Misconceptions impede Asthma responses

Diana Esther Wangari, CNS Correspondent, Kenya
Photo credit: CNS
(first published in The Star, Kenya)
Mwololo is a ten year old girl from the Turkana tribe, a Semitic community in Kenya. The little manyatta that serves as her home is inhabited by seven other children-her siblings and cousins. Temporary shelters, communal sharing of resources and caring for their herds is the way of life for this small nomadic group. With such fragile societal structures, the uniting factors remain to be their livestock and the healer.
The healer is believed to be a person chosen by the gods and he is supposed to cure all diseases and, more importantly, able to read the skies and lead the community to greener pastures (literally) that could sustain their livestock.

The morning after her tenth birthday, Mwololo woke up in a coughing fit and naturally the healer was called upon to recommend a concoction that would ‘heal’ the little girl. His methods seemed to work until a few days later when Mwololo woke up wheezing and could not complete a single sentence. The attack was short lived but when it became a regular pattern every morning, the healer was convinced that she was possessed by evil spirits, and so every morning when she had an attack, Mwololo was carried to the healer’s manyatta where he performed a ritual that seemed to relieve her symptoms.

It was during such a ritual that some doctors who were carrying out studies on Trachoma in nomadic communities found ‘the spirit of breathlessness’ being exorcised from Mwololo. They were able to recognize that she was having an asthmatic attack and were able to administer a bronchodilator. Mwololo was allergic to animal fur, a gift she had received for her tenth birthday to shelter her from the cold nights. Consequently, she would have an attack after spending a night under the fur and only got relief after spending time away from her manyatta, the same amount of time the healer perfomed his ritual in a different, fur-free shelter.

The community members had never heard of asthma, a chronic respiratory disease that affects 235 million people worldwide, and as such had no way of knowing that she was not possessed. Dr. C. J. Mureithi, chairman of Kenya Association for the prevention of Tuberculosis and lung diseases had this to say, “It is sad that the herbalists and unconventional therapists have captured this idea to propagate often misleading information to the public. But it is our role together with the Ministry of Health to set the standards and keep the public perception scientifically oriented.”

Mwololo is just an example of the many cases of asthma that go undiagnosed, especially in rural settings. However, not many children are fortunate as she was because they end up needing hospitalization, with disabilities or worse die before treatment. The greatest tragedy is that asthma is easily manageable with the right medication.

Agrees Dr Karen Bissell, Consultant at the International Union Against Tuberculosis and Lung Disease (The Union) that, “Many health services are finding it a challenge to introduce asthma management into the general health services. Many are still struggling to access quality-assured essential asthma medicines that are affordable for their populations. As a result, most cases of asthma, in low- and middle-income countries, where the majority of the world's asthmatics live, go undiagnosed, untreated or mismanaged. We need to increase the commitment of governments and donors to investing in asthma and accompany countries in their efforts to implement asthma management within primary health care and the general health services”.

The need of the hour is raising awareness about not just the risk factors and manageability of asthma, but also about informing people that asthma IS a respiratory disease and NOT a passing phase or a mere reaction to cold and most definitely NOT a sign of possession by evil spirits.

Diana Esther Wangari, CNS Correspondent, Kenya
13 May 2014
(first published in The Star, Kenya)