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Dr. Mokeira Nyamache

 Did you know that the popular movie Sarafina was based on the happenings of 16 June 1976, exactly 44 years ago? In what came to be known as the Soweto Uprising, the morning of this date saw an estimated 20,000 students from around South Africa take part in demonstrations against the poor quality of education. They demanded to be taught in their own language as opposed to Afrikaans and English that were to be introduced. During the protests, police brutally killed 700 of them. It is in honor of their courage and resilience that Africa celebrates The Day of the African Child yearly on the same date.

The theme this year is “Access to a Child-friendly Justice System in Africa

 About seven years ago in a health facility in Nairobi, a six-year-old girl was escorted by her grandmother to the health facility for treatment following reported molestation by her maternal uncle. All procedure was followed in her care and it emerged that this was not the first incidence she was experiencing this. In fact, it seemed as though it was a normal part of her life. We wondered why she had not received prior professional attention based on this information. It emerged that her grandmother feared that if she had sought help earlier then her uncle (grandma’s son) would have been arrested and that would have ruined his life… So why did she bring the child this time around? The uncle had married a new wife and this issue was causing problems in the marriage so his mother decided to try to help. One is left to wonder:

who was the grandmother really helping? Was it be her son by trying to help with his marital problems? Or her granddaughter who had become accustomed to molestation? The patient’s mother was a single parent who traveled frequently to buy merchandise in a neighboring country for business in Kenya. She trusted her mother to care for the child while she ran the business that supported the entire family including the perpetrator in this case. The little girl (survivor) had suffered injustice and she was not even aware that it was a big deal. The guardian who should have protected her had enabled and facilitated it by not reporting and seeking help promptly. Normalization of abuse in children sets the stage for further mental health and psychosocial problems including Gender-Based Violence, dysfunctional relationships, substance abuse, mood disorders, low self-esteem, and suicide among others. The treatment journey is usually long and without guarantees of full recovery.

What does justice mean for the African child? Who ensures it and how?

It starts with the home and the local community. Guardians and parents need to be aware of this and should take responsibility in safeguarding the same. Children must be protected from witnessing and/or experiencing abuse such as domestic violence, verbal abuse, economic abuse, child labor, molestation, unfair treatment of children, discrimination, and brutality from law enforcers. Ignorance, poverty, peer pressure, social injustices, and self-identity problems in the larger community all reinforced by slow legal systems, cultural norms fostering inferiority in certain groups, and social tolerance of different forms of abuse are all predisposing factors. Abuse jeopardizes the future of the children by risking their achievement of full potential and positive contribution to society as well. During this time when the world is fighting the Covid-19 Pandemic through lockdown measures;

 children require responsive caregiving; good health; adequate nutrition; opportunities to learn and protection from abuse and stress. These elements are interdependent and mutually reinforcing. They are essential to enable children to thrive and achieve all they can. Denying them is in itself a big injustice to children. All stakeholders have a responsibility to take care of children’s mental health by protecting them from exposure to abuse and taking the right immediate actions in the event it happens.

Dr. Mokeira Nyamache

 The world recently marked the Myeloma Awareness Week. Myeloma is a common but probably the least known or discussed type of blood cancer within the general public. The number of cancer cases has drastically increased in the past few years. The World Health Organization ranked it the second largest cause of death in 2018 with 1 in 6 deaths globally being attributed to it.

But first, what is cancer? 

 It is a collection of different diseases characterized by abnormal multiplication and growth of any cell type in the body. This leads to abnormal cells which continue to further multiply and grow in an abnormal manner and the cycle continues. Multiple myeloma is a type of cancer that originates in the plasma cells. These cells are a type of white blood cells and they originate in the bone marrow. They play a critical role in immunity because they produce antibodies in the fight against any foreign particles in the blood.

Risk factors for developing multiple myeloma

 Though causes of the disease are unclear, there are risk factors that may influence a person’s risk of developing it. These are older age, female sex, and family medical history. Other risk factors for cancer are high body mass index, low fruit and vegetable intake, lack of physical activity, tobacco use, and alcohol use. The disease is known for high rates of delayed diagnosis as symptoms are usually vague or even absent in its early stages. It is often discovered by accident during a routine blood or urine test. Early diagnosis and detection is important for better outcomes following treatment. Symptoms may include bone pain, extreme fatigue, nausea, and numbness in the limbs, opportunistic infections which can be life threatening and kidney problems.

Psycho-social support and multiple myeloma

A diagnosis of myeloma is life changing. Receiving treatment for any medical condition let alone chronic diseases and cancer in particular requires a lot of psycho-social support. It is human to feel tired of persisting in a treatment plan that seems endless. The symptoms to deal with are another burden. The effect on family, social relationships and financial state can be overwhelming. Feeling hopeless, depressed, anxious and even indifferent is common during these trying seasons. This is where counseling and support groups can help lighten the load. Individual counseling is aimed at tackling and helping one to cope with emotional reactions like depression and anxiety, family and relationship issues, personal issues and practical issues that often arise while undergoing cancer treatment. While it goes a long way in helping patients in the journey, it faces limitations in that it lacks opportunity to socialize and connect with people undergoing similar experiences. Patient support groups fill the gap by providing a safe space for patients to share, learn and work through feelings, challenges and other similar situations. The same issues covered during individual counselling can also be discussed among support group members and ideas freely exchanged. These groups add quality to the lives of members regardless of the number of years lived. Many such groups also take initiatives to fund raise for research and treatment of multiple myeloma as well as raising awareness about the disease.

The fight against cancer is a collective effort. Together we can.

As individuals, we ought to normalize taking regular wellness checks including cancer tests in order to increase chances of early detection and treatment in case we have the disease. The earlier any type of cancer is diagnosed, the better the chances of getting cured. Let us all provide support for people in our circles affected by cancer in one way or the other.  It is a tough journey that cannot be borne alone. Governments and other institutions need to also increase budget allocations to cancer diagnosis, treatment and research to confront the disease with the energy it deserves.