Bush Doctor in the City. Vol 11

BUSH DOCTOR IN THE CITY. Vol. 11
The Bush Doctor knew he was in a crisis. The whole Bush knew he was in a crisis. It was so bad that last night he referred 12 patients to the witch Doctor. The wards were overflowing.
Lassa fever had struck. Unmistakable rashes, sore throat, bloody diarrheoa, bleeding from the nostrils and lymph glands popping up ever where like Bush rats; Bush rats called Mastomys natalensis.
The Bush Doctor had warned them not to drink garri.
‘Make eba with hot boiling water. The rats have been feeling on the garri spread out in the sun. Their saliva carried the Lassa fever virus. Boiling hot water will kill the virus’ he had warned during his health education classes. No one listened.
‘We have been drinking garri long before you came here’ Mumu had said.
There was no need to say ‘I told you so’. The patients all said it. They should have listened.
The big city hospital had been informed of the outbreak and they were ‘looking into it’ from a distance. The courier brought two courses of Ribavirin tablets with a note to say more was on the way. ‘Tell them they should know I need intravenous stuff here!’ he screamed at the poor messenger.
The Bush Doctor put himself and the Bush nurse on the treatment.
‘Someone has to be alive to look after this lot’ was how he justified his actions to the Bush nurse. She took the course willingly.
No scarcity of Anti viral treatment for the Bush Doctor in the City. He has a Specialist for every Virus.
12-6-07. 1pm
Have come for my weekly dose of continuing education. A special lecture this time. The David Perry Memorial lecture to be given by Dr David Mutimer. Liver specialist at the QE Hospital. Birmingham.
At sit in the quiet hall and do what all good Doctors do at such meetings; let the mind wander.
Chief Basorun Moshood Abiola was the acclaimed winner of the Nigerian Presidential elections held on the 12th of June 1993 which was subsequently annulled (eleven days later) by the then military head of state; General Ibrahim Babangida.
And right now as I sit in this lecture theatre, Nigerians are again crumbling about the recently conducted elections which many claim was flawed.
Democracy infection leads to a carrier state ie chronic democratitis. After a few years this leads to Democratic cirrhosis and that in turns leads to Democratic failure or Democratic cancer and eventual dermocratic death and that……..
My neighbour sneezes and I am back to reality. ‘Bless you Doctor’.
Now the topic is nasty Hepatitis B.
644,000 deaths a year. Prevalence in Nigeria >10%. Chineke! That means in any group photograph containing over 10 persons at an Owambe party, at least one person has Hepatitis B.
It is also the number one preventable disease (by way of a national immunization programme) that people die of. Next being Measles; 610,000 deaths a year.
The slides of the world map, where the highly prevalent areas were painted bright red, came on. Nigeria even looked redder than most. Chineke! Or perhaps I should cream, Oghene!
Then came the slides where countries with immunization programmes were coloured differently from the rest. Cameroun stood out next to Nigeria, for having a vaccination programme for neonates against Hepatitis B. (I thought we were richer than them).
The UK has no programme as endemicity was low. However all pregnant women were screened and if found to be positive are followed up after delivery. The babies were immunised at birth to prevent infection.
Dr Mutimer noted his patient numbers have been going up in the last few years due to immigration from India , Africa and parts of Europe. These are places with high prevalence but no immunisation policy against Hepatitis B. (I suppose in Africa they have more pressing issues like Aids & Egunje abi?).
For Nigeria , it will make good sense to jab all babies with the Hepatitis B vaccine. The risk of being a carrier is 100% when infected at birth, 50% when infected as a toddler and less than 5% when infected as an adult.
After 30 to 50 years of being a carrier, the disease (Chronic Hepatitis) progresses to Liver Cirhosis and then to Liver failure or Liver Cancer). Like HIV, the replication of the virus (how many pickin di virus dey born) with determine how fast the liver damage progresses.
Rather than say God forbid three times, you need a hepatologist and some very expensive medicine.
At the QE hospital they start with Lamivudine,(Cheap but with a 70% incidence of resistance in about four years) and add Adefovir, when the Viral load starts to rise again. Three monthly blood tests are essential to keep an eye on viral load.
My mind begins to wander again.
Enemies of democracy are viruses. What drug will work for Naija.
Did I hear someone sneeze, ‘coup-divudine?!’ . ‘Bless you Doctor’.
Special thanks to Dr David Mutimer for kindly e-mailing me a copy of his power point presentation- Heptitis B. Threats! & Promises?. The David Parry Memorial Lecture. Good Hope Hospital. June 12th 2007.
Reference-Anyabolu I Oliver.(2000). Classic Publishing Company Limited. Nigeria ,Past to the present.pp158