The horror of fibroids.............. One out of three women has it: but it can be tamed, says doctor

By ANN ZULU

OUT of every three women in Zambia, one has fibroids but despite these alarming records, there is less information about the preventive and treatment of the health condition.

According to consultant obstetrician and gynaecologist Dr Steven Mwape, fibroid cases were on the increase and women above 30 years were more likely to have the disease.

Dr Mwape, however, noted that most fibroid cases do not cause any health problem.

He explained that the same hormones that control menses promote the growth of fibroids, adding that if a female has been having her period throughout her life the chances of having fibroids were higher.

“When a woman is pregnant, they do not have menstruation and so there is a break in the menstrual cycle. It has been observed that people who have several pregnancies in their lifetime are least likely to have fibroid.

“However, those who have had no break in their menstrual cycle are most likely to have fibroids,” Dr Mwape said.

He said fibroid was a benign growth of the womb, which was not dangerous but the malignant growth (cancer) could pose health challenges.

Dr Mwape noted that one could live with fibroids but should seek treatment if it causes pain around the abdomen during and after menses or experiences visible enlargement of the lower abdomen and excessive bleeding with lots of blood clots, dizziness and weakness as a result of the blood loss.

He said if the fibroid was causing problems then the patient needed surgery - myomectomy or hysterectomy.

“Myomectomy involves the removal of fibroid growth while hysterectomy involves the removal of the womb.

“People usually discover they have fibroid accidentally when they go for a scan for another health situation because there is no clear symptom to show one has fibroids.

“When this happens one should not worry because medical doctors are able to manage those that cause problems,” he said.

The most visible sign of fibroid is the enlargement of the lower abdomen. However there are other reasons why a lady may start developing a big tummy.

While there may be some health reasons there is also lifestyle. Inevitable situations may also cause a lady to have a visibly big stomach.

One such condition is pregnancy, however some women may not have flat stomach after giving birth.

Dr Mwape explained that the increase in the belly size after childbirth was due to the stretch in the abdominal walls that occurred during pregnancy.

He said the womb begins to expand especially during the second half of the pregnancy, as it expands to cater for the growing foetus, and the increasing amount of amniotic fluid around the baby.

Said Dr Mwape: “The stretch sometimes becomes so much that there is a lot of stretch marks called striae.

“After the baby is delivered, the womb may try to return to its original size but it usually doesn’t because of the stretch that has taken place. However, there is individual variation.

“Some women have a lot more elastic muscle tissue, so even when they are stretched, they come back a little normal than others, but for most people the stretch causes the abdominal walls to become lax,” he said.

Dr Mwape advised women to do the abdominal wall exercise for a few weeks after pregnancy.

“If a woman had a normal delivery then three weeks after delivery when she is completely well, then she can start the exercise,” he said.

He added that the results are better if one starts the abdominal wall exercise early after childbirth.

“The woman should lie on her back and the neck resting in both hands. Then lift the legs with knees stretched up to the waist level. This can be repeated a number of times.”

Meanwhile, a survey by this reporter revealed that most women develop a bid stomach after childbirth and some men have a high regard for those who are able to maintain a flat belly even after childbirth.

Most of the women talked to explained that after birth, they used cloth to tie their stomachs for some time, but the reduction was not significant.

Others explained that they wore a corset beneath their clothing, and very few exercised after childbirth.

There were also the ladies who did nothing at all after childbirth, but had their bellies return to normal.

From the survey, it was also discovered that some women were overly worried about their tummies after pregnancy whereas their husbands did not.

However, some men were critical of young ladies who have not delivered but have visibly big stomachs.

They explained that it was a complete turn-off for them.

Fibroids may cause ladies’ tummies to be big, post-pregnancy conditions may also cause their abdomen to enlarge, or even cholesterol.

Through vigorous exercises one could reverse her big tummy and through good diet the health problems associated with high cholesterol could also be under control.

The challenges of fibroids could also not be out of control if women take seriously the advice their doctors give them. 

Changing feminine face of poverty ……women rise to become backbone of agriculture and owners of land

By ANN ZULU 

MANY widows in Zambia, especially in rural areas, have taken up farming as a way of supporting their children’s education.

Chaka Mbewe, a 50-year-old woman from Chongwe district, is one such person.

She lost her husband years back and had to depend on farming to cater for the four children the husband left behind.

She has a four and a half acres of land on which she grows maize and groundnuts. She also rears a few goats and pigs.

Ms Mbewe said farming was the only thing she could do to support her children’s education, but several challenges such as lack of fertilizer, traction services and others made it difficult for her to succeed.

Generally, rural communities lack lots of opportunities including income generating activities for women to take advantage of.

The effect of this is the constant migration of young females from rural to urban areas to engage in illicit activities.

Undoubtedly, women comprise the largest percentage of the workforce in the agricultural sector, yet they produce less than their male counterparts.

That is not because women are less able than men or because they are less resourceful. Certainly, it is also not because they are less motivated than their male counterparts.

According to gender activist Gladys Mutukwa, it is because women do not benefit equally from farm inputs such as fertilizer, insecticides, machinery and information on modern farming practices.

This gap is making it impossible for Zambian women to become the thriving farmers they need to be in order to pull themselves out of poverty and give their children a better life.

Ms Mutukwa said if women countrywide had the same access to productive resources as men, they could boost agricultural production and help reduce levels of hunger.

“In rural areas the majority of women are engaged in agriculture as their main economic activity and many of these women are the breadwinners of their families. It is out of their sweat that children are fed, clothed and school fees paid,” Ms Mutukwa said.

Culturally in Zambia, women do not own land even though they form the largest percentage of the agriculture workforce.

Lack of access to land is making it difficult for women to engage in commercial agriculture. Also because of lack of resources, they do not have access to hired labour and tractor services.

They struggle on their small farms alone, hence their engagement in subsistence farming.

Women also tend to face greater challenges when it comes to securing credit. They are generally less experienced with borrowing from an institution, and without assistance and support, they find it difficult to access the much needed finance.

Most agricultural extension officers’ focus is always on owners of large-scale commercial farms while providing limited research and farming techniques to smallholders, the majority of whom are women.

Most advanced technology such as tractors, cultivators, planters and other farming equipment often benefited male farmers to the detriment of women.

Lack of market research and information limit women farmers to market access as they are confined to local markets where prices are generally low and exploitative.

Lands Minister Jean Kapata says Government was aware of the fact that majority of women in the country, especially in rural areas, did not have access to land.

She however said this might soon be a thing of the past as Government was working towards giving priority of land acquisition to women.

She said the Patriotic Front (PF) government under President Edgar Lungu’s administration was committed to its promise of ensuring that 40 percent of women had access to land.

 “Access to land still remains a challenge to women, but that will no longer continue because the PF government under the leadership of President Lungu is determined to empower women through land and ensure that women have access to land just like the men.

“We are more interested in empowerment and attainment of gender equality as a prerequisite for sustainable social and economic development of the country.

“In Zambia only about 20 percent women have secure access to land, but as Government we will make sure that at least 40 percent of land in the country goes to women,” Ms. Kapata said.

She observed that having secure access to land would help to empower women, both individually and collectively.

Ms. Kapata stressed that women were also entitled to land, saying that Government would ensure that women’s rights such as land were protected and promoted.

She said affirmative programmes to support women’s access to land administration services were underway.

Ms. Kapapta said land was a form of security and collateral for women, building women’s resilience and food security, as well as raising their social status and dignity.

“Access to land means that women will have access to financial assets, including credit and savings, and also reduce the poverty levels in Zambia, because poverty has a feminine face. So we will ensure that women’s rights on land are protected and promoted,” she said.

Meanwhile, Government through the ministries of Community Development and Gender, in collaboration with the World Bank, has also embarked on the Women Empowerment and Livelihood Project.

About 75,000 women from 51 districts countrywide would be empowered and trained in financial literacy and life skills, which includes farming.

Minister of Community Development Emerine Kabanshi said the main objective of the project was to increase access to improved livelihood for women in extreme poor households in selected districts.

“The project became effective in April 2016 after the signing of the agreement between Government and the World Bank. The total financing amount is US$65 million over a period of five years.

“The selected women will be supported with training in life and business skills, including savings and productivity grants that will be provided to assist them finance their small livelihood activities,” she said.

Empowering and investing in women farmers, specifically in rural areas, will significantly increase agricultural productivity while reducing poverty in Zambia