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The head of the World Health Organization (WHO) on Wednesday observed a minute of silence during a virtual press conference on COVID-19 to remember the nurses and health professionals who have been killed in their daily work.
"Yesterday was International Nurses Day...I was shocked and appalled to hear of the attack on an MSF hospital in Afghanistan, which led to the deaths of nurses, mothers and babies," WHO Director-General Tedros Adhanom Ghebreyesus told reporters.
"Civilians and health workers should never be a target, the weaponization of health is not helping anywhere," he said.
He urged all stakeholders to put aside politics and prioritize peace and a global ceasefire under the current global pandemic.
According to a government statement, dozens of people, including medical staff, were killed or wounded after two explosions and ensuing shooting rocked a maternity hospital in the western part of Afghanistan's capital Kabul on Tuesday.
The Chairman of Borno High Powered Taskforce on COVID-19, Alhaji Umar Kadafur, says the state’s taskforce is still waiting for results of the first suspected Coronavirus (COVID-19), case in the state.
Kadafur, who is also the state’s deputy governor, told newsmen on Sunday in Maiduguri, that speculation over the death of a nurse working with MSF in Pulka, Gwoza Local Government Area (LGA), should be regarded as mere speculation pending outcome of the test.
“His sample has been taken, and we are waiting for the result from the Nigeria Centre for Disease Control (NCDC).
“People, particularly the media, should be patient and stop preempting the result.
“We have a patient who has passed away, there is need to be patient as we await the result,” Kadafur said.
Also speaking, the Borno Commissioner of Health, Dr Salihu Kwaya-Bura, said the taskforce had put in place surveillance teams in all the 21 LGAs, monitoring communities for persons with possible symptoms; to take samples for investigation.
“We have also given out phone numbers for people to call us in case of any suspected case,” Kwaya-Bura said.
The commissioner lauded the support and cooperation of the public, and called for sustainability to effectively contain the pandemic.
Edited By: Angela Okisor/Nyisom Fiyigon Dore (NAN)
After more than a decade of armed conflict, outbreaks of severe malnutrition, malaria, measles and cholera, approximately 1.5 million internally displaced people in Nigeria's Borno state now face the spectre of COVID-19.
Many displaced people live in vastly overcrowded camps with poor water and sanitation facilities, limited supplies of hygiene essentials such as soap and water, and often no individual space at all.
Functioning health infrastructure in Borno is scarce, and the capacity to refer patients is extremely limited. With so many people already vulnerable to outbreaks of disease, essential humanitarian assistance must be maintained; water and sanitation facilities must be improved in camps for internally displaced people; and frontline health workers, on whom the population will depend, must have access to personal protective equipment.
Médecins Sans Frontières (MSF) has been working in Borno state since 2014, and during that time we have witnessed the deplorable living conditions of the internally displaced, many of whom already suffer from illnesses endemic to overcrowded settlements, such as water-borne diseases and respiratory tract infections like pneumonia, which has been identified as a significant threat when coupled with COVID-19.
Maintaining lifesaving operations
COVID-19 has had a devastating effect on healthcare systems, economies and populations worldwide and it poses a substantial threat in Borno. However, even if COVID-19 were not present in Nigeria, the need for humanitarian assistance in Borno would still be massive.
In just over a month, rainy season will commence, bringing with it a surge in cases of malaria and malnutrition. In Maiduguri, Ngala, Pulka and Gwoza, our hospitals run 24 hours a day, seven days a week, and during the rainy season they will all be full.
In 2019 alone, MSF teams treated more than 10,000 patients for malnutrition in Borno and more than 33,000 confirmed cases of malaria; over 40,000 patients were admitted to MSF’s emergency rooms.
The effect that COVID-19 will have on our patients must not be underestimated, but if the chaos caused by this pandemic is allowed to curtail humanitarian assistance, the results will be catastrophic.
We are extremely concerned about the spread of COVID-19 and the potentially disastrous impact it will have on the most vulnerable. As the virus spreads in Nigeria, our priority is to maintain our operations which save thousands of lives every year, and to protect our patients and staff.
To do this, our medical and logistical teams have reinforced infection prevention protocols, informed local communities on the best prevention measures against COVID-19, installed hand washing points in local communities, established isolation zones and adapted our triage processes.
At a time of unprecedented global demand for medical supplies, the procurement of personal protective equipment for healthcare staff poses a substantial challenge. However, it is a challenge we must face in order to protect frontline medical workers and continue treating our patients.
Clean water: a precious and limited resource
In Pulka, where MSF runs a comprehensive hospital with outreach activities, surgical capacity, maternity care, and treatment for sexual and gender-based violence, the situation is dire. Pulka is a garrison town; a population centre controlled by the Nigerian military.
It is now home to approximately 63,000 people, 78 per cent of whom have been displaced at least once since 2015. There are 27,000 people living in overcrowded camps for internally displaced people in Pulka, with limited access to basic services, including water, food and healthcare.
In both Pulka and Gwoza (a neighbouring garrison town), the transit camps for new arrivals are overcrowded; in Gwoza, the transit camp population is triple the recommended capacity; and in Pulka, communal shelters host people for months or even years when they are designed to be a temporary solution for just two weeks.
In a recent water and sanitation assessment, MSF found that the daily provision of water per person in Pulka was just 11 litres, far below the minimum humanitarian standard requirement of 20 litres required for health and hygiene. Of these 11 litres, only an average of two litres was chlorinated and safe to drink. Quantities as low as 4.5 litres per person have also been recorded in previous surveys.
In Maiduguri, the capital of Borno state, the water and sanitation is not much better. Between 1999 and 2011, MSF responded seven times to outbreaks of cholera in Maiduguri, and in 2018, more than 4,000 people were diagnosed with cholera in 18 local government areas in Borno, Adamawa and Yobe states.
“In all the settings for internally displace people where MSF has operations in Borno state, gaps in essential water and sanitation facilities exacerbate the threat posed by COVID-19,” says Siham Hajaj, MSF head of mission
“These gaps, combined with the levels of overcrowding, and endemic health issues with a lack of corresponding health infrastructure, underscore the vulnerability of the population. There is no doubt about the danger posed by COVID-19. However, one thing we know for sure is that other diseases and medical conditions will not relent. We cannot afford to let this pandemic disrupt other medical assistance – the continued provision of medical services at this time is essential and it will save lives.”
COVID-19 is not the only threat facing people in Borno state, but its presence in Nigeria highlights the extreme vulnerability of so many who have already endured the horrors of war, disease and malnutrition. For them, social distancing is an abstract luxury, and frequent hand washing diminishes a precious resource.
In the face of this pandemic, the ramifications of Borno’s fragile health infrastructure are clearer than ever. It is imperative that humanitarian assistance be maintained for this population. Failure to do so will cost lives.
The Afghan government says it has started a campaign on social media to raise public awareness to prevent the further spread of the novel coronavirus in the war-torn country with a fragile healthcare system.
In a new effort, a senior government official responsible for public awareness officially requested all government institutions on Wednesday to change the cover pages of their social media accounts to a standard logo that reads, “Let’s take the coronavirus seriously.”
The letter was shared via the official Twitter account of the country’s Defence Ministry on Wednesday but was removed immediately.
All government institutions are obliged to share the awareness messages released by the country’s Health Ministry and other relevant authorities.
From over 2,000 suspected cases, 196 people have tested positive, the Health Ministry said on Wednesday, with five deaths due to the virus, the number of new cases is rising day by day.
It feared that the actual number of cases is likely to be significantly higher since testing is currently very limited.
It said that several cities are in a three-week lockdown at the moment, including the capital Kabul and the western Herat province, which is considered the epicentre of the country’s outbreak.
The authorities have also urged people to pray at home and halt any type of gatherings.
Doctors without Borders (MSF), an international humanitarian medical organisation, says that clear, timely and honest communication is essential to control the outbreak.
Afghanistan is very vulnerable given that public medical facilities are often not equipped with enough staff and medical supplies, the organisation warned.
Edited By: Halima sheji/Felix Ajide
(NAN)
Ivory Coast has now registered 140 cases of COVID-19 (as of March 29 according to WHO) and recently entered the stage of local transmission. In response, the Ivorian authorities, like those in most neighboring countries, have quickly taken measures to restrict movement, according to the medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF), which has been supporting preparation measures in the country for over two weeks.
For several days, increased surveillance has been implemented in travel points and airports in the country. At a transit center in Abidjan, MSF supported the Ministry of Health by screening and referring people with symptoms compatible with COVID-19 to a care center. Over four days, an MSF doctor and two nurses examined more than 800 passengers from Europe, Asia, and the United States. The team also set up a hygiene system and informed passengers about the need for self-confinement and measures they should adopt at home in order to limit the risk of transmission to others.
MSF teams are also present in Bouaké, the country's second largest city, assessing the local capacity to manage cases of COVID-19. In Ivory Coast, as elsewhere, the limited availability of tests is a major obstacle to rapid response, but some suspected cases have been tested in the area in the past days.
"Bouaké is located on the northern road that connects to the border of Burkina Faso and Mali," said Abdoul-Aziz Mohamed, executive director for West and Central Africa for MSF in Abidjan. "With the current evolution of the situation in Burkina Faso, it is essential to ensure a presence there to be able to react quickly if a case is confirmed and quickly cut the chain of transmission. To do this, it is necessary to prepare for the management of cases, to ensure the protection of health personnel, but also, and above all, to invest in raising awareness among the population."
Training activities for health workers and screening at the different entry points of the city are already ongoing. Water and sanitation activities are also being implemented in Bouaké: Hand-washing points have been set up in six health centers as well as in the university hospital center. In the coming days, a hospitalization capacity of 10 beds will be established for the care of potential patients. An additional series of training sessions for health workers is also planned in Bouaké and Abidjan to train medical staff on preventive measures and case management.
MSF's priority has been to keep its current medical activities running, where possible, and to coordinate with local health authorities to offer support in prevention and case management in countries where it works. In some parts of West Africa, notably in Senegal and Burkina Faso, MSF is in discussion with health authorities and the WHO to support the response.
Mohamed warns that some of the prevention measures being taken in West Africa, such as restrictions on the movement of people and supplies, could have negative consequences on the health and humanitarian situation in areas already shaken by armed conflict and population displacement.
"While we understand that these measures are essential today to help stop the spread of coronavirus, in the long term they are likely to exacerbate the difficulties of access to health services for people who are already in vulnerable conditions," he said. "They will also reduce the capacity of health structures to respond to the already numerous killer diseases in the region, particularly due to the lack of pharmaceutical supplies, since more than half of the continent's supplies are imported."
More information about MSF's activities and the global coronavirus pandemic is available here.
A team of experts working for Doctors Without Borders have been in limbo in Iran since Sunday as politicians wrangle over whether to accept urgently-needed foreign aid to combat the coronavirus.
While President, Hassan Rouhani is quoted on his website as saying on Wednesday that “we will accept all help from abroad,’’ in the case of the team from Medecins Sans Frontieres, or Doctors Without Borders (MSF), the health ministry doesn’t appear to agree.
MSF had sent a team of nine experts to Isfahan in central Iran to set up a 50-bed hospital in the province, which has been particularly hard hit by the outbreak.
The mission had reportedly been approved by both the foreign and the interior ministry, as well as by the Iranian embassy in Paris.
“It’s true, the mission was coordinated with all relevant authorities beforehand,’’ said government spokesman Ali Rabiei, according to the news agency Fars.
But after the project began late last week, the Iranian health ministry suddenly announced that it did not need a foreign hospital and that Iran could set up its own facilities with the help of the army.
MSF was surprised by the sudden withdrawal of the approval, said Michel Olivier Lacharite, who heads the organisation’s emergency programmes.
Lacharite confirmed that the mission had been coordinated with the Iranian authorities over the last few weeks and had begun late last week as planned.
The team had been warmly welcomed by the local health authorities, he added.
IRNA, Iran’s state news agency, ran an editorial on Tuesday stating that the health ministry’s sudden rejection of urgently needed foreign aid was surprising, as the numbers of infections and deaths in the country continue to rise.
According to the most recent figures published by the health ministry on Wednesday, more than 27,000 people have coronavirus in Iran. Some 2,000 people have died.
The MSF team is now waiting for the government to make a decision.
The organisation said it would also be willing to set up the clinic in another part of the country. If the mission isn’t approved, however, MSF will send its team and equipment to a different country.
Iran has also rejected offers of aid by the U.S., saying it is unwilling to accept help from “its worst enemy’’.
However, Tehran has asked the U.S. to suspend its sanctions on Iran, at least while the country is fighting the epidemic, and has called on other countries, and the UN, to support this request.
Edited By: Halima Sheji/Emmanuel
(NAN) Yashim
In remote parts of countries like Democratic Republic of Congo (DRC), where patients often have to walk long distances to get to a hospital, many health centers struggle with a very basic issue—a lack of access to electricity. Doctors Without Borders/Médecins Sans Frontières (MSF) teams have been coping with this logistical challenge for decades, usually relying on diesel generators. But in DRC´s South Kivu province, MSF teams are finding a cheaper, more effective, and sustainable solution through solar power.
In Kigulube, South Kivu, where villages are scattered across the hills, people get around by motorcycle when they can. Otherwise, they have to walk, often for hours. People in Kigulube also suffer from the fighting between armed groups in the area, making movement from one place to another even more difficult.
“Kigulube hospital is in the heart of a jungle, surrounded by bad roads and paths full of stones,” says Miguel Balbastre, an energy specialist with MSF. “People have a hard time getting to any health care post.” In a case of emergencies, it can be very difficult for them to reach the nearest city with a fully equipped hospital.
“The key areas for saving lives in a hospital are the operating room and the intensive care unit, and these require a continuous and reliable power supply,” says MSF’s medical coordinator in DRC, Chiara Domenichini.
Although generators are the most common option when it comes to providing electrical energy in remote areas, they pose a lot of challenges—one is the enormous difficulty of transporting fuel to places that are not always accessible by Land Cruisers or trucks. Transporting diesel by motorcycle or by air is extremely costly and has many logistical difficulties.
Although solar energy has been around for decades, until now, existing power systems and batteries made it unviable in terms of price, capacity, and lifespan for uses such as powering a remote hospital in the hills of South Kivu. Batteries that could have been transported and maintained in such a challenging environment did not have enough storage capacity to guarantee the operation of complex biomedical equipment over long periods.
The availability of new technologies has changed this. “We are using the latest generation lithium batteries that have not even been commercialized on a large scale,” says Balbastre, who is part of the team providing Kigulube hospital with solar power.
Before installing a photovoltaic system in Kigulube hospital, MSF opened its first solar-powered hospital in South Kivu a year ago, in the Kusisa area in the mountainous Ziralo region.
The installation at each of the two hospitals consists of 100 solar panels and seven batteries capable of accumulating the necessary energy to run the facilities for two full days. Each of these storage units has a lifespan of at least five years, although it may be two or three times longer. This type of assembly also includes a unit capable of controlling both the charge and the release of energy from each of the batteries, which greatly extends their lifespan. In addition, this control unit is able to detect anomalies and can be operated remotely with an internet connection, so technicians can monitor the system from anywhere in the world. Everything is designed to guarantee a continuous and autonomous energy supply, but in the unlikely event of failure, there is a back-up diesel generator ready to take over and maintain the hospital's power supply at all times.
“This solar-powered facility makes a big difference to the treatment we can offer patients in Kigulube hospital,” says Dr. Pacifique Kapimbu, director of the hospital. “Before, we sometimes had to operate in the dark because there was no lighting anywhere in the center. Now, all the rooms will have electricity to ensure adequate medical treatment for patients.”
MSF teams transported all of this equipment from Europe to a remote corner of Africa on a journey that sounds like an adventure story. “The panels traveled by boat along the Suez Canal to Tanzania, where they were unloaded at the port of Dar es Salaam,” says Balbastre. “From there, they crossed Tanzania and Rwanda by truck until they reached the border town of Goma, in DRC. They crossed Lake Kivu, again by boat, to the city of Bukavu, the capital of South Kivu province. And from there, they went by helicopter to the Mulungu area. And finally, around 50 porters carried them to the hospital.”
The transport and installation of such a system requires a large initial investment. However, taking into account the enormous savings in fuel and in not having to transport fuel by motorcycle or helicopter, the investment is expected to be recouped in just two or three years. After that, the annual cost of running the system is 95 percent less than it would be with generators. Even when MSF may need to redirect its resources to other emergencies, the tens of thousands of inhabitants of Kusisa and Kigulube can continue to have functioning solar-powered hospitals. As the medical coordinator explains, “When MSF is gone, they will not need extra money and will not have the usual difficulties of getting the generators to work…. We will ensure that all the equipment we leave can continue to function and do the work that is needed.”
The Chief of Army Staff, Lt.-Gen. Tukur Buratai, has called on humanitarian organisations operating in the Northeast to operate with understanding of the prevailing security dilemma in the zone.
Buratai made the call when the International President of Medicins San Frontier (MSF), Dr Christos Christuo, led his team on courtesy visit to Army Headquarters on Friday.
The Chief of Policy and Plans, Nigerian Army, Lt.-Gen. Lamidi Adeosun, received the delegation on behalf of the Chief of Army Staff.
He commended the contributions of MSF, also known as Doctors Without Borders, towards alleviating the medical suffering of the victims of insurgency in the North Eastern part of Nigeria.
Buratai said that while the government and the armed forces recognised the effort of MSF, it must understand the conflict of interest and security dilemma that are prevalent in conflict zones.
He said that in as much as international humanitarian organisations were meant to observe neutrality and impartiality in conflict situations, the security forces must be allowed to play their roles.
According to him, we also know that in spite of your neutrality and impartiality, situations sometimes make it difficult for you to have the reach you would like to have neutrally without the security.
He explained that such neutrality could be practicable if the conflict happens to be an interstate one, adding that war against terrorism might not respect that.
“To the terrorists, everything is a target, they don’t know what it is to even attack you as a group that is concerned and responsible for their well-being because they are not trained in that manner.
“They are only trained to kill for killing sake and for what they believe which does not advance the cause of humanity in any way.
“So, we still have to define a way of handling this security dilemma especially in far remote areas which you also would want to reach without any form of security.
“Don’t forget, if anything happens to you, it is the same security people that must not be seen around you that would take the blame, they would still be the same people that would be tasked to rescue you wherever you are.
“Even the negotiators cannot go to anywhere if security is not provided for them.
“On this note, I want to say that we must continue to operate with understanding so that while you are providing succour for the people, you also don’t come into harms way that may eventually jeopardise what you have sworn to do.
“If any of you is kidnapped, it will rubbish all the work that you have been doing. It will even escalate the conflict the more and it will also put undue pressure on the government of the state where you are operating.
“So, I want to crave your indulgence and understanding on this issue so that those in the field operate with understanding with those who are actually in charge of security in the respective areas where you are operating,” he said.
Earlier, Christou disclosed that the organisation was aimed at alleviating the medical suffering of people in conflict zones.
Christuo said that their services were based on their medical ethics of impartiality which means treating everyone no matter what irrespective of religion, race or regions they come from.
He disclosed that the organisation had its footprint in Nigeria since 1996, adding that it currently operate five hospitals in the North East where the country is battling with insurgency.
Christuo said that the visit was to interact with Nigerian army and find ways to do more by reaching more victims in need of medical assistance in the conflict zone.
“We want to continue to engage and work together with army to improve our response and to facilitate our effort where ever possible. Our team are ready to do more with the provision of the needed security.
“When I met my team in Pulka, they did not ask me about their personal security but the only question they asked me is how can we do more. How can we lift more people, we can see them coming, but what about those that cannot reach us.
“That is why we are here to see how we can do more. I’m not here to talk. I am here to listen and share ideas on how to do more for those who need us,” he said.
Edited By: Ismail Abdulaziz
The Water, Sanitation and Hygiene (WASH) in Emergency Working Group, has expressed concern over refusal of some landlords to provide land for sanitation facilities and water schemes at IDPs camps in Borno.
The UNICEF WASH Sector Coordinator for the North East, Mr Bob Bongomin, expressed the concern at a meeting on Friday in Abuja.
Bongoomin also noted that some community leaders and water operators were resisting initiatives to upgrade existing water schemes.
Giving an update on humanitarian situation in Borno at the first WASH Sector meeting, Bongomin said the challenge had impacted on construction of physically segregated WASH facilities.
According to him, some areas like Pulka are already experiencing water stress and chronic infrastructure breakdown.
He said for instance, some landlords had halted the drilling of borehole, saying that this may be due to fear of losing their livelihoods and spheres of control.
The coordinator said that although some humanitarian actors had carried out advocacy to the state government on the issue, not much progress had been made.
He called for renewed commitment from all stakeholders to meet the needs of no fewer than 2,393 displaced people.
“Currently, some areas have had chronic infrastructure breakdown; population is overflowing and these facilities are overstretched.
“Our access and intervention is for all and we do not segregate between the host and IDP communities, with the principle of ‘Do No Harm.’
“There is the need for all sector partners to do more, current latrine ratio is 1 toilet to 50 persons, no space and privacy, dignity is lost and there is an increase in gender-based violence owing to lack of toilets.”
In Adamawa, Bongomin said there were currently 196,888 IDPs, with 182,329 and 14,559 living in host and IDPs camps respectively.
He said 851 cholera cases were recorded with four deaths in 2019 in the state, adding that nine Local Government Areas (LGAs) were cholera-prone.
“They are Maiha, Mubi North, Mubi South, Hong, Song, Girei, Fufore, Yola North and Yola South,’’ Bongoomin said.
He said there was low access to safe drinking water, inadequate sanitation facilities and poor hygiene practices, noting that continued flooding was a worrisome trend and possible cause.
He added that the issue of effective sludge management was of great importance and called for a proper designated landfill to dump solid waste.
Mr Kennedy Tembo, Medecins sans Frontieres (MSF Spain), expressed concerns over increase in water-borne diseases in hospitals in Pulka, noting that the assessment shown that e.coli was present in their water.
Tembo called for more commitment from sector players to support those communities, adding that underground water was non-existent.
Nigeria News Agency reports that the WASH in Emergency Working Group was established in 2012, when the country experienced serious devastating flood that affected 85 million people from 14 states.
The group has since remained active, especially in the North-East, where IDPs exist and have responded immediately to outbreaks.
Membership of WASH sector players cut across institutions, Development Partners, International and Local NGOs, CSOs responding to WASH issues in the North East, with UNICEF as co-lead.
Edited By: Johnson Eyiangho/Ismail Abdulaziz
One of the world's most common neurological diseases, epilepsy affects nearly 50 million people, but in low-income countries more than 75 percent of people with epilepsy do not have access to treatment, according to World Health Organization figures. In Liberia, Doctors Without Borders/Médecins Sans Frontières (MSF) works in collaboration with five local health facilities to treat more than 1,300 epilepsy patients. Ahead of International Epilepsy Day, February 10, Emmanuel Ballah, an MSF mental health and epilepsy supervisor in Monrovia, Liberia, describes the challenges that people face with epilepsy and how MSF is working with families, communities and health facilities to treat these patients:
What are the experiences of people with epilepsy that you see through the course of your work?
Many of the patients that we see have serious problems from neglect and stigma, because people mistakenly believe that epilepsy is a contagious disease. This is especially true for patients who have convulsions throughout the day. Because of the continuous seizures, they are not able to do anything for themselves, they lack self-care, and family members fear them.
For example, a patient has been abandoned by his relatives, is injured because of falling, and no one cares for him because they are afraid of catching his condition. This is something that we continually work on in explaining epilepsy to a person's family and community members.
In late January we had a community awareness event in the West Point township of Monrovia, with more than 50 community leaders, imams, pastors and school principals. Our health volunteers put on a drama to talk about what happens when someone has a seizure and other people are not willing to help them, because they are afraid.
People shared some myths that explain why they are afraid of epilepsy. One person in the community said when a patient has a seizure, their saliva is like a virus. So these are the beliefs people have about epilepsy, which is why people so often keep away from them.
But people appreciate when we have a good discussion in a community, because they are able to understand how people develop epilepsy and how it is not passed from person to person. They learn how is it treated, and how they can encourage people with epilepsy to seek treatment.
How do you treat epilepsy in Liberia?
As MSF we work with the local health workers in five health facilities in Montserrado County, including in West Point and several other areas of Monrovia. We provide the training, medications and clinical supervision for these health workers to treat patients with epilepsy, as well as patients with mental health disorders. We also work with teams of psychosocial workers and government community health volunteers to explain epilepsy to a patient's family and community, advocate for their inclusion in school and other normal activities, and help people understand that people with epilepsy are not a danger to other people.
The program started in 2017 and is still growing. We now have more than 1,300 patients receiving care for epilepsy on a regular basis, and most report that their condition and their quality of life have significantly improved.
What medications are used?
In Liberia, health workers often think that when you are epileptic, you can be treated with phenobarbital. However, not everyone is treated successfully with phenobarbital, and there are three other medications that may be used, depending on a patient's condition: phenytoin, sodium valproate and carbamazepine. The problem is that these medications often cannot be found in other health facilities in Liberia.
For example, we have a patient who has to travel from miles away in central Liberia each month to come to our clinic, because they cannot find the carbamazepine that they need. The money they use on transportation to come to us, they could have used to buy the medication, but they cannot find it in their community. That's why even though our idea was initially just to treat patients from Montserrado County, we are seeing people come from almost everywhere in Liberia.
People also go to traditional healers, because of nonmedical explanations of the symptoms they see, such as demon possession. They may take herbs or powders, which are not effective and which may be harmful. When people start to take medication from a clinic in our program, they start to get better, and they realize this is better than traditional healing methods.
How does treatment affect patients' lives?
People are so appreciative because we evaluate them, give them the right treatment, and now they are seizure-free. We just had one patient who graduated from the University of Liberia who was taking treatment from other places, buying medication from the drug stores, and he kept having seizures. But after we started to treat him, he is seizure-free for two years.
We recently had four children who were expelled from different schools because of the stigma of epilepsy, and we worked with their families and their schools to readmit them. Once they are on treatment, they can go to school.
We had a new patient yesterday who is about 18 years old who has been having seizures five or six times a day, every day, for years. They have been giving him herbs and other things which do not work. You can see that his social and intellectual development is stunted because he is excluded from everything, but now we are putting him on treatment.
This is the most rewarding part of the work that I do. I see that I have a result, that our patients can become functional, and their lives are restored.
This update can be found online here.
