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A celebration of a woman's body. It's uh to commemorate International Women's Day. And um it's a great pleasure to have you all today here. My name is Maria and I study Control of Infectious Diseases as a master's student at the London School of Hygiene and Tropical Medicine in London. And I'm also one of the event team members at Tomo. So before we start, please ensure that you have um stable internet connection and that you turn off your video during, they turn off the camp, your camera during the talk. Always make sure that you're muted if possible and please do not record or take any screenshots if you have any troubles. Um Technologically, please just message Iona um who is also on the call here today. Um So I'll now introduce the agenda. Oh yeah, so sorry. So the first part is to um so this is the agenda. Um So, well, first go over what tommo global health is and then we will move on to the guest speakers event today, which is my Queens childbirth story. Then we will move along to the community members presentations um which are about menstrual health challenges in their respective countries. And then afterwards, we will conclude with taking a photo of everyone who has participated. Uh We hope you enjoy our event and that you learn something new. So what is to be global health? So, Tomo Global Health is, this is a team, this is the event team that were the people that make them the events. Um And so the team leaders alma and then the rest of us is Mizuki Iona and me. So we all work together to make up the team. And um sorry. Yeah, and it was founded by uh Masako, she motto, who is a six year medical student at U C L. And essentially Tomo is a group of healthcare students that um organize an online program um for sustainable, you know, to foster sustainable global health leaders from high middle and low income countries were output focused. Uh And with case studies, we do community based events and project based learning. Um And so we aim to establish an online community where healthcare students and professionals from all over the world can actively collaborate on various seminars, discussion events and peer coaching sessions. We hope to interact with members from diverse backgrounds and create a strong healthcare network around the world. So now we will move on to the keynote speaker of the event. And so I'll introduce our guest speaker uh Otieno mccree in Elizabeth, who is um also a community uh member of to Makgoba Health and she is a community health and development student at the Great Lakes University of Kisumu. And yeah, I hope maybe you guys can recognize her from some of our other events and please mcqueen if you want to take the floor. Thank you. Hi, everyone. Oh, I'm my kind, Elizabeth A Kenyan. I'm studying at Great Lakes University of the Zoo. I'm uh community else and development student at idea. Can I carry on? And today I would like to take you through my child. Bad story. Also, the big at the beginning, I had a prolonged liver that went for one week. I went back for Matic couple times to check uh if my time is ready for delivery. But what I was being told that it is not yet time, but I felt that it was the right time since uh the E D D was already uh the do that was already there. And I was feeling that it was the right time for me to believe. But what they could tell me those days that are I was going and pursue absolutely isn't better. Uh My servants not opened yet and it had a posterior, a posterior presentation. And I believe the medical students were here, understands what the post photos. Uh These are the ways in which stab, it's my present. So yes, the fetus, the fetus has already turned down, meaning he was ready, he was ready to deliver. Be. Yes. No. So I went to the first hospital that is uh in Kenya. We call it uh level three hospital or a some county hospital, but they could not attend to me because I was a crime me gravity. Uh I was for the first time, those I was going to believer for the first time, but they could not attend to me because at level three, they're not emergency services. Maybe like a blood transfusion. Mm maybe yes he says so they couldn't, they couldn't attend to me. And what they told me is that uh they were going to refer me to another hospital for hospital is uh uh a level for hospital is where now you can received the emergency services, things like blood transfusion CS and also in case they would like to refer you to theater, they can do so because all the emergency services are being taken care of. So here is the really at birth they give but at uh 42 weeks. Yeah and that the virginal back know assistance. So when I said there was no assistance, I mean that the healthcare providers or the healthcare professionals who are, they're, they're they could not attend to me because they were feeling that my time is not ready yet. So I struggled myself whenever I came to the to the room where women were delivering, they could chased me away to go and do some more exercises and then come back when I'm really do. Thank you. So later later and I went back. Um No, I went, I was still within the facility. Know when I went back to the delivery room, they told me when I went back to the delivery room, I was never really lived for delivery and my service open. Yeah, and they give, but at back, uh my boy was doing 3.7 kgs. So after after giving birth, I felt very busy and even fainted because I lost a lot of blood. Yes. And here at at in our country, our healthcare professionals, they work in shifts. So the one that assisted me, that's very early morning when I delivered, my boy was the one that was working at night shift and it was to live by morning. So it did not attend to me very well because he was preparing to uh lean so that the next NASA. So next look as well having the money shifts to maybe continue attending to me. I was having a postpartum prime already was really bleed. I was really bleeding. Mm And uh myself, I thought it was normal because I didn't know anything about delivery, maybe possibly liver. They did not know anything. So the women or moms were given back and you were in the same room and they wants to. So it's not uh something normal. And what they did is that they called one of the doctors to come and the attempt to me at this time, I was not stable. I could not stand for long because I was feeling dizzy if a till. Yeah. So uh I delivered the placenta but I was diagnosed to the retain products of conception. So what they did to me, they took me back to the delivery room. So here um here the bits of the plus central or the fetus tissue are left inside the uterus after the end of pregnancy. And I strongly believe that it is what happened in my case because after delivery, if someone would look at my tummy, it was still swollen. A sip, there was another baby remaining. Uh it means the you terrors is unable to contract down properly to stop blood flow and can lead to postpartum Highbridge. And I also believe that it was that forced partum haemorrhage because it was leaking like a tap. The bleeding was too much. So this room where I was referred to uh the the delivery room, the room where I delivered to before I was taken to uh the word to rest to the baby, they pressed my tell me to expel the remaining, the retained products of conception. And this process is called a bundle massage. So they did the handle massage. And this process is really painful that someone cannot wear. It was really, maybe it was painful for me. I don't know, maybe had this field, but it was really a painful process. So they massage my, my tummy very well remove the excess blood's, remove the retain product. And now, uh, ordered me to get back to the world. The doctors then examined me. Yeah, they did, uh, they did, uh, I think for you, medical students, you understand these terms. I think they did some speculum because they were using some instruments to examine the, the, the, the vagina. So they pulled out the cervix examine and what they found out till that the cervix had turn two centimeters, both sides. Yes. And they suggested that I should go to theater host teaching. Yeah, because they were trying to say that the procedure of doing this teaching is a very unbearable process where maybe someone is just conscious. So they were preferring that I go to the Caterham so that they continue the teaching. And here now when they wanted to take me to the theater room, they also suggested that uh the baby should be taken to the nursery nursery where babies are taken. Maybe these babies where the babies whose mothers uh and I went through surgery. So, you know, the babies are taking to the nursery because at this point, they are so weak that they can't attend to babies. And that is what they were referring to. But for myself, I did not like it. They've been being taken to the nursery because mom was around and I was saying that mom could remain with the baby. So that may be myself. I proceeded the theater room. Uh So here after those, those many examinations, the speculum being done, you know, I was surrounded by many a while, care professionals and each and everyone was coming with with own idea. Someone even said, said that there is a drug that can be placed up to my learners. And this one will help to contract the virgin and also contract the the cervix. Another one said that theater would be a good idea for teaching in case I would like to have maybe another baby in the future. Another one did an examination and said that two centimeter is not a big bill that to send two centimeters can heal by itself. And I was really happy because I did not to want to go to the theater and I wanted to come back and meet my baby. However, I was still feeling dizzy and fainted. I was so tired. So after fainting, I don't know. But this is what I was told because you know, when one phase you're unconscious and you can't know whatever thing is ongoing. So I was told that they did some first aid and now wanted me to have blood transfusion than so. Yeah, at a blood trans to sh in the professional healthcare professionals recommended the blood transfusion for me because I had lost a lot of blood. But for me, I did not like the blood transfusion because I was having so many questions about it. I was wondering what if the blood is not compatible? Maybe to my blood or my body. Yes, I was also thinking that maybe if a blood transfusion was done to me, I would become sickling or maybe a sickler. I also, I was also thinking that uh maybe a blood transfusion would not be enough to replace the amount of blood that I have lost. So I did not like myself. I did not like blood transfusion burden is not to stable. So yes, I refused the, the blood trans to shin I was thinking of the nutritional support and at the nutritional support territory requested the doctor for me drugs, my blood level. So at the facility that recommended ran for on two L, uh this one is very rich, it is highly rich in iron. So I was given this under instruction that I would take it for three weeks, you know, once it is in suspension from and one bottle goes for one week and I was to take it or uh I was to take it for three weeks. And yes, um I can, I can then I need to meet expensive because imagine using you're using it for one week and it is about 900 Shillings, 900 Kenya Shillings. Yeah. So I tried it, I tried it for the three weeks that was recommended by the healthcare providers like that. So uh the facility was given the unfair in and it contains the folic acid iron, vitamin B 12, vitamin C and zinc. So these nutrients are vital to increase the uh hemoglobin level apart from so I was also using the uh viscous and beetroot. Know, beetroot is a fruit. Is it a future a vegetable? But it is in that category. So I changed my diet. I was now using the Hibiscus tea and also that uh true to boost the blood level. You know, I discussed it boosts the iron level. I also I was also using some vegetables and fruits. So the vegetables are in these pictures. I don't know, I'm not sure if these are only in Kenya, but maybe the other side where you stay there also different kinds of vegetables and where I stay. These are the commonly found vegetables. This one is called a case and the group and then blue plan is called mm spine injury is called spine injury. So, so I was miss jet and still like the continuous bleeding. So after labor, I was discharged and the med, the right medical term that I think and we used is the logic to the post partum bleeding. It is called loggia. And the lecture went for two good weeks. And when I went back to the facility because I was disturbed, they told me that it is normal, that logic can even last for 30 days. So I trusted that, but it was still, I I was still bleeding so much that what they call the loggia, I was struggling. I even lost, stop. Let me see, I was eating to die because the bleeding was too much and it was really prolonged and even my genitals was so painful and I could not sit down. I think the pain from the vir genitals was due to that. The V E that was done to me and the process of doing it was really uncomfortable, you know, inciting those, those instruments. Yeah, it was really painful, a very painful process. Then finally, I give myself hope that things would one day be all right. And they are right now. I'm so happy. So in the pictures, the first one is Trevor and uh Masako Sh Martin named him Tomoyuki and the meaning of Tomo, he told me Tomo means friends. Then Yuki happiness, something like that. Then the second one is him at four months. Then the last picture is at nine months. So this is me the picture and Trevor and it was, it was nine months by then. So this is now balancing everything. So it is uh while I was pregnant, I was trying to balance every activity that I was doing that joining the Tomo community events, which I don't really think if there is any event that I missed. So I was balancing to, to join the activities. I was also balancing my classes. Yes, the physical classes also balancing, we're going to do the job. So I really tried. I think I really tried. I think I gave it my best. So in my last slide, Trevor will be turning one year at 27th of this month, 2023. I thank God and thank you for listening. So, is anyone having creations or a question to me or maybe a slide where I was not clear, you can ask. Thank you so much mcqueen for this presentation for this very personal account. Um And hopefully for the people who watched you've learned something and that this inspires you. Um So now we'll move on to the community member presentations. Um And so we'll start off with Maria who is a student at the University of Nicosia and she will be presenting about Poland. Uh I would like to talk to you today a bit about Poland. Uh I study in Cyprus. So I don't have like day to day contacted this, but obviously, that's where I come from. So I know a lot about it and probably you'll think that compared to some other countries that are less developed, it's still not that bad, but I'll tell you today a bit of the negative things that are happening. So let's start with the environmental factors. I think it's a general problem in the more developed countries where their life becomes faster and we don't have that much time to take care of our diet and physical activity. We have more and more stress. Uh And we struggle dissident terry lifestyle and that brings on a lot of problems for especially young women and it can cause like hormonal imbalance, probably like one in three women in Poland struggles with hormonal imbalance, which can present with all the symptoms that I've listed on the right on that image. So, acne and extreme fatigue, weight gain cravings are the most common ones that we have and the problems like PCOS are in dysfunction and hirsutism are becoming more and more popular. Um And we also have a growing issue of pelvic floor health and public floor dysfunction. And we still are kind of behind of the awareness around this. I'm talking about uh urine incontinence and any types of sexual dysfunction. It's still kind of a taboo subject. Okay. So now we're talking about the cultural obstacles. So there's a lot of stigma around this mainly because 92.9% of people in Poland identify as Catholics and that has a tremendous impact on how the view fertility, sexual health, menstrual health. Um And there's other things that are normalized in the society like period pain. Um And the only solution that the doctors could offer you is oral contraceptive pill because it's still not spoken openly about and everybody's like silently okay with this. Um and endometriosis and PCOS are very common these days and are still a very underdiagnosed. Another thing that happened quite recently in 2022 October, they passed a very strict abortion law where women are no longer allowed to um, sites severe fetal defects as a reason for having an abortion. So basically, now you can have a legal abortion at any stage for any reason. There's, there used to be until 2022. 3 main reasons why you could have an abortion. So when the life of the mother is threatened when there's severe foetal defects and um and when it was a product of rape or incest, those were the free reasons where you could do it until I think the third month and now you can't do it for any reason. And that caused a lot of protests on the streets. I put a few pictures of what happened in October and November. The protest was going on for a few weeks straight. Every day. Women would go on to the streets and protest against this lobbying past we called it the black protest because on most of these days, the weather is so rainy like the world was giving signs. People were treating it as a sign. So an umbrella became a symbol of this protest. And uh unfortunately, this did not cause any changes. The law is still there. And since October, a lot of women have passed away because they were not giving medical attention when they should have foreseen the abortion, they got sepsis and sadly passed away. So I also put here a graph of the birth rate. And we can see that we also have a few other neighboring countries and the pattern is very similar but mainly due to strict laws like this, we have event uh uh smaller birthright and it's estimated now that only 50% of women in Poland plan to have Children in the future. So we can't just say this, this problem is gonna get even worse after passing this strict laws. Okay. And this graph is supposed to represent um how many percent of people have access to contraception. And unfortunately, poems in the middle of Europe, it's a massive country and we have the lowest access to contraception and it's really sad to look at. Um So I just wanted to, to show a comparison. It's not like all countries and the Easter like that, but this is just than becoming a more serious problem, especially for us. Okay. And um I also wanted to show you that it wasn't always like that. We did have a lot of progress in access to contraception. But unfortunately, since the government changed the more religious and conservative one from 2017, it's been progressively becoming less and less um accessible. And we are the only country in Europe and probably the world that are going backwards in terms of access to contraception. So the I found another data that stated that from 2013, 2018, we had 44.8%. Uh And then in 2022 we have 33.5%. And the way it was measured that they were free main factors and they measured the availability of contraceptive method methods to both men and women. Access to consultation with a special specialist to discuss the contraceptive measures and access to an online information about the subject. So they summed up all these three factors and that's how they came up with these percentages for each country. And yeah, you can just see how bad we look compared to other countries. We also um don't have that much information. And the other graph shows the only um 53% of women on the oral contraceptive pill know anything about the pill. So 40% know a bit and then 6% don't know anything at all. So not only we have low access, but we also have bad information. There's no government website about contraception. All the resources that can you can find online are non government funded. And it's really sad to see the new generation have to go through these struggles. So I think that sums up my presentation, it's not going in the right direction, but hopefully I can get better. So we just want to thank you for coming around today and that um please join our community if you're already not a community of Tomo Global Health. Um I think Iona should be posting the different links. Um And please fill out the feedback form on medal. Um Our feedback is your feedback is very important for us to improve our events. And so we've just had a music medal and that's a new platform that we are very excited about. Uh And so we can post recordings from previous events there. So you can be able to see our past events as well as new ones in the future. And for more information about us, please check out our Facebook Instagram and website. Um Thank you very much.