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Plans underway to eliminate Malaria in 6 endemic districts

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Health Minister Dr Alfred Madigele has urged Batswana to make proper use of available malaria interventions to reduce the rate of infections and death by Malaria.

Addressing the nation on radio during the World Malaria Day themed; ‘Zero Malaria Starts with Me’ Dr Madigele said malaria was still a disease of significant public health importance in Botswana, with high morbidity and infection rates, and that although deaths, due to the disease have reduced considerably, there was still a long way to go.

The theme, he said seeks to empower individuals across the world to make a personal commitment to saving million more lives, and help communities and economies to thrive by ending malaria.
“This global movement seeks to re-energise the fight to eliminate the disease, which still threatens half of the global population and kills one child every two minutes”.

The African region is the worst hit by the killer disease in the world. In the World Malaria Report 2018, WHO estimates that we still have more than 4.4 million cases in the region and sub-Saharan Africa accounted for 93% (404,550) of the global malaria deaths.

Botswana has made incredible progress towards malaria elimination in the last decade, but Dr Madigele said sustaining gains will take extra effort until the job is finished and malaria has been eliminated.

“We have managed to reduce the incidence of malaria from 28.7/1000 population in 2001 to 0.24/1000 population by 2018. While efforts are on course to conduct active and passive case detection, notify, investigate, list and map all cases and deaths, resource limitation becomes a big challenge in the area of malaria surveillance and rapid response to contain secondary cases and outbreaks.
Nevertheless, we have also managed to introduce modern technology for rapid notification of cases and mapping of malaria transmission areas,” he shared.

He indicated that available interventions had proven to work and urged the public to support the National Malaria Elimination Programme (NMEP)’s strategies of using the Long-Lasting Insecticide Treated Nets (LLINs), Indoor Residual Spraying, and Intermittent Preventive Treatment of pregnant women (IPTp) to prevent being infected.

Others, he said, include vector control intervention designed to destroy the mosquito larvae conducted in three districts of Tutume, Bobirwa and Boteti. The country has also introduced a radical anti-malaria therapy for effective treatment of malaria.

To address the challenge of low community response, participation, ownership and ultimately low uptake of malaria elimination interventions, Dr Madigele said the NMEP with the support from the Global Fund adopted the Communities Acting Together to Eliminate Malaria (CATTEM) in 2018.

“This is an approach that seeks to involve community leadership and other community structures to drive malaria elimination in their communities; resonating well with this year’s theme that drives for personalisation of malaria elimination by all,” he said. The approach is being implemented in the 6 endemic Districts with plans to expand to the whole country.

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Sun Health

Don’t use garlic for yeast infections

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Public Health Specialist, Dr Orapeleng Phuswane-Katse has warned women against using garlic for yeast infections, citing risk for further infections.She explained that while there are a few studies to support the claim that garlic has anti-fungal properties, it is never safe to put anything that is not regulated in the vaginal area.

On Monday, a woman took to social media to seek a remedy describing her symptoms as itchiness and a white discharge from her private area. Out of the 375 comments that she got, almost half advised her to insert garlic into her genital area. The comments indicated that the symptoms would disappear within three days.

“I remember I had the same problem back in 2017, I could not stand the itchiness, a friend of mine advised me to insert garlic, and within two days it was gone,” wrote one commentator. Another one wrote: “Take a clove of fresh garlic and peel off the natural white shell that covers it, leaving the clove intact. At bedtime, put the clove in the private area. “In the morning, remove the garlic clove and throw it in the toilet. I did this one time, if the itchiness goes on, continue for one or two days until all the itchiness is gone.”

However, Dr Phuswane-Katse advised that the only alternative is to see a doctor when one has the symptoms.“The vagina is a fragile moist area that has bacteria that regulates the PH in there. Any foreign objects can cause laceration and even introduce unwanted bacteria that can cause more harm than good”. Furthermore, she added, “There is no regulated size of the garlic to insert and this may pose danger.

Questions like, ‘how many hours do you remove it, in what state should you insert it, crushed or whole’? Since its not regulated medicine, there can be no clear answer”. Dr Tebogo Oleseng, a gynaecologist and obstetrician said women need to be more careful, saying that the birth canal is the ‘perfect’ environment for the botulism bacteria to grow, which can be life-threatening.
Botulism, a condition caused by Clostridium botulinum bacteria, can be offset when someone eats food containing toxins because it has not been properly canned, preserved or cooked.

He advised women not to take medical advice from anyone recommending vaginal garlic for yeast or anything else because there are antifungal drugs specifically for yeast infection. He explained that garlic contains allicin, which in the lab has shown to have antifungal properties. “Bacteria from the soil can be pathogenic for the body. That is why we clean wounds. If you actually happen to have an inflamed yeasty vagina, soil bacteria would be more likely to infect it,” he said.

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Know Your Specialist

Caroline Gartland speaks on Children and Mental Health

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Tell us about yourself and your background
I’m originally from the UK but have been in Botswana for eight years so this is now home! I have a Combined Honours degree in Psychology an MSc in Mental Health and have had a pretty varied career.
I started off working with offenders doing rehabilitation programmes; went on to support the victims of domestic violence then ended up working in Child and Adolescent Mental Health Services for the National Health Service.
I’ve done a lot of work, mainly voluntary, in different fields since being in Botswana but my passion is now Early Childhood Mental Health.

What does your work entail?
Early childhood mental health is mainly working with parents, caregivers and teachers to help them understand how children develop and the best ways to support their mental health and brain development as they grow. It’s about providing training and opportunities for families to bond with their children and introducing new ways of playing and interacting.

What sparked your interest in early childhood mental health?
Quite simply, having my own children! My daughter was born five years ago and I was fascinated watching her develop and grow. It occurred to me that the younger you begin to consider mental health and provide tools for resilience against life’s adversities, the better outcomes you are likely to have.
I began reading everything I could get my hands on, and completed a diploma in Infant Mental Health. I’ve worked down the lifespan but I feel I’m now where I belong, working with babies and young children.

What mental health issues have you observed in children in Botswana?
Mental Health is still stigmatised around the world and Botswana is no exception. Most people immediately think of mental illness, but mental health is about so much more; we all have mental health and some days we are fine and able to deal with life’s challenges and some days we need more support and tools under our belt to help us cope.

Young children can experience mental health problems. Anxiety is a common one, but we are more likely to focus on the behaviour we see rather than how the child is feeling. An anxious child who refuses to go to school may be labelled as ‘difficult’ or ‘naughty’ but what they are expressing is a painful emotion that they need help dealing with.

Describe one thing you find fulfilling and challenging about working in this industry.
Working with children and families is a pleasure and a privilege. To make life a little bit easier for someone is all that matters, you don’t have to be out there saving the world to make a difference.
My major challenge is time. I would love to do more, I’d love to do an MSc in play therapy and a couple of other therapeutic techniques I’ve come across in Europe but that gets put on hold as I focus on my own family and business.

Can you share an anecdote about how mental health consultation works?
I think that education, understanding and connection are the three keys to giving a child the best start in life. Led by that, SensoBaby provides classes in the community for parents and caregivers to connect with their infants.

We offer workshops on parenting and play to foster understanding of child development and wellbeing and we are available to troubleshoot specific problems an individual or agency has with the young children in their care or the systems they have in place. When it comes to individual parents, mostly what they need is to feel heard, supported and guided in their parenting choices.
You can read all the baby books in the world but they won’t give you the answers you need for your child, through responsive parenting and connection, you’ll find you have the solutions you need.

What advice do you have for child-care providers or early childhood teachers who are at their wits’ end over a child’s challenging behaviour but don’t have access to a consultant?
Empathy is an important and undervalued skill – the ability to consider another’s viewpoint. What is that child feeling? Their behaviour might be challenging and hard to deal with but often the root cause is an unmet need. There’s a famous quote from an American Clinical Psychologist, “The children who need love the most, will ask for it in the most unloving ways.”

Does a mother’s mental health affect her foetus? How important would you say is paying attention to women’s well being during pregnancy as with their physical well being?
100% yes. It is so important to support a woman’s wellbeing during pregnancy. As an example, if the mother experiences significant stress and rising levels of cortisol (the stress hormone) during pregnancy, the foetus will be affected and in some cases will be more sensitive to stress in childhood or later in life.

Pregnant women and new families (Dads as well!) deserve nurturing care themselves and shouldn’t be afraid to ask for support. SensoBaby run FREE monthly coffee mornings to support pregnant and new mothers because we understand the importance of maternal wellbeing.

Do smart phones and television make our children mentally ill as is often purported?
I don’t think technology is always the villain it’s made out to be. The key is in the relationship with that technology. Moderate use of TV’s and smart phones are fine, as long as they aren’t a substitute for outdoor play, imaginative play and meaningful interactions. If a child is crying or upset and we hand them a device to keep them quiet then we have missed an important opportunity for connection, helping them process what is going on and supporting them to calm down and settle themselves.

Now, I know you are involved in an exciting programme that helps caregivers and children to bond and get the children off to the best start in life through play. Can you say a little bit about that work and just how you are seeing it play out?
SensoBaby is our baby; a project born from passion and a desire to support families in Botswana. We offer play-based classes for children and their caregivers that are underpinned by the principles of child wellness as well as early foundations for learning.

When you provide developmentally appropriate opportunities to play, you learn so much about your child. That understanding and observation builds strong connections, which will form the basis of that child’s future relationships and self esteem. Play is so much more than ‘a fun activity.’

We offer a number of trainings and workshops for parents, nannies and community stakeholders and hope to increase our offerings this year. Our community partnerships and voluntary programmes have been successful so far and we hope to see more impact in 2018.

We currently serve the Gaborone community but would like to expand throughout Botswana as opportunities arise. The response to SensoBaby has been fantastic so far and we can’t wait to see how far we can go with the concept!

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