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Uganda Malaria spares nobody |
HEALTH
Dr Sebbaale, who run an exclusive clinic in Kampala had his licence suspended because he mishandled a case of malaria that resulted in a child of an influential citizen dying. This child became part of the yearly statistics of 110,000 children under five, who succumb to the deadly disease which is considered more lethal than AIDS. Malaria is fatal to Uganda’s economy as it accounts for 50% of all absenteeism from work.
In the 1960s, Uganda had an impressive medical system and Mulago Hospital was considered to be a «Mecca» for sick people from Kenya, Congo RDC and Tanzania. But then chaos throughout the country ended this and with the country’s numerous civil wars and the on-going social unrest, plus a turnaround in Uganda’s weather pattern, malaria is now flourishing.
The clearing of vegetation in southwestern districts brought about an increase in temperature, and encouraged conditions in which malaria could flourish. The National Environmental Management Authority (NEMA) which is a government body concerned with environmental issues has said: «Malaria transmission in Uganda is due to deforestation, the construction of brick pits and fish ponds, all of which provide fertile breeding grounds for the mosquitos». Obviously, then, there is going to be some clash between the needs of the economy and the eradication of disease. But a first line of defence should be to minimise man-made environmental hazards whereby malaria can flourish.
Major health problems
For example, the construction of dams results in flooding and an increase in areas covered by water — again, breeding grounds for malaria and other water-born diseases. In Uganda, there are at least six dams being planned and it makes one shudder to think what will happen if these dams still on the drawing board are actually constructed.
Loti Pottinges is an official of the US-based International Rivers Network (IRN) and is worried about the environmental effects of building too many dams in too small an area. «There is great potential in using the River Nile for both hydro-electric power and for tourism, but I wonder whether sufficient comprehensive homework has been done to look at the price Uganda will have to pay. The key question is, does Uganda have all the plans in place to appreciate the effects of having three dams in less than 4 kms?».
Pottinges, along with numerous international environmentalists, opposes the construction of the $450 million Bujagali Dam capable of generating 250 MW, because of its long-term environmental effects and eventual risks to health. The dam is less than 5 kms from the Owen Extension Dam and another Owen Falls Dam — both dams are capable of generating 480 MW.
According to President Yoweri Museveni, Uganda has already planned for exporting electricity to neighbouring countries, and is pushing for the Bujagali Dam, which is financed by some American interests. Thus, he is more concerned about how much money will be brought in, and the prestige the project carries. «After all, projects accrued can help boost the health services».
One wonders if Uganda’s leaders know where they are taking the nation. «There are major health problems associated with big dams because they become breeding grounds for diseases like bilharzia. It is important that people are aware of the negative aspects attached to building large dams,» stresses Pottinges.
The lack of adequate checks on imported drugs is putting lives at risk. Some medical authorities are said to have given the go-ahead to use drugs imported especially from India, drugs which lack an adequate chemical composition. This makes Uganda a paradise for all kinds of drug dealers. Drugs from India are favoured because they are cheap. But some are not effective and many Ugandans rate them poorly. «I had malaria, and kept on taking drugs for weeks without getting cured» says Semugooma Fred. «Then I learnt from my friends that Indian drugs are not effective». No wonder unscrupulous pharmacists and some doctors stuck with these drugs have attempted to re-label them, so as to hoodwink customers that they were imported from UK or from Germany, where drugs are costly but highly rated for their beneficial effects.
Yes, Uganda’s doctors must carry some blame. The existence of crooked medical personnel is a problem and Ugandan medical qualifications are increasingly being scrutinised.
«Roll back malaria»
Rolling back malaria initially requires simple techniques. Busy parts of Kampala could be cleared of bushes (breeding grounds for mosquitos) and migration from rural areas into the towns and cities should also be stemmed. Statistics show that most residents in Kampala live in overcrowded conditions making it possible for malaria to spread easily.
Some efforts are being made by the Government to roll back the threat. In his «mosquito net» budget, Finance Minister, Gerald Sendawula, announced tax cuts on mosquito nets. Statistics showed that only 5% of Ugandans were using mosquito nets, yet impregnating nets with insecticides can save many lives as figures from other African countries show.
Another challenge facing the government is to restore confidence in the country’s medical system. Ugandans are not always prepared to consult authorised medical practitioners when they fall sick. Unscrupulous medical personnel are known to be giving half-doses knowing the patient will return. Restoring confidence in the medical services is an absolute priority and people need to learn the value of early treatment.
The government agrees that it has adopted a major strategy against malaria too late. The first step in such a strategy is to tackle the question of using appropriate drugs. Also, a malaria control unit has been established to maintain a database of all research on malaria, and to develop research relevant to the programme. An early warning and monitoring system is to be designed and implemented from the smallest political unit, upwards. Uganda’s 49 districts will prepare and implement contingency plans for the management of malaria epidemics, and will be supported by national malaria control and epidemiological surveillance units.
The Government is looking for foreign assistance in the «roll back malaria» campaign, but many scientists say that self-reliance attitudes will go a long way towards eradicating this scourge.
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