The Africanists

Insights. Comments. Thoughts. Analysis. Africa.

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health

A crisis is emerging in the fight against Aids

A crisis is emerging in Africa in the fight against HIV because of increasing resistance to the most commonly used antiretroviral(ARV) drugs. “The problem is very serious. In our hospital we see more and more patients who after several years of treatment develop resistance to the medicine against the HIV virus”, says internist Furaha Lyamuya. He works at the Kilimanjaro Christian Medical Centre (KCMC), a regional referral hospital in Moshi, a small Tanzanian town at the foot of the Kilimanjaro. “In the hospital we can only see the tip of the iceberg. In the countryside there is fear, because many patients have already died because of the failure of antiretroviral therapy.”

The experience with the failing antiretroviral therapy in KCMC is confirmed in a study conducted in 36 countries between 1998 and 2015. Based on that research, the medical journal The Lancet Infectious Diseases(May 2016 issue)  publishes an important article about increasing resistance to one of the most widely used antiretroviral, tenofovir.

Co-author of that article is the Dutch fellow infectious diseases Raph Hamers, affiliated with the Department of Global Health of the Academic Medical Centre in Amsterdam. He is stationed at KCMC for several months as part of his research on HIV therapy resistance in Africa. “Treatment fails in one out of five HIV patients in Africa, and in six out of ten of them it is because the virus has become resistant to tenofovir.”

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How a village in Sierra Leone fought effectively against Ebola long before the aid workers arrived

DSC01279

Devils dance madly among the rattling inhabitants of the village of Njala Giema in Sierra Leone. The spirits, who are masked and draped with colourful strings of beads, press their pelvises suggestively against the visitors to welcome them. These rainforests where the three borders of Sierra Leone, Liberia and Guinea meet, formed the epicentre of the Ebola epidemic which swept across West Africa from the end of 2013, killing 11,300 people.

The epidemic is still not completely under control. But residents of Njala Giema managed to bring the disease under control long before international aid workers dressed in moon suits took action.

What did the locals do right, what did the foreigners do wrong? How can Sierra Leone better defend itself against a possible future epidemic? With these questions in mind, researchers from the universities of Wageningen in the Netherlands and Njala in Sierra Leone travelled to Njala Giema. With financial support from the Dutch Ministry of Foreign Affairs they want to research and learn lessons of the indigenous response to the Ebola epidemic, because the international response fell so far short in what was needed.

The welcome ritual belongs the visible world. But who hide behind those devil masks? These are the invisible village leaders. The ancient secret societies in the rainforests of West Africa maintain a parallel power structure, an essential part of the daily management of a well-organized society. But invisible to anyone outside of the village.

DSC01286Devil dancer in Nyala Ngiema

This morning the spirit of an old village man departed this earth. Although everybody is aware of this nobody weeps because his death is not yet official. First, the chief Musa Kallon and members of the secret society will perform the proper rites, so that the deceased makes a peaceful transition to the afterlife. Without touching the body an Ebola test is taken. “That lesson we have learned,” said Musa Kallon. “Soon after the beginning of the outbreak, I told my people not to touch dead bodies and not to shake hands. We took those measures because there were no aid workers. “

DSC01397The play begins

Today in the community hall the villagers perform a play that will show how the epidemic struck Njala Giema. Tears appear in the eyes of the chief when weeping women throw themselves on a fictional Ebola corpse. Musa Kallon’s wife was one of the first victims. Spectators look sombre, the devil dancers do not move, the play has become real. The village has 500 inhabitants, 89 were in 2014 infected by Ebola, of whom 68 died.

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What West Africa can learn from earlier outbreaks of ebola in East Africa

The Ebola plague in West Africa is worrying. It is the largest and most extensive outbreak since the disease was first identified in 1976. That was in Congo and consequently outbreaks have occurred in DRC again in 1995 in 2003, and in Uganda and Sudan in 2000.

The total recorded deaths recorded in these outbreaks was – according to Wikipedia – 606. All these were in rural areas. Already in West Africa the outbreak has spread to towns and more than 1000 people have died. More than 2000 are infected and numbers are still rising

Three points are worth making.

First, if this disease had broken out in London, New York or Paris there would be a cure by now; I am sure someone will come up with a shocking comparison between what we spend on slimming drugs and what we spend on fatal diseases in Africa.

As it is we are faced with more images of dangerous, disease-ridden Africa unable to help itself.

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Africa can solve its own problems

“We are not immature, poor, backward people. We Africans have our own ideas about how to solve our own problems”, says Kenyan business woman Atia Yahya. The proof lays in her innovative ideas to create access to affordable healthcare for millions of her country folk. She sees fertile fields where others see dry savannas.

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