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80-458: "Vezo" literally means 'the people who fish', but also has been known to mean 'to struggle with the sea'. Vezo do not identify with a particular Malagasy ethnic group but instead with their way of life. They currently populate most of the littoral zone along Madagascar's west coast between Toliara and Mahajanga . Like most other Malagasy ethnic groups, their origins can directly be traced to that original mix of Austronesian settlers from Asia and

160-723: A spatula mundani . After the advent of the germ theory of disease then the idea of "auto-intoxication" entered popular Western thought in a fresh way. Enema as a scientific medical treatment and colon cleansing as alternative medical treatment became more common in medical practice. Since the 1700s in the West there has been some popular thought that people with constipation have some moral failing with gluttony or laziness . Approximately 3% of children have constipation, with girls and boys being equally affected. With constipation accounting for approximately 5% of general pediatrician visits and 25% of pediatric gastroenterologist visits,

240-404: A benefit on constipation, while potentially causing cardiac arrhythmias and deaths. Enemas can be used to provide a form of mechanical stimulation. A large volume or high enema can be given to cleanse as much of the colon as possible of feces, and the solution administered commonly contains castile soap which irritates the colon's lining resulting in increased urgency to defecate. However,

320-411: A better understanding of the multiple uses of the available habitats but when it comes to pooling their knowledge into one system, they just can not make it by themselves. This shows that traditional ways of solving problems have failed to make its way to modern days. Traditional leaders used to play an important role in preserving wealth of the community by providing guidance to resource users according to

400-424: A bowel movement so as to avoid pain. The pelvic floor muscles play an important role in helping pass a bowel movement. Injury to those muscles by some of the above risk factors (examples- delivering a large child, lengthy second stage of labor, forceps delivery) can result in constipation. Enemas may be administered during labor and these can also alter bowel movements in the days after giving birth. However, there

480-457: A few more months to grow in a closed fishing ground, it allows octopus individuals to get to bigger sizes. The Vezo have a long history of subsistence turtle exploitation and associated cultural traditions. By local law, turtles are protected under Decree 24 passed in 1923, but this law has seldom been enforced. The low reproductive potential and delayed sexual maturity of turtles make all species unsuitable for intensive harvest. Even as far back as

560-532: A group uncommon with Hirschsprung's disease (HD) being the most common. There are also congenital structural anomalies that can lead to constipation, including anterior displacement of the anus, imperforate anus , strictures, and small left colon syndrome. The diagnosis is typically made based on a person's description of the symptoms. Bowel movements that are difficult to pass, very firm, or made up of small hard pellets (like those excreted by rabbits) qualify as constipation, even if they occur every day. Constipation

640-491: A low enema is generally useful only for stool in the rectum, not in the intestinal tract. Constipation that resists the above measures may require physical intervention such as manual disimpaction (the physical removal of impacted stool using the hands; see fecal impaction ). Regular exercise can help improve chronic constipation. In refractory cases, procedures can be performed to help relieve constipation. Sacral nerve stimulation has been demonstrated to be effective in

720-410: A male pregnancy. A man sick with hanimboky is constipated and this causes his stomach to swell up until it resembles the belly of a pregnant woman. The illness is caused by food that the male kin of a sexually active woman accepted and ate from her. The food is said to be dirty, for it is assumed that the woman had acquired it with 'tangy', the presents her lover gives her for having sex with him. When

800-423: A man accepts food from one of his female kin, it is therefore as if he were receiving food from the woman's lover; if a man accepted such food, he would be put in a very inferior position. In essence, they are treated as if they were women by their daughter's or sister's lover. Vezo cemeteries lie in the forest, far away from the villages and are so well hidden by the vegetation that they are considered "invisible to

880-404: A medical disease, and treatment can be focused on simply relieving the symptoms. The six-week period after pregnancy is called the postpartum stage. During this time, women are at increased risk of being constipated. Multiple studies estimate the prevalence of constipation to be around 25% during the first 3 months. Constipation can cause discomfort for women, as they are still recovering from

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960-433: A minority of cases. Colectomy with ileorectal anastomosis is another intervention performed only in patients known to have a slow colonic transit time and in whom a defecation disorder has either been treated or is not present. Because this is a major operation, side effects can include considerable abdominal pain, small bowel obstruction, and post-surgical infections. Furthermore, it has a very variable rate of success and

1040-530: A number of ethnic groups, often into the standard eighteen. In addition, communities of Indians in Madagascar and Arabs and Somalis have long been established on the island and have assimilated into local communities to varying degrees, in some places having long since become identified "Malagasy" ethnic groups, and in others maintaining distinct identities and cultural separation. More recent arrivals include Europeans and Chinese immigrants. Madagascar

1120-423: A population of 1,200, with over 50% under 15 years of age. Household income is mainly from fishing. Fishermen make use of mangroves for timber, wood, and fishing. The fishers participate in an artisanal fishery reliant on pirogues (canoes, made by hollowing out a large log) powered by sail and paddle, and most fishing occurs 5 km or less from shore. Men predominantly fish with line, nets, and spears. Women glean

1200-811: A result of chronic constipation. Constipation can be caused or exacerbated by a low-fiber diet, low liquid intake, or dieting. Dietary fiber helps to decrease colonic transport time, increases stool bulk but simultaneously softens stool. Therefore, diets low in fiber can lead to primary constipation. Many medications have constipation as a side effect. Some include (but are not limited to) opioids , diuretics , antidepressants , antihistamines , antispasmodics , anticonvulsants , tricyclic antidepressants , antiarrythmics , beta-adrenoceptor antagonists , anti-diarrheals , 5-HT3 receptor antagonists such as ondansetron , and aluminum antacids . Certain calcium channel blockers such as nifedipine and verapamil can cause severe constipation due to dysfunction of motility in

1280-442: A set of symptoms that help standardize the diagnosis of constipation in various age groups. These criteria help physicians to better define constipation in a standardized manner. The causes of constipation can be divided into congenital , primary, and secondary. The most common kind is primary and not life-threatening. It can also be divided by the age group affected such as children and adults. Primary or functional constipation

1360-633: Is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement. Complications from constipation may include hemorrhoids , anal fissure or fecal impaction . The normal frequency of bowel movements in adults is between three per day and three per week. Babies often have three to four bowel movements per day while young children typically have two to three per day. Constipation has many causes. Common causes include slow movement of stool within

1440-774: Is also common in individuals with muscular and myotonic dystrophy. Systemic diseases that may present with constipation include celiac disease and systemic sclerosis . Constipation has a number of structural (mechanical, morphological, anatomical) causes, namely through creating space-occupying lesions within the colon that stop the passage of stool, such as colorectal cancer , strictures , rectocoles , anal sphincter damage or malformation and post-surgical changes. Extra-intestinal masses such as other malignancies can also lead to constipation from external compression. Constipation also has neurological causes, including anismus , descending perineum syndrome , desmosis and Hirschsprung's disease . In infants, Hirschsprung's disease

1520-483: Is because when a person dies, the breathing stops, the body becomes stiff, cold and soon begins to stink and to decompose. But when a person dies, the ‘spirit’ – known as fanahy up to the moment of death – permanently departs from the body. In its new disembodied, ghostly form, the spirit – now known as angatse – is invisible, and moves around like wind. To be seen by living people, it enters their dreams, where it appears together with its original uncorrupted body, just as it

1600-621: Is defined by ongoing symptoms for greater than six months not due to an underlying cause such as medication side effects or an underlying medical condition. It is not associated with abdominal pain, thus distinguishing it from irritable bowel syndrome . It is the most common kind of constipation, and is often multifactorial. In adults, such primary causes include: dietary choices such as insufficient dietary fiber or fluid intake, or behavioral causes such as decreased physical activity . In children, causes can include diets low in fiber and fluids, underlying medical conditions, and reluctance to go to

1680-521: Is difficult to determine and has been estimated by counting the dugout canoes called pirogues ( lakanas in Malagasy language ) around Madagascar. The Vezo tribe is from Southwest Madagascar. The Vezo are a fishing people who inhabit a coastal belt extending from Intampolo in the south to Morondava in the north of southwest Madagascar. Andavadoaka is a village whose population are of the Vezo tribe. It has

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1760-676: Is discouraged, as having bowel movements may come to be dependent upon their use. Soluble fiber supplements such as psyllium are generally considered first-line treatment for chronic constipation, compared to insoluble fibers such as wheat bran. Side effects of fiber supplements include bloating, flatulence, diarrhea, and possible malabsorption of iron, calcium, and some medications. However, patients with opiate-induced constipation will likely not benefit from fiber supplements. If laxatives are used, milk of magnesia or polyethylene glycol are recommended as first-line agents due to their low cost and safety. Stimulants should only be used if this

1840-536: Is done manually by a physician and is used to guide which diagnostic tests to order. Functional constipation is common and does not warrant diagnostic testing. Imaging and laboratory tests are typically recommended for those with alarm signs or symptoms. The laboratory tests performed depends on the suspected underlying cause of the constipation. Tests may include CBC ( complete blood count ), thyroid function tests, serum calcium, serum potassium, etc. Abdominal X-rays are generally only performed if bowel obstruction

1920-403: Is drinking of alcohol. After the ceremony the child is called savatse. The community life of the Vezo, as elsewhere in Madagascar, is guided by numerous fady (taboos). During the course of the life of a Vezo man, he is exposed to the danger of catching hanimboky , a very unpleasant disease that only affects men. The name literally means 'swollen/full with food', which makes it considered thus

2000-454: Is more concerning when there is weight loss or anemia , blood is present in the stool , there is a history of inflammatory bowel disease or colon cancer in a person's family, or it is of new onset in someone who is older. Treatment of constipation depends on the underlying cause and the duration that it has been present. Measures that may help include drinking enough fluids, eating more fiber , consumption of honey and exercise . If this

2080-402: Is not effective, laxatives of the bulk-forming agent , osmotic agent , stool softener , or lubricant type may be recommended. Stimulant laxatives are generally reserved for when other types are not effective. Other treatments may include biofeedback or in rare cases surgery. In the general population rates of constipation are 2–30 percent. Among elderly people living in a care home

2160-430: Is not effective. In cases of chronic constipation, polyethylene glycol appears superior to lactulose . Prokinetics may be used to improve gastrointestinal motility. A number of new agents have shown positive outcomes in chronic constipation; these include prucalopride and lubiprostone . Cisapride is widely available in third world countries, but has been withdrawn in most of the west. It has not been shown to have

2240-457: Is often diagnosed as irritable bowel syndrome (IBS) when no obvious cause is found. Poor dietary habits, previous abdominal surgeries, and certain medical conditions can contribute to constipation. Diseases associated with constipation include hypothyroidism , certain types of cancer , and irritable bowel syndrome . Low fiber intake, inadequate amounts of fluids, poor ambulation or immobility, or medications can contribute to constipation. Once

2320-452: Is renowned internationally for its erotic wooden figures, often depicted during copulation and showing oversized phalluses and breasts. It is unknown as to why the sculptures have this sort of eroticism, but it may have to do with meeting growing tourist demand. Even after their ancestors have passed, the Vezo keep them involved in many different affairs. Many events in the productive, reproductive and social life of any Vezo family require that

2400-421: Is significant stool burden and may reveal abdominal discomfort. Rectal examination gives an impression of the anal sphincter tone and whether the lower rectum contains any feces or not. Rectal examination also gives information on the consistency of the stool, the presence of hemorrhoids, blood and whether any perineal irregularities are present including skin tags, fissures, anal warts. Physical examination

2480-430: Is suspected, may reveal extensive impacted fecal matter in the colon, and may confirm or rule out other causes of similar symptoms. Colonoscopy may be performed if an abnormality in the colon like a tumor is suspected. Other tests rarely ordered include anorectal manometry , anal sphincter electromyography, and defecography . Colonic propagating pressure wave sequences (PSs) are responsible for discrete movements of

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2560-428: Is the most common medical disorder associated with constipation. Anismus occurs in a small minority of persons with chronic constipation or obstructed defecation. Spinal cord lesions and neurological disorders such as Parkinson's disease and pelvic floor dysfunction can also lead to constipation. Chagas disease may cause constipation through the destruction of the myenteric plexus . Voluntary withholding of

2640-434: Is the responsibility of the senior head of the family to call the dead and talk to them, asking for their protection or their forgiveness, and ensuring that they are kept well informed of life's events – for whenever the dead have reasons to be “surprised," they will want to ask questions, thereby causing trouble for the living. The dead communicate with their living descendants through the dreams that they induce in them. This

2720-503: Is traditionally defined as three or fewer bowel movements per week. Other symptoms related to constipation can include bloating, distension , abdominal pain, headaches, a feeling of fatigue and nervous exhaustion, or a sense of incomplete emptying. Although constipation may be a diagnosis, it is typically viewed as a symptom that requires evaluation to discern a cause. Distinguish between acute (days to weeks) or chronic (months to years) onset of constipation because this information changes

2800-480: Is very case dependent. Complications that can arise from constipation include hemorrhoids , anal fissures , rectal prolapse , and fecal impaction. Straining to pass stool may lead to hemorrhoids. In later stages of constipation, the abdomen may become distended, hard and diffusely tender. Severe cases ("fecal impaction" or malignant constipation ) may exhibit symptoms of bowel obstruction (nausea, vomiting , tender abdomen) and encopresis , where soft stool from

2880-523: The differential diagnosis . This in the context of accompanied symptoms helps physicians discover the cause of constipation. People often describe their constipation as bowel movements that are difficult to pass, firm stool with lumpy or hard consistency, and excessive straining during bowel movements. Bloating, abdominal distension , and abdominal pain often accompany constipation. Chronic constipation (symptoms present at least three days per month for more than three months) associated with abdominal discomfort

2960-412: The population of Madagascar include population density , ethnicity , education level, health of the populace, economic status, religious affiliations and other aspects of the population. Madagascar 's population is predominantly of mixed Austronesian and East African origin. Since the country's independence in 1960, three general census of population and dwellings (RGPH) have been conducted by

3040-404: The rectosigmoid colon . Supplements such as calcium and iron supplements can also have constipation as a notable side effect. Metabolic and endocrine problems which may lead to constipation include: pheochromocytoma , hypercalcemia , hypothyroidism , hyperparathyroidism , porphyria , chronic kidney disease , pan-hypopituitarism , diabetes mellitus , and cystic fibrosis . Constipation

3120-677: The African continent in hand-carved pirogues. Increasingly, commercial boats, mostly from Asia and Europe, are fishing those same waters. Thus, it is difficult for the traditional fishermen to compete in the market. In response, many Vezo have resorted to fishing hundreds of miles offshore, spending six to nine months a year in rough and dangerous waters in search of sharks and sea cucumbers, both in high demand in Asian seafood markets. Some bring their families and all their possessions and set up camp on sandbars far from civilization. Fishermen believe that

3200-556: The Bantu migrants from mainland East Africa with Arab-Persian and Indian ancestry since the Middle Ages. They have been known to state emphatically that they need have no common origin or shared essence with one another. Their identity is instead contextual and embodied in learned skills such as fishing or swimming and the calluses they produce, rather than in shared origin. Because of their semi-nomadic marine migrations, their population

3280-459: The Church of Jesus Christ of Latter-day Saints (Mormons), Jehovah's Witnesses , Seventh-day Adventists , Eastern Orthodox Christians and evangelicals. Many incorporate the cult of the dead with their other religious beliefs and bless their dead at church before proceeding with the traditional burial rites. They also may invite a pastor to attend a famadihana. A historical rivalry exists between

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3360-614: The Indians in Madagascar have a high level of education, particularly the younger generation. A sizeable number of Europeans also reside in Madagascar , mostly of French descent. Religion in Madagascar (2020) according to the Pew Research Center According to the 1993 national census, 41% of Malagasies practised Christianity and 52% practise traditional religion, which tends to emphasize links between

3440-530: The Merina dialect. Indians in Madagascar descend mostly from traders who arrived in the newly independent nation looking for better opportunities. The majority of them came from the west coast of India known as Karana (Muslim) and Banian (Hindu). The majority speak Hindi or Gujarati , although some other Indian languages are also spoken. Nowadays the younger generations speak at least three languages, including French, Gujarati and Malagasy. A large number of

3520-659: The US Centers for Disease Control and Prevention (CDC) issued a Travel Alert for polio in Africa; Madagascar is currently considered a high risk to travelers for circulating vaccine-derived polioviruses (cVDPV); vaccine-derived poliovirus (VDPV) is a strain of the weakened poliovirus that was initially included in oral polio vaccine (OPV) and that has changed over time and behaves more like the wild or naturally occurring virus; this means it can be spread more easily to people who are unvaccinated against polio and who come in contact with

3600-467: The age of 15 in 2010 was 43.1%, 53.8% was between 15 and 65 years of age, while 3.1% was 65 years or older. Population Estimates by Sex and Age Group (01.VII.2019) (Unrevised data. Data refer to projections based on the 1993 Population Census.): UN medium variant projections: Registration of vital events in Madagascar is not complete. The Population Department of the United Nations prepared

3680-670: The assistance of Kulanu, a nonprofit organization focusing on remote Jewish communities. In 2023, the country scored 3 out of 4 for religious freedom. Demographic statistics according to the World Population Review in 2022. The following demographic are from the CIA World Factbook unless otherwise indicated. The largest city in Madagascar is Antananarivo . The next largest cities are Toamasina , Antsirabe , Fianarantsoa , Mahajanga , Toliara , Antsiranana and Ambovombe . note: on 21 March 2022,

3760-620: The bathroom. In the elderly, common causes have been attributed to insufficient dietary fiber intake, inadequate fluid intake, decreased physical activity , side effects of medications, hypothyroidism , and obstruction by colorectal cancer . Evidence to support these factors however is poor. Secondary causes include side effects of medications such as opiates, endocrine and metabolic disorders such as hypothyroidism , and obstruction such as from colorectal cancer or ovarian cancer . Celiac disease and non-celiac gluten sensitivity may also present with constipation. Cystocele can develop as

3840-477: The best available judgment. This role has been weakened by several factors including his social status. Even worse, there is no significant improvement of household revenue in short term by setting up a marine reserve, it is hoped that the approach is likely to bring a much bigger impact on targeted fisheries in a mid and long term exploitation. From a biological point of view, a larger female octopus for example tends to lay many more eggs than young ones. By providing

3920-523: The bowel contents and are vital for normal defecation. Deficiencies in PS frequency, amplitude, and extent of propagation are all implicated in severe defecatory dysfunction (SDD). Mechanisms that can normalize these aberrant motor patterns may help rectify the problem. Recently the novel therapy of sacral nerve stimulation (SNS) has been utilized for the treatment of severe constipation. The Rome III Criteria for functional constipation must include two or more of

4000-520: The colon, irritable bowel syndrome , and pelvic floor disorders. Underlying associated diseases include hypothyroidism , diabetes , Parkinson's disease , celiac disease , non-celiac gluten sensitivity , vitamin B 12 deficiency , colon cancer , diverticulitis , and inflammatory bowel disease . Medications associated with constipation include opioids , certain antacids , calcium channel blockers , and anticholinergics . Of those taking opioids about 90% develop constipation. Constipation

4080-404: The current fishing practices have to change by keeping successful skills, removing destructive fishing practices and adopting new fishing technologies. The lack of a system allowing local users to have a shared assessment of the fishing conditions and to define a common vision is the main problem for Vezo traditional fishers. They are so good at tracking the changes in fish catches over time and have

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4160-450: The dead be promptly informed, for example if one intends to move to a temporary fishing location, if one is moving into a newly built house or is launching a new canoe, if one is having a difficult birth or if a newborn is brought out of the house for the first time, if one is about to sit a school exam, if difficult words have been spoken which make people's heart heavy with anger, if the visiting anthropologist arrives or leaves, and so on. It

4240-416: The delivery process especially if they have had a perineal tear or underwent an episiotomy . Risk factors that increase the risk of constipation in this population include: Hemorrhoids are common in pregnancy and also may get exacerbated when constipated. Anything that can cause pain with stooling (hemorrhoids, perineal tear, episiotomy) can lead to constipation because patients may withhold from having

4320-451: The early twentieth century, it has been reported that turtles play an important role to Malagasy fisheries. There has been a decline in numbers of the hawksbill turtle and the disappearance of nesting populations. The raiding of the turtle nests and hunting for the meat and carapaces are believed to be the fundamental causes of decline for four of the five species in the region. Ethnic groups of Madagascar Demographic features of

4400-486: The elderly is felt to be due to an increasing number of health problems as humans age and decreased physical activity. Since ancient times different societies have published medical opinions about how health care providers should respond to constipation in patients. In various times and places, doctors have made claims that constipation has all sorts of medical or social causes. Doctors in history have treated constipation in reasonable and unreasonable ways, including use of

4480-437: The eye". The cemeteries must be hidden in this way because the sight of tombs makes the people sad and unhappy. Cemeteries are not places the Vezo like to visit very often. One does not simply go for a stroll near the cemetery. The living only approach a cemetery when they bear a corpse or when they have to "work" for the dead, such as digging graves and building tombs. In western Madagascar, Sakalava and Vezo funerary sculpture

4560-454: The following and present for the past three months, with symptoms starting for at least 6 months prior to diagnosis. Constipation is usually easier to prevent than to treat. Following the relief of constipation, maintenance with adequate exercise, fluid intake, and high-fiber diet is recommended. A limited number of cases require urgent medical intervention or will result in severe consequences. The treatment of constipation should focus on

4640-460: The following estimates. Source: UN DESA , World Population Prospects, 2022 Total Fertility Rate (TFR) and Crude Birth Rate (CBR): Fertility data as of 2008-2009 (DHS Program): Source: UN World Population Prospects The island of Madagascar is predominantly populated by people broadly classified as belonging to the Malagasy ethno-linguistic group. This group is further subdivided

4720-604: The full, routine polio vaccine series receive a single, lifetime booster dose of polio vaccine 2020 figures (2021 est.) noun: Malagasy (singular and plural) adjective: Malagasy Malayo-Indonesian ( Merina and related Betsileo ), coastal ethnics (mixed African , Malayo - Indonesian , and Arab ancestry – Betsimisaraka , Tsimihety , Antaisaka , Sakalava ), French , Indian , Creole , Comorian , Chinese Malagasy (official, and national language), French (official). definition: age 15 and over can read and write (2018 est.) Constipation Constipation

4800-556: The living and the razana (ancestors); by 2020, only 4.5% of Malagasies exclusively practised folk religions and 85% were Christian (according to the Pew Research Center ). The Association of Religion Data Archives noted that in 2020, 58.1% of the population is Christian , 2.1% is Muslim and 39.2% practices traditional faiths, while 0.6% of the population is non-religious or adheres to other faiths. Madagascar's traditional religions tend to emphasize links between

4880-428: The living and the dead. They believe that the dead join their ancestors in the ranks of divinity and that ancestors are intensely concerned with the fate of their living descendants. This spiritual communion is celebrated by the Merina and Betsileo reburial practice of famadihana , or "turning over the dead". In this ritual, relatives' remains are removed from the family tomb, rewrapped in new silk shrouds, and returned to

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4960-738: The many children who do not own a blackboard are allowed to play in the burning heat outside. Family ties are extremely important among the Vezo and elders are greatly respected in the community. Families often provide for each other with younger members building boats for the elderly to use. Maintaining family ties is important to ensure that one is looked after in old age, or after an accident or ill health. Family relationships are particularly important to Vezo fishers because they determine access to marine resources and fishing gear. The Vezo have official cultural ceremonies called Fomba. These include Bilo, Tromba, Savatse, Takasy and Soro. All these ceremonies, except Takasy, are practiced (with some variations) by

5040-404: The national statistics office INSTAT under the supervision of the ministry of economy. The first census in 1975 counted 7.4 million Malagasy people , the second one in 1993 censused 12.3 million citizens and the 18h May to 10 June 2018 census numbered 25 674 186 inhabitants. [1] The problem with population estimation in Madagascar is that data is very old and limited. The last population census

5120-411: The neighbouring inland Masikoro people. The circumcision ceremony typically lasts from 4 am until 9 am. The parents ask a wise elder to suggest the best date and time for the ceremony, and identify a nurse or doctor who knows how to perform the circumcision. Family members are invited to attend the ceremony, and one of the uncles holds the child during the ceremony. After the physical cut, there

5200-443: The one village school building, where there are two designated teachers. However, due to the deterioration of public administration in Madagascar, the building and the teachers are hardly ever occupied. Whenever children are in the building, and if the teacher has not run out of chalk, the teaching largely consists in copying letters, numbers, and short sentences from the blackboard onto the child's own A5 size blackboard. Understandably,

5280-455: The politically and economically advantaged highlanders of the central plateaux and the people along the coast. For example, in the 1970s there was widespread opposition among coastal ethnics against the policy of "Malagasization" which intended to phase out the use of the French language in public life in favour of a more prominent position for the Malagasy language , whose orthography is based on

5360-649: The predominantly Catholic masses, considered to be underprivileged, and the predominantly Protestant Merina aristocrats, who tend to prevail in the civil service, business, and professions. Followers of Islam constitute approximately 3% of the population in 2022, according to the US Department of State; there are also small numbers of Hindus and Jews . The Church of Jesus Christ of Latter-day Saints had more than 13,000 members in 42 congregations in Madagascar in 2013. A small community started practicing Judaism in 2010, and formally converted in 2016 with

5440-753: The presence of constipation is identified based on a culmination of the symptoms described above, then the cause of constipation should be figured out. Separating non-life-threatening from serious causes may be partly based on symptoms. For example, colon cancer may be suspected if a person has a family history of colon cancer, fever, weight loss, and rectal bleeding. Other alarming signs and symptoms include family or personal history of inflammatory bowel disease, age of onset over 50, change in stool caliber, nausea, vomiting, and neurological symptoms like weakness, numbness and difficulty urinating. A physical examination should involve at least an abdominal exam and rectal exam. Abdominal exam may reveal an abdominal mass if there

5520-467: The rate of constipation is 50–75 percent. People in the United States spend more than US$ 250   million on medications for constipation a year. Constipation is a symptom, not a disease. Most commonly, constipation is thought of as infrequent bowel movements, usually fewer than 3 stools per week. However, people may have other complaints as well including: The Rome III Criteria are

5600-614: The reef flats for invertebrates including octopus and sea cucumbers. Fish sales, processing and trade supplement local income, as does tourism and local commerce. The Vezo traditionally traded with the neighboring agro-foresters, the Masikoro . The Vezo also trade with the Mikea , exchanging fish for honey and tubers . However, increased trade has changed the economy from barter to cash-based. Furthermore, growth in fish export from Madagascar has encouraged fish processing and export companies to

5680-417: The region, such as Murex and Copefrito (now operating in the southwest). Their purchases of marine products have increased fish demand and strengthened the cash economy. Besides gleaning from the reef flats, women are the ones who sell the catches that men bring them. With what they earn, women buy rice, the staple food, as well as other essential foodstuffs and a variety of luxury items. Children go to school in

5760-430: The small intestine bypasses the mass of impacted fecal matter in the colon . Constipation is the most common chronic gastrointestinal disorder in adults. Depending on the definition employed, it occurs in 2% to 20% of the population. It is more common in women, the elderly and children. Specifically constipation with no known cause affects females more often affected than males. The reasons it occurs more frequently in

5840-474: The stool is a common cause of constipation. The choice to withhold can be due to factors such as fear of pain, fear of public restrooms, or laziness. When a child holds in the stool a combination of encouragement, fluids , fiber , and laxatives may be useful to overcome the problem. Early intervention with withholding is important as this can lead to anal fissures . A number of diseases present at birth can result in constipation in children . They are as

5920-458: The stool or respiratory secretions, such as from a sneeze, of an “infected” person who received oral polio vaccine; the CDC recommends that before any international travel, anyone unvaccinated, incompletely vaccinated, or with an unknown polio vaccination status should complete the routine polio vaccine series; before travel to any high-risk destination, CDC recommends that adults who previously completed

6000-507: The symptom carries a significant financial impact upon the healthcare system. While it is difficult to assess an exact age at which constipation most commonly arises, children frequently experience constipation in conjunction with life-changes. Examples include: toilet training, starting or transferring to a new school, and changes in diet. Especially in infants, changes in formula or transitioning from breast milk to formula can cause constipation. The majority of constipation cases are not tied to

6080-459: The tomb following festive ceremonies in their honor. In the festivities, they eat, drink, and literally dance with the dead. After one or two days of celebrating, they shower the body with gifts and rebury it. Malagasy Christians are roughly 50% Catholic and 50% Protestant (mainly Reformed Protestant Church of Jesus Christ in Madagascar (FJKM) , Lutheran , and Anglican ) or Roman Catholic , but there are also smaller groups such as members of

6160-401: The underlying cause if known. The National Institute of Health and Care Excellence (NICE) break constipation in adults into two categories: chronic constipation of unknown cause, and constipation due to opiates. In chronic constipation of unknown cause, the main treatment involves the increased intake of water and fiber (either dietary or as supplements). The routine use of laxatives or enemas

6240-551: Was carried out in 1993, after an initial 1975 census. There was an attempt at a census in 2009, but this attempt ultimately failed due to political instability. Therefore, the demographic situation is inferred but reliability of any estimates from any source has a large margin of error. According to the 2022 revision of the World Population Prospects the total population was 28,915,653 in 2021, compared to only 4,084,000 in 1950. The proportion of children below

6320-596: Was probably uninhabited prior to Austronesian settlement in the early centuries AD. Austronesian (particularly Malay ) features are most predominant in the central highlands peoples, while coastal peoples are phenotypically more East African , sometimes with minor Arab, Somali, European and Indian admixtures. The largest coastal groups are the Betsimisaraka (1,500,000) and the Tsimihety and Sakalava (700,000 each). Malagasy society has long been polarized between

6400-609: Was when the person was alive. The Vezo speak a dialect of the Malagasy language , which is a branch of the Malayo-Polynesian language group derived from the Barito languages , spoken in southern Borneo . Off the coast of Madagascar, overfishing has become a major issue. The Vezo rely entirely on fishing, who for the past 2,000 years have been navigating the stretch of the Indian Ocean that separates Madagascar from

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