The lingering crisis of diphtheria (Mashako) in Kano has rebounded with a strong hit. In the Infectious Diseases Hospital (IDH) alone, ‘over fifty patients were confirmed dead within this month’ (with the exception of home deaths and brought in dead patients). What is our government doing to change this tragic narrative?
Diphtheria is a highly contagious disease caused by ‘corynebacterium diphtheriae’. It affects the throat and nasal passages, rarely the skin and genitalia. It is characterized by sore throat, appearance of white or grayish patch on the tonsils and/or throat, painful swallowing, respiratory distress, drooling of saliva, among others.
Ultimately, life-threatening complications: renal damage, cardiac problems, neurological damage, respiratory failure, sepsis, often occur on account of late identification, and certainly, poor management. Through proper vaccination, good hygiene, and abstaining from infected persons or environments, diphtheria could be prevented.
Diphtheria came to Kano in the twilight of 2022 and has grabbed attention in the early days of 2023. At the throes of its peak, Non-governmental Organizations (NGOs), MSF WaCA specifically, extended helping hands. They based in Murtala Muhammad Specialists Hospital. Since then, the killer disease has perdured for months. Eventually, in June of the same year, another center was flagged off in IDH.
In November, 2023. Alliance for İnternational Medical Actions (ALIMA) came into the mix and took over the newly established center in IDH from MSF. In collaboration with the state ministry of health, both organizations deployed foot soldiers to navigate the streets of Kano and educate people on diphtheria. Through their stay, they provided in-patients with a free balanced diet, free drugs and all other hospitals expenses. Free drugs goes also to the out patients.
Adequate staff were hired to run the centers. In IDH alone: over thirty nurses, ten doctors, over five health promoters, six hygienists, one generator operator, one electrician, two data clerks, one vaccinator, and of course, adequate security team, among others.
In the first few months of 2024, Diphtheria was presumed to breath its last. We assumed wrongly. MSF exited earlier, they left in the last days of 2023, while ALIMA blew off their whistle on 31st May, 2024. The state government took over from the colossus.
After taking over, the staff were reduced to a very negligible quantity. Vaccinator, generator operator, hygienists, foot soldiers, are now all off the list. The number of nurses has fallen from thirty to barely nine, running a shift in a facility with three wards and over thirty patients, sometimes over forty, most of which are severe cases with low tendency of survival. The same goes to doctors, from ten to five doctors.
Free food and drugs are now a thing of the past. Besides, before their exit, the NGOs has made some huge donations of drugs and other valuables of which presence we barely witnessed. The center has further depleted from the already crippled healthcare system of the state. Patients on admission do not have access to potable water. The environment is unhygienic; littered with dirt all over. The toilets are messed: patients sometimes deficate in their backyard. Soiled bed sheets, contaminated mosquito nets. Poor segregation and of course increased cross infections.
Among the key managements of diphtheria is ‘isolation’. Nonetheless, proper isolation is now not observed. Unlike in the old times, when patients don’t get to buy anything. Now, food must be brought from home, drugs must be bought from outside. All these could eventually lead to cross infection.
Furthermore, some patients are lost to hunger. Ill and hungry! We’ve lost so many patients to hypoglycemia than we can count. I have seen a patient that spent over fourteen hours without taking even a black tea; they cannot afford it. I often come across patients that cannot afford their medications. This makes me to wonder, ‘what is our government doing to change these narrations?’
Moreover, the number of cases are drastically increasing everyday. People are dying. Both the patients and the staff have become helpless. In a critical setting like this, you’ll barely see basic life support equipments. No emergency drugs. We often spend the nights without electricity. When a patient desaturates in the night and is due for oxygen administration, we had to fall back and fold our arms. The oxygen concentrator requires electrical supply to work. Same goes to patients that requires emergency drugs to survive: they are unavailable . Certainly, with the provision of effective services, so many tragedies are avoidable.
The leadership of the center have demonstrated a degree of tolerance and patience. They never cease to channel the status of the center to the right authority. It did not pay off. Alas!
Since last two years, diphtheria has claimed the lives of thousands of people: children and adults. Over fifty in this month; August, 2024. Diphtheria is deadly.It is killing. It is highly contagious , and it catches without discrimination! The government must heed to the call and make necessary provisions in order to save the lives of its subjects. People are dying. People are absconding, ultimately taking the threat to their neighborhoods. Dear government, do it the way you see fit, our hope is, through this piece, diphtheria is kissing goodbye. Thank you!
Deedat writes from Kano, Nigeria.
24/08/2024.
