It sounds unrealistic, but over the years, Trypanosomiasis, commonly known as sleeping sickness, has killed many Africans, Malawians inclusive. There are inadequate and in many instances no drugs at all in Malawi’s public hospitals to fight the disease. In this edition of FRIDAY SHAKER, Patience Lunda takes us to Nkhotakota, Ntchisi, Kasungu and Mzimba which are some of the hotspots of the disease.
On February 5 2018, Solister Nyasulu was drying tobacco in his live barns that he had constructed along Mwazisi Mountains when a tsetse fly stung. He ignored the ‘cool’ pain he had felt and continued with his work.
After a week, Nyasulu started experiencing joint and body pains and he was sweating profusely. He decided to go and seek medical attention at Mwazisi Health Centre at Rumphi.
He was tested for malaria after showing signs of the disease but he was sent home after being found negative and the hospital concluded that he might have just been experiencing sepsis.
Nyasulu continued experiencing the pains and went to the hospital again. The tests did not bring any change at all until Health Surveillance Assistants (HSAs) found that he had sleeping sickness when they were testing people in his village.
“I immediately started treatment. I should have started it earlier but still, I recovered a month later,” he recalls.
Nine months later, his 32-year-old elder brother, Fortune, got stung by a tsetse fly as he was working in his crop field one morning.
Unlike Nyasulu, Fortune asked hospital authorities to test him for sleeping sickness right away. He was diagnosed positive and was sent to Rumphi District Hospital some 50 kilometres (km) away from his village.
A health centre in his area could only test but not treat. At the district hospital, he was sufficiently treated and he recovered.
“I adhered to all the prescriptions and I finally got well,” Fortune says.
A month later, Nyasulu and Fortune’s elder brother, Mavuto, who is a farmer, also tested positive for sleeping sickness.
The three live within the same compound at Mugomba village in Mwazisi area which is under Traditional Authority (T/A) Chikulamayembe in Rumphi District.
In Malawi, sleeping sickness is recorded in the districts of Rumphi, Nkhotakota, Ntchisi, Kasungu and Mzimba with more males being affected by the disease than females.
This could be attributed to greater exposure to the parasite by men because of the nature of the activities which they engage in which include poaching, honey-gathering and encroachment into wildlife reserves to clear land for farming.
A laboratory technician at Rumphi District Hospital, Fredrick Juma, who also coordinates sleeping sickness response in the district, says his office has recorded many cases of the disease this year as compared to the same period last year.
He fears more cases might be recorded later in the year.
At least 57 cases were recorded in 2019 with two deaths and 41 cases have already been recorded this year with one death.
Juma revealed that Mzimba has emerged to be a hotspot as 65 percent of the cases have been recorded in the district while 35 percent have been recorded in Rumphi this far.
This has resulted into congestion at Rumphi District Hospital which is the only referral hospital for sleeping sickness in the Northern Region.
Juma further discloses that the hospital is currently conducting a research to come up with new medicine that can be used in health centres.
“The medicine we use currently can only be handled by trained personnel and once this research is successful, the new drug will be sent to health centres too so that they can also treat the disease,” Juma says.
The disease has not spared game rangers who work at Vwaza Marsh and Wildlife Reserve which is said to be a breeding ground for tsetse flies due to the presence of wild animals.
One of the rangers who opted for anonymity said they are not given personal protective wear and said they would be writing the government to voice their concerns on poor working conditions.
While admitting that a ranger and his son had recently suffered from sleeping sickness at Vwaza Marsh, Director of Parks and Wildlife, Brighton Kumchedwa, said tsetse flies are also wildlife animals and are not supposed to be terminated completely.
Kumchedwa added that his department used to supply medicine to the rangers but he is not aware if that is still happening.
“We received a report that a ranger and his son were admitted to Rumphi District Hospital because of sleeping sickness. The challenge is that tsetse flies are also wildlife and we can’t terminate them completely and that is why we only reduce their population by trapping some of them,” he said.
He further promised that he would follow up with his department’s Northern Region office to find out if they were still distributing the medicine.
Mwazisi Health Centre Senior HSA, Verson Chenje, said his office is doing massive testing in all villages surrounding the health centre with help from chiefs even though there is need for training of health workers to treat the disease in health centres.
Concurring with Chenje, Chief Principal Galang’anda from Rumphi District pleaded with the government to capacitate health centres to treat the disease “because many people in rural areas live in poverty and cannot afford to sustain themselves when referred to the district hospital”.
“Many people are held back because they cannot afford to sustain themselves when referred to the district hospital and even though we are trying our best to increase awareness, there is still need for more to be done about the disease,” he said.
On his part, Minister of Health Jappie Mhango said there is need for a multi-sectoral approach in handling the disease as it involves two ministries.
Mhango, however, admitted gaps in the health sector for prioritising emerging health issues but said his ministry is striving towards attaining Universal Health Coverage.
“We will talk with the Department of Parks about this issue because the disease is becoming a threat to many lives and at the same time we are doing our best to prioritise all neglected diseases,” he said.
Maziko Matemba, a health rights activist, said the health sector needs to pay attention to all diseases the way it is doing with the Covid-19 pandemic.
“We tend to look more at pandemics but seem to ignore other diseases that are also claiming lives. Just as more attention is placed on diseases like Covid-19, tuberculosis and HIV and Aids, we need to also check other diseases,” he said.
The most recent sleeping sickness prevalence estimates from the World Health Organisation are 50,000 to 70,000 cases based on a total number of 17,500 new cases reported per year in Africa.
Sleeping sickness is categorised as one of the neglected tropical disease although it is curable with medication, but can be fatal if left untreated.
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