By Chancy Namadzunda:
Long thought for ages to be eradicated in the region, Leprosy, like a vicious giant that had been sleeping is now back, seemingly pouncing at will this time around.
Since the country attained the World Health Organization (WHO) leprosy elimination status in 1994, Malawi, just like its colleagues elsewhere, seemingly relaxed its effort against the disease.
Since its re-emergence in the country, there has been increased cases reported in many a health facility in the country.
In Nkhotakota District from example, over 60 cases have already been reported this year alone; according to District Health Clinician, Andrew Namakhwa.
Namankhwa confirmed there remain a lot more undetected cases within the communities, despite the reported cases in health facilities.
Among others, shortage of well-trained health personnel the District Health Office currently faces is making early detection a mountain to climb.
With only two well-trained leprosy officers for the district hospital and its 21 satelite health centers, Nkhotakota remains at risk; calling for immediate external interventions.
This, Namakhwa said is chocking efforts to curb the re-emerging health challenge in the district; coupled with mobility as well as lack of civic education among the communities.
“These cases are from a few health centers, and we believe that there are a lot more out there. We get just a handful clients for screening. These are those who come on their own, unlike in other dieseses where we have trained people handy for them in the communities,” said Namakhwa.
The new cases in the re-emerged cases are not only restricted to Nkhotakota.
As of last week, Mzimba South District Hospital had registered nine patients since January this year.
The hospital’s Leprosy Focal Person Dan Kwacha said three of them were discharged upon completion of treatment.
With 33 health centers under the hospital, the district has only two Health Surveillance Assistance (HSAs) who are trained in leprocy; so much for an area of such magnitude.
Said Kwacha; “Mzimba South is one of the biggest districts. We can’t manage to reach out to all the health centers with just two HSAs. Looking at past trends, we used to have a lot of leprocy cases in the district than the rest”.
He, however, said the district hospital feels that the ones just decimal, and that the number could have been much higher with more trained hands on the ground.
“As it stands, we can’t manage to do surveillance, like routine visits to these health centers, community sensitization because we don’t have resources,” he said.
Meanwhile, the hospital has resorted to using nurses with little knowledge of the disease to complement the efforts by the two HSAs.
“Otherwise, I would say that we mostly meet those suspected to have leprocy by chance,” Kwacha said.
Before Malawi attained WHO leprosy elimination status, there were Leprocy Control Assistants (LCA) who were active on the ground in the fight against the disease, which was easier to reach out to the communities.
“However, we no longer have them. The prolonged ‘break’ kind of rendered them useless, and as a consequence, it’s like starting afresh now,” he said.
Kwacha feared that the knowledge gap amongst health workers remains big; suspecting that a lot of people are suffering silently out there.
Mbelwa District Council Director of Health and Social Services, Ted Bandawe, attributed to the low case reportage to a breakdown in civic education campaigns in the communities.
“Being a re-emerging condition, many health workers have been taken by surprise, with the knowledge gap, we are looking at several ways on how best we can effectively engage ourselves in the fight against it,” said Bandawe
He however, said the district is trying to find ways to involve Public Health Emergency Committee (PHEC) to reach out to the masses with leprocy messages.
“We have also written proposals to the Ministry of Health, Non-governmental Organizations (NGOs) and other stakeholders to conduct trainings amongst ourselves to bridge the knowledge gap as well as reach out to the communities with leprocy messages,” he said
Bandawe said they are further looking at engaging with various learders in the district, starting from the full Council, Counselors and traditional leaders.
Recently, National Tuberculosis and Leprosy Elimination Programm (NTLEP) Programme Manager James Mpunga told the local media that the resurfacing of the disease to the withdrawal of support towards leprosy management after WHO declared that Malawi had achieved elimination threshold for the disease 28 years ago.
He explained: “Government and its partners shifted their support to other disease conditions, as such, leprosy was not given priority.
“Knowledge level towards leprosy among the community is very low to the extent that they are not aware of the early symptoms and signs, thereby not seeking medical attention in time.”
Mpunga said 10 of the country’s 28 districts have recorded the cases, but was quick to point out that all the districts could be affected as some are not able to diagnose leprosy.
He said: “This is worrying and we are taking all the measures to make sure that we address this challenge. Among others, we continue to orient healthcare workers to be able to diagnose and treat patients.
“We are also raising awareness to the public on the symptoms, signs and prevention. If treated early, the disease is curable. It becomes worrisome when it causes disability because it is irreversible”.
Featured picture source: Internet
