So you have just finished having your coffee and you feel a burning sensation in your chest. You are probably experiencing heartburn or lesokolela in mother tongue. Despite its name, heartburn has nothing to do with the heart! Heartburn is caused by stomach acid refluxing up and irritating the oesophagus. Mild and occasional heartburn is no cause for alarm and can be effectively managed at home. However, heartburn that has been more frequent (more than twice per week) and severe can be hard to differentiate from a heart attack, and may also be an indication of a serious condition. Medical attention should be sought if this happens.
Symptoms of heartburn
The most common symptoms of heartburn include: A sharp or burning sensation behind the sternum (breast bone) that occurs after a meal (this can last for a few minutes to several hours) Crampiness or tearing pain in the upper abdomen (go sega mo setshwabung), usually going up the chest to the neck Sour or bitter taste in the throat and mouth Chest pain that is worse upon bending over, lying down or sleeping
What causes heartburn?
When one eats, food passes from the mouth down the oesophagus into the stomach. The stomach produces acids and enzymes that combine with food to begin digestion.
There are mechanisms in place that protect the stomach and the oesophagus from being eroded by these acids. The stomach has special protective cells that line it to prevent the contents from causing inflammation. The lower oesophageal sphincter which is located at the end of the oesophagus closes as soon as food has passed through the oesophagus entering the stomach, as the oesophagus does not have this same protective cells against acid. If the sphincter muscles are weak, acid from the stomach can leak back through the defect into the oesophagus causing heartburn. This is called acid reflux.
What predisposes one to heartburn?
The following risk factors can bring on heartburn, or make it worse.
Certain foods – what you eat and how you eat can trigger heartburn. A number of different foods and beverages can cause heartburn by aggravating the tissues that line the esophagus or by affecting the ability of the lower esophageal sphincter to close properly and keep acids in the stomach. Examples are spicy foods, chilli, sour foods, peppermint and spearmint, chocolate, tomatoes and tomato products like sauce, citrus fruits, fried and fatty foods, white processed starch, caffeinated drinks, coffee (even decaf), and fizzy drinks.
Overeating – How much and when you eat may have as much to do with heartburn as what you eat. Heartburn is most common after overeating, even worse when bending over or when lying down /sleeping immediately after the meal.
Pregnancy – more than half of all pregnant women report symptoms of severe heartburn particularly during their second and third trimesters. This may be due to two reasons; change in hormonal levels causing the oesophageal sphincter to relax, allowing stomach acids to splash back up into the oesophagus and pressure effect from the growing uterus pushing stomach acids upward.
Constipation – constipation just like pregnancy put too much pressure on the stomach and can aggravate the acid to reflux back into oesophagus.
Overweight/Obesity – Studies have mentioned few theories relating obesity to heartburn, including excess body fat compressing the stomach, the effects of food (especially fatty foods), and high incidence of hernias in overweight people Alcohol – alcoholic beverages including wine, beer, and hard liquor irritate the stomach and oesophagus Some medications – certain medications can irritate the gut or increase acid production thus triggering heartburn or making it worse e.g. Ibuprofen, bisphosphonates, blood pressure medications like calcium channel blockers and beta blockers, and drugs containing aspirin.
Smoking- smoking has been listed as the major contributor to heartburn as it relaxes the oesophageal sphincter and stimulates stomach acid production.
Stress – according to research, stress may very well be another trigger for heartburn. Most people who suffer from heartburn might try to behave and stay away from all other triggers like spicy foods and orange juice but still find that their symptoms of heartburn return when their body is under stress e.g. just before an interview. This is because stress can increase acid production or the sensitivity to the smallest amounts of acid.
Hiatus Hernia – the diaphragm separates the chest (where oesophagus is located) from the abdomen (where the stomach is). Hiatus hernia is when a portion of the stomach is protruding into the chest at or next to the oesophageal opening. This can affect the way the oesophageal sphincter works and cause acid reflux.
Heartburn is not without complications. Ulcers – If untreated, recurrent irritation and inflammation of the oesophagus can lead to ulcers. These can cause serious bleeding from the gut Swallowing difficulties- Scarring and stricture/narrowing of the oesophagus can develop after prolonged exposure to acid and cause difficulty swallowing Oesophageal cancer- Changes in the type of cells lining the oesophagus may result from acid reflux, causing a condition known as Barrett’s oesophagus which is associated with an increased risk of oesophageal cancer
Dental carries – Reflux over prolonged periods of time can be severe enough that acid wears away the enamel on teeth and causes decay Persistent cough – If there is acid reflux near the throat, this may lead to coughing episodes or hoarseness of the voice
Next week we will discuss the home remedies and treatment options of heartburn.
For comments or questions please email HYPERLINK "mailto:firstname.lastname@example.org" email@example.com
Parliament, the second arm of State through its parliamentary committees are one of Botswana’s most powerful mechanisms to ensure that government is held accountable at all times. The Accounting Officers are mostly Permanent Secretaries across government Ministries and Chief Executive Officers, Director Generals, Managing Directors of parastatals, state owned enterprises and Civil Society.
So parliament plays its oversight authority via the legislators sitting on a parliamentary committee and Accounting Officers sitting in the hot chair. When left with no proper checks and balances, the Executive is prone to abuse the arrangement and so systematic oversight of the executive is usually carried out by parliamentary committees. They track the work of various government departments and ministries, and conduct scrutiny into important aspects of their policy, direction and administration.
It is not rocket science that effective oversight requires that committees be totally independent and able to set their own agendas and have the power to summon ministers and top civil servants to appear and answer questions. Naturally, Accounting Officers are the highest ranking officials in the government hierarchy apart from cabinet Ministers and as such wield much power and influence in the performance of government. To illustrate further, government performance is largely owed to the strategic and policy direction of top technocrats in various Ministries.
It is disheartening to point out that the recent parliament committees — as has been the case all over the years — has laid bare the incompetency, inadequacy and ineptitude of people bestowed with great responsibilities in public offices. To say that they are ineffective and inefficient sounds as an understatement. Some appear useless and hopeless when it comes to running the government despite the huge responsibility they possess.
If we were uncertain about the degree at which the Accounting Officers are incompetent, the ongoing parliament committees provide a glaring answer. It is not an exaggeration to say that ordinary people on the streets have been held ransom by these technocrats who enjoy their air conditioned offices and relish being chauffeured around in luxurious BX SUV’s while the rest of the citizenry continue to suffer. Because of such high life the Accounting Officers seem to have, with time, they have gotten out of touch with the people they are supposed to serve.
An example; when appearing before the recent Public Accounts Committee (PAC), Office of the President Permanent Secretary, Thuso Ramodimoosi, looked reluctant to admit misuse of public funds. Although it is clear funds were misused, he looked unbothered when committee members grilled him over the P80 million Orapa House building that has since morphed into a white elephant for close to 10 successive years. To him, it seems it did not matter much and PAC members were worried for nothing.
On a separate day, another Accounting officer, Director of Public Service Management (DPSM), Naledi Mosalakatane, was not shy to reveal to PAC upon cross-examination that there exist more than 6 000 vacancies in government. Whatever reasons she gave as an excuse, they were not convincing and the committee looked sceptical too. She was faltering and seemed not to have a sense of urgency over the matter no matter how critical it is to the populace.
Botswana’s unemployment rate hoovers around 18 percent in a country where majority of the population is the youth, and the most affected by unemployment. It is still unclear why DPSM could underplay such a critical matter that may threaten the peace and stability of the country. Accounting Officers clearly appear out of touch with the reality out there – if the PAC examinations are anything to go by.
Ideally the DPSM Director could be dropping the vacancy post digits while sourcing funds and setting timelines for the spaces to be filled as a matter of urgency so that the citizens get employed to feed their families and get out of unemployment and poverty ravaging the country. The country should thank parliamentary committees such as PAC to expose these abnormalities and the behaviour of our leaders when in public office. How can a full Accounting Officer downplay the magnitude of the landless problem in Botswana and fail to come with direct solutions tailor made to provide Batswana with the land they desperately need?
Land is a life and death matter for some citizens, as we would know.
When Bonolo Khumotaka, the Accounting Officer in the Ministry of Land Management, Water and Sanitation Services, whom as a top official probably with a lucrative pay too appears to be lacking sense of urgency as she is failing on her key mandate of working around the clock to award the citizens with land especially those who need it most like the marginalised. If government purports they need P94 billion to service land to address the land crisis what is plan B for government? Are we going to accept it the way it is?
Government should wake up from its slumber and intervene to avoid the 30 years unnecessary waiting period in State land and 13 years in Tribal land. Accounting Officers are custodians of government policy, they should ensure it is effective and serve its purpose. What we have been doing over the years, has proved that it is not effective, and clearly there is a need for change of direction.
His Excellency Dr Mokgweetsi EK Masisi, the President of the Republic of Botswana found it appropriate to invoke Section 17 (1) of the Constitution of the Republic of Botswana, using the powers vested in him to declare a State of Public Emergency starting from the 2nd April 2020 at midnight.
The constitutional provision under Section 17 (2b) only provided that such a declaration could be up to a maximum of 21 days. His Excellency further invoked Section 93 (1) to convene an extra- ordinary meeting of Parliament to have the opportunity to consult members of parliament on measures that have been put in place to address the spread and transmission of the virus. At this meeting Members of Parliament passed a resolution on the legal instruments and regulations governing the period of the state of emergency, and extended its duration by six (6) months.
The passing of the State of Emergency is considered as a very crucial step in fighting the near apocalyptic potential of the Novel COVID-19 virus. One of the interesting initiatives that was developed and extended to the business community was a 3-month wage subsidy that came with a condition that no businesses would retrench for the duration of the State of Public Emergency. This has potentially saved many people’s jobs as most companies would have been extremely quick to reduce expenses by downsizing. Self-preservation as some would call it.
Most organisations would have tried to reduce costs by letting go of people, retreated and tried their best to live long enough to fight another day. In my view there is silver lining that we need to look at and consider. The fact that organisations are not allowed to retrench has forced certain companies to look at the people with a long-term view.
Most leaders have probably had to wonder how they are going to ensure that their people are resilient. Do they have team members who innovate and add value to the organisation during these testing times? Do they even have resilient people or are they just waiting for the inevitable end? Can they really train people and make them resilient? How can your team members be part of your recovery plan? What can they do to avoid losing the capabilities they need to operate meaningfully for the duration of the State of Public Emergency and beyond?
The above questions have forced companies to reimagine the future of work. The truth is that no organisation can operate to its full potential without resilient people. In the normal business cycle, new teams come on board; new business streams open, operations or production sites launch or close; new markets develop, and technology is introduced. All of this provides fresh opportunities – and risks.
The best analogy I have seen of people-focused resilience planning reframes employees as your organisation’s immune system, ready and prepared to anticipate risks and ensure they can tackle challenges, fend off illness and bounce back more quickly. So, how do you supercharge your organizational immune system to become resilient?
COVID-19 has helped many organisations realize they were not as prepared as they believed themselves to be. Now is the time to take stock and reset for the future. All the strategies and plans prior to COVID-19 arriving in Botswana need to be thrown out of the window and you need to develop a new plan today. There is no room for tweaking or reframing. Botswana has been disrupted and we need to accept and embrace the change. What we initially anticipated as a disease that would take a short term is turning out to be something we are going to have to live with for a much longer time. It is going to be a marathon and therefore businesses need to have a plan to complete this marathon.
Start planning. Planning for change can help reduce employee stress, anxiety, and overall fear, boosting the confidence of staff and stakeholders. Think about conducting and then regularly refreshing a strategic business impact analysis, look at your employee engagement scores, dig into your customer metrics and explore the way people work alongside your behaviours and culture. This research will help to identify what you really want to protect, the risks that you need to plan for and what you need to survive during disruption. Don’t forget to ask your team members for their input. In many cases they are closest to critical business areas and already have ideas to make processes and systems more robust.
Revisit your organisational purpose. Purpose, values and principles are powerful tools. By putting your organisation’s purpose and values front and center, you provide clear decision-making guidelines for yourself and your organisation. There are very tough and interesting decisions to make which have to be made fast; so having guiding principles on which the business believes in will help and assist all decision makers with sanity checking the choices that are in front of them. One noticeable characteristic of companies that adapt well during change is that they have a strong sense of identity. Leaders and employees have a shared sense of purpose and a common performance culture; they know what the company stands for beyond shareholder value and how to get things done right.
Revisit your purpose and values. Understand if they have been internalised and are proving useful. If so, find ways to increase their use. If not, adapt them as necessities, to help inspire and guide people while immunizing yourself against future disruption. Design your employee experience. The most resilient, adaptive and high performing companies are made up of people who know each other, like each other, and support each other.
Adaptability requires us to teach other, speak up and discuss problems, and have a collective sense of belonging. Listening to your team members is a powerful and disruptive thing to do. It has the potential to transform the way you manage your organisation. Enlisting employees to help shape employee experience, motivates better performance, increases employee retention and helps you spot issues and risks sooner. More importantly, it gives employees a voice so you can get active and constructive suggestions to make your business more robust by adopting an inclusive approach.
Leaders need to show they care. If you want to build resilience, you must build on a basis of trust. And this means leaders should listen, care, and respond. It’s time to build the entire business model around trust and empathy. Many of the employees will be working under extreme pressure due to the looming question around what will happen when companies have to retrench. As a leader of a company transparency and open communication are the most critical aspects that need to be illustrated.
Take your team member into confidence because if you do have to go through the dreaded excise of retrenchment you have to remember that those people the company retains will judge you based on the process you follow. If you illustrate that the business or organization has no regard for loyalty and commitment, they will never commit to the long-term plans of the organisation which will leave you worse off in the end. Its an absolutely delicate balance but it must all be done in good faith. Hopefully, your organization will avoid this!
This is the best time to revisit your identify and train your people to encourage qualities that build strong, empathetic leadership; self-awareness and control, communication, kindness and psychological safety. Resilience is the glue that binds functional silos and integrates partners, improves communications, helps you prepare, listen and understand. Most importantly, people-focused resilience helps individuals and teams to think collectively and with empathy – helping you respond and recover faster.
Article written by Thabo Majola, a brand communications expert with a wealth of experience in the field and is Managing Director of Incepta Communications.
Parliament was this week once again seized with matters that concern them and borders on conflict of interest and abuse of privilege.
The two matters are; review of MPs benefits as well as President Mokgweetsi Masisi’s participation in the bidding for Banyana Farms. For the latter, it should not come as a surprise that President Masisi succeeded in bid.
The President’s business interests have also been in the forefront. While President Masisi is entitled as a citizen to participate in a various businesses in the country or abroad, it is morally deficient for him to participate in a bidding process that is handled by the government he leads. By the virtue of his presidency, Masisi is the head of government and head of State.
Not long ago, former President Festus Mogae suggested that elected officials should consider using blind trust to manage their business interests once they are elected to public office. Though blind trusts are expensive, they are the best way of ensuring confidence in those that serve in public office.
A blind trust is a trust established by the owner (or trustor) giving another party (the trustee) full control of the trust. Blind trusts are often established in situations where individuals want to avoid conflicts of interest between their employment and investments.
The trustee has full discretion over the assets and investments while being charged with managing the assets and any income generated in the trust.
The trustor can terminate the trust, but otherwise exercises no control over the actions taken within the trust and receives no reports from the trustees while the blind trust is in force.
Botswana Democratic Party (BDP) Secretary General, Mpho Balopi, has defended President Masisi’s participation in business and in the Banyana Farms bidding. His contention is that, the practise even obtained during the administration of previous presidents.
The President is the most influential figure in the country. His role is representative and he enjoys a plethora of privileges. He is not an ordinary citizen. The President should therefore be mindful of this fact.
We should as a nation continue to thrive for improvement of our laws with the viewing of enhancing good governance. We should accept perpetuation of certain practices on the bases that they are a norm. MPs are custodians of good governance and they should measure up to the demands of their responsibility.
Parliament should not be spared for its role in countenancing these developments. Parliament is charged with the mandate of making laws and providing oversight, but for them to make laws that are meant solely for their benefits as MPs is unethical and from a governance point of view, wrong.
There have been debates in parliament, some dating from past years, about the benefits of MPs including pension benefits. It is of course self-serving for MPs to be deliberating on their compensation and other benefits.
In the past, we have also contended that MPs are not the right people to discuss their own compensation and there has to be Special Committee set for the purpose. This is a practice in advanced democracies.
By suggesting this, we are not suggesting that MP benefits are in anyway lucrative, but we are saying, an independent body may figure out the best way of handling such issues, and even offer MPs better benefits.
In the United Kingdom for example; since 2009 following a scandal relating to abuse of office, set-up Independent Parliamentary Standards Authority (IPSA)
IPSA is responsible for: setting the level of and paying MPs’ annual salaries; paying the salaries of MPs’ staff; drawing up, reviewing, and administering an MP’s allowance scheme; providing MPs with publicly available and information relating to taxation issues; and determining the procedures for investigations and complaints relating to MPs.
Owing to what has happened in the Parliament of Botswana recently, we now need to have a way of limiting what MPs can do especially when it comes to laws that concern them. We cannot be too trusting as a nation.
MPs can abuse office for their own agendas. There is need to act swiftly to deal with the inherent conflict of interest that arise as a result of our legislative setup. A voice of reason should emerge from Parliament to address this unpleasant situation. This cannot be business as usual.