TABOOS TO BLAME FOR POOR HEALTH

TABOOS TO BLAME FOR POOR HEALTH

By Pamela Omwodo (1993)

Women in developing countries are often in poor health and over burdened with pressure of work.  Many suffer from malnutrition, a state that is partly due to age old practices that hamper their health.  Up to date food taboos that have defied health education still deny women and especially pregnant ones the protein rich foods which are a necessity in their nutrition.

Among the Miji Kenda group – a Swahili word meaning nine villages – along the coastal region of Kenya food taboos are still prevalent. 

“Women are not allowed to eat fish and eggs throughout the period of pregnancy”, says Josephine Kalama, a mother of three. Josephine is from Chonyi, one of the nine Miji Kenda groups.

Among the Miji Kenda it is believed that a child whose mother ate fish or eggs during pregnancy will have eyes like that of a fish and that his head will be round and hairless like an egg.   They also believe the child will be born with jaundice, because of the yellow colour of the egg yolk.

The prevailing belief has been handed down from generation to generation.  “These are beliefs that have been there ever since I was born and so I have to adhere to them”, justifies Josephine. Mothers adhere to these prescriptions mostly because they believe; the unborn child’s life can be harmed if they violate the taboo. 

Many other tribes in Kenya also still have one or so such beliefs that affect the female gender.

In Yambo County situated in South Sudan, pregnant women are deprived of chicken, eggs and red meat from certain animals.  The taboo persist among the Yambios two largest tribes – the Zande, estimated to have 80,000 in the county alone and the Balanda.  The believe that a pregnant woman who eats chicken or eggs during pregnancy is bound to have  a baby who will be slow in grasping languages and may stammer in his speech. 

A pregnant woman is also banned from eating giraffe and elephant meat for fear that her baby will be born with a spotty skin or a long nose respectively. They also believe eating meat from the spotted antelope may lead to breach birth.

Despite the repeated messages on the harmful practice to traditional birth attendants and mothers at ante-natal clinics, the taboos have persisted except among the wives of the well to do who are a minority in the developing countries.  In Kilifi and Kwale district where the Miji Kenda and the majority, it is estimated has 61 to 71 per cent of all the women are illiterate according to the Kenya Rural Literacy Survey of 1988.

Because of the wide spread observance of the taboos among the Miji Kenda, the Yambios and many other women in developing countries, many women are anaemic, a situation that is worsened by repeated attacks of malaria.  As a result maternal mortality is very high.  Estimates from rural hospitals in the Coast Province show that for every 100,000 live births in 1984, 350 women died from pregnancy related complications.  Dr. Katini Nzau-Ombaka, an obstetrician and gynaecologist at Kenyatta National Hospital, stressed that ” a pregnant mother’s highest needs amongst all the food stuffs is proteins which she can  only get from eating eggs, fish, meats, liver, milk, beans among other legumes.

The World Health Organization recommends 2535 calories a day for pregnant women yet between 20 – 45 per cent of women of child bearing age do not eat the WHO recommended calories a day under normal circumstances.

In a study on maternal mortality in Kenya carried out between 1991 and 1992, Dr. Shanyisa Khasiani a senior consultant with the Population Council of Kenya found out that among the Miji Kenda and most other tribes of Kenya, men still believe it is the women’s duty to do all the household work even when pregnant and vulnerable.  If she acts lazy and sickly, then she is not a desirable woman. The saddest bit of this she says,   is that the work load will certainly not be reduced even if she is malnourished.

Among the Miji Kenda a woman must look strong at all times.  She must work out her house chores without help.  She must bear as many as eight to sixteen children among them must be several boys. She is also expected to be brave and persevere the pains of child birth and if possible give birth with as minimal help as possible. Women who are operated on during child birth are perceived by the culture as weak.  For this reason most of the women do not seek medical help lest they get a caesarean section

Anne Ouma, a 36- year old expectant mother of five from Busia district admits. She says pregnancy is not a disease.  “Even now that am pregnant I still have to collect firewood, fetch water three Kilometers away, look for food and cook for my family! That’s my duty, I don’t have a choice”.

The house chores plus garden work may just take an expectant woman a longer time to do because of the state of her health, but it is still expected of her.  Like Anne Ouma many millions of women in the developing countries accept this as normal and one of the most disturbing things is that they bring up their daughters

Poverty, combined with other factors that undermine women’s nutritional status like heavy work, repeated pregnancies, low social status and discrimination in food distribution within the family make it very difficult to educate women about their nutritional needs.  The customs reflect the relative status or value assigned ages ago to different members of the family. 

In Africa where women are responsible for 60- 80 percent of all food production, one would expect malnutrition not to be a problem, but it has persisted on. Tanzanian women use up to 20 per cent of their daily calories intake fetching water. All these a woman does with no credit even when she deserves it. “Looking at some of the cultural practices, women were restricted from doing certain things when the resources were limited.  May be the restrictions were a means of helping the family allocate resources”, observes Dr. Khasiani.  She challenges researchers and nutritionists to study the taboos deeply and find out if the cultural beliefs were for vulnerability purposes hence protecting the women.  For example women are known to have food cravings when they are pregnant.  To date people are being discouraged from eating too many eggs which may cause cholesterol.  Could traditional communities have recognized this? She wonders. One thing is clear, any effort to improve child survival must include improvement of literacy and other forms of basic education for women.      

              

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DRESSING UP AGAINST AIDS

               

DRESSING UP AGAINST AIDS

By Pamela Omwodo (2006)

               

“Wow”,” Absolutely stunning”, “Creative”…...,

These were some of the comments in Adriana Bertini’s visitor’s book at an exhibition of her master pieces at the 2006, XVI International AIDS Conference in Toronto Canada.

Adriana Bertini, a rubber artist from Brazil’s handiwork attracted more than 350 interviews from top international journalists who all sought to interview her.  Speaking in broken English and in a very heavy Spanish accent, Adriana a humble and soft spoken Brazilian artist spent most of her time struggling to answers questions from  hundreds and hundreds of the XVI International AIDS Conference participants who all sort to know more about her unique handiwork, her way of fighting AIDS.

When I first saw the bright and beautiful clothes the mannequins were wearing at her exhibition, I was equally stunned and refused to believe what they were made of.  Despite of a very clear notice at the bottom of every mannequin with the words “DON’T TOUCH”, my eyes refused to see the notice and my hand went forth and did the violation.  I touched to believe.  Thereafter, I could not speak, and opted to take photographs and sort to know who was behind this.  

I later tried severally to get to Adriana for an interview with no success.  Every time I went to her exhibition space, there was either someone interviewing her or a photo session of her works going on. What I did not know was that at the end of the 4 days exhibition I was the 350^th journalist to interview her, each journalist requiring ample time to do their thing. In her own words she apologized saying “Please forgive me if I wasn't able to speak with you or to give you the attention desired due to the great number of people I had to talk to, the stress I had, and the little lack of mood at some moments. Please just understand that between 16th and 18th of August I gave more than 350 interviews to different media which was the reason for my fatigue.”

I was just one of the many journalists let alone interested persons who sort an audience with her and when I finally got the chance to interview her I was ecstatic.

The theme of her exhibition was entitled “DRESSING UP AGAINST AIDS”, a theme so befitting the all condom international designs only seen on fashion catwalks.

FIGHTING HIV/AIDS AMONG YOUTH IN KENYA

FIGHTING HIV/AIDS AMONG THE YOUTH IN KENYA

By Pamela Omwodo (2003)

“I am 20 years and I first had sex when I was 18” explains Ocholla.  “We had gone for a VCT seminar in one of the prestigious hotels in Kisumu. On the last day of the seminar, all my friends had a partner for the night.  I was the odd one out. After taking some beer I got some courage and approached a girl (prostitute) whom I spent that night with”

Ocholla is not alone. Picture this. Mwangi meets Sarah along the path to the hostels.  They are not friends, just acquaintances. In fact, he does not know her very well to even dare make sexual advances at her let lone ask for any favour.  But he tries his luck anyway. After persistent persuasions Sarah gives in. It is at night and there is no open shop to buy a condom, worse still, if he does not seize the moment she may change her mind.  So to satisfy his desire Mwangi goes right ahead and has unprotected sex with Sarah.  

Several behaviours may lead to increased risk of contracting HIV.  One of them being  unsafe sex.  Unsafe sexual behaviour includes having unprotected sex especially with multiple partners. As a result,  2% of young Kenyans aged 15-19 and 6% of those 20-24 years are HIV positive. This is irrespective of their knowledge about the existence of HIV and AIDS.

The Demographic Health Survey Conducted in 2003 indicates that 98 per cent of all young men and women in Kenya have heard about HIV and AIDS.

Consequently, the same statistics indicate that almost 50 percent of all young women in Kenya have sex by the time they turn 18 and almost one out of every ten girls have had sex by the time they turn 15. On the other hand young men start having sex at an earlier age. 60 per cent of all young men have had sex by the age of 18 and 25 per cent of the young boys have had sex by the time they turn 15.

No one determines when a young person should become sexually active.

Readers may argue that sex education has been made readily available to young people and that they have been provided with all the information they need so as not to make grave mistakes in matters pertaining to sex. But what can one say in the case of Ocholla who after keeping his virginity for 18 years had his first sexual experience after going through a VCT workshop, a strategy that is considered to be a powerful weapon in the fight against HIV/AIDS and is associated with behaviour change that reduces HIV transmission.

How are young people coping in this era of HIV/AIDS? Traditional methods of preparing young people for adult life are not enough in the face of HIV/AIDS and other multiple challenges.   Many parents are either too busy to give adequate attention to their children’s needs, often because the demands of their work or survival. Some parents who may otherwise have time to educate their children are ill equipped to communicate effectively to their children.  This is aggravated by the culture in Africa where matters of sexuality are not openly talked about especially between parents and children.  Most  parents therefore, leave it up to the schools and churches to counsel and guide their children. 

The Ministry of Education does not have a policy on guiding and counseling for all the educational institutions in Kenya. Currently there are heads of departments in charge of Guiding and Counseling in schools who have no job descriptions and as a result some teachers and head teachers do not support the departments. 

The situation is not better in Churches.  Some churches do not have programs that address the felt needs of the youth.  Many of their needs are spiritualized and given different meanings such as quoting the Bible as saying “ During the end times there shall come a radical generation full of evil” as such they claim the Bible prophesy is being fulfilled.

With early sex maturity and late marriage due to extended years in school, it is almost impossible to sit back and hope for the best.  As a result many interventions that target the youth have been started to help them to overcome challenges that affect them at this stage of their lives.

“Different approaches may be used to reach the youth but HIV/AIDS interventions geared towards the youth must realize that the youth are already entangled with multiple complex issues which are intertwined with matters of sex.  Drug abuse, low self esteem, poverty among others”, says Sylvia Obushuru a 24 year old youth who is the Youth Coordinator of Organization for Health, Education and Research Services (OHERS) based in three provinces of Kenya.

People who try to reach the youth must be extra tactful. “Youth do not like information that is forced onto them”. She adds.

Having worked with the youth for a couple of years, Sylvia feels that though they are more often portrayed as “problems” many young people are intelligent, energetic, talented and inquisitive. They want accurate information and answers to their questions. They also want respect, and their ideas to be taken seriously.

“Many talented youth are working to improve the lives of those infected and affected by HIV and AIDS”, says Kennedy Ochieng Awach, chairman of Candles in The Wind a Civil Society Organization based in Egerton University in Kenya.  Their organization    consists of 50 members of concerned students, staff and people from the surrounding community. Their objective is to educate their peers, provide information and support the infected students in their community. 

Candles In The Wind also provide capacity building to the members and distribute condoms mostly to students, and the surrounding community. Ochieng says his major fear is the careless way in which the young people engage in casual sex. “ We have allot of impromptu sex that take place in the campus that has a population of 6000 students and about 1500 staff in a given semester”.  They therefore also distribute condoms, which Ochieng says in a small way, can help the young people to preserve their lives as they further their education.    

Fortunately some churches have responded to the situation of HIV/AIDS in Kenya. Baptist Aids Response Agency (BARA) is an initiative of the Baptist Church in Kenya. They advocate for total abstinence with the understanding that True Love Waits. This is a program designed for the youths advocating for abstinence or in other words saving sex for marriage. 

Abstinence is a spiritual virtue that even though is not very popular among the young people especially in the Kenyan educational institutions has become the only sure effective way of avoiding Sexually Transmitted Infections including HIV/AIDS. Since BARA began three years ago, more than 140 church based True Love Waits Clubs have been established across Kenya.           

There are many other initiatives that have been formed. But as an old Jewish saying goes,  "If you save the life of one person, it is as if you were saving the world". There are lots of problems in our world, but if each person helps a little, even if its just by being responsible over oneself, then we can all make a big difference. It is not possible to change the whole world singly, but one person can make an impact in his or her community.