Category Archives: Health and Sanitation

Quit that smoking environment or your unborn baby dies

Smoking while pregnant








By Chioma Obinna

When Ngozi Ugonna’s blood laboratory test result revealed she was  pregnant, her joy knew no bounds. The smile on her face as the news was broken to her after three years of childlessness was infections. No one in her family needed a soothsayer to know that something extraordinary has happened in her life.

Her husband, Eddie, was equally elated.  Over and over again,he went through the lab result. He was happy that, at last, his yearning for a baby was being realised.  As weeks rolled by, the hope of the couple grew.

But, unexpectedly, Ugonna’s excitement was cut short. At precisely 20 weeks gestation, she lost the pregnancy. Findings showed that a major contributor to the loss was her smoking habits. Even before marriage, Ugonna had been  a heavy smoker.

She had had been smoking since her first year in the university. Efforts by her husband to make her drop the habit failed as she claimed she couldn’t do without  at least a stick of cigarette every day.

But little did she know that cigarettes contain dangerous chemicals, including nicotine, carbon monoxide, and tar that can significantly increase the risk of pregnancy complications, some of which can be fatal for the mother and the baby.   Simply put, cigarettes and pregnancy don’t mix.

Ugonna’s woes began  one morning when she could not feel the usual movement of the foetus (baby). This prompted her visit to her doctor. The doctor listened to the baby’s heartbeat using a handheld ultrasound device called a doppler.   Sadly, there was no heartbeat. Ugonna was heartbroken.

The doctor recommended an ultrasound scan immediately.   Sadly, it was discovered that the baby had died. Ugonna had a stillbirth. Available statistics showed that about 1 in 160 pregnancies end in stillbirth.

According to the United States Centres for Disease Control and Prevention, CDC, smoking raises the likelihood of both early miscarriage and stillbirth. The dangerous chemicals in cigarettes are often to blame and such was the fate of Ugonna’s  pregnancy.

Thousands of women are faced with the same challenge including women whose husbands are smokers or those who live in a smoking environment. Findings showed  that second-hand smoke is dangerous to the foetus. Grace Egbe, 32, whose husband’s addiction to smoking almost destroyed her life and that of her unborn child, is a classic example.

Grace, a mother of two, almost lost her life while she was pregnant for her third child, no thanks to “second-hand smoke”, also called environmental tobacco smoke.   Second-hand smoke is the combination of smoke from the burning end of a cigarette and the smoke breathed out by smokers. Second-hand smoke contains more than 7,000 chemicals. Hundreds are toxic and about 70 can cause cancer.

Harm from ‘show of love’

Just like most pregnant women, Grace had no inclination of the negative implications of the smoke she usually inhaled while her husband smoked until she had a preterm birth.

No doubt, every couple enjoys the company of one another. Grace’s case was no different. She was always at the beck and call of the husband as they usually sat together while her husband smoked.  Out of ignorance, Grace was enjoying his company even in pregnancy.   But little did she know that what she termed as ‘show of love’ could harm her and her unborn child.

Five months into her pregnancy, she was diagnosed of placenta previa. Smoking has been identified as a risk factor for placenta previa.   Placenta previa is when the placenta stays in the lower part of the uterus, partially or fully covering the cervix. When this happens, the placenta often tears, causing excessive bleeding and depriving the foetus of vital nutrients and oxygen.

In ideal situation, during pregnancy, the placenta normally grows in the uterus towards the top of the womb and this leaves the cervix open for delivery.   Unfortunately, Grace’s case was different.

Upon discovery, her doctors placed her on bed rest to see if the placenta will revert. While still battling with the problem, she developed placenta abruption, a condition in which the placenta separates from the uterus before childbirth.

At this point, Grace had severe bleeding and her life and that of her baby were threatened.   The doctors handling her case became worried.   Further medical investigations were conducted on her.   In the course of taking her history, it was discovered that Grace was a second-hand smoker.   While responding to questions posed by her doctors, Grace confirmed that his husband smoked in the house frequently.   Although, Grace was puzzled as to why that should be a factor in her case, the doctors made her to understand that although she was not a smoker, inhaling smoke from a smoker or staying in a smoking environment made her a second-hand smoker and it was dangerous to her and the baby.

Efforts to save her pregnancy proved abortive since there is no surgery or treatment to reattach the placenta.   With the development, the baby was no longer getting enough nutrients and oxygen to stay alive in the uterous because studies have shown that placenta is the lifeline structure that forms during pregnancy to provide the foetus with nutrients and oxygen.

Although, immediate medical attention may have helped increase the chance of Grace having a healthy birth despite placenta abruption, she was not lucky. She had preterm birth.

Her baby was born premature at seven months with low birth weight. As if that was not enough trouble for the family, her baby also had congenital heart defects.   Today, their baby is one of many children born with various birth defects due to ignorance about the dangers of cigarettes smoking.

Infant deaths

Smoking during pregnancy results in more than 1,000 infant deaths annually.   Second-hand smoke in adults can lead to coronary heart disease, stroke and lung cancer.

Today, 10 percent of women report that they smoked during the last three months of pregnancy despite available evidence which showed that smoking during pregnancy raises the risk of babies being born with birth defects such as cleft lip and cleft palate as well as Attention  Deficit Hyperactivity Disorder  (ADHD),  one of the most common neuro-behavioral disorders of childhood.  About  one baby in 10 has the disorder.

It has been established that second-hand smoke causes numerous health problems in infants and children, including more frequent and severe asthma attacks, respiratory infections, ear infections, and Sudden Infant Death Syndrome (SIDS).

According to a  consultant cardiologist and Head, Paediatric Cardiology Unit, Lagos University Teaching Hospital, LUTH, Professor Christy Okoroma, studies have shown that 35 percent of pregnant smokers risk baby heart defect.

Okoroma explained that congenital heart disease is a major birth defect and the most dangerous because it can kill a child. “For every 1,000 live births, you have 8 to 10 children with congenital defects. The commonest is specifically the one known as hole-in-the-heart. The burden is huge if for every 1000 live births between 8 and 10 are affected, it is a major problem,”the consultant cardiologist said.

“Unfortunately, the heart begins to form early in pregnancy, sometimes even before the mother knows that she is pregnant.   You can imagine while the heart is forming and the mother is already consuming alcohol with herbs and other concoctions or inhaling cigarette smoke?”

Lagos State Commissioner for Health, DrJide Idris, during an activity to mark “World No Tobacco Day,” said women comprise 20 percent of the world’s one billion smokers and, in pregnancy, smokers are at higher risk of miscarriages, complications of pregnancy including bleeding during pregnancy, detachments of the placenta, premature birth and etopic pregnancy. “Low birth weight babies, congenital defects and still births are also common occurrences, “he added.

A  renowned cardiologist and President, Nigeria Heart Foundation, NHF, Dr. Kingsley Akinroye, also explained that   scientific evidence is available that nicotine, contained in cigarette smoke, is a health danger for pregnant woman and ‘developing’ babies in the womb and can damage the babies developing blood vessels, brain and lungs.

“Smoking can negatively affect the development of the placenta, because it could reduce the blood flow to the foetus from the mother; with less delivery of oxygen and nutrient to the foetus. Therefore, the foetus will not be able to grow fully, and develop. Such babies may also develop thickening of the blood vessels (arteries) in adult age with concomitant development of cardiovascular disease,” he stated.

To Akinroye, there are many risks from smoking before and during pregnancy, so it is important that women do not smoke before during and after their reproductive years.

According to the journal PLoS One, nicotine in cigarettes can cause contractions in the fallopian tubes. These contractions can prevent an embryo from passing through. One possible result of this is an ectopic pregnancy. This happens when a fertilized egg implants outside of the uterus, either in the fallopian tube or in the abdomen. In this situation, the embryo must be removed to avoid life-threatening complications to the mother.

Health watchers say for people who are concerned about smoking in pregnancy, the hard truth is that although quitting smoking can be hard, it is one of the best ways a woman can protect herself and her baby’s health.

What you should know about smoking in pregnancy

*Smoking makes it harder for a woman to get pregnant.

Women who smoke during pregnancy are more likely than other women to have a miscarriage.

*Smoking can cause problems with the placenta—the source of the baby’s food and oxygen during pregnancy. For example, the placenta can separate from the womb too early, causing bleeding, which is dangerous to the mother and baby.

*Smoking during pregnancy can cause a baby to be born too early or to have low birth weight.

* Smoking during and after pregnancy is a risk factor for SIDS.

*Babies born to women who smoke are more likely to have certain birth defects, like cleft lip or cleft palate.

Article Disclaimer: This article was published by Vanguard and was retrieved on 01/08/2017 and posted at INDESEEM for information and educational purposes only. The views, ideas, materials, and content of the article remains those of the author. Please cite the original source accordingly.


Sanitation is Namibia’s neglected stepchild

Source: Southern Times
Source: Southern Times

Written by:   Lahja Nashuuta. March 10, 2016

Windhoek, Namibia – Every year on November 19, the global community observes the World Toilet Day, an event designated by the United Nations (UN) to raise awareness about the people in the world who don’t have access to proper toilets, despite the fact that it is a human right to have clean water and sanitation.

According to UN Water, an agency that coordinates the UN’s work on freshwater and sanitation, the World Toilet Day is about the 2.4 billion people who lack access to improved sanitation. It is about the nearly 1 billion people who have to defecate in the open.

The UN says the state of sanitation remains a powerful indicator of the state of human development in any community. It said that improved sanitation also brings advantages for public health, livelihoods and dignity-advantages that extend beyond households to entire communities.

In his statement to observe last year’s World Toilet Day, UN Secretary General Ban Ki Moon noted that sanitation is central to human and environmental health as well as to individual opportunity, development and dignity.  But he registered his disappointment that to date, one in every three people lacks improved sanitation, and one in every eight practices open defecation, worldwide.

The Millennium Development Goal (MDGs) 7, target 3, outlined the global ambition to the proportion of people without access to clean drinking water and basic sanitation by 2015.

But up to the end of last year, there has been no tangible progress by the global community, especially in developing countries like in Africa to provide proper sanitations facilities, which the UN has warned is having negative effects on people’s health, safety, and dignity.

A 2014 progress report by the WaterAid has revealed that majority of governments in Southern African region, like the rest of the continent have failed to deliver on their promises on water and sanitation.

This left over 40 million people in the region without access to safe drinking water and 73 million without sanitation. Botswana and Angola have been rounded for their efforts to half the number of people without access to clean drinking water and sanitation during the implementations of the MDGs.

Justine Eilonga, a resident of Havana informal settlement in Windhoek is one of thousands of Namibians who were let down by their own government, which failed to provide them with basic sanitation facilities.

Although Namibia has met the target for water provision with over 87 percent of the households in the country have access to improved water supply, the target for sanitation was missed dismally.

While most of their country men and women are line-up in banks or in the shops to pay for their goods and services, Eilonga and other residents of Havana in the periphery of Namibia’s main city, Windhoek are queueing up and impatiently waiting for their turns to make use of a single toilet that serves close to a thousand people, irrespective of gender and age.

“We are sharing this one toilet with many people,” she said while pointing to a solitary toilet that was erected by the Windhoek Municipality.

“It’s just unhygienic and unbelievable that people from other informal settlements also track long distances to come use this toilet. I cannot blame them because I am aware that there is not a single toilet there but it is the municipality responsibility to ensure that the inhabitants have access to portable water and toilet facilities,” she said

Eilonga said the situation forces many people to relieve themselves in open, and at night especially women and children are forced to use baskets, which they dispose in the river beds the next morning, a situation which she distribute as undignified. Others especially those that are living in the new informal settlements dig their own traditional latrines.

Helodia Amadhila, also the resident of Havana, who is concerned about using public toilet at night due to especially with regard to security and health issues.

“I suffer a lot when nature calls during the night time because the only available toilet is very far and there are lots of bad people in the area. Although I stay with my two sons, some time they are not in the house and there is no one to escort me, leaving me with no choice but to use a basket which is very unhygienic,” she said.

Simon Nghindini, also a resident of Havana and whose shack is over a kilometer from the nearest public toilet relate a similar story to that of Amadhila, Eilonga and thousands of other Namibians without proper sanitation facilities.

“Most of the time the toilets are not working. This can be explained by a large number of people using the toilets, and municipal officials take their time to come fix them,” he said about a block of 12 toilets that were built by the City of Windhoek to serve the community of Havana.

“We decided to dig our own toilet because there is nowhere to relieve ourselves. This place is overcrowded and open space are scares. It’s a terrible situation we are living in,” Losivite Tuyeni, a resident of Gereagob, while pointing at family toilet her boyfriend has dug for them, a few meters from their corrugated irons house.

Namibia Demographic and Health Survey of 2013 indicated that only 34 percent of the population having access to improved sanitation which is against a target to have reached 66 percent of the population by 2015 as set out in the National Sanitation Strategy.

During the 9th Water and Sanitation Sector Joint Annual Review on February 2, in Windhoek by the government ministries and stakeholders in water and sanitation sector  including the European Union, as development partner, the Minister of Agriculture, Water and Forestry John Mutorwa has acknowledged the country’s failure to provide proper sanitation to the majority of the population.

“Access to water has increased overally, even if sanitation remains – despite our genuine efforts – the neglected stepchild of this country.  The challenge now lies with lack of progress on sanitation with only 34 percent of the population having access to improved sanitation,” he said.

“However, the victims affected by inadequate access to sanitation are as usual are primarily the poor.  The problem of poor access to sanitation is particularly acute in the rural areas where only 17 percent of the population has access to improved sanitation facilities with an alarming rate as high as 46.5 percent of open defecation.   Also equally affected are the informal settlements. The low access to improved sanitation constitutes a serious public-health problem”.

Minister Mutorwa also blamed the poor sanitation standard in urban centers such as Windhoek on the rapid increase in rural to urban migration, saying that the country needed to find urgent solution to the low access of sanitation in informal settlements.

“The disparity of water and sanitation service coverage between urban and rural is cause for concern. We cannot also ignore the rapid rural to urban migration that is going on at an estimated alarming rate of 3.5 percent per annum. This has a major impact on water and sanitation service delivery particularly in urban areas,” said the minister.

Having failed to deliver better sanitation facilities during the past 15 years, Namibia has now set herself a mammoth task to improve access to sanitation from the current 34 percent to 70 percent by 2017.

According to the Sanitation Strategic Plan, a total required budget to implement all initiatives in the plan was N$1.579 billion over the five year period from 2010/11-2014/15, with an average of N$316 million per annum. However, media reports indicate that the Ministry of Agriculture, Water and Forestry has been sitting on the funds that were a solution to the problem of poor sanitation in the country.

The ministry’s Director of Water Supply and Sanitation Coordination, Theopolina Nantanga gave a lame excuses in an interview with The Villager newspaper in June 2015 that the sanitation project failed to get off the off the ground because of numerous challenges including public education.

Nantanga however explained that the  water  and  sanitation  situation  currently prevailing in  the  country  is  characterised  by  scarce  water resources, poor access to running water in rural areas and a large percentage of the population living in vulnerable conditions in informal settlements.

The City of Windhoek manager for corporate communications, Joshua Amukugo said water and sanitation provisions one of the top priorities issues at the municipality.

“The City of Windhoek sees access to water and improved sanitation as one of the key challenges to the general upliftment of our society, in particular the more vulnerable portion thereof. In this regard the city has expended millions in the provision of water and sanitation facilities throughout the city to those in need and will continue to do so as the organization is fully aware of its social responsibility and is making a real, concerted effort to address all issues at hand,” Amukugo said.

The city official pointed the maintenance of facilities and water shortages as the most pressing challenges. “The maintenance of established sanitation facilities is proving to be by far the biggest challenge. Technical solutions exist in a variety of forms and even funding can be sourced, but sustaining the facility in working order has failed in many instances.

“Given the nature of a sanitation installation and the fact that these toilets are not under care of a single individual or household in many instances lead to these installations being subjected to vandalism, unhygienic usage and even the theft of water.

“The provision of adequate sanitation is a major challenge on its own, however maintaining this has proven almost impossible under the current model.

This is also one of the primary reasons the City of Windhoek has embarked on an extensive process to review the current model of providing sanitation throughout the spectrum of service provision under the mandate of the organization.

“A second and equally important issue that has become overdue and need to be urgently addressed is the ever increasing shortage of water in the central areas of Namibia.

This situation is seriously straining development and impacting on the ability of the City of Windhoek to expand service delivery to all residents.

The Namibian Government should realise the challenge posed by this and ensure that this is resolved sooner rather than later,” he said.

Meanwhile, countries in Southern Africa like Namibia still have a chance to deliver on renewed promises following the adoption by the world leaders of the 2030 Agenda for Sustainable Development in September 2015.

This agenda includes a set of 17 Sustainable Development Goals (SDGs) to end poverty, fight inequality and injustice, and tackle climate change by 2030. The SDGs are built on the MDGs that ended last year. And the universal access to clean drinking water and sanitation is one Sustainable Development Goals.

However it is going to be costly to achieve universal access to water and sanitation by 2030, according to Jean-Philippe Bayon, the coordinator for the UNDP-Global Water Solidarity. In blog post on the UNDP official website, Bayon noted US$ 27 billion are needed annually to provide clean water and sanitation by 2030. He said official development assistance (ODA) may covers approximately one third of the target but 17 billion are still missing.

He believes that local and regional authorities like the City of Windhoek, “can contribute to filling the endemic resource gap that cripples water interventions.

I believe local to local cooperation is an important part of the solution but to make it fully effective we need to improve its modus operandi”.

Article Disclaimer: This article was published by the Southern Times and was retrieved on March 10, 2016 and posted at INDESEEM for educational and information purposes only. The views, thoughts and contents of the article remains those of the author. Please cite the originally source accordingly.