to lose at least 5%  to 10 % of your weight
.    Make:
.    breakfast :1/3 grains, 1/3 fruits(starch/fiber),1/3 proteins
.    Lunch : 1/2 vegetable, 1/4 starch, 1/4 proteins
.    Dinner : 1/2 grains, 1/4 fruits, 1/4 proteins
To put things in prospective:   I cup is a bit less than a pick milk tin
You need 30 to 40 grams of carbohydrates a meal which could be found in:
.    2 slices of bread (the size of a CD case)
.    1 cup of cereal  
.    One large orange
.    1  mango
.    1 cup of milk
Make sure you know your hemoglobin A1c number and monitor the trend every 3 months with your doctor
Great Resources
1.    Fadupin GT. Food exchange lists of local foods in Nigeria. African J Diabetes Med 2009, 17; 2: 215–19.

2.    Food Composition Table For Use In Africa

Prof. Joyce Akwe

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Prof. Joyce Akwe

24.Nov.2016

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Emmnauel Ugochukwu Michael runs a dating agency in Nigeria for people with HIV-AIDS. He helps them escape from isolation, rebuild their lives and recover their sense of dignity.

Emmanuel Ugochukwu Michael's mobile phone never stops ringing. The 45-year-old takes every call and has a friendly chat with each caller. He often gets as many as 100 calls a day, which invariably end with the same question. "Are you HIV positive?"  It is a question which some people might find offensive, but Michael takes it in his stride. He runs Nigeria's first dating agency for people with HIV-AIDS. These days everybody in Nigeria seems to be talking about Michael's agency. He has spread his message far and wide. "HIV+ need wife or husband?" reads the graffiti which - complete with his telephone number - he has sprayed on walls, fences and stonework throughout  the Nigerian capital of Abuja.

Michael trained as an electrician. The first time he picked up his spray can was in 2012. He'd already been visiting people with HIV in hospital. These encounters made a deep impression on him. "When I looked into their faces, I caught myself thinking this is no life for them and I wondered how I could help."

Women under pressure to marry          

The official figure for the number of people with HIV-AIDS in Nigeria is 3.5 million, but the real figure is probably twice or three times as high. Those who know they are infected generally keep this knowledge to themselves. There is a huge fear of being stigmatized. Finding a partner is almost impossible. Yet women in Nigerian society are under pressure to find a husband and get married  when they are young. "It is part of our culture. A man can wait until 50 before marrying. But once a woman reaches 30 or 35, then menopause starts to kick in and life can become traumatic," Michael said. In many African cultures, a marriage without children isn't a proper marriage.

35-year-old Gloria is one of the women whom Michael has been able to help. That's not her real name as she doesn't wish to reveal her true identity. A few years ago her family started pressuring her into finding a husband. "Everybody said I should get married." Because Gloria is HIV positive, she thought marriage was out of the question. She kept her HIV status a secret. The only person she told was her mother.

Infected despite precautions         

Gloria doesn't know how she became infected. It could have happened while she was at the hair dressers or at the hospital where she worked. In spite of all the safety precautions, she must have pricked herself with an infected needle. Gloria's mother eventually gave her Michael's phone number and persuaded her to call him. "After the phone call, I went to see him. He gave me counseling, we prayed and he really encouraged me to battle on in my life."

 When Gloria discovered that she was HIV positive, she fell into a bottomless pit of despair. It was Michael who saved her. It was through him that she met her future husband, she calls him John. They married within months of their first meeting. "We also wanted to have a child," she said.

Gloria became pregnant and was kept under constant medical supervision. She was terrified that her child, a son, would be born HIV positive. Even after he was born, she remained anxious. But when he was six months old, the doctors were able to confirm that he had been born HIV negative.

Michael says he has 7,000 people on his books seeking a partner. In many ways, his agency works like similar organizations elswhere. Every applicant fills out a form. The fee, though, of 200 Naira (five Euros) is largely a symbolic gesture. Michael has never had trouble with the authorities even though his agency isn't registered as a club or a business.

But Michael has his critics. "Religious fanatics, evangelists," is how he describes them. They accuse him of wanting to spread HIV. "Of course, I don't want to do that," he said. "People with HIV are still people and somebody must look after them." 

DW    

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Rita Akana

07.Nov.2016

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The Managing Director of Caisse Nationale de Prévoyance Sociale (CNPS), Alain Noël Olivier Mekulu Mvondo Akame and the Managing Director of Tunisia Medical Services (TMS), Slim Maraoui, signed on 26 October 2016 in Yaoundé a medical assistance agreement relating to medical evacuations.

This agreement will assure patients of receiving the medical care and surgery for pathologies where medical evacuation is justified. In addition to these services, medicines, consumables and required devices will be taken care of, in compliance with the norms and international standards and in accordance with professional and medical ethics requirements.

Also covered under this agreement are: Blood and radiology tests, scans, MRI, transfusions, haemodialysis or any other cardio-vascular surgery. CNPS patients with 100% coverage from TMS, will have to respect the terms and conditions of the agreement (respecting appointment times, attending doctors, etc.).

The document signed by both directors covers some important progress in terms of medical evacuation of Cameroonian patients abroad. Indeed because these past years, despite the improvement in the facilities of its four medical structures throughout the country (Centre hospitalier d’Essos in Yaoundé, medical and social centres in Maroua and Garoua, as well as PMI in Bertoua), CNPS had to resort to medical evacuations in Europe. In France and the UK in particular.

Now, the distance has been shortened to Tunisia which has medical infrastructure of a level comparable to Europe.

S.A.

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Rita Akana

02.Nov.2016

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