ADHABU NA MABADILIKO YA TABIA-AFYA

ADHABU AU MAONYO KATIKA KUBADILI TABIA YA MTU

Constantine Ntanguligwa(MD student Muhimbili university of health and allied sciences)
 1215hrs 24th August 2016

Karibu tuzungumze:

Ni wangapi tumechapwa na wazazi wetu baada ya kukosea nyumbani? Ni wangapi tumepigwa na rula vidoleni na mwalimu mwalimu wa hesabu pale ambapo tumekosea kujumlisha darasani? Ni wangapi tumewanyima chakula wafanyakazi wetu wa ndani sababu alisahau kumbadilisha mwanao nepi? Lakini pia, ni wangapi wamewachoma moto vidole watoto wao kwasababu ya udokozi?

Labda kabla sijaanza, niseme kwanini nimeamua kuongelea kuhusu adhabu leo. Afya ya binadamu, Si pale tu ambapo mtu anaumwa au kutokuumwa magonjwa mbalimbali kama malaria. Afya hujumisha maisha yote ya mwanadamu. Hali yake kimwili, kiakili(kisaikolojia), mazingira anayoishi na jamii kwa ujumla. Vyote hivi ni "afya" ya mwanadamu.

Adhabu ni kitu kinachotambulika na kukubalika katika ulimwengu wa wanasaikolojia. Adhabu hutumika kama njia ya kufanya mtu asirudie kosa endapo tu itatolewa kwa usahihi. Leo tutajua nakujibu maswali yafuatayo:

1. ADHABU INAWEZA KUSABABISHA KOSA LISIRUDIWE AU KUTOSABABISHA MABADILIKO YOYOTE, JE ADHABU INATAKIWA KUWA VIPI?
2. BAADA YA KUTOA ADHABU, JE KUNA KITU NATAKIWA KUFANYA ILI NIHAKIKISHE INAFANYA KAZI INAVYOTAKIWA?

Kwa mazoea, huwa tunamfanyia mtu vitendo au matukio yasiyomridhisha au yasiyompendeza au yanayokatisha tamaa mtu mara tu baada ya kufanya kosa au kuonesha tabia mbaya ambayo hupelekea mabadiliko ya tabia hiyo. Huweza kuwa faini, kufungwa, kupigwa, kufelishwa, kufukuzwa kazi/shule na kupewa barua ya onyo. Vitu hivi huitwa "aversive events" kwenye saikolojia, hili ni somo lefu linalojitegemea.

Adhabu ni kitendo yakuikandamiza tabia mbaya kwa kufanya vitendo hai(active supression). Adhabu si lazima ilete maumivu kwa mtu. Adhabu hutofautiana kuanzia zile zinazoleta madhara madogo mpaka zile zinazoweza kupelekea ulemavu wa mtu kabisa ila mwisho wa siku lengo la mtoaji likiwa kubadili mienendo mibaya kwa mlengwa.

Adhabu huweza kuwa kwa mifumo mitatu au aina tatu:

• "Aversive events" kama nilivyoielezea hapo juu.
• Kuondoa faida zinazodhaniwa kuwepo na muhusika au raha baada ya kufanya kosa flani au kuwa na tabia mbaya. Hasa kwa watoto.
• Kufanya kazi ili kukandamiza tabia flani.

1.AVERSIVE EVENTS:

Hizi hugawanyika sehemu mbili. 

• Sehemu ya kwanza ni pale ambapo utamfanyia mtu kwa vitendo atakavyohisi kwa kuona au kugusa(physical perception) mfano kwa mupata maumivu. Kama vile kumchapa fimbo au kumfinya masikio kama ni mtoto.
• Sehemu ya pili ni pale ambapo utamfanyia vitu atakavyohisi kiakili kuwa si sahihi mfano, pale atakapotaka kufanya kosa halafu ukatikisa kichwa kumaanisha hapana. Pale atakapofanya kosa halafu ukakunja uso akajua umekasirishwa na anachofanya hivyo hutambua akilini mwake na kuacha mara moja, pale atakapofanya kosa halafu ukamnyoshea kidole au pale atakapo kuomba kwenda club na ukamwambia hapana kila mara mwisho wa siku ataona kuwa hauridhishwi nacho kisha akaacha kukuomba.

2.KUONDOA "FAIDA"/RAHA

Kama nilivyosema hapo awali kuwa, kuna watu ambao hufanya makosa au huwa na tabia mbaya inayoendelea kwasababu kuna faida anayoiona yeye anaipata baada ya kufanya hayo. Mfano mtoto asipofanya kazi za shuleni nyumbani kwasababu ya TV ukamkataza kuangalia TV kwa wiki moja. Atahisi anapitwa kama ni tamthilia na mara nyingine hatarudia hasa atakapofika shuleni na kukuta wenzake wanasimuliana kilichotokea kwenye tamthilia jana yake. Kama anapewa Ada akalipe na halipi kwa wakati na kwenda kufanya matumizi yake na hatimaye kukopa kwa wenzake na kulipa ada kwa kuchelewa labda kwa mazoea kuwa hafanywi kitu akimwelezea("kumdanganya danganya kwa maneno kidogo") mwalimu mkuu huwa anamuacha hivyo mnaweka faini kubwa isiyohitaji maelezo ambapo ataacha kwa kuona hamna maelezo tena yanayosikilizwa bali ni faini tu. Au kutoruhusiwa kuja shule mpaka utakapolipa hata kama unasababu ya msingi ya kutolipa.

3.KUFANYA KAZI

Hapa ni pale mtu anapofanya kosa au kuonesha tabia mbaya na kufanyishwa kazi kama malipizi ya tabia hiyo. Kazi hii mara nyingi huhusiana moja kwa moja na kosa lile na huweza kuwa kulazimishwa kufanya kinyume chake. mfano, mtu anapotupa takataka ovyo nje, utamwambia asafishe uwanja wote. mtoto anapomwaga chakula mezani makusudi huweza kuambiwa asafishe meza na kudeki sehemu wanayotumia kula, lakini pia mtu anapokosea kuandika jina lake utamwambia aliandike kwa usahihi mara 50.

Kunakitu tunaita "reinforcements"/viimarishi. Zenyewe hutumika kuendeleza tabia fulani. Mfano, mtoto wako anapofaulu halafu ukampa zawadi ya kitu alichokuwa anakitamani sana, hii itamjengea hamu ya kuendelea kufanya juhudi za kufaulu aendelee kupata zawadi hizo. Si lazima kutoa vitu, unaweza kuimarisha tabia kwa kunyima pia. Mfano, kama wafanyakazi wako wana sheria ya kumaliza kazi ijumaa na kwa wasiomaliza kwa wakati hutakiwa kurudi kazini wikendi lakini wanaomaliza ijumaa wanapata likizo wikendi. Kuwambia warudi wikendi ni kuwanyima uhuru ambao utapelekea kufanya kazi kwa bidii na kuimarisha tabia hii ya kumaliza kwa wakati.

TOFAUTI YA REINFORCEMENTS/VIIMARISHI NA PUNISHMENT/ADHABU: viimarishi hulenga hasa kuimarisha tabia fulani na adhabu hulenga kukandamiza tabia flani.

Hivi vinaingiliana na huweza kuchanganywa lakini ni vitu tofauti. Hii inamaanisha ni vema vitu hivi viwili vikatumika kwa pamoja. Mfano, mtoto anapokuwa na kiburi, unaweza kumchapa fimbo na matokeo yake anaweza kukuchukia na kukuona mbaya lakini kwa yale mazuri aliyonayo ukimpongeza baadaye atabadilika na kukuona kumbe si kama alivyokudhania una malengo mazuri na yeye. Hivyo inashauriwa kutumia njia zote mbili. Hivyo ni vema baada ya adhabu ukatafuta njii ya kuimarisha tabia nzuri uliyolenga kuijenga.

MADHARA YA ADHABU:

Madhara ni mengi kutokana na njia unayotumia hasa ikiwa si sahihi. mfano kuchukiwa, kukimbia shule, kutoroka nyumbani, kulia sana, kisasi na nidhamu ya woga.

Mfano, mtoto wako ni mwizi na mdokozi:

 Mtu mmoja yeye amemchoma moto vidole na mwingine amemchapa fimbo.

•  Aliyemchoma vidole kuna hatari kubwa mwanao akakimbia nyumbani na pengine kwenda kuendeleza wizi huko anapoenda.
•  Lakini, anayemchapa anafanya njia sahihi kwani ni uzito unaostahili kwa kesi hii na ni vema zaidi baada ya hapo ukaangalia chanzo cha kwanini mwanao ni mdokozi.                                  

Pengine wewe mzazi humuweka kwenye vishawishi vya kumuacha mwanao aende shule wenzake wakiwa wanakula wewe humpi hela ya matumizi shuleni na kuishia kuwaibia wenzake huko shuleni au hata kuiba nyumbani anapoona hela. Lakini utakapokuwa unamfungashia mfano chakula anachokipenda shuleni na kumpa hela ndogo ya matumizi kama atanunua pipi mfano utakuwa umetoa adhabu na umeimarisha(reinforce) tabia nzuri unayotaka awe nayo.

Mfano mwingine, mwanao hasomi na kagoma kwenda shule kwasababu anaamini kuwa wapo wengi wamefanikiwa na hawajasoma nakukukupa mifano kama Diamond Platnumz, Ronaldo na Messi. 

• Mmoja akamwambia mwanae kama hutaki kusoma ondoka kwangu nisikuone ambayo ni adhabu tayari kumfukuza kwako hapa.
• mwingine akamwambia mwanaye kuwa usinipande kichwani, kwa kuwa wewe ni mwanangu utafanya yale ninayokuongoza mimi na utakapofika umri wa kujitegemea fanya utakacho amua lakini si kwa sasa hivyo unaenda shule na nakupa kazi ya kuniandikia watu kumi waliofanikiwa bila kusoma na kumi waliofanikiwa kwa kusoma, uorodheshe historia za maisha yao na mwisho uainishe wapi waliofanikiwa kirahisi na kupita njia rahisi kufikia mafanikio yako. 

Tunakubaliana kuwa wote wanaweza kuwa sahihi kulingana na mazingira ingawa wa kwanza anaweza kumpa ushawishi mwanae kutoroka nyumbani na hata hivyo maisha yakimshinda huko atarudi amejifunza lakini huyu wa pili ametoa suluhisho lenye kiimarishi/reinforcements kwani kwa kuandika hayo aliyomwambia atajifunza kuwa shule ni chaguo zuri zaidi lenye unafuu zaidi.

HIVYO UNAPOTOA ADHABU NI VEMA UKATAFUTA NAMNA/UPENYO WA KUTOA KIIMARISHI TABIA PIA(REINFORCEMENT)

VIBOKO SHULENI:

Serikali imeagiza viboko kutotumika shuleni. Wakitoa sababu kuwa inasababisha utoro shuleni. Hii ni kweli kabisa kulingana na namna viboko hivyo vilivyokuwa vinatumika kwa baadhi ya walimu kusaka heshima ya lazima au sifa bila kuzingatia matumizi sahihi ya viboko hivyo.

Viboko vikitumika shuleni, huweza kuwa na msaada mkubwa kwa wakati sahihi, kwa kiasi sahihi na kwa nia ya dhati.

Cha muhimu, tutumie adhabu sahihi lengo likiwa kubadilisha tabia za watu na kuzuia madhara yaliyosababishwa kutokea tena. Chanzo kiangaliwe na reinforcement(viimarishi tabia) vihusike kwenye vyanzo hivyo.

Swali: Wazazi wanaotumia adhabu zilizozidi kipimo, watoto wao huwa watukutu zaidi. Je hii ni kweli?

Until next time.

VICIOUS CIRCLE OF SOCIAL DETERMINANTS OF HEALTH

HEALTH AND THE CURATIVE APPROACH

Constantine Ntanguligwa(MD student Muhimbili university of health and allied sciences)
 0945hrs 18th August 2016

Karibu tuzungumze:

Kwanza nianze kwa kuelezea maana ya "vicious circle". Huu ni mzunguko wa mfumo kama wa duara unahusisha kitu flani na sababu zake kuwa na mwendelezo usioisha. Tunaposema "vicious circle of social determinants of health" tunamaanisha duara linaloanza na Afya yako na yale yote yanayoweza kufanya afya yako kuwa bora au kuidhoofisha katika uhusiano usio na kikomo. Ni dhahiri kwamba, duara huzunguka bila mwisho

Pili, tunaposema "curative approach" huu ni mfumo wa ki-tiba ambao hukazia zaidi kwenye matibabu ya mgonjwa mwenyewe moja kwa moja, mfumo ukizingatia hasa vijidudu vinavyokufanya uumwe na vyanzo. The center of focus kwenye mfumo huu wa tiba vina concentrate zaidi kwa vimelea kama chanzo kikuu cha magonjwa (parasites and vectors as primary to health). Huu ndo mfumo tunaotumia katika sekta yetu ya afya hapa.



Watalamu wa sayansi ya tabia(behavioural sciences) wanatuambia, vitu vilivyo msingi kwa afya ambavyo ndivyo vitakavyoamua afya yako kesho itakuwaje(social determinants of health), si mbu wala nzi wala vimelea vya homa, lakini ni hivi vifuatavyo:

1.LIFE STYLES(mienendo ya maisha yetu)

Hizi ni tabia/mienendo yetu ya kila siku. Je, tunakunywa pombe sana? Je, tuna wapenzi wengi? Je tunafanya ngono zembe? Je,tunakula kabla ya kunawa? Hii yote ndiyo itakayoamua afya yako wewe itakuwaje, kama ni magonjwa ya zinaa yatakuwa rafiki yako au homa ya tumbo na kipindupindu. Sigara inauwa watu milioni 6 kila mwaka inazidi idadi ya watu wanaokufa kwa UKIMWI, TB na MALARIA ukijumuisha kwa mwaka.
JE, MIENENDO YETU YA MAISHA NI RAFIKI KWA AFYA ZETU?

2.AGE(umri)

Umri unachangia sana baadhi ya magonjwa. Mfano, si ajabu kuanzia umri wa miaka 30 na kuendelea kupata magonjwa ya moyo, figo, kisukari na presha, labda kwasababu ya misuli na mishipa ya damu kuanza kuchoka. Si, ajabu watoto wadogo kupata minyoo labda kwasababu ya kula kila wanachoweka mikononi bila kujua hali ya usafi na usalama. Si ajabu vijana wengi kuwa wahanga wa magonjwa ya zinaa na madawa ya kulevya labda kutokana na ushawishi wa makundi na tamaa. Si ajabu vijana wengi kuwa wahanga wa ajali za boda boda labda kwasababu wao ndo watafutaji maisha wakubwa katika umri huo.
JE, TUNATAMBUA UMRI WETU HUWEZA KUPATWA NA MAGONJWA GANI ZAIDI NA YALE YA WATOTO WADOGO WANAOHITAJI USIMAMIZI WETU?

3.CULTURE(tamaduni)

Hapa ndipo zinapokuja mila na desturi. Hivi ni kweli unakubali kurithishwa mke wa kaka yako bila kujali uhusiano wao ulikuwaje? kama ana ukimwi je? Ni kweli mila na desturi zetu zinatuambia tukae na wanyama wetu ndani ya nyumba zetu? Usalama wa magonjwa ya wanyama kutokua yetu uko wapi?
Ni kweli watoto wetu wa kike wanakeketwa mpaka leo hii? Afya yao ya uzazi, saikolojia na magonjwa ambukizi i hali gani? Hivi ni kweli kuna makabila ambayo kumpiga mke wako ni lazima, kufanya uzazi wa mpango ni mwiko na kujifungulia nyumbani ndo mpango mzima? Nani kama mama inakujaje sasa hapo? Pamoja na mila na desturi nyingine nyingi sana.
JE, UKO TAYARI KUBADILI MILA NA DESTURI ZINAZOHATARISHA AFYA YAKO NA MAISHA SASA?

4.GENDER(jinsia)

Ni kweli kabisa, ukiwa mwanaume kuna magonjwa yanayokuhusu na ukiwa mwanamke kuna ya kwako pia. Hivyo, kuwa na jinsia tayari na chanzo cha magojwa fulani mfano kutokwa damu nyingi wakati wa hedhi kwa wanawake lakini pia tatizo la nguvu za kiume kwa wanaume. Labda ndo maana tunawatalamu kama wanaoitwa madaktari wa kina mama(gynaecologists). Takwimu zinaonesha pia kuwa, wanawake hutembelea hospitali mara nyingi zaidi kuliko wanaume. Labda kwasababu wanamatatizo mengi zaidi au kwasababu wanaume hujikuta wako imara na kwenda hospitali utaonekana dhaifu. Labda nikwambie tu kuwa, kirusi cha ukimwi kikikuingia, hakijali wewe ni mwanaume au mwanamke.
JE, TUNATAMBUA MAGONJWA YANAYOIKUMBA JINSIA YETU(ANGALAU MACHACHE MUHIMU) ILI KUJILINDA?

5.EDUCATION(elimu)

Ni kweli, mtu ambaye ameenda shule walau elimu ya msingi ni tofauti sana na yule ambaye hajaenda kabisa. Angalau nikiwaangalia wadogo zangu mmoja yupo chekechea na mwingine darasa la nne, kabla ya kula wana nawa mikono. Wanajua maji wanayotakiwa kunywa inabidi yachemshwe kwanza. Wewe mwenye elimu kubwa zaidi tunategemea uwe na uelewa mkubwa zaidi na uwezo wa kuepuka vyanzo vya magonjwa vinavyoepukika. Maajabu yanakuja pale ambapo leo hii mwanafunzi wa form 6 anapokunywa maji ya bomba bila kuchemsha au mwanafunzi wa chuo kikuu anapokula bila kunawa. Hadi hili tutailaumu serikali kuwa kuna mfumo mbovu wa elimu? Ni uzembe na kutozingatia yale tunayoyajua. Namna hii magonjwa yataendelea kuwa rafiki zetu. Leo hii nchi kama Denmark ukiona mbu basi ni utalii umefanya. Malaria ni historia. Kwanini uwe ghala la vimelea na elimu yote uliyonayo? Basi fanya vile vinavyowezekana kutokana na elimu uliyopata uepuke baadhi ya magonjwa. Elimu si ya darasani tu, familia ndiyo shule ya kwanza kwenye maisha ya binadamu. Kuwa msimamizi wa afya nyumbani na mahali unapoishi.

JE, ELIMU ULIYONAYO INAKUSAIDIA KUWA NA AFYA YA TOFAUTI NA ASIYEKUWA NAYO?

6.WORKING CONDITIONS(mazingira ya kazi)

Ni kweli wanasema, mfanikiwa hachagui wala kubagua kazi. Ni kweli hali za maisha yetu zinaweza kutupelekea kufanya kazi zinazoweka afya zetu matatani, na mara nyingine ipo nje ya uwezo wetu. Mtu unapolazimika kufanya kazi kama msafisha jiji, mda wote uko na uchafu wa jalalani, unafanya kazi kiwanda cha cement au mashine ya kukoboa mda wote uko na vumbi kali au kwenye minara ya simu mda wote upo kwenye mionzi hatarishi kwa kansa. Muhimu ni kuzingatia utendaji wa kazi tujilinde inavyowezekana. Kama ni jalalani, tuvae gloves, kama ni mionzi tujitahidi kupunguza kukaa maeneo hayo bila sababu, kama ni vumbi kali tukumbuke kuvaa mask usoni. Mwingine atasema, kama ni kahaba au changudoa uvae kondomu ujilinde. Inaweza kuwa sawa unajilinda lakini hiyo ni tofauti. Kama ni kazi fanya kazi halali zenye risk kidogo sababu hatari ipo katika kazi zote zinatofautiana tu uzito. Hata daktari yupo kwenye hatari kubwa ya maambukizi kutoka kwa wagonjwa.
JE, UNAFAHAMU MAZINGIRA YA KAZI YAKO YANA HATARI GANI KWA AFYA YAKO?
 

7.NUTRITION(vyakula):

Mwili wetu hufanya kazi vizuri pale tu ambapo tutakuwa tumeshiba vizuri. Ni wangapi wanaweza kukaa kwa makusudi siku nzima masaa 24 bila kula chochote wakaishi bila shida yoyote, comfortably. Mara zote tutahitaji kula, je tunakula nini? Mlo wetu unafaa kuitwa chakula bora. Tunatakiwa kula matunda kwa sana, kunywa maji kwa sana na kuhakikisha mlo wetu una mahitaji yote katika kiasi sahihi. Wanga kidogo(vyakula kama mihogo,ugali,wali na viazi), protini kigodo(samaki,nyama,mayai), mafuta kidogo(karanga,vyakula vya kukaanga kama chipsi), vitamini(mboga za majani na matunda). Tujitahidi tuwe tunapata hivi angalau kila siku na kupunguza ulaji wa vyakula vya mafuta na kuongeza matunda(somo hili refu kidogo tutalitafutia makala yake).

JE, WANGAPI SISI MLO NI CHIPSI,KUKU,PIZZA NA BURGER TU MASAA 24 SIKU SABA KATIKA WIKI. TUNAJIANDAA KUWA DILI KWA MADAKTARI WA MOYO?

8.ENVIRONMENT(mazingira)

Uchafuzi wa mazingira ni tatizo kubwa sana katika nchi zetu zinazoendelea. Hata hivyo mbali na kuwa tatizo la ki-nchi bado tuna nafasi katika yale mazingira tunayoishi. Je, mifumo yetu ya maji nyumbani haikaribiani na mifumo ya maji taka au shimo la taka? Je, tunafagia mazingira yetu nyumbani? Je, tunasafisha kila mara vyoo vyetu? Nyasi ndefu je?. Mazingira yasipokuwa safi ndipo wadudu na vimelea huweza kujipatia hifadhi yao.
JE, WANGAPI VYOO WANAVYOTUMIA HUFANYIWA USAFI MARA KWA MARA?

9.PHYSICAL EXERCISES(mazoezi)

Mazoezi ni muhimu kwa afya. Fanya mazoezi mara kwa mara ni muhimu sana kwa afya yako. Rejea makala:http://www.ntanguligwa.com/2016/07/madhara-ya-kiafya-yanayotarajiwa.html


Yapo mengine mengi ambayo huweza kusababishwa na mfumo wa kisiasa nchini na ya kiserikali na sera zake kama BIMA ZA AFYA, UCHAFUZI WA MAZINGIRA KWA VIWANDA NA UPATIKANAJI WA MAJI SAFI NA SALAMA, hivi tuwaachie wao tufanye yaliyopo ndani ya uwezo wetu.

MUHIMU: UNAKUJA KUONA KUWA KUKAZANIA KUTIBU UGONJWA HOSPITALINI SIYO TIJA, MAGONJWA YAPO KWENYE JAMII HUKU HUKU TUNAPOISHI NA NDIPO KILA KITU KINAPOANZIA. HIVYO KAMA NI DAWA INAYOFAA INABIDI IWE NI SISI WENYEWE. SISI WENYEWE NDIYO DAWA SAHIHI YA MAGONJWA. TUUNGANE KUTOKOMEZA MAGONJWA KWENYE JAMII ZETU.

HUDUMA DUNI ZA AFYA:

SASA WAJUA:

The food you eat: a fruit a day keeps the doctor away. Information on healthy food must be given to people. These are social determinants of health

Untill next time.

Je, unafahamu wale wote(wahudumu) wanaohusika na matibabu yako hospitali? Je, unafahamu fursa sekta ya Afya?

WAHUDUMU WA AFYA(HEALTH PRACTITIONERS AND HEALTH PRACTICE)

Constantine Ntanguligwa(MD student Muhimbili university of health and allied sciences) 

2230hrs 25th July 2016

Karibu tuzungumze:

Habarini, watu wangu wa nguvu. Leo nakuletea Makala hii:

• Yenye manufaa kwa watu wote kufahamu watu wa Afya wanaowahudumia.Mara nyingi, tumekuwa tukisema tu doctor asante. Lakini je, tunajua ni watu wangapi wanahusishwa kwenye matibabu yako mpaka unapona? Ni kweli mchango wao unaweza kuwa mdogo kuliko daktari lakini kamwe sehemu yao ni muhimu sana katika sector ya Afya.

•  Kushawishi wanaojiunga na vyuo kujiunga na sekta za Afya mbalimbali mbali, hivyo wajue fursa zilizopo kwenye sector ya Afya. Ili nchi yetu ipate wahudumu wa kutosha nikifanya reference Vyuo vya Afya mbali mbali nchini. 

Naongelea kwenye degree level. Hii ni kwasababu, watu wengi huchanganya sana na kutowajua ipasavyo watu hawa na pengine kuwadharau. Labda kwasababu tumezoea kuwaona kwenye vituo vya afya mbali mbali (dispensaries) lakini hao ni wale wenye hadhi ya diploma kwenda chini. Mimi ntaongelea wenye hadhi ya degree, ili angalau uone uzito wao. Wenye hadhi hii wengi utawakuta hospitali za wilaya, mkoa mpaka taifa na kimataifa, hivyo ni watu wenye umuhimu mkubwa sana kama ifuatavyo.

   1.  NURSES:

 Opportunities available:

•          Bachelor of Science in Nursing (BSc N)
•          Bachelor of Science in Nursing (Management) (BScN Management)
•          Bachelor of Science in Midwifery (BScM)- wakunga

Mistakanely watu wanadhani nursing ni kwa women tu. Si hvyo. Nurse ni mtu yoyote anaweza kuwa na kazi yake kubwa ni kuhandle caring ya mgonjwa and sometimes wana assist operations. Na mda mwingine kama katika kujifungua kwa kina mama kwa kawaida wao ndo wahusika wakuu.

“Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health care providers by their approach to patient care, training, and scope of practice. Many nurses provide care within the ordering scope of physicians, and this traditional role has come to shape the historic public image of nurses as care providers. 

"Nurses develop a plan of care, working collaboratively with physicians, therapists, the patient, the patient's family and other team members, that focuses on treating illness to improve quality of life. Nurses may help coordinate the patient care performed by other members of an interdisciplinary health care team such as therapists, medical practitioners and dietitians.”(https://en.m.wikipedia.org/wiki/Nursing)

    

  2.PHARMACISTS:

Opportunities: Bachelor of pharmacy

Mistakenly watu wanadhani hawa ndo wale wanaokaa kuuza dawa kwenye pharmacy. It maybe true, some of them stay in the pharmacies but not because they studied to work there but rather just a matter of choice and self employment. Wao ndo wahusika wakuu wa dawa tunazotumia, wakipima uwezo wa kila dawa, madhara yake n.k.

“Pharmacists are healthcare professionals who practice in pharmacy, the field of health sciences focusing on safe and effective medication use. A pharmacist is a member of the health care team directly involved with patient care. Pharmacists undergo university-level education to understand the biochemical mechanisms and actions of drugs, drug uses, therapeutic roles, side effects, potential drug interactions, and monitoring parameters. Pharmacists interpret and communicate this specialized knowledge to patients, physicians, and other health care providers.” (https://en.m.wikipedia.org/wiki/Pharmacist)

         3.   DOCTOR:

Opportunities:

•         Doctor of Medicine
•          Doctor of Dental surgery (East Africa ipo Muhimbili University na Nairobi university tu)-Mtaalamu wa meno

Huyu yeye tumemzoea na ndo tunayemjua siku zote na kumuona tunapokwenda hospitali, daktari. Swali ni kwamba kwanini watalamu wa meno huwa wanachukuliwa ni madaktari wa kipekee? Kwa sababu watu hawa husoma miaka mitano na badala ya kuwa madaktari wa kawaida wao wanakuwa watalamu wa meno moja kwa moja. Hapo ndo utakapojua kuwa mwili wa binadamu unahitaji uangalizi na ulinzi mkubwa kwani meno tu yamepewa hadhi ya kipekee.

     

     4. LAB TECHS (wataalamu wa maabara)

Opportunities:

·         Bachelor of Medical Laboratory Sciences in Clinical Chemistry (BMLS Clin.Chem)

·         Bachelor of Medical Laboratory Sciences in Haematology and Blood Transfusion (BMLS Haem.BT)

·         Bachelor of Medical Laboratory Sciences in Histotechnology (BMLS Histotech.)

·         Bachelor of Medical Laboratory Sciences in Microbiology and Immunology (BMLS Micro.Immunol.)

·         Bachelor of Medical Laboratory Sciences in Parasitology and Medical Entomology (BMLS Para.Entomol.)

·         Bachelor of medical Laboratory Sciences General Degree.

Watu hawa ni wataalamu wa maabara. Watu hawa wana kazi kubwa sana. Mfano, pale HOSPITALI YA TAIFA MUHIMBILI kuna central pathology lab. Jengo hili linafanya kazi kubwa sana mfano kupima kila aina ya magonjwa kutoka kwenye sampuli za wagonjwa wote wa hospitali ya taifa, huusika kwenye kuchangia damu na kuihifadhi. Hivyo hawa kazi yao ndo itaamua kwa kiasi kikubwa kama alichohisi daktari ni kweli au lah!

So we need these people so much and their work is highly in constant need of specialists in this field.

5.       RADIATION THERAPIST (watalamu wa mionzi)

Opportunities: Bachelor of Science in Radiation Therapy Technology (BSc RTT)

Watu hawa wanaojua umuhimu wao ni wale waliokwisha fanyiwa X-ray, CT-scan, Ultrasound au kutibiwa kansa kwa mionzi. Watu hawa ni wataalamu wa mambo yote katika sekta ya afya yanayohusu mionzi.

Kansa ni tatizo kubwa sana linalotabiriwa kuongezeka kwa kasi sana. Watu hawa kwa kiasi kikubwa husaidia matibabu kwa mionzi katika ugonjwa huu wa hatari sana. Hivyo wanaumuhimu mkubwa sana na wanahajika.

6.       Health Environmentalist (wataalamu wa Afya mazingira):

Opportunities: Bachelor of Science in Environmental Health (BSc. Env. Health)

Watu hawa hawakutani na sisi moja kwa moja lakini wao ndo wahusika wakuu wa mazingira yetu. Kwani magonjwa yanatoka wapi? Si kwenye mazingira yetu? Wao huchunguza mazingira, kufanya tafiti na huweza kutabiri magonjwa mapya na kuangalia namna gani tunaweza kurekebisha mazingira yetu hata mda mwingine kufanya magonjwa kuwa historia. Labda ndo chanzo cha baadhi ya nchi kutokuwa na magonjwa mengine tunayoyafahamu katika nchi zao. Wana mchango mkubwa sana. Ni watu wa NGO’s hawa na opportunities za kutumika na Umoja wa mataifa (UNO).

 Unajua kinga ni bora kuliko tiba. Sasa, ukitibiwa kipindu pindu kwa mfano, halafu usipobadili mazingira na kuyaweka safi itakuwa kazi bure sababu utarudi kwenye ugonjwa ule ule. Hivyo kazi ya watu hawa ni kuhakikisha kuwa ikitokea bahati mbaya umeumwa, usiumwe tena.

Kuna mchanganyiko wa mambo hapa. Kuna wanaosoma Environmental engineering hao sitawagusia kwasababu wao hawajabobea katika mazingira kiAfya, wao ni wahandisi wa mazingira mfano kutafuta namna ya kutengeneza vyanzo rafiki vya nishati na kulinda uchafuzi wa mazingira au kuhakikisha viwanda vinatengenezwa katika teknolojia ambayo haiharibu mazingira.

   

      7. Viungo bandia:(hii inapatikana KCMC tu kwa sasa)

Opportuinities: Orthopaedic Technologists na Prothetist/Orthotist

Watu hawa, kama inavyojieleza hapo, wanahusika katika utengenezaji na utumiaji wa viungo bandia. Kuwapa mazoezi watu waliopata ajali na kuhakikisha wanapewa tiba mbadala hasa inapotokea matatizo ya ulemavu. Kwa ajali hizi za barabarani zinazoendelea hasa bodaboda, hii inaweza kuwa fursa nzuri sana kama utaweza kusoma na kuamua kuanzisha kampuni yako ya viungo bandia kwani hapa nchini sekta hii ipo wazi sana (hajapewa kipaumbele sana na serikali).

Conclussion/Reccomendation: Watu hawa ni wa muhimu sana. Ila huwezi kutambua umuhimu wako mpaka pale watakapokuwa katikati ya maisha yako na kifo. Wanajitoa sadaka sana na wanajiweka katika hatari ya kila namna.

 Hawa ni watu wa kwanza kupata ugonjwa wowote wa maambukizi mapya kutoka kwa wagonjwa. Ndiyo maana tunachomwa chanjo mbalimbali kujilinda.

Tumejitolea maisha yetu kwajili yako, hivyo pindi upatapo shida tuone hasa kabla tatizo halijawa kubwa. TUPO KWAJILI YAKO.

Sekta ya Afya ni sekta yenye fursa nyingi sana. Kwasababu, utafanya yote lakini Afya itabaki kuwa sekta muhimu sana kwenye jamii. Fursa ni nyingi sana kupita maelezo. 

Asanteni.

LETS SHARE EXPERIENCE MY BROTHERS AND SISTERS

UNIVERSITY APPLICATIONS ADVICE TO FORM VI 2016

Constantine Ntanguligwa(MD student Muhimbili university of health and allied sciences) 

2030hrs 19th July 2016

Karibu tuzungumze:

Dear, Form VI 2016. Before all I congratulate you all for your successful completion of studies. Wengi walitamani kufika hapo lakini hawajafika na pengine hawatafika huko mnakoelekea sasa. Welcome in the system of "study-kifanyie mtihani-kipotezee" life. Napenda kuwashirikisha experience yangu ya kuapply vyuo, mwaka jana kwa sababu ya rafiki zangu wengi kukosa vyuo walivyotaka au course wanazotaka. Ntaelezea kila step na umuhimu wake na recommendation(ushauri).

    First, you are required to know the in and out of  atleast three to five alternative courses you wish to study in the university make consultations from your recent brothers and sisters especially those who are in the same field as your dream's. We were required to fill in three to five courses in our application, in order of priority i.e, if Medicine is your first priority, put it first. If pharmacy is the second, put it second. Au unaweza kujaza, 1st priority chuo cha muhimbili, 2nd hiyo hiyo MD chuo cha Bugando.
Umuhimu: Itakusaidia sana especially kama usipofikia vigezo vya course na chuo husika, au kama una vigezo lakini chuo kimeshajaa na kuna watu wenye vigezo zaidi yako waliochaguliwa kwanza especially kama watu walio apply hiyo course wamefaulu sana mwaka wenu.
Ushauri: Ni vema kabla hujapanga priority, hakikisha ume evaluate roughly ufaulu wa watu wanao apply hiyo course ili kujua competition iliyopo. Usijekujikuta unagrade za kawaida halafu uka apply vyuo vikubwa vyote mwanzo na vyenye competition kubwa ukakosa vyote kutokana na watu wengi kufaulu sana kupita wewe. Ni bora uka apply chuo cha kawaida tu chenye ubora. Mfano, its very likely kama una DIV II mfano ya 12 PCB mwaka huu hutapata MUHIMBILI atleast for MD. Sasa hakuna ulazima wa kukiweka mwanzo then pili ukaweka UD ambacho unajua kabisa idadi ya wanaochukuliwa UD ukihesabu tu wenye DIV II inayokuidi wanajaza UD tayari. Option ya tatu utakuta wenzako wenye grade kama yako wameshajaa waliojaza 1st priority then ukakosa vyote. Ukabaki na vyuo vya kawaida sana ambavyo hukuwahi kutegemea kusoma na huenda usiridhike nacho. So kwanini mtu kama wewe usijaze tu UD, pili KCMC  then Bugando etc. Hapa utakuwa nachance kubwa ya kupata chuo kizuri.

Second: Don't lie yourself that you have already secured a certain university. Don't be so sure, be cautious(kuwa makini) and then the remaining choices you just fill in just for the sake of filling in gaps.
Umuhimu: Watu wengi sana mwaka jana wamejikuta 1st priority zao na 2nd wamepigwa chini. Sasa system inalazimika kukuchagua option ya tatu ambayo uliijaza ilimradi tu. Utasoma course ambayo hutaki so kuwa makini sana.
Ushauri:Tulia na pima ndoto zako na chagua alternative atleast 3 za kazi unayotaka kufanya au hata kama ni course hiyo hiyo vyuo tofauti tofauti ujaze kwa umakini siyo ilimradi tu.


Third: Take your time before you apply but not too much. Apply as soon as possible. The good thing is that when you save your application online, you can go back and edit and change things like order of priority or courses anytime you wish untill when its the deadline.
Umuhimu:Itakusaidia kuwa unajiuliza, hivi nilivyojaza ni sahihi kweli? utajiuliza maswali na mwisho wa siku unaweza kufanya changes za kuboresha mpaka ukapata unachohitaji na kukiota siku zote.
Ushauri:Usizubae kuapply na kusubiri tarehe za mwishoni, Itakucost sana na kukufanya ujaze under pressure na kusababisha kulipua na ita kugharimu.

Fourth: Follow your heart not who takes what. Don't apply a place because your best friend has applied the same place.
Umuhimu: haiko guaranteed kuwa kama mmepata DIV sawa kuwa mtapata vyuo sawa. Fuata uamuzi wako sababu chuo utasoma wewe awepo au asiwepo rafiki yako, trust me, chuo is a very wonderful place.
Ushauri: Kuwa realistic(muhalisia). Kama grade zako unaona kabisa kwa competition hii probability ya kupata ni ndogo, just open your heart na apply sehemu unazoweza kupata kirahisi. Don't risk kuapply kama mwenzako. Fuata maamuzi yako.

Fifth: Have confidence to fight and defend your dream and choices even if your family and parents force you to.
Umuhimu: wazazi wetu ni vema wakatushauri lakini jua kwamba enzi walizopita wao na tunazopita sisi ni tofauti sana. Wasikilize na zingatia kwa umakini yale wanayokushauri, kama kuna kitu unafikiri unajua zaidi na uko updated wajulishe na kuwaeleza vizuri na kwa upole na heshima wajue. Kama ni order za priority za vyuo au courses.
Ushauri: kuna rafiki yangu alipata Credit mwaka jana PCB. Kwa mwaka wetu ingekuwa ngumu sana kupata vyuo vya Medicine sababu watu walifaulu sana PCB. Sasa nyumbani wanakomaa asome Medicine, maskini akajaza Muhimbili mwanzo, UD, Bugando na KCMC. Akakosa vyote na hatimaye kuishia kusoma finance kitu amabcho hajawahi kuwaza. Namshukuru Mungu mwanzo alikua hana furaha but now amezoea na anaendelea vizuri sana.. Mtu huyu kama anapenda afya angeweza kusoma course nyingine nyingi tu za afya akapata lakini amekosa kwa sababu ya shinikizo la nyumbani hasa ukizingatia vyuo vilishajaa walio apply hizo course nyingine.

Mwisho niwashirikishe nilivyoapply mimi mwaka jana. Priority zangu zilikuwa (in order)
1.DOCTOR OF MEDICINE (MUHIMBILI UNIVERSITY OF HEALTH AND ALLIED SCIENCES)
2.DOCTOR MEDICINE(BUGANDO-WEILS UNIVERSITY OF HEALTH AND ALLIED SCIENCES)
 3.DOCTOR MEDICINE(KCMC)
4.DOCTOR MEDICINE( UNIVERSITY OF DSM)

Namshukuru Mungu nikapata Muhimbili.


I PRAY FOR YOU TO GET TO YOUR DREAM UNIVERSITIES. JUST REMEBER, NO MATTER WHERE YOU GO, YOU CAN ALWAYS GET BACK TO YOUR DREAM. THE ROUTE DOESNT MATTER USIKATE TAMAA. MUNGU AWABARIKI SANA NA KUWAONGOZA.

Consult me for queries and questions in comments section below for the benefit of others too

NJOO TUOKOE MAISHA

BLOOD DONATION(KUCHANGIA DAMU)

by Constantine A Ntanguligwa- MD student Muhimbili University of health and allied sciences

What is blood donation? 

•  A blood donation occurs when a person voluntarily has blood drawn and used for transfusions.
•   Donation may be of whole blood or of specific components directly
•  Blood banks often participate in the collection process as well as the procedures that follow it.
•  A blood bank, just like any other bank is responsible to obtain safe blood and monitoring the provision to the needy

HISTORY OF BLOOD TRANSFUSION:

http://www.redcrossblood.org/learn-about-blood/blood-transfusions/history- blood-transfusion

Why give blood?

• Giving blood saves lives. The blood you give is a lifeline in an emergency and for people who need long-term treatment 
• Many people would not be alive today if donors had not generously given their blood.
• Forexample, We need over 6,000 blood donations every day to treat patients in need across England. Which is why there’s always a need for people to give blood.
•   Every two seconds someone in the U.S. needs blood.
•   For developing countries like Tanzania its even worse and the demand is highest.
• 

Process of donating blood

1.            Getting ready for donation

• Hydrate, Be sure to drink plenty of fluids on the day of your donation.
• Wear Something Comfortable, Wear clothing with sleeves that can easily be rolled up above the elbow.
• Maintain a Healthy Level of Iron in Your Diet Before Donating,If possible, include iron-rich foods in your diet, especially in the weeks before your donation.
• Please bring either your donor card if you had previously donated or other forms of identification if any.
• Bring along a friend, so that you may both enjoy the benefits of giving blood.

Relax! Blood donation is a simple and very safe procedure so there is nothing to worry about

2. DONATION PROCESS

3. AFTER DONATION

  Hydrate More. You should continue to drink water throughout the day of your donation. 

 Avoid Heavy Lifting or Exercise. Try not to exert yourself too much for the rest of the day. 

What Happens to Donated Blood?

 Step 1: After The Donation

  The bag, test tubes and the donor record are labeled with an identical bar code label to keep track of the donation

  The donation is stored in iced coolers until it is transported to a Red Cross center

Step 2: Processing

 Donated blood is scanned into a database

 Most blood is spun in centrifuges to separate the transfusable components – red cells, platelets, and plasma.

  Single donor platelets are leukoreduced and bacterially tested.  Test tubes are sent for testing.

Step 3: Testing

  Steps 2 and 3 take place in parallel

The test tubes are received in one of three Red Cross National Testing Laboratories

A dozen tests are performed on each unit of donated blood – to establish the blood type and test for infectious diseases.
Test results are transferred electronically to the manufacturing facility within 24 hours.

  If a test result is positive, the unit is discarded and the donor is notified. Test results are confidential and are only shared with the donor.

Step 4: Storage

 When test results are received, units suitable for transfusion are labeled and stored

 LASTLY:  Blood is given to the needy.

Advantage ya kuchangia damu kwa mchangiaji:

 Utapatiwa kitambulisho maalumu ambapo ukiwa na mgonjwa wako mwenye uhitaji wa damu au wewe mwenyewe ukihitaji damu, utapatiwa bure sababu ulishaokoa maisha ya wengine. 

NB:Ongezeko la uhitaji wa damu salama hasa katika hospitali yetu ya taifa muhimbili ni mkubwa mno.

Who can use your donated blood? Only blood groups that match can be transfusable

Blood group classification:Blood can be classified into various groups

•       All human blood may look alike, but you can’t donate to just anyone and you can’t receive blood from just anyone. Different blood types need to be matched correctly.      
•           We have blood groups A,B, AB and O        
•        Like eye color, blood type is passed genetically from your parents. Whether your blood group is type A, B, AB or O is based on the blood types of your mother and father. It’s inherited

Facts about blood transfusion:

•  A recent research conducted by the National Blood Transfusion Service (NBTS) shows that the requirements for safe blood within Tanzania is at about 400,000 to 450,000 of bottles with a capacity of 450 millilitres.
•  Low donor turnouts means that the national demand is not being met.
•   In the first quarter of 2015 alone only 18,000 bottles have been collected. In a country where key national health institutions such as Muhimbili requires 50+bottles on a daily basis the numbers represent a very dark picture.
•   Every two seconds someone in the U.S. needs blood.
•    The blood type most often requested by hospitals is type O.
•     The blood used in an emergency is already on the shelves before the event occurs.
•     It is estimated that sickle cell disease affects 90,000 to 100,000 people in the U.S. About 1,000 babies are born with the disease each year. Sickle cell patients can require frequent blood transfusions throughout their lives.
•     More than 1.68 million people are expected to be diagnosed with cancer in 2016. Many of them will need blood, sometimes daily, during their chemotherapy treatment
• A single car accident victim can require upto as many as 10 bottles of blood.

How can one donation help multiple people?

•      In modern medical treatments, patients may receive a bottle of whole blood or just specific components of the blood needed to treat their particular condition.
•     Up to four components can be derived from donated blood
•     This approach to treatment, referred to as blood component therapy, allows several patients to benefit from one unit of donated whole blood.
•   The main transfusable blood components include: blood as whole, red cells,platelets and plasma

BLOOD BANKS:

 The blood bank is available at the Muhimbili national hospital near the emergency building where you can visit any time during week days upto 1pm ofices are open.    You can also become a member of blood donors association voluntarily where you get a chance to donate blood on regular basis

Story time….

 

View real life stories for yourself here:

    https://youtu.be/1UvWiysSt4Q

    https://youtu.be/ovtCQDWCskU

    https://youtu.be/eDPwxYRQpxM

    https://youtu.be/cVJQ886VynQ

ANY QUESTIONS? OR MISUNDERSTANDING?

THANK YOU FOR YOUR ATTENTION