Breast is best

Breast is best

         

By Melody Gwenyambira

HIV positive mothers should practice exclusive breastfeeding in the first six months.

This means that no other liquids or foods are given to the infants.

“ Mixed feeding in the first six months carries a greater risk of transmission because other liquids and foods given to the baby alongside breast milk can damage the delicate gut wall of the baby and allow the virus to be transmitted more easily,” Roselyn Dete the Southern African AIDS Trust Country Director said.

Breastfeeding carries significant health benefits for infants and young children and is an essential child survival intervention.

Laiza Bvute from Masvingo and is HIV positive has breastfed her one year six months old daughter since the day she was born.

“The nurses told me that I should only give my daughter breast milk. I followed the instruction and when my baby was tested she was found to be HIV negative,” she said.

Laiza is among some of the women in Zimbabwe who can bear testimony that “breast is best.”

“Mothers should only introduce other liquids and foods after consulting health practitioners and even in the process they should be guided well. The foods must not be introduced all at once but slowly,” Roselyn added,

Dete also called on mothers who give their baby formula milk to exercise good and hygienic methods to prevent the babies on falling sick.

“The measurements of the formula milk versus the water should be according to the guidelines. The bottles and tits should be sterilized and before preparation of the milk, hands should be washed. It is very important to follow instructions because if one doesn’t the baby might fall sick.”

Goodbye stitches hello laparoscopy +pic

                     

Goodbye stitches By Melody Gwenyambira

A swift breeze swept by near the orchard. Dry leaves and twigs rustled softly on the ground. A squish squash sound of car wipers could be heard in the stillness of Mother Nature.

Rumbidzai Dzomba jumped out of bed and ran to the bathroom to throw up. At first she thought she had a stomach virus. Her stomach hurt and she was throwing up. The next day, instead of feeling better, she felt worse.

She had a fever and decided to go to her doctor and it turned out that Rumbidzai had appendicitis and needed surgery.

‘I was scared of the idea of surgery because I knew I was going to have a cut that needed a lot of attention and the stitches also needed quite some time to heal. The healing process as I knew would be quiet long and it meant that I had to take some time away from my busy work which I could not afford to. I was also worried about the scar,” the 24 year-old consultant said.

However what she feared the most did not happen as the surgeon performed minimal invasive surgery.
“There has been an overwhelming trend for surgery to be minimally invasive to a patient’s body and hence the term minimal access surgery. Initially surgeons resorted to making the smallest possible incision (cut) on the area they intended to operate on and subsequently performed the most minimal tissue handling,” Dr Gerald Madziyire a healthcare practitioner, specializing as a Gynecologist and Obstetrician said.

A few days later when Rumbidzai went for her review she was happy by what she saw.

“Instead of a big scar with stitches I saw a small line which looked like a scratch and my doctor explained to me that it was minimal invasive surgery. I was so happy and I now call it the seal and heal operation,” she said with her face shining.

The idea of using telescopes to visualize the interior of the area being operated on made it possible for even less invasion into the patient’s body. Apart from introducing a telescope to visualize the area being operated on instruments could also be introduced to help in carrying out the surgical procedure.
“The advantages of minimal invasive surgery, in particular endoscopic surgery are; better cosmetic outcome, reduced hospital stay, less operative pain and its cheaper. There are obviously disadvantages of this type of surgery which include, limited operating space( as compared to open surgery), organ damage during instrumentation and steeper learning curve( time taken for a trainee surgeon to master the skill,)” Dr Madziyire added.

The branch of minimal access surgery where visualization is through a telescope is called 'Endoscopic Surgery'.  The type of endoscopic surgery derives its name from the area being operated on. Examples would be:
                                        Abdomen and pelvis - laparoscopy
                                        Joints                            - arthroscopy
                                        Oesophagus                - oesophagoscopy
                                         Cervix                           - colposcopy
                                         Bladder                         - cystoscope
                                         Stomach                        - gastroscope

“Zimbabwe has been no exception to this world wide trend and surgeons in various disciplines are jostling to acquire the skills of endoscopic surgery. Laparoscopic surgery has become more common both in the private and public sector with procedures such as , laparoscopic appendicectomy, ovarian cystectomy , cholecystectomy and adhesiolysis(breaking of intra abdominal scar tissue) topping the list. We are still lagging behind however in the equipment required to successfully execute most of the laparoscopic procedures,” said  Dr Madziyire.

Laparoscopic surgery is done in a surgical theatre. The suitable patient is anaesthetized ( put to sleep). The surgeon then introduces gas into the patient’s abdomen. This is meant to push away the intestines and other organs far from the instruments being introduced into the abdominal cavity. Trocars are introduced into the abdominal cavity. These are spear like instruments which pierce the abdominal wall and then their sharp part is removed leaving a metal sheath. The telescope is introduced through the sheath. A light source and a camera are connected to the camera. The images are then visualized on a video monitor. The rest of the metal sheaths are used for introducing the operating instruments. The surgeon and the assistants operate while looking at the video monitor.
Rumbidzai also revealed that it did not take long for her to get back to work and the scar does not bother her as it looks “smart and neat.”

“At home I never put anything. I went to my doctor after three days and he removed the bandage. He told me not to let anything come in contact with the wound and in a week it was dry. I do not have any other problems. Even when it’s cold I do not feel any pain.”

Big organs like the uterus can be removed laparoscopically (laparascopic hysterectomy ).
Women who are having Caesarean sections are happy as they are also experiencing this new trend.

One such woman is Lisa Mandidza who delivered her baby through a C-Section.

“My gynecologist said he was taking me into the theatre and he would give me a bikini operation. It was indeed a bikini op because there was just a thin line below my belly button. It did not look as if I had had a major operation.”

Dr Madziyire also highlighted,

 “The most urgently required equipment are those for tissue cutting and sealing ( e.g harmonic scalpel) and the tissue retrieval equipment (e.g tissue mocillator). The cost of this equipment is prohibitively high at the moment. We remain hopeful however that soon we will be able to acquire the latest instruments and keep abreast with the latest innovations in the medical industry.”