Insomnia is excruciatingly tiring to deal with. It incapacitates you by making you unable to deal with changes — it took me 2 days to shift my schedule around so that I could have enough time last night to prepare for deep sleep. But all it took was a text message to send my mental state into anxiety, worry, depression, all at once. I laid in bed wide awake for 5 hours and towards the end, thought about how productive I could have been, if I hadn’t spent all this time lying on the bed.
When you don’t get enough sleep, you are never fully present in the moment. Tiredness looms over your whole presence. Productiveness decreases. You turn up late, or you miss meetings in the morning because that’s the time when you start to fall asleep — and you refuse to let anything get in the way. Guilt consumes you.
You feel hopeless, worthless, and cancel on anything that makes you anxious, and everything makes you anxious and annoyed, even people on the train chatting on their phones. Whenever you’re present in a class, or at a meeting, it takes you tremendous effort and courage. You feel like you’ve conquered something, until you realise that you’re putting in so much effort for something that requires minimal effort for others, and start to despair.
The emotional detriments of insomnia is an endless cycle of guilt, tiredness and hopelessness. Trying to escape drains both willpower and reputation.
Reputation, because insomnia is not an excuse, and neither is depression. Wanting to sleep is seen as lazy. Not sleeping earlier is seen as a mismanagement of time. To the working world, the dark rings under your eyes represent no more than inefficiency as a human being.
They tell you that they understand you, and give recount of that one time when they stayed up all night, not knowing you’ve been awake for 3 days straight more times than you can remember. They give advice on scented candles, and classical music, not knowing that you’ve tried even alcohol in desperation. You thank them for their good will, while they walk away wondering why you’re too stubborn to take their advice. They shake their heads at you.
But insomnia is not just insomnia. Insomnia is often a symptom of something larger that should be solved. Of health problems. Of mental discomfort. Insomnia is a symptom that aggravates the already aggravated situation. It traps you and eventually consumes you, making you question your sanity every night when you lay in bed with an overactive mind, thinking about all the mistakes in your life. It doesn’t help that insomnia has high comorbidity with depression and anxiety, all of which rides on each other to escalate the demise of your mind.
There is no easy solution to sleeplessness, because the causes are so diverse. This is a picture of what insomnia can be, and the hidden emotional costs of this debilitating condition.
“ Are you going to sleep soon? “
“ I try.”
But Joshua Sikhu Okonya, a research associate with International Potato Center’s Crop and Systems Sciences Division says that the absence of extension services and other safeguards is making the increased use of pesticides disastrous.
Okonya, who has conducted a number of surveys around pesticide use in the country, says farmers have tended to apply pesticides even at times when the threat is not that enormous. He says dealers tend to profiteer in selling pesticides to unsuspecting farmers.
Okonya’s most recent studies involved pesticide use and knowledge of smallholder potato farmers in Uganda involving districts in the Albert, South Western highlands and eastern highlands.
45 percent of the farmers according to findings of the survey received information about which pesticide to use from other farmers. Only two percent of them received information directly from agricultural extension officers.
When it came to the doses of pesticides, most farmers in the southwestern highlands and eastern highlands relied mostly on their own previous experience.
On average, findings of the study published by BioMed Research International indicated that agro-input shops were the primary source of pesticides in the three agro ecological zones, followed by general household merchandise.
Farmers in all the three agro ecological zones reported some health-related complications resulting from pesticide use. All those that got infections according to Okonya thought it was normal.
Okonya says crops can only be sprayed against fungicides and pests when the perceived damage is likely to be above a given threshold. He adds that other control measures like Integrated Pest Management (IPM) can be applied other than depending on costly pesticides and fungicides.
A study commissioned by Ministry Agriculture in 2014 found that pesticide use was largely poorly regulated. It said monitoring and regulation of the sectors require USD 15 million (53 billion Shillings).
The environment study conducted by Nelson and Associates Environment consultancy said there is lack of human resources to inspect and enforce regulations.
National environment Management Authority has warned that the contamination of water bodies with pesticides can pose a significant threat to aquatic ecosystems and drinking water resources.
Source Of Pesticides
There are no agricultural pesticides manufactured or formulated in Uganda. Suppliers of imported pesticides come mainly from India, China, Taiwan, Israel, Europe or branch offices of international companies in Kenya.
Nelson and Associates Environment Consultancy found another challenge with how to dispose agrochemicals and generally pesticides. Only UPDF-owned Luwero Industries would meet requirements for incinerating pesticides.
Health facilities in Kabarole district are yet to adhere to the guidelines for treating severe malaria issued by the World Health Organization- WHO.
In 2013, the WHO recommended that artesunate, a derivative of artemisinin that is injected directly into the vein, replace quinine as the preferred treatment for severe malaria.
However a survey by Uganda Radio Network around Kabarole district found that major facilities like Rwimi, Karambi and Busoro Health Centre III still administer quinine to patients with severe malaria.
At Karambi Health Centre III, Fred Kugonza, a health worker says that they are still using the standard treatment for severe malaria which is an intravenous infusion of quinine or quinidine. Kugonza however says that patients are often referred to Fort Portal Regional Referral Hospital when they become resistant to quinine treatment.
Enock Balya, the in-charge of the malaria ward at Rwimi Health Centre III says that he is aware of the new drug, but none of the health workers at the facility knows how to administer it.
Moses Businge, the Kabarole district malaria focal person, says that failure to use artesunate could cause an increase in cases of severe malaria leading to deaths especially in children. He adds that in facilities such as Fort Portal Regional Referral Hospital, there is no constant supply of artesunate injection.
Dr Richard Mugahi, the Deputy District Health Officer says that officials from the Malaria Consortium are yet to train medical workers about use of the drug. Several drugs have been used to treat malaria, which remains the number one cause of morbidity and mortality in Uganda.
In 2000, chloroquine was the first-line drug for treatment of uncomplicated malaria in Uganda. However, between 2001 and 2004, the efficiency of chloroquine reduced significantly, with treatment failure ranging from 22 percent to 77 percent.
In 2004, in line with the WHO recommended threshold for antimalarial drug policy change, Uganda embarked on yet another policy change process that culminated in the adoption of artimesinin combination therapies as the first-line treatment for uncomplicated malaria.
According to WHO 1.2 million people die of malaria every year, 86 percent of whom are children under the age of 5. It also states that severe malaria represents end stage of untreated or improperly treated uncomplicated malaria.
The World Health Organization (WHO) has published it’s first-ever catalogue of antibiotic-resistant bacteria that pose the greatest threat to human health.
The list of priority pathogens consisting of 12 families of bacteria was drawn up as of the agency’s efforts to address growing global resistance to antimicrobial medicines.
The list highlights in particular the threat of gram-negative bacteria that are resistant to multiple antibiotics. These bacteria have built-in abilities to find new ways to resist treatment and can pass along genetic material that allows other bacteria to become drug-resistant as well.
A statement by the WHO shows that the most critical group of all includes multi-drug resistant bacteria that pose a particular threat in hospitals, nursing homes, and among patients whose care requires devices such as ventilators and blood catheters. They can cause severe and often deadly infections such as bloodstream infections and pneumonia.
These bacteria have become resistant to the best available antibiotics for treating multi-drug resistant bacteria. The second and third tiers in the list contain other increasingly drug-resistant bacteria that cause more common diseases such as gonorrhea and food poisoning caused by salmonella.
“Antibiotic resistance is growing, and we are fast running out of treatment options. If we leave it to market forces alone, the new antibiotics we most urgently need are not going to be developed in time,” Dr Marie-Paule Kieny, WHO’s Assistant Director-General for Health Systems and Innovation, said.
The list is intended to spur governments to put in place policies that incentivize basic science and advanced research and development by both publicly funded agencies and the private sector investing in new antibiotic discovery.
WHO spokesperson Christian Lindmeier;
The list was developed in collaboration with the Division of Infectious Diseases at the University of Tübingen, Germany, using a multi-criteria decision analysis technique vetted by a group of international experts.
The criteria for selecting pathogens on the list were: how deadly the infections they cause are; whether their treatment requires long hospital stays; how frequently they are resistant to existing antibiotics when people in communities catch them; how easily they spread between animals, from animals to humans, and from person to person; whether they can be prevented, how many treatment options remain and whether new antibiotics to treat them are already in the pipeline.
Prof Evelina Tacconelli, the Head of the Division of Infectious Diseases at the University of Tübingen and a major contributor to the development of the list says that the new antibiotics targeting this priority list of pathogens will help to reduce deaths due to resistant infections around the world.
“Waiting any longer will cause further public health problems and dramatically impact on patient care,” she adds.
However, tuberculosis – whose resistance to traditional treatment has been growing in recent years – was not included in the list because it is targeted by other, dedicated programmes. Other bacteria that were not included, such as streptococcus A and B and chlamydia, have low levels of resistance to existing treatments and do not currently pose a significant public health threat, the statement adds.
This is according to a survey conducted by the Ministry of Health aimed at understanding how effective VHTs are at managing their communities. Uganda has 180,000 VHTs members but only 60,000 of these have acquired training.
Uganda adopted the VHT strategy in 2001 as a bridge in health service delivery between community and health facilities. But according to the survey, only a few were trained to effectively monitor and manage patients.
Their work includes community mobilisation for public health campaigns such as immunisation and family planning, nutrition and home visits.
Prof. Anthony Mbonye, the Director General Health Services, notes that the training gap has been caused by lack of funding. He notes that the development partners have trained some of the VHTs in districts where they operate.
Jova Kamateeka, the Woman Member of Parliament for Mitooma district, says it is unfortunate that VHT members are untrained. She notes that the government should borrow
money to train them.
Dr. Joachim Osur, the Amref Health Africa Director, says that governments have been reluctant to invest in VHTs. He notes that governments are trying several policies without really funding them.
But according to Prof. Mbonye, the health ministry has drafted a new policy that is aimed at reducing the number of VHTs and emphasising their training.
Persons living with Albinism in Kisoro District are appealing for free photophobia glasses that could avert the effects of direct sunlight on their sight.
They say that although it is advisable that they wear photophobia glasses as a relief from light sensitivity the glasses are costly and inaccessible on the local market. Albinism as a condition is synonymous with low intolerance to light, a situation which often results into intense pain.
Annet Tumushiime, 26, a resident of Kibaya cell, Nyakabande Sub County says that when there is sunshine, images that are far from her appear out of focus and blurred.
She says that although she needs the glasses, they are unaffordable for her. The glasses are sold at not less than 350,000 Ugandan Shillings on the open market. Tumushiime appeals that government prioritizes the issuance of photophobia glasses as a way of extending affirmative action to the albino community.
Brian Iraguha 15, a senior two student of Kisoro Vision Secondary School says that he sometimes fails to read and interpret some of the questions typed on papers due to sight problems caused by albinism.
Michael Sabiiti, the founder and executive director for Site for Community Services Program, a Non-Governmental Organization (NGO) operating in western Uganda says that he has registered fifty children with Albinism, 23 of them, hailing in Kisoro district.
The NGO had partnered with Ruharo Eye Center operating under Ankole Diocese in Mbarara to donate some glasses to albinos. However, Sabiiti says they failed to cater for all of them due to financial incapacitation. They only provided five pairs of glasses.
Kisoro District Chairperson Abel Bizimana pledged to table the concern before the council so that they can be considered in the District budget.
President Yoweri has hailed the UPDF leadership for using their own human resource to build infrastructure and save money through strengthening the health care capacity among the security forces.
The President who was en-route to Apac District to preside over Tarehe Sita celebrations, made a stop-over at Bombo Military Barracks where he commissioned the newly built UPDF Officers’ Wing and Intensive Care Unit.
The 25-bed capacity facility consists of the Intensive Care Unit (ICU), maternity and delivery room, general ward as and a VIP suite. Construction of the medical facility cost 925million Shillings, while the medical equipment cost another 723 million Shillings, According to Col Bekunda Besigye, the Deputy Commander of the UPDF Engineering Brigade.
Brig Dr Ambrose Musinguzi, the UPDF Chief of Medical Services says that 70 percent of the patients at the facility are civilians who are offered services at no cost.
President Museveni commended the work of the two core groups, the medical team and the Engineering Brigade which he said has greatly reduced on the cost of construction done by hired contractors.
He said the facility will help the institution in treating and handling their own patients in privacy without ‘advertising’, but also serve the local community.
“You have done well. You have done it yourselves and you will examine and treat our soldiers. You should continue to cover more areas of the body to handle issues of cancers, kidneys, Urinary tract diseases and heart diseases among others,” he said.
Defense Minister, Hon Adolf Mwesige said the hospital was an important facility for the UPDF and for the country and that it will foster harmony and understanding between the military and civilians including through activities such as extending free medical care, responding to epidemics and disasters.
Russia’s oldest working surgeon turns 90 this year and with 10,000 operations already under her belt, she has no plans to retire.
Alla Ilyinichna Levushkina, 89, has worked with a scalpel in her hand for 68 years and still rattles out four surgeries a day at Ryazan City Hospital near Moscow.
The seasoned campaigner is only 150cm (4ft 9in), so has a special step to stand on to make sure she can reach her patients.
The 89-year-old worked in the air medical services for 30 years, when she treated patients living in the Russian wilderness.
She has now returned to Ryazan where she grew up and studied, and her appetite and drive has not wavered.
‘Being a doctor isn’t just a profession but a lifestyle,’ she told Lite FM when asked why she hasn’t retired.
‘If I stopped working, who is going to perform the surgeries?’
The tenacious pensioner has steady hands despite her age, and regularly has to deal with invalids who feel uneasy with her treating them.
One patient called Irina told Lite FM: ‘At first I felt I couldn’t trust a surgeon who is so old, but after she palpitated me with her firm fingers – all doubts gone.’
Alla refers to herself as the ‘racing horse’, because she is immediately filled with energy when she enters the operation theatre.
She will turn 90 on May 5.