Lemon Tree Foundation - Health issues

Health Issues

HIV/AIDS

HIV Chart

Sign in Zambia Says it all.

Zambia has been hit hard by HIV and AIDS. The epidemic is fueled by

Migration

Urbanisation

Poor control of sexually transmitted infections

Collapse of the copper economy

Poverty

AIDS is blamed for decimating the cream of Zambian professionals, including engineers and political leaders. It kills around 100,000 people each year. More than a million Zambians are now living with HIV and an estimated 300 more people are infected daily. 40% of babies born to infected women are also infected. Pregnant women tested at Nampundwe Rural Health Clinic were found to be 50% HIV positive. Pregnant Women alongside their partners now receive voluntary counselling (VCT) at booking in Nampundwe Clinic. Drastic reductions of HIV prevalence have already been seen, with free condoms and increase of Anti-Retroviral medication all having an impact. However, it is clear that stigma, gender inequality and opposition to condoms remain deeply entrenched.

People with HIV face the following social problems:

Gender inequality (men have higher status within households; they control the money and are seen as more deserving of treatment)

breaches of confidentiality (people who fear stigma do not want to reveal that they are HIV positive).

Inadequate information about the drugs and how to manage a life on treatment language difficulties and illiteracy (infected people sometimes have trouble communicating with staff and completing documents).

Because those who receive treatment will live longer, the number of people living with HIV is likely to rise unless there is a significant fall in the number of new infections. Zambia will continue to face colossal challenges in the fields of HIV/AIDS prevention and care, and will suffer the epidemic's terrible impact for many years to come.

By educating the population, we can help eradicate the spread of HIV.

MALARIA

200-300 people affected worldwide each year
1 million die from infections

The World Health Organisation says:
“Malaria and HIV are two of the worst global health problems of our time. Together they cause more than 4 million deaths a year. Both are diseases of poverty, and both cause poverty. It is vital that diagnosis and treatment occur within 24 hours to prevent progress of symptoms that can cause death. HIV people must be considered as particularly vulnerable to malaria. Antenatal care must address both diseases and their interactions."

Malaria can not only cause death if untreated, but regular attacks leave a person weak and anaemic, unable to work properly and open to other problems.

Malaria Information given here.
30 Mosquito Nets given here.

What is Lemon Tree doing to combat Malaria?
At Lemon Tree Foundation, we see prevention as the most important key to eradicating malaria. This includes enhancing public awareness through sponsoring health education and the supply of impregnated mosquito nets, especially to the most vulnerable in the society. At each visit, we supply many nets to villagers and sponsor teaching of schoolchildren and adults alike that mosquitoes can breed in even the smallest puddle of water. The habit of leaving buckets or bowls of water around uncovered only increases the risk of mosquito proliferation. The use of certain essential oils can be a cheap and effective deterrent to mosquitoes.

We have now begun to sponsor the use of malaria testing kits to prevent the overuse of malaria medication and thereby preventing sensitisation of drugs and the build up anti-malarial resistance.

MALNUTRITION

Constantly we are told by villagers that all they can afford to eat are one or two meals a day of nshima- the maize meal porridge which is the staple diet in Zambia.

With anaemia at a rate of 40% and constant risk of worms and malaria, these people are in a recurrent state of malnutrition. Iron pills are not always available at the clinic. Lack of education, alongside poverty and poor resources have perhaps the largest parts to play in this equation.

What Lemon Tree Foundation intends to do is to help to extend the health education to all the poor of the area, to help to encourage local employment and to increase personal wealth.

We believe that teaching on nutrition is a priority in schools, clinics and the community.

POLLUTION

With ‘Green’ issues taking such a precedent in the Western world at the moment, the ‘Keep Zambia Clean’ campaign the Zambian government has promoted was a good opportunity to help people to look at ways to combat the immense problem of waste. It is evident that this problem is escalating not just around Nampundwe, but throughout the country as a whole. Piles of rotting rubbish around the streets and dirty plastic bags billowing about are everywhere.
At present, most households just make a pit in their back gardens to burn all this litter together, giving off noxious fumes from the burnt plastic and wasting the valuable vegetable debris.
Lemon Tree Foundation promotes the teaching on Green issues throughout the community-in schools, clinics and the villages.
As there is no refuse collection service, we look at ways to try and help to reduce the amount of plastic use, as well as composting available vegetable waste. Although we subscribe to the advice to separate the different kinds of rubbish, unfortunately, as there is no collection of plastic, glass, metal or paper or recycling, there is no option but to land fill - not a very healthy alternative!

HYGIENE

Home made village "tap" made from plastic bottle and sticks.

“Five Fingers” is the term given to the method of eating the staple diet of Nshima-a maize meal porridge eaten daily. Although people often rinse their hands at the table with water, they are not dried and no soap is used. Added to this is the fact that most of the toilets are open air latrines which have no washing facilities, the many animals that are around food as it prepared outside in the rural areas and lack of rudimentary hygiene education means that risk from diarrhoea and dehydration due to poor hygiene is high.

Babies and children are particularly at risk.

As villagers have to collect their water from a common borehole, it is important that this is protected from farm animals.

One of our "Most Urgent" priorities is to provide local boreholes for villagers to access clean water without having to walk long distances.

Toilet taps appeared in many rural locations due to a big push at "World Toilet Day" when visiting dignitaries held a special meeting to promote the building and use of toilet taps, and awareness of risks of infection by not washing hands. This simple yet effective contraption is sure to save many lives.

We support teaching on hygiene as a main concern, and the showing of the importance of Hand Hygiene to people in the villages along with the issue that there are easy ways to make washing facilities from a ‘tippy tap’ at their latrines.

By teaching their children from an early age, the risk of stomach bugs is decreased dramatically.

SANITATION

No sewerage system in the villages means that most households have an open air latrine.

Lemon Tree Foundation regularly support the teaching around the provision of healthy sanitation and promote the use of ‘VIP’ latrines (which have funnels to prevent contamination by flies) and the more eco-friendly use of ‘Thunderbox toilets’, which not only are more hygienic, but can be utilised to create compost.

We see it as a concern that the people living in rural areas are focused on to improve sanitation, and work in conjunction with the local environmental health officer and community health workers.

TUBERCULOSIS

Sub-Saharan Africa rate 350 cases per 100,000
1.6 million deaths resulted from Tuberculosis (TB) in 2005
Highest number of deaths and the highest mortality per capita are in Africa
The number of new cases arising each year is still increasing globally and in WHO regions of Africa (WHO 2007)
TB is on the increase because of the knock-on effects of HIV and poverty
When a person’s immune system is attacked and laid susceptible to opportunist infections, TB is often the one which takes advantage
With inadequate diet and poor housing, the risk of TB amplifies

What is Lemon Tree Foundation doing about Tuberculosis ?

We at Lemon Tree Foundation see it as part of our duty to support local Health Education Initiatives which inform and help prevent TB, and to refer patients for speedy treatment if the need arises.
As the old saying goes 'Prevention is better than a Cure'.

Educating the population not to spit or cough and sneeze with an uncovered mouth, is a zero cost method of helping to prevent Tuberculosis.

Whilst vaccines are issued to children when possible, health education is of paramount importance.

CHILDBIRTH

	60 million mothers in the developing world give birth at home every year without a skilled person to help More than three million babies are stillborn annually, and about four million die within one month, of disease or complications from childbirth Half of these die on the first day of their lives Africa has the highest maternal and infant mortality rate on the planet (State of the World's Mothers 2006) (WHO 2007) The Infant mortality rate is 109 per 1,000 births in Zambia(UK rate is 5 per 1,000)
Sadly, there is a high risk of sexually transmitted Infections and unwanted pregnancies around Nampundwe. Although we support the teaching on abstinence, the fact that most teenagers start having sex aged 12, means that contraceptive advice is really necessary, and donations of condoms go like hot cakes! Obviously, there are concerns over the encouragement of underage sex with distribution of condoms, but we know that education is the key here again, to promote a shift in social attitude towards sex. There are 448 expected deliveries in Nampundwe a year. Much time is taken up by screening and counselling the women for HIV. Anaemia is rife at 40% prevalence and often no iron to treat it. Twins and breech are regularly delivered at the clinic as the women cannot make it to Lusaka in time to deliver. All the women lie on their backs, reluctant to mobilise as we advise them in the UK. Women bring a ‘chitenge’ (cloth used as a wrap around skirt-cum-baby sling) to lie on as there are no sheets on the beds. Because of the risk of water being cut off, there are big containers of water around the one delivery room and a one bar electric fire to warm cold babies. Women after delivery walk back home with their babies after an hour or two’s rest, sometimes for miles.
	All the staff in the local clinics are very conscious of the risk of blood contamination, and amongst the list of equipment that the women are told to bring in with them in labour are a bottle of bleach, a cord clamp, a pair of clinical gloves, a roll of toilet paper, a plastic sheet and a razor blade to cut the cord. There is no analgesia to use for the women in labour. What should be a happy and joyful occasion is overshadowed by the lack of equipment, staff and transport.
The traditional birth attendants look after most of the women in the community and have very little equipment, sometimes having no gloves or even light to conduct a delivery. One TBA had to drag a woman out of her hut and conduct a delivery in the moonlight as it was the only source of light! Hence we have donated them all hurricane lamps and wind-up torches. Lemon Tree Foundation have also donated blood pressure monitors, delivery equipment, gowns, gloves, baby scales and unused clean surplus from British hospitals. We have also assisted with the donation of iron pills. We support and sponsor talks on hygiene, contraception, child care, immunisations, HIV/AIDS, infections, pregnancy, birth and the post natal period to women, nurses, midwives, community health workers and traditional birth attendants. These sessions are always very well received with the colourful charts and childbirth graphics we have been donated.

EDUCATION

Although education for children is compulsory and highly prized by Zambians, most of the older rural population are illiterate. It becomes very difficult for children to attend school if the family is struck with illness, especially given the prevalence of HIV/AIDS. Many children are forced into the care of their parents and siblings.

With state schools having up to 85 children in a class, however well meaning the teachers are, the education has to suffer. We support regular visits to schools in the community where they receive health education on a variety of subjects, and we see it as a priority in our work.
We also support the teaching of health education in village settings to anyone who will listen! We found it disturbing to realise that many of the children at one High School are boarders with no-one to oversee where they sleep or what they got up to at night- resulting in the obvious behaviour! We also find a conflict of information given to people, and some mistaken ideas regarding HIV and condom use. Although we give for distribution free condoms (which are very popular!), we know that education is vital to promote a shift in social attitude towards sex.

POVERTY

More than 70 percent of Zambians live in poverty, and unemployment is a serious problem. Millions of Zambians live below the World Bank poverty threshold of $1 a day. In a country that depends so heavily on agriculture, the loss of so many bread-winners through HIV and other health problems is having a catastrophic effect on the farming sector and on society in general.

Some of the roads in Zambia are just impassable, especially in the rainy season. This makes it doubly difficult for subsistence farmers to get their wares to market even if they have transport. In 2006 Zambian farmers lost out on subsidised agricultural inputs when tough World Bank and International Monetary Fund conditions were imposed. Farmers are being urged to diversify and end their over-dependence on maize. HIV/AIDS, malaria, and tuberculosis are themselves major causes of poverty. (WHO 2000).

Our intentions in Lemon Tree Foundation are to support locals to grow grow foods such as soya beans and sunflowers, so that they can promote the growth of plants for essential oil production such as lavender, tea tree, thyme, geranium, lemon and eucalyptus.
Not only will these crops bring useful revenue into the area, but they will increase employment and create wealth in the region.
The essential oils could even be sold in lucrative perfumery markets abroad.

In time, we intend to invest in bringing an essential oil distillery and bottling plant to the vicinity, creating jobs and therefore prosperity locally.

Our vision to support the local provision of free health care and education, along with aromatherapy through community health personnel, will have a great impact in increasing the people’s physical condition to improve the prospect of helping people out of the poverty trap.

The relationship with education being supported by the Lemon Tree Foundation and the ability of local people being skilled enough to improve their lives will be felt for generations to come.