Yasser Ahmed
Yemen Times

Since the beginning of civilization, human efforts have been concerned with the environment he lives in. With the advancement of technology and modern industries, this effort has been more negative than ever, and steps to prevent and overcome the disasters occurring are more crucial today than ever.
As a step in this direction, Yemen signed the Vienna Agreement for ozone protection in March 1995, and the Montreal Protocol in February 1996. Yemen is also aiming to join the Montreal amendments which have taken place in London in 1990, in Copenhagen in 1992 and in Montreal in 1997. This is an attempt to participate in the world’s struggle for environment protection.
Again Yemen took lead in this matter and hosted the fifth regional meeting of ozone officers on the 8th and 9th of January 2001. Representatives from Jordan, Syria, Bahrain, Saudi Arabia, Qatar, Kuwait, Lebanon, Oman, Palestine, the Emirates and a number of environmental experts attended the conference held in Sana’a. Participants from the different regional countries presented their county’s statistics in this regard in a display of concern of their governments and well as International Organizations such as UNEP, UNDP, WB, UNIDO, Halon Bank, GTZ and others.
The 16th of September of every year is celebrated as the Ozone World Day and the Yemeni Environment Protection Council celebrates this day through highlighting the achievements accomplished by the Ozone Unit of this council, starting from an overall awareness program, through all media instruments, as well as field survey covering a number of national and international companies to find out the kind of equipment used and how environmental friendly they are, not to neglect the activation of the Ministry Council Law No. 120 for year 1998 which prevented the importing of equipment and machines which work on or use CFCs and Halons.
The Ozone layer is considered a protecting shield around the globe. There are two types of this gas; one which is located close to Earth’s surface in the Troposphere layer about 10-15 Km. It is just above the ground, and is created as a result of air pollution. This gas is one of the warm gases causing acid rain as well as global warming and the Greenhouse Effect. The other Ozone, which is the concern of environmentalists, is found in the Stratosphere layer about 15-50 km above the ground. This three-atom Ozone (O3 or Oxygen-3 which is a unique link of 3 oxygen molecules) protects earth through the prevention of the harmful ultra-violet rays emitted by the sun from reaching all life forms on earth.
In 2010, the dead line for the International projects which aim at terminating the Ozone depletion seems too soon, especially when considering the latest information reported by the NASA AR vesicle that the Ozone layer in the North Pole has decreased 60% during the period between January to mid March 2000. Scientists from NASA and the EU said that the long winter in the North Pole is the reason behind that. However, experts blamed human activities for this harm in a discussion, participated by more than 350 experts in Sweden last year.
The British scientist Mr. Joe Forman, the discoverer of the Ozone hole in Atlantic, the South Pole in 1985, declared that the main reason behind this effect is China and India who are not getting rid of used products and material in an environmental friendly way. Although since the Vienna Agreement the usage of CFC components has been reduced in those regions, and the area of the hole has reached 5.4 million square kilometers as on September 2000, it is worth mentioning that there is no hole in the North Pole as yet. However, there is drastic depletion due to the chlorine compounds resulting from Industrial pollution.

Main recommendations of the Eighth meeting for Ozone officers were:
1. Authorities in the Ozone Network recommend two meetings to be held annually prior to the Meeting of Montreal Protocol Members (MMPM). This was to give an opportunity for following up last years decisions and the reflections of them in the region as well as discussions regarding topics and issues to be forwarded in the annual MMPM.
2. Coordination between regional and other countries through the MMPM in order to unite their stands regarding approximation of the HCFCs related timetables.
3. The essentiality of carrying regional directive council meeting for the Halons banks simultaneous with the main meetings of the network.
4. Ozone officials should supply a regional coordinator with their suggestions and views regarding the network activities fundamentals for years 2002 and 2003, so that these views could be taken to consideration in the network plan before next February.

Nadia Al Saqqaf
Yemen Times

In cooperation with Pacific Institute for Women Health and supported by Carter US Establishment the Health Delivery and Family Organizing Unit, Health Ministry organized a-two day discussion workshop on female genital mutilation (FGM) and women’s health. The workshop was to address this topic in all its aspects and to spread the awareness of hazardous effects of FGM on females.

General Background on FGM:
Female circumcision, widely known as female genital mutilation (FGM), is a term used for a variety of surgical operations carried out on female genitalia. These operations are practiced on healthy female children for traditional reasons backed by great social pressure. The operations may lead to immediate health risks and, sometimes to long term health damage. The practice of female circumcision is prevalent in parts of Africa and the Near East. In Yemen, it is believed to be limited to certain areas in coastal areas. In many cases, this phenomenon leads to the defamation of muliebria.
Studies and demographic surveys, Yemen, in 1991 revealed that 23% of women, responding to the study, acceded to FGM, especially in Taiz 24%, Aden 28%, Hodeidah 80%, Hadramout 90% and Mahrah 98% governorates. The survey revealed that 1263 women respondents have heard of the practice.

K A P study & Results:
Not much information has been collected about FGM and about the effects that might occur as a result of this social phenomenon in a country like Yemen. A study was conducted, during 1-17. 8. 1999, to find ways to end this terrible practice, and improving healthy delivery. Objectives of K A P study were to collect information on the kind of operation made during female circumcision, competence of those who carried out operations, instruments and materials used, female circumcised sexual complications and side-effects, scholars vantage point, respondents’ attitudes and finally FGM relation to education levels. Questionnaire of 600 forms were distributed in governorates as follows: Aden 200, Hadramout 200, Hodeidah 200. Forms were distributed to mothers who had at least one circumcised daughter.
The study reveals that 87% of those who carried out the procedure are not the medical personnel. 40% of them were “Rayssah” meaning a woman who usually performs this procedure, 34% were done by “Dayah” meaning midwives, 2% by male nurses, 9.2% by hospital attendants 12.5% by medical personnel and 3.3% were carried out by doctors.
The study also showed the kind of instruments being used when carrying out female circumcision; razor (50.5%), scissors (39.5%), lancet (3%), knife (0.2%). Those who do not know about the instrument used are 6.6%. The same study indicates that 80.6% of women targeted by the study approve of the continuation of the circumcision. The reasons cited for this are multiple among which are cleanness (25.5%), good tradition (8.5%), keeping the virginity of girls (3%) and cleanness and limiting the sexual desire (8.1%).
14.2% respondents supported the discontinuation of the process viewing it as a suppression against females (3.1%), away from religion (1.6%) and bad tradition (3%).
According to educational levels, the process of FGM is much spread among illiterate women with 54% in contrast to 12.5% in case of literate ones. The percentage of those who have only joined the primary education constituted 20.2%, those in the secondary education (11.7%), those in institutes (1%) and those in universities (0.5%).

FGM Health Complications:
The study reveals a vital issue pertaining to health complications associated with female circumcision. Respondents and tests could reveal multiple and many medical complications, immediate and long term. Bleeding, on the top of the list with 73%, is unavoidable since damage to the blood vessels is inevitable. Shock from the loss of blood and pain since the operation is performed without anesthetic cover invariably occur to some degree with 7.9%. Bleeding, puss and bleeding accompanied by fever have the same proportion each with 4.5% out of 88 sick females due to this practice. Fever is spread in 2.3%. Strong pain and alginuresis have the proportion of 2.3%. A percentage of 2.3% was reported as death cases as a result of circumcision, pains with 1.1% and tumor with 1.1%. Infection is also a common complication due to unhygienic conditions in which the operation is performed.
Female circumcision was widely condemned in the World Population Conference and World Women Conference. It was also condemned in a joint report published by the WHO, UNICEF and UNPF as a violation of women’s rights.
In the workshop, an overview on FGM meaning “female circumcision” in many countries including Yemen was covered. The key findings of the KAP study on FGM in the selected areas: Aden, Hodeidah, Hadramout, were discussed. The role of the NGOs, MOPH, other Ministries, Institutions, channels of Information, Education and communication in raising health awareness in FGM also came up for discussion.

OPHTHALMIC EDUCATION (22)

Are you a Diabetic Patient?

Mahfouth A Bamashmus
FRCSEd, FRCOphth
Consultant Ophthalmic Surgeon
Ibn-Al-Haitham Clinic
University of Science & Technology, Sana’a

•Diabetes mellitus or ‘sugar diabetes’ means that the body cannot cope normally with sugar and other carbohydrates in the diet.
•Diabetic patients have a higher risk to develop serious eye problems.
•Don’t joke with your diabetes. It should be well controlled to prevent the complications of diabetes in the eye and in other parts of your body.
•Diabetes is one of the main causes of blindness in Yemen and usually patients present late because of lack of education.

Loosing your sight from a treatable disease: -
•Most sight loss from diabetic retinopathy can be prevented. But it is vital that it is diagnosed early.
•Regular eye visits to your eye doctor are extremely important.
•Diabetes can cause temporary blurring of vision. These are signs that your diabetes is not well controlled.
•Cataract (opacity of the lens) can be treated easily nowadays by surgery and intraocular lens implant.
•The most serious eye condition that affects diabetic patients is damage to the retina, that is the film of the eye.

The importance of regular visits to the eye doctor: -
Although your vision may be good, changes can be taking place to your retina that needs treatment: -
•Early diagnosis is vital
•Have an eye examination every year
•Do not wait until your vision has deteriorated to have an eye test.
•Remember, however, that if your vision is getting worse, this does not necessarily mean you have diabetic retinopathy. It may simply be a problem that can be corrected by glasses.
•Most sight-threatening diabetic problems can be prevented by laser treatment if it is given early enough. For the advanced cases surgery can sometimes help to restore some vision.

What is laser treatment?
•Laser treatment is carried out at the eye clinic and you will not have to stay in hospital. It is usually not painful.
•Laser treatment prevents deterioration of your vision but doesn’t restore what is lost.
•No treatment is possible without some side effects, but the risks of laser treatment are far less than the risks of not having treatment.

REMEMBER:
•Ask your physician about the problems of diabetes and the best way to prevent them.
•If you have diabetes, you need to visit your eye doctor for a check-up every year.
•The earlier the disease is diagnosed the better the results of laser treatment, because it is extremely difficult to treat advanced cases.
•Laser treatment for diabetic retinopathy aims to save the sight you have – not to make it better.

Routine eye exam by an eye specialist is very important. It is your sight and your eyes need every care they deserve.

Reference: Royal College of Ophthalmologists educational leaflets, London.