By Valentine NGWA, St. James University Hospital - Leeds, UK
I have read with keen interest, Dr Sanjay Gupta’s take on various health related issues in the rural parts of Cameroon, initially wondering what his real intentions were. One could easily misconstrue his intentions as being Information, Education/Entertainment and Communication (IEC), which I believe are those of a genuine journalist. However, I finally realised Sanjay Gupta’s primary assignment is that of portraying Cameroon/Africa as the origin of many of the world’s diseases; as a land where diseases easily spread from animals to man due to their supposedly close co-habitation.
Nowhere is this truer than in this article on Buruli ulcer in Akonolinga, Cameroon in which Medical science has been totally insulted; an article which should cause anyone calling himself a trained medical doctor to bow his head in shame. And I will go on to tell you why I think so.
First, let us start with the name of the disease. Sanjay Gupta said this;
As I visited the clinic, I learned they had given this disease a name: Buruli.
Now, the name Buruli was NOT coined by the people of Akonolinga. In the 1960s, many of such cases occurred in Buruli County (now called Nakasongola District) in Uganda and that is where the disease got its name from. And I will trace the history of Buruli Ulcer (BU) below.
Now, Sanjay Gupta also had this to say.
As a doctor, it was amazing to see this previously unrecorded disease slowly become deciphered.
He obviously needed some more schooling on this. The first recorded cases of this disease were in 1897 by Sir Albert Cook, a British Physician working at the Mengo Hospital Kampala, Uganda. Again in 1948, Professor Peter MacCallum in Australia described this disease in six patients in the Bairnsdale area near Melbourne; He and his team were the first to isolate the causative organism. That is why in Southern Australia, BU is still referred to as Bairnsdale Ulcer.
In the 1960s, due to the occurrence of many cases in Buruli district, it was named as such. And since 1980, the disease has rapidly emerged in many parts of the world such that in 1997, after encountering patients with the disease while visiting Cote D’Ivoire, Dr Hiroyoshi Nakajima who was then Director-General of WHO announced the deployment of a coalition of international efforts against Buruli Ulcer. In February 1998, WHO formed the Global Buruli Ulcer Initiative (GBUI) to coordinate BU control and research and in July 1998 WHO organised the first BU conference.
In May 2004, the world Health assembly adopted Resolution WHA57.1 on BU and today more than 40 NGOs, Research Institutions and foundations are participating in the GBUI.
Is it willful ignorance then for Sanjay Gupta to describe BU as ‘Previously unrecorded disease’?
And here he potrays his real intentions;
It was also a fascinating glimpse into the very real connection between animals, plants and humans. Not only is the Buruli causing pathogen likely from an animal, but the medication used to treat it is from a local plant.
I find it amazing that someone who had no clue on what Buruli Ulcer is already knows that there is a connection between animals, plants and humans. Suffice to say, it is never too late to educate. The causative organism for BU is the bacteria Mycobacterium ulcerans which is of the same family with the causative organism for TB and Leprosy and this was discovered way back in 1948 by Professor Peter MacCallum and his team in far away Australia. Current evidence shows that the infection is transmitted through abraided skin after contact with contaminated water or soil while the evidence for transmission by insects is still very weak; however, the scientific community waits anxiously for this evidence because this will mean it is the first Mycobacteria to be transmitted by insects. Readers might want to read more on the WHO fact sheet on BU revised in 2007.
I find the next paragraphs fascinating;
‘Now, if you think what you are reading is too far fetched, you may be interested to know I sat down with an educated medical anthropologist with her PHD, named Karen Saylors, who explained all of this to me. Along with researchers associated with Johns Hopkins, they are studying the origins of Buruli.’……
‘Instead, Karen has busied herself studying the possibility that Buruli may in fact be a microbacteria that is zoonotic, spread from animal to human.’
Studying the origins of Buruli Ulcer? The conclusion has been made and the study designed by the Medical Anthropologist to fit it. And we are supposed to clap for the myth that has been solved. Some people make me laugh!!
Now the Doctor said this;
‘As it has many similarities to a staph infection, which can cause flesh to be ulcerated and "eaten" appearing, the doctors have started using powerful antibiotics with good success.’
Doctors did not just ‘start’ using antibiotics for BU. Combination antibiotics for the treatment of BU has been known for ages; after all it is a Mycobacterial infection - use your medical knowledge for God’s sake!! And should I remind Sanjay Gupta that World Health Assembly resolution 57.1 chapter2.2 encourages member states to intensify research to develop tools to diagnose, treat and prevent Buruli Ulcer. I wonder if he bothered finding out if Cameroon, as a member state of the WHA, is complying with this resolution. Or he probably believes it is a country of ignorant people who need westerners to come and tell them what transpires in their own backyard!
And as to the cause, Sanjay Gupta says this;
‘I also learned something that stunned me — what many in this town believe is the origin of Buruli. Witchcraft’.
Medical myths just like myths in many other discplines are nothing new and that happens the world over. After all, have we not heard supposedly enlightened movie stars blaming China’s earth quake as a punishment from a supreme being for China’s maltreatment of the Tibetans, or the 2004 Tsunami as a punishment for the sexual immorality and child pornography in the exhotic holiday resorts in Thailand or former Israeli PM’s stroke as his punishment for compromise on Gaza?
And if Sanjay Gupta had taken the time to find out the African’s cosmology of Health in an attempt to understand some aspects of their culture; an aspect of Medical sociology which is vital for any doctor venturing into Africa in whatever capacity, then he wouldn’t have been stunned! Again, he must have wondered ‘why bother?’
And of course Sanjay Gupta drew his conclusion on the supposed transmission of Buruli Ulcer from animal to humans;
‘And, if we look deep enough, we find this is in fact the case with many diseases.’
This is quite sickening! And to think that CNN will publish such rubbish is to show how much one needs to be careful about the things he reads and watches and especially to protect the vulnerable population from such display of ignorance in the guise of information and Education!
St. James University Hospital
Click here for my 2006 interview with Dr. Ngwa on the Brain Drain phenomenon within the medical profession in Cameroon.