And now, the spec­tre of dis­ease looms over EA

The East African - - OPINION -

The warn­ing by the World Health Or­gan­i­sa­tion that Tan­za­nia and Kenya are likely hotspots for the plague that has hit Mada­gas­car, cou­pled with the resur­gence of the Mar­burg virus in east­ern Uganda, should jolt the re­gion’s health sys­tems into im­me­di­ate ac­tion.

The plague, which his­tor­i­cally was re­spon­si­ble for high mor­tal­ity — in­clud­ing caus­ing more than 50 mil­lion deaths in Europe in the 14th cen­tury — is still a deadly dis­ease. In Mada­gas­car, more than 1,100 peo­ple have been in­fected, with 124 deaths re­ported since the dis­ease broke out.

For­tu­nately, an­tibi­otic treat­ment is ef­fec­tive against the plague bac­te­ria, and it is pos­si­ble to save lives with early di­ag­no­sis and early treat­ment.

The Mar­burg virus too is a highly fa­tal dis­ease, caused by a virus from the same fam­ily as the one that causes Ebola, which claimed thou­sands of lives in Liberia in 2014 and 2015.

At least five cases of the Mar­burg virus have been re­ported in Kween district in east­ern Uganda where an out­break was de­clared on Oc­to­ber 19.

For­tu­nately, Uganda’s Health Min­istry quickly ac­ti­vated its sys­tems to re­spond to the out­break. With sup­port from in­ter­na­tional part­ners, it moved to round up and place un­der ob­ser­va­tion peo­ple who have been in con­tact with those in­fected with the highly con­ta­gious dis­ease. It has also put health­care work­ers on high alert and pro­vided pro­tec­tive equip­ment and ini­ti­ated train­ing for health­care.

With the threat of the spread of the Mar­burg virus and the plague to East Africa, gov­ern­ments must be bet­ter pre­pared to not only pre­vent an out­break, but to also man­age any out­break in an ef­fec­tive way to pre­vent deaths. Screen­ing and sur­veil­lance must be en­hanced not only at air­ports and ma­jor bor­der posts, but also within com­mu­ni­ties. Well-trained med­i­cal and com­mu­nity health work­ers should be vig­i­lant within their com­mu­ni­ties to de­tect and present for quick di­ag­no­sis any pa­tients who ex­hibit symp­toms of the two dis­eases. The threat also calls for gov­ern­ments to work with their part­ners to stock­pile emer­gency drugs, in­clud­ing an­tibi­otics for the plague, so that any out­break is con­tained fast. The sit­u­a­tion also calls for in­creased in­vest­ment in pub­lic health ed­u­ca­tion. Cit­i­zens of the re­gion must be made aware of the risk, and how to pro­tect them­selves from in­fec­tion.

In Uganda, where there is a link be­tween peo­ple who vis­ited caves in­fected with bats and the dis­ease, there is a need for pub­lic aware­ness cam­paigns to warn res­i­dents to avoid this kind of con­tact. In ad­di­tion, tra­di­tional burial rites that cause con­tam­i­na­tion, both in the case the Mar­burg virus and the plague, should be dis­cour­aged.

Above all, the sit­u­a­tion calls for ef­fec­tive and ef­fi­cient health sys­tems. This can­not be said of some of the coun­tries in the re­gion where pro­longed labour dis­putes are threat­en­ing to roll back all the gains in pri­mary health care.

Thus, in Kenya, a pro­tracted strike by nurses has nearly crip­pled im­mu­ni­sa­tion ser­vices, ex­pos­ing chil­dren to pre­ventable child­hood dis­eases.

A health emer­gency would be cat­a­strophic.

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