Wame Gori, a youth officer at the Botswana Family Welfare Association (BOFWA) talks to SunHealth about helping young people aged between 10-24 years with a whole range of issues from behavioural difficulties to teenage pregnancy.
What does your work at BOFWA entail?
Capacitating young people in Youth Centred Approach model
Empowering young people on leadership and governance skills in the SRHR field
Assisting young people to plan and implement annual youth plans in accordance with Organisational Strategy.
Discuss the overall services BOFWA provides?
The services at BOFWA are categorised into three strategic pillars which are;
Advocacy Services: The organisation has projects that advocate for the key populations, which are men having sex with men (MSM) and Female sex workers. The advocacy wing also looks into the lives of adolescents and young peoples including underserved and marginalised populations.
Education Services: BOFWA provides Comprehensive Sexuality Education to adolescents and young people who are out of school and also equip them with life skills and workplace wellness
Clinical service provision: The clinical services that are provided are done in three service points being static (BOFWA clinics), outreach (reaching out to the community) and drop in centres (safe spaces).
The services provided are;
HIV Testing Services
ARV services – Provision of ARV drugs to the HIV positive clients and continues monitoring their CD4 counts and viral loads and other general tests. Both the positive and negative clients are then linked to care either to nurses or to doctors.
Sexually Transmitted Infections (STI) screening and treatment- BOFWA provides screening and treatment of most of the STIs
Screening of cancers of the reproductive health – Pap smear, VIA, and cancer of the prostate gland
Family Planning Services: Long Acting Reversible Contraceptives (LARCs) and Short Acting Reversible Contraceptives (SARCs) which are Implants, IUCD, injectable, pills, condoms
Psychosocial support: BOFWA provides psychosocial support to its targeted population in all areas of life not only SRHR and relationships.
What is your normal day at work like?
Working with young people is interesting, mainly because there is nothing for them without them, every decision making and any plan or activity that I may think of, I have to request for their input. Again there is competition with other NGOs , thus there is need to focus and produce competing initiatives and have a calendar of events at the top of your head for better response with country youth programmes.
What would you change about your profession, given a chance?
I recently went on a big change in my profession. I was a regular IT person, but now, the combination of technology and young people is amazing. I had shifted from only focusing in hardware/software, networking, databases and web development to making technology add value to BOFWA. Aligning it to their strategy, all they need is to reach more young people with ASRH information by any means and technology is the way
What are some of the challenges you have had to tackle in life/in your job?
Working for an NGO on its own is a challenge; you multitask, as I had to transition from the world of IT to that of youth empowerment and have time for them both, the only thing is not to concentrate on the difficulty of the work, instead on its results and rewards, else you will be discouraged. By entering the NGO life you don’t ask yourself what the organisation can do or has for you, but what you can do or have for the organisation.
What do you love about your work?
It’s not about profession, but patience and passion and determination. Growth and love for reading and research will automatically expand. Putting yourself into the lives of young people becomes involuntary. Love for people, caring for them, guiding them and being more concerned about making them feel good about themselves than making them feel good about you; and acceptance of every human being regardless of their sexual orientation is what I like about my work.
What’s you take on unsafe abortion in Botswana? How prevalent is the problem and what can be done to fix it?
I am aware that Unsafe Abortion contributes 15% of the total maternal deaths in Botswana, and I acknowledge that unsafe abortion requires intense programming to reduce the incidence of abortion-related deaths.
Sexual and reproductive health including HIV is a key adolescent health area. What are your thoughts and your experiences as you work with young people?
Working with young people has proven to me that they lack knowledge in various key SRHR areas. For example HIV knowledge levels in adolescents is 48.3% and this can only be managed by using the Youth Centred Approach in SRHR Programming
Empowering those young people helps develop their negotiation skills and decision making. They will start to open up and start sharing SRHR issues on their social media to inform their peers.
How do you think we can effectively prevent a vast majority of adolescent pregnancies and HIV infections?
Upscale uptake of Comprehensive Sexuality Education (CSE) for adolescents and young people, this will increase access to contraceptives. BOFWA is one of the NGOs that have service providers that are forever youthful at heart, who are trained in Comprehensive sexuality education, attitude transformation and values clarifications; and who can communicate well with adolescents to lay the foundation for them and to make them feel free and accepted the way they are. If young people are made free by communicating and educating them on CSE issues, and if their parents can accept the reality that their adolescents need that communicator who will educate them from a different angle, not the classroom setting- then I see a decline in pregnancies and new infections.
What are your thoughts on PrEP being made available for young people to prevent HIV transmission?
Prep requires intensive knowledge building in adolescents and young people to prevent myths and misconceptions that will lead to a rapid growth in new HIV incidences
‘Cancer took away my boobs, not my life’
Sun Health: What events led up to your diagnosis, or, how did you discover that you were suffering from cancer?
Mpho Kgaodi:My journey with Breast cancer started in 2012. Around April I felt a lump on my right breast. It was not painful at all, just slightly itchy. It was on the upper part of my breast. I ignored it for about three days but it kept nagging me and then I decided to go see my doctor. He also confirmed that there was a lump on my breast He sent me for mammogram that confirmed an abnormality on the structure of my right breast. I then went to see him with the results and he informed me that there are two ways to test that lump – Biopsy, which meant that he will be taking a piece of that lump to send it to the laboratory for examination and the other option was to totally remove the lump, Lumpectomy. I decided that he removes the whole lump, because I really didn’t want that Lump on my breast.
SH: We know that about 10% of all breast cancers are hereditary. Are there other women affected in your family?
MK: I don’t know of any other woman or even man in my family who has had cancer, though it is hereditary.
SH: What were your first thoughts when you received the diagnosis?
MK: I cried for a brief moment. I was overwhelmed with emotions, fear of death. I quickly recovered from that dreadful thought and remembered that I have a great husband and three boys. I felt that I had so much to live for.The doctor informed me about the options I had regarding treatment and he gave me time to think about it. I drove back home to Lobatse and by the time I arrived at my house, I had already made up my mind that I am going for total removal of the breast. I broke the news to my family and they were just as shocked as I was when the doctor broke the news to me. I explained to them my decision to go for surgery and they were very supportive. Few weeks later, I went for a mystectomy.
SH: How long were you in treatment
MK: The surgery was followed by Chemotherapy. The first time I walked into the oncology centre, I found so many people there already. I then realised that I am not the only person with cancer, it is so many of us. It gave me strength and courage. I had heard that the side effects of chemo are brutal, seeing those people made me realise that if others can do it so can I. I decided to go for it as I had so much will and spirit to stay alive and raise my kids. After the second session of chemo, I started losing my hair, nail beds turned black. I was never discouraged though, despite my aching body and the constant nausea after chemo. I had six cycles of it. In 2013 around April again, I experienced severe pain on my left breast, but with no Lump. My doctor again recommended I go for a mammogram. It confirmed cancer which was still at stage 1. I then insisted that they remove the breast. I would lose both my breasts but I knew staying alive for my boys was more important. Other people thought the pain was psychological, and I knew what I felt and my mind was made up. I had the second mastectomy and had to go through another cycle of chemo which I completed. I am now on oral medication. I take my tablet daily. It is recommended that I take it for ten years. I have just started on my year 6 on the tablet. I do go for regular check ups, to establish if the cancer is not back.
SH: What helped keep your spirits up and gave you support during this period?
MK: A good friend of mine and colleague told me about Journey of Hope Botswana. He introduced me to them, and I had tremendous support from them. I also went to Cancer Association Botswana to introduce myself. My family has also been my backbone, supporting me through it all. I am so greatful. On days that my spirits are low, I always take my mind to positive thoughts. I try to remind myself of the good times, sometimes I even find myself laughing out loud.
SH: How has this affected you at a psychological level?
MK: My life has not really changed for the worst. Like the saying “when life gives you lemons, make lemon aid out of them”. I lost my job after the second diagnosis of cancer. While this affected my family financially I never got discouraged, as this gave me time to take care of my family. I am a full time stay home mom. I walk this journey with my family. My boys understand that I had Cancer but now I am okay. They sometimes check if I have taken my medication, and they would even ask about my next appointment. I am blessed to have them.
SH: Facing the diagnosis of breast cancer is one of the most feared experiences in our society. What has been your experience as you worked with communities through Cancer Association of Botswana (CAB)?
MK: Working with CAB has been eye opening. Through motivational talks and other actives like the annual stiletto walk, the message has been positively received. There is still a lot to be done though, especially to make people understand that breast cancer is NOT a death sentence. So many lives can be saved.
SH: Amongst raising awareness, cancer awareness month is about celebrating individuals like yourself and their triumphs over cancer. Is there anything you would like to say to the community of cancer survivors and women in general?
MK: I have learnt so much from being diagnosed with cancer. I appreciate life more. I never used go and see a doctor without any pains or any thing “wrong” with my body. Now I do it regularly and so far I always get a clean bill of health. I encourage everybody to do regular self -breast examination. It is easy, convenient, cost-effective and can really help with early detection. I believe there is a lot to be done as far as breast cancer awareness. Remember men can also have breast cancer.
To all those who are going through cancer at the moment, remember you are not alone. Let’s walk this journey together. Let’s walk with Hope, Courage and Strength. There is life after cancer. Cancer took away my boobs it did not take my life. As October is breast cancer awareness, let’s support those affected, honour the survivors and remember the fallen.
PINK RIBBON ALWAYS
Caroline Gartland speaks on Children and Mental Health
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!