A personal blog about everything Sierra Leone from Social Issues, Entrepreneurship, Art & Poetry, Fashion & Beauty, Health, Entertainment, Food, Weddings & Promoting Change. If it is NOT about Sierra Leone then it is NOT on Dasalonetiti's blog #peace✌
Black tax is a system where African/ black professionals are expected to cater for the rest of the family, whether immediate or extended. Such expectations are mostly placed on the first child of the family, but it goes for every young educated professional. In a country where extended family links are prevalent, you can understand how embedded the black tax system is for young professionals. No wonder everyone is in a rush to make the soft life rather than put in the hard work and getting the results.
In our African cultures, it is impressed on us from childhood, especially firstborns that the prosperity of our family rests on our shoulders. We are taught to be a piece of a whole, and our parents intentionally impress certain characters in us to make us feel responsible to honour the black tax. Statements like “remember where you are coming from, and know where you are going” are re-echoed throughout our lives. With little or no preparation, the responsibility of providing for your immediate and extended family will rest on you immediately you can lift your head above water. We take on these roles, sometimes unconsciously. We see it as a way of paying back our family for their sacrifices or so we think. Black tax is mostly driven by guilt because of how we were raised.
Black Tax can be just the feeling of entitlement or the expectation by some people who think they should have access to your finances. Through community words or action they will tag you “the umbrella in the family”. When you hear such sentiments, run, don’t get lost in them. Most times, they come from people who did not contribute in any shape or form towards your wellbeing, they never cared. The moment you make something of your life you are in trouble. They try to create a benefactor position in your life with statements like ‘Na we men am ooo’ (meaning: we raised him/her). The black tax is one of the reasons responsible for low savings and capital accumulation by young people and hence they cannot make investments that will take them out of poverty. The recipients of black tax sometimes think you owe them. And so they’ll spend/mismanage whatever they receive from you. The sad part is they’ll come demanding your help because they know you are unable to say NO.
This system has led to a lot of financial and mental stress on young professionals since they most times find it difficult to say No. This is particularly so when the demand is coming from their parents. To be honest, most African parents are good at manipulating and gaslighting their children either for themselves or for other members of the household/community. So it is very important as young educated professionals we figure out ways to cope with this system. We should learn how to read and see through their demands and make informed decisions based on our budget.
LET ME SHARE WITH YOU SOME TIPS ON HOW TO DEAL WITH BLACK TAX.
1. Don’t you ever make the mistake of giving them everything they asked for, they will think you have a lot and will come again. Start by giving a fraction – half or a quarter of what they asked for.
2. If you are finding it difficult to say NO, then focus on giving only towards important things that will make an impact on their lives. Focus on certain things that you consider serious such as health and education.
3. Choose one person in a family within the community at a time. If you decide to help that person make sure you let the rest of the household know that you will be helping that person and cannot be in the position to help anyone else within the same family for that period.
4. Do not give immediately they ask for help unless it is an emergency. Always try to give yourself time to work within your budget to be financially in the place where you can help them without neglecting your needs.
5. Try to know your limit financially and say No to anything above that limit.
6. Now by all means try not to fall into the ‘nice person trap. You do not give to be recognized as a good person.
7. Do not be a people pleaser because you will be left unpleasant. Those you are trying to please will never be pleased, and most importantly they can never please you.
8. Try to say No when the manner they request is not right. If the tone suggests you have money and don’t want to give or you have money and should give them, then try not to give them, that’s the typical entitlement syndrome.
9. Try to emphasise your needs and let them know if anything happens to you they won’t be able to help you or your family.
I truly hope these tips help you to navigate your way through the black tax system and just know that there is light at the end of the tunnel. Try to help and give back to your family and community within your means. Black tax can take its toll on your life and well-being, therefore always be sure to put your needs first above all else.
Today March 8th is celebrated as International Women’s Day all around the world. This year’s theme is “women in leadership – achieving an equal future in a covid-19 world.” There is no equal future where a woman’s life will be cut short due to childbirth and other maternal health issues. Someone who gives life does not deserve to die in the process. Today on women’s day let us talk about maternal health in Sierra Leone. So we go by the general theme this year which is “choose to challenge” we challenge you all that no woman should die due to childbirth. We strongly believe that maternal health is something that should be championed by every gender. Women have carried the continued existence of the world for far too long. If the future depends on female reproduction then all hands must be on deck.
This is a topic I have been avoiding for so long because it touches the deepest part of my heart. In 2011, I lost a dear friend and colleague to maternal mortality at the Princess Christian Maternal Hospital and that experience scarred me for life. Her death was preventable, the placental did not follow immediately after delivery, we don’t know what they did to salvage that situation. She eventually died at 23 years of age. I will remember it for the rest of my life. This year we will be celebrating her tenth death anniversary, ten years just like that. Therefore to celebrate women’s day this year we went to PCMH to interview a gynaecologist on the state of affairs.
Interviewers: Tell our readers about self
DVJC: I am Dr Valerie John-Cole, obstetrician and gynaecologists at the Princess Christian Maternity Hospital (PCMH) popularly known as Cottage Hospital. I work there in the capacity of a specialist obstetrician and gynaecologist. I have worked for five years as a specialist but a total of eleven years as a doctor in the maternity hospital.
IV: What are the common health issue among women in Sierra Leone?
DVJC: The common complaints are numerous but as a gynea, I’ll say; infertility issue is the most common, then fibroid that is otherwise known as uterine myoma is also becoming prevalent among women of childbearing age; menstrual irregularities caused by Polycystic Ovarian Syndrome (PCOS); cancer is also on the rise affecting women of all ages, women who have reached menopause sometimes wake up to bleeding and when the test is done it will be discovered that the bleeding was due to cancer; there is also the issue of sexually transmitted diseases (STD) and Urinary tract infections (UTI).
IV: What is the most effective form of birth control?
DVJC: Birth Control is also known as contraception or anti-conception. It is a method or device used to prevent pregnancy. The most effective form of birth control is abstinence. This is so because each form of birth control has a failure rate, we have had incidences of patients who are on birth control but end up getting pregnant. Another problem here also is that most people do not do consultations to know which birth control works best for them. Before birth control is prescribed for a patient, past medical history and present medical information must be reviewed to know which one works best. Some people do well with the pill, some with condoms, others with implants, some are better off with depo etc. Therefore, a proper examination should be conducted before any prescription. But what is common in Sierra Leone is that most people follow the advice of their peers, and do get these birth control methods over the counter without a prescription. The most effective depends on the patient’s clinical history.
IV: Do birth control have side effects?
DVJC: yes, of course, each one of them has its side effects, take for instance Intrauterine Device(IUD) what we commonly call coil; if it is not properly fixed it can lead to bleeding, infections, blocked tubes and or ectopic pregnancies. Other side effects of birth control methods are; nausea, bloating, withdrawal symptoms (small amount of blood or spotting), menstrual irregularities, mood change caused by hormonal imbalances, etc. Each of these methods has a side effect.
Iv: Have you ever had a patient who has reached menopause but experiencing bleeding?
DVJC: Yes! We call it post-menopausal bleeding. In most cases, it is due to cancer( cervical cancer, endometrial cancer) but there are other causes. Let me use this medium to tell each and everyone out there with parents who have reached menopause, to see a gynea immediately they start seeing blood. It is also important to note that any form of smelly discharge should also be a cause for concern and to visit a gynaecologist immediately. Because in most cases it starts with smelly discharges and they stay home until it gets to the point of bleeding. Other times post-menopausal bleeding can be caused by polyps. Polyps are ball-like structures that grow on the inner lining of the uterus. Polyps can sometimes be malignant growth that can be cancerous. Menopausal bleeding usually happens rarely with older women.
IV: Can you tell us what fibroids and ovarian cyst are and if they are the same thing?
DVJC: No! They are not the same, even though they have some similarities they are different. Fibroids are unusual growths that develop in or on a woman’s uterus. Sometimes these tumours become quite large and cause severe pain and heavy periods. This growth can be benign but non-cancerous. Sometimes, it can be corrected through a surgical procedure.
Ovarian Cyst- are fluid-filled sacs or pockets in an ovary or on its surface due to ovulation. Many women have ovarian cysts at some point. Most ovarian cysts present little or no discomfort and are harmless. The majority disappears without treatments. However, ovarian cysts especially those that ruptured – can cause serious symptoms.
IV: What are some of the challenges you face in the health care systems in general and how does that affect women’s health and maternal mortality?
DVJC: Hmmm, the challenges are many, some of them affect the health systems generally, and some are peculiar to our facility.
I am sure you may have read a tweet in recent weeks about the lack of water in our hospital. Yes, we do have a regular supply of water now from Guma since the tweet went viral, but even that is not sustainable. Somedays the water finishes at night and we go the whole night without it until we have a supply in the morning. In instances where we have to perform overnight surgery, what do we do? That is a major challenge.
Another I’ll say is the lack of human resources. When we talk to our colleagues overseas, we find out that they have teams made up of over thirty personnel. Here we have a team of five people to work the whole. What if you have to perform ten caesarean sessions? By the time you get to the fourth or fifth, you are tired and when you are tired you cannot work as effectively as you should. The most important thing is that these operations cannot be deferred because most of them are emergencies.
Logistics and supply is another challenge. For us who work at the free health care section, the supply of resources is not commensurate to the influx of people. Supply is never enough sometimes we have to put our private resources into the job.
A conducive working environment again is another factor. No sustainable electricity, medical supply not available, no proper coordination, e.g even our blood banks do not have a single drop of blood. Before now we used to have a policy that each pregnant women should donate blood, but due to some legislation, that policy was scrapped. If you go to places like Aberdeen women centre they religiously follow that policy and they always have blood for patients who need it. These are some of the reason why Sierra Leoneans abroad do not want to come back to work in the medical sector.
Limited space is another issue. The fact that our facility is small, and we are now catering to more than the number of people it was built for is a problem. It was called a cottage because it was built for a small number of people. Now with the free health care, there is a large influx of patients. It should no longer be a cottage. Another reason is that some other health clinics are not equipped to handle all the health issues, thereby causing the influx of patient at our facility and we can’t efficiently cater to everybody
Demotivation: The staff are demotivated, the salary is nothing to write home about. In other countries doctors have on-call allowances, here we don’t have perks like that and this is contributing to brain drain. Medical personnel are diverting to public health and avoiding the clinical aspect of the job. Others are leaving for greener pastures abroad and even other private facilities within the country.
Finally, the lack of public health education by most people, especially, pregnant women. A large number of them do not show up to the hospitals until they are in their second trimesters.
All of the aforementioned are challenges that affect maternal health directly or indirectly. Each of them weakens maternal health care in the country.
Interviewers: would you say the health care situation in the country is improving or deteriorating?
DVJC: This is difficult to tell because in some areas there are progress but the deterioration in other areas will derail and override all the efforts or progress that has been made in some. Until we stop recording the death of pregnant women in high digits or incidents of child mortality, we cannot claim any progress. For now, PCMH is being highly supported by an NGO and if that NGO decides to pull out there will be serious implications. This place will be left completely naked and exposed.
IV: So what are your expectations, recommendations, and advice?
DVJC: We look forward to days when we will have a proper hospital setting, where both patients and doctors will be satisfied working or using the facility. If Patients know that when they go to the hospital they will get efficient and effective service delivery they will be excited about their visits. Doctors and nurses are motivated to work, money is important but it is not all we need. The working environment should be conducive, medical supplies must be always available and enough. We hope to have a twenty-four-hour functional lab for investigation and diagnosis. For instance, if a patient needs a CT Scan we will have to refer such a patient to private institutions like Ramsey and Ecomed. Since these services are not available in government hospitals, and the cost can be a burden to some patients, considering the economic situation in the country. We need twenty-four hours running water( pipe-borne), twenty-four hours electricity (it is high time hospitals have special electricity line). We should have a rich blood bank, blood is essential when a patient needs blood nothing can substitute that. You will be surprised to know that emergency hospital gets medical supplies from government, but we either don’t get the same supply or we just have a broken hospital system here. All of us have to do more, government, health workers, and even you people blogging. We should all do more in raising and creating awareness and education for more people.
IV: Thank you so much for your time, Doctor Valerie.
Conclusion: Sierra Leone has one of the highest (if not the highest) maternal mortality rate in the world. A UNICEF report of 2019 indicated that 1360 mothers die in every 100000 live births. The mortality rates of neonates, infants and children under five are also amongst the highest globally at 34, 82, and 111 deaths per 1000 live births, respectively. These staggering figures represent the real and pervasive challenges women and children face in Sierra Leone with poor healthcare practices and sub-standard and ill-equipped health care facilities.
I wished to jot something down So I took my pen and a slab In my head juxtapose of thoughts, My unexpressed emotions rallied As perceptions fought their way through My ink dried up leaving my pen thirsty, desperateto write more Ultimately, my pen kissed the pages With every stroke a lifeline Handwriting like a sloppy artwork My mouth yearned to speak All that my pen wanted to write Yet, it couldn’t, my lips refused to open As I struggled to question What could have gone wrong?
I rubbed my pen to the right Then to the left I rubbed it upwards Then downwards I rubbed it some more But nothing stayed
Deception of ink’s reflection It is still full or that’s what I felt No visions, no characters Just like the movies the director yelled, cut! I paused, as I looked down All that I saw were marks Of what could have been A fine print for the history makers
But for those who are hungry for more Glad I got to pen this down Before my ink expired.
Love and light from my sides to yours❤💡 and have a pleasant week ahead
Life’s too cruel to live, yet we refuse to die. Lips too saddened to curve up in a smile, yet we laugh. Heart shattered into pieces, no way it can’t be fixed. We can only hope, as humans there is only one way home.
The turmoil of the mind Where is it coming from?
The universe aligns and breathes down judgement. A connection between light and gloom I am always in the middle. The courtroom is where frenemies abode with a heart as black as their frock. Life can be either black or white, no time for grey except for the wigs Evidence in my memory, not document by my defence. My life is proof, yet they did erase it like writings on a chalkboard Karma is on a journey that has made me the destination. On my hands are not blood but the weight of my fingers. I am not guilty is on a replay musical note to the mind.
“I put it to you” an angered voice screamed in my head. My thoughts aimlessly on handcuffed Muffled tone from my doppelganger The scorned voice shouts “you deserve it bitch” Against my spirit, the gavel lands with screams that jolted my realities. When the accused becomes the accuser, I am who I am not built for the orange suit. Prosecutors build their belief on my doubt but I swear to say the truth and nothing but the truth. My mind drifts to dark thoughts that need cleansing with my acidic tears. Where are the lords when I am being condemned? Are they not supposed to prove beyond a reasonable doubt? But the gavel came down again this time too loud for me to listen. GUILTY!! the Judge says I am You are not INNOCENT either my mind said My head cries out you have been FRAMED
Early this morning, sitting on my bed pondering, my thoughts drifted to where I was last weekend. You might be thinking where that was, right? There is a discovery around the Freetown Peninsula deep in the hills of Mambo, a waterfall that has been attracting a lot of local tourists even amidst the Pandemic. In fact scratch ‘discovery’, this waterfall has always been there. Hidden, untouched, pure, mystical, a secret that was known to only but a few in the Mambo neighbourhood. Even though its voice can be heard from miles away in a slow rush as it falls on black rocks as if it were cleansing them, the irony is this voice is lost on most of its people. Its voice can only be heard by those who dare to listen. Human interventions and deforestations happening around the peninsula has brought this mystery place to the knowledge of Freetownians, it is no longer a secret. In fact, it seems as if all the lands around that territory are now in the hands of private individuals. Stones marked with white paints and tiny aluminium structures depicting ownership are the views along the way. My friend asked me, what if someone comes to claim this waterfall as his/her property? We had a great laugh about it, but deep down we know this is Sierra Leone where anything can happen, especially when it seems all the landmark around it are now privately owned.
I asked myself questions: Who own these lands, the community or the government? Who are selling these lands? Why are people buying these lands? Those who are claiming to own these lands in the Mambo community, how did they come about it? If not for anything but we have seen, how building structures on these hills can be disastrous. Lessons that Sierra Leoneans are refusing to learn. When shall we start to care about our safety and that of others, these are not easy terrain. These lands should be preserved, the whole ecosystem up there had been altered. You can see the damage, as exposed land stand naked in the cold heat of the July evening asking the passersby for a blanket. We are not listening to their pleas and these hills had long stopped to re-echo our cries likewise.
I was not expecting to go to Mambo waterfall that day, but I am pleased I did. After what seemed like broken arrangements with friends. I got a call from one saying let’s do this, “I am leaving now, let’s meet at your junction”. As a lover of adventure, I jumped right in. It was about 5:00 pm in the evening when we left my junction. The road to that place is the worst I have ever experienced in Freetown. Steep hill, sharp rocks, slippery slopes, sharp edges of fallen trees for coal burning, and land clearing that require every bit of your mental and physical energies. The climb is not for the faint-hearted, I can assure you.
The amazing detail is that the trip to the waterfall is unexplainably eventful; this came as a shock to me as I was not expecting the crowd, especially in this pandemic. People moved in groups; community members as well as others who just want to see the great waterfall: those who want to take pictures for social media, couples, friends, pregnant women, teenagers, kids all in anticipation. Some in the deep conversation of what government should do, how countries in the west would have turned this into some money. The usual ‘Salone man’ talk of the knows and the know not, the haves and the have not. How we all have an opinion, yet nothing seems to be working properly in the country.
No! I didn’t see a single person in a mask. The climb did force me to take mine off so I can breathe properly, maybe the same thing happened to others too. I thought it was a national holiday or some other festivities. My people will never disappoint when it comes to having a good time. Musical sets, Bluetooth speakers all through the walk, great ambience, young guys intoxicated from alcohol, and others on some kind of high. Young girls clad in bikinis and short. I turned and looked at my friend we smiled at each other with the understanding that we were definitely not dressed for the occasion. My long turn jeans and Jesus print T-shirt on Sunday was definitely out of place, I guess. Her long black jumper seemed to have no place either. We were like, duh! who made the rules?
The view from up there is to die for, I can’t even lie. Freshwater which I was made to understand by the locals is from Guma dam waste running through their community. The fall is soothing to the soul as it will take your mind off everything else. Magical spring falling with so much grace at a pace enticing to the eyes. Romancing with the wind and creating a mist in the air just above the water. The birds chirping was music to my worried soul, I was lost on the climb but immediately found myself, only to get lost again in awe of the view.
As we left the falls trying to brave the walk back to where we were dropped off by the bike riders, I can’t help but felt sick to my stomach. Other questions came running through my mind. What is the Environmental Protection Agency doing to protect that area? I am afraid human activities will cause the water to dry out someday. What is the Ministry of Tourism doing to see how best they can build our local tourism? Can they work with other government Ministries like Lands and Works? Can they make the roads? Bring solar light and set up structures around the waterfall? Imagine if cars could get really close to the waterfall? Eventually, we reached where we were dropped off by the bikes and not a single bike in sight. This was the most painful part of it all because at this point our feet were shaking and aching. Don’t these bikers saw the crowd coming to these hills? Why can’t they see it as an opportunity to make money by doing multiple trips? In my frustration, I forgot it was dark and no one will risk himself or his bike for a thousand five. That’s how we walk from the waterfall to Mambo Junction on our way back. Lesson Learned “one might never climb down the way you went up, be humble”
Tips For First-Timers:
• Be on flat (Sneakers, Sandals or Slippers) • Get a backpack • Pack food and water if you don’t want to drink the water from the fall. • Pack your Bikinis, one-piece, minis and short or extra clothing • Best time to climb is Morning or the early evening. • Prepare your mind, be ready and be fit.
A lot has changed for women in the 21st century, so much so that a lot of women do have a career which they will choose any day over societal stereotypes. Women do have careers and plans that are well thought out. Nowadays, a lot of us strive for financial and economic independence. Sometimes this might pose a challenge to other social needs like having a family and raising kids. Some women, therefore, choose to pursue their dreams first and postpone childbearing to a later age compared to our mother’s generation. Even though fertility issues concern everyone but for the purpose of this article, we are going to concentrate on the women
Women are increasingly embracing the idea of harvesting and saving their eggs for when they will need it. In this fast-paced life of ours, women can only rely on these procedures to help them have children when and how they choose, and when they are done chasing their dreams. Such procedures, include IVF and surrogacy. IVF and surrogacy have given hope to more women in the world, to not worry about societal and biological pressures. Yet, society has placed so much importance on the idea that pregnancy and childbearing can only be complete when the woman/mother carries the embryo in her womb for nine or ten months and give birth to the baby. The question here is does it always have to be this way?
Enough! preamble already. Now let’s dive into the topic proper. Questions; What is surrogacy? or who is a surrogate mother? If faced with infertility as a Sierra Leonean parents would you try surrogacy? I know we have neither the laws nor the clinics in Sierra Leone. But, I also think it’s about time we have a discourse about this and at least bring the information closer to the people. To let them know they have choices, and that there are so many ways women can be mothers and surrogacy is one of the options.
WHAT IS SURROGACY?
Surrogacy is a procedure of aided reproduction where planned parents work with gestational carriers(GC) or surrogate who will carry and care for their baby(ies) until birth. Intended parents use surrogacy to start or grow their families when they can’t do so on their own. In another word, surrogacy is the process where an individual (woman) will willingly decide to carry a baby(ies) for another through the duration of the pregnancy, sometimes for financial gain but most importantly to help other parents enjoy the fruits of the womb.
Some types of surrogacy enable parents who are incapable of having children fulfil this desire. It’s a procedure that mandates medical and legal knowledge, as well as a healthy support method throughout the journey.
HOW SURROGACY WORKS
Through In Vitro Fertilization(IVF), embryos are created in a lab at a fertility clinic. Sometimes the intended parents use their own egg and sperm material. Other times, an egg or sperm benefactor is employed. At a fertility clinic, one or more embryos are implanted into a womb of the surrogate, who carries the baby(ies) to term.
Who Is a Surrogate Mother?
There are four kinds:
Traditional surrogate: Here a woman gets artificially inseminated with the father’s sperm. What we should understand is, with traditional surrogacy the surrogate also provides her egg to create the embryo, so the surrogate is biologically connected to the offspring and may assert in the court of law to contend the parental rights of the child. This type is certainly not recommended due to the lack of lawful defence for the parents seeking the service. She then carries the baby and delivers it for the parent in question to raise. It can also be a situation where both husband and wife want a baby but the wife’s egg is not viable, they can get a surrogate whose egg would be fertilized by the husband’s sperm. Note also that a donor sperm can be used
Gestational Surrogate. A procedure named “in vitro fertilization” (IVF) now makes it possible to gather eggs and sperm from a donor or the spouse that are requiring the service. Fertilize them, and place the embryo into the uterus of a surrogate mother.
The surrogate then carries the baby until birth. This type is free from most of the legal issues present in the traditional surrogacy. As the surrogate does not have any genetic ties to the child because it wasn’t her egg that was used.
Altruistic Surrogacy: In these arrangements, the surrogate doesn’t receive any monetary compensation. Here the intended parents will cover all the medical and legal expenses incurred during the process, including those directly derived from the pregnancy and the wellbeing of the surrogate, such as maternity clothes, special foods, vitamins and antenatal.
Commercial Surrogacy:Here the surrogate earns a financial dividend for the enormous bodily and emotional change she makes, as being pregnant brings a major change in a woman’s life. But the amount is restricted by law in order to deter the commodification of the woman’s body and surrogacy from becoming abusiness. This amount should not be an encouragement for women living in poverty to become surrogate. It should be a symbolic amount that rewards her solidarity and intention to help others and not for profit.
IMPORTANCE OF SURROGACY
1. It helps parents who have struggled with infertility to have a child(ren). 2. Makes it easy for women who are unable to physically carry a baby to have one. 3. It can help parents who have some form of genetic deformity, deficiency or health situation that is hereditary to have healthy babies. 4. It helps people who are in a same-sex marriage that want to have a baby that they are genetically connected with have one. 5. Women who had gone through vasectomy and their wombs were removed. 6. Conditions that make pregnancy impossible or too risky to carry by the wife such as terrible heart ailment.
HOW TO SELECT A SURROGATE?
Right now there aren’t any regulations about who can be a surrogate mother. But experts agree on a few points about how to select. You should choose a surrogate who: 1. Who is at least 21 years old.
2. A woman that gives birth to at least one healthy child, so she knows firsthand the medical threats of pregnancy, childbearing and other sentimental matters related to not bonding with the baby.
3. She must have been approved by psychologists to ensure that there are no underlying mental health issues, especially, issues such as giving up the baby after birth.
4. Signs an agreement about her role and obligations in the pregnancy, such as prenatal care and agreeing to give you the baby after birth.
We don’t have fertility clinics here and so we are not privy to some information on this matter. What we do know is how our societies most time make a woman who is unable to birth her own child(ren) feels less than or not much of a woman. Other countries in West Africa are at the forefront of fertility options, especially with options like IVF, countries like Ghana and Nigeria. There are people who have gone there with infertility problems and were able to have children. I also know that there will be a time in the not too distant future when surrogacy, will be a way of life for most women, irrespective of where they are in the world. Especially, those who can afford it, and are frightened of the birthing process and what pregnancy can sometimes do to the female body.
Some of the questions we should be asking ourselves are; Are there local forms of surrogacy happening in our societies already, but we don’t have a name for it? If not, the next question should be; Are we there yet as a nation? Are we ready for surrogacy and all its entanglements? If we do have fertility clinics here, would you opt for these measures to have a child? If you have the right information and resources as a woman would you go for surrogacy? Are our men open and ready to have these conversations? If you are a man with infertility would you be willing to use donor sperm? Since we don’t have laws that cover this particular problem. How are we going to handle the legal aspects of this process? If you are a woman with fertility issues would you be willing to use a surrogate? If you are a young fertile woman, would you be inclined to be a surrogate? If you were to be paid to be a surrogate how much would you accept as a fee? If you were to pay for these services, how much would you be willing to part with?
Bear in mind that surrogacy is a complex topic and do have some ethical and moral issues surrounding gender, labour, exploitation, and inequality.
As a nation that claims to have an interest in women, these are the issues we should start discussing. I think it’s about time, Sierra Leone starts thinking about the health of the citizens, as infertility affects both genders. In the light of establishing fertility clinics in Sierra Leone that will be providing safe and affordable answers to infertility. This is the time we look at what is important to us and map out ways to achieve them. These are topics we need to discuss as a proactive nation that takes the health of its citizens seriously. Till my next curiosity and write up peace!! and take care of yourself.
This article is for information purpose only. Kindly, seek adequate information on this topic from your health professionals.
Women of Sierra Leone lets us have our first health talk today on this platform. Women’s health education is such a huge and daunting task, and in a country like ours, where societal/ cultural ideals do not favour women this has made it even difficult to access some of the information we need. Women are left at the mercies of quacks and quick fixes which usually result in so many irreversible consequences. Sexual and reproductive health for women needs more attention in this country. Women go through a lot of issues, and most times we don’t have absolutely any idea of what our symptoms are. Even though its incidence ratio is lower when compared with the early decades. It is still the main reasons for maternal morbidity and mortality in the first trimester of pregnancy, especially in developing countries. These are some of the reason why we should not be in awe when there are discussions about high maternal morbidity and mortality in Sierra Leone. There is little or no access to information that will help women of this country make informed decisions and seek proper help from the experts.
Today, we will be looking at ectopic pregnancy. Have you heard of ectopic pregnancy before now? Has your gynaecologist ever mentioned the word ectopic to you before? Have you experienced it? If you have, what were your signs and symptoms? How was it diagnosed and treated? Did you confide in anyone about your condition? By the way, I am not a health practitioner and I am just here to share some of my experience, research and curiosity with you.
WHAT IS ECTOPIC PREGNANCY?
Otherwise known as extrauterine pregnancy or tubal pregnancy is when a fertilized egg grows somewhere outside the uterus, precisely, the egg attached itself on the fallopian tube. Because the egg is not inferred to develop outside the womb if left to grow, can damage nearby organs and cause life-threatening conditions. For the understanding of the layman, an ectopic pregnancy is a pregnancy that happens out of the womb. It is a condition wherein the fertilized egg attached itself on the fallopian tubes, where it will start to grow and develop instead of the womb which is the safest place for it to develop. This condition is life-threatening if not diagnosed and treated immediately. We don’t have the statistics here in Sierra Leone but according to other sources, 1 out of every 50 pregnancy is ectopic.
CAUSES OF ECTOPIC PREGNANCY
Ectopic Pregnancy more often than not is caused by damage to the fallopian tubes. A fertilized embryo may have a problem passing through a distress tube resulting in the egg attaching and thriving in the tube. Some may happen without any perceived cause. Ectopic Pregnancy can cause your fallopian tube to rupture which can lead to drastic inside bleeding that if not treated with quickness might lead to death. The causes are not clear but here are some; • Smoking- women who smoke or use to have higher chances of getting ectopic pregnancy. • Women older than 35 • Hormones • Genetic irregularities • A previous Ectopic pregnancy • Pelvic Inflammatory Disease (PID)- such as some form of chlamydia, and gonorrhoea as they can create scar tissues in the fallopian tubes. • If you have an Endometriosis history. • Fertility drugs and In vitro fertilization. • Pelvic Surgery. • Tubal Ligation and Reverse Tubal Ligation as it causes damaging.
SIGNS OF ECTOPIC PREGNANCY
• Not too heavy vaginal bleeding • Sharp abdominal pain • Severe one-sided abdominal pain • Throwing up • Dizziness • Weakness • Shoulder and neck pain • Passing out • Pelvic pain • Rectal pressure • Severe cramps
DIAGNOSIS FOR ECTOPIC PREGNANCY
This can be done by a gynaecologist or specialist through tests such as pregnancy test, pelvic examination, a transvaginal ultrasound, ultrasound of the uterus and fallopian tubes. After an Ectopic pregnancy has been diagnosed, below are the two ways it could be rectified;
If your Fallopian tubes are fine and the pregnancy isn’t up to twelve-weeks, the specialists can give you methotrexate (trexall). This shot can stop the cells(embryo) from enlarging and your body will eventually absorb them.
SURGERY AND TYPES
There are two types of Ectopic surgery known as Laparoscopy and Laparotomy. Laparoscopy is further divided into two; Salpingostomy A small opening will be made in your lower abdomen and a flexible and thin tube will be used to extract the embryo when it ruptures and the tube is left to heal on it own. On the other hand, Salpingectomyis where the embryo and the tube are both removed. The procedure you will have will depend on the amount of bleeding and damage and whether the tubes are ruptured. The second factor is whether your other tube is normal or show signs of prior damage.
Laparotomy– Here the doctor might perform emergency surgery, and a much larger opening will be made to remove both the embryo and the fallopian tube. If there is heavy bleeding, This can be done laparoscopically or through an abdominal tear. In some circumstances, the fallopian tube can be preserved. Typically, however, a ruptured tube must be removed.
But if the fallopian tube is damaged. Prompt treatment lessens the danger of developing difficulties from an ectopic pregnancy. Its also improves your likelihood for future successful pregnancies and lessens prospective health complications.
POST ECTOPIC PREGNANCY
After ectopic medication or surgery, consider talking to your gynaecologist or fertility specialist, if you want to have a child or have more children especially if your tube(s) was removed. Try to also know how long to wait before you try again though, some expert has suggested at least twelve weeks, as this will allow your body to heal adequately. The important thing also at this stage is to know that one ectopic pregnancy can increase the risk of another. Therefore, one should be mindful of how your body changes until you can get your doctor’s confirmation the pregnancy is in its natural rightful place.
Deterrence is not possible in most cases. You can reduce your risk through good sexual and reproductive health education and maintenance. Use protection during sex to avoid sexually transmitted diseases/infections that may inflame or scar your fallopian tubes. A regular visit to your gynaecologist for examination and screening. If you are a smoker quit smoking and take care of your personal health.
If you are a woman in Sierra Leone who had suffered quietly from miscarriage(s) due to ectopic, feeling alone and not having the correct information my heart goes out to you. Look for a professional, a trusted family or friend you can confide in. Your mental health is as important as your physical health. Stay strong and I hope this helps.
To grow up in Sierra Leone as a girl child through adulthood without being molested, abused, sexually harassed or raped is a privilege, a big flex actually. It seems as if women are meer sheep among wolves and this sick notion is only getting worse, even after the presidential proclamation about rape. My heart weeps for myself, my heart weeps for Khadija Madinatu Saccoh, and for all the Khadijas who died through this inhumane act without anyone knowing. For those who lived to tell their stories, yet no one believed them. For those who told their stories but were gaslighted and blamed for being raped.
I see no justification for this sick act of rape, none at all. It is just selfishness and cowardice in the first degree by those who commit rape. But, then the most distasteful part is the hypocrisy of some of our leaders. They will come out and shout with the people, meanwhile, not making the necessary decisions that will help us see a downward spiral of these cases. They know the longest these shouting will last for is a week. After that, life will go back to normal and Sierra Leoneans will forget or pretend this never happened. They feign to be oblivious to how much of a problem RAPE is in a small nation like ours. Rape culture is deeply embedded in our society, and most times perpetrated by people the victims know. Most times these are people with power or people that are associated with power; traditionally, socially, religiously and politically.Rape is prevalent in Sierra Leone and mostly committed by family members, family friends and neighbours, but this does not mean strangers don’t commit these crimes.
We grew up hearing stories of fathers raping their daughters and people manufacturing phrases like “udat cook soup na ein first de taste am.” Interpreted as the cook is the first to taste his sauce. Instead of bringing them to book, these stories are humourized by our communities. We grew up in a society where men see a day-old girl child as a potential wife. We grew up in a society where men think it is normal to touch the woman’s body inappropriately in offices and other public spaces. A society wherein male bosses use sexual advances as a tool to intimidate female employees. A society where women are seen first as an object before anything else. A society where neighbours observe these happenings but turn a blind eye, in the guise of minding their businesses. A society where people would birth a child and think it’s the responsibilities of others to train them. A society where parents think it is the responsibility of the children to fend for them. A society filled with rapists and paedophiles preying on vulnerable young girls. They are known in these communities yet community members chose to ignore them, why? A society where children are giving out to family members, acquaintances, friends to train (referred to in Sierra Leone as “menh Pekin”). These children suffer the brunt of this barbaric act.
We all have failed ourselves, we have failed this generation, our leaders have failed us, those in decision making positions have failed us, especially, the rape apologists who by their actions or inactions are normalizing rape and the rape culture. Now let look at what rape is and the other things that can be classified as such;
RAPE– is a form of sexual aggression involving violent penetration without personal consent.
SEXUAL ASSAULT is a form of rape– it is when a man knowingly touches a girl/woman in a sexually motivated manner without the girl/woman consent. This can include intimidation or causing the woman to engage in sexual activity when she will rather not.
SEXUAL HARASSMENT is a form of rape– it is making undesirable and improper sexual comments or advances in any situation. We all have seen the recurring topic here is CONSENT. Now, what is consent? For every literate woman or man reading this;
CONSENT here means actively agreeing or accepting to be sexual with a man. But bear in mind, consent cannot be given by a child, a minor, a girl below eighteen years. Consent cannot be given by an individual who has an intellectual disability. Consent cannot be given by a girl/woman who is challenged or intoxicated. Consent cannot be given by a girl/woman who is unconscious.
So sleeping with a woman who is drunk is rape. Sleeping with a girl below eighteen is rape. Touching a girl/woman’s vagina while she is asleep isrape. Compelling a girl/womanafter she has said no, is rape.
Even though this happens less often than with girls and women. The Boychild can be raped as well, by a fellow man or woman. Someone who is married can be raped, A person in a relationship can be rape by the partner. No man has the right to force a woman to have sex without her consent.
Meanwhile, there are some actions that are not rape but are still forms of sexual abuse and add to promoting the rape culture, such as;
1. Rape Apologist: A rape apologist can be of any gender that endorses the acts of rape, usually by arguing that rape is not a significant crime or that people do not need to give approval before sex. Any individual who indicates that women may be able to take precautions to reduce their chances of being raped, such as carrying a hidden weapon for self-protection or avoiding places where a rape crime is likely while alone at night.
2. Victim Shaming/Blaming 3. Jokes about rape 4. Catcalling Women 5. Nonconsensual removal of condoms 6. Revenge Porn
There is a lot of advocacy and social work on rape and other gender-based violence in Sierra Leone. What I have not seen is engaging the men in our communities of their actions and to create awareness, education, and engagement targeted at them on thegrassroots level.
What I have not seen is mothers/ women paying more attention to their daughters and learning to listen to them, they should try to investigate their every concern. Teaching them to know about their bodies, having the sex talk with them, teach them to be comfortable with their Vaginas, train them on how to look for the signs of rape or abuse, such as what’s appropriate and inappropriate touches by the opposite sex is our best bet.
What I have not seen is the creation of programs directed at teaching parents, the village elders and community members about rape, its effect on the victims and it’s implications on the society as a whole. The criminality of the act and the punitive measures for those who commit these offences and those that may try to sweep it under the carpet.
What I have not seen is teaching girls that rape is not normal, and to speak up and speak out to someone, when they are faced with such situations. Girls mostly, cannot defend themselves against these perpetrators who are likely to be physically stronger than them.
What I have not seen is the forming of women groups and training them on how to detect the signs of rape and abuse and how to look out for these signs among girls within their communities. They could be young women who have taken a leadership position in our communities. They may also act as a medium with whom these victims may feel safe to report or open up to about these incidents. If they are afraid or frightened to talk to anyone else at home. These women will then forward these casesto the appropriate law institutions.
What I have not seen is Providing community health workers with the training on how to diagnose and treat rape cases, provide rape kits for community health centres. The government or NGOs should try to establish more Rainbow centres all around the country. Whose job will not only be to treat rape victims, but also to engage in awareness and educational activities in these communities. Develop laws, reform outdated laws, empowering law institutions and law officers especially, on rape cases. Develop proper punitive measures, charged rape cases to court, monitor and make sure that the courts treat rape cases with the required urgency they need. Set examples with guilty perpetrators and see theactual result.
Are we not tired of merely giving lip service to rape issues in the country? Are we not tired of not getting the answers we need? Are we not tired of protesting with no much result? Are we not tired of seeing culprits walking freely after a short period of time? We need actual results, weneedanswersandweneeditnow.
Black is the absence of colour Yet, when they see us, they see colour Why is something that is not, can be so much? Why is there so much hate, when love is never enough? Why does everyone hate black, a few times, even blacks? More so, they say, it is the absence of.
He was the absence of; when he begged please, I can’t breathe. He was the absence of; when so defenceless and cuffed. He was the absence of; on bloody tarmac from his nostril, flat on his face helpless in broad daylight. He was the absence of; when he called out, I need water, please or something. He was the absence of; when he cried out for his mama. He was the absence of; when two knees squeezed hard and sucked the life out of him.
When the full four, couldn’t resist the full force on the full floor. When the protector becomes the murderer. When the law becomes the perpetrator
He was the absence of; when injustice breeds resentment, frustration, and revolt. He was the absence of; when the wolf of slavery is wrapped in sheep fur, under the guise of freedom.
Four big white bears went straight home, a sigh of achievement for a day’s work; when a good job is done badly. The absence of one is still progress for the agenda Heads on their pillows, they smiled God must have loved us more; so, he made us white, he caused this divide, not us. Black is the absence of colour, but they see colour when they see us, we are not colourless. We will get rid of them a day at a time, all lives matter, except black. Turn off the light and it becomes the absence of; Yet, when they see us they see colour and now I can’t breathe because he can’t breathe.
*Since COVID-19 regulations to enter destinations around the world keep constantly changing, you are strongly advised to check official announcements by health authorities daily while preparing for your trip