The New Nation - Internet Edition

How to protect women and children from bird flu

Md. Sazedul Islam

Women and children, who are vulnerable to bird flu, should be protected from the disease. Children who play with dead birds or fowls can be affected.

The issue of protecting women and children demand attention as they face risk because they have to touch, deal or use poultry birds, other birds and eggs.

Bird flu - avian influenza - is caused by a virus that mainly affects wild and domestic birds (particularly domestic poultry and waterfoul such as chicken and ducks). It can spread rapidly between birds causing sickness and high death rates, especially in poultry farms and live bird markets where birds are kept close together.

Anyone can be affected if they slaughter the affected birds or touch it while separating its feathers.

Bird flu symptoms in humans are fever, headache, cough, muscle pain, eye infections, pneumonia, and severe respiratory diseases such as acute respiratory distress.

Bird flu has hit poultry flocks across the world and killed more than 175 people since late 2003, most of them in Southeast Asia, according to the World Health Organisation.

The virus has been found in Pakistan, India and Afghanistan in the last year. Wild migratory birds have been blamed for the global spread of the disease.

The first documented cases of bird flu in people appearing in Hong Kong in 1997, when 18 people infected with an H5N1 virus strain were admitted to hospital, six of whom died

Though the government took necessary measures to face bird flu situation, people particularly women and children have been asked to be cautious in dealing with poultry birds and other birds for their protection.

Experts advised people to be aware while buying live fowls because if fowls seem sick, then it has to be avoided. They also asked people not to buy prepared fowls from shop. They also advised people to wash eggs with detergent powder after buying from shops.

They said people should not approach the guest birds and also not allow our poultry birds to go near the guest birds.

They said acute awareness about bird flu could combat the disease. According to UNICEF and World Health Organization,

fence or wall should be raised around farm so that other birds and animals cannot enter into it from outside and main entrance to the farm should always remain closed.

Those who work at farm should wash their hands and legs with germicide. Others who work and provide health service at farm should enter the farm after taking necessary protective measures.

Any vehicles, which intend to enter the farm, should be germ free by cleaning its mud with water and antiseptic.

Fowls and ducks cannot be reared at same farm or on farm premises. Dead fowls should be put under ground or burned and chickens, eggs and foods for domestic animal should be bought from well-known and specific places. Sick or abnormally dead fowls or other poultry birds should not be touched with bare hand. Disease affected fowls and ducks should not be slaughtered, touched or its feathers not be separated. Children should be asked not to go to disease affected poultry birds and not to play with these.

Hands should be washed well with water or wash after touching the poultry birds.

Nose and face should be covered with clothes while looking after the poultry birds and other domestic animals. After touching the poultry birds, hands should not touch eyes, nose or face till the hands are washed.

Meat of poultry birds should be cooked well. Half cooked meat, items made of half cooked eggs or meat should not be eaten. Residents of those areas where bird flu has spread out should refrain from visiting live poultry birds and other birds selling centre or slaughtering place. Stool of disease-hit poultry birds or other birds should not be used as fertilizer or food for fish. If any woman or child suffer from fever and cough after touching poultry birds or other birds, they should visit physicians immediately.

If any poultry birds or other birds die unnaturally, local ward commissioner, local administration or livestock office should be informed about it. People should be cautious while burying dead fowls, ducks or birds. The Fisheries and Livestock Ministry has taken up Avian Influenza Preparedness and Response Project to combat the menace of bird flu.

It said it is safer to eat cooked meat of fowls and full boiled eggs. It suggested following protective measures.

According to ministry, people were asked to buy healthy and live fowls. Hands should be washed well with soap before and after touching poultry birds and eggs, because soap water damage avian influenza virus. After buying eggs, it should be washed well with soap or detergent water.

People were asked to bury dead poultry birds and other birds, not to bring poultry birds, other birds, eggs and poultry feeds from those areas where bird flu has spread out.

Any clothing that has been in contact with the dead bird should be washed using ordinary washing detergent at the temperature normally used for washing the clothing.

Any contaminated indoor surfaces should be thoroughly cleaned with normal household cleaner. Women and children must be cautious and use gloves, dried cloth or polythene bag while burying dead poultry birds.

Eggs should be washed with soap or soda. It should be taken after boiling it well or fried on both sides.

Bird flu can spread through sniffing, coughing and spitting. We should not throw cough and spit here and there and take sniffing by covering faces.

Sick or dead poultry and other birds should be buried under the ground and it should not be left at dustbin, river or water bodies. Hands should be washed well with soap, ash or water after touching eggs, poultry birds or other birds.

If anyone suffers from coughing or coldness two-week after touching poultry or other birds, they should immediately visit nearby health complex or hospital.

-PID

Assign female doctors for medical examination of rape victims

Jharna Moni

Payel Islam, a class VIII student of Srimongol in Sylhet, returns home from school in the evening every day and falls victim to eaveteasers. Payel does not feel like disclosing it to her parents lest they stop her studies. But one evening, the worst possible thing happened to the teenager.

On her return home, a local wayward youth found her in a desolate spot near a tea garden and fled the scene, leaving her in a pool of blood. Later, some tea garden workers took her to a local hospital.

Though the evidence of rape is clear, a medical certificate is necessary for launching a legal battle. This certificate is issued only after a medical examination is conducted by female doctors and for that the victim has to be undressed fully. But, Payel's mom is not ready to do that.

"My daughter has already suffered. And to prove the offence I don't want the repeat of the rape by allowing male doctors to examine her whole body," says the distressed mother. For the refusal of medical examination, the case of Payel (not her real name) did not go to court and the rapist was let off the hook.

Alo, an 18-year-old daughter of Ramiz Ali of a remote village in Barisal, faced the same fate of Payel. She was violated by Rasel, a local thug. A day after rape, Ramiz took Alo (name changed to protect privacy) to Barisal Medical College Hospital for medical examination, but she did not allow male doctors to examine her.

There are many instances where rape-related crimes in Bangladesh cannot reach courts, as victims do not want to be examined by male doctors, allowing the rapists to go unpunished.

What is rape?

The existing law defines rape as having sex forcibly with a woman by a man without her consent.

In Bangladesh many rape incidents go unreported for various reasons. A rape victim becomes unwarranted in society if the incident is made public and there are some people who blame the victim, not the rapist, for the offence. And many women commit suicide after rape out of shame.

According to a monitoring report prepared by Bangladesh Mohila Parishad, during 1997-2001 period, some 1,656 women were raped, 614 gang-raped, 53 raped after promise of marriage and 159 murdered after rape. In 2006, some 549 rape incidents took place in the country, 249 were victims of gang-rape and 170 women were killed after rape.

Executive director of National Women Lawyers' Association Salma Ali says, "The actual figure of rape incidents is much higher than what we can see in newspapers."

An analysis of the incidents that took place in the past few years shows most of the rape victims are from illiterate and poor classes. Exceptions are also there. Women belonging to middle and upper classes also fall victims to rape. But, the rate is much lower than that of the lower-class families.

Women and Children Repression Prevention Act, 2000 ensures stringent punishment up to death for rape-related crimes. And, women leaders, human rights activists, lawyers and civil society members have no problem with the law. But, their complaints are about medical examinations after rape.

Medical examinations are required for taking any legal actions against rapists. But, forensic departments of the country's hospitals do not have enough female doctors to conduct the medical examinations. So, it is done by male doctors, which many consider as a second rape.

"Conducting medical examination by male doctors is undoubtedly tantamount to a second rape. First time, a woman is raped physically and during medical examinations, she is raped psychologically," says Sanjeeda Akhter, a teacher of Dhaka University's Women and Gender Studies Department.

According to information provided from Forensic Department of Dhaka Medical College Hospital (DMCH), 4-5 rape victims come to the hospital every day on average for medical examinations. Prior to examinations, the victim or her guardian has to sign on a blank paper giving consent to all types of medical examinations.

Many are found unwilling to be examined by male doctors. Therefore, many guardians take their girls back without examinations. Recently, Reshma (not her real name) of Dhaka's Amin Bazaar went back from hospital without being examined by male doctors. "I was raped once. Now, I don't want to expose my naked body in front of male doctors," says Reshma, who also wanted the perpetrator to be punished. But, seeing the examination methods, she changed her mind. Now she does not want justice.

The doctors at Forensic Department of DMCH admit that some women do go back home without being examined. They claim the rate is very low. They also say that their main job is to prove how one is victimised. And these examinations are done with due respects to the women. Besides, a female employee remains present during the examinations.

Experts say different examinations are very important to identify the rapists and get them punished. As said earlier, many women do not want to get examined by male doctors and there is a huge shortage of female forensic doctors.

There are only five female doctors in Forensic Departments in the country. Of them, three are at DMCH, one each in Mymensingh and Comilla. Women leaders, human rights activists and the civil society members demand appointments of adequate female doctors to the department.

Deputy Director of Bangladesh Legal Aid and Services Trust (BLAST) Farida Yasmin says, "These examinations must be conducted confidentially by female doctors. The rapist himself doesn't see the victim's body as much as seen by doctors while being examined. This is very insulting for women."

Zinat D Laila, a doctor of Forensic Department at the DMCH, says female doctors should join the department for humanitarian ground. "If there are adequate female doctors, no tortured woman will go back without being examined."

Writer Selina Hossain says in 2000 a six-year-old girl was raped by a police constable at Panchagarh Police Lines. And medical examinations could not be done, as the girl used to get scared at the sight of a male.

She says the government needs to address the issue immediately.

-News Network

Women need to be more aware

Quamrun Nahar Ruma

Shahida Sultana, wife of an affluent bank official and mother of three, had been enjoying a good health until recently. Now she has started gaining weight abnormally. Reason: Taking of birth control pill for a long time.

"My man hardly uses condom. To him, it's nothing but a trouble. And I'm a woman. So, apart from performing many other responsibilities of the family, this is also my job to control birth," Shahida, in her late 30s, says. A survey, conducted among 50 couples in Dhaka for this report, shows 17 of them have chosen pill as birth control measure" while eight used condom and 25 adopted none of them. Among the 17 pill users, there is a couple where both the husband and the wife are doctors. The wife says, "In this male-dominated society, all the responsibilities fall 011 women's shoulders, even that of birth control. And there is nothing unique in my case. I'm also bearing the same burden."

According to Demographic Health Survey-2004 carried out by NIPORT, from 1991 to 2004, the use of condom was the least among the birth control methods. The rate of its use was the same in 2004 as it was in 1991. During 1996-97, the condom use had marked a rise a bit, but it went down again. On the other sidle, the year 2004 had seen a larger use of oral pills compared to 1991. According to statistics of 2004, the use of oral pills was the highest among other contraceptive methods.

A global handbook for providers, jointly published by the Centre for Communication Programmes at John Hopkins Bloomberg Health and World Health Organization (WHO), shows that condom is the safest among all the birth control methods. This book has been published with research articles of doctors from different parts of the world.

According a WHO survey conducted in 1997, women become victims of health problems like high blood pressure, heart disease, liver complications, weight gain, ammonia, anemia, irregular period, headache, appetite Ross and depression due to the use of the oral pills which are not suitable for health.

Samia Islam, a mother of two, is a college teacher. Her husband is also ateascher. Samia remains ill round the year for contemptuous use of pills. She suffers problems like headache, vomiting and even irregular period. Doctors advised the couple to use condom. "Pill doesn't suit my body, but I can't make my husband understand the problem. He doesn't want to use condom for reasons unknown to me:' she says. Not only Samia, most of the women using pills suffer from such side effects.

About the means to increase the use of condom, director of Family Planning Association of Bangladesh (FPAB) Halida Hanum says, "First of all, one-to-one communication needs to be increased. There should be a better understanding between husbands and wives. A husband must have compassion for his wife. He should use condom considering that has no side effect."

She says the government should undertake various prograrmmes to increase the use of condom among illiterate, less educated people and those living in rural areas, as surveys suggest the use of condom is very low among them.

Halida says women will have to be made aware about their rights. If so, a woman will understand that she too has the right to choose. Awareness will encourage women to discuss frankly about contraceptives and motivate their husbands to use condom.

Samina Chowdhury" a gynecologist of Dhaka Central Hospital, is critical of the mentality of men in this regard saying, "Due to domination of men, women have to take all the responsibilities that are hazardous. It's necessary to get men (Out of this mentality through counseling. "

NIPORT research director Ahmed Al Sabir says there is a stereotype thinking among men. They think birth control is a woman-related issue. This attitude needs to be changed.

Referring to another important aspect, he says, "Most of the family planning workers are women. Naturally, they are approaching women more and talk about female methods. The number of male workers has to be increased. And, men will have to be informed that condom is the best among the birth control methods."

Dr Roushan Ara, head of gynecology department at Holy Family Hospital, emphasizes the need for more and more campaign about condom through ads. "The number of advertisements on condom is unusually fewer than that of pills. It needs to be increased on TV, radio, newspapers and magazines. Billboards will have to be used as much as possible," she says.

Dr Mahmuda Islam" assistant professor of Apollo Hospital's; gynecology department, says there is a wrong perception among men that using condom me cannot have the complete sexual satisfaction. It has to go. If this wrong perception can be corrected, men will be interested in using condom. Motivational activities are necessary to do that. And the government must play the leading role in this regard.

Halida Hanum says" "The use of condom is not a hormonal process. Since it is used externally, there is no side effect. And this is the safest birth control method. Many men think using condom they get less pleasure, as there is no skin-to-skin contact. Therefore, they don't want to use this method. This view has to be changed."