Maternal Postpartum Depression

Maternal Postpartum Depression Is Avoidable
By James Achanyi-Fontem, Cameroon Link
According to the World Health Organization's website, "Depression is a common mental disorder that presents with depressed mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration. These problems can become chronic or recurrent and lead to substantial impairments in an individual's ability to take care of his or her everyday responsibilities. At its worst, depression can lead to suicide, a tragic fatality associated with the loss of about 850,000 lives every year."
Depression is common, affecting 121 million men, women and children worldwide. Depression is among the leading causes of disability worldwide and will be the second leading cause of disability globally by 2020. Depression can be reliably diagnosed and treated by health care providers, but fewer than 25 % of those affected have access to effective treatments.
One time that depression may begin is following childbirth, often with severe negative outcomes for mother and child. Recognition and treatment of this problem lead to positive outcomes for both.
The following blog feature aims to raise awareness of the symptoms of maternal postpartum depression, the impact that depression can have on everyday life, the common misconceptions about depression, and the need to treat depression.
It should be noted that depression is only one type of mental disorder. This means that it is important to know how common depression is around you in the community. What are the short-term and long-term effects of depression? What kinds of services exist to treat depression in your area? Try talking to mental health services in your area if they exist or in the capital city of your country for more information about depression and other mental health issues. By sharing this information, you can help to improve the mental health of your neighbours and offer valuable information that radio and television programs may not be providing.
Generally, when a baby cries all the time, the mother becomes stressed up and fails to eat well. She does not sleep either and she is more like confused. The end result is that she become so skinny.
For some mothers this may not be a problem as the feeling goes away after a few days. At the beginning, one would hear a mother complain of not sleeping enough, feeling tired and stressed. A first time mother will often get very angry with the baby because the baby is always crying, instead of finding out what makes the baby to cry.
Sometimes, after a baby is born, a mother feels depressed. She may lose interest and pleasure in life, she may not sleep much or want to eat food, and she may have low energy and poor concentration. These are all symptoms of what is called postpartum depression. Mothers who experience postpartum depression should get help from health workers. This is a serious condition and can become chronic, damaging both the mother's and her children's chances for a healthy, happy life.
This message has been brought to you by Cameroon Link. For more information click on http://cameroonlink.blogspot.com

Breast Cancer Can Be Prevented

Many Cancers Could Be Prevented
According to estimates in a landmark report, over 40 per cent of bowel and breast cancer cases in the UK are preventable through healthy patterns of diet, physical activity and weight maintenance. The report has set out recommendations for policies and actions to reduce the global number of cancer cases. The preventability estimates are about a third of the most common cancers in high-income countries and about a quarter in lower income countries.
Because of the way that different lifestyle factors are inter-linked, it is not possible to simply add the preventability estimates from smoking and other lifestyle factors together to get a total
The report, Policy and Action for Cancer Prevention, published by the World Cancer Research Fund (WCRF), has estimated that about 43 per cent of bowel cancer cases and 42 per cent of breast cancer cases in the UK could be prevented.
The overall message of the report is that all sections of society from governments to households should make public health and cancer prevention in particular, a higher priority. And it includes estimates on the proportion of cancer cases that could be prevented through diet, physical activity and weight that demonstrate how important the issue is.
The estimates for the US are that 45 per cent of bowel cancer cases and 38 per cent of breast cancer cases are preventable by these means. The report has also estimated the preventability of cancer in China and Brazil, which represent low and middle-income countries, respectively.
The overall estimate is that about a third of the most common cancers in high-income countries and a quarter in lower-income countries could be prevented. These figures do not include smoking, which alone accounts for about a third of cancers.
As well as breast and colon cancers, across the world many cases of other cancers, such as those of the kidney and stomach, are preventable.
As part of the evidence-based report, thought to be the most comprehensive ever published on the subject, two independent teams of scientists systematically looked at the evidence for how policy changes and interventions influence the behaviours that affect cancer risk.
Following this, a panel of 23 world-renowned experts made 48 recommendations spread across different groups in society to follow. These groups are: multinational bodies; civil society organisations; government; industry; media; schools; workplaces and institutions; health and other professionals; and people. The recommendations include:
-Schools should actively encourage physical activity and provide healthy food for children.
-Schools, workplaces and institutions should not have unhealthy foods available in vending machines.
-Governments should require widespread walking and cycling routes to encourage physical activity.
-Governments should incorporate UN recommendations on breastfeeding into law.
-The food and drinks industry should make public health an explicit priority at all stages of production.
-Industry should give a higher priority for goods and services that encourage people to be active, particularly young people.
-Health professionals should take a lead in giving the public information about public health, including cancer prevention.
-People should use independent nutrition guides and food labels to make sure the food they buy for their family is healthy.
Professor Sir Michael Marmot, Chair of the WCRF Panel, said: “This report shows that by making relatively straightforward changes, we could significantly reduce the number of cancer cases around the world.
“When people think of policy reports, they often think they are only relevant to governments. But while governments are important in this, the evidence shows that when it comes to cancer prevention, all groups in society have a role to play. This report is relevant to everyone from heads of government to the people who do the weekly food shopping for their family.
“We have been fairly specific about what different groups need to do. But the Report’s overall message is that everyone needs to make public health in general, and cancer prevention in particular, more of a priority.”
Professor Martin Wiseman, Project Director of the Report, said: “Making estimates on the proportion of cancer cases that are preventable is complex and challenging.
“The figures in this report have been agreed by the most eminent of scientists and they are as accurate as they can be with the available data.
“On a global level every year, there are millions of cancer cases that could have been prevented and this is why we need to act now before the situation gets even worse.
“We are expecting a substantial increase in cancer rates with the ageing population, obesity rates soaring, and with people becoming less active and increasingly consuming highly processed and energy dense foods and drinks. The good news is that this is not inevitable and we still have the chance to avert a crisis before it is too late.”
Professor Mike Richards, National Clinical Director for Cancer, has welcomed the report. He said: "The evidence linking diet, physical activity, obesity and cancer has become stronger over the last decade and this report can play a part in people adopting healthier lifestyles.
"I welcome this report, which has been produced by leading scientists in the field. After not smoking, it is clear that diet, physical activity and weight are the most important things people can do to reduce their cancer risk."
This messages has been brought to you by Cameroon Link, courtesy of Richard Evans who can be reached on 020 7343 4253 / 07789760094. E-mail: r.evans@wcrf.org

HIV Related Stigma Research In Cameroon

Research on HIV Related Stigma Survey Among Nursing Students In Cameroon
Dr. Neal Rosenburg of Goldfarb School of Nursing, Barnes Jewish College and Pr. Donna Taliaferro of the Washington University at St. Louis, USA started work in Cameroon on March 1, 2009 on a planned HIV-related stigma survey among nursing students in Cameroon. During the academic working visit, Dr. Neal Rosenburg and Pr. Donna Taliaferro have visited nursing colleges in Douala, Nkongsamba and are expected in Buea and Limbe to collect data on stigma among nursing students on March 9. The data will be analyzed and compared with a similar operation at the Washington University at St. Louis in the United States of America. An investigation on how to ameliorate on the care for HIV orphans is also conducted with the objective of encouraging nursing students in the USA to work out strategies for supporting orphans in Cameroon through exchange visits.
The visiting medical academic professionals gave a conference at the Complexe Universitaire EFPSA, INSAM, ISSAS at Ndokoti, Douala on Friday, March 6 and accorded leaders of associations in Cameroon working for the improvement of the well being of HIV orphans audiences aimed at the partnership exchanges in experiences for research in areas of capacity building, care delivery and support to the vulnerable children of Cameroon. The activities are conducted with the technical support of the University of Buea and Cameroon Link Human Assistance Programme in Douala.
Research Objectives
1. To identify different aspects of experiences among culturally diverse populations of HIV positive individuals.
2. To understand circumstances affecting culturally appropriate care for HIV positive clients.
3. To analyze the impact of perceptions among nursing students on global healthcare issues surrounding HIV nursing.
4. To describe the impact of associated stigma relating to nurses caring for HIV positive populations.
5. To search means for delivery of quality services to patients and care to HIV positive persons.
Stigma as a concept is associated with various societal and personal attributes and attitudes. The deficit of a clearly accepted definition contributes to the prblematic nature of measuring the impact and outcomes of stigma in the research setting. A repetitive element in the definition of stigma is that of a mark, or a well defined stain on or associated with an individual. This proposes a stain on the individual’s character which may transcend to the interpersonal and societal levels. However, the common usages of the definition exclude a redundant usage of the term in the context of behavior, culture, and physical attributes that are also associated with stigma.
Historically, the Greeks utilized the term stigma in the context of a physical blemish designated to identify something morally curious about a member of society. In the Greek culture, the identifiable mark was cut or burned into the physical body. This form of representation clearly identified a marked individual within a particular societal text (Goffman, 1963). The dominant or unmarked members of society could easily differentiate themselves by being free from the mark or stain which suggested a violation of a code or a representation of societal status such as a slave or a criminal. Goffman (1963) has explained stigma in terms of a tainted or discounted individual. The negative connotations of these attributes equate to the differences between what society presumes in terms of common or acceptable characteristics of a person. The problematic nature of this definition arises as the attribute itself is not discrediting, rather it is the variance between the individual and the societal influence.
The contemporary usage of this concept relies heavily on the original meaning; however, today the individual’s stigmatizing identifier may indeed be invisible to the rest of society, such as with the case of the human immunodeficiency virus (HIV). According Goffman (1963), three abundantly different types of stigma exist. The first, he referred as abominations of the body that account for physical defects identified to an individual.
Next, he described the blemishes of individual character. These traits are possessed by weak individuals as well as individuals with unnatural desires. Lastly, he proposed tribal stigma. This category of individuals share unique characteristics acquired via lineage such as race, ethnicity, and religion. Stigma is present throughout all societies. The nature and harm of stigma are uniform; however, the degree and circumstances of stigma vary among societies and cultural groups. Regardless of the context, the concept of stigma produces destructive effects. Blame, shame, fear, personal injury, violence, and death account for potential effects of stigma. The potential for both physical and emotional damage to the individual underscores the importance of this concept. In addition, the efforts of changing the defining attitudes of stigma pose unique challenges. Many attitudes attached to contemporary stigma are deeply engrained in the societal norms, the familial values, and the cultural mores of an individual. The changing tapestry of the American society requires a shift in attention to that of multiculturism. Regarding multi-cultural groups, HIV, and stigma, Burrage & Rocchiociolli (2003) reported that the understanding of multiculturism and stigma within the context of interventions accessible to the various groups of people infected with HIV is paramount.
The act of discrimination against an individual or group discerned to be deviant, unacceptable, or inferior is enacted stigma (Scambler & Hopkins, 1986). The critical attribute of enacted stigma is prejudice. Prejudice is defined as “preconceived opinion that is not based on reason or actual experience” (Concise Oxford Dictionary, 2006, p. 697). An essential aspect of the phenomenon of prejudice includes a social orientation towards whole groups of people and/or towards individuals because of their association is a member of a particular group (Brown, 1995).
Methods for measuring this concept are available but restrictive. The outcomes of stigma are merely identified, questionnaires offer a rank-order aspect of the degree of certain pieces of stigma within select populations, and finally a limited number of studies have been published to determine other components or constructs involved with this complex concept. A workable instrument with proven reliability and validity would strengthen the studies on stigma as well as properly place this concept in the forefront of attention with an instrument that can be utilized across various populations and translated into many languages to gauge the scope and impact of stigma among nursing students.
Study Design
This cross sectional research design will be implemented among nursing students at the University of Douala, the University of Dschang in Cameroon, West Africa and Goldfarb School of Nursing at Barnes Jewish College in St. Louis, MO, USA. Nursing students enrolled in the eighth semester (last semester of nursing clinicals) will be sampled by convenience method. The nursing students will complete the HASI-NS (HIV/AIDS Stigma Instrument – Nursing Students). This researcher modified instrument is intended as a pilot implementation as it appears to be unused within the student nursing population. This instrument is a modified version on the HASI-N (HIV/AIDS Stigma Instrument – Nurse) developed Uys, Holzemer, Chirwa, Dlamini, Greeff, Kohi, et al. with supported funds from the NIH and the Fogarty International Center. This instrument utilizes 20 items concerning behaviors, communication, and perceptions addressed to
nursing students in the clinical setting. The data will be cleaned, coded and analyzed using SPSS v.16. The results of this study will acknowledge the perceptions of Cameroonian and American nursing students who provide patient care or will be faced with delivering patient care to the growing population of diverse HIV positive patients. The results of this study will be disseminated at national conferences as well as provide the framework for manuscript submission to peer-reviewed journals. Most notably, the data from this pilot study will begin the rigorous process of establishing reliability and validity within new instrument development with the intent to expand to larger studies gauging HIV related stigma among nursing students across both continents.
Nurses are an integral part of the global health care picture as we rapidly move into an era of multi-cultures, multi-languages, and multiple illnesses that reinforce the acts of stigma. Most notably, it is important to remember that nurses are not excluded from harboring and delivering the devastating acts of stigma. In increase in awareness and education will serve as the weapons of choice for nurses of the twenty-first century to combat the destructive forces of stigmatization. As nurse researchers, the nursing science will accelerate the process via methods devoted to exploring strategies at the intervention levels with an ultimate outcome of diminishing current levels of stigma while greatly ameliorating the quality of delivered nursing care when working with marginalized groups facing the many faces of stigma

ENN Launches Field Exchange
By Rupert Gill, ENN Project Manager
The Emergency Nutrition Network (ENN) has just launched a greatly improved online search facility for Field Exchange to improve accessibility for you and your colleagues. The entire archive of Field Exchange since first produced in 1996 (35 issues) has been catalogued and may be searched using free text using a simple or advanced search facility, or located via theme, article type, country, or issue.
The Field Exchange Catalogue can be found at http://fex.ennonline.net/ or via the link on the ENN website. A CD version and a printed catalogue will soon be available to download and limited CD/print copies available from the ENN. Send requests to the ENN at office@ennonline.net. ENN also welcomes feedback on the resource. Please contact ENN at the same email or via the office mail/telephone contacts below. ENN
32 Leopold Street, Oxford,
OX4 1LN UK
Tel: +44 1865 324996
mailto:office@ennonline.net
The ENN gratefully acknowledge the support of the UNICEF-led Inter-Agency Standing Committee (IASC) Nutrition Cluster in funding this resource.

ASSISTANCE – ACTION

Birthing Assistance Action Partnership
At Cameroon Link
ASSISTANCE – ACTION is an organisation based in Douala and a partner of the Cameroon Link. Human Assistance Programme. The association was created by Mrs. Nfong Yette Marie Delphine on the 26th August 2006 to promote care and the rights of orphans and vulnerable street children in Cameroon.
The activities of ASSISTANCE – ACTION through the Cameroon Link Networking Group aim at reducing poverty and juvenile delinquency within communities, especially the big cities of Cameroon.. Since the creation of the organisation, it has successfully removed over 150 children from the streets of Douala and integrated them within families in well structured health areas with educational and health care facilities. Funding for assistance –action has been raised through contributions of its members, patronage and donations from the public during fund raising mass events.
The interventions of ASSISTANCE – ACTION NGO are direct on the field through counselling of the children on the needs before the search for families where they are integrated. After integration, the organisation through Cameroon Link undertakes action to raise funds for assuring the education and nutritional needs of the vulnerable child.
The organisation carries out mass sensitisation activities and campaigns to identify the origins of the children. I was discovered in Bonaberi-Douala during a house to house survey that most of the street children in some health areas are from countries bordering Cameroon, where there have been conflicts and instability due to war. Most of the former street children have refused to return to their countries, saying they do not know where they are going to restart their lives if back home. They have preferred Cameroon as their new home because it is difficult to establish original birth certificates for these children aged between 5 and 18 years in great need of shelter.
Children above primary school age identified are placed in private professional institutions for their initiation into a trade, which later leads to their settling autonomously. Before the creation of assistance action activities, the street girl children were abused and involved in child labour.
The ministry of social affairs in Cameroon has in the past two years supported the human programme through the payment of school fees of some of the children at the primary and secondary school levels.
Activities in favour of vulnerable street children and orphans
The partnership of Assistance Action and Cameroon Link encourages economic, social, educational and animation of the vulnerable children of Cameroon.. In the field of economic action, apprenticeship of motor-mechanics, carpentry, electricity technician, welding, IT training and secretariat functions, electronic maintenance, tailoring and hair dressing are amongst trade of training inclusion.
In the area of social assistance, material support is attributed to poor families housing the vulnerable and under advantaged children within the frame work of the inclusion action. The children are associated to health care facilities for the guarantee of their health.
In the area of education, the promotion literacy of the vulnerable children, especially the girl children is encouraged, through the creation of libraries within health area communities. IT training initiation is conducted at the Cameroon Link centre in Grand Hangar for secretariat training on information and communication.
Recreational activities are planned on weekly basis for the children to give them the opportunities to participate in games, leisure sports, and audio-visual arts animation like all other children in family homes.
Assistance Action Cameroon Link Approaches
Down-to-earth approaches are applied for cost effectiveness. Counselling centres have been created and these centres are managed by the Women Gender Councils (COGESID) put in place by Cameroon link through specialised training. It is in these centres that professional orientation sessions, educative talks and exchanges are organised with community leaders on how to get the population appropriate and own the vulnerable children inclusion programme.
Well placed individuals within the national and international communities are invited to patronise the vulnerable children action through sponsorship. Individuals interested receive profiles of the children with their specific needs, to facilitate the decision on the type of help the children can benefit like the sponsoring the their education or apprenticeship in an income generating trade.
At the end of each academic year, the report card of the child supported is sent to the sponsor for evaluation of the changes achieved during the inclusion period. Some individuals prefer to make a donation to cover the nutritional needs of the children, clothing and recreational needs.
The partners of the human assistance programme are currently reflecting on the possibility of creating a vulnerable children’s training home that would house children not integrated into families. Learning facilities, a library and children recreation tools will be installed in the vulnerable children’s home to be situated in Bonaberi-Douala.
We are using this opportunity to request for support from the public for the vulnerable children of Cameroon. This can be done by donating a book or sponsoring the nutritional or education needs of a child or sending essential health care materials and drugs for simple reoccurring diseases. For more information click on http://cameroonlink.blogspot.com or send a mail to camlink99@gmail.com in English or assistance-action@yahoo.fr in French. Click on the following link to sponsor a child in need http://www.assistance-action-parrainage.blogspot.com/