Tuesday, 28 August 2012

Disability and Your Libido

People with physical or intellectual disabilities in our society are often regarded as non-sexual adults. Sex is very much associated with youth and physical attractiveness and when it is not, is often seen as “unseemly”.

If sex and disability are discussed, it is very much in terms of capacity, technique and fertility – in particular, male capacity and technique and female fertility – with no reference to sexual feelings. This approach ignores other aspects of sexuality, such as touching, affection and emotions.

Disabled people not non-sexual

If we accept that sexual expression is a natural and important part of human life, then perceptions that deny sexuality for disabled people deny basic right of expression. The perception of people with disabilities as non-sexual can present a barrier to safe sex education, both for workers who may be influenced by these views and for disabled people themselves in terms of gaining access to information and acceptance as sexual beings.

For paraplegic and quadriplegic people, loss of sexual function does not mean a corresponding loss of sexuality. Sexual function may be impaired but can, like other functions, be increased, although fertility is usually lost for men.

After spinal cord injury the spinal centre for sexual function is generally intact; it is the communication from the brain to the spinal centre that is usually disrupted. Unless some sensation in the area of the sexual organs remains, the usual sensation of orgasm is lost, but phantom orgasm elsewhere in the body may be experienced. However, the physical and emotional aspects of sexuality, despite the physical loss of function, continue to be just as important for disabled people as for non–disabled people.

In addition, opportunities for sexual exploration among disabled people, particularly the young, are very limited. There is often a lack of privacy and they are much more likely than other young people to receive a negative reaction from an adult if discovered. The general reduction in life choices also has an impact on self – esteem which in turn affects sexuality.

It is important for health care professionals, particularly those involved in education programs with disability workers or disabled people, to understand community attitudes towards disability and sexuality and the impact of these views upon disabled people themselves.

Let’s not sexually discriminate.

Depression and Your Libido

The "new generation" of antidepressants, of which Prozac is one, have helped return millions of people worldwide suffering from depression (as well as other serious conditions such as obsessive compulsive disorder and eating disorders) to mental health. One of the chief selling points of these drugs has been their negligible side-effects compared with earlier antidepressants.

 However, there is one common side-effect that is often a serious cause of concern: sexual dysfunction.

At least 30%-60% of the men and women who take one of the popular newer antidepressants such as Prozac and Zoloft, experience some degree of sexual dysfunction.

 Drug-related sex problems may include erection and ejaculation impairment in men, loss of lubrication in women, and, in both sexes, decreased or lost libido and delayed or blocked orgasm.

Some do get it up when they are down
For many people, the benefits of having their depression lifted far outweigh any possible sexual problems. There is also the argument that depression itself usually severely dampens libido. However, there is no question that healthy sexual function is an important component of quality of life for many people.

 Often, as people experience their depression starting to ease, they feel eager to return to normal life - and that includes normal sexual behaviour.

Most people don't need to take antidepressants for their entire lives: once they stop taking the drugs, their sexual functioning returns to normal. Thus sexual dysfunction may not be a serious issue for people receiving short-term antidepressant treatment. But many chronically depressed people require treatment for many months or years.

For some, sexual side-effects can be a serious problem that leads them to stop taking the drugs, often without telling their doctors. This may result in relapse of the depression, which can be very serious.

What can you do?

There are numerous treatment options if your medication is causing sexual dysfunction. These options have not been successful in treating antidepressant-induced sexual problems in everybody, but usually a helpful alternative can be found.

Report any worrisome changes in sexual functioning to your doctor so that together you can seek a way to resolve the problem. Don't terminate your medication without a health professional's supervision and approval - this could lead to a relapse into depression.

Don't be shy to seek help.

Be inspired by a true story (Married to a Devil) on disability and how a strong woman conquered it all by determination. Married to a Devil can be found on  http://chipmunkapublishing.co.uk/shop/index.php?main_page=product_info&products_id=2172

or get it on Amazon http://www.amazon.co.uk/Married-To-A-Devil-ebook/dp/B0087PTP4M

Tuesday, 21 August 2012

Eczema-Your skin gone crazy?

Eczema (atopic dermatitis)

I was too tired to blog today but I thought I owe my friend an examination of eczema as promised. We all know how annoying itchy skin can be. It is getting more and more common and can be stressful.


  • Atopic dermatitis is a chronic, itching, superficial inflammation of the skin.
  • It is often associated with a personal or family history of other allergy-related problems, such as hay fever and asthma.
  • The exact cause is not known, but there is strong evidence for a genetic predisposition.
  • Itching is a constant feature.
  • Emotional stress, temperature or humidity changes, bacterial skin infections, house dust mite, foodstuffs and wool contact may also aggravate the condition.

This is a chronic, itching, superficial inflammation of the skin, often associated with a personal or family history of related problems such as hay fever, allergic conjunctivitis (‘allergic eyes’) and asthma. Doctors and patients often loosely refer to this condition as ‘eczema’.

The exact cause is not known. It is felt that interaction of many factors leads to the development of atopic dermatitis. The latest research shows that atopic dermatitis sufferers may have a (genetically) inherited skin barrier defect. This makes the skin dry and strips it of its natural protection from infections and substances that may cause an allergic reaction or irritation. These patients also seem unusually prone to develop inflammation. People who suffer from atopic dermatitis often have high levels of an immune substance called IgE.

Atopic dermatitis is becoming far more common, a trend that is being noticed in many other allergic diseases.

Food allergy may be associated with atopic dermatitis in infants and young children; however there is no evidence of any role of food allergy in teenagers and adults. Your GP or dermatologist can test your child for common food allergies with a simple blood test (Fx5) or using skin prick testing. This is only indicated if there is a poor response to treatment or a very clear history of food-associated flares.

A common sensitivity amongst atopic dermatitis patients is to house dust mite. This may be assessed using skin prick tests. This allergen is however extremely difficult to avoid.

Things that tend to cause atopic dermatitis flares include: staphylococcus growth on the skin, destruction of the skin barrier, exposure to allergens, exposure to irritants (e.g. rough clothing like wool, soaps) and stress.

  • The pattern of AD tends to change as a person gets older.
  • The condition may start within the first few months of life with red, weeping, crusting lesions on the face, scalp, and the limbs.
  • In older children or adults it may be more localised and chronic.
  • The redness and thickened skin is most commonly found in the creases in the elbows and knees, the eyelids, neck and wrists. The rash may become more widespread across the rest of the body.
  • Itching is a constant feature. The constant itch leads to rubbing and scratching, which in turn leads to more itching. Itching is made worse by the dryness commonly observed in these patients.
  • Secondary bacterial infections and swollen glands are common.
  • Because people with atopic dermatitis often use drugs, over-the-counter or prescribed, contact dermatitis frequently complicates this condition. There are many substances that irritate the skin and can exacerbate the condition.
  • Emotional stress, temperature or humidity changes, bacterial skin infections and wool can also aggravate the condition.

Diagnosis is usually clinical – which means the doctor examines the skin condition and asks questions to make the diagnosis. It is based on the location of the lesions, how long they have been there and whether there is a family history of allergic disorders. In some cases, if the doctor is not certain of the diagnosis, he/she may take a piece of skin for examination under a microscope (a biopsy). Your doctor may in some cases recommend patch tests, skin prick tests or blood tests for specific allergens. In most cases these are unnecessary.

There are several general measures:
  • Avoid overheating (turn the air conditioner down etc.).
  • Avoid irritants like soaps, bubble baths, etc.
  • Avoid wearing rough, irritating fabrics like wool directly on the skin.
  • Avoid activities or occupations that may damage the skin e.g. sports involving long periods in the water (this may damage the barrier function of the skin).
  • Keep baths short and not too hot.
  • Immediately after bathing (within minutes), pat (don't rub) the skin dry and apply appropriate moisturiser (emollient).
  • There are a multitude of emollients on the market. Frequently used examples are UEA and CMG. Your pharmacist will prepare this for you. Do not use fragranced body lotions!
  • Avoid topical (applied to the skin as creams/ointments) antibiotics and antiseptics (these promote bacterial resistance).
  • Fingernails should be kept short to minimise damage when scratching.

 I am not a dermatologist so visit your doctor for advice.

Saturday, 11 August 2012

Alcohol -what actually happens in the brain?

Alcohol and it's Effects

Guess what I don’t drink alcohol and never touched it in my life but I can’t help ask why people drink themselves to comatose. I do have relatives and friends who abuse alcohol and it has always been a mystery to me. In one of my articles I did look at alcohol abuse and this is a continuation.Be warned and know your facts.

Effects of Alcohol
Here is how it works according to research,
The effects of alcohol hit your brain like a tidal wave. You can go from jovial, to falling-down drunk, to dead and it doesn't take very long to get there.
Firstly it suppresses the frontal lobes, then it goes to the back of your brain, and then to the parts deep in the centre.

Alcohol is a suppressant as it suppresses the normal functions of your brain.

This suppressing effect on the brain is almost like a wave crashing over your head. First it suppresses the frontal lobes, then it washes further backwards over the parietal lobes, then to the parietal lobes, the occipital lobes right at the back, then deeper into the brain to the cerebellum and lastly to the diencephalon and the mesencephalon (midbrain), and then down to the brainstem and the medulla oblongata.

This process is continuous, but certain functions, for example peripheral vision, may already be affected at an earlier stage.

The jovial phase

The frontal lobes house the functions that control, among other things, your inhibitions, self-control, willpower, ability to judge and attention span.

Suppress it, and your self-confidence increases, you start getting jovial, you become more and more generous, and start talking more. This is why alcohol is seen as a good social lubricant.

This effect can already be detected with blood alcohol levels as low as 0,01g/100ml - in other words, while you are within the legal limit of 0,05g/100ml.

The problem is that even at this level, which is perfectly legal, your loss of judgement ability and your changed personality already increase your risk of dying an unnatural death, for example as a result of being in a fight.

Maybe you are better able to control yourself and your behaviour in this phase as a result of good self-control, or education, and the onslaught of the alcohol might pass by relatively unobtrusively, or, maybe not.

The slurring phase

The next parts of the brain that come into the firing line, the parietal lobes, are affected at a blood alcohol level of approximately 0,10 g/100ml.

This is when your motor skills become impaired, you have difficulty speaking, except in a in slurred fashion (which oddly enough, you cannot hear yourself), you start shivering, and complicated actions become very difficult to execute (I always used to watched alleged drunk drivers trying to fasten their shirt buttons – an everyday activity that suddenly becomes as difficult as threading a needle). At the same time your sensory abilities are hampered.

The can’t-see-properly phase

The occipital lobe is reached when the alcohol level is usually at about 0,15 g/100ml.

Your visual perception ability becomes limited. You experience increased difficulty with movement and distance perception. Your depth perception becomes impaired and your peripheral vision decreases. If, at this stage, you drive at dusk, you will have great difficulty seeing a little boy chasing a ball, or your fellow drinking buddy, staggering by the roadside.

The falling-down phase

At about the alcohol level of 0,20 g/100ml the cerebellum becomes affected and maintaining your balance could become difficult.

With a bit of luck, by this time your friends will have placed you somewhere safe.

The down-and-out phase

I hope you are lying down in a safe place, because at this stage the wave is crashing at 0,25 g/100ml over your diencephalon and the mesencephalon (midbrain).

You become tired and very unsteady – you are now probably out for the count.

You start shaking and you vomit. Maybe your reflexes will not be so badly suppressed that you cannot protect your airways, otherwise you could inhale your own vomit and die. Your consciousness is now suppressed, and you may be comatose.

In the valley of the shadow of death phase

Should the alcohol wave wash further, driven by a blood alcohol level of 0,35 tot 0,40 g/100ml, and it reaches your brain stem, including the medulla oblongata, you have life-threatening problems. The centres controlling your breathing and your blood circulation are suppressed, and you are busy dying.

The chronic drinker

These effects refer to the social drinker. Chronic abuse of alcohol will increase someone's tolerance, and would therefore cause these effects to become visible only when a chronic drinker has reached much higher levels of alcohol in the blood than those mentioned above.

Usually the person would appear to be less under the influence at a specific blood alcohol concentration (BAC), when the BAC is busy dropping, than when it is busy increasing. This is called the Mellanby effect, and is the result of the development of acute tolerance in the brain with regards to alcohol.

Know your limits and think of the others around you and their safety.

Hopefully this helps .

Friday, 10 August 2012

Abuse of the Elderly: Are you aware?

Abuse of the Elderly

All that is born gets old and it is every one‘s responsibility to care and support the elderly. However there are people who take advantage of ageing relations or clients and make their life hell. A friend of mine’s grandmother lost all she had to unscrupulous relations. Be on the lookout for loved ones who might be abused by the cruel and heartless.

What is abuse?

 Abuse is the improper usage or treatment for a bad purpose, often to unfairly or improperly gain benefit.

There are many forms of elder abuse some which include the following,

Physical abuse: acts that cause injury or physical discomfort, e.g. slapping, hitting, shaking, pushing, use of any physical or chemical restraints, administering incorrect or excessive medication.

Psychological/emotional abuse: acts that inflict emotional or mental suffering, e.g. confinement, isolation, verbal abuse, shouting, ignoring, humiliation, intimidation.

Financial abuse/exploitation: misuse of funds and assets or obtaining property or funds without full consent, knowledge or under duress, e.g. extortion, coercion

Active or passive neglect: withholding or not providing the care and basic necessities required for physical and mental well being e.g. food, warmth, clothing, essential medication.

Sexual abuse: sexual behaviour towards a person without their full knowledge and / or consent, e.g. sexual assault, harassment.

Violation of human rights: the denial of fundamental rights - the right to freedom, security, accurate information and not to be subjected to cruel and inhuman or degrading treatment e.g. respect for dignity, personal privacy, freedom of thought, belief opinion, speech, expression and movement.

Systemic abuse: any abuse or violation of human rights suffered by an elderly person or group of elderly persons as a result of an action or inaction by a statutory body or the state.

Withcraft: Elderly black people, mainly women, are sometimes "identified" as witches by others in the community, and along with their hut they are set alight and burnt to death. It is reported that those "identified " as witches often have particularly wrinkled or darkened skins due to age, or are reclusive or independent and successful. It is also reported that a reason to rid an elderly person from the community might be motivated by the wish to obtain the elderly persons' property or possessions.

Below is a list of possible indicators of neglect by caregiver

  • dirt, faecal/urine smell, or other health and safety hazards in elder's living environment
  • rashes, sores, lice on elder
  • elder is inadequately clothed
  • elder is malnourished or dehydrated
  • elder has an untreated medical condition

Possible indicators of self-neglect

  • inability to manage personal finances, e.g. hoarding, squandering, giving money away or failure to pay bills
  • inability to manage activities of daily living, including personal care, shopping, meal preparation, housework etc.
  • suicidal acts, wanderings, refusing medical attention, isolation, substance abuse
  • lack of toilet facilities, utilities or animal infested living quarters (dangerous conditions)
  • rashes, sores, fecal/urine smell, inadequate clothing, malnourished, dehydration etc.
  • changes in intellectual functioning, e.g. confusion, inappropriate or no response, disorientation to time and place, memory failure, incoherence, etc.
  • not keeping medical appointments for serious illness

Possible indicators of abuse from the caregiver

  • the elder may not be given the opportunity to speak for him or herself, or see others, without the presence of the caregiver (suspected abuser)
  • attitudes of indifference or anger toward the dependent person, or the obvious absence of assistance
  • family member or caregiver blames the elder (e.g. accusation that incontinence is a deliberate act)
  • aggressive behaviour (threats, insults, harassment) by caregiver toward the elder
  • previous history of abuse of others
  • problems with alcohol or drugs
  • inappropriate display of affection by the caregiver
  • flirtations, coyness, etc. as possible indicators of inappropriate sexual relationship
  • social isolation of family, or isolation or restriction of activity of the older adult within the family unit by the caregiver
  • conflicting accounts of incidents by family, supporters, or victim
  • unwillingness or reluctance by the caregiver to comply with caregiver to comply with service providers in planning for care and implementation
  • inappropriate or unwarranted defensiveness by caregiver

Be aware of these tell tale signs and remember we will all get old and there is no need for abuse. Don't be part of it and remember we all age.Help, Love and Support the elderly.

Tuesday, 7 August 2012

Violence against Children

 Violence against Children

Violence against anybody is wrong and a crime against humanity but on children it is worse.

All over the world, children with disabilities are suffering from sexual violence at the hands of perpetrators who operate with almost total impunity. Almost as shocking as the abuse itself is the fact that so little is known about it.

Sexual Violence

Sexual violence against any children is a gross violation of children’s rights. Yet it is a global reality across all countries and social groups. It takes the form of sexual abuse, harassment, rape or sexual exploitation in prostitution or pornography. It can happen in homes, institutions, schools, workplaces, in travel and tourism facilities, within communities - both in development and emergency contexts.

 In many countries, violence against children such as corporal punishment, remains legal and socially accepted. Growing up with violence seriously affects a child's development, dignity, and physical and psychological integrity.

The violence children face takes many forms, such as sexual exploitation and abuse, trafficking, physical and humiliating punishment, harmful traditional practices (including early marriage and female genital mutilation/cutting) and recruitment into armed forces and groups.

Increasingly, the internet and mobile phones also put children at risk of sexual violence as some adults look to the internet to pursue sexual relationships with children. There is also an increase in the number and circulation of images of child abuse. Children themselves also send each other sexualized messages or images on their mobile phones, so called ‘sexting’, which puts them at risk for other abuse.

In 2002, WHO estimated that 150 million girls and 73 million boys under 18 years experienced forced sexual intercourse or other forms of sexual violence involving physical contact (United Nations study on violence against children).

 Millions more are likely exploited in prostitution or pornography each year, most of the times lured or forced into these situations through false promises and limited knowledge about the risks. Yet the true magnitude of sexual violence is hidden because of its sensitive and illegal nature. Most children and families do not report cases of abuse and exploitation because of stigma, fear, and lack of trust in the authorities. Social tolerance and lack of awareness also contribute to under-reporting.

Evidence shows that sexual violence can have serious short- and long-term physical, psychological and social consequences not only for girls or boys, but also for their families and communities. This includes increased risks for illness, unwanted pregnancy, psychological distress, stigma, discrimination and difficulties at school.

Children are often afraid to report incidents of violence. In many cases parents remain silent if the abuse is perpetrated by a spouse or family member or a more powerful member of society, such as an employer, a police officer, or a community leader.

Physical Punishment

Physical and humiliating punishment is the most common form of violence against children. However, it remains lawful and widely socially accepted in all but 32 states (June, 2012). This means that more almost 95 per cent of children in the world do not have the same protection against this form of violence as adults.

Children continue to be physically punished and deliberately humiliated in almost all societies and across all cultures as this practice remains far too common at home, in schools and institutions:

Physical and humiliating punishment in schools has been abolished in over 100 states but is still considered and practiced to discipline children in schools in most countries.

Only 1 out of 10 children live in a country where physical and humiliating punishments are forbidden in all alternative care settings.

It is still lawful to sentence children to caning, whipping or flogging in the penal systems of 145 states all over the world.

This form of violence might be a deliberate act of punishment or just the impulsive reaction of an irritated adult. Regardless of which, it is still a breach of the universal principle that all human beings should be treated with respect for their human dignity and their right to physical integrity.
One main reason for physical punishment is that caregivers or teachers see no other way of correcting the child’s behavior and instill discipline.

However, it has been proven that physical and humiliating punishment is not only a violation of children’s human rights but is also ineffective as a means of discipline. In addition, a commitment to ending all forms of physical and humiliating punishment is a priority because:

  • It is a violation of children’s right to protection, but can also threaten children’s rights to education, development, health and even survival.

  • It can cause serious physical and psychological harm to the children

  • It teaches the child that violence is an acceptable andappropriate strategy for resolving conflict or getting people to do what you want.

  • It may give the impression that some forms or levels of violence against children are legitimate which makes protection of children difficult in general.

  • It encourages children to be aggressive, creates anger and resentment and damages the parent-child relationship.

Child labour

Children work in rich as well as in poor countries. The biggest number of working children is found in Asia. This is not surprising as this is where most children live. The highest proportion of working children is found in Africa, where one child in four is engaged in ’child labour’

Reasons: In order to protect children from workplace abuse, it is important to understand the reasons for children’s entry into to labour market. There is much evidence to suggest that many children work for their own or their family’s survival.

A lack of access to good quality, relevant education is regarded as another key reason for children’s work, as governments have failed to ensure that education is genuinely free, or to invest in improvements in the quality of schooling. Negative attitudes and lack of skills among teachers, and the levels of abuse in schools, are factors that children and their families take into account when they regard work as more relevant than school.

Structural inequalities are important determinants of the types as well as the amounts of work that girls and boys do. For example, children may be discriminated against on the grounds of gender, ethnicity or disability, leading to exclusion from school, limited employment prospects and little choice but to work in harmful forms of work. When gender norms prevent women from entering paid employment, children might have to join the workforce.

Seemingly unrelated issues like HIV/AIDS, conflict and climate change, can have a major impact on child work. For example, the HIV/AIDS pandemic has reduced the adult workforce and diverted expenditure away from social protection and education, pushing boys and girls into harmful work. Conflict can lead to an increase in child soldiers and to children being separated from their families, becoming vulnerable to exploitation. Environmental disasters associated with climate change can increase household vulnerability, forcing children to work to enhance the amount or stability of incomes.

Children living without Proper Care

Children without appropriate care' encompasses a broad range of children who are not receiving suitable, continuous and quality care, nurture and guidance at a physical, emotional, social and psychological level from either their families or from other primary carers that are meant to replace the family environment and are responsible for their well-being and development. The number of children living without appropriate care is staggering.

• The world is home to 18.3 million orphans

• There are more than 15 million children under the age of 18 who have lost one or both parents to AIDS

• More than one million children are trafficked every year

• An estimated eight million children around the world are living in

care institutions, such as orphanages

• In the last decade, an estimated 20 million children were forced to flee their homes

• More than one million have been orphaned or separated from their families by an emergency

 Children are often afraid to report incidents of violence. In many cases parents remain silent if the abuse is perpetrated by a spouse or family member or a more powerful member of society, such as an employer, a police officer, or a community leader.

 There are many charities that are helping children across the world like Save the Children and many others. Lets all help protect children.

Sunday, 5 August 2012

Human Trafficking-Modern Day Slavery

Human Trafficking
Recently I was contacted by a long lost friend and she had come back to the land of the living with a shocking story. She is a victim of human trafficking. She has however managed to break away recently. I will be featuring her story in this blog but I thought I should share with you the fact on human trafficking. It is not only an African issue but affects all of us.   Whoever you are please say no to this evil practice. Sometimes people are recruited without knowing to smuggle victims in and out of other countries.
What is Human Trafficking?
Human Trafficking is a crime against humanity. It involves an act of recruiting, transporting, transferring, harbouring or receiving a person through a use of force, coercion or other means, for the purpose of exploiting them. Every year, thousands of men, women and children fall into the hands of traffickers, in their own countries and abroad.
Elements of human trafficking
  On the basis of the definition given in the Trafficking in Persons Protocol, it is evident that trafficking in persons has three constituent elements;
The Act (What is done)
Recruitment, transportation, transfer, harbouring or receipt of persons
The Means (How it is done)
Threat or use of force, coercion, abduction, fraud, deception, abuse of power or vulnerability, or giving payments or benefits to a person in control of the victim
The Purpose (Why it is done)
For the purpose of exploitation, which includes exploiting the prostitution of others, sexual exploitation, forced labour, slavery or similar practices and the removal of organs.
To ascertain whether a particular circumstance constitutes trafficking in persons, consider the definition of trafficking in the Trafficking in Persons Protocol and the constituent elements of the offense, as defined by relevant domestic legislation.
Human trafficking in Africa is a serious problem and warrants intervention on all fronts. Many African States still do not have legislation on human trafficking, or only have laws that criminalize some aspects of human trafficking (such as child trafficking).
 Nearly 130,000 people in sub-Saharan Africa and 230,000 in the Middle East and North Africa have been recruited into forced labour, including sexual exploitation, as a result of human trafficking. These estimates by the International Labour Organization paint a grim picture of human trafficking in Africa. Although a large number of victims of human trafficking of African origin are found within the continent, many are also transported to Western Europe and other parts of the world, according to a recent UNODC report on trafficking in persons world wide
The report, Tsireledzani: Understanding the dimensions of human trafficking in southern Africa, says victims are mostly women, girls and boys trafficked for variety of purposes, including prostitution, pornography, domestic servitude, forced labour, begging, criminal activity (including drug trafficking), and trafficking for the removal of body parts (or muti).
 Young boys are trafficked to smuggle drugs and for other criminal activities.
Research shows on the following:
    Intercontinental trafficking (to South Africa from outside of Africa).
South Africa is a destination county for long-distance flows for people (mainly women) trafficked from Thailand,Philippines, India, China, Bulgaria, Romania, Russia and the Ukraine. The main point of entry of this trafficking stream is OR Tambo Airport in Johannesburg.
      Trafficking to South Africa from other African countries. People are trafficked from within Africa across the extensive land borders of South Africa, mostly from Mozambique and Zimbabwe and to a lesser extent Malawi, Swaziland and Lesotho. Longer-distance trafficking involve victims trafficked from the Democratic Republic of Congo (DRC), Angola, Rwanda, Kenya, Cameroon, Nigeria and Somalia. All documented cases in this last category are women trafficked for both sexual and labour exploitation.
     Domestic trafficking. The largest movement of trafficked people is from rural areas to cities. Women, girls and boys -and to a lesser extent, men - are the targets of traffickers for prostitution for the same purposes listed. The albino community was identified as vulnerable to human traffickers for the harvesting of body parts, due the belief of a ‘white' skin having potent powers.
Research shows trafficking in Southern Africa as rampant and destination countries include Ireland, Zimbabwe, Israel, Switzerland, the Netherlands and Macau. In all cases, the victims were women trafficked for either sexual exploitation, labour exploitation or forced marriage.
The study confirmed that, as elsewhere, women constitute the largest group of victims in human trafficking in Southern Africa, with the main purpose of sexual exploitation. Young girls are also trafficked for sexual exploitation because they are perceived to present less of a risk in terms of HIV and AIDS and because of the ‘sexual desirability of youth'.
Some of the findings include:
Human trafficking is driven by networks situated in source countries with links to South Africa as the destination country. Perpetrators and intermediaries include large organised-crime networks. South African men with ex-military backgrounds work together with these syndicates.
Relationship of human trafficking to other forms of crime
There is a distinct trafficking-narcotics nexus, as criminal syndicates are usually involved in several areas of illegal activities - including smuggling, weapons and narcotics trafficking. Trafficked women may also be involved in the ancillary line of selling drugs to their clients. In many cases of trafficking for sexual exploitation, victims are made dependent on narcotics to reduce their capacity to leave. Young boys are also trafficked to sell drugs.
Collusion of officials as facilitating factor
The collusion of border and other immigration officials is a key factor facilitating trafficking. Human trafficking syndicates target border posts where lax border controls and vulnerability to bribery enable the illegal transportation of a variety of goods. The Lebombo border was identified as one of the land ports of entry where these problems operate on a large scale. The same problems were cited regarding OR Tambo Airport.
Aggravating factors
Factors that facilitate and aggravate human trafficking in Southern Africa include poverty and inequality; the lack of educational and employment opportunities in surrounding countries and within the country; lax security at ports of entry; collusion of government officials; the lack of trained personnel to identify and handle trafficking cases; and societal beliefs that tolerate violence against women and children.
How to Help
Be aware that this is a crime that can be prevented and for those looking for greener pastures elsewhere be aware you can be duped into modern slavery. Virtually every country in the world is affected by these crimes. The challenge for all countries, rich and poor, is to target the criminals who exploit desperate people and to protect and assist victims of trafficking and smuggled migrants, many of whom endure unimaginable hardships in their bid for a better life.
Vocational training can reduce the risk of them being sucked into exploitative situations again.

Wednesday, 1 August 2012

On Mental Health- ADHD

Mental Health: ADHD
This article is for any family that has gone through some stigma for having a family member with mental health issues. I was thinking the other day of a lady I knew while I was growing up. She had a mental health condition and she walked about the streets. Unfortunately she was always available for men to sleep with and most of the time she had what I think was a sexually transmitted. The whole family was so isolated even the father and other family members were shunned. Such was the lack of knowledge on the members of the community. A little bit of support would have made a difference to the family. I never knew what happened to the lady but hers is not the only family going through that stigma. For all families with ADHD and any other conditions, you are not alone. I am no expert but knowledge is power and it makes all the difference. In Africa I have known families accusing relatives of witchcraft due to lack of knowledge of mental health conditions.
ADHD is a disorder characterised by three primary symptoms: hyperactivity, impulsivity and inattention (difficulty focusing and sustaining attention).
There are three types; inattentive type, impulsivity-hyperactivity type and a combination type including both inattention and impulsivity-hyperactivity.
ADHD is a neurological condition and runs in families.
Diagnosis requires a comprehensive assessment and involves a team of professionals.
Treatment includes medical, psychological and educational intervention as well as behavioural management.
With appropriate intervention and support, people with ADHD can function successfully in society.

Occasionally, we may all have difficulty sitting still, paying attention or controlling impulsive behaviour. For a person with ADHD, though, these problems become so pervasive and persistent that their ability to function effectively in daily life is compromised.
ADHD is a neurological syndrome, found in children as well as adults, that is characterised by poor concentration and organisational skills, easy distractibility, low tolerance for frustration or boredom, a greater tendency to say or do whatever comes to mind (impulsivity) and a predilection for situations with high intensity.
The name Attention-Deficit Hyperactivity Disorder reflects the importance of the inattention/ distraction aspect of the disorder as well as the hyperactivity/ impulsivity aspect. The disorder ADHD symptoms arise in early childhood, unless associated with some type of brain injury later in life.
ADHD is caused by differences in neurotransmitter patterns in certain parts of the brain. Neurotransmitters are chemicals that make it possible for nerve impulses to travel from one nerve cell to another, and therefore play an essential role in the functioning of the brain. The brain performs a vast range of tasks or functions, allowing us, for instance, to see, hear, think, speak and move. Each function is performed by a different part of the brain. In individuals with ADHD there are lower than normal levels of certain neurotransmitters (especially dopamine) in the regions of the brain that are responsible for regulating behaviour and attention. Research also confirms that the Norepinephrine system is also involved in some patients.
ADHD has a genetic component and a group of genes involved has been identified. The genetic component is confirmed with epidemiological studies looking at family groups. Research has shown that in the case of identical twins, if one of the twins has ADHD there is an almost 100% chance that the other twin will show symptoms of ADHD.
ADHD can also be present in some patients with neurological damage occurring either before or after birth. Certain developmental disorders or syndromes, like Foetal Alcohol Syndrome, are associated with a higher incidence of ADHD.
Diet is often cited as the cause for ADHD. Patients with malnutrition or a poor diet may manifest some of the symptoms. In a small subgroup dietary factors may play a role in the worsening of symptoms, especially that of impulsivity/hyperactivity in younger children. Ongoing research is looking at the role that essential fatty acids play in some patients. Poisoning with heavy metals like lead will create a similar clinical picture in some patients.
Although environmental factors do not play a causal role in ADHD, a disorganised, chaotic and stressful environment can cause behaviour which mimics that of ADHD.

There are three primary subtypes of ADHD:

ADHD primarily inattentive type
  • Fails to give close attention to details or makes careless mistakes.
  • Has difficulty sustaining attention.
  • Does not appear to listen.
  • Struggles to follow through on instructions.
  • Has difficulty with organisation.
  • Avoids or dislikes tasks requiring sustained mental effort.
  • Is easily distracted.
  • Is forgetful in daily activities.
Clinically they present as the classical dreamers, disorganised and often living in their own little world. This leads to major problems with planning and task completion.

ADHD primarily hyperactive/impulsive type
  • Fidgets with hands or feet or squirms in chair.
  • Has difficulty remaining seated.
  • Runs about or climbs excessively.
  • Difficulty engaging in activities quietly.
  • Acts as if driven by a motor.
  • Talks excessively.
  • Blurts out answers before questions have been completed.
  • Difficulty waiting or taking turns.
  • Interrupts or intrudes upon others.

The classical hyperactive group are often a danger to themselves because of the impulsive behaviour.

ADHD combined type
The individual meets both sets of inattention and hyperactive/impulsive criteria, constantly fidgeting and busy with something other than what it expected of them at that moment.

Coexisting disorders

In studies as many as 60 percent of individuals with ADHD present with at least one other major disorder. The most common of these coexisting disorders are briefly described below.
Disruptive Behaviour Disorders

Oppositional-Defiant Disorder (ODD) and Conduct Disorder (CD): ODD involves a pattern of arguing with multiple adults, losing one's temper, refusing to follow rules, blaming others, deliberately annoying others, and being angry, resentful.
CD is associated with efforts to break rules without getting caught. Such children may be aggressive to people or animals, destroy property, lie or steal things from others, run away, be truant from school, or break curfews. CD is often described as delinquency.

Mood Disorders


ADHD is often associated with depression, which usually appears after ADHD has developed. Depression is characterised by sadness (a child may cry frequently, and for no apparent reason), social withdrawal, loss of appetite, self recrimination, insomnia or excessive sleeping, and a loss of interest in activities that were previously enjoyed.

Mania/Bipolar Disorder
Bipolar Disorder may present with symptoms of ADHD in the pre-pubertal child. A family history of bipolar disorder is an important indicator. This disorder takes the form of periods of abnormally elevated mood (mania) alternating with episodes of depression. In children, the manic phase can manifest as pervasive irritability and unprovoked aggression.
The manic phase in adults is usually characterised by an expansive mood, such that the person feels euphoric and extremely confident. The manic individual may go for days without sleeping, tends to speak rapidly and incessantly, and is inclined to behave inappropriately in social settings (having lost their normal inhibitions). During a manic phase people often develop an unrealistic belief in their capabilities, as a result of which they engage in activities or projects which are doomed to failure and which often lead them into financial or other difficulties.


Approximately one third of children with ADHD will also have an anxiety disorder. People with anxiety disorders often worry excessively about a number of things and may feel edgy, stressed out or tired, tense, and have trouble getting restful sleep. A small number of patients may report brief episodes of severe anxiety (panic attacks) with complaints of pounding heart, sweating, shaking, choking, difficulty breathing, nausea or stomach pain, dizziness, and fears of going crazy or dying. These episodes may occur for no reason.

Tourette's Disorder

About seven percent of those with ADHD have Tourette's Disorder. This disorder involves movements and vocal tics. Tics are sudden, rapid, recurrent, non-rhythmic, involuntary movements or vocalisations. The diagnosis of ADHD may precede the onset of tics.
Learning Disabilities

Up to 60 percent of individuals with ADHD have some form of learning disability. Learning disabled persons may have a specific problem reading or calculating, but usually have normal IQ. Dyslexia may have a major impact.

Substance Abuse
Recent research suggests that adolescents with ADHD are at increased risk for very early cigarette use, which is likely to be followed by alcohol and drug abuse if their symptoms are not controlled.

Three to five percent of children are affected by ADHD. Until recent years, it was believed that children outgrow ADHD in adolescence. Hyperactivity often does diminish during the teen years, but it is now known that symptoms can continue into adulthood. In fact, up to 65 percent of children with ADHD will continue to exhibit symptoms in adulthood and in a major proportion it may still have a negative impact on their functioning in all aspects of life and society.
Males are far more likely to get ADHD, with the ratio of males to females with ADHD being 3 to 1. However, ADHD tends to be under-diagnosed in girls as they more frequently present with the inattentive type, which is more difficult to identify than the hyperactive-impulsive type.
In certain conditions a higher incidence of ADHD are found i.e. Tourette’s syndrome or Foetal Alcohol Syndrome.

There is no single test to diagnose ADHD. Instead, a comprehensive evaluation is necessary to:
  • reach a diagnosis rule out other causes for the symptoms
  • establish whether coexisting conditions are present.
Such an evaluation requires time and effort and should include a clinical assessment of the individual’s academic, social and emotional functioning. In children, a careful history should be taken from parents and teachers. Often, both a psychologist and a medical practitioner, usually a psychiatrist or a paediatrician, should be involved in the assessment process.
Before reaching a diagnosis, it is important to rule out the following conditions, which usually manifest similar symptoms to those of ADHD.

  • Emotional difficulties/social and environmental problems.
  • Low Muscle Tone – some children have to focus so hard on sitting up straight that they fidget more.
  • Motor-co-ordination difficulties – if present this often leads to problems with task completion and the quality of work presented. It often coexists in patients with ADHD.
  • Sensory Modulation Disorders – These children have problems being tactile or light defensive. The noise defensive child has difficulty blocking out background noise when having to pay attention.
  • Global development delay - concentration and functioning should be evaluated according to functional, not chronological age.
  • Absence Epilepsy - often presents between ages six - 10 years.
It is important to realise that some of the above can also be present in patients with a classical picture of ADHD. Other problems may present with symptoms suggestive of ADHD but often leads to a later diagnosis because the interaction with concentration problems is not explored. They often coexist.
In order for a diagnosis of ADHD to be made the following conditions should be met
  • Some symptoms must have appeared by the age of seven.
  • At least six symptoms must be present and must have persisted for at least six months.
  • Symptoms must occur in at least two different settings (for example, at school and at home).
  • The symptoms must cause significant impairment of social and academic functioning.
It is imperative that children who present with ADHD receive appropriate and adequate treatment.
Treating ADHD in children requires medical, psychological and educational intervention, as well as behavioural management. It therefore requires a team approach and also includes parent training. Parents need to be educated on how to cope with and assist a child with ADHD. Parental support is a crucial component in any successful treatment programme. Positive reinforcement, in which desired behaviour is rewarded, is the most appropriate and effective form of behavioural management. It is important that reinforcement is consistently applied.
Many children with ADHD can be taught in a regular classroom with minor adjustments to the environment, but some children require additional assistance using special educational services, especially if they have complex learning difficulties.
Treatment for adults with ADHD involves medical intervention and psychotherapy. Psychotherapy is important because adults with ADHD need to be helped to understand that their educational, vocational and/or personal difficulties are not the result of an irremediable personality flaw.
Patients with ADHD often present with emotional difficulties and problems due to the negative impact of ADHD on their lives. Psychotherapy and coaching helps with understanding the condition, taking control of the symptoms and making better choices.