Archive for 2014
If you get migraines – or have a close friend or family member who does – you may think you already know how to deal with them, or perhaps you have even given up trying to alleviate them. Here's the good news: There are new medications and treatments that can really help, says Dr. Michael Zitney, director of the Headache and Pain Relief Centre in Toronto. Here's what you need to know about managing migraines. • Know your triggers. Some of the most common migraine triggers include hormonal fluctuations, weather changes, stress – or the letdown after stress – red wine, aged cheese, chemicals in food and drink (such as aspartame), strong odours, bright lights, too much or too little sleep, and irritation in your neck or jaw muscles. "Most migraines are not caused by one trigger – it's almost always a combination," says Zitney. While some things, such as the weather, are unavoidable, you can definitely limit your suffering by steering clear of your triggers and adapting your lifestyle. "Most people don't put enough emphasis on the things they can change," he says.
• Sign up for weather alerts. A drop in barometric pressure appears to be an important factor for many migraine sufferers. According to a 2009 study in Neurology, it may affect the fluid protecting your brain from the inside of your skull, resulting in increased pressure on external brain tissue. Register for the weather health warning system MediClim (mediclim.com) to receive free email updates about specific weather conditions in your area. "But don't get too obsessed," says Zitney. "If you'e changing the things you can, such as getting more consistent sleep and eating throughout the day, then weather won't be as big of an issue."
• Keep a migraine diary. Track your diet, exercise, stress levels and symptoms. It worked for Julie Hewlin, from London, Ont., who now gets four migraines a year instead of 12. After keeping a journal to identify her main triggers, Julie, 38, learned to manage them better by taking walks on her lunch break and getting regular chiropractic adjustments.
• Watch what you eat and drink. Avoid foods that contain chemicals such as MSG and artificial sweeteners. You should generally avoid both red and white wine, too. Yes, it's a drag, but wine can be a trigger because it contains sulfites and preservatives. "If you're going to drink wine, look for organic white wine, which has fewer chemicals, and drink it in moderation," adds Zitney.
And take a pass on fruity cocktails, too. They're often loaded with food dyes, preservatives and high-fructose corn syrup, which are all headache triggers, says Dr. Christine Lay, director of the Centre for Headache at Women's College Hospital in Toronto.
In addition, the chemicals in steak seasoning and barbecue sauces, and nitrates in meats and smoked meats can also pose a problem, so choose what goes on your plate wisely.
If you skip meals or have a serious sweet tooth, it's time to rethink your eating plan. The sugar in carbohydrates causes blood sugar to rise and fall. That roller coaster ride can result in a roaring migraine when you eat too many carbohydrates and not enough protein. To keep your blood sugar levels stable, eat protein-rich foods, healthy fats and lower-glycemic carbs, such as fruits and vegetables, every two to four hours.
• Cut back on caffeine. If your coffee habit doesn't seem to affect the number of headaches you get, there's no reason to stop loving those lattes. But if you're regularly drinking caffeine and getting migraines, switch to decaf. Kick your soda and caffeine habit slowly, by gradually switching to drinks that won’t cause migraines, such as mineral water or herbal tea.
• Give your senses a break. If you have migraines, you're susceptible to sights and smells, so look for fragrance-free sunblock, insect repellent and skin-care products.
• Take your sunglasses with you. Exposure to bright sunlight or glare from the sun's reflection on water or metal can trigger a migraine in some people. Experts aren't sure why this happens, but migraines may be triggered by bright light or glare when it reaches the visual cortex of the brain.
• Set your alarm clock. Too much or too little sleep is a huge trigger. Shoot for the same number of hours each night and wake up at the same time daily – yup, even on weekends. To get a good, deep sleep, wind down before bedtime: shut off your Blackberry an
d get into relaxation mode by reading, meditating or taking a bath. • Exercise your way to fewer migraines. Regular workouts appear to reduce the number and severity of migraines, says Dr. Werner J. Becker, a professor in the departments of clinical neurosciences and medicine at the University of Calgary. Experts aren't exactly sure why exercise reduces migraines, but they do know that it helps keep your weight in check, which is another way to manage migraines: recent studies have linked obesity to migraines. Just make sure you warm up slowly and keep an eye on your posture; if you're straining your neck to read a magazine on the treadmill, it could exacerbate migraine symptoms later.
Medications • Take the right medication at the right time. Triptans, such as Imitrex, are widely accepted as the best treatment for migraines. "They can stop a migraine within an hour about 70 per cent of the time," says Zitney. If you take triptans and experience flushing, palpitations and chest pain for more than 30 minutes, get medical help. However, if you don't have high blood pressure, or heart or kidney disease, and have not experienced these side-effects, Zitney recommends giving triptans a try.
"There are now seven brands available in Canada, and you should try them all until you find one that is going to help," he says. For the best results, use them correctly: Take the medication as soon as the pain hits. Wait one to two hours for it to work. If you do not experience significant migraine relief, take another painkiller if you feel you need it. If you need to take 10 or more doses of triptans a month, talk to your doctor about preventive medications.
• Consider preventive medications. If you have chronic migraines, triptans alone may not be enough – you may need to consider one of the nonmigraine medications that can help reduce the frequency of your migraines. Certain antidepressants, such as amitriptyline, may be helpful because they let your brain release neurotransmitters that help you sleep better, which is a headache-fighting tool. Beta-blockers such as propranolol, which are normally used to treat high blood pressure, may also help ward off migraines. And antiseizure medications, such as topiramate, may also prevent some of the changes in brain chemistry that can cause a migraine headache to start.
• Use painkillers effectively. If you're reaching for over-the-counter painkillers, "take a strong enough dose to kill the pain and then lie down and sleep to stop [your headache] from escalating into a three-day migraine," says Zitney. To minimize menstrual migraines, start taking an anti-inflammatory such as ibuprofen or naproxen a few days before your period. To avoid rebound headaches from overusing painkillers, talk to your doctor or pharmacist about the correct dose and taking preventive medications.
• Think twice about the pill. For about one-third of women in their 20s and 30s, the estrogen in the contraceptive pill can lead to more migraines, says Lay. If you want to use the pill, she recommends a low-dose monophasic type, which will contain a stable amount of estrogen. If you get migraines around the time of your period, talk to your doctor about taking the pill continuously, so you won't get a period or the hormonal fluctuations that go with it.Alternative options
• Book a massage. Strain in your shoulders or neck, from sitting at your desk or driving, may be a trigger. "You may not even notice it that much, but your brain does," says Zitney. Massage can help by relaxing your muscles and reducing the effect of pain on your central nervous system. To keep those upper-body aches and pains from morphing into a migraine, see a massage therapist, chiropractor or physiotherapist, or take up yoga or tai chi, which emphasize good posture and relaxation. "Make sure your massage therapist is experienced with migraine patients," adds Zitney. "If the individual is too aggressive, the treatment can cause a migraine to flare up."
• Vitamins and herbs. Certain vitamins and herbs appear to be helpful for warding off migraines, says a 2009 study in the Clinical Journal of Pain. "Correcting all of your vitamin deficiencies and consuming a healthy diet in sufficient quantities (not skipping meals) will help your brain fight off migraines better," adds Zitney.
Taking 500 milligrams (mg) of magnesium (a natural muscle relaxant that’s also found in dark leafy greens, nuts and whole grains) may be particularly helpful if you get migraines with your period. If you're not getting enough vitamin B2 (also known as riboflavin) from lean meats, eggs and dairy products, try taking a 400 mg B2 supplement each day.
The herb butterbur (50 mg, three times daily, reducing to twice daily) and the nutrient co-enzyme Q10 (300 mg a day) can also be helpful but may be more difficult to find; check with a health food store or naturopath.
For each vitamin and herb, start with a low dose and gradually build up to the recommended dose, says Lay. Some studies suggest the herb feverfew may be a good migraine preventive, but Lay doesn't recommend it because it can cause rebound headaches.
• Acupuncture. This may also help prevent migraines, according to a 2009 review of studies by researchers at the University of Munich in Germany. But Lay says acupuncture’s effectiveness for preventing chronic migraines is still in question.
• Botox. Lay says this neurotoxin is particularly effective for people who get six or more migraines a month; it's injected into the areas where you get migraine pain. The cost varies, but you can expect to pay about $600 per treatment. To treat migraines, most people need Botox injections every 12 weeks, but will eventually be able to reduce that number to twice a year. Studies on the effectiveness of Botox for migraines have had mixed results, but the treatment has been a lifesaver for migraine sufferer Nancy Smith* of Saint John.
How to Get Rid of a Migraine (9 ways)
How Can I Prevent Ulcers?
No one knows for sure how H. pylori spreads or why some people develop peptic ulcers without being infected with H. pylori, so prevention is difficult. Researchers are trying to develop a vaccine to prevent infection.
If you have already developed a peptic ulcer, there are things you can do to prevent worsening of your symptoms. They include:
- Avoid foods that irritate your stomach. Use common sense: If it upsets your stomach when you eat it, avoid it. Everyone is different, but spicy foods and fatty foods are common irritants.
- Stop smoking. Heavy smokers are more likely to develop duodenal ulcers than nonsmokers.
- Practice moderation. Heavy consumption of alcohol and nonsteroidal anti-inflammatory drugs (NSAIDS including aspirin and ibuprofen) has been shown to contribute to the development of ulcers, so keep your intake to a minimum.
- Learn how to control your stress levels. Regular exercise and mind-body relaxation techniques (such as guided imagery and yoga or tai chi) are often helpful.
What Are the Treatments for an Ulcer?
Medications are usually used to treat mild-to-moderate ulcers. If the cause is bacterial, antibiotics can cure the ulcer. For recurrent, severe cases that do not respond to medication, surgery may be necessary.Although alternative therapies have been shown to aid in the relief of symptoms, they should be used only as supplements to conventional treatment.You should not treat an ulcer on your own without first seeing your doctor. Over-the-counter antacids and acid blockers may relieve some or all of the pain, but the relief is always short-lived. With a doctor's help, you can find relief from the ulcer pain, as well as a lifelong cure from the disease. Proton-pump inhibitor drugs such as Prilosec are the most cost-effective treatment options for peptic ulcers.The chief goals of treatment are reducing the amount of acid in the stomach, strengthening the protective linings that come in direct contact with gastric acids, and -- if your ulcer is caused by bacterial infection -- treating the H. pylori infection with medication. Your doctor will likely prescribe a combination of antibiotics, such as amoxicillin or tetracycline with metronidazole, along with Pepto-Bismol, proton-pump inhibitors, and/or histamine H2 blockers, all to be taken for 10-14 days.If these treatments are unsuccessful, or if you have developed serious complications as a result of your ulcer, surgery may be necessary. If your ulcer is hemorrhaging, the surgeon will identify the source of the bleeding (usually a small artery at the base of the ulcer) and repair it. Perforated ulcers -- holes in the entire stomach or duodenal wall -- must be surgically closed. This is an emergency procedure.In some cases, a surgery to decrease stomach acid secretion may be necessary. However, peptic ulcer surgery is done only in emergency situations, because there are many potential complications associated with the procedure, including ulcer recurrence, liver complications, and ''dumping syndrome,'' which causes chronic abdominal pain, diarrhea, vomiting, and/or sweating after eating.
Understanding Ulcer Treatment
Tips for Living With Ulcers
- If you have an ulcer, be cautious when choosing over-the-counter pain relievers. Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may not only irritate the ulcer but also prevent a bleeding ulcer from healing. Avoid powdered headache powders, which are usually powdered aspirin. Your best choice may be acetaminophen (Tylenol, for example), which does not cause or promote stomach ulcers.
- Don't overdose on iron supplements. Although people with bleeding ulcers can develop anemia and may need to take iron as a treatment, taking too much can irritate the stomach lining and the ulcer. Ask your doctor how much iron you need.
- Learn how to deal with stress. While there is no evidence that stress causes ulcers, it can exacerbate existing ones. Practicing relaxation techniques -- including deep breathing, guided imagery, and moderate exercise -- can help alleviate stress.
How To Prevent,What Are the Treatment And Understand the Treatment of ULCER
What Are Ulcers?
There is no clear evidence to suggest that the stress of modern life or a steady diet of fast food causes ulcers in the stomach and small intestine, but they are nonetheless common in our society: About one out of every 10 Americans will suffer from the burning, gnawing abdominal pain of a peptic (or gastric) ulcer at some point in life.
Peptic ulcers are holes or breaks in the protective lining of the duodenum (the upper part of the small intestine) or the stomach -- areas that come into contact with stomach acids and enzymes. Duodenal ulcers are more common than stomach ulcers. Comparatively rare are esophageal ulcers, which form in the esophagus -- or swallowing tube -- and are often a
result of alcohol abuse.
Until the mid-1980s, the conventional wisdom was that ulcers form as a result of stress, a genetic predisposition to excessive stomach acid secretion, and poor lifestyle habits (including overindulging in rich and fatty foods, alcohol, caffeine, and tobacco). It was believed that such influences contribute to a buildup of stomach acids that erode the protective lining of the stomach, duodenum, or esophagus.While excessive stomach acid secretion certainly plays a role in the development of ulcers, a relatively recent theory holds that bacterial infection is the primary cause of peptic ulcers. Indeed, research conducted since the mid-1980s has persuasively demonstrated that the bacterium Helicobacter pylori (H. pylori) is present in more than 90% of duodenal ulcers and about 80% of stomach ulcers.
Other factors also seem to contribute to ulcer formation. Overuse of over-the-counter painkillers (such as aspirin, ibuprofen, and naproxen), heavy alcohol use, and smoking exacerbate and may promote the development of ulcers. Research indicates that heavy smokers are more prone to developing duodenal ulcers than are nonsmokers, that people who drink alcohol are more susceptible to esophageal ulcers, and that those who take aspirin frequently for a long period of time are more likely to develop stomach ulcers than those who don't.
Other studies show that stomach ulcers are more likely to develop in older people. This may be because arthritis is prevalent in the elderly, and alleviating arthritis pain can mean taking daily doses of aspirin or ibuprofen. Another contributing factor may be that with advancing age the pylorus (the valve between the stomach and duodoneum) relaxes and allows excess bile (a compound produced in the liver to aid in digestion) to seep up into the stomach and erode the stomach lining.
Also, for no known reason, people with type A blood are more likely to develop cancerous stomach ulcers.
Duodenal ulcers tend to appear in people with type O blood, possibly because they do not produce the substance on the surface of blood cells that may protect the lining of the duodenum.
Fortunately, peptic ulcers are relatively easy to treat; in many cases they are cured with antibiotics, antacids, and other drugs that reduce the amount of acid produced by the stomach. There are also a variety of self-help and alternative treatments that can aid in relieving pain. Still, the dangers associated with peptic ulcers -- such as anemia, profuse bleeding, and stomach cancer -- are serious, so ulcers should always be monitored by your doctor.
What did you understand by Ulcer?
High blood pressure (hypertension) is a leading cause of kidney disease and kidney failure (end-stage renal disease).
Hypertension can cause damage to the blood vessels and filters in the kidney, making removal of waste from the body difficult. Once a person is diagnosed with end-stage renal disease, dialysis -- a blood-cleansing process -- or kidney transplantation are necessary.
What Are the Symptoms of Kidney Disease?
The symptoms of kidney disease include:
- High/worsening blood pressure
- Decrease in amount of urine or difficulty urinating
- Edema (fluid retention), especially in the lower legs
- A need to urinate more often, especially at night
How Is Kidney Disease Diagnosed?
As with high blood pressure, you may not realize that you have kidney disease. Certain laboratory tests can indicate whether your kidneys are eliminating waste products properly. These tests include serum creatinine and blood urea nitrogen (BUN); elevated levels of either can indicate kidney damage. Proteinuria, an excess of protein in the urine, is also a sign of kidney disease.
Who Is At Risk for Kidney Disease Due to High Blood Pressure?
Kidney disease caused by high blood pressure affects every group and race. However, certain groups are at higher risk, including:
- African-Americans
- Hispanic-Americans
- Native Americans
- Natives of Alaska
- People who have diabetes
- People with a family history of high blood pressure and kidney disease
How Can I Prevent Kidney Disease?
To prevent kidney damage from high blood pressure:
- Try to keep your blood pressure controlled.
- Make sure you get your blood pressure checked on a regular basis.
- Eat a proper diet.
- Get moderate exercise, such as walking, 30 minutes daily.
- Take the medication your doctor prescribes.
How Is Kidney Disease Treated?
For patients who have high blood pressure and kidney disease, the most important treatment is to control your blood pressure through lifestyle changes. ACE(angiotensin converting enzyme) inhibitor and angiotensin II receptor blocker (ARB) drugs lower blood pressure and can protect the kidneys from further damage.
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High Blood Pressure and Kidney Disease (symptoms, diagnosed, who is at risk, prevention)
Here are four simple techniques for managing stress:
Emergency Stress Stoppers
There are many stressful situations — at work, at home, on the road and in public places. We may feel stress because of poor communication, too much work and everyday hassles like standing in line. Emergency stress stoppers help you deal with stress on the spot.
Try these emergency stress stoppers. You may need different stress stoppers for different situations and sometimes it helps to combine them.
. Finding Pleasure
When stress makes you feel bad, do something that makes you feel good. Doing things you enjoy is a natural way to fight off stress.
You don't have to do a lot to find pleasure. Even if you're ill or down, you can find pleasure in simple things such as going for a drive, chatting with a friend or reading a good book.
Try to do at least one thing every day that you enjoy, even if you only do it for 15 minutes.
Daily Relaxation
Relaxation is more than sitting in your favorite chair watching TV. To relieve stress, relaxation should calm the tension in your mind and body. Some good forms of relaxation are yoga, tai chi (a series of slow, graceful movements) and meditation.
Like most skills, relaxation takes practice. Many people join a class to learn and practice relaxation skills.
Deep breathing is a form of relaxation you can learn and practice at home using the following steps. It's a good skill to practice as you start or end your day. With daily practice, you will soon be able to use this skill whenever you feel stress.
- Positive self-talk
- Emergency stress stoppers
- Finding pleasure
- Daily relaxation Positive Self-Talk
Self-talk is one way to deal with stress. We all talk to ourselves; sometimes we talk out loud but usually we keep self-talk in our heads. Self-talk can be positive ("I can do this" or "Things will work out") or negative ("I'll never get well" or "I'm so stupid").
Negative self-talk increases stress. Positive self-talk helps you calm down and control stress. With practice, you can learn to turn negative thoughts into positive ones. For example:Negative Positive "I can't do this." "I'll do the best I can." "Everything is going wrong." "I can handle things if I take one step at a time." "I hate it when this happens." "I know how to deal with this; I've done it before."
To help you feel better, practice positive self-talk every day — in the car, at your desk, before you go to bed or whenever you notice negative thoughts.
Having trouble getting started? Try positive statements such as these: - "I can get help if I need it."
- "We can work it out."
- "I won't let this problem get me down."
- "Things could be worse."
- "I'm human, and we all make mistakes."
- "Some day I'll laugh about this."
- "I can deal with this situation when I feel better."
Emergency Stress Stoppers
There are many stressful situations — at work, at home, on the road and in public places. We may feel stress because of poor communication, too much work and everyday hassles like standing in line. Emergency stress stoppers help you deal with stress on the spot.
Try these emergency stress stoppers. You may need different stress stoppers for different situations and sometimes it helps to combine them.
- Count to 10 before you speak.
- Take three to five deep breaths.
- Walk away from the stressful situation, and say you'll handle it later.
- Go for a walk.
- Don't be afraid to say "I'm sorry" if you make a mistake.
- Set your watch five to 10 minutes ahead to avoid the stress of being late.
- Break down big problems into smaller parts. For example, answer one letter or phone call per day, instead of dealing with everything at once.
- Drive in the slow lane or avoid busy roads to help you stay calm while driving.
- Smell a rose, hug a loved one or smile at your neighbor.
. Finding Pleasure
When stress makes you feel bad, do something that makes you feel good. Doing things you enjoy is a natural way to fight off stress.
You don't have to do a lot to find pleasure. Even if you're ill or down, you can find pleasure in simple things such as going for a drive, chatting with a friend or reading a good book.
Try to do at least one thing every day that you enjoy, even if you only do it for 15 minutes.
- Start an art project (oil paint, sketch, create a scrap book or finger paint with grandchildren).
- Take up a hobby, new or old.
- Read a favorite book, short story, magazine or newspaper.
- Have coffee or a meal with friends.
- Play golf, tennis, ping-pong or bowl.
- Sew, knit or crochet.
- Listen to music during or after you practice relaxation.
- Take a nature walk — listen to the birds, identify trees and flowers.
- Make a list of everything you still want to do in life.
- Watch an old movie on TV or rent a video.
- Take a class at your local college.
- Play cards or board games with family and friends.
Daily Relaxation
Relaxation is more than sitting in your favorite chair watching TV. To relieve stress, relaxation should calm the tension in your mind and body. Some good forms of relaxation are yoga, tai chi (a series of slow, graceful movements) and meditation.
Like most skills, relaxation takes practice. Many people join a class to learn and practice relaxation skills.
Deep breathing is a form of relaxation you can learn and practice at home using the following steps. It's a good skill to practice as you start or end your day. With daily practice, you will soon be able to use this skill whenever you feel stress.
- Sit in a comfortable position with your feet on the floor and your hands in your lap or lie down. Close your eyes.
- Picture yourself in a peaceful place. Perhaps you're lying on the beach, walking in the mountains or floating in the clouds. Hold this scene in your mind.
- Inhale and exhale. Focus on breathing slowly and deeply.
- Continue to breathe slowly for 10 minutes or more.
- Try to take at least five to 10 minutes every day for deep breathing or another form of relaxation.
Four Ways to Deal with Stress
The international conference on HIV/AIDS in Durban, South Africa that ended recently dominated the mainstream print and electronic media in Western capitals. Various media organizations provided graphic information on the devastating consequences of this hydra-headed monster of a disease in Africa. As the more than 12,000 conference participants debated the scope of President Mbeki of South Africas speech or argued over the origin of the HIV virus in the palatial settings of Durban, it is important to make the following observations on what may have occurred during the week-long Conference.
During the week-long Conference:
1) Between 7,500 and 10,000 South Africans will have contracted the dreaded HIV infection;
2) More than 10,000 Nigerians will have become infected;
3) At least 70,000 Africans will have become infected; and,
4) At least 42,000 families in Africa have buried someone, most often a man or woman at the prime, productive stages of their lives.
2) More than 10,000 Nigerians will have become infected;
3) At least 70,000 Africans will have become infected; and,
4) At least 42,000 families in Africa have buried someone, most often a man or woman at the prime, productive stages of their lives.
The HIV/AIDS crisis in Africa is the most devastating disaster to befall the continent. Within the last two decades, the AIDS virus is responsible for ten times more deaths in Africa than all wars combined. Sale of coffins is booming in many African countries such as Zimbabwe and Zambia from the high death toll of AIDS. According to UNAIDS (the UN agency responsible for HIV/AIDS), about 25 million persons live with HIV/AIDS in Africa, and 13 million have already died of the disease. In the next ten years, most of the HIV positive Africans will die painful deaths without access to life saving treatment. Africa accounts for 95% of the 13 million orphans worldwide. More than 95% of all new infections in children 15 years or below occur in Africa. At least 95% of all mother-to-child transmission occurs in Africa. By the year 2010, at least 40 million African children will have no father or mother to assist them as they go through their most critical formative years in life. For the first time in many traditional African societies, the extended family system is no longer adequate as many orphans have to fend for themselves.
The rates of HIV infection in the so-called high risk African countries range from 13% to 36% among the adult population. For example, Botswana has an infection rate of 36%, Zimbabwe, 25%, and South Africa 13 percent. Although Nigerias current rate of infection is about 5.4% (one in 20 adults), the large population base of 110 million people will likely ignite a major catastrophe in a few years time. According to some estimates, by 2020, more than 75 million Nigerians may carry the virus if the present trend continues.
The Direct and Collateral Effects of HIV/AIDS in Africa
The HIV infection is like a stealth bomber that moves at supersonic speed, with major direct and collateral effects. There are two important direct effects of the infection: The infective status which is infinite, and, the deteriorating health status during the AIDS stages of the disease. Once an individual becomes HIV positive, that person is theoretically, and for all practical purposes, capable of transmitting the infection to another individual. At least 90% of all infected individuals worldwide are unaware of their high risk status because of their robust physical appearance. These individuals may continue to propagate the disease, unwittingly. Thus, it is not surprising that in many parts of Africa, robust or healthy looking individuals are not seen as at risk of transmitting the virus. The second direct damage is the deteriorating health status that invariably incapacitates the individual during the AIDS phase of the disease, with multiple opportunistic infections. This is the stage that many relatives begin a whispering campaign on the cause of the individuals illness.
The collateral effect of HIV/AIDS is as devastating as the direct effects. I will summarize the collateral effects as follows:
1) Poverty is the second cousin of HIV infection. Poor countries, poor neighborhoods or communities are more likely to have high rates of infection, and less likely to have the resources to combat the disease. Once HIV/AIDS establishes a foothold in a poor setting, that community is on a slow but progressive economic, social, and cultural decline;
2) Sex is a taboo subject in most African societies, and the predominant heterosexual transmission of HIV in Africa makes it a difficult subject matter. According to World Bank estimates, only 3% of HIV positive individuals go into clinics because of the stigma associated with AIDS;
3) HIV/AIDS is closely related to sexually transmitted diseases and Tuberculosis, two common conditions in Africa;
4) HIV/AIDS has devastating effect on the life expectancy of any nation. For example, by 2010, Namibias life expectancy rate would have been 70.1 years compared to the projected 38.9 years because of AIDS. Many countries in Southern African will lose at least twenty or more years of life expectancy in the next decade because of AIDS.
5) HIV/AIDS destroys the economic engine room of African societies such as teachers, professors, doctors, nurses, engineers, lawyers, community leaders, and so on. The children of these bread winners are likely to drop out of school, with the older children assuming increasing parental roles for their younger siblings;
6) Gender inequity in Africa continues to be a major problem for HIV prevention programs. For example, a woman who is faithful to her husband cannot, in many African societies, refuse sexual advances from her high risk husband, without fear of physical harm, economic retaliation or social ostracism. Rape of teenage girls or seduction of these girls by high risk sugar daddies continues unabated;
7) HIV/AIDS creates an undue burden on the health care system of African countries. Health authorities in Africa are now spending their paltry budget on AIDS related clinical care. For example, large provincial hospitals in South Africa report 50% or more occupancy rates of their hospital beds by AIDS patients. In addition, many African governments in the next several months must reach a decision on how to reconcile the use of a promising drug, nevirapine that significantly reduces maternal transmission of HIV infection with the transmission of the infection through continued breast feeding. Preliminary results suggest that HIV positive nursing mothers can re-transmit the virus to their babies during breast feeding after receiving nevirapine at birth. This dilemma is very real as the manufacturers of nevirapine are promising to donate large quantities of the drug to needy African nations.
8) HIV/AIDS may lead to the political instability of many African countries. For example, the high rates of infection among the Military of South Africa, Zimbabwe, and Zambia portend danger signals for civilian governments if the infected soldiers die in large number without receiving life saving drugs. Furthermore, as scare resources of poor African nations become diverted to AIDS palliative treatment, the internal conflicts in many countries over resource sharing and power may grow worse. The tepid, indifferent, and at times, hostile response of many African leaders to the HIV/AIDS conundrum is a recipe for disaster. To behave as if the HIV/AIDS problem does not exist or to waste time in puerile ideological or moral debates, could lead to catastrophic results. Fortunately, some presidents such as Museveni of Uganda and Obasanjo of Nigeria have publicly stated their personal commitment to halting the rampaging effects of the disease and have technical persons reporting directly to them;
9) No African country can afford the $11,000 to $15,000 annual cost of life saving antiretroviral cocktail therapy that has dramatically changed the HIV/AIDS landscape in Western countries. Even with the availability of these drugs, I am not aware of any African country that has the infrastructure to manage the logistics of delivering the complex drug regimen to HIV/AIDS patients; and,
10) A new generation of Africans will grow up in this century believing that no matter what they do, they may never live to adulthood because of rampaging effects of the virus. The rate of infection among African youth is the highest in the world. In some countries, female teenagers between 15 and 19 years of age have infective rates of 15% or more.
How to Respond to the HIV/AIDS Epidemic in Africa
The danger of the HIV/AIDS epidemic is real in Africa. Present and future generations of Africans are at grave risk of a multifaceted menace. As elites jostle over semantics, many Africans become infected or die of the disease. As noted by President Nelson Mandela in his closing speech to the Durban Conference, it is important to square the concern of the HIV/AIDS patients with the rhetoric of experts. The time is now ripe for a comprehensive approach to HIV/AIDS prevention strategy in Africa.
The HIV/AIDS strategy in Africa should be predicated on four fundamental principles:
1) The need for the international community to mobilize resources to provide life saving treatment to the 25 million Africans living with the HIV virus. There is no justification for denying millions of Africans, access to life saving drugs. These drugs have made it possible for HIV positive individuals in Western countries to go back to work, assist their families and contribute to the betterment of their society. Until the West resolves the issue of providing the same treatment opportunities to all HIV/AIDS patients, the rhetoric of HIV/AIDS will remain hollow. To prosecute the Bosnia campaign, the Western Alliance reportedly spent at least $80 billion without any dent on their current economic prosperity;
2) The need for African leaders to develop and implement a credible HIV prevention program that recognizes the following facts: There is no known cure for HIV/AIDS; The best safe sex message is abstinence or monogamous relationship after relevant tests and knowledge of HIV status, and ; The urgent need to lift the conspiracy of silence about sexual matters in many African societies. Uganda, Tanzania, and Senegal reportedly made significant advances on HIV prevention through a national dialogue on sex and how it can lead to HIV infection;
3). The critical importance of revamping the health care system in Africa. As of today, the current health system in African cannot manage the complex logistics of providing cheap or free drugs to HIV/AIDS individuals if they are made available. Many African countries neglect their health systems and do not provide incentives for their health workers. The strategy of multisectoral sectoral approach to health matters is not firmly rooted in Africa. As shown in a recent World Bank report on health care in Africa, the health infrastructure in most African countries leaves much to be desired. The political will to fund health services in African countries is lacking. National ministries of health lack technical expertise or serve as backwaters for failed politicians and operatives; and,
4) The ultimate responsibility for managing and eventually conquering the HIV/AIDS menace lie with Africans, in the continent and the diaspora. As shown by the debacle of aid and debt relief, no amount of international assistance will change the HIV/AIDS situation in Africa unless sustained progress is achieved in the following areas of governance (a) Adequate political representation where various shades of opinion are represented at the highest decision-making apparatus of government (b) Transparent macroeconomic policies that promote private enterprise, ensure the implementation of unambiguous rules and regulation, and, assure the protection of the weak and the infirm in the society, and, (c) Engage community-based entities and non governmental organizations in the design and provision of grassroots health programs.
African governments must develop a mechanism for engaging their professionals in the diaspora in the design, implementation, monitoring and evaluation of HIV/AIDS programs. This approach should be multisectoral with sustained interactions with experts in clinical care, public health, pharmacy, economics, agriculture, business, manufacturing, engineering, political science, anthropology, sociology and other professionals that can help design proactive health and non health programs that will address the direct and collateral effects of HIV/AIDS. It is also important to establish direct relationships with U.S. and other Western-based organizations that are promoting the treatment and prevention of HIV/AIDS in Africa. For example, the
Constituency for Africa in Washington, D.C. is promoting an AIDS Marshall Plan for Africa, and organizing town meetings on HIV/AIDS in Africa across America. Finally, African governments should establish direct linkages with sympathetic legislators and appropriators in Western countries. For example, the U.S. Congressional Black Caucus is active on HIV/AIDS issues in Africa and will benefit from sustained consultations and briefings by African governments.
CONCLUSION
HIV/AIDS is real in Africa. No matter the origin of the HIV virus or the so-called disagreement about the pathogenesis of the disease, millions of Africans have died of this horrible disease, and 25 million individuals are living under a certain death sentence. The time to act is now to save lives and create a better future for Africa. The much vaunted African renaissance will become a pipedream if African intellectuals and leaders waste time chasing shadows while the proverbial Rome burns. The die is cast.
