Kenya’s first human milk bank has opened at Pumwani Maternity Hospital. Moina Spooner, from The Conversation Africa, spoke to the team spearheading APHRC’s research efforts in the establishment of Kenya’s first milk bank.
How long has it taken to open? What were the biggest obstacles?
The process of establishment of human milk banking in Kenya started in 2016. It was spearheaded by the NGO PATH, in partnership with APHRC and Kenya’s Ministry of Health, among other partners. It was rolled out in two phases.
During phase one we assessed people’s perceptions and acceptability of using donated human milk. We also looked at how feasible it would be to set a bank up. The results were encouraging. About 90% of participants were positive about it, 80% would donate their breast milk, and about 60% indicated that they would allow their children to be fed with donated human milk.
A committee was also set-up to provide oversight and guidance on human milk bank work in Kenya. They were sent to South Africa to learn more about the human milk banking process. Finally, local strategies were developed.
We are now in phase two of the project: the establishment of a pilot human milk bank in Pumwani Maternity Hospital. This includes the launch of a research project which examines its feasibility, effectiveness, acceptability and aims to estimate the cost of establishing an actual human milk bank in Kenya.
There have been challenges. Being a new concept, there have been some logistical challenges, for instance some of the equipment wasn’t locally available so it took longer to get it all done and installed.
There have also been concerns by some community members and health workers over the safety and quality of the donor human milk.
However, we’ve had support from the government which has been critical in addressing the logistical challenges. Advocacy and communication activities are also being rolled out to create awareness on human milk banking and address any concerns.
What is a milk bank and how does it work?
Human milk banks are facilities that systematically collect, pasteurise, test, store, and distribute donated breast milk.
An effective system has many operational processes to ensure it provides safe, high quality donor milk. They start with screening and recruiting donors who must be healthy mothers with surplus milk beyond the needs of their own child’s. Donors must undergo health checks including tests that screen for HIV, syphilis, and hepatitis B and C. Diseases could be passed to children through breastmilk.
Donors must then express milk in hygienic conditions, after which the milk is pasteurised. This involves heating the milk in a water bath at 62.5°c for 30 minutes followed by rapid cooling.
At the bank, the milk is frozen and stored at -20c. When needed, it’s thawed to room temperature and issued to children who don’t have access to their own mothers’ milk. A prescription by a qualified health professional is needed for this.
Why are they needed?
Although breastfeeding is the most natural and best way to feed infants, many babies may lack access to their mother’s milk. This could’ve happened for many reasons – maybe the mother is sick, hasn’t got enough breast milk or is dead.
From our formative research, 44% of newborns in urban health facilities were separated from their mothers for varying periods of time. This ranged from less than an hour to more than 6 hours and even days after birth. Of these infants, only 14% were fed on mother’s own milk during separation. 36% of the newborns weren’t fed on anything during this period and an additional 23% were fed on formula or cow’s milk.
When breastfeeding is not an option, the World Health Organisation (WHO) recommends donated human milk as a lifesaving alternative. Particularly for babies that were born early, have low birth weight, are orphaned, malnourished or are severely ill.
Evidence paints a very strong picture in favour of donated human milk over infant formula. It’s more effective in reducing the risk of disease and infections – like inflammatory bowel disease, leukemia and respiratory tract infections – in newborn babies and is better tolerated by babies that are born prematurely.
In the US and Brazil, the use of donated human milk was reported to reduce the length of hospital stay for sick infants and save on the cost of health care.
Given the benefits of using donated human milk over infant formula, the WHO has called for the global scale-up of human milk banks. These are expected to increase access to safe donor human milk.
Is this the first of many?
Although WHO recommends that the milk banks be set up, Kenya is just the second, after South Africa, to establish a human milk bank in sub-Saharan Africa – even though it is a pilot.
We hope that human milk banking will be scaled up in Kenya and the rest of sub-Saharan Africa, using the evidence we generate from our research.
-Elizabeth Kimani-Murage; Research Scientist at the African Population and Health Research Center and Adjunct Assistant Professor, Brown University
-Milka Wanjohi, Taddese Zerfu, Esther Anono and Eva Kamande from the African Population and Health Research Center contributed to the writing of this article.
[IN NUMBERS] Coronavirus Update: COVID-19 In Africa
While most cases of the COVID-19 coronavirus have been reported in the U.S. , Europe, and China, the virus is spreading rapidly across the African continent.
The confirmed worldwide cases for the virus have surpassed 18 million with the current figure being at 18,304,554.
The increase in new reported cases around the world has led the World Health Organization (WHO) to declare the coronavirus a global pandemic.
The death toll continues to rise globally. It is currently at 694,052.
The U.S. leads with 158,480 deaths. Brazil comes second with 94,130. The U.K is with 46,210 deaths; Mexico is with 47,746, and Italy’s deaths are at 35,166.
China, where the virus originated from, maintains that the country’s death toll is at 4,634.
The figure of the global recoveries stands at 11,508,854.
The African continent has 964,042 confirmed cases of Covid-19, while the death toll stands at 20,407. The continent has made 617,722 recoveries.
Here are the country-wide numbers for Africa:
|Country||Confirmed Cases||Confirmed Deaths||Confirmed Recoveries|
|Cabo Verde (Cape Verde)||2,547||24||1,860|
|Central African Republic (CAR)||4,614||59||1,635|
|Cote d’Ivoire (Ivory Coast)||16,182||102||11,801|
|Democratic Republic of the Congo (DRC)||9,133||215||7,424|
|Eswatini (formerly Swaziland)||2,775||43||1,214|
|Sao Tome and Principe||874||15||787|
Note: The numbers will be updated as new information is available.
4 Ways Women Can Better Advocate For Their Own Health
One morning, when I was 14 years old, I woke up with excruciating stomach pain—the worst I’d ever had. My mom took me to urgent care, and the doctors there concluded that I had gastritis, or essentially a “bad stomach ache.”
But I knew they were wrong. I knew it was more than just a bad stomach ache. I kept pushing my parents until they finally took me to the hospital. After doing a variety of exams, the doctors said something along the lines of, “We really can’t find what’s wrong, but you seem to be in a lot of pain.” They gave me two options: wait four hours until the next available CAT scan, or let them do exploratory surgery and see what they find.
I decided to do the exploratory surgery. It ended up being a major, major surgery—over six hours long—and they found a tear in my intestine. They had to remove about 10 feet of my intestine, and it turns out that if I had waited for the CAT scan, I actually would have died. So, I like to say that that was the first time I learned how to trust my gut (in this case, my literal gut).
I think about this experience all the time, but I found myself reflecting on it even more as I was reading my friend Dr. Alyson McGregor’s new book, Sex Matters: How Male-Centric Medicine Endangers Women’s Health and What We Can Do About It. I don’t know how much of my near-death experience was linked to my being female, but I do know that when it comes to our medical system, women have consistently experienced poorer outcomes in every area of health than men.
McGregor writes: “One of the biggest and most flawed assumptions in medicine is this: if it makes sense in a male body, it must make sense in a female one.”
Our methods for evaluating, diagnosing, and treating disease for both men and women are based on previous research performed on male bodies. But women are physiologically different from men on every level—and these differences can have major impacts on everything in medicine, from how drugs are prescribed, to how routine tests are performed, to how pain is assessed and treated, to how systemic disease is diagnosed.
Here’s an example. Coronary artery disease is the leading cause of death in both men and women, but women have statistically poorer outcomes and higher mortality. Why? Because women’s symptoms are simply different from men’s. While men might experience left arm pain and chest heaviness (“typical” heart disease symptoms), women often present with only mild pain and discomfort, possibly combined with fatigue, shortness of breath, and a strong feeling that “something isn’t right.” Since women’s symptoms are not the symptoms that doctors typically associate with heart disease, their heart disease is 50 percent more likely to be initially misdiagnosed.
There are hundreds more examples like this one. It’s clear that there is work to do when it comes to unconscious biases in medicine—but, as women, how can we best advocate for our health and ensure that our concerns are heard and taken seriously?
1. Be prepared.
Your doctor may have gone through years of medical school, but that doesn’t mean they’re all-knowing. Research your conditions, your prescriptions, and how your prescriptions interact with each other. This way, you can have an informed conversation with your physician if something is wrong. Also, keep an up-to-date list of your prescriptions and allergies with you at all times so that any provider who cares for you will have all of the information they need.
2. Ask questions.
Even after you do your research, you may still have questions. Don’t be afraid to ask them—especially gender-specific ones. For example, “Has this medication been tested in women? If, so are there different dosing guidelines?” Or, “Will this prescription/test/procedure affect my birth control/pregnancy/breastfeeding?” It’s important to make sure you’re not only being treated for the correct conditions, but also that you’re being treated properly as a woman with those conditions.
3. Trust yourself.
Just like 14-year-old me trusted her (literal) gut! No one’s voice should take precedence over yours when it comes to your body and your health care. As women, we tend to be more attuned to our own bodies than men. We are more likely to notice symptoms when they first appear, and we usually seek treatment more frequently and earlier than men. If you feel like you’re being misdiagnosed or undertreated, keep pushing until you get answers—your life may depend on it.
4. Make your voice heard.
It’s important to advocate for yourself on an individual level, but you may be inspired to do even more. Financially, you can donate to research and advocacy foundations, or even specific research projects within your local universities and hospitals. Other effective advocacy ideas that don’t cost anything are to join a medical research trial, join a support group, or harness the power of social media to share your story. Any of this could be what makes it possible for others to get the treatment they need.
How The Billionaire Behind The Movie ‘Contagion’ Is Working To Stop This Pandemic—And The Next One
Jeff Skoll has been funding pandemic preparedness for more than a decade, even longer than Bill Gates. In recent months, he’s increased his philanthropic giving to help combat Covid-19.
Nine years ago, Jeff Skoll’s film company Participant Media partnered with Warner Brothers to put out Contagion, a movie about a global pandemic that started with a virus from a bat. An American businesswoman (played by Gwyneth Paltrow) came home from a trip to China and unknowingly spread a novel, and at times, deadly disease. While many viewed the film as pure science fiction, Skoll had ulterior motives. He hoped the movie would help build support for funding the U.S. Centers for Disease Control and Prevention and also warn the world about the potential dangers of a global pandemic.
Skoll, 55, became a billionaire just over two decades ago as a result of stock he received as eBay’s first president. He left eBay in 2001 and has since co-produced more than 100 films and TV programs, all with socially relevant themes including the climate change documentary An Inconvenient Truth featuring Al Gore, factory farming documentary Food Inc., the miniseries When They See Us and the 2016 Academy Award best picture winner Spotlight, about The Boston Globe’s investigations into child sexual abuse by Catholic priests.
While his impassioned film-making pretty much ground to a halt temporarily with California’s shelter-in-place orders, his 2011 movie Contagion has become the must watch-at-home hit of the pandemic—it’s the number one selling title to date this year, according to Warner Brothers, the distributor. (It won’t disclose the number of times it’s been rented or sold.) In late March, Participant, Contagion screenwriter Scott Z. Burns and director Steven Soderbergh worked with Matt Damon, Kate Winslet, Laurence Fishburne and other cast members to produce public service announcements about washing your hands and staying home.
Beyond backing a movie about a pandemic, Skoll has been funding pandemic preparedness and prevention since 2009 — six years before Bill Gates’ now well known TED talk warning about them — through the Skoll Global Threats Fund, to which he pledged $100 million. (The other threats: climate change, water scarcity, nuclear weapons and conflict in the Middle East.)
Since the start of this year, Skoll has contributed an additional $200 million to his charitable foundation—$100 million of which was announced in late April and will go toward fighting Covid-19. He put the other $100 million in earlier this year, he tells Forbes, adding that he hadn’t bothered to publicize it. “I don’t see this as a money squirt,” Skoll explains. “This is a resource allocation to an area we know well. And this is an emergency.”
Newly bulked up, the Skoll Foundation promised to quadruple its grantmaking this year to $200 million. New beneficiaries in 2020 include some of the poorest folks in Los Angeles and the contact tracing program being launched across California.“This is the rainy day we’ve all been saving for,” Skoll says of his charitable giving. “If not now, when?”
He’s been working up to 20 hours a day in his kitchen in Beverly Hills — on a call in early June, he jokes that it’s his “command center,” equipped with a couple of iPads, a MacBook and some bluetooth devices — talking to people around the globe, taking the pulse of the pandemic and searching out individuals, organizations and companies with new ideas. “Just the science, the learnings of the virus — almost every day there’s some revelation that we didn’t know,” says Skoll.
The pandemics research that Skoll started funding through the Skoll Global Threats Fund spun off into a nonprofit called Ending Pandemics in January 2018, with a seed grant from Skoll. “It’s all about early detection and rapid response,” says Ending Pandemics President Dr. Mark Smolinski.
Skoll has been funding pandemic preparedness and prevention since 2009 — six years before Bill Gates’ TED talk warning about them — through the Skoll Global Threats Fund, which he spun off into Ending Pandemics in 2018.
Skoll got wind of the novel coronavirus early on, back in December —where it started. “We had colleagues on the ground in Wuhan. We had an idea that a zoonotic disease had jumped to humans,” he says. By January he and his team began to be concerned about countries with trade ties to China — particularly in Africa, where some of the social entrepreneurs that the Skoll Foundation has supported are operating.
In early February, the Skoll Foundation made its first Covid-19 related grant: $3 million to the African Field Epidemiology Network, a group working with the African Centres for Disease Control and Prevention (the Africa CDC) to help coordinate African countries’ response and to boost surveillance and detection. The Bill & Melinda Gates Foundation donated to the same group around the same time. Beginning with those two grants, says Africa CDC Director Dr. John Nkengasong, “we were able to rally rapid responders to Addis Ababa [for training] and send them to Nigeria and Cameroon. We were able to scale up diagnostics.” Funding from others then followed, including the MasterCard foundation, Germany, Sweden, the U.K. and the U.S.
In March it made a grant to the Southern African Center for Infectious Disease Surveillance Foundation (SACIDS) and a similar group in East Africa. One outcome: Mozambique, which had the infrastructure to test for Covid-19 but limited money to buy tests, got the needed funds and ramped up testing four-fold, according to Smolinski.
The Skoll foundation’s next move was to quickly create a fund for both its current and past grantees — mostly social entrepreneurs. Sixty-four organizations were given $50,000 grants. “We figured they would need emergency funding,” Skoll explains.
Though the Skoll Foundation has traditionally supported social entrepreneurs who work in lower income countries, in the past few months it has made some donations closer to home. Because Los Angeles County has been particularly hard hit by the pandemic, Skoll reached out to Los Angeles Mayor Eric Garcetti to offer assistance. In late April, his foundation made a $2 million gift to the Mayor’s Fund for Los Angeles, which is providing cash assistance to families hit hardest by Covid-19.
Skoll also connected with California Governor Gavin Newsom and his senior advisor on social innovation, Kathleen Kelly Janus. The Skoll Foundation is donating $8 million to support California’s response to Covid-19, starting with $4.1 million for the public awareness campaign around contact tracing, which Janus says “will be really critical to preventing a second wave of Covid-19.”
Smolinski’s team, which had already partnered with Harvard and Boston Children’s Hospital to build a crowdsourced symptom reporting tracker called Flu Near You in 2012 to show flu trends in neighborhoods and cities, rolled out Covid Near You in early March. The app lets people anonymously report if they’re feeling healthy or not, with zip code info, as a way to track current and potential hotspots.
Skoll’s Ending Pandemics has partnered with governments and public health authorities in 36 countries — 11 of which have surveillance systems tracking Covid-19 and other infectious diseases.
Ending Pandemics has partnered with governments and public health authorities in 36 countries — 11 of which have surveillance systems that Smolinski says are “up to speed.” One is Cambodia, a country of 14 million people, where all four telecom companies support a free mobile app that both receives info about disease and provides information. Calls have gone from 600 a day before the pandemic to 15,000, and the vast majority of the Covid-19 cases in the country were first identified through the hotline, Smolinski says. Cambodia, the country that took in a cruise ship no one else wanted, so far has just 129 cases and no deaths, he adds.
Through the Audacious Project, a philanthropic group with about 30 members launched by TED conference curator Chris Anderson with Jeff Skoll and Richard Branson, Skoll and others are supporting Boston-based Partners in Health, which responded to the Ebola crisis in 2014. The multi-million dollar grant from the Audacious Project enables Partners in Health to share its contact tracing expertise over the coming year with roughly 19 public health departments across the U.S. “We started by helping the state of Massachusetts put together a contact tracing system, and everyone else wanted to know what we were doing,” says Joia Mukherjee, Chief Medical Officer of Partners In Health. “This funding has allowed us to expand our team. What we are hoping is that state and federal money will be forthcoming.”
Mukherjee applauds Skoll’s approach to philanthropy. “Jeff has always been a systems thinker, and that has been transformative for Partners In Health,” she says.
Skoll also contributed funding to an ambitious global project called the Global Infectious Disease Epidemiology Network — GIDEoN for short —being spearheaded by Columbia University epidemiologist Ian Lipkin, who directs the university’s Center for Infection and Immunity. Lipkin has lined up the equivalent of the National Institutes of Health in 12 countries including India, Brazil and China and together they’ll share information about outbreaks and disease samples. With GIDEoN, Lipkin explains, “we’re trying to upgrade the capacity for detecting infectious agents and toxins, particularly in the developing world.”
While Skoll has been involved in global philanthropy for nearly two decades, he now has an even more personal reason for being involved in the fight against deadly diseases. While working on Ebola in 2014, he contracted a rare tropical disease that took two years to diagnose. He took an 18 month medical leave of absence and is feeling better now.
Despite many challenges, Skoll is an optimist, even about pandemics. Yes, the number of cases will likely increase as U.S. states open back up, he says. But he’s hopeful that a treatment for Covid-19-an existing drug—can work and be scaled up for distribution sometime this summer. “I hope we can get the solutions in place in the next few months. I see a path to it,” he says.
As for future pandemics, Skoll sees a silver lining. “There are so many zoonotic viruses that jump over from animals to humans. Most of them peter out and turn into something less lethal. I don’t think it’s likely that we’ll see any terrible new pandemic any time soon, says Skoll. “If anything, the world is on watch now.”
Download issues of Forbes Africa
- Single Digital Issue: James Mwangi Cover - Forbes Africa Aug/Sep2020 R50.00
- Single Digital Issue: Forbes Africa June/July 2020 R50.00
- Single Digital Issue: Forbes Africa April 2020 - 30 Under 30 R50.00
- Single Digital Issue: Forbes Africa March 2020 R50.00
- Single Digital Issue: Forbes Africa February 2020 R50.00
Subscribe to Forbes Africa
Ink Is In: Tattoos In The Time Of Covid
How Fine Art Is Closing Deals On Multi-Million Dollar Homes | Forbes
Bill And Melinda Gates On The Dangers Of Coronavirus and Vaccine Conspiracy Theories | Forbes
Mauritius-Africa, a partnership for shared prosperity
THE FUTURE JUST ARRIVED: THE ROLE OF BANKS IN A POST-COVID WORLD
- Health4 days ago
[IN NUMBERS] Coronavirus Update: COVID-19 In Africa
- Cover Story3 days ago
The People’s Banker: ‘Entrepreneurship Means Folding Up Your Sleeves And Working’
- Brand Voice1 day ago
THE FUTURE JUST ARRIVED: THE ROLE OF BANKS IN A POST-COVID WORLD
- Strategies3 days ago
From The C-Suite: ‘The Digital Economy Is An Extremely Powerful, Transparent Tool’
- Brand Voice7 days ago
Focus on Namibia: The Vision Which Is Breaking Down Boundaries To Expand Namibia’s Infinite Horizons
- Entrepreneurs1 day ago
Enterprise And Traceable Tea From Tanzania
- Brand Voice7 days ago
Egypt’s Blueprint For A Better Tomorrow
- Entrepreneurs4 days ago
Farmer Forays: ‘Creating A New Line Of Business’