post Nodding Disease

October 23rd, 2012

Filed under: Social Issues, The Unspoken — Lissan Magazine @ 19:52

A mysterious disease is killing thousands of children in Uganda, Sudan and Tanzania.

The cause of the “nodding disease” is as yet unknown but it only affects children between the ages of five and 15.

Thought to be an epileptic neurological effect of the Onchocerca volvulus parasitic worm that causes Onchocerciasis or river blindness, victims suffer seizures that often start with nodding of the head, giving it its name.

Malcolm Webb reports from northern Uganda.

Source: Aljazeera


Nodding Disease baffles Experts.

Here in a hot, dusty part of northern Uganda, children are falling victim to a mysterious disease that has confounded health officials.

It’s known loosely as “nodding disease” and almost every family in the village we’ve come to see in Pader District has at least one child suffering from it.

Nine year old Vicky Ayaa began showing symptoms on the day we arrived.

The disease gets its name from its most noticeable symptom. The young girl appears to be nodding off. Her eyes begin to close and her head drifts downwards as if she’s falling asleep, yet she’s not tired and doesn’t want to lose focus.

Every few seconds her head jolts upwards and her startled gaze is upon us, then the eyelids become heavy and she fades again.

Over time, Vicky will likely get much worse, falling down and injuring herself, losing cognitive ability and experiencing stunted growth.

School often becomes too difficult for many children with nodding disease and they drop out. Indeed many of them die young.

They can fall into cooking fires when losing consciousness. Drown during a seizure. Die of opportunistic infections that strike the malnourished. Or they may simply be abandoned by their families.

“Within the communities some of the parents have thrown their children onto the streets,” says Dr. Emmanuel Tenywa, the World Health Organization’s team leader in the area. “They say they are tired. For how long will they be looking after these children? If you have seen these cases in their homes, you would cry when you look at them.”

When Vicky recovers from the nodding bout, she’s able to fetch water, but she must be watched closely.

Her mother weeps behind a nearby tree, distraught because she has only two children, and now, both of them have the condition.

William Oyet, a government health officer in the district, says this family’s case is typical. “It can start anywhere, and the whole people in the village are worried because any time, any day, your kid will start nodding.”

Experts from the World Health Organization and the Centers for Disease Control and Prevention in Atlanta have been trying to find the cause of this condition. So far they’ve come up empty-handed.

Dr. Scott Dowell, from the CDC’s Division of Disease Detection & Emergency Response, led an investigation in the area. He says they’re not only baffled by the cause of the disease. They can’t determine why it only preys on children. “It really is very tightly clustered between five and 15 years of age,” he says. “In the study we did in northern Uganda 93% of kids were in that age window and I don’t know why that is.”

Throughout the village, some parents of the children are desperate.

As cruel as it seems, one mother keeps her son, David Okot, tied at the ankle with a rope so he can’t wander off.

David first showed symptoms of nodding disease in 2003. He’s 15 years old now, but looks much younger. He spends most of his days, angry and confused, tethered to a post on his family’s hut.

Since he became afflicted with the condition, David has developed a mental disability. He hasn’t spoken clearly for two years. Some villagers are frightened by him and consider him dangerous.

And these dangers, and fears, are in evidence almost everywhere you turn in the village.

William Oyet, the local health official, shows us two more children who appear to be about six or seven years old. “Monica is 13 years old and when you look she has stunted growth and cannot go to school, cannot do anything.”

The other child wears only a pair of faded shorts. His face and distended belly are covered in saliva. “He’s 11 years old,” says Oyet. “When you see the syndrome it has affected the growth. He cannot do much. The head, the saliva is all over the body and he’s really malnourished.”

Indeed many of the affected children are malnourished because eating food seems to spark bouts of nodding and sometimes seizures. Epilepsy drugs have been used to control the episodes, but they do not cure the condition, for which the key question is: what’s causing it?

“I wish we knew. It’s really frustrating,” says the CDC’s Dowell. “We know now from the most recent investigation that it is a brain disease. There’s clearly something wrong with the brains of these kids who have it. We’ve documented by MRI scans that the brains have some atrophy and by EEG that the brain waves are abnormal. In fact some of the kids with nodding have almost continuous seizure activity although they appear fairly normal.”

But the elusive question remains. “We understand the path of physiology of nodding but we still don’t know what causes it,” says Dowell.

The WHO’s Dr. Emmanuel Tenywa says there are other clues. For example, he says all the affected children have onchocerciasis, a parasitic condition that can cause blindness.

“I think that gives us a bit of a starting point,” says Tenywa. “But the whole issue is now if you are infected with onchocerciasis, how does it cross the brain barrier to go into the brain, and what damage does it exactly do? These are the things which we are trying to understand.”

But onchocerciasis is common in many African countries, so why doesn’t nodding disease appear elsewhere? So far it’s only been found in small pockets of northern Uganda, Sudan and Tanzania, but the number of cases is growing. That’s raising fears that it could spread to more areas, sparking a greater sense of urgency in the health community.

But for the people in this village in northern Uganda, the sense of urgency couldn’t be any greater. To them it’s not a medical mystery. It’s a blight that’s picking off their children, one by one.


post Is Shyness Curable?

March 26th, 2011

Filed under: Social Issues — Lissan Magazine @ 14:39

Curing Shyness and other Social Fears
by Vicki

source: Helium: Emotional Health & Wellbeing

Shyness and social fears can be dramatic side effects of deeper issues. Self-esteem plays a major role in the way people interact in all social aspects. Other factors to consider when determining the causes of social fears are life and social experiences. Our child hood experiences provide insights into our many adult behaviors. The way in which we are conditioned to interact or react to people and situations is a process in which we learn through out our lifetimes.

In 1902, after extensive research, C. H. Cooley introduced the concept of “The looking-glass self”. The Looking-glass self is created through the imagination of how one’s self might be understood by another individual. The “self” can be defined as ones sense of personal identity.

There are three components to the looking-glass self:

1.We imagine how others view us.
2.We imagine how they will judge us based on that view.
3.We develop our self through our ideas on how others judge us. (Yeung)

“The way we imagine ourselves to appear to another person is an essential element in our conception of ourselves. In other words, I am not what I think I am, and I am not what you think I am. I am what I think you think I am.”
Bierstedt, Robert.

“I am not who I think I am
I am not who you think I am
I am who I think you think I am.”

“Each to each a looking-glass
Reflects the other that doth pass.”
C. H. Cooley

Not every person will experience social fears at the same level. Some will find themselves mildly shy, and they will be able to warm up to a person or situation with a little time and comfort. Others with more severe distress may find it impossible to gain the level of comfort they need for security. Severe social distress or social anxiety may bring about ringing in the ears, tunnel vision, seeing spots or colors, trembling, a sudden rise in body temperature, a shaking or stuttering voice, and even entirely losing train of thought. Beyond shyness, social anxiety disorder or social phobia affects 13.3% of our population with a male to female ratio of 1:1.5.

Our parents, our peers, our environments, society, and we condition ourselves throughout our lives. In realizing that behaviors can be conditioned, and knowing how they are conditioned, we can come up with options for reconditioning the same behaviors to a more desirable and realistic view of what we perceive as the norm.

Social learning theory proposes that our behavior changes are affected by environmental influences, personal factors, and attributes of the behavior itself. Each may affect or be affected by either of the other two. A person must believe in their own capability to achieve social tasks and there must be a positive incentive over the negative expectations. The person must desire and believe in the outcome of the particular behavior modification one is working on.

Children raised with criticism are often stripped of their self-esteem. They may lack in will for accomplishments and withdrawal from social situations with peers for fear of judgment and criticism. Child abuse also discourages children’s desire to pursue closeness, and thus they do not allow themselves social situations that could potentially expose them to the risk of involvement.

Society pulls our children to strive for a set standard that some simply cannot seem to achieve. Societal expectations have grown, and not everyone is able to keep up with the standards. Those who cannot achieve societies set norms will often have feelings of depreciated value. They will feel as though the way they see themselves is the way others view them as well (the looking glass self).

The first questions to ask would be what it is that instills the social fear and in what situation is the fear most prevalent. It is a good idea to explore the triggers to the fear. Which are considered normal and which are heavy burdens to your functions in society? If your social fear is mild, you may not have to go as far in depth with the environmental details that conditioned your fears. However, the person who suffers severely, who is more controlled by the fears, would need more in depth reconciliation. The more severe cases benefit considerably from behavioral therapy, and many even find it helpful to utilize anxiety or depression medication for added support.

In either mild or severe situations of shyness or social fear, what is very important is that the will for change is there. The fact that the behavior was conditioned shows that it can be reconditioned with effort and the will to try, and try again. Modifying behaviors in day to day events is necessary and should be done over a period of time. Make sure you are working on all of your self-esteem issues, and realize you are not alone in this. So many individuals around us every day suffer some type of social fear; you will cross their paths daily. It really is a large portion of our population in the United States.

The focus should be on just doing it and believing you can. Put yourself in the situation repeatedly. Although it is hard to deal with the feelings of fear, it is necessary for change. Just like anything else to be mastered, you must practice until you reach the comfort zone you are out to achieve.

Change does not happen over night, and it will prove to be a lot of pain staking, emotional work. The more you place yourself in situations that drive that fear, reconditioning will occur with out a doubt. Believe in your capacity to function in a manner that you believe is best for you.

source: Helium: Emotional Health & Wellbeing

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