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Women Hit Especially Hard In Congo’s Worst Ebola Outbreak

For the afflicted, the road to recovery is long and lonely.

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Ebola, WHO, UNICEF, congo, Uganda, women
Congolese health workers register people and take their temperatures before they are vaccinated against Ebola in the village of Mangina in North Kivu province of the Democratic Republic of Congo. VOA
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The Democratic Republic of Congo is in the throes of its worst-ever Ebola outbreak, with more than 420 cases in the country’s volatile east, and a mortality rate of just under 60 percent. But this outbreak — the nation’s tenth known Ebola epidemic — is unusual because more than 60 percent of patients are women.

Among them is Baby Benedicte. Her short life has already been unimaginably difficult.

At one month old, she is underweight, at 2.9 kilograms. And she is alone. Her mother had Ebola, and died giving birth to her. She’s spent the last three weeks of her life in a plastic isolation cube, cut off from most human contact. She developed a fever at eight days old and was transferred to this hospital in Beni, a town of some half-million people in the east of the Democratic Republic of Congo.

More than 400 people have been diagnosed with Ebola here since the beginning of August, and more than half of them have died in a nation the size of Western Europe that struggles with insecurity and a lack of the most basic infrastructure and services. That makes this the second-worst Ebola outbreak in history, after the hemorrhagic fever killed more than 11,000 people in West Africa between 2013 and 2016.

This is 10th outbreak to strike the vast country since 1976, when Ebola was first identified in Congo. And this particular outbreak is further complicated by a simmering civil conflict that has plagued this region for more than two decades.

Guido Cornale, UNICEF’s coordinator in the region, says the scope of this outbreak is clear.

“It has become the worst outbreak in Congo, this is not a mystery,” he said.

What is mysterious, however, is the demographics of this outbreak. This time, more than 60 percent of cases are women, says the government’s regional health coordinator, Ndjoloko Tambwe Bathe.

“All the analyses show that this epidemic is feminized. Figures like this are alarming. It’s true that the female cases are more numerous than the male cases,” he said.

Congo, Uganda, ebola, Women
Health workers walk with a boy suspected of having been infected with the Ebola virus, at an Ebola treatment center in Beni, near Congo’s border with Uganda. VOA

Bathe declined to predict when the outbreak might end, though international officials have said it may last another six months. Epidemiologists are still studying why this epidemic is so skewed toward women and children, Cornale said.

“So now we can only guess. And one of the guesses is that woman are the caretakers of sick people at home. So if a family member got sick, who is taking care of him or her? Normally, a woman,” he said.

Or a nurse. Many of those affected are health workers, who are on the front line of battling this epidemic. Nurse Guilaine Mulindwa Masika, spent 16 days in care after a patient transmitted the virus to her. She says it was the fight of her life.

“The pain was enormous, the pain was constant,” she said. “The headache, the diarrhea, the vomiting, and the weakness — it was very, very bad.”

Congo, Ebola, Women
Marie-Roseline Darnycka Belizaire, World Health Organization (WHO) Epidemiology Team Lead, talks to women as part of Ebola contact tracing, in Mangina, Democratic Republic of Congo. VOA

For the afflicted, the road to recovery is long and lonely. Masika and her cured colleagues face weeks of leave from work to ensure the risk of infection is gone. In the main hospital in the city of Beni, families who have recovered live together in a large white tent, kept four meters from human contact by a bright orange plastic cordon. They yell hello at their caretakers, who must don protective gear if they want to get any closer.

And for Baby Benedicte, who is tended to constantly by a nurse covered head to toe in protective gear, the future is uncertain. Medical workers aren’t entirely sure where her father is, or if he is going to come for her.

Also Read: Congo Start Trials For Drugs Against Ebola

She sleeps most of the day, the nurse says, untroubled by the goings-on around her. Meanwhile, the death toll rises. (VOA)

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Pregnancy is Possible For Survivors of Breast Cancer

Kaur suggested that young women diagnosed with breast cancer need to be made aware about the methods to preserve fertility prior to starting treatment

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Pregnancy is safe for breast cancer survivors: Experts. Pixabay

Breast cancer, the most prevalent cancer among Indian women, cannot deter motherhood, if intervention takes place at the right moment, say health experts. According to them, pregnancy is possible for women survivors of breast cancer — it does not increase risk of recurrence and neither does it cause any harm to the baby.

“Yes, pregnancy is possible for breast cancer patients. Currently there is no reason or evidence to believe that becoming pregnant after treatment for breast cancer can cause any risk to the mother or the baby,” Upasna Saxena, Consultant (Radiation Oncology), at Mumbai’s HCG Cancer Centre, told IANS.

“It is possible for women to continue with their pregnancy even while diagnosed with breast cancer and take treatments tailored to the stage of their pregnancy concurrently. They can go on to deliver healthy babies,” added Kanchan Kaur, Associate Director, Cancer Institute at Medanta in Gurugram.

However, for some even “natural pregnancy is possible,” Kaur stated.

In a striking case from the hospital, Paula, 33, from Rwanda, conceived naturally and delivered a healthy baby five years after she was diagnosed with breast cancer, the doctor said.

Paula was at high risk of developing breast and ovarian cancer in 2013. She completed four years of hormone blockade treatment, which blocks the action of Estrogen Receptor (ER) on breast cancer cells. Pregnancy is not advisable whilst on this treatment.

Although she had her eggs frozen before she started her chemotherapy, she conceived naturally and delivered a healthy baby after the treatment stopped.

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Pregnancy after breast cancer does not increase a woman’s risk of a relapse. Pixabay

In another case from HCG, a patient who was diagnosed with breast cancer at the age of 27 and treated in 2007 opted for breast conservation, against a full masectomy — and delivered a healthy baby boy in 2013.

“Previously, there were concerns over increased risk of cancer recurrence in women who contemplate pregnancy, but it’s good news that studies show no such higher risk in women who conceive as compared to women who do not conceive,” Saxena said.

In yet another case, also from HCG, a patient treated for breast cancer in her late 30s conceived and delivered a healthy baby — but 2.5 years after her treatment. She had a history of seven miscarriages.

“However, it is not a blanket statement for all breast cancer patients. It depends on the age of the patient. And while deciding about pregnancy, it is important to consider and talk to the patient about her age, family size and type of breast cancer (aggressiveness and risk of recurrence),” Saxena noted.

According to a report from the Indian Council of Medical Research (ICMR), India had 14 lakh cancer patients in 2016 and this number is expected to increase.

“Breast cancer is currently the most common cancer among Indian women, both in terms of incidence as well as mortality, with proportional prevalence in younger age-groups being higher than the global average.”

“The age standardised rate is approximately 25.8 per one lakh women and is expected to rise to 35 per one lakh women in 2026,” the report stated.

Pregnancy after breast cancer does not increase a woman’s risk of a relapse.

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Cancer Ribbon. Pixabay

According to the American Cancer Society, surgery for breast cancer is generally safe in pregnancy while chemotherapy seems to be safe for the baby only if given in the second or third trimester of pregnancy, not in the first trimester.

Other breast cancer treatments, such as hormone therapy, targeted therapy and radiation therapy, are more likely to harm the baby and are usually shunned during pregnancy.

“The risk could be the need for caesarean section, premature baby and low birth weight baby (vis-a-vis women with no history of breast cancer treatment),” Saxena said.

“There is, by no means, any increase in the chances of birth defects or deformities in the baby or increased risk of cancer in the baby (unless it is a cancer due to genetic mutation which can be transmitted to the baby).

Also Read- OnePlus to Make its Hyderabad R&D Centre Biggest Globally

“There may be difficulty in breast-feeding post surgery and radiation, but it is still possible with probable lower milk production on the treated side,” Saxena explained.

However, it would be advisable to wait for two years post-treatment to check for an early recurrence.

Kaur suggested that young women diagnosed with breast cancer need to be made aware about the methods to preserve fertility prior to starting treatment.

“Their ova (eggs) can be harvested (as is done for patients undergoing IVF) and preserved for future implantation either in the treated patient or a surrogate,” she explained. (IANS)