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ON LIVING WITH A BLOOD DISEASE

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Bubbly James Nkomo still exudes oodles of a positive spirit and is not deterred by a genetic blood condition that predisposes him to frequent bleeding. He has since found a way to live life fully with haemophilia, a condition he was diagnosed with when he was only one year old.

Born in Maitengwe, Nkomo remembers outgrowing his mother’s and grandmother’s laps to explore the exciting world around him. “Crawling was painful; my knee joints ached endlessly and navigating outside was worse. I always had bruises that bled longer than usual and also took longer to heal,” says Nkomo. The swellings were worse and would take ages to heal; little Nkomo was discouraged from playing with his peers. Not long after, further medical investigations led to a diagnosis of haemophilia.

His mother and grandmother were told by the doctor to ensure that he did not engage in play that predisposed him to injuries, since the ability of his blood to clot was severely reduced, causing him to bleed severely even from slight injury. However, these medical warnings only made a growing Nkomo less popular among his friends. “Playing the ‘soft’ games was not fun at all. I was always isolated because if I got injured, my grandmother would reprimand my friends,” he says, recalling that this only led him to rebel against his family.

“I wandered beyond our homestead and got involved in the dangerous games to prove that I was a worthy playmate. However, I would go home with swollen ankles and lots of bruises that gave way to painful nights,” he says.And the play got dangerous. When Nkomo was eight years old, together with adrenaline-filled peers, they would hang on the back of a pick-up to quell their desire for adventure.

“As we were enjoying our free ride, the driver noticed us and took emergency breaks to discourage us. I hit my chin against one of the metallic guards of the vehicle, leading to uncontrolled bleeding of my gums,” he says. His friends deserted him and when he got home, he paid the price for defying authority. “I could not be treated at the local clinic and was referred to the Princess Marina Hospital where I got a series of stitches and was admitted for one month to ensure the wounds were well-healed,” says Nkomo.

He had to learn to take up more favourable pastimes like swimming that gave him even more gratification than an aggressive game of football. “Haemophilia is a painful disease yet learning how to cope provides an almost normal lifestyle,” says Nkomo, a human resource practitioner. At 34 years of age, married and father to six-year-old Tiffany, Nkomo has also taken up the role of being mentor and big brother to his male cousin who also has the same genetic condition.

Nkomo cites the need to create nationwide awareness on the condition in order to improve the quality of life for individuals living with it and for families unaware of how to cope with it.
“Once you know what you are dealing with, a normal life is possible,” he says. Haemophilia is a rare disorder in which the blood clot does not clot normally because it lacks sufficient blood clotting proteins.

A patient with haemophilia may bleed for a longer time after an injury than he/she would, if the blood clotted normally. This internal bleeding can damage organs and tissues, and may be life-threatening. Some symptoms of haemophilia include, excessive bleeding from cuts or injuries or after surgery or dental work, prolonged menses in women, many large and deep bruises.

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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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