A young woman lies in intensive care at Liberia’s Phebe Hospital.

Her mother comes running in with the drugs she needs, but the doctor shakes his head. It is too late.

“When patients come, we are obliged to send (family members) out to get drugs. Sometimes by the time they get back (the) patients are dead,” laments Dr Jefferson Sibley, the hospital’s medical director.

“People are dying in front of our eyes, and we cannot do anything.”

Battered by years of civil war and then in 2014-16 by the worst Ebola epidemic in history, Liberia’s health sector is on its knees.

The crumbling infrastructure lacks almost everything — medicine, beds, equipment, ambulances, even a reliable electricity supply.

Phebe, in central Bong county, is the second largest hospital in Liberia, with 200 beds and seven doctors on its staff.

Despite chronic shortages, it still manages to treat at least 2,500 patients every month.

“We are supposed to get supplies from the ministry of health and the National Drug Services (NDS) but we haven’t received supplies for almost a year,” Sibley told AFP.

“We can’t do anything about it.”

Malaria was the cause of death of the woman in the intensive care unit.

She was 25.

– ‘Only the mercy of God’ –

According to the World Health Organization, total health expenditure per person per year is about $100 (87 euros) in Liberia, among the lowest in the world.

There is fewer than one regional or district hospital per 100,000 people in the country of about 4.7 million.

In 2010, accordiong to the latest available data, there were eight hospital beds per 10,000 people.

In Jenepeleta, a village 30 kilometres (19 miles) from the hospital in Phebe, Regina Kollie, 45, is trying to lower the fever of the youngest of her five children, a four-year-old girl.

Like many in the region, Regina sought help in traditional medicine and gathered leaves with which to wash her daughter, following the advice of a healer.

The treatment is not working and the child’s fever has raged for days. But going to the hospital is not an option.

“I don’t have the money to take my daughter to Phebe. The ambulance used to help us in these cases, but we don’t see it any more,” Regina says, weeping.

“The two ambulances we had are broken down,” Sibley confirmed, noting the vehicles had been “instrumental when it comes to saving lives”.

The ambulances “used to go for pregnant women, children and other people who are seriously ill in the villages… and bring them to us,” he said.

But now if there is an emergency case, “only the mercy of God can help.”

– Surgery by storm lantern –

“We have so many problems, but the key problem is that no funding is coming to the hospital,” said Sibley.

“We find ourselves indebted to vendors. People we take fuel from, people we take drugs from, all of them refuse to supply us because we owe them lots of money. The hospital owes $300,000 (265,000 euros) to vendors.”

The hospital’s electricity is frequently cut off, plunging it into darkness at night and forcing the lone surgeon to carry out operations by the light of storm lanterns.

A shortage of medicines is also crippling Liberia’s largest national health facility, the John F. Kennedy Hospital in Monrovia, says its medical director Jerry Brown.

“There are some drugs you can’t find in local pharmacies and government regulations prohibit us from procuring drugs currently from pharmaceutical companies outside the country,” the chief doctor told AFP.

“Our next source of drugs is the National Drug Services,” but it provides only enough to treat the most vulnerable, including children.

The hospital was negotiating with the ministries of health and finance for authorisation to buy directly from manufacturers, Brown said.

Health Minister Wilhelmina Jallah said the problem stemmed from the previous government, under which hospitals ran up big debts by obtaining drugs and fuel on credit.

“We have inherited all these debts, and the vendors no longer want to give us credits,” she said. “We have to pay some of these debts so that we can open the credit lines.”

In a sign of progress, eight container-loads of drugs had arrived, and these will help to ease shortages, she said.

AFP

After a prison sentence for crimes he committed while stoned, Eric Ndem, a drug user in Cameroon’s economic capital Douala, said he wanted to end such a way of life.

Ndem, 38, a homeless person, is among many drug users in Douala, which is believed to be a center of illegal narcotics activities.

According to estimates by Cameroon’s national anti-drug committee (CNLD) in 2018, 21 percent of the country’s population have already tried hard drugs.

In many ways, the Cameroonian government is coming to Ndem’s rescue by putting in place various programs and structures to check the abuse of illicit drugs.

Owona Noah, an addictionologist and public health expert, works in a government-sponsored drug prevention center named “La vie” (meaning “life” in French) in the capital Yaounde.

His job is to change the behavior of drug addicts and help them reintegrate into the society as “responsible people.”

“We receive a patient who is suffering from a psychological or psychiatric problem (because of drug consumption)… But once the patient goes back to his community, home, or job side, he is likely to start facing the same stressful situations that caused the psychological trauma again,” Owona said.

“That’s where we intervene to facilitate the socio-professional integration of the patient so that he can participate again in the development of his community,” he added.

According to Cameroon’s Ministry of Public Health, such centers have been created in all the 10 regions of the country since 2015.

“In five or 10 years if things continue to evolve in the right way, we will have very few mental disorder patients caused by drugs in the community,” Owona said.

According to him, about 60 patients have visited his center in April and May, and “a good number” of drug addicts have already stopped abusing drugs after consultation.

As part of the measures to battle against drug abuse and trafficking, the Cameroonian government has also established a health care control brigade in the Ministry of Public Health.

“We conduct sensitization campaigns against drug abuse not only in colleges but also universities. We work in collaboration with forces of law and order,” said Joseph Ekoum, who heads the brigade in the Littoral region with Douala as its regional capital.

“We also act as what we called health police. This means that we have control posts at the various entries of the city frontiers. We have two control posts, at the airport and seaport. These are two places where the illicit products can easily enter,” he added.

Ekoum is proud that such tactics and collaboration with government forces has produced “outstanding” results.

From 2010 to 2014, this collaboration has led to the seizure of 320 kg of cocaine and 30 kg of heroine, according to figures from the Ministry of Public Health. Recent statistics are unavailable.

The local civil society is also working closely with the government to enhance anti-drug sensitization campaign among the youth, primary victim of narcotics, according to CNLD’s finding.

Dadjio Emilienne teaches philosophy in a high school in Yaounde. At the same time, she is a member of a local non-governmental organization (NGO) whose mission is to educate young Cameroonians about the harmful effects of drugs.

“As we now know that drug abuse is causing havoc in school milieu, we think it is important to meet young people and tell them about the consequences of consuming drugs,” Dadjio said.

During the field campaigns, Dadjio urged young people to never start the drug, “because it is a road of no return.”

Source: Xinhuanet

A four-year-old boy with a history of stomach pain, vomiting and abdominal distension eventually landed on the operating table where surgeons manually removed dozens of “writhing” worms that had been living in his intestines.

The boy, who was not named in the case report but was said to live in Cameroon, West Africa, had no history of deworming since birth, which is typically a common practice in that region, Fox News reports.

The youngster’s mum had taken him to hospital after three days of stomach pain, vomiting and severe constipation.

He had also experienced bloating for around six months, according to an article published in the Journal of Medical Case Reports. After being admitted, doctors carried out a number of tests and diagnosed the boy with ascariasis — a parasitic worm infection in the small intestine.

Doctors manually removed dozens of worms living in the stomach of a four-year-old.

“Ascariasis is the leading helminthic infection worldwide, with its peak prevalence noticed in children aged 2-10 years,” the authors wrote in the shocking article, which was published on May 24. “Although mainly asymptomatic, chronic and heavy infestation could lead to severe complications such as malnutrition, poor physical and cognitive development as well as intestinal obstruction.”

Upon examination, the boy’s doctors recognised a small bowel obstruction, which prompted them to make a 2cm cut. Surgeons then removed “bundles of ascaris lumbricoides worms” manually and “by milking through the stoma”.

The boy was given nutrients to rehydrate him and administered with paracetamol intravenously before doctors could operate.

Three days after being admitted, surgeons discovered his bowels were blocked by a “mass of writhing worms”.

An estimated 807 million to 1.2 billion people in the world are infected with ascaris lumbricoides — parasitic worms known as soil-transmitted helminths, according to the Centers for Disease Control and Prevention (CDC). The parasites live in the intestine, and eggs are passed in the faeces of infected people. If an infected person defecates outside, or if the faeces of an infected person are used in fertiliser, eggs are deposited on the soil. The eggs can then mature into a form of the parasite that is infective.

The shocking find was recorded recently in the Journal of Medical Case Reports.

Infection can occur when hands or fingers that have contaminated dirt on them are put in the mouth or by consuming vegetables or fruits that have not been carefully cooked, washed or peeled, according to the CDC. Heavy infections cause intestinal blockage and may impair growth in children. Other symptoms may present as a cough due to the migration of the worms through the body. It can be treated with medication, but in the boy’s case, surgeons decided to operate.

After the surgery, doctors dewormed the boy and his family members with an oral dose of mebendazole, and he was released after seven days. One week later, surgeons recorded his wounds had healed.

The authors noted that the boy’s case points to a larger public health issue in Cameroon, where deworming programs are affected by lack of funding and access in high-risk areas.

Source: News.Com

Cameroon has declared a public emergency after reporting a polio case in its far north, four years after the virus disappeared from the country, the health ministry said on Thursday.

The confirmed case of polio type 2 was found in the Mada area in the remote north bordering Chad and Nigeria, the ministry said in a statement.

It declared a “new polio epidemic following the confirmation of a case of poliovirus type 2 detected in samples.”

A source at the ministry said the outbreak may have been caused in part by a refusal of vaccinations and the cross-border movement of people in the area.

Polio is a highly infectious viral disease which mainly affects young children and can result in permanent paralysis. There is no cure and it can only be prevented through immunisation.

International polio vaccination efforts have run into problems in Pakistan and Afghanistan. Militants and religious leaders in rural areas often tell locals immunisation is part of a shadowy conspiracy to weaken their faith.

Source: AFP

For Professor Torimiro, her research journey started years ago in the rainforests of Cameroon where she observed how hunter-gatherers live in close proximity to animals. At the time, she was among the first Cameroonian scientists to study zoonoses — disease or infections that are transmissible from animals to humans.

After years of study and postdoctoral research in clinical biochemistry and applied molecular biology in Nigeria, the United Kingdom and the United States of America, she returned to her country Cameroon, to support the national health system, teach and train health workers, and research infectious diseases that pose a risk to women and children.

From an assistant researcher to senior scientist

Since her return home in the 1990s, Professor Torimiro has helped create four health research institutions in Cameroon.

As Chair of the Department of Biochemistry at the University of Yaoundé I, she is a key figure in building academic capacities in molecular biology in her country and shaping Cameroon’s next generation of scientists. The research carried out by her students cuts across the use of molecular techniques to identify disease-associated genes to AIDS, hepatitis B, cancer, diabetes, fibroids and cardiovascular diseases. 

“Research output drives health policy and therefore patient management and care. In other words, responsible conduct in research yields reliable and accurate data that could be used for policy change,” she explains.

Professor Torimiro says that Cameroonian scientists are increasingly able to conduct research to international standards, thanks to better access to tools, facilities and training.

“Since I returned to Cameroon in 2005, I have done all my laboratory work in Cameroon without having to take a single specimen to Europe or the USA. This is a giant step in terms of capacity-building and retaining talents in Africa.”

Research that responds to health challenges

Professor Torimiro is driven by an interest in operational research because “research output, especially in low- and middle-income countries, is only useful and meaningful if it responds to the health challenges of the population,” she says.

While HIV diagnosis is routinely performed in health facilities in her country, early diagnosis and quality control remain a challenge. That is why she supports system-wide improvements. 

She is proud to have participated in a multi-disciplinary research group dealing with early infant diagnosis of HIV infection of children born to HIV-positive mothers and was instrumental to the creation of the national programme on this work, a key component of the National AIDS Treatment Programme. She later built capacities among health workers through international seminars on good clinical laboratory practice in the management of HIV/AIDS and co-infection of AIDS and hepatitis B patients.

“I wanted to transfer technical know-how, skills and competencies in research to gather evidence from populations in Cameroon that would make policy change possible in the diagnosis and treatment of HIV/AIDS.” 

Professor Torimiro also leads a group of physicians, biologists, public health experts, career scientists and policymakers (including from Cameroon, Zimbabwe and the United Kingdom) to research hepatitis B in pregnant and breastfeeding women and its impact on mother and child health. The aim is to improve cost-effective early diagnosis of hepatitis B infection among infants born to hepatitis B-infected mothers.

Women supporting women

Ever since her very first grant back in 1994, Professor Torimiro has dedicated herself to addressing the problems of AIDS, cancers and hepatitis among poor women in rural areas of Cameroon. 

For her outstanding achievements in maternal health, she received in 1999 the Award for Women’s Health from the Commonwealth. 

“I personally sponsored many screening campaigns for cervical and breast cancer, as well as free screening for HIV, hepatitis B and hepatitis C,” she says.

This initiative was supported by national authorities and in particular the Ministry of Women’s Empowerment and the Family, and involves various women’s associations in Cameroon. She also trains and mentors junior female scientists in health research.

“I was and still am motivated to study how viruses move from a pregnant woman to her fetus and the differential clinical outcomes for the infant,” she says, confirming that her work aims to help women suffering from sexually transmitted diseases (syphilis, gonorrhea, HIV and hepatitis B).

Professor Torimiro says she has seen a big change in the success of treating sexually transmitted diseases among rural women in her country. More women are assertive in addressing sexually transmitted infections and are committed to engage in addressing them.

What more needs to be done? Integrate early diagnosis of other bloodborne pathogens (such as hepatitis B virus that can be transmitted from mother-to-child) among pregnant women into routine antenatal care services, and for free.

Source: WHO