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Dr. Mokeira J. Nyamache 

You see, these populations by the nature of their economic activities were mobile, lived in close interaction with specific communities, were stigmatized and largely lived in low socio-economic states. So thanks to my loud thoughts the task force was drawn to the attention of key populations’ and truckers’ needs and circumstances which would make them highly at risk as well as a source of spread across borders. A good discussion ensued even suggesting inclusion of WASH partners in the plan for hygiene considerations.

I left the meeting a happy doctor, knowing my clients would be well catered for in the national and by extension regional contingency plan. I drafted the infection prevention and control guidelines for them in my head and could not wait for the enrichment that would come from sharing it with the task force. That moment felt like true service to humanity. Never mind that the chair of the meeting seemed to struggle with the definition of the term key populations and the relevance of truckers in this discussion. In my naivety I offered to explain just so that the minutes would capture the details accurately albeit briefly. Notably though, the minute taker upon reading through the draft notes prior to the meeting conclusion had coined a term to refer to these categories of populations and my attempt to have it correct was met by ‘’the members of the task force will understand the point’’. I trustingly rested my case.

The phone call

Nothing prepared me for what would come next. It was about 3:00pm and I was in the office having late lunch while updating my colleagues on the meeting when my phone rang and I eagerly picked up as it was from a colleague from the meeting. She was responsible for its convening and worked for an influential global health organisation. She said that she had received concerns about the ‘’controversial topics’’ I raised in the meeting: key populations, truck drivers, transport corridors, borders. She asked if our organisation did HIV programing and I responded that it was one of the programs under our primary healthcare umbrella. She said that our contribution was not welcome nor valid for COVID-19 contingency planning based on the complaints from the Ministry of Health leadership in the task force. My attempts to explain the logic to her for almost 15 minutes were futile.

Finally I requested at least for training of our frontline staff. That too was denied because they were not really in ‘’the line of danger’’ because they were dealing with ‘’just truckers and key populations who were mainly HIV positive and being followed up. By the time a person reaches your team,’’ she continued, ‘’ they will have been screened and so no chance of risk. In fact, it would be impossible for a COVID-19 client to reach your team before being reached by a different facility…’’ She seemed to be saying. My heart sunk. I knew better and suspected that in a short while we would have to contend with reality: infected truckers crossing borders and key populations moving to different locations due to movement restrictions and closure of hotspots. Three weeks later, the dilemma arose at the western border and just days after that, a truck driver tested positive. That trucker was one of our regular clients and the first in a growing list of truckers being diagnosed positive across our network.

On the brighter side, not all was lost and our close working relationship with the ministry still allowed us to forge ahead in partnership. We started trainings, awareness raising campaigns and active case finding. The guidelines I had drafted in my mind came to life and our target population was getting the attention it required. Thinking back to the phone call, I could not help wondering if it was not too late firefighting as was the norm in these parts of the world. Perhaps if the controversial topics had been included in the planning, the ongoing trucker case numbers might have been less.

That aside however, I could not help weighing knowledge versus experience, and the answer was the same as before: synergy in timely application of knowledge and experience; inclusion would be a good addition for perspective too. Then I remembered my patient and the blind men of Indostan, it should never be about who gets credit but about credibility of the intervention knowing that no one knows it all. After all, nobody is perfect and this thinking would keep us ahead of the virus I am sure. So now, each day I watch the news or receive reports from my colleagues in the frontlines about more truckers turning positive I remember that afternoon phone call. They won’t let me forget it. It reminds me to grow no matter what.  

Dr Mokeira J. Nyamache

Any man can be a father, but only a special one can be a dad. A father does not have to be biological to be a great dad. He is like the superhero who is always ready to take on everyday troubles for his dependents. He lets them dream and offers his shoulders to stand on while they reach for the skies and beyond. Working and sacrificing tirelessly to fulfill the demands that come with the responsibility does not make him upset and mean.  A dad is a friend whose significance and worth goes beyond words. It is for the love of dads that I choose today to address one most pertinent issue that most of them unfortunately tend to forget or ignore; that is their health.

Many dads avoid preventive care that would have kept many health challenges at bay. Unlike most women who tend to seek medical advice whether or not they are symptomatic; men often believe that if one “feels fine,” then there is no reason to go to the doctor. This might be explained by the fact that many communities with deep-seated cultures and stereotypes dictate how men should behave. They are generally expected to be tough within an unspoken code of conduct. ‘Small’ ailments should not put them down.  It is not surprising therefore that most of them fear visiting hospitals for checkups due to the fear of being labeled  or feeling  ‘weak’ .They usually only do so at advanced stages of illness.

Many dads do not even realize or accept that it is possible for medical conditions such as high blood pressure, high cholesterol, cancer or abnormal blood sugar levels to attack them silently. Some even fail to comply with treatment once diagnosed. They also commonly indulge in unhealthy behaviors like smoking, excessive alcohol use, unhealthy diet, little physical activity, workaholism and sleep deprivation among others increasing their risk of these Non-Communicable Diseases. Being a good dad is not as simple as reading about it or trying to emulate someone else. It is more of a dedicated and deliberate process that involves developing among others good health practices over time. Great dads are a result of the daily choices they make and habits they grow into. The responsibility of being a dad demands strength not only mentally and emotionally but also physically.

This directly correlates with life style.  As a dad, you should consider and understand that your health is no longer just about you. Your dependents may not tell you often enough but the truth is that there is nothing they would want more than to see you healthy and happy.

What are some of the healthy habits dads should practice?

First, healthy eating. As it is often said, 'we are what we eat'. Dads should provide leadership by setting the example in the family even in food choices. Studies have shown that parental health is a good predictor of children's health. This is because children learn what and when to eat by observing then developing their own eating habits. Therefore, the healthier the choices a dad makes, the healthier the habits his dependents are likely to develop. An adult requires 3 liters of fluids per day from a combination of healthy drinks and food ingested.

Balanced meals should comprise of locally available and affordable energy rich, body building and protective foods from a variety of sources ingested at least 3 times a day. Fruits, vegetables and whole grains are a source of the much needed of fibre in the diet. It is advisable to have heavier meals for breakfast and very light meals for dinner. Additionally, it is best to eat the last meal of the day at least 2 hours before bedtime. Second, physical fitness. Let us face it; there is nothing like instant fitness. The only way to improve our physical health is to get into the habit of regular physical exercise. One does not necessarily need to go to a gym or buy expensive equipment. It can be as simple as jogging, walking or even running around with the kids for half an hour at least 5 times a week. The simpler and more fun it is, the easier for one to follow through on a regular basis.

Exercise choices like playing with the kids not only contributes to physical wellness but also to emotional and psychological health of dads and the entire family because they increase bonding. Sweating, increased breathing and heartbeat while you can carry a conversation are the basic signs of healthy moderate physical exertion. More intense exertion should still allow one to converse though in shorter sentences. It is wise to consult your doctor too on the level of exercise you should do especially if you are on follow up for any medical condition. Third, emotional fitness. While a healthy diet and physical fitness are a critical component of well-being, emotional health carries just as much weight for a healthy dad.

A stressed dad who is constantly in a bad mood might cause similar effects on his family; sometimes, even years down the line. It could lead to behavioral problems and long-term effects on his children’s emotional and social skills including but not limited to poor self-esteem, lack of cooperation and self-control, psychoactive substance abuse and even vulnerability to vices like Gender Based Violence. Work-life balance is key for emotional health. Good time-management to ensure dedicated rest and recuperation periods from the demands of a responsible life is a necessity. Self-awareness and building of a healthy support system are complimentary to all efforts towards good health. A healthy, stress-free dad translates to a happy family because he creates an enabling environment for them to engage with and be around him. Participation in family activities becomes easier; hence, the strengthened bonds.

A dad’s role as a leader in the family becomes more satisfying when good health abounds. On the other hand, being unhealthy increases family stress that may have many unpleasant outcomes. As we celebrate this year's edition of Father's Day, make it a priority as a dad to take care of your physical and mental health.  It is not just about you but your whole family. Let us all remember, appreciate and honor the contribution of dads to our lives.

Dr. Mokeira J. Nyamache

The speed with which I learned new things, shared ideas and updated my knowledge was more than I had ever before imagined. I even stopped referring to my medical textbooks and calling colleagues to consult because with just the touch of a button everything popped up on a screen in front of me. I could research material from different sources and triangulate within minutes. No matter how hard I invested my meagre resources in these pages though, I was constantly giving, emptying, seldom getting satisfaction. I was chasing my tail, a mirage to be precise.

On the other hand, valuable things like school, friendships, family relationships, and work were falling behind. The worst was when one of my social media accounts was used to plan my daughter’s failed kidnap. I learned the hard way. I had to stop yelling every detail of my life to the world through those accounts. Fast forward to a few years later. Nothing comes close to the stress I experience when my child is glued to a gadget. It is even worse if they are on social media without my direct supervision. Any parent to generation alpha category of kids knows how they are with technology.

They do not need introductions nor training. Their ability to soak information within seconds is beyond my understanding. It is even more complicated for me the perspectives they take and creativity with which they apply it. Do not get me wrong. I still like and admire technology. It is at the center of global development even in health. We are updated on many issues today instantly for almost free unlike years ago. Voice calls across countries and continents are instant and as good as free.  Social media has revolutionized almost every aspect of our lives. It is where you find all sorts of people and information, some good and some not. Wisdom from hard lessons learned through experience has reminded me however a thing or two about moderation and stewardship. Even too much of a good thing can be toxic. There is a lot of competition in the virtual world that can be draining in real life.

Everyone seems to be having great fun, achieving greater success or getting more attention.  This predisposes to poor mental health especially among the youth. Studies have linked social media to an increased risk and occurrence of depression, anxiety, loneliness, low self-esteem and even suicidal thoughts. Infomania is another area of caution in dealing with social media. The numerous pieces of information spread through these sites with sometimes-disturbing images often lead to some people compulsively checking for information across sites in their gadgets.  This pre-disposes to anxiety. Trolling and cyberbullying that which have now become common have caused unprecedented harm to many people’s mental health such as low self-esteem and depression. To continue...