Sarah Ooko
26 June 2011
Nairobi — In the early 90s, Eliud Chichi led a normal life. He was healthy, happy and full of life. His disk jockey and events organising business also thrived. He did not have to worry about anything.
Then the nightmare began in 1996. “I started having frequent coughs that would not go away. My friends advised me to take whisky and try herbal medicine, but they didn’t work.” By then, he thought it was nothing serious.
Two years later, Chichi was diagnosed with tuberculosis (TB). However, as he later found out, the drugs prescribed for him were under dose and he developed resistance.
“My conditioned worsened. I coughed out blood and was in a lot of pain,” he says in a slightly subdued voice.
In 2004, he eventually experienced a breakthrough after visiting the Moi District Hospital, at the Kenyan coastal region. “After conducting tests, doctors put me on a more advanced first line treatment for the disease. And for the first time in years, I began feeling better.”
Chichi’s reprieve was, however, short-lived. The post election violence that rocked the country in 2007 crippled his business. “I had to cut short my treatment since I couldn’t afford the weekly Ksh12,000 ($134) needed to buy medicine”.
Then all hell broke loose, he says. “The TB germs woke up with a vengeance, and I was bedridden for three months looking like a skeleton. It is only through prayers that I managed to hold on to life.”
His elder brother then took him to Nairobi where he was diagnosed with Multi-Drug Resistant TB and referred to Kenyatta National Hospital. “I was now put on second line TB drugs for 28 months, as the others were ineffective,” says Chichi, who recently completed the treatment in April this year.Even though the disease is gone, he says, its adverse effects still haunt him. He has lost more than half of his right lung, causing him breathing difficulties and altering his posture. When he stands or walks, his slanted shoulder becomes more pronounced.
To manage the lung damage and associated side effects, he spends about Ksh18,000 ($200) per month on treatment. “Because of my condition, I can’t go back to my old job. I depend mainly on family and well-wishers to foot the bills, as I look for alternative sources of employment.”
Chichi, who will be on medical observation for life, lives in constant fear of re-infection. He now volunteers as a TB advisor in a Nairobi clinic. “This is my new purpose. I encourage patients to get tested and complete the dosage,” says the 37-year-old.
Chichi’s story is shared by many people afflicted by the severe effects of anti-microbial resistance across East Africa and worldwide. Jayesh Pandit of the Kenya Pharmacy and Poisons Board says this happens when disease causing micro-organisms (microbes) become resistant to drugs.
He cites late diagnosis, failure to complete treatment, and mismanagement of drugs as major causes of resistance. Even though the most affected anti-microbial medicines are antibiotics, certain anti-malarials and anti-virals are now also ineffective against the diseases they target.
The World Health Organisation has warned that if anti-microbial resistance is not halted, many infectious diseases — like TB, pneumonia and HIV/Aids — risk becoming uncontrollable. This could derail the progress already made by East Africa towards achieving the health related Millennium Development Goals.
Dr Pandit says life-saving medical technologies are also threatened. “Without effective antibiotics to ward off infections, organ transplants and major surgeries would be compromised.”
To curb this problem, Jennifer Cohn of Médecins Sans Frontières says medical practitioners and pharmaceutical companies should work in harmony to ensure that anti-microbial medicines are appropriately used. “For instance, tests should be done properly before prescriptions are made to prevent drug misuse.”
She also says health funding should be increased. “This will prevent interrupted supply of medicines, which predisposes patients to drug resistance.”
William Mwatu of GlaxoSmithkline says East African governments should put in place tough penalties against the production of counterfeit medicines as this contributes to drug resistance.
He notes that the production and use of vaccines should be encouraged. “They prevent diseases and consequently protect anti-microbials from resistance by minimising their use.”
Dr Mwatu adds that the public and medical staff should be sensitised on proper use of these medicines.
“Since it takes a long time for pharmaceutical companies to produce new anti-microbial drugs, we should protect what we have now or risk having no cure in future,” he says.
AllAfrica – All the Time
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East Africa: Rising Drug Resistance Worries Doctors