|Photo Credit: Owen Nyaka|
Viral Hepatitis is a global public health problem affecting millions of people every year, causing disability and death. Yet Malawi seems to be showing no sign of safeguarding its citizens from the devastating health consequences of this dreaded disease.
Sylvester Sandifolo, a patient of Hepatitis, was quoted in the local press saying that the government of Malawi has not lined up any activity for the World Hepatitis day this year, which is a clear indication that government lack’s seriousness in the fight against hepatitis.
Malawi is a signatory to the World Health Assembly resolution WHA63.18, which was adopted to call for a comprehensive approach towards the prevention and control of viral hepatitis.
Resolution WHA63.18 stipulates that WHO work closely with member states, including Malawi, amongst others, to mobilize support to strengthen surveillance system, prevention and control programmes, diagnostic and laboratory capacity, and management of viral hepatitis in developing countries in an equitable, efficient, and suitable manner.
When contacted on what should be done to internalize and implement the resolution in order for Malawi to attain the goals outlined in the framework, the Ministry of Health spokesperson, Henry Chimbali refused to comment.
Chimbali asked for more time but never responded to a questionnaire sent by me. Patients in Malawi have wished that the government-- through the Ministry of Health-- should consider coming up with programmes aimed at reducing diseases such as Hepatitis, Diabetes and others, as well as raising awareness about them in the general population in the country.
Macmillan Lingomanje, Senior Anaesthetist, who specialises in ICU care, Obstetric anaesthesia at Zomba General Hospital in Malawi’s old capital said in his personal capacity that the country should be concerned about HIV and Hepatitis co infections because they are all deadly viral infections.
Lingomanje, who is also Associate lecturer in anaesthesiology, National Quality Improvement Assessor and trainer, ART provider and mentor in care of the carers, further said that policies are available but not fully adhered to or complied by the authorities, hence people need to demand their rights at all costs.
“There is nothing which is cheap and easy to handle when we talk of patient care. Policies and medical procedures need to be adhered to when we want to protect and treat people holistically regardless of one’s status,” says Lingomanje.
Lingomanje, who is living with HIV, felt that there is need for countries like Malawi to treat them accordingly in order to save lives of people living with HIV and Hepatitis.
Dr. Gourdas Choudhury, Director and Head of Department of Gastroenterology and Hepatobiliary Science at Fortis Health, India says there is need to create a lot of awareness about the disease as most people are unaware of it. High risk individuals must go for diagnosis much before symptoms appear.
Secondly, Dr. Choudhury says there should be good hospital practices, more stringent testing for HCV (hepatitis C virus) in blood banks, use of disposable syringes/needles which are not reused, and very good management/control of intravenous drug use.
“Although most modern hospitals now use disposable syringes/needles, but reusable accessories are used for some invasive procedures, like cardiac angiography, or some procedures involving gastrointestinal tract, in order to reduce costs, and this poses a bit of risk for Hepatitis C,” says Dr. Choudhury adding as such sterilisation process for these accessories should be done meticulously and monitored closely. The recent vogue of tattooing is another proven risk factor for HCV.
According to one study, in Malawi intravenous drug use is virtually unknown and haemodialysis is not available. However, needles, syringes and surgical instruments are often sterilized without adequate quality control measures and could be a possible mode of transmission of HCV.
Another likely mode of transmission is through blood transfusion. The blood supply in Malawi is routinely screened for HIV, Syphilis and Hepatitis B, but not for Hepatitis C. With one daunting truth glaring right at our nose, Malawi is home to 50, 000 new HIV infections every year in a population of 13, 077, 160 million, according to 2010 UNGASS and Malawi Demographic Health survey.
World Hepatitis Day has since 2011 been celebrated annually on 28th July. The day provides a unique opportunity for communities all around the world to join together on one day to focus attention on the global health threat of hepatitis and promote actions to confront it.
The World Health Organization (WHO) and partners across the globe celebrated the day this year under the theme; ‘Hepatitis, think again’. Malawi should take the cue of rethinking about viral hepatitis.
Owen Nyaka, Citizen News Service - CNS
28 July 2014