BY FRANCIS OKOYE
A few years ago, madam .N. (not real name), died of tuberculosis in Onitsha-Nigeria. A widow with several children and a trader at the food market in town. She was the sole bread winner of her family and was taking care of a daughter in a top flight high school in the town. Once she died, the children all dropped out of school, including the daughter in the top fight school.
This is one aspect of tuberculosis, which is now repeating itself all over Nigeria and in other parts of Africa, as the disease strikes, the children scatter and fall back into poverty.
Taking a trip to the General Hospital Onitsha – the State Government owned hospital where TB cases are often treated free, the wards are full and the cases are many – fueled by the HIV/AIDS epidemic.
One interesting thing about it all, is that often uneducated persons who contact TB, Claim that they have been poisoned, especially when they begin to vomit blood, and rather than go to the General Hospital, they choose to try all sorts of remedy like drinking crude oil, chewing mustard seed, going to Traditional Healers, and prayer ministries springing up everywhere to find solution to their problem.
Others who contact TB prefer to go the pharmacy and big drug markets to purchase TB drugs, because of the stigma attached to TB in most parts of Nigeria.
TB-killer Disease Ravaging Nigeria
TB has confounded attempts at control ever since the discovery of mycobacterium TB by Robert Koch 120yrs ago.
Today control is seriously hampered by drug resistance and co-infection with HIV which increase 10 fold the risk of developing TB.
20,000 people develop Tb and 5000 die daily. They are 8.8 million cases yearly and 1.7 million deaths yearly according to Global drug facility Achievement Report-4 million treatments in 4 years.
According to the global plan to stop Tb, 2006-2015, it is estimated between 2000-2020, 1 Billion people will be newly infected. 200 Million will get sick and 35 Million will die from TB, if control is not strengthened, reports the ACSM subgroup at country level, WHO and stop TB partnership 2006 publication: Advocacy, communication and social mobilization to fight TB-a 10years game work for action.
The case of Nigeria
In Nigeria, when one goes through pages of magazines and newspapers, it is no longer strange to see adverts placed by Native Healers, Claiming to cure TB, in fact every traditional Healer who advertises, has one or two drugs, which come with NAFDAC number (The National Food and drugs Administration Control Agency in Nigeria), that they say can cure TB, since no one knows whether these claims are true or false, no doubt, this contributes to the spreading of the TB and drug resistance when such victims finally arrive the Hospital.
Can herbal medicine cure TB? Even the Health minister and Authorities are silent on these and the Healers appear to take advantages of the great number of person suffering from TB to do quick business, charging as much as three times the minimum wage for their remedies.
Nigeria is ranked among the 22 high burden countries, accounting for 80% of all global TB cases. In 2001, 274,972 numbers of cases with incidence rate of 235 was recorded according to world TB day 2003 report.
Progress in TB control in Nigeria recorded treatment success in 2001 control 79% and Dots detection rate 2002 of 12%. Constraints to achieving targets include funding gap of at least US 4.6m dollars in 2003, insufficient number of health workers trained in DOTS and low staff motivation. Nigeria has 89 TB mortality per 100,000 population, which means that out of every 100,000 Nigerians, 89 die from TB, 27% of adults (15-49yrs) are TB cases with HIV, while 1.7% are new cases of multi drug resistant TB.
DOTS is largely delivered through NGO’s with public sector expansion of Dots aiming to strengthen the network of NGOs in Nigeria.Most of the partners supporting TB activities in Nigeria are initially leprosy NGO’s diversifying, so says WHO Report 2004, Global Tuberculosis control, surveillance, planning, financing-Nigeria, country profile.
HOPE FOR NIGERIA
When a cousin of mine contacted TB at the higher institution, everyone feared for him. Since TB in Nigeria is seen as a death sentence on the person who contacts it, so became his case.
He visited the mile 2 Hospital at Abakaliki for Dots treatment, it took him many months and finally he was given a clean bill-showing that TB is not a killer disease when Dots treatment is available free and the patient takes the drugs as and when due.
Nigeria has a long way to go. According to TB-WATCH in Onitsha, Nigeria, the Government needs to move very fast to curb the menace of native Healers and their wonder drugs, the prayer Houses and ministries who often tell those with TB that they have been poisoned and need healing and prayers done to battle the problem. In each instance – TB patients are extorted of huge amounts of money until they die.
Another area to look at, is the case of people living with HIV, compulsory test for TB should be carried out on them as soon as they test positive for HIV and every 3months another TB test conducted on them.
Nigeria is a rich country and should be able to access the Global drug facilities expertise in getting drugs for TB and in Dots expansion, to remove the nation from the high burden Nations. Money should be set aside for Dots expansion at all Teaching Hospital, in the Federation and all State General Hospitals, before it is too late or is it already too late.
Like my cousin who met TB face to face and survived, so too are many Nigerians surviving TB-it all shows that with Dots-we can have a world free of TB. Why should people refuse free treatment and die in the hands of quacks-only ignorance can cause this-so enlightenment is needed-As for Nigeria There is still hope as TB ravages the Nation.
Francis.O. Okoye is publisher of nigeriapoliticsmagazine.com