Monthly Archives: July 2011

Diabetes Myths:- Liberia

Lucy Dollokieh, a mother of four from Liberia’s Nimba County, developed severe pains when urinating and thought she had been cursed by a witch, but when a volunteer came to her village describing diabetes symptoms she recognized them, went to a nearby hospital and was diagnosed with diabetes. She now injects herself daily with insulin.

With low awareness of the disease’s symptoms and only one hospital in the country that can diagnose it  – Ganta Methodist Hospital in Nimba County – the vast majority of the estimated 50,000 cases in Liberia go undiagnosed, according to the World Diabetes Foundation (WDF). Many sufferers who seek treatment do so when the disease is well developed and they are already losing their eyesight or limbs, staff at Ganta Methodist Hospital, where Lucy was diagnosed, told IRIN.

John Dowee, a diabetes victim, 45, told IRIN he had no idea he was suffering from diabetes until he was told by a doctor at the hospital. “I suffered a lot. Whenever I urinate I go through severe pain. It hurt me a lot, but I never knew I was infected.”

Many diabetes sufferers think they have been cursed by a witch, said Viktor Tayror, an administrator at the hospital. They visit witch doctors, offering them kola nuts to decipher the curse, he said. Many are instructed to sacrifice animals to get better. One patient recently treated at Ganta hospital went into a diabetes coma that she thought had been inflicted by witches.

Misdiagnosis in clinics compounded these beliefs, said Tayror. “If they come to a clinic they may get treatment for different things – for a UTI [urinary tract infection] or something else. So people don’t get better and they consider it to be a witch,” he told IRIN. “They don’t know what to do.”

Diabetes, which the UN World Health Organization says causes about 6 percent of deaths worldwide every year, is a chronic condition that occurs when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. (See WDF’s diabetes facts).

While infectious diseases are the biggest killers in the developing world, non-communicable diseases, including diabetes, will become the biggest killers in the next 25 years, according to the World Health Organization.

To raise awareness of diabetes, WDF-trained practitioners run regular radio shows on local radio stations on what they call the “sugar sickness”, said Nora Keah, a nurse and diabetes supervisor at the hospital.

Health staff keep the message simple: “We tell them,` this is what happens, and we can help you’,” added Tayror.

WDF also trains nurses and midwives at Ganta Hospital in proper diabetes care, including running regular screenings at the hospital and around the county to teach them how to manage the disease, including injecting themselves with insulin, and taking their own blood tests. Taking a train-the-trainers approach, practitioners teach community volunteers to encourage people to get tested.

All testing is free, but patients must pay for treatment: US$3 for a vial of insulin, to be injected daily, versus the $20 market rate. Most patients use one vial a day.

Some 200 people have been diagnosed and treated in the two months since the programme began, far higher than previous numbers, said nurse Keah.

While WDF covers training it does not finance staff salaries or drug supply, to try to encourage the project to be sustainable, according to Hanne Strandgaard, programme coordinator at WDF. The Ganta Hospital runs a revolving fund for drug purchase – “people have to get used to buying,” said Tayror – “but $3 per day is still a lot for many Liberians.” Some 83 percent of Liberians earn less than $1.25 a day according to the World Bank’s most recent statistics.

To move forward, the government needs to subsidize diabetes treatment – it currently gives the disease no support because it is low on the health agenda, said Strandgaard. All diabetes care is currently funded by two donors: the WDF and Insulin for Life though Ganta Hospital staff are trying to encourage the US Agency for International Development to come on board.

It is now up to the hospital to persuade the government to adopt the project’s model and to show that it is working, to try to elicit some longer-term funding, Strandgaard told IRIN.

Tayror said hospital staff plan to extend the project further into communities, even into schools, if they can secure more funding, which officially runs out at the end of the year.

While many patients were grateful to finally receive relief from their suffering, some are not optimistic they will be able to keep up treatment. “My condition is very critical,” said patient Zokeh Suah. “I would prefer to die and stop suffering from this disease. I sometimes wonder how my life will turn out.”

[Courtesy IRIN News]

Cholera, Measles Kill Hundreds:DRC

Outbreaks of measles and cholera in parts of the Democratic Republic of Congo have killed hundreds of people, with thousands more infected, says an official of the UN World Health Organization (WHO).
“Since September 2010, 115,484 measles cases and 1,145 related deaths have been reported in South Kivu, Katanga, Maniema, Kasaï Occidental, Equateur, Bas Congo and Kasaï Oriental provinces,” Tarik Jasarevic, a WHO media and advocacy officer, told IRIN.

According to Jasarevic, a lack of government funding halted follow-up mass immunization activities in the regions, leading to the measles outbreak.

Close to six million children were vaccinated in the most affected areas in April and May, but the epidemic spread to other provinces not covered in the immunization campaign.

Mass immunization campaigns are planned. At least 915,000 children in nine provinces are targeted for vaccination in the first two campaigns scheduled for July.

WHO and the UN Children’s Fund (UNICEF) are seeking an additional US$9 million to carry out these two campaigns in September and the first semester of 2012.

Measles is a highly contagious viral disease, preventable by immunization. It can cause complications such as blindness, encephalitis (inflammation of the brain), severe diarrhoea, ear infections and pneumonia.

Cholera 

Some 1,449 cholera cases and 74 deaths have also been recorded since March in Kisangani, Orientale, with the outbreak spreading along the Congo River to Bandundu and Equateur provinces and to Kinshasa, the capital, Jasarevic said. As of 8 July, 3,245 cholera cases had been reported with 192 deaths.

The International Federation of the Red Cross (IFRC) is supporting the DRC Red Cross in hygiene promotion activities in the affected provinces, according to a 13 July report by the UN Office for the Coordination of Humanitarian Affairs (OCHA).

The health ministry and partners are also setting up water chlorination points and providing free cholera treatment to contain the outbreak, said Jasarevic.

Cholera is an acute intestinal infection caused by the consumption of food or water contaminated with the bacterium Vibrio cholerae. Associated diarrhoea and vomiting can lead to severe dehydration and death without prompt treatment.

The DRC is also grappling with new cases of the wild polio virus, with a total of 62 cases recorded by 7 July, according to Victor Makwenge Kaput, the Minister of Public Health.

[Courtesy of IRIN]

‘One Billion People with Disabilities Worldwide’ – UN

 

More than one billion people worldwide experience some form of disability, the United Nations and the World Bank said in a report that calls for the elimination of barriers that often force the people with disabilities to “the margins of society.”

The World Report on Disability, developed by the World Health Organization (WHO) and the World Bank, with contributions from over 380 experts, urges governments to “to step up efforts to enable access to mainstream services and to invest in specialized programmes to unlock the vast potential of people with disabilities.”

“Disability is part of the human condition,” said WHO Director-General Margaret Chan at a ceremony in UN headquarters to launch the report. “Almost every one of us will be permanently or temporarily disabled at some point in life.”

“We must do more to break the barriers which segregate people with disabilities, in many cases forcing them to the margins of society,” Dr. Chan said.

Etienne Krug, a WHO disability specialist, suggested that the barriers themselves are a cause of disability.

“Disability results a lot from the barriers that society erects for people with disabilities,” he said, “barriers such as stigma and discrimination; such as lack of access to health services and rehabilitation services or problems of access to transportation and buildings and information services.”

Speaking to UN Radio, Dr. Krug called for the “mainstreaming of all services. That means to make everything accessible. Children with disabilities shouldn’t go to school to a segregated school, but rather be integrated in a normal school as much as possible.

“Employment should be accessible to people with disability so that they don’t have to live in poverty or from charity. Health services should be designed so that they also respond to the needs of people with disabilities. So basically all services should be accessible to people with disabilities.”

 

The famed British theoretical physicist Stephen Hawking, who suffers from amyotrophic lateral sclerosis (ALS), told the launch via video: “We have a moral duty to remove the barriers to participation for people with disabilities, and to invest sufficient funding and expertise to unlock their vast potential. It is my hope this century will mark a turning point for inclusion of people with disabilities in the lives of their societies.”

The barriers mentioned in the report include: stigma and discrimination; a lack of adequate health care and rehabilitation services; and inaccessible transport, buildings and information and communication technologies.

“As a result, people with disabilities experience poorer health, lower educational achievements, fewer economic opportunities and higher rates of poverty than people without disabilities,” WHO said.

The report recommended that governments and their development partners provide people with disabilities access to all mainstream services, invest in specific programmes and services for those people with disabilities who are in need, and adopt a national disability strategy and plan of action.

In addition, governments “should work to increase public awareness and understanding of disability, and support further research and training in the area. Importantly, people with disabilities should be consulted and involved in the design and implementation of these efforts.”

Nearly 150 countries and regional organizations have signed the Convention on the Rights of Persons with Disabilities (CRPD), and 100 have ratified it, committing them to removing barriers so that people with disabilities may participate fully in their societies, WHO said.

[Courtesy of UN News service]