PROVIDING EASY ACCESS TO HEALTHCARE TO TEENAGE SEX WORKERS

Giving attention to vulnerable groups and key populations needs to be a major priority for societies who are concerned about providing equitable improvement in health for all including minority populations. These minority populations include commercial sex workers, Lesbian Gay Bisexual and Transgender (LGBT) people, prisoners and drug addicts. There are so many limitations which hinder the attention given to people who fall in this category and in most cases, they are not only marginalized but ostracized by most societies. 

In Ghana, commercial sex workers like other key populations are consequently shunned leaving them more likely to have limited access to health information and care which includes the risks of contracting sexually transmitted infections. This is mostly because sex work is illegal in Ghana and also unacceptable in most societies. You may not agree with the need to look out for them because your values are strongly against sex work but keep reading. 

What implications does this have on the health of commercial sex workers, especially children and teenagers who by no fault of theirs, find themselves in the trade? 

To find some answers, I set out to ‘Railway’, an area at the Kwame Circle in Accra to find some answers. I interacted with some teenage sex workers to find out their journey in commercial sex work and how they protect themselves from Sexually Transmitted Infections (STIs) and other diseases.

Then I met Hope....

Nineteen year old Hope (pseudonym) is a Junior High School drop-out and a mother of one. She got pregnant at age twelve and gave birth to her son who is now seven years old. She left her child with her family and set out to find greener pastures. 

Today, Hope works as a commercial sex worker at the Kwame Nkrumah Circle to eke out a living. She was introduced to the trade by a friend who decided not to help her anymore with money and other

basic needs.

Today, Hopes sleeps with about fifteen men each night in order to raise at least One Hundred and Fifty Cedis (GH150.00). She explained; “Here at Circle, the prices are not high. We charge either ten or fifteen Ghana cedis per shot (per customer). Most of them pay ten cedis, so in order to get one hundred and fifty cedis at the end of the night, I need to sleep with at least fifteen men.”

When questioned how she protects herself from STI’s Hope said she insists on using a condom even though she admits some of her colleagues do not mind sleeping with clients without a condom. According to her, she feels safe by using a condom. 

“The condoms are given to us by the people who rent make-shift rooms out to us. They charge us two Ghana Cedis per customer, and give us condoms wrapped in toilet roll as part of the package” she said.

Bless is just one of hundreds of girls who sleep with men for money. Unlike her, many other girls are not fully aware of the risks involved in having unprotected sex especially with multiple partners. This emphasizes the need to promote initiatives and projects with the primary aim of making people like Hope have access to quality health-care. In essence, it gives key populations easy access to quality information on health, improved access to health care and the ability to make informed reproductive health choices. This will also create a responsive environment to address their health concerns for a a general improvement in their health status. 

In other words, if key populations such as sex workers are given the necessary education, they will be empowered to join majority groups to demand accountability on how resources allocated to improve the health of citizens are utilized. Mainly because the health system is a key component of societal systems which need to be made more friendly to minority groups. 

With increasing concerns by sex workers on the rate at which they are stigmatized even at some health centers, there is a possible drawback in the fight against Sexually Transmitted Infections and other consequential effects of unregulated sexual behavior. In 2016, there were reports that some sex workers in the Adansi-Obuasi constituency of the Ashanti Region of Ghana were demanding as a matter of urgency that government decriminalizes sex work. This goes to prove how ‘sexual minorities’ in the country seek the attention of decision makers in other to make policies friendly to their needs. Also, recognizing that sexual minorities including sex workers face setbacks such as discrimination and limited access to resources on health can be the beginning of more pro-minority health projects and policies.

It may be difficult for young children who unfortunately find themselves in commercial sex work to have access to ‘judgment-free’ health assistance. Even though there are Non Governmental Organizations and bodies to assist in this regard, it is equally imperative to recognize the difficulty for children to open up and explain their real situation to health professionals due to fear of neglect or rejection. For teenage sex workers, it is almost frightening to share their reality with their parents and family members for fear of being ostracized. 

Commercial Sex must not be endorsed, but people especially children in the trade need to be protected. We need to embrace them, listen and make it easy for them to ask for help. This should be applied to other minority groups such as prisoners and drug addicts. We need to give people like Hope a chance to safe and accessible health-care for a better life because a health- care system can only be holistic if it cares for minority groups.

SHE BEAT CELEBRAL PALSY TO BECOME CELEBRATED SOFTWARE ENGINEER- FARIDA BEDWEI

“ I have to prove to the world and prove to myself that despite my challenges, I can still be successful”.

At the very core of a society which has a history of rejecting children with a condition  as hers, Farida survived. Her survival is a remarkable story of optimism, endurance, and success, and she has not only grown to become an inspiration to the often marginalized group of disabled people in Ghana, but to the young Ghanaian women seeking to thrive in the ever growing technological industry. 

Diagnosed with Celebral Palsy at ten days old, Farida Nana Efua Badwei is the software engineer who is transforming Ghana’s micro-finance sector with her company Logiciel Ghana Limited. Her condition which is a neurological disorder permanently affects body movement, muscle coordination and balance, and affects the part of the brain that controls muscles movements. This condition is one which usually hinders chances of a breakthrough for its patients, but Farida, who has lived with the condition all her life has refused the limitations, defied the odds and fought through the stigma to become Africa’s Most Influential Woman in Business and Government (Financial Sector) in 2013, with many more accolades to her name.

With two diplomas and a Bachelor of Science degree in Computer Science,her ability to start her own IT company in response to a gap in the market of micro-finance software is one I draw so much inspiration from. Working as Co-Founder and Chief Technical Officer of Logiciel, she is revolutionizing the use of technology among micro-finance companies in the country by providing suitable software to help improve efficiency.

Miss Bedwei is an inspiration not only to me, but to many young Ghanaian women disabled or not, who have a strong desire to change the status of women in technology. As a child, she saw opportunity in her weaknesses. Celebral palsy patients are out of control of their own body movements, and Farida is not left out. Her handwriting as a child was not legible so she started using computers at a very early age unlike most children in Ghana at the time. Starting with a manual typewriter, she was introduced to an electric typewriter and then later to computers. According to her, her profession was carved out of her limitation to learning with machines in the early days but luckily, she discovered her passion for computers in the process. Farida, who wrote her first program at age 8 has not relented in her quest to leave her mark as one who contributed to technological advancement in the world. 

Unlike most students in Ghana, she created her own educational route by skipping Senior High School to enroll in a one year computer course. This was when she discovered her real passion for computer programming. This decision can be said to be one of the best decisions in her life since her career has earned her many awards including the Young Global Leader Award at the World Economic Forum in March, Africa’s Most Influential Women in Business and Government (Financial Sector), Danaa Excellence Awards for Persons with Disabilities-Leadership and Technology Sector by the Ghana National Council of Persons with Disabilities, National Youth Achievers Award (Special Award) by the Government of Ghana and the Legacy and Legacy Ideas Award.

Her story is a real inspirational footpath for success beyond barriers and I am mostly moved by her quest to achieve and change the face of women in society which is identical to my desire to advocate for the protection and empowerment of the feminine sect using  technology. 

A software developer with about 20 years experience, her love for technology keeps growing and she encourages more women to venture into IT and innovate to solve local problems. Farida worked as a software programmer at Soft Company for three years, after which she landed a role as Senior Software Architect at Rancard Solutions where she worked for nine years before moving to work as Head of IT at G-Life Financial Services where she also worked as an IT consultant before starting Logiciel with her partner Derrick Dankyi. 

My admiration for Farida Nana Efua Badwei heightens considering her courage to write her book, “Definition of a Miracle” which addresses the misleading perceptions people have about disabled people. Farida believes that the only limitation any individual can have is in their mind and if the barriers of containment are broken, nothing can stop anybody from achieving what they desire. Another important thing which I salute is when she stated that every human being has a strength and a weakness, the only difference is, the weaknesses of disabled people are visible.

Miss Farida Nana Efua Bedwei is simply an exceptional women with exceptional qualities. She is a software engineer who doubles as a human rights advocate. She advocates for equal opportunities for all and believes that people with disability do not want preferential treatment, but want the opportunity to achieve competitively as anyone else. 

She is one out of the many female IT experts who inspire me, but she stands out owing to her zeal to move the world with IT in the midst of her condition. She inspires me and I always celebrate her. 

The Complete Woman brings you some tips to serving the family some healthy crunch. Enjoy the goodness!!!

MUNCH ON THAT CRUNCHY GOODNESS!

Its simple! Get some lettuce, carrots, cucumber, tomatoes, red onions and some hard boiled eggs (optional) and make this delicious veggie salad. This is easy to make and is surely what your body needs for a good health. 

Directions

• Wash ingredients thoroughly with water and vinegar, and rinse in ordinary water afterwards.
• With a clean paper towel, napkin or salad spinner, wipe out some of the moisture from the veggies.
• In a plate, gently arrange your veggies in layers, and top with your slices of hard boiled eggs.
• Serve with your favorite salad dressing. Preferably, french salad dressing or avocado salad dressing.
• This can be served alone or as a side dish, with an accompaniment of your choice.
• Enjoy!

WHEN THE MEN START GIVING BIRTH

If only men could get pregnant and give birth,
they would appreciate the strength of their women 

"WHEN THE MEN START GIVING BIRTH"

Today, you and I are going to change the story of creation!!! Of course, I am not talking about creating new software or inventing a new technology; I am referring to the real story of the creation of man. Have you ever wondered how the world would be, if the words of God changed after he found that Adam and Eve had eaten the forbidden fruit? What if there was an exchange of roles, sounding like this: 

“…And to you Adam, I will make your pains in childbearing very severe; with painful labor you will give birth to children. Your desire will be for your wife, and she will rule over you…”

This I’m pretty sure would have made the world a sane place and made a big difference. Really! 

 If only men would go through the painful process of keeping a pregnancy and giving birth, a majority of the men who do not, will appreciate the strength of  their women and the special attention they need.

Married or unmarried, people have sex for all the reasons there can be. When pregnancies come, it then becomes the sole responsibility of the woman to bear all the stress and tiredness during pregnancy, the excruciating pain of childbirth and the responsibility of breastfeeding, changing diapers and more after delivery. Now is the time to define the real responsibilities of men in the lives of their pregnant partners, daughters and children.

Though they may seem farther to reach,  organizations and agencies such as the United Nations Population Fund(UNFPA) are close enough and vigorously leading the campaign towards securing the lives of our pregnant women, however,  some of the men who are major ‘investors’ in creating the pregnancies are just too busy to care.  So now, you may be wondering what on earth the man is expected to do, except to relish the pride in being able to get his woman pregnant and preparing for the naming ceremony. Well, there’s a lot more responsibility than that vague description of the role of men in caring for pregnant women.

To set the premise, I need to give you the very reason agencies such as the United Nations Population Fund (UNFPA) are calling for all-inclusiveness in fighting mortality among pregnant women.  The death of a woman while pregnant or within 42 days of termination of pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes is what best describes maternal mortality. This can be measured in terms of maternal mortality ratio, which is the number of maternal deaths during a given time period per 100,000 live births (WHO, UNICEF, UNFPA & The World Bank 2012). It must be acknowledged that thousands of lives worth saving have been lost from maternal mortality.

In Ghana, where the maternal mortality ratio is 350 deaths for every 100,000 live births, (one of the highest in the world) women die daily from pregnancy related complications. These deaths occur regardless of the many efforts which were put forth to meet the fifth goal of the Millennium Development Goals (MDGs), by September this year.  2015 is here, and unfortunately, Ghana is unlikely to meet this target. All these give rise to the need to having the support of everyone including men.

If only men would be by the side of their women and support them through it all, some of the deaths associated with pregnancy would be prevented.

Now these are three very important ways men can help in improving maternal care in Ghana.

Men Need to Educate Themselves on Pregnancy

Women react differently when pregnant, from the swelling feet to the morning sicknesses and pretty annoying habits. When you are willing to accept these changes your wife might be going through, your possibility of understanding her is assuring enough of your support. I believe men can educate themselves on taking care of their pregnant wives by reading books and other materials, and also speaking to a professional. If men are involve in the process, such as accompanying their pregnant partners to anti natal care, it will help clear the misconceptions and superstition associated with pregnancy and help contribute to healthy lifestyles of pregnant women.

Encourage Women to Seek Pre-Natal Care and Post- Natal Care

Men’s role in ensuring good health care of their wives is very essential in the life of pregnant women.  This will help reduce the risk of pregnancy complications and ensure good health of the unborn child. In most Ghanaian societies where the man is the head of the family, the woman is expected to consult the man before taking any decision of going to the hospital or the clinic to seek medical help. This can be dangerous to the health of the woman since emergencies cannot be managed at home or by Traditional Birth Attendants. Therefore, encouraging pregnant women to visit health centers immediately there is an emergency is a crucial role which needs to be played by men.

Leaders (men) should involve Maternal Health in key Policies and Ensure proper Implementation

The free maternal health policy in Ghana, which was an initiative by the Ministry of Health, and launched in 2008 to provide subsidized health insurance to pregnant women in the country is one of the interventions by Ghanaian leaders to help address the challenges pregnant women face with regard to access to healthcare delivery services. This initiative is one of the few policies by the country’s leadership with central focus on the healthcare of pregnant women in Ghana.   According to an evaluation report by the United Nations Children’s Fund (UNICEF) on the free maternal healthcare initiative in Ghana in 2012, it was found that, since the inception of the initiative in 2008, there has been a steady increase in the number of facility-based deliveries from about 300,000 in 2007 to about 500,000 in 2011. This brought an improvement in the previous years, where access to health facilities highly depended on one’s ability to afford the services of professionals in health facilities. Even though the  initiative had its challenges such as the distance and cost of transport to health facilities, perceived hostility of maternity staff, cultural beliefs and superstition and shortage in supplies and human resources, the general outcome brought about an improvement in the desire for safe healthcare and delivery  for pregnant women in Ghana.

Due to these benefits derived, it is prudent for the men who occupy positions of leadership than women in this country to know that all inclusive participation by men in decision making including political leaders, opinion leaders, chieftancy institutions and other decision making bodies will go a long way to save the lives of women who die from pregnancy related complications. Its not worth waiting till when the men start giving birth!

   Hello guys, its Day Two of the"Facts on cervical Cancer"series. We take a look at prevention of Cervical Cancer, HPV Transmission and more....Lets read, understand and explore the issues!!

FACTS ON CERVICAL CANCER

WHAT HAS TO BE DONE TO PREVENT CERVICAL CANCER?

Education

  Primary Prevention

  Preventing HPV(Human Papilloma Virus) transmission

•    Most importantly to modify sexual behavior – cervical cancer is sexually transmitted!
•  To strive to get cheap vaccines against HPV for girls and young women.

•       Secondary Prevention

• Cervical cancer is preventable with screening, detection and treatment of early ‘disease’ that could progress to cancer.
•  Empowerment of women.
•  Reduction of poverty 
•   Infrastructural development – to reach the vulnerable women in the remote villages.
•  Training, training, training! 

 PREVENTING HPV TRANSMISSION

HOW IS HPV TRANSMITTED?

1.     Sexual Contact.
2.     Non sexual contact.

HPV TRANSMISSION

SEXUAL CONTACT

•  Through sexual intercourse.
•  Genital-genital, manual-genital, oral-genital.
•  Genital HPV infections in virgins may result from non penetrative sexual contact.
• Condom use may help reduce risk but does not fully protect.

HPV TRANSMISSION 

NON SEXUAL CONTACT

•     Mother to newborn (vertical transmission – rare)
•       Fomites (eg undergarments, surgical gloves, instruments…)

   HPV TRANSMISSION

                   Bulb syringe (‘Bentoa’) – for enemas

BULB SYRINGE FOR ENEMAS

BULB SYRINGE (BENTOA) FOR ENEMAS  

    To be continued....

     

    Credit: Dr. Kofi Effah
Catholic Hospital, Battor.

      Medical Knowledge  Fiesta, 2012.

      Presented on Wednesday, August 8, 2012 at the Ghana College of Physicians and Surgeons in Accra.

                                                                                       

Hello guys, lets get informed and fight in this battle; the battle against cervical cancer.  This is the first of the " Facts on cervical cancer" series running this week. Please beware of some “disturbing” images. Enjoy and learn. Stay Healthy!!!

FACTS ON CERVICAL CANCER 

WHAT IS THE CERVIX?

The cervix is the neck of the womb, consisting of a narrow passage, leading to the vagina. The cervix widens greatly during childbirth to permit delivery of the baby.

                                  ANATOMY OF THE UTERUS AND THE CERVIX

      CANCER?

•      Abnormal (uncontrolled) proliferation or growth of cells
•        Tumor (lump)
•        Infiltration and invasion of surrounding tissues
•        There may be spread to distant parts (of the body)        
• 
  

•                                                                                                                                    NORMAL CERVIX  

                                                             CERVICAL CANCER

 CERVICAL CANCER

MAGNITUDE OF THE PROBLEM OF CERVICAL CANCER

GLOBAL ESTIMATES

•      493,000 new cases each year, 83% in developing countries

•      274,000 women die of the disease annually, about 85% in developing countries

•      Every 2 minutes at least one woman dies from cervical cancer

•      Leading cause of death in gynecological cancers in Ghana

WHAT CAUSES CERVICAL CANCER?

•      99.7% of cervical cancer is caused by persistent infection with High Risk HPV.

•      Cervical cancer is rare without (High Risk) HPV infection.

•      A little over 70% of cervical cancers are caused by HPV 16 and 18.

WHO IS AT RISK OF CERVICAL CANCER?

•      Early age of first intercourse
•      Multiple sexual partners
•      Increased parity
•      A male partner with multiple previous sexual partners
•      Immunosuppression (eg. in HIV)
•      Exposure to Nicotine (smoking)
•      Genital infections (trichomoniasis,chlamydia etc.)

To be continued...

Credit: Dr. Kofi Effah
Catholic Hospital, Battor.

Medical Knowledge  Fiesta, 2012.

Presented on Wednesday, August 8, 2012 at the Ghana College of Physicians and Surgeons in Accra.

                                         UNFPA VRS FISTULA

Growing up in this country on the west coast of Africa is one of great adventure and expectation in the life of a young Ghanaian girl. Right from puberty to adolescence to the warm arms of adulthood, it is the dream of every woman to be a mother and cuddle her baby in her arms, singing one of the numerous soothing Ghanaian lullabies. For whichever reason, a woman needs to get married and have babies; it is one of great cultural essence and prestige. However, it becomes stressful and heartbreaking for a woman who is unable to have babies or have a safe delivery due to limited health care and awareness. One of such hurdles is fistula, a condition in women. 

According to the results of the 2010 Population and Housing Census on 31^st May 2012 by the Ghana Statistical Service, there is an estimated 12,633,978 women in Ghana. This represents 51.2% of the total population, stressing the essence of the United Nations Population Fund in addressing maternal health challenges. The pace of female dominance in Ghana’s population over the years undeniably exposes the country to more cases of female related health issues.

Obstetric Fistula also known as vaginal fistula is a severe morbidity caused by prolonged obstructed labor unrelieved by timely medical intervention. Though this condition can be treated, it is the major cause of maternal mortality especially in the Northern part of the country. According to the World Health Organization, between 500, 000 and 100,000 (cross-check these figures) women worldwide are affected by obstetric fistula, which is characterized by a hole in the birth canal. 

In some parts of Ghana where access to healthcare is an issue to contend with, there have been increasing reports of women living with fistula for over forty years without seeking medical attention. Fortunately, fistula is avoidable. Unfortunately, not many women know about it. Obstetric fistula can be avoided by timely access to obstetric care, delaying the age of first pregnancy and the cessation of harmful traditional practices such as Female Genital Cutting. 

The United Nations Population Fund has taken giant strides to thrush out this canker. UNFPA has rolled out programs to educate young and adult women on the causes and implications of this condition. The UNFPA has recognized the essence of education in fighting the problem of fistula. This is reiterated by media training programs organized in the bid to create awareness on the condition. UNFPA has also gone a step further to equip women with tools that will help rid them of this condition which is done in the effort to reduce maternal mortality to the barest minimum in Ghana. Obstetric Fistula contributes to the number of maternal deaths we have in the country. 

The highest rates of obstetric fistula are found in countries that are less developed. Fighting Fistula falls under the mandate of the UNFPA which focuses on improving Adolescent Reproductive Health, reducing the rates of teenage pregnancy, improving sexual health, and eliminating early marriages. 

The global campaign to End Fistula is an integral component of UNFPAs overall strategy to improve maternal health which also includes interventions to avoid fistula, treat women who have fistula and help women affected by fistula recover. Women with fistula face among other medical symptoms, incontinence, shame, social segregation and stigma. It is sad to say that lack of access to contraceptives among girls in rural Ghana results in adolescent and teenage pregnancy cases which in turn causes the risk of conditions such as fistula and invariably maternal mortality. Goal 5 of the Millennium Development Goals is a major priority of the UNFPA. It aims at improving maternal health by reducing by three- quarters the maternal mortality ratio. UNFPA’s priority is to help make fistula as rare in developing countries as it is in the developed world. This is because; a decrease in the number of fistula patients means a decrease in the rate of maternal deaths. It is worth noting that the interventions used helps UNFPA not only reduce the fistula rate, but achieve other positive results in the interest of young people and women. 

In Ghana, pregnant women in some rural areas lack access to obstetric care where some Traditional Birth Attendants (TBAs) are unable to provide the right anti-natal advice or care to their clients. Some of these TBAs are unable to manage complications that come alongside child birth due to no or less professional training in handling labor complications.  In some parts of Ghana, women who give birth without assistance are seen as brave. This is causing a major challenge of likely maternal mortality cases. Women in such areas are not aware and informed on modern birth practices and the implications of some decisions and actions they take. This makes the issue of maternal mortality more than a mandate but a drive of passion to UNFPA as it seeks to improve the livelihoods and Sexual and Reproductive Health of women and young people in Ghana.

The implications of some decisions by the Government of Ghana to tax condoms is one that will undeniably affect the effort and path the UNFPA Ghana Country Office has taken in reducing maternal mortality. The male and female condoms are the most popular dual purpose contraceptives – prevents pregnancy and, HIV & AIDS and other STIs. Affordability and accessibility of condoms as contraceptives is one of the most effective ways of avoiding maternal deaths through preventing unplanned and early pregnancies. When young people have access to condoms, they can avoid unplanned pregnancies and invariably prevent maternal deaths. Therefore it is rather disheartening that the Government of Ghana is proposing an increase in the prices of condoms in the country. In a bid to contribute to the development of the country, it is prudent for all stakeholders and civil society organizations to take up issues of healthcare and essentially the welfare of Ghanaian women in Ghana and make them a priority in every issue of human development.

The issues of obstetric fistula can be reduced or curbed with access to quality healthcare and adequate education. It is therefore my wish that civil society organizations, Non Governmental Organizations, the Ministry of Health and other government machinery in charge of education, healthcare and rural development to take up these responsibilities to help save the lives of Ghanaian women in a direction that will complement the work of the United Nations Population Fund to help attain Goal 5 of the Millennium Development Goals.