Helping Doctors Save Women's Lives
WMP Donates Colposcope for Early Diagnosis of Cervical Cancer in Ndola, Zambia
Pictured (L to R): Roxane Richter (WMP President), Adam Sallee (Ndola University, Zambia), and colposcope donor Dr. Beth Files (OB/GYN).
Pictured (L to R): Dr. Thomas Flowers (WMP Medical Director), Adam Sallee (Ndola University, Zambia), and colposcope donor Dr. Beth Files (OB/GYN).
While in northern Zambia, the WMP meet with numerous nurses and doctors, and one of the TOP NEEDS according to local doctors was a colposcope for the early detection of cervical cancer and rape exams. As one local doctor said: "By the time we can detect it ourselves, it's too late for the woman..."
In 2010, Dr. Beth Files (OB/GYN) donated a colposcope to World Missions Possible for use at NUCare Clinic in Ndola, Zambia. A colposcope is used for rape exams and to look at the cervix for problem areas when abnormal tissue is found after a Pap test. This singular piece of equipment will help save many women's lives by allowing doctors to have an early diagnosis of cervical cancer, while it may still be at an operable and successfully treatable stage.
During our stay, we met with and interviewed Dr. Pascal Luboya Betu, Dr. Elizabeth Mwape, Dr. Tumba Tschula, Dr. Luboya Nsungula, Dr. Moffat Zimba (NorthRise Univ.), Doreen Zimba, Adam Sallee, and district clinical nurses Mary Sichula and Lynette Mammbo.
WMP advised NorthRise University on its construction of NUCare, a clinic situated on the grounds of NorthRise University, on the equipment and supplies needs for the planned clinic (opened July 2011). WMP compiled a brief report on local and national healthcare issues we believed to be pertinent to the provision and treatment at the planned NUCare clinic in Ndola. The information in this report was compiled during the World Mission Possible’s summer of 2010 visit to NorthRise University, local hospitals and regional healthcare providers (physicians, pharmacists, midwives, and nurses with both public and private sector experience). During our stay, we met with and interviewed Dr. Pascal Luboya Betu, Dr. Elizabeth Mwape, Dr. Tumba Tschula, Dr. Luboya Nsungula, and district clinical nurses Mary Sichula and Lynette Mammbo.
WMP proposed a three-tiered approach to the clinic's set-up: based on basic, intermedicate and advanced needs for both primray and emergency medical care. As for the pertinent health programs and hospital care in the region of Ndola, we understand:
there is one ambulance in the district
HIV, TB and malaria (adult, over age 40 - stroke) (and pediatric – malaria, meningitis & infectious disease) are the primary causes of hospitalization/care
Arthur Davison Children’s Hospital – nearby pediatric hospital has 2 pediatricians, 78 nurses, 250 beds/3 ORs/ICU/isolation & observation ward – x-ray, ultrasound, EKG. Immunizations are conducted July & August. Monthly eye screenings. Burn unit needs assistance & foreign aid help. Lab techs & 3 microscopes. Orthopedic lab & counseling off-site.
Ndola Central Hospital – 250 beds, 80 doctors, 10 surgeons. 5 ICU beds (1 vent). Specific needs are for orthopedics, fetal monitors, AED, vital signs monitors, and colposcopes (rape, cervical cancer).
Malnutrition is an issue (esp. among pediatric patients) Sept. – Jan., due to lack of harvest in this season
c-section is approx. 20,000-50,000 kwacha ($4 - $10)
CT scan available only in Kitwe & Lusaka – private hospital, about $400.
there is a recommended 1:6 nurse to patient ratio, but current rates are 1:30-40
sex education is offered nationally in 6th /7th grade. ABCs = abstinence, be faithful, condoms.
ZAMBIA: INFANT AND CHILD MORTALITY
(2007 National Report)
The vast majority (94%) of Zambian women receivesome antenatal care (ANC) from a skilled provider,most commonly from a nurse/midwife (87%). Only19% of women, however, had an antenatal care visitby their fourth month of pregnancy.Almost all women who received antenatal carereceived iron tablets (90%); only 36%, however, tookintestinal parasite drugs. Only about three-quartersof women were informed of signs of pregnancycomplications during an ANC visit. Urine sampleswere taken from less than a quarter of pregnantwomen receiving antenatal care, but more than halfof women had a blood sample taken. Eight in ten ofwomen’s most recent births were protected againstneonatal tetanus.
Delivery and Postnatal Care
Less than half (48%) of Zambia’s births occur in healthfacilities, 43% in the public sector and 5% in privatesector facilities. Fifty-two percent of births occur athome. Home births are more common in rural areas(67%) than urban areas (16%). Only 47% of births areassisted by a skilled provider (doctor, clinical officer,or nurse/midwife). Another 23% are assisted by a
traditional birth attendant and 25% by untrainedrelatives or friends.Postnatal care helps prevent complications afterchildbirth. Half of women did not have a postnatalcheckup.
The ZDHS 2007 asked women about deaths of theirsisters to determine maternal mortality - deathsassociated with pregnancy and childbearing. The 2007maternal mortality rate for Zambia is 591 per 100,000live births.
Assistance During Delivery
47% of births wereassisted by a trainedprofessional
According to the 2007 ZDHS, 68% of Zambian childrenage 12–23 months had received all recommendedvaccines - one dose of BCG, three doses each ofDPT and polio, and one dose of measles. Only 6% ofchildren had not received any of the recommendedvaccines. Vaccination coverage is slightly higher in urbanareas than rural areas (71% versus 66%). There is alsovariation in vaccination coverage by region, rangingfrom only 52% fully vaccinated in North-Western to80% in Western. Coverage increases with mother’seducation and household wealth.
In the two weeks before the survey, 5% of childrenunder five had symptoms of an acute respiratoryinfection (ARI), and 18% had a fever.During the two weeks before the survey, 16% ofZambian children under five had diarrhea. The ratewas highest (28%) among children 6 to 11 months old.Almost two-thirds of children with diarrhea weretaken to a health provider.
Breastfeeding and the Introduction of Complementary Foods
Breastfeeding is very common in Zambia, with98% of children ever breastfed. Almost two-thirds (61%) of children undersix months of age are being exclusively breastfed.Infants should not be given water, juices, other milks,or complementary foods until six months of age,yet a quarter of Zambian infants under six monthsreceive complementary foods. On average, childrenbreastfeed until the age of 20 months.Complementary foods should be introduced when a child is six months old to reduce the risk ofmalnutrition. In Zambia, 93% of children ages 6–9 months are eating complementary foods.The Infant and Young Child Feeding (IYCF) practices recommend that breastfed children age 6-23 monthsalso be fed three or more other food groups. Sixtyeightpercent of breastfed children in Zambia meetthis recommendation. It is also recommended thatnon-breastfed children be fed milk or milk products,and four or more food groups. However, only one infive non-breastfed Zambian children receive milk ormilk products, and a little more than half were fed four or more food groups.
Children’s Nutritional Status
The ZDHS measures children’s nutritional status by comparing height and weight measurements against an international reference standard. According to the 2007 ZDHS, 45% of children under 5 are stunted, or too short for their age. This indicates chronic malnutrition. Stunting is more common in rural areas (48%) than urban areas (39%). Stunting is least common among children of more educated mothers and those from wealthier families. Wasting (too thin for height), which is a sign of acute malnutrition, is far less common (5%). Fifteen percent of Zambian children are underweight, or too thin for their age.
Household Ownership of Mosquito Nets
In Zambia, more than half (53%) of households have atleast one insecticide-treated mosquito net (ITN).
Use of Mosquito Nets by Children
Overall, 29% of children under five slept under anITN the night before the survey. Childrenin the wealthiest households were almost twice aslikely to slept under an ITN as children in the pooresthouseholds (33% versus 19%).
Antimalarial Drug Use
Malaria during pregnancy contributes to low birthweight, infant mortality, and other complications.It is recommended that pregnant women receive atleast two doses of the antimalarial drug SP/Fansidaras intermittent preventive treatment (IPT). Overall, 82% of pregnant women received SP/Fansidar duringan ANC visit, and 63% received two doses of the antimalarial drug.Among children under five years who had fever inthe two weeks before the survey, 38% were givenantimalarial drugs, while only 21% were givenantimalarial drugs the same day or the day followingthe onset of the fever.
The 2007 ZDHS included HIV testing of over 10,000women and men age 15-49. Seventy-seven percent ofwomen aged 15-49 and 72% of men 15-59 agreed to betested for HIV.
In Zambia, HIV prevalence has decreased slightly. TheHIV prevalence of 14.3%, according to the 2007 ZDHS,represents a slight decrease from the 15.6% prevalenceobserved in the 2001-02 ZDHS. In the 2007 survey,16.1% of women and 12.3% of men are positive for HIV.By comparison, in 2001-02, 17.8% of women and 12.6%of men had HIV.
We hope this report shines some light on the current needs of the people of Ndola and its surrounding neighbors in need. We pray for your continued hard efforts and work at NorthRise.