Tag: Educational

My lush green field in the village after a week of good rains.

As long as I can remember, the agriculture sector  has been the most important one in Uganda.  Currently, it employs 72 percent of our population and contributes about 32 percent of the Gross Domestic Pruduct.

Many of us of my age were educated on earnings from coffee and cotton and we survived the civil wars partly because we could plant food items like plantains, maize, cassava , sweet potatoes, beans, ground nuts, peas and feed on them.

Surprisingly, very little has changed since my childhood as peasants still use the hand hoe and depend on the natural weather conditions. The distribution of food crops from areas of abundancy like the south and west of the country to areas of scarcity like Karamoja in the north still remains a huge problem.

If commercial farming and irrigation is widely introduced, then Uganda could become the food basket of Africa- feeding 200 million people. Available statistics show that 80 percent of Uganda’ s land is arable but only 35 percent is being cultivated. 80 percent of our population live in the rural area; they till the land and sow crops but have limited knowledge of modern farming practice. By cultural practice, the land tends to be divided into small plots for the families. The quality of seeds available to the farmers is poor.

I remember growing up on a hundred acres’ farm about 70 kilometers west of Kampala, Uganda’s capital city. The farm employed about twenty workers, we kept a big herd of cattle and goats. We grew coffee, cotton, plantains fruits like pineapples, passion fruits, oranges throughout the year . My parents could sell over four hundred bags of coffee each season and the Indian buyer collected them from the farm.

The Ministry of agriculture was well funded and the field officers trained in supervising the  farmers of the main crops were a permanent feature in all our villages to ensure high production  and quality from the land.

Uganda’s agricultural potential was hugely affected by the civil wars of the 70s and 80s.

At the moment, the global climate effects are creating hardships to different communities in the world.

These include:

• Extreme weather conditions- droughts and floods are becoming more frequent and severe. The temperatures have increased and there is more erratic and heavy rainfall. Forced displacement is on the increase leading to hunger and poor nutrition.
• Increased incidence of pests and diseases- the high temperatures and humidity enable insects and pathogens to reproduce easily. Making it essential to use chemicals and fertilisers.

The climate change effects result in low crop yield and low animal productivity.

Uganda stands a great risk from climate change but being among the least developed countries of the world, we are hardly prepared for it.

The rains of the second season started in early September and suddenly, the fields are all fresh and green. As I travel to my small field near Mityana, I am thrilled to see people clearing and planting seeds in their own. If the rains are not so harsh, the beans will be harvested in eight weeks, maize in three months and pumpkins in four months! The prices will be determined mainly by the usual market forces of supply and demand. Households will have food till the next rainy season.

Once a doctor, always a doctor. The lush green fields reminded me that my colleagues and other health workers in Uganda are now busy looking out and treating more cases of Malaria disease.

Everyone who grows up here in Uganda knows this close association of heavy rains or planting season with high incidence of Malaria fever. The girl children know it so well because they are entrusted with looking after their siblings while the mothers are out in the fields.

I grew up knowing what to give to my siblings and how to give it if he/she developed a fever at home in the absence of an adult.

Hardly anything has changed! According to the Ministry of health , malaria remains the leading cause of morbidity and death in Uganda.  Malaria is endemic in 95 percent of the country and in 90 percent of the population- 33million people. It is responsible for 35 percent of hospital admissions and 9-14  percent deaths. In children under five years, it causes more than 50 percent of the deaths.

 From afro.who.int/Malaria website:

World Health Organisation(WHO) recorded 619,000 deaths due to Malaria in the 84 endemic countries in 2021.

95 percent cases reported were from Africa and 96 percent of the deaths were in Africa.

78.9 percent of deaths were in children under the age of five.

 For Uganda, WHO estimated 13 million cases of Malaria  and 19,600 deaths due to malaria in 2021. Malaria is a preventable disease.

Malaria is a serious mosquito –borne tropical infectious disease caused by five species of  the plasmodium parasites. The female anopheles mosquitoes bites an infected person and transmits it to the next persons it bites.

The parasite requires warm temperature above 20 degrees centigrade to complete its growth cycle in the mosquito. In cold temperatures below 20 degrees centigrade (68 degrees Fahrenheit) the parasites cannot survive to be transmitted by the mosquito.

Climate change result in high average temperatures , allowing mosquitos to survive even at high altitudes.

We are in the El Nino event year with high rainfall and high average temperatures so malaria cases are likely to increase even in areas of high altitude. People living in such areas have low natural immunity to Malaria due to infrequent exposure to the parasites. They are likely to get the moderate to severe forms of the disease.

People like me who grew up in the endemic areas of Malaria have had frequent bites of the mosquitos and developed some degree of natural immunity to the disease. We tend to get mild or moderate forms of the disease.

Having said that , I am now among the most vulnerable group of the population : children under 5 years   pregnant women, people living with HIV/AIDS and mobile populations,

 for acquiring Malaria infection.  For the 25 years I was away in a country with few malaria cases, I lost the natural immunity I had acquired in the 40 years of my adult life. Frequent exposure to malaria through mosquito bites sustains the acquired immunity. If I got infected now I would get the severest form of malaria and could easily die. I sleep under an insect- treated mosquito net all the time to minimise contact with the mosquitos.

My 12 years old daughter survived a severe form of malaria after being away in Botswana for six years. She was only saved by our high index of suspicion of the disease and quick access to the right diagnosis and effective treatment then.

An old childhood friend who had retired and returned home after thirty years in Botswana did not survive the malaria assault four years ago!

In my 46 years of medical practice I have been guided by the cardinal rule I was taught as early as the third year of training:

In Uganda, any fever is Malaria until proved otherwise.

The Malaria blood slide /rapid test can  be repeated in the patient as often as it is required.

Putting these two in practice, saves many lives.

Malaria cases increase during the rainy season because waterlogged and damp places provide suitable breeding grounds for the mosquitos that transmit the disease among the humans.

Malaria is a preventable disease and WHO collaborates with the 84 countries endemic for Malaria to develop and sustain national prevention and control programs whose main goal is to reduce malaria infections and malaria –related deaths. And finally eliminate Malaria disease.

In most least developed countries like mine, such programs tend to be stalled by lack of funds.

On the ground, the biggest challenges are :

The mosquitos continue to develop resistance to the common insecticides used to kill them.

The Plasmodia parasites continue to develop resistance to the effective drugs used for treatment over time.

These two demand rigorous surveillance and regular review of the drug policy.

The frequent shortages of drugs in the government health facilities contribute to the high number of deaths and  to the development of drug resistance.

The main WHO recommendations for the prevention and control of Malaria in the endemic countries like Uganda are:

1. Prevent transmission by spraying waterlogged, damp areas around the homes. Clear the bush around houses.
2. Use screens in windows and doors to keep out the mosquitos.
3.  Indoor residual spraying. Wear long pants and long sleeves to cover exposed skin. Apply mosquito repellents to exposed skin if staying outside for long during the night.
4. Sleep under an Insecticide –treated mosquito net all through the night every day.
5. When visiting from a non-endemic area take Malaria preventive tablets two weeks before you enter an endemic area, take it throughout your stay as prescribed and continue with it for two weeks after leaving the endemic area.
6. Malaria Vaccine- a new tool in the control of Malaria kit. In 2019, a malaria vaccine was launched in Ghana, Malawi and Kenya with the aim of reducing the disease burden and deaths due to Malaria in the under five. Four doses  are given at regular intervals for maximum protection along other routine childhood vaccines. It is an ongoing pilot study to be rolled out nationwide and other countries.

As for the treatment of Malaria infection in all ages, it demands early diagnosis and treatment with the effective drugs of the area and follow up.

Malaria disease will for a long time remain on top of Uganda’s public heath agenda though we have many other intractable diseases that kill millions of us every year.

 Defeating it requires the participation of everyone.

While the farmers are busy tilling their land and sowing, the health workers should be busy reminding the population of their vital role in the prevention and control of Malaria. The trainers should be training the health workers on best practices and changes in the drug policy and the suppliers stocking the health facilities with the effective malaria drugs and the diagnostic kits.

Prevention has always been better than cure and cheaper too.

QUESTION:

Are you aware that a bout of malaria  reduces your productivity at home, in your field or at your work place? Are you taking all the necessary precautions to limit your exposure to the malaria transmitting mosquitos more so during the rainy seasons?

Courtsey of istockphoto.

Music as we know it today has evolved over many centuries and can be said to be as old as man himself.
Most ancient cultures like those of Greece, Rome, China, India and Africa used songs accompanied with local instruments and dances to celebrate births, weddings, seasons and commiserate over funerals. Music entertains, teaches and connects people.

“Music expresses that which cannot be put into words and that which cannot remain silent.’’- Victor Hugo
In my country, the Baganda- an ancient kingdom on the shores of Lake Nalubaale/Victoria, have used drums, xylophones, flutes and lyres in the Buganda Court Music, community communication and in rituals.
Studies done by neuro physicians and music therapists of our time have proved that listening to music exercises our brains- it stimulates the brain, connects the right (logic)and the left(creative) sides producing a total brain work out. You have to engage almost all areas of your brain to make sense of the music.
As a result of the workout :
• The heart rate slows down
• The blood pressure goes down
• The Stress hormone: Cortisol , level in the blood goes down
• The brain produces more Dopamine, Serotonin, endorphins- the ‘ Feel good hormones’. It elevates the mood of each individual, gets you excited, relaxes muscles, calms and relaxes you.

Human beings have five major senses: Vision, hearing, smell, taste and touch. Using High Resolution foetal Ultrasound, it has been revealed that the baby growing in the womb can smell the amniotic fluid surrounding it by 10 weeks of the pregnancy.
It can hear by 18 weeks of pregnancy. It can hear the mother’s heartbeat. Between 27-29 weeks, the foetus can hear some sounds outside the mother’s womb like her voice though muffled. The mother’s voice becomes clearer as the brain matures. The foetus responds to the sounds heard by changes in its heart rate, breathing and movements. Music psychology researchers have shown that playing music , talking and reading to the growing baby helps to develop the baby’s hearing, memory and emotions.

Studies done by Sleep coaches show that adequate sleep of 7-8 hours a day promotes good health and plays a big role in the control of chronic infections and mental health illnesses like depression.
During sleep, the body repairs itself and the Immune system detects and eliminates molecules and cells that display foreign antigens and altered self-antigens or evidence of cellular damage.
The Immune cells kill germs and contain the infection – promoting healing and recovery. Adequate sleep promotes the health of the Immune system. Inadequate sleep is associated with changes in the Immunity. It increases infectious disease risk, causes slow healing of injuries and recurrent infections.
Having less than five hours of quality sleep is associated with morbidity and mortality from coronary heart disease and stroke over time.
Those aged 65 years and above, are most vulnerable to infectious diseases and cancer due to the natural ageing of the Immune system.
Listening to soft music of 60-70 decibels has shown to boost sleep quality and quantity.
It makes you feel happy, relaxed and lowers the stress hormone, Cortisol, levels.
For generations, parents have been singing lullabies to children to help them go to sleep.

“ In my solitude, I sing to myself a sweet lullaby, as sweet as my mother used to sing to me.’’- Albert Cohen
Soft music distracts us from the troubles of the day, helps our bodies to relax and to fall asleep.
For a normal adult, listening to music from another era or genre challenges your brain more than listening to the old and familiar. Struggling to understand the new sound works out the brain. I can compare it to trying out the difficult crossword after the easy one or elevating yourself from the Sudoku to the Mudoku number-placement puzzle.
I for one listen to some good gospel music regularly as I drift off to sleep. Sometimes, I wake up much later to switch off the music.

In the last one month, I have had two close relatives seriously sick in Intensive Care Unit at two different hospitals in Kampala.
In an attempt to promote their recovery, we have had to play some music to them . It helps to stimulate both sides of the brain , giving it a total work out. It is believed that as we grow, each one develops her /his favourite music. We had to look for their type of music- songs known and of meaning to them to jog their memories.
According to the healthharvard.edu website, such music activates the memory centre , the emotional one and motor( movements). The electric activity of the brain measured during this time of stimulation is increased.

“ Music can heal the wounds which medicine cannot touch.’’– Debasish Mridha
Interestingly, touch and hearing are the last senses to lose function in a dying patient.

“Music gives soul to the universe, wings to the mind, flight to the imagination and life to everything.’’- Plato
Archives show that Formal Music Therapy has been used to treat soldiers recovering from the effects of war in Army hospitals in USA since 1945, after the Second World War. It helped the soldiers to heal psychologically, emotionally, physically, spiritually, cognitively and socially. It took the forms of listening, singing, playing instruments or composing music.
Since then, Music therapy services have gained significance in accomplishing individualised goals like reducing stress, improving mood and self-expression.
Research studies have shown that people of all backgrounds, ages and cultures can respond to music and music therapy in hospitals, schools, nursing homes, mental health centres, outpatient clinics, prisons, juvenile detention centres and homes. Through involvement in music your abilities are strengthened and transferred to other areas of your life.

“Where words fail, music speaks.’’– Hans Christian Anderson
Next time you listen to music, appreciate and enjoy it for all what it is: a universal language, a powerful tool of communication, relevant to our physical and mental health and essential to the function of our society and culture.

QUESTION :
How often do you turn to your favourite music or write songs or poetry to comfort yourself when facing a big challenge?

Painting the canvas of life is simply to create the life you want for yourself. You use your gifts , talents and strength of character to build what you want. What matters most is that at the end of your life you have completed what was your own to do and influenced others around you to build a better world. Like the successful professional artist, painting on the canvas of your life demands a lot from you. You create to express beauty and significance in your life depending on your imagination and what you know at that moment in time.

As children,our parents nurture and care for us; teaching us the knowledge and skills that we need to grow and develop into independent and self-sufficient adults. The formal education enables us to become useful to ourselves and the communities we live in.
Generally, by the age of twenty we have developed the sense of responsibility to decide to be ourselves and a plan to achieve our biggest dream in life. We develop a vision for our lives and commit to fulfill that vision.

All of us are at different stages on our journeys and the psychologist agree on the most important characteristic traits we need to complete painting the canvas of our lives.
• Passion- the fuel that drives your desire to create, to paint the canvas the colours of your choice. Without passion you cannot get satisfaction out of what you do with yourself.
• Persistence- to start and finish what you choose to do, learn new skills to improve yourself and sustain you through over the course of a lifetime.
• Patience- painting the canvas of life takes a lifetime. It requires barrels of patience to take you through the twists and turns of such a journey. There is no guarantee that it will turn out as you planned. Patience and persistence are together fuelled by passion.
• A Sense of Adventure- life itself is an adventure, loving life and having a spirit of adventure allows you to explore new things and to be willing to follow the direction in which the wind blows you.
• Discipline- You need it to start the painting and follow it through. Each morning you have to wake up determined to put one foot in front of the other over the course of a lifetime. This is the only way you can finish painting the canvas and have something to show for having lived in your time and made a difference.
It is never lost on me that little by little, I get the work done.

As a senior citizen I can look back at my life and share with you on how I have fared so far.
Between the ages of 20-30, I started claiming my own power; I learned to depend on myself while gradually taking on life’s challenges and responsibilities.

30-40- it was essential that I honed my craft and this drove me to push the boundaries. I recognized that what I loved worked its way into what I was creating. It was thrilling to take simple things like two people in love and turn them into something strikingly beautiful – marriage. It increased my willingness to try new things. Through trial and error, I got it right.

40+-It dawned on me that half of my life was over so I no longer had all the time in the world. I looked closely at my life and saw the need to make some important changes. I had to listen to my inner voice , reduce my circle of friends and choose to belong to something bigger than myself if I were to be more effective in life. I became an active member of my community. I was creating a new identity for myself during this mid-life period. I needed to discover and express my true Self at a deeper level. At the same time, I was still clinging on the big dreams for my life.

I needed to stay motivated and to persevere to achieve my big dreams. I needed to become better and better; there was no room for complacency. Through the challenges and struggles that life had thrown at me, I had come to realize that I was not the master of my destiny but instead I needed to acquire more knowledge to help me understand myself and what I really wanted in life.

By my sixtieth birthday, I had been there , I had done that and yet I did not feel complete and whole. The urge to express my authenticity and uniqueness other than follow the predetermined roles of culture and society had become more pronounced. There was no going back on the recreation of my life: my life my own. I was fully awakened and ready to take the responsibility for being true to myself. I had more to gain than to lose by being my true self.
Oscar Levant(1906-1972) an American pianist said: “It’s not what you are, it’s what you don’t become that hurts.’’

I tapped into the fullness of my capacities, the good and the bad. This was the time when my heart, mind and soul worked in unison to influence the direction of my life. To my amazement, at that moment in time, I reached the highest level of mastery. The psychologists tell us that when we create from our hearts ,minds and souls, we create things that are true and beautiful. This is what makes it possible for any individual to have spiritual depth and to be successful in life, work and love.

For where I am at this moment in time, I am both mature and humble enough to take full responsibility for what I create and be held accountable for it. I can even stand back to admire and take pride in what I have created. The older I grow, the more I understand that painting is a lifetime responsibility and as long both my heart and belly are not full, I cannot hang up my painting brushes.

With hindsight, I am happy to have created my own life. I recognize that there were moments when I never painted, other times I created masterpieces beyond my own imagination and other times I have had to improve on the colours. I now prefer to use vibrant and brilliant colours when painting.

The greatest lesson that I have learned so far is that: little by little, doing what seems right and authentic, I grow into what I was meant to be. The responsibility to remain useful to my community urges me to share my wealth of knowledge and experiences with those around me.
Robert John Meechan said : “ Your life as a teacher begins the day you realize that you are always a learner.’’
Since learning is a lifetime job then we are all naturally lifelong teachers.

QUESTION: While painting the canvas of your life, how often do you remember that you have all the colours of the rainbow to choose from?