Thursday August 22, 2019

More hurdles for people with autism in Africa

Videos of the boys appear in “Autism: Breaking the Silence,” a special edition of VOA’s weekly Straight Talk Africa TV program. It was recorded Wednesday before a small studio audience of people who live with the condition or deal with it professionally.

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While autism generally is associated with low IQ, the condition also affects people with high mental abilities.
Representational image, pixabay

The 4-year-old Cote d’Ivoire boy couldn’t walk, speak or feed himself. He was so unlike most other kids that his grandparents hesitated to accept him. The slightly older Kenyan boy was so restless that his primary-school teachers beat him, until they discovered he was a star pupil.

The two children reveal different faces of autism — and how society sometimes reacts to the condition.

Videos of the boys appear in “Autism: Breaking the Silence,” a special edition of VOA’s weekly Straight Talk Africa TV program. It was recorded Wednesday before a small studio audience of people who live with the condition or deal with it professionally.

The program’s goal: to help demystify and deepen understanding of autism spectrum disorder. It affects the brain’s normal development, often compromising an individual’s ability to communicate, interact socially or control behavior. The condition can range from mild to severe.

New CDC findings

New findings released this week by the Centers for Disease Control and Prevention indicate an increase in autism’s prevalence in the United States.

Some of those indicators could mislead when assessing African children, said panelist Morenike Giwa Onaiwu, a Texas-based member of the Autism Women’s Network.
Spinner, Pixabay

The agency estimates it affects 1 in 59 children, up from 1 in 68 several years ago and 1 in 150 almost two decades ago. The research is based on studies of more than 300,000 8-year-olds in 11 U.S. states.

Globally, one out of every 160 children has an autism spectrum disorder, the World Health Organization reports. Rates of autism are harder to determine in low- and middle-income countries, including those in sub-Saharan Africa with limited access to clinicians.

Everywhere, “poor people get diagnosed later,” Scott Badesch, president of the Autism Society of America, said in a video overview that set the stage for discussion. “… There’s more services today than ever before but there’s nowhere near the services needed for all who need help.”

A complex condition

Stigma and superstition can heighten the challenges.

In parts of Africa, youngsters with autism “are labeled as devils and they’re not diagnosed and they are not given treatment,” Bernadette Kamara, a native of Sierra Leone who runs BK Behavioral Health Center in a Washington suburb, commented from the audience.

Some people believe the disorder is punishment for a parent’s bad behavior or an affliction that can be prayed away, said Mary Amoah, featured with 15-year-old daughter Renata in a related VOA video.

Also Read: Antidepressants are linked to high risk of dementia: Study

“They don’t understand this is purely a medical condition. It can happen to anyone regardless of your background,” said Amoah, coordinator at a treatment center in Accra, Ghana, for children with disabilities. “A lot needs to be done in our part of the world in terms of education, acceptance and understanding.”

Causes

Researchers haven’t determined the exact cause of autism, though they cite genetic and environmental factors.

Panelist Susan Daniels, who directs the office of autism research coordination for the National Institute of Mental Health, part of the U.S. National Institutes of Health, stressed that research supported by the NIH and CDC shows no link to childhood vaccines.

Though the condition has no cure, early intervention can improve the quality of life for people with autism and their families.

Parents need to observe their children closely from infancy, advised Dr. Usifo Edward Asikhia, clinical director of the International Training Center for Applied Behavior Analysis in Lagos, Nigeria.

“When you have a baby at the age of 12 [months] that cannot babble, that’s a signal,” he said. Another is an inability to grasp objects, a sign of low muscle tone common in autism.

Other hallmarks include lack of eye contact or sensitivity to sounds, Daniels said. She added that a definitive diagnosis “can’t really be done accurately until age 2. But most kids aren’t diagnosed by then.”

“Children with autism in Africa tend to be diagnosed around age 8, about four years later, on average, than their American counterparts,” the Spectrum Autism Research News site reported in December.

Call for cultural sensitivity

Some of those indicators could mislead when assessing African children, said panelist Morenike Giwa Onaiwu, a Texas-based member of the Autism Women’s Network.

“In a lot of African cultures, it’s customary not to make direct eye contact. That’s not a red flag,” said Onaiwu, whose parents came from Nigeria and who learned she was autistic only when two of her own six kids were positively identified with autism. “In terms of not babbling? We speak when we have something to say. … Certain things culturally may be missed because of the way diagnostic criteria are viewed through Western standards.”

While autism generally is associated with low IQ, the condition also affects people with high mental abilities.

If they can “express themselves in some way, they’re actually geniuses,” said panelist Tracy Freeman, a Washington-area physician who has an autistic child. “Their challenge is neurodiversity and getting people to recognize their intelligence.”

At one point in the discussion, moderator Linord Moudou noticed Onaiwu twisting a metal coil in her hands. Onaiwu explained that the repurposed Christmas ornament is a “stimming” device for repetitive motion that provides relaxing sensory stimulation.

Asikhia said families dealing with autism had few public supports in Nigeria or elsewhere in Africa. Most schools lack training in developmental delays that should be flagged for physicians, he said.
African Child, Pexels

“It helps to calm me,” Onaiwu said. She has other strategies: “Sometimes you might see me rocking. … This kind of helps me to navigate in the neurotypical world.”

Growing role for governments?

Asikhia said families dealing with autism had few public supports in Nigeria or elsewhere in Africa. Most schools lack training in developmental delays that should be flagged for physicians, he said.

“Those teachers just don’t know what to do,” he added.

Many African countries lack laws ensuring public education or health interventions for youngsters with autism or other developmental disorders.

But Chiara Servili, a child neuropsychiatrist and WHO technical adviser on mental health, sees rising interest. Representatives of more than 60 countries supported a 2014 WHO resolution urging member nations to develop policies and laws to ease “the global burden of mental disorders” and to devote “sufficient human, financial and technical resources.”

Also Read: Irregular Periods Strongly Linked To Type 2 Diabetes In Girls

Many governments once focused just on improving child mortality rates, she said in a phone interview. Now, there’s “much more awareness not only that they survive but thrive. There is a new focus on early childhood development.”

The WHO is trying to improve supports for family caregivers as well as for teachers, social workers and other professionals in positions to encourage clinical evaluation, Servili said.

With international partners, the organization has developed a guide for caregivers, usually parents, to nurture children with developmental issues. For instance, “we teach them strategies so they can better engage children in play. Sit down at the level of the child. Provide some toys or some object from the house, observe what the child is doing and try to follow the lead,” Servili said. “… Reinforce any attempt to communicate.” (VOA)

 

Next Story

CDC Sends Staffers to Democratic Republic of Congo Border City to Manage Ebola Cases There

The agency indicated it would send more staffers if armed conflict in the northeastern region subsided

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Congolese people walk near the gate barriers at the border crossing point with Rwanda following its closure over Ebola threat in Goma. VOA

The Centers for Disease Control and Prevention said Thursday a dozen staffers had been sent to a Democratic Republic of Congo border city to manage Ebola cases there. The outbreak, which began a year ago Thursday, has now killed more than 1,800 people. The agency indicated it would send more staffers if armed conflict in the northeastern region subsided to safer levels.

Twelve CDC employees will go to Goma, a major transit city near the Congolese border with Rwanda. On Thursday, the city confirmed its third case of Ebola.

CDC Director Dr. Robert R. Redfield said Thursday on Twitter that armed conflict was hampering health officials’ attempts to manage the outbreak, “increas[ing] the risk of disease spread.”

Henry Walke, CDC director of preparedness and emerging infections, said the agency could add more staff if safety improves enough. The CDC said it is working with the U.S. State Department to determine if it is safe to send more U.S. health workers to areas outside Goma.

CDC, Ebola, Staffers

The Centers for Disease Control and Prevention said Thursday a dozen staffers had been sent to a Democratic Republic of Congo border city to manage Ebola cases there. VOA

The announcement came hours after Rwanda briefly closed the border it shares with the Congo over fears the disease would spread.

Witnesses told VOA that authorities prevented most people from crossing between the Rwandan city of Gisenyi and Goma for several hours, after the Ebola virus was detected in Goma. The only people allowed to cross were Congolese nationals in Rwanda returning home.

Rwanda’s ministry of health denied the border was ever closed, and by Thursday afternoon people were crossing between the cities again.

Congolese health officials said the 1-year-old daughter of a man who died of the virus earlier this week is showing symptoms of the disease, in the city’s third confirmed Ebola case. The man was diagnosed a few days after arriving in Goma from a northeastern rural community in Congo’s Ituri province.

Also Read- U.N. Agencies Urging Governments to Encourage Mothers to Breastfeed Their Babies

Emergency declared

Earlier this month, a pastor tested positive and later died after arriving in Goma by bus, prompting the World Health Organization (WHO) to declare the Ebola outbreak in Ituri and the conflict-ridden North Kivu province a global health emergency.

The brief shutdown ran counter to a plea made by the international health officials for countries not to close their borders or impose restrictions on travel to the DRC.

WHO spokeswoman Dr. Margaret Harris said Thursday it is vital that more people who are at risk receive the vaccine used to combat the spread of the virus.  She said the vast majority of such people accept the vaccine, but to be effective, “we really need 100 percent acceptance.”

CDC, Ebola, Staffers
The outbreak, which began a year ago Thursday, has now killed more than 1,800 people. VOA

Harris said health officials also struggle to identify those who “hide” and “flee” to avoid “being identified as a high risk contact.” She said many of them “think that being taken to the Ebola treatment center is like being taken to the death house” when the centers actually provide “an incredibly high standard of care.”

Harris said if people experiencing early symptoms such as fevers and headaches report to a center in a timely fashion, there is a “90 percent chance of survival.”

2,600 cases of Ebola

More than than 2,600 cases of Ebola have been reported in Congo since the current outbreak began a year ago, with a death rate of nearly 70 percent.

Also Read- Assam Government Relaxes Restrictions on Cultivation of Scented Agar Tree

This is the 10th outbreak of the virus over the last four decades in the DRC.  It is the second largest outbreak after the historically deadly 2014 epidemic in West Africa that killed more than 11,300 people. (VOA)