Monday, March 30, 2009

2009 TRIP: the Kiburara church grows (up and outward!)

Hi Brethren,

Pray with us so that God may supply the resources needed for this worship centre. It will be as a training centre, worship centre,conference hall. We believe it will bring glory to God. Manypeople within the community have tried to give us their contribution and so far this is where we have reached. We are stopping here as welook for more funds and resources so that we may build another ringbeam and then do the roofing.

This church is 53ft x 64ft. We trust the Lord is faithful. This weekfrom Friday through sunday we are holding Women conference and everyevening we are reaching the community with the message of hope. Praywith us. Within the last two weeks two homes have been won to Christ throughour sponsorship program. Sponsorship program of the orphans and caregiven to their caregivers have given us an opprtunity to minister to them. This means that the worship center we are currently building isreally needed.


The medical did a great work in evangelism and everysunday a new convert is coming to the Lord. This is amazing. Childrenare being won to Christ and most of the children in the program a recommitted members in the church. I can i have future leaders oftomorrow. This is a great task but worth it and at the end of the day you become joyful and glorify God.

As a church we are so happy. This is to let you know that your investment as you send in yourfinances,there is a great impact in the lives of many even those who would be dying because of poverty.

May the almighty God reward you and bless your hands as you continue investing in His kingdom.

Pray with us.

Moses

NEWS: Meningitis hits Yumbe district




Meningitis hits Yumbe district



Sunday, 29th March, 2009 from NEW VISION ONLINE

Health workers check the meningitis screening tent at Yumbe Hospital


THE insurgency in Sudan and Congo has destroyed the health infrastructure in those countries, leading to the spread of diseases to neighbouring countries like Uganda as displaced people seek refuge. Yumbe district health officer, Dr Alfred Yayi, says Uganda has always taken precaution by immunising its people, but the booming business across borders brings in many diseases. Between August and December last year, the World Health Organisation confirmed two cases of meningitis in Juba, Sudan, and three in Congo. Although Yumbe district carried out meningitis immunisation in 2007, a case was reported there on January 9. A 13-year-old girl died on arrival at Kulikulinga Health Centre III. Dr Yayi blames the death on the delay of the patient to report to hospital. “It is advisable to report a stiff neck and fever to hospital as soon as the symptoms appear, for quick treatment,” he says. The survey revealed that the girl had prior to this visited relatives in Drajini sub-county near the Sudan border. Currently, Yumbe district is experiencing a meningitis outbreak. So far, 43 cases have been reported since January. Of these, 34 were treated, four are still on treatment, while five victims died, according to Dr Yayi. “Although many of the cases were identified by symptoms, six of the victims were tested and confirmed to have the Neisseria germ which causes menigitis type A,” Dr Yayi explains. The most affected areas are Apo sub-county with 10 cases and Yumbe Town Council with eight cases. Others are Dra, with four cases; Kei two; Kuru five; Odravu three; Romoge two and Midigo five. The source of four cases was not established. A screening centre has been set up at Yumbe Hospital, while tests are done at Kuluva Hospital in Arua. Although the Ministry of Health was informed of the outbreak in January, nothing had been done by the time of interview two weeks ago. However, the district officials met recently and resolved that councillors should sensitise the masses about the disease to curb further spread. The officials also meet every Tuesday to get updates from health workers. Kassim Ayisuga, the deputy district chairman, advises residents to avoid crowded places like night clubs. He says there are more chances of catching the disease through droplets from an infected person. Next month, the district plans to immunise people aged five to 30 years in Apo and Yumbe Town Council. “Those below two years cannot be vaccinated as the vaccine may be harmful to their lives. Those above 30 years are expected to have acquired enough immunity. So they may not be at a high risk,” Dr Yayi says. He urges caretakers to take precaution since being above 30 years may not guarantee one’s safety after handling patients carelessly. Unfortunately, the health workers say the vaccine is too expensive to be used on everyone. The incubation period for meningitis, Dr Yayi says, is between one to 10 days. He says if treatment is started early, there are high chances of survival. According to the health workers, although there are various types of meningitis — A, B, C and Y — only Type A has a vaccine. However, they say the available treatment can be used on all types of meningitis. Patients are given IV chloramphenicol, ceftriaxone injection and oily chloramphenicol.

NEWS: Preventing TB requires community approach

Preventing TB requires community approach

Monday, March 30, 2009 from MONITOR ONLINE

Tuberculosis is trasmitted by airborne bacteria. For every single case that is successfully treated, 10 to 15 new infections are prevented. With an estimated 80,000 new tuberculosis infections occurring annually and yet only 42,000 get registered for healthcare, the threat of TB in Uganda cannot be under estimated.

And those who get identified and started on treatment, on average, lose four months of income because they will be incapacitated to work. According to Dr Francis Adatu, the National TB and Leprosy Programme Manager at the Ministry of Health, the economic burden to the family becomes “too much” especially if the patient is the main bread winner.

The World Health Organisation defines Tuberculosis (TB) as an infectious bacterial disease caused by Mycobacterium tuberculosis, which most commonly affects the lungs. And it is transmitted from person to person via droplets from the throat and lungs of people with the active respiratory disease.

But in healthy people, infection with Mycobacterium tuberculosis often causes no symptoms, since the person’s immune system acts to “wall off” the bacteria.

With only 50 per cent of the cases being identified, Dr Adatu says this should not be happening for a disease that is preventable, treatable and curable.

“The problem is that some people look at TB as a purely medical problem. This is not the case; it belongs to the community and efforts to contain or prevent it should greatly involve the communities,” says Adatu.

“Let them start with their own homesteads. Anyone in a homestead who has had a cough lasting for two weeks or more and not responding to ordinary treatment, should be supported to go for a check up to rule out TB.”

He adds that for every single case, that is successfully treated, 10 to 15 new infections are prevented.

Although drugs to cure the disease have been available for over 50 years, the emergence of multi drug resistant tuberculosis (MDR-TB) and extremely drug resistant tuberculosis (XDR-TB) has complicated treatment and control of the disease.

While the current vaccine BCG (Bacillus Calmette-Guerin) can protect children against the severe form of the disease, it cannot help adults. However, there are some WHO approved strategies that can help adults guard against infection. These include hospitalisation of patients suffering from tuberculosis and treating them effectively until the chances of them spreading the disease become negligible.

It is also advisable to avoid enclosed congested places with poor ventilation. For the HIV positive, preventive treatment can be got from healthcare providers. And family and friends need to minimise contact or take precaution when visiting patients on the first two weeks of treatment.

None-the-less, it helps a great deal if one concentrates on building immunity, staying healthy, eating well, and exercising regularly to prevent getting infected by tuberculosis or any other disease condition.

NEWS: Gonorrhea, syphilis resistant to Penicillin

Gonorrhea, syphilis resistant to Penicillin

Monday, March 30, 2009 from MONITOR ONLINE

Gonorrhea and syphilis, the sexually transmitted infections that have for long been treated and cured using penicillin have become resistant to the medicine, Health Ministry officials have confirmed.

The Director General of Health Services, Dr Sam Zaramba, confirmed last Friday that both gonorrhea and syphilis had become resistant to the first line medicine for their treatment.
“It is true the penicillin which we imported to treat sexually transmitted infections like gonorrhea have become ineffective and we are in the process of introducing the second line medicines,” Dr Zaramba said.

He was addressing the press during the launch of the Medicine Transparency Alliance in Kampala.

Dr Zaramba said a number of diseases are increasingly becoming resistant to the widely used medicines mainly because of misuse.

Tuesday, March 24, 2009

NEWS: HIV/Aids threatens education sector

HIV/Aids threatens education sector

Tuesday, March 24, 2009 from MONITOR ONLINE

The impact of HIV/Aids on the education sector is damning and if not contained the consequences will be dire, a senior official in the Ministry of Education has warned.

“If the effects of HIV/Aids are not addressed, know that your brothers, your sisters, your children in school are going to be affected,” Mr Yusuf Nsubuga, the director for basic and secondary education, told journalists at the Media Centre yesterday.

Mr Nsubuga was speaking ahead of next week’s launch of the World Vision and USAID-funded Supporting Public Sector Workplace to Expand Action and Response to HIV/Aids (SPEAR) programme. The programme is also to be extended to the ministries of Internal Affairs and Local Government.

The education sector, Mr Nsubuga added, is facing an increase in staff attrition partly due to HIV-related factors. “We are experiencing low morale of the workers because when people get sick and cannot perform as expected, and the morale of both learners and educators is affected.”
While he said no studies have been done to establish the prevalence of HIV among the sector, the abundant stigma and discrimination indicated an underlying problem.

HIV prevalence has declined from 18 per cent in 1992 to 6.4 per cent in 2005.

NEWS: Access to clean water still a rare luxury

Monday, March 23, 2009 from the MONITOR ONLINE


Access to clean water still a rare luxury


SURVIVAL OF THE FITTEST: Residents of Acherer village in Moroto District scramble for water with goats at a borehole.


Access to water is a basic right, yet it is a right denied to millions of Ugandans everyday.
With over 34 per cent of Ugandans having no access to clean water, the country is unlikely to meet its targets to provide clean water to its citizens in line with the UN Millennium Development Goal target of 100 per cent coverage by 2015.

MDG goal seven requires countries to reduce by half the proportion of people without sustainable access to safe drinking water and basic sanitation through improved drinking water sources and sanitation facilities.

But figures from latest Value for Money Audit report by the Auditor General on the distribution of water to urban areas by the National Water and Sewerage Corporation says that although there is a 70 per cent access of clean water to urban areas, there is still a high concentration of people living in these areas who do not have access to clean water.

“Supply of clean drinking water is estimated to have risen from an average of 54 per cent in 2002 to 70 per cent in 2006 against the national target of 100 per cent set by the National Water Policy by the year 2000 in urban areas,’’ the report reads in part.

And as the population grows, water scarcity is likely to increase, and as the AGs report points out that with urban populations growing at a faster rate than water supply in the major towns of Uganda, there has been an outcry from potential water customers who expect water services, while those already connected to the system spend long periods without water.

Another report by the Anti-corruption Coalition of Uganda, an anti corruption watchdog, puts national water coverage at just 63 per cent.

It says that although the water sector is one of the highly funded sectors by both government and donors, clean water coverage is still a luxury to many Ugandans, especially in the rural areas and districts affected by conflict in the east and northern region.

ACCU’s findings are supported by similar statistics from the Population Secretariat in its annual state of population report.

For example, the 2008 report indicates huge disparities still exist in water converge throughout the country, ranging from 12 per cent in the least served district of Kaboong to 95 per cent converge in Kabale.

According to the report, the 10 least covered districts with protected drinking water, with coverage of less than 40 per cent are Kaboong, Yumbe, Kotido, Isingiro, Kiruhura, Bugiri, Kisoro, Mayuge, Manafwa and Nakapiripirit. While Kabale, Kanungu, Rukungiri, Ntungamo, Bushenyi and Kamwenge are some of the districts with the highest water coverage in the country.

With lack of access to clean water comes poor sanitation coverage, standing at a low of 42 per cent for rural communities and 26 per cent for urban areas according to the 2008 Population report. The worst affected areas are slum dwellers, fishing community and displaced persons.

In the ACCU commissioned report on Public Expenditure Tracking Study carried out in October 2008, in eight districts of Kabarole, Koboko, Gulu, Bushenyi, Rakai, Soroti, Kamuli, and Mukono similar findings were unearthed.

Report findings indicate that of the eight districts studied, Koboko had the least water and sanitation coverage, followed by Gulu and Kamuli districts.Bushenyi District had the highest coverage among the districts studied.

The ACCU report says coverage and use of safe and clean water is still affected by poor community behaviour in upholding good sanitation measures.

“In Koboko and Gulu, some communities are yet to appreciate the importance of using safe and clean water. In Koboko District for example, the use of existing water facilities is still poor. People prefer to use nearby dirty water than walk a distance to draw clean water from a protected source,’’ the report says.

Sanitations conditions, the report says is particularly dire during the rainy season when swamps are full.This, it adds, explains the frequent outbreak of water borne diseases like Cholera and diarrhea.

On the contrary, the report says that sanitation and water coverage for Rakai District is affected by long dry spells.

Despite the fact that water coverage is 68% slight above the national average, some communities walk up to 10 kilometers in such for safe and clean water.’’

NEWS:NDA clears questioned cold syrups

NDA clears questioned cold syrups

Monday, March 23, 2009 from MONITOR ONLINE

The National Drug Authority yesterday gave a clean bill of health to the 12 cough and cold syrups for children that the regulatory body was investigating, saying they are neither poisonous nor dangerous if taken as recommended by a healthcare provider.

And while the NDA described the syrups as being of “good quality, safe and efficacious”, the regulator indicated that they are not a cure, saying they can only relieve symptoms.

“Cough and colds occur frequently in children and will usually get better by themselves, however, cough and cold medicines provide symptomatic relief,” read a statement signed by Mr Gabriel Kaddu on behalf of the NDA’s Executive Secretary/Registrar.

The NDA last week announced an investigation into the medicines after doctors in the United States, Kenya, and the World Health Organisation raised concerns about the efficacy of the syrups, most of which are used to treat coughs and colds in infants.

The syrups that have been under investigation include Actifed Wet (Cough and Cold) Syrup 100ml, Actifed Compound Linctus (Dry and Cold Cough), Ascoril syrup 100ml, Benylin Expectorant Syrup 100ml, Benylin Paediatric Syrup 100ml and Benylin with Codiene Syrup, some of the most popular on the Ugandan market.

Others are Bisolvon Elixir 100ml, Bro-zedex cough Syrup 100ml, Cadistin Expectorant 100ml, Linctifed forte syrup 100ml, Linctifed Paediatric Syrup 100ml, and Piriton Expectorant 100ml.

Mr Kaddu said yesterday: “There is no cause of alarm and panic among parents and guardians since the syrups are neither poisonous nor dangerous when taken as recommended by healthcare provider.”

“[The] NDA wishes to state that these medicines are neither being recalled, withdrawn nor banned from the market because there is no sufficient evidence to do so,” the statement added.

The agency none-the-less called upon all health workers and the public to report any suspected Adverse Drug Reaction and any quality issues related to drugs to the regulatory body.

The NDA also gave hospitals and other health facilities the green light to amend their lists of essential medicines, but the amendments are limited to the respective institutions.

The US-based Centers for Disease Control and Prevention in 2007 warned against giving syrups to children after the deaths of three babies were linked to the toxic effects of cough and cold medicines.

A CDC study showed that more than 1,500 toddlers and babies wound up in emergency rooms between 2004 and 2005.

Consequently, the CDC warned parents against giving common over-the-counter cold and cough remedies to children under two years without consulting a doctor.

But Uganda’s statutory body insisted that they have in place adequate quality assurance mechanism to ensure that only good quality, safe and efficacious medicines are available to our population.

NEWS: Irish envoy irked by HIV rate

Irish envoy irked by HIV rate

Monday, 23rd March, 2009 from NEW VISION

THE Irish ambassador to Uganda has expressed concern over the stagnated national HIV prevalence rate, which ranges between 6 and 7%. Kevin Kelly regretted that despite the many interventions by the Government, the prevalence rate had almost doubled in urban areas. He noted that although there were changing trends in the HIV epidemic in the last 20 years, the response was poor. Kelly made the remarks while handing over computers and accessories to AIDS focal persons from 50 districts at Imperial Royale Hotel in Kampala on Thursday. The computers, he said, were aimed at coordinating and strengthening HIV/AIDS programmes at the local government level. The Irish government has provided 1.3m euros over three years to support HIV/AIDS programmes run by local governments. Kelly added that the Irish government provides a total of 50m euros in aid to Uganda annually. Local government state minister Perez Ahabwe thanked the Irish government for its continued support to Uganda. Peter Muwanga, the chairperson of the Alliance of Mayors’ Initiatives at Community Level, advised the focal persons to send HIV messages cautiously and accurately. “If you do not want to use condoms, please keep quiet, but do not send conflicting messages,” he warned. The director general of the Uganda AIDS Commission, Dr. Kihumuro Apuuli, in a statement read by Rose Nalwadda, the director for planning, said the increase in HIV-infections, especially among married couples, should be checked.

NEWS: World health body lauds Uganda over polio fight

World health body lauds Uganda over polio fight

Monday, 23rd March, 2009 from NEW VISION

Dr. Mallinga immunises Daisy Naiga, as her mother, Rita Namaganda, looks on


THE World Health Organisation (WHO) has commended Uganda for its timely reporting and response to the recent wild polio outbreak in Amuru district. WHO representative Dr. Joachim Saweka said Uganda set a world record when she responded to the February 25 outbreak within four weeks. The global response time is six weeks, he explained. Saweka was speaking during celebrations to launch the sub-national synchronised immunisation days in Luweero district on Saturday. The event was presided over by Dr. Stephen Mallinga, the health minister. Uganda, Southern Sudan, Kenya, Somalia, Chad and the eastern DR Congo, have launched similar immunisation campaigns against the wild polio virus. The campaign will cover 29 high-risk districts in Uganda. To launch the campaign, Saweka, Mallinga and the Luweero Woman MP, Rebecca Lukwago, each immunised one child. Saweka urged the health ministry to ensure that all children receive a booster dose of the vaccine. “If we do not reach all children, the imported polio virus will stay in our country and re-establish the transmission. This will erase all the gains made since 1996 when the country became one of the first polio-free countries in Africa.” Saweka noted that the decrease in polio cases had led many parents to become complacent and not complete immunisation. Dr. Mallinga said the polio virus type that was confirmed in Amuru is linked to that which was recently detected in Juba, Southern Sudan. He advised leaders from districts on the Kampala-Juba highway to encourage the locals to improve their hygiene in order to check the spread of the virus. Polio is spread through contact with the faeces of an infected person.

Monday, March 23, 2009

NEWS: Mulago rots as doctors flee country

This is a truly tragic story which reveals the need for further medical missionary work in Uganda. Pray that God would provide a door for His workers...........

Mulago rots as doctors flee country



Sunday, March 22, 2009 from MONITOR ONLINE

Tereza Aol, 49, lies on a thin, old mattress writhing helplessly in pain. This ward at Mulago Hospital’s Cancer Institute has been a ‘neglected’ sickbay of sorts for her in nearly a month. Her right breast is charred by cancer. She says she has not been attended to.

“They only gave me this fluid to drink,’ she said, showing a bottle marked “Morphine Oral Solutions”.Mr John Okot, the husband, says the syrup is for pain relief. But Ms Aol needs more than just that to assuage the pang. Her tear-filled eyes and fading, feeble voice underlined years of intolerable suffering.

Ms Aol, fighting cancer of the breast, arrived at Mulago Hospital on February 23 upon referral from St. Mary’s Lacor Hospital in Gulu District, and it was not until March16 that doctors performed an X-Ray to ascertain the cancer damage to her breast.

Dr Jackson Orem, the director of the Cancer Institute at Mulago said the Institute is grossly under-staffed, under-funded and ill-equipped to deliver meaningful health care to the growing patient numbers.

The Institute receives an average of 60 patients a day, with 85 per cent of them coming from the countryside. This drains the skeletal staff and imposes pressure on use of the limited facilities.

As Ms Aol’s case demonstrates, accessing treatment at the country’s largest and only national referral hospital is a nightmare for many people as doctors battle to keep the hospital running under the most adverse circumstances.Mulago Hospital, which has reported Shs50 billion arrears, is also short of health care professionals and basic diagnostic equipment.

The hospital’s director, Dr Edward Ddumba told a visiting team of MPs on the Social Services Committee on March 16, that he only had half of the 1, 000 doctors required to run the hospital.
Dr Ddumba attributed the scarcity of human resource to a de-motivated staff. Currently, government offers newly-recruited medical officers a gross monthly salary of Shs626, 181 as a result, the hospital has lost doctors particularly to Rwanda which has been offering more lucrative salary packages.

“Rwanda pays a doctor $2, 000 [Shs4 million] per month compared to the Shs900,000 that Uganda gives to [senior] doctors,” Dr Ddumba said.

Dr Ddumba, however, could not give figures of the number of health professional who have emigrated but said “the rate is alarming.”

According to a report in yesterday’s Sunday Monitor, the government reportedly spent more than Shs1 billion on the treatment of eight well-placed public officers. The money would have gone a long way in motivating the team of doctors and nurses at the hospital.

Against the backdrop of rising cancer infections in Uganda, the few radiotherapy machines at the hospital are reported to be too old and falling apart due to irregular maintenance.

Dr Joseph Mugambe, who heads the Radiotherapy department, said the cobalt machine which helps in external chemotherapy (the treatment of cancer) is now fragile due to over use. The device installed in 1995 breaks down frequently, raising the risk of death for cancer patients.
Dr Mugambe said the unit receives 120 patients every day, overwhelming staff using rickety machines.The hospital’s decay is more manifest in the Maternity or Ward 5C as it is commonly called. The ward is crowded and stinks, yet many expectant women lie on the floor and corridors due to shortage of beds. There is limited privacy overall.

Built to handle only 20 mothers a day, the labour suite today handles an average 65 deliveries daily.“This number is too big for us to handle. We are seeing thrice the number that we should be seeing and so some end up delivering on the floor and in the corridors,” he said.

Dr Kalisoke, who heads the hospital’s gynecology and Obstetrics department, said the hospital carries out some 20 cesarean births each day in a theatre of one bed.With few staff and rapid turnover of women delivering on the same bed, the possibility of improper cleaning exposes mothers to cross infection.

Dr Kalisoke said on average, 12 doctors, nurses and mid wives are available to handle the maternity section.But Mulago’s woes do not end at the maternity ward. A visit to the Special Care Unit, where premature babies are incubated, reveals a thin line between life and death for the new babies.

Only two of the 29 incubators at the unit are fully functional and doctors have to devise crude means of using the others to keep the premature babies alive. Dr Jamil Mugalu, a neonatologist (a pediatrician trained in the care of premature babies) said the unit receives about 60 babies every day forcing them to share the incubators.

The hospital administration is aware of these problems, though. Dr Dumba said the main reason for the disastrous state of the hospital is chronic underfunding and understaffing. The hospital currently runs on a paltry Shs5 billion annually.

MP Rosemary Sseninde, who chairs the Social Services Committee shocked at the sight of the hospital’s decay, said that although the medical workers are doing their best amidst limited resources, government needs to come in and increase funding to the hospital in the next financial year.

Dr Orem said with the poor state of health care, many curable diseases have returned with a vengeance like Tuberculosis, typhoid, diarrhea and other waterborne illnesses.

NEWS: Resistance to TB drugs worries experts

Resistance to TB drugs worries experts

Sunday, 22nd March, 2009 from NEW VISION

AS the world commemorates World Tuberculosis Day (tomorrow), Uganda is busy strategising on how to combat the effects of the looming multi-drug resistant TB, which could reverse strides made in the fight against the disease. The day coincides with reports of severe TB drug shortages, which experts warn, will undermine efforts towards the World Health Organisation’s goals of detecting and treating TB by 70% and 85%, respectively come 2010. Dr. Henry Luwaga from the National Tuberculosis and Leprosy Programme says: “We shall not only continue falling short of the global targets, but also risk doubling cases of multi-drug resistant TB which can be very tragic given that the other alternative second line treatment is expensive.” “The first line treatment for ordinary tuberculosis costs about $30 (sh60,000) per patient for eight months. The second line treatment is estimated at $1,500 (sh3m) for each patient over a two-year period,” Luwaga says.

What causes TB?

TB is a viral disease caused by germs that are spread through the air. They usually affect the lungs, but can also affect other body parts. These germs can float in the air for several hours, so people who breathe in the germs may become infected, depending on their immunity and no symptoms may show. Luwaga says the disease is treatable, but patients can die if they do not get proper treatment. “And it can also fail to respond to treatment if the patient does not follow the drug schedule and instructions,” Luwaga says. He says multi-drug resistant TB is one whose strains are resistant to at least two of the best anti-TB drugs, isoniazid and rifampicin, which are considered first-line drugs for TB. Apparently, not all the four common anti-TB drugs — Isoniazid, Rifampin, Pyrazinamide and Ethambutol are out of stock, but still the damage can be enormous. “The patient is started on all the four drugs but ends up with only the two that are available. This affects treatment. The reason they are administered in clusters is because they interact,” he explains. The Government requires about $1.5m (about sh3b) per year to buy TB drugs, but often relies on the Global Fund for malaria, TB and HIV/AIDS. The mishap has pointed at poor management as the delay found no fall-back and this can be a lesson learnt as we celebrate the global holiday.

TB and HIV/AIDS, a double jeopardy:

According to the WHO, about 16% of new TB patients are HIV-positive. TB is one of the leading causes of death in people with HIV, with about 13% of AIDS-deaths worldwide. Joseph Imoko, the WHO national professional officer for TB, says in many countries with a high prevalence of HIV/Aids, TB cases have gone up. “TB infections increased by almost 12% between 2001 and 2005 and we estimate that 70% of Ugandans living with it also have HIV,” he adds. Nsambya Hospital’s Dr Maria Musoke says living with both HIV/AIDS and TB often leads to early deaths, drug adherence problems and resistance. “Both conditions increase pill count as either drugs come in clusters. Sometimes we are forced to stop ARVs for a while (particularly the first two months) for one to effectively adhere to TB drugs,” she reveals. But experts also warn of increasing resistance against ARVs. “Patients also tend to abandon treatment courses once they improve, which increases resistance,” she adds. Resistance to anti-TB drugs can occur when these drugs are misused or mismanaged for instance when patients do not complete their full course of treatment; when health-care providers prescribe the wrong treatment, the wrong dose, or length of time for taking the drugs; when the supply of drugs is not always available; or when the drugs are of poor quality. Research shows that people who are more susceptible to resistance usually do not take their medicine as prescribed, have recurrent active TB even after full course medication, come from areas where drug-resistant TB is common or have spent time with someone with drug-resistant TB. Musoke says if one suspects they have been exposed to someone with TB, they should contact a doctor or local health department about getting a TB skin test or special TB blood test. It costs at least sh25,000. She says there are low detection rates because of poor access to healthcare services, a limited number of skilled staff and diagnostic facilities. Besides, certain drug combinations, especially for children are hard to import. Up to 3% of deaths in children globally and 6% of children below five years in sub-Saharan Africa are a result of TB.

Burden of TB and multi-drug resistant TB

Globally, 9.2 million new tuberculosis cases and 1.6 million deaths occur annually. Dr. Francis Adatu-Engwau, the programme, says in 2007, the country reported 41,579 cases, of which 20,364 were infectious. About 80,000 new cases occur annually, and studies put the infection prevalence at 600 per 100,000 people, with the 20 — 45 age group mostly affected. “Unfortunately, only about half the cases are tracked, yet people infected with TB do not necessarily become ill but can infect between 10 and 15 people a year, if left untreated,” he says. However, Uganda has no local comprehensive survey to ascertain the problem. Adatu says the process, which is a prerequisite to qualify for the Green Light Committee funds that help governments procure second line drugs for the disease, is underway. Dr. Maria Musoke, the coordinator of Nsambya Hospital Homecare Department where HIV and TB patients are treated, says they are handling 11 cases of multi-drug resistant TB. “Since we have no drug alternatives, we give them drugs that are showing resistance. We deliver the drugs to the patients’ homes so they do not infect others with the resistant strains,” she explains.

Prevention of tuberculosis

The health ministry recommends that every child at birth be given a TB vaccine commonly known as BCG to reduce the spread of the disease. However, Luwaga says the vaccine does not provide 100% protection. It only protects a child from severe forms of TB, but it is highly recommended. Dr. Joseph Kawuma, a consultant with the German Leprosy and Tuberculosis Relief Association, says the only way of containing TB spread is early detection and treatment. He recommends a check-up when one gets cough for three weeks. “Health workers should look out for multi-drug resistant TB to minimise its spread. Healthcare providers can help prevent multi-drug resistant TB by diagnosing cases, following the recommended treatment, monitoring patients’ response to treatment and making sure therapy is completed.” An internet site, www.medicineplus.com, advises people to avoid exposure to multi-drug resistant TB patients. TB symptoms include body weakness, weight loss, fever and night sweats. Uganda has embarked on a plan to increase the TB case detection rate from 49.6% in 2006 to 75% by 2011. It also plans to increase the treatment success rate from 73.2% in 2006 to 80% by 2010. This year’s theme, I am stopping TB and controlling HIV, aims to encourage people living with HIV/AIDS to often consider TB tests.

NEWS: Tuberculosis- Shortage of drugs raises the risk of transmission

Tuberculosis- Shortage of drugs raises the risk of transmission

Sunday, 22nd March, 2009 from NEW VISION

PAUL coughs persistently as if he is about to die. For two years, the 40-year-old has been suffering from tuberculosis (TB). He was receiving treatment from Mulago Hospital until January 2009 when the hospital ran out of drugs. Paul went to Kawolo Hospital in Lugazi, hoping he would get the drugs, but they were also out of stock. Justin List, an American medical student, says: “I visited the TB wards at Mulago in January and there hadn’t been any pediatric TB medication since December 2008.”

List is in Uganda for a year on a US-funded research to learn about the progress of the disease. He says the TB drug, Ethambutol, that was being given to patients at Mulago had expired.

“There was a two-month initial phase treatment for only 12 people as of January 2009. But on March 19, when I visited the TB wards pharmacy, there had been no new medication received even after the stock had been replenished,” he adds.

Dr. Sam Zaramba, the director general of health services, confirms the shortage. “We know the problem is there, but there is nobody giving patients expired drugs. I will personally cross-check with Mulago and punish anybody doing this,” he says. Zaramba, however, blames the shortage on unfulfilled promises by the Geneva-based Global Fund. “Donors had given us drugs that will last till December 2008. The Global Fund had been promising to fill the gap, but when we ran short of drugs, there was no response from them,” he says.

Uganda’s problems with the Global Fund started in 2005 when all grants were suspended for three months, following mismanagement by the Programme Management Unit. But a source in the ministry blamed the ministry for the shortage. “We do not have any money budgeted for tuberculosis-related activities. The ministry depends on donors, yet many of them give empty promises.” Following the frustration of the Global Fund, Zaramba discloses that the ministry purchased TB drugs on a loan from Kenya to counter the shortage.

TB continues to be a major health problem in Uganda. According to a 2004 study entitled: Burden of tuberculosis in Kampala, Uganda, Uganda has a high prevalence of Tuberculosis infection at 14% annually. The study was jointly carried out by Makerere University Institute of Public Health and the US-Ohio based Centre for Global Health and Diseases. The study, however, cautions that healthcare managers and TB control authorities believe the prevalence of the disease is much higher than the notification figures reveal because of under-reporting and poor access to healthcare. Mulago sees about 25% of Uganda’s TB cases and has been receiving 250 TB patients per month.

What does the shortage mean to patients? A drug shortage creates a dire situation in the country since many patients are suffering from TB. Speaking at the Uganda Health Communication Health Alliance Workshop recently, Dr. Francis Adatu-Engwau, the programme manager of the National TB and Leprosy Programme, said Uganda is ranked 15th among the 22 TB high-burden countries worldwide.

“In 2007, the country reported 41,579 cases, of which 20,364 (49%) were infectious. The proportion of expected cases detected was 50.2%, below the 70% global target. Only 75.5% of the 2006 cohort were successfully treated, below the 85% target,” he said.

List says a shortage of TB drugs means a patient’s treatment regime is interrupted, leading to a high risk of TB transmission. The disease is spread through air droplets which are expelled when someone with infectious TB coughs, sneezes or speaks. It is common in areas where living conditions are unsatisfactory with overcrowding, poor hygiene and inadequate sanitation. Such living conditions, coupled with high prevalence of HIV at 6.4% and lack of access to healthcare may lead to a vicious circle of TB interruptions and transmission.

List warns that patients with interruptions in TB treatment are at risk of developing multi-drug resistant strains of TB, which are difficult to treat with first line TB drugs Isoniazid, Rifampin, Pyrazinamide and Ethambutol, currently used in Uganda. “Worldwide, multi-drug resistant TB is more difficult to treat and the drugs are more expensive. It is, therefore, in everyone’s interest to have uninterrupted treatment,” List adds.

To counter the transmission, Zaramba says the Global Fund has finally released money to purchase anti-TB drugs to last a year. “The manufacturer has been paid and by next week, we shall be receiving the drugs. For the time being, we are still using the drugs purchased from Kenya,” he says.

NEWS: Obama picks Carson for Africa affairs


Obama picks Carson for Africa affairs

Sunday, 22nd March, 2009 from NEW VISION

US President Barack Obama on Friday nominated the former US Ambassador to Uganda, Johnnie Carson, to be assistant secretary of state for African affairs. Carson is currently the national intelligence officer for Africa at the National Intelligence Council. In the late 1990s, he served under Susan Rice, the UN ambassador, as principal deputy assistant secretary for the State Department’s Bureau of African Affairs. Carson’s foreign service career also includes ambassadorship to Kenya and Zimbabwe.

Friday, March 20, 2009

NEWS: Drug shortage hits Uganda

Medical officers dispense drugs to a patient at Kiruddu Kampala City Council Health Centre in 2006


Friday, 20th March, 2009 from NEW VISION

UGANDA is facing a shortage of essential drugs in Government health facilities, according to the latest survey by Uganda Country Working Group. The study, conducted over the past four years, show that 32-50% of essential medicines to treat common diseases like malaria, pneumonia, diarrhoea, HIV/AIDS, TB, diabetes and hypertension are not readily available.
Consequently, a consortium of five Ugandan health civil society organisations on Thursday launched a nationwide campaign, code named Stop stock-outs. Their partners are Action for Development, Action Group for Health, Human Rights and HIV/AIDS and Alliance for Integrated Development and Empowerment, Coalition for Health Promotion and Social Development and National Forum of People Living with HIV/AIDS Networks in Uganda.

According to these organisations, an essential medicines crisis is looming in Uganda because a major stock-out is establishing itself in government hospitals and clinics.

A workshop on Health Sector Transparency and Accountability organised by Action Group for Health, Human Rights and HIV/AIDS in Soroti recently revealed that there is a national stock-out of the first line recommended drug for malaria – Coartem at the National Medical Stores (NMS). And, as a result, malaria was being treated by quinine in many of the facilities. In some cases, quinine for children was not available and health workers said they improvised by breaking the adult tablet into smaller pieces to give the children the required dosage. Sometimes, where adult doses were unavailable, adults were treated using Coartem for children.

One official from the district health office told the workshop that Soroti had received tuberculosis medications remaining with only three months to the expiry date.

The situation is the same countrywide. Patients are forced to travel long distances to other health facilities where they still fail to get drugs, opt for alternative medicines or, in the worst case scenario, just wait at home to die.

Doctors say this trend may lead to treatment failure and emergence of drug resistance. They complained that it can take up to 60 days instead of 30 to process and deliver an order to the district. In some cases, the districts receive drugs which have not been ordered.

Participants, who included health officials, doctors, administrators and development partners, blamed monopoly by the NMS as the major cause of delayed drug supply and called upon the Government to decentralise the drug supply and procurement mechanism.

Currently, districts buy drugs either through the conditional grants or through District Medicines Credit Line System, where districts can buy essential drugs from NMS on creditand the finance ministry pays later. Where drugs are not available, NMS is required to issue a certificate of non-availability so that districts can procure the essential medicines from elsewhere, like the Joint Medical Stores. However, a the workshop it was revealed that NMS in most cases fails to issue these certificates, making it difficult for the districts to order drugs from elsewhere hence the stock-outs.

Denis Kibira, the Stop Stock-outs campaign coordinator, says although Uganda updated its Essential Medicines List in 2007, it does not adequately provide for key medicines crucial for the treatment of diseases like cancer. It also does not cater for specific age groups like children and the elderly.

He adds that two-thirds of the Government health centres do not have the list, according to the 2008 Pharmaceutical Situation Assessment survey by the health ministry.

The Uganda Country Working Group is a collaboration of the Ministry of Health, the World Health Organisation and Health Action International Africa (HAI-Africa).

It conducts quarterly surveys on medicine prices and availability in the four regions of the country. This is part of monitoring the ongoing interventions by the Ministry of Health within the second Health Sector Strategic Plan (HSSP II) to increase access to essential medicines for all Ugandans. The Coalition for Health Promotion and Social Development (HEPS-Uganda) represents HAI-Africa. “Stock-outs disproportionately affect the nine million Ugandans (31.1%) who live on less than a dollar-a-day,” Kibira said.

“To compound these problems, stock-outs force people in already dire circumstances to buy medicines at much higher prices from the private facilities.”
Medicines are often the largest health-related expense for poor families, he said. He calls for representation of civil society on the board of the National Medical Stores and increased transparency in medicine supply management.

He also wants the Government to live up to its commitment to spend 15% of the national budget on health care and to provide a dedicated budget line for essential medicines.

According to the survey, the availability of Coartem, the first line anti-malarial, was 28% in the private sector. Drugs for children were found to be consistently below 30% in the public sector, Amoxillin suspension was 13% and of Cotrimoxazole (Septrin) suspension was 29% and yet upper respiratory tract infection is a leading cause of death in children.

Availability of anti-diabetic medicines Glibenclamide and Metformin was respectively 46% and 25% in public sector.

Medicines for hypertension, like Nifedipine, was available in 46% of public sector facilities. “The continued low availability of children, anti-diabetic and anti-hypertensive medicines in both public and private sectors is not a good prioritisation of medicines for children and chronic diseases during procurement and hence poor emphasis on the non-communicable diseases which are on the increase in Uganda,” the report states.
However, NMS spokesperson, Hamis Kaheru, wondered how they could tell there is a stock-out because they are not the only suppliers. “We supply only 30-40% of medicines to the Government health centres,” Kaheru said. “The rest are bought by district health officials using the money given to them by the Government.”

He said if there are any shortages, they should be blamed on corrupt district officials who either fail to buy medicines or sell some to private clinics.

“We suspect the biggest cause of shortages could be theft of medicines,” he said. He added that the solution is to follow President Yoweri Museveni’s directive to have all Government medicines embossed (labelled). “At NMS, we are already doing it. But since we are the smallest suppliers, it may not solve the problem.”

Kaheru also dismissed reports that they delay processing districts’ orders for medicine. He said under the new management that is almost a year old, they now publish delivery schedules. These indicate the date when the health facility placed an order and the day medicines leave NMS for the districts.

“Some districts delay to send orders and yet we follow our monthly delivery schedule,” he said. “Those who miss will have to wait for the next schedule when the truck goes to their region again.”

HOW MEDICINE GETS TO YOU

 The Government forecasts how many medicines will be needed to treat the population, based on the major public health challenges in the country.

 Orders and tenders are then generated by the National Medical Stores.

 Medicines are then purchased and stored centrally.

 District stores and local health facilities decide what quantity of medicines they need and then place orders for these at the national medical stores.

 National Medical Stores then delivers the drugs ordered and if they are out of stock, they issue a certificate of non-availability for the facilities to procure the drugs externally.

 Patients then receive the medicines from health facility pharmacies

Thursday, March 19, 2009

NEWS: NDA lists syrups in investigation


NDA lists syrups in investigation from DAILY MONITOR ONLINE

The National Drug Authority has named 12 infant syrups whose safety and efficacy it is investigating.

A spokesman for the NDA, however, says parents should not panic and pharmacists should not withdraw the listed syrups from their shelves until the investigation is complete.

The NDA investigation comes after doctors in the United States, Kenya, and the World Health Organisation raised concerns about the efficacy of the syrups, most of which are used to treat coughs and colds in infants.

NDA spokesperson Fred Ssekyana told Daily Monitor that the investigation is focusing on 12 syrups that are registered and on sale in Uganda. He said the NDA would not issue an advisory for or against any of the listed syrups unless investigations conclude that they are harmful or useless to children.

“We are dealing with sensitive issues; we cannot work on hearsay,” Mr Ssekyana said. “The raised concerns have to be scientifically investigated until we get an evidence-based conclusion.”

The NDA spokesman said the investigation is covering the following syrups: Actifed Wet (Cough and Cold) Syrup 100ml, Actifed Compound Linctus (Dry and Cold Cough), Ascoril syrup 100ml, Benylin Expectorant Syrup 100ml, Benylin Pediatric Syrup 100ml and Benylin with Codiene Syrup.

Others are Bisolvon Elixir 100ml, Bro-zedex cough Syrup 100ml, Cadistin Expectorant 100ml, Linctifed forte syrup 100ml, Linctifed Paediatric Syrup 100ml, and Piriton Expectorant 100ml.

The spokesman said the NDA routinely inspects drugs prescribed and sold in the country.
“This is part of the usual work we do only that we do not always announce that we are going to do it,” he said. “We do it randomly and in an intelligent way. The dispensers should not be in the know; otherwise it would defeat the purpose.”

A senior official in the Health Ministry yesterday called for a speedy investigation into the matter to help parents and health practitioners make informed decisions about which medicines to give or not to give.

Dr Jeremiahs Twa-Twa, the acting assistant commissioner for health services in the Child Health Division, said: “The advice that can be given to parents is that the best approach to the situation is to always consult with their health workers on what medications to give their children.”

Syrups are popular among parents and many doctors because they are sweet and therefore easy to administer to children, and can also be bought over-the-counter.

Many parents have, however, been left with a bitter taste in the mouth after the US-based Centers for Disease Control and Prevention in 2007 warned against giving syrups to children after the deaths of three babies were linked to the toxic effects of cough and cold medicines.

A CDC study showed that more than 1,500 toddlers and babies wound up in emergency rooms between 2004 and 2005. Consequently, the CDC warned parents against giving common over-the-counter cold and cough remedies to children under two years without consulting a doctor.

In Kenya, top health facilities, including the Aga Khan University Hospital, are discontinuing the use of such syrups. In a public statement issued this week, the chairperson of the Kenya Pharmacy and Poisons Board said the reported syrups were neither being recalled nor banned.
Dr Francis Kimani, however, added that use of the syrups among children under 6 years “is not recommended but can only be used under prescription”.

Ugandan doctors started weighing in on the debate yesterday with Dr Vincent Ojoome, a senior consultant pediatrician, calling for caution in the administration of syrups to children.

“We are trying as much as we can to discourage the use of cough and cold syrups especially those that have sedative elements because they can be detrimental,” Dr Ojoome, who is also the medical superintendent at Mbale Regional Referral Hospital, said. “They give a false sense of security.”

He, however, emphasised that some syrups – for instance antibiotics – are vital in the management of infection.

NEWS: Spring, borehole water unsafe

Spring, borehole water unsafe’

Thursday, 19th March, 2009 from NEW VISION

WATER experts have warned against drinking un-boiled water from boreholes and spring wells. They said less than 15% of such water was safe for human consumption. “Less than 15% of the water collected from boreholes and spring wells is clean,” said David Mukama, a health ministry official. “Drinking water, which is not boiled, is a recipe for water borne diseases like diarrhoea.” Mukama who is also a member of the Water and Sanitation Working Group, a network of organisations working on water issues, said contamination of the water starts at the point of collection with dirty containers. He said further contamination was inevitable during transportation, storage and consumption of the water. Mukama was speaking in Kampala ahead of the World Water Day that will be celebrated on March 22. The national celebrations will take place in Namutumba district on March 23 during which the World Forestry Day and the World Meteorological Day would also be celebrated. Mukama warned that the sanitation coverage was only 62.5% and that households that lacked latrines posed a danger to the rest that had latrines because vectors do not have boundaries. “Prevention is better than cure,” he said, adding that better sanitation would reduce disease incidences. He also said people should be encouraged to wash their hands, pointing out that for every sh1 invested in proper sanitation, sh9 was saved. Gaster Kiyingi from the Global Water Partnership, said the reduced funding for the water sector was a step backwards.

NEWS: Cost of Health Care Going Up

from the DAILY MONITOR ONLINE

Cost of health care going up - expert

More than 60 per cent of Ugandans live under the poverty line, defined as subsisting on one dollar a day, and most of these people stay in high-density areas surrounded by poor drainage systems and health facilities.

Should they be unfortunate to be diagnosed with any illness, the cost of medication is prohibitive and they often opt not to buy the medicine but to plough through life and hope for the best.
According to Lucas Greyling, Managing Director of Microcare, a health insurance management firm, medicine costs are going up due to increasing transport costs, higher US dollar prices and imported inflation.

“This is an important area in which more support for locally manufactured medicines can play a big part in reducing the cost of medical treatment,” Greyling told Daily Monitor in a recent interview.

The current national planning for the distribution of health care facilities is based on the income per capita of the people.

Mulago, the national referral hospital, is by far the largest hospital in the country, with equipment, rooms, beds and facilities that can cater for over 20,000 people at any given time. However, the district or division hospitals can only cater for a smaller number of people and health conditions.

“If Uganda’s recent economic growth can be maintained, these difficulties will be overcome by supply and demand. It must also be said that a great deal of rebuilding has had to be done to facilitate the more recent successes in key areas such as HIV/Aids, good economic growth and a manageable rate of inflation,” says Greyling.”

Through a number of saving schemes and organisations, individuals are able to access quality health care in case of emergencies such as heart surgery, kidney transplant amongst others. This however, does not address the issue for every day health care which involves the prevention as well as curative measures.

“It is a good place to be, to know that if you have a toothache, you can quickly make an appointment or go to the nearest hospital for check up and treatment,” comments Dr Kwizera a private medical specialist.

“Health insurance is quickly becoming a must for individuals and corporations. Very soon, hospitals and doctors will be asking for your insurance card, as this will give them the peace of mind that the bills will be taken care of and they can take action without insisting that the patient fill numerous documents before treatment. This way, we are able to abide to our Hippocratic Oath without being accused of making the hospital lose money,” he adds.

“The concept of health insurance is new to most Ugandans and insurance firms like Microcare carry out sensitisation about the insurance coverage offered: list of hospitals, the level of referrals, cover inclusions, exclusions and ceiling limits,” Greyling said.

In line with MDG 2010, Uganda’s health care sector is mapped to grow proportionally nationwide, providing better quality health care for all and at an affordable cost.

NEWS: Alert issued over baby cold syrups


from DAILY MONITOR ONLINE

Alert issued over baby cold syrups

Parents will have to wait for an on-going investigation by the National Drug Authority to determine whether they should continue giving their children syrups that other countries have discouraged or banned.

A spokesman for the NDA told Daily Monitor yesterday that an investigation had been launched after doctors in the United States and in neighbouring Kenya raised questions about the safety and efficacy of 20 syrups.

“The moment we learnt of this development in Kenya, we embarked on investigations because most of these products are already on our market,” said Mr Fred Ssekyana.

“We have also received a notification from the World Health Organisation regarding the matter and when done with the investigations, we shall report back to the public. We are assessing whether these drugs pose any danger to the users.”

Mr Ssekyana said the NDA cannot withdraw the medicines from the market without evidence. The hospitals in Kenya, Ssekyana added, could have acted at institutional level because this happens everywhere. Twelve of the blacklisted syrups are registered by the NDA and are in circulation in Uganda.

Efforts to get comment from the WHO Country office in Kampala were futile by press time. However, in 2007 the US Centers for Disease Control and Prevention (CDC) warned parents not to use the treatments in infants, after the deaths of three babies were linked to the toxic effects of cough and cold medicines.

A CDC study showed that more than 1,500 toddlers and babies wound up in emergency rooms between 2004 and 2005. Subsequently, the CDC warned parents not to give common over-the-counter cold remedies to children under 2 years old without consulting a doctor.

Mr Ssekyana, however, said although NDA has not received any complaints regarding the said syrups yet, it could be that parents are ignorant of the problems that the said medicines might be having, if any.

“Users of medical products should always consult their health workers or report any effects to NDA,” Mr Ssekyana said.

Several of the drugs are in circulation in Uganda and are popular because parents find it easy to administer the syrups to children instead of tablets.

Ms Aida Nalubega is a parent whose child was recently given one of the listed syrups to treat a cough without much success.

“My daughter was given the syrup to be administered over a five day period but there was no change. When I returned the child to the clinic, the same medication was given for another 5 days but still it failed to work.

Up to now the child has cough,” Ms Nalubega said in an interview. Ms Nalubega says she is thinking of resorting to traditional ways of relieving cough like the use of honey and lemon, as medical authorities in Kenya have advised parents.

The Aga Khan University Hospital is among the top health facilities in Kenya that have raised the red flag and stopped stocking up to 20 types of syrups.

The hospital said in a circular that they based the decision on a recent world wide medical professional’s opinion that the listed medicines are neither safe nor effective as previously believed.

The move has since prompted the Kenyan authorities to act saying the said syrups cannot be used in children below two years.

Yesterday, in a statement published in the Daily Nation newspaper, the Chairperson of the Kenya Pharmacy and Poisons Board, however, said the reported syrups were neither being recalled, withdrawn nor banned from the market for lack of sufficient evidence.

Dr Francis Kimani, however added that “for children below 6 years, it [syrup] is not recommended but can only be used under prescription only.”

Wednesday, March 18, 2009

NEWS: Cash-strapped U.N. to halt West Africa aid flights

GENEVA, March 17 (Reuters) -

The United Nations will shut down its humanitarian air services in much of West Africa because of a shortage of funds, a spokeswoman said on Tuesday.

Emilia Casella of the World Food Programme (WFP) said the chartered aircraft used to ferry aid workers and supplies to remote parts of Guinea, Sierra Leone, Liberia and the Ivory Coast would stop on Friday, March 20.

"In areas that are not reachable by land ... aid workers will not be able to reach vulnerable people with medical care, food, water and sanitation, and other crucial services," she told a news briefing in Geneva.

"The U.N. will also not be in a position to carry out timely medical and security evacuations of humanitarian personnel, if and when needed," the spokeswoman said.There are 250 humanitarian agencies now working in the affected West African countries, Casella said.

The exact number of people receiving help from the U.N. air service was not known, but thousands of people would be affected, she said.

The suspension follows the halting of air deliveries to Niger in February, and temporary shutdowns of flights to the Central African Republic, Niger, and Sudan last year because of budget constraints that aid groups fear will worsen this year as the world's recession bites government budgets.

Casella said the U.N. air service had faced "chronic underfunding problems for years," making the prospect of aid cuts in response to economic pressures a real worry for the programme that brings assistance to hard-to-reach people.

"We are concerned that there is a risk that donors will find it difficult to maintain their contributions," she said, while stressing that funding levels had not fallen to date.

Donor funds from the European Union, United States, Britain, Canada, Spain and the Netherlands amounted to $115 million last year, far below the $193 million budgeted for the flights, which cut days off the time needed to get help to the needy.

Aid workers in West Africa have said they will have extreme difficulty doing their work without the helicopters and aircraft to help them reach places where roads and bridges are impassable or where security problems make road journeys unsafe.

Ron Redmond, a spokesman for the U.N. High Commissioner for Refugees (UNHCR), said the flights were crucial for reaching people displaced by conflict and disasters.

"We work at the end of the earth and the only way to get there is on the humanitarian air service," he said.

Worldwide, the U.N. air service last year carried 15,000 tonnes of humanitarian cargo and 360,000 U.N. staff, aid workers, donors and media staff. The 58 helicopters and aeroplanes also carried out medical and security evacuations in Chad, Mozambique, Myanmar, Somalia and Sudan. (Reporting by Laura MacInnis; editing by Stephanie Nebehay and Giles Elgood)

Tuesday, March 17, 2009

NEWS: Mosquito laser gun offers new hope on malaria

One of the biggest challenges to world health is malaria. After visiting Uganda earlier this year, I have since thought of the challeges that face countries where malaria is prevalent. In treating the multiple cases that we saw, there was always the knowledge that another mosquito could start the cycle of sickness all over again. Here is an interesting solution being developed:
________________________________


AMERICAN scientists are making a ray gun to kill mosquitoes. Using technology developed under the Star Wars anti-missile programme, the zapper is being built in Seattle where astrophysicists have created a laser that locks onto airborne insects.

Scientists have speculated for years that lasers might be used against mosquitoes, which kill nearly 1m people a year through malaria.

The laser – dubbed a weapon of mosquito destruction (WMD) – has been designed with the help of Lowell Wood, one of the astrophysicists who worked on the original Star Wars plan to shield America from nuclear attack.

“We like to think back then we made some contribution to the ending of the cold war,” Dr Jordin Kare, another astrophysicist, told The Wall Street Journal. “Now we’re just trying to make a dent in a war that’s claimed a lot more lives.” The WMD laser works by detecting the audio frequency created by the beating of mosquito wings. A computer triggers the laser beam, the mosquito’s wings are burnt off and its smoking carcass falls to the ground. The research is backed by Bill Gates, the Microsoft billionaire.

It is speculated that lasers could shield villages or be fired at swarming insects from patrolling drone aircraft. “You could kill billions of mosquitoes a night,” said one expert.

The anti-mosquito laser was originally introduced by astrophysicist Lowell Wood in the early 1980s, but the idea never took off. More recently, former Microsoft executive Nathan Myhrvold revived the laser idea when Bill Gates asked him to explore new ways of combating malaria.
Now, astrophysicist Jordin Kare from the Lawrence Livermore National Laboratory, Wood, Myhrvold, and other experts have developed a handheld laser that can locate individual
mosquitoes and kill them one by one. The developers hope that the technology might be used to create a laser barrier around a house or village that could kill or blind the insects. Alternatively, flying drones equipped with anti-mosquito lasers could track the insects with radar and then sweep the sky with the laser.

The researchers are tuning the strength of the laser so that it kills mosquitoes without harming other insects or, especially, people. The system can even distinguish between males and females by the frequency of their wing movements, which may be important since only females spread the parasite.

In experiments, the system could target mosquitoes with a flashlight, and then uses a zoom lens to feed the data to the computer, which fires at the insect. Each time the laser strikes a mosquito, the computer makes a gunshot sound. When the mosquito is hit, it bursts into flame and falls to the ground, and a thin plume of smoke rises.

The anti-mosquito laser is just one of many novel ways to kill the disease-carrying insects, in addition to the conventional strategy of vaccinating humans. Other ideas include devices that disrupt the mosquitoes' senses of sight, smell, and heat; feeding them poisoned blood; infecting them with a genetically altered

bacterium; and creating a malaria-free mutant to overtake the natural mosquitoes.
sources = www.physorg.com/news and www.timesonline.co.uk/tol/news/uk/science

Sunday, March 15, 2009

NEWS: Deadly weed invaded Uganda

A lady with wounds caused by the weed, left, seen growing in Busia spreads to 12 districts, kills animals, harms people


Friday, 13th March, 2009 from NEW VISION

AN alien weed that harms human beings, kills livestock and chokes crops has invaded Uganda. Congress weed, scientifically known as Parthenium hysterophorus, has been seen rapidly multiplying in several spots especially along the highway across Uganda from Busia and to Kabale. Dr. Gad Gumisiriza, head of the invasive species project in the agriculture ministry, said the weed has so far been detected in at least 12 districts. “This is a very aggressive weed which requires quick response. If you delay it can grow and get out of hand.” The most affected areas are Busiu along the Tororo-Mbale highway and Busia border town, each having over two acres of the weed. In Busia, a charcoal burner got a severe skin reaction and only improved after being hospitalised. Other affected areas include Karengare in Kabale district, Mbarara town, Bugembe town council near Jinja, Ibanda, Namutumba along Tirinyi road, Busesa in Iganga district, Namulemba in Bugiri district and Queen Elizabeth National Park in Kasese district. At Makerere University Kampala and Masaka town, two decorators were found growing congress weed as flowers without knowing it is a dangerous alien species. Witchdoctors also use the plant to invoke evil spirits, Gumisiriza said. Saturday Vision recently saw two herbal gardens in Bugembe where diviners have planted the weed. One of the diviners, Despite looking beautiful and smelling sweet, congress weed is among the world’s 10 most dangerous weeds. On contact with the human body, it causes a burning effect that can peel off the skin. Human beings who inhale pollen from the flowers can get an asthma-like illness or persistent flu-like symptoms. Cattle that eat it produce foul-smelling milk or even die. Gumisiriza said the weed can reduce maize yield by 40-60%. It can also reduce the amount of pasture in a grazing area by 90%. The congress weed is thought to have been introduced into Uganda from Mexico through Ethiopia and Kenya. It accidentally got to Ethiopia through relief grain imported from Mexico during the great famine that hit the Horn of Africa in the mid 1980s. It is dispersed mainly by long distance trucks, rivers, water streams and storm water (floods). The Jinja district production and marketing officer, Dr. Stephen Kiwemba, was shocked by how fast the weed multiplied in Bugembe. “When we came here in December, the seedlings were not as many as you can now see,” said Kiwemba. The weed can grow to the height of an adult and produce tens of thousands of seeds in one to two months. The seeds germinate easily but if the ground is not moist, it can remain viable (able to germinate) for up to 20 years. “The situation may not be as simple as we had earlier thought,” said Kiwemba. “We are headed to decline in agricultural productivity, food insecurity and poverty will set in as a result.” Nalongo Zamu Mukoda, said the weed resembles another local herb known as buza. She said they had turned to the new weed because the indigenous look-alike is getting extinct. So far, Kiwemba has organised a meeting in Bugembe to create awareness about the weed. But despite mobilisation by LCs, the locals are reluctant to attack the weed, except if it grows around their homes. A group of boda boda riders at Bugembe told Saturday Vision that they could not stop their money-minting routines to go uprooting the weed. LC1 chief for Katende West in Budumbuli-Bugembe, Siraje Kisuule said for better results the Government should provide funding to fight the menace. “It is important to intervene today instead of waiting until the problem is out of hand,” said Kisuule. In Busia, the communities are organising to pluck off the weed and caution children not to touch it. Kiyemba points out that while such local efforts are useful, controlling the weed requires a massive national programme. “The problem is that people are not looking at it as an issue. But if we remain reluctant it will become a bigger problem.” Agriculture ministry officials agree with Kiyemba. According to Gumisiriza, the ministry is planning to deal with the weed using chemical spraying, uprooting it and bugs to kill the weed. “We have prepared a programme to spray the weed in key areas. We have also contacted Kenya to see how we can handle the weed in the no man’s land at Busia border,” he said. “In the meantime, we are going to keep monitoring and creating awareness about the dangers of the weed.”


NEWS: Army at high risk of HIV/AIDS

Brig. Silver Kayembe, a UPDF officer, (L) chatting with Col. Johnson Muma in Jinja



Friday, 13th March, 2009 from NEW VISION

ARMIES in Africa are at high risk of getting HIV/AIDS by the nature of their job, the director of the Joint Clinical Research Centre (JCRC) has said. Prof. Peter Mugyenyi said because army officers live a distance away from their families, it puts them at a high risk of contracting the virus. Mugyenyi added that despite the preventive measures put in place, the prevalence of the disease had increased in Africa, with only three million, of the 25million infected, on treatment. He was on Wednesday opening a three-day international conference at the Jinja Nile Resort Hotel. The conference was convened by the African Union and sponsored by the Institute for Security Studies (ISS) based in South Africa. The armed forces in African countries, Mugyenyi advised, should come up with prevention campaign programmes and initiate joint unit operations to fight HIV/AIDS. The conference attracted 60 participants from South Africa, Swaziland, Botswana, Zimbabwe, Zambia, Malawi, Tanzania, DR Congo, Burundi, Uganda, Kenya, Togo, Nigeria, Ghana and Chad among others. Mugyenyi, also the Chancellor, Mbarara University of Science and Technology, urged the soldiers not to succumb to the pressures of low levels of education and poverty which hinder the fight against the HIV/AIDS pandemic. Maj. Felix Kulayigye, the UPDF spokesman advised African armies to come up with an African HIV/AIDS and military common policy. “We should control the infections through educative programmes, HIV testing and counselling and share experiences and control methods with other military forces in Africa,” Kulayigye suggested. He noted that HIV/AIDS had highly affected the UPDF and other forces on the peace keeping mission. “Most soldiers are always away from their families on peace keeping missions (like) in the DR Congo and in Somalia; they are the most prone to HIV/AIDS.” We need a joint plan for servicemen who get infected in the course of military services.” Brig. Charles Angina the UPDF Chief of Staff, called for a joint effort to fight the disease.


NEWS: Vaginal gel reduces HIV by 30%

Friday, 13th March, 2009 from NEW VISION

A vaginal gel being tested in Uganda to protect women from HIV has yielded promising results in separate trials in South Africa and USA. The microbicide candidate PRO2000 is being tested by Masaka Medical Research Council (MRC) in a study involving approximately 15,500 people from 25 villages. Microbicides are gels, foams or devices that are inserted in the vagina before sex to prevent HIV transmission during sex. Prof. Salim Abdool Karim of the University of Kwazulu Natal, South Africa, announced at the 16th Conference on Retroviruses and Opportunistic Infections, which ended on February 11 in Montreal, Canada, that the experimental microbicide reduced HIV transmission by 30%. It is the first time an experimental microbicide registers such success. The US-funded Microbicide Trials Network, which involved 3,099 women in Malawi, South Africa, Zambia, Zimbabwe and the US, prevented about a third of potential infections in women who used it, Karim said. Dr. Clementia Nakabito, one of the leading microbicide researchers in Uganda, said results of the PRO2000 trial in South Africa and America were ‘promising’ rather than ‘effective’. “Although it is very exciting, 30% is not good enough. It fell short of the statistical baseline of 33%,” she said. “But generally, the study, while not conclusive, provides a glimmer of hope to millions of women at risk for HIV, especially young women in Africa.” She said results of related trials in Uganda, Tanzania, Zambia and South Africa are expected this month. If these sites also show a 30% success rate, the microbicide may be tried on a bigger population or studied closer in comparison with the new generation vaginal microbicides which use ARVs. Nakabiito is the principle investigator in another microbicide study by Makerere University-John Hopkins University research Collaboration, which is formulated using antiretroviral drugs. Currently, women make up half of all people worldwide living with HIV. In sub-Saharan Africa, they represent nearly 60% of adults living with HIV. An effective microbicide could provide women with an HIV prevention method they can initiate. This would be particularly helpful in situations that abound in many places in Africa where it is very difficult, if not impossible, for women to refuse sex or negotiate condom use with their male partners.

Friday, March 13, 2009

NEWS: 50,000 more to get free Aids drugs

Thursday, 12th March, 2009 from NEW VISION

By Anthony Bugembe

ANOTHER 50,000 people living with HIV/AIDS are now eligible for free treatment under the new guidelines which the Ministry of Health released yesterday. The ministry recommended that anti-retroviral (ARV) treatment should start when the CD4 count of adults is less than 250, instead of 200 as has been the case, Sam Zaramba, the director-general of Health Services, said in a statement. CD4 count is a measure of the strength of the immune system. A higher CD4 count means that a person’s immunity is still strong. Dr. Kihumuro Apuuli, the Uganda AIDS Commission chairman, said under the new rules, the number of people eligible for the treatment will rise from 350,000 to about 400,000 people. ARVs suppress HIV to the extent that it cannot be detected in the blood. As at the end February, about 160,000 patients had been initiated on the treatment, just 50% of the people who need the life-prolonging drugs. For pregnant women and children less than 12 months, the treatment can start when CD4 cell counts are above 250 but less than 350, Zaramba said. Research in Uganda shows that treatment should start at the CD4 count of 350. However, due to shortage of resources, for many years the Ministry of Health has kept the cut-off point at 200. Dr. Andrew Kambugu, the head of mentoring and training at the Infectious Diseases Institute, said: “The 250 cut-off point is the balance between what science says and what the health ministry can afford.” Antiretroviral therapy first became available in 1998. About 1,500 patients are enrolled monthly. In August 2008, the drugs ran out and the ministry averted the shortage partly through soliciting for donations. “In order to reach the majority of all patients who require ARVs, steps are being taken to scale up HIV counselling and testing services,” Zaramba said. He said when people know their HIV sero-status, it can facilitate them to enter treatment early before they start getting complications. Only 25% of Ugandans know their HIV status. However, the Government has been encouraging people, especially the youth, to find out their HIV sero status to promote responsible living in case they are HIV-positive. Nearly 650,000 Ugandans unknowingly live with HIV-positive sexual partners. If nothing is done to make them aware of the risk, about 13% of them (about 85,000) will become infected this year. This partly explains why Uganda’s HIV infection rate is going up. More than a million Ugandans live with HIV. This translates to a prevalence rate of 6%.

Thursday, March 12, 2009

NEWS: Sleeping sickness kills 18 in Dokolo

Wednesday, 11th March, 2009 from NEW VISION

Some of the patients admitted to the sleeping sickness ward at Dokolo Health Centre


By Patrick Okino
A total of 18 people in Dokolo district have died of sleeping sickness. The director of health services, Dr. Samuel Ojok, said the latest death occurred last week and that 11 other people were still admitted and undergoing treatment at Dokolo Health Centre IV. “The cases have become common and we are asking people to come for testing in case anyone feels feverish,” Ojok told journalists at the health centre on Monday. He said the disease spread to the district in 2004 following the arrival of infected animals from the Busoga region for sale by businessmen. Ojok said because the disease presented itself in a confusing form, patients diagnosed with malaria were also being tested for the virus. He added that many people were unaware of the symptoms and that it had resulted into late reporting of the disease. The district has so far recorded 120 cases. Sleeping sickness or human African trypanosomiasis is a parasitic disease of people and animals caused by protozoa and transmitted by the tsetse fly. Its symptoms begin with fever, headaches and joint pains after the parasites enter through both the blood and lymph systems. The district information officer, Musopiri Suwet, said Kwera, Kangai and Dokolo sub-counties were affected with the disease. “The campaign is ongoing and we are asking people to report any person bitten by the tsetse fly,” Suwet told The New Vision. The World Health Organisation has released sh71m to help the district train health officials to contain the tsetse fly, spray of animals and follow up.

Wednesday, March 11, 2009

NEWS: West African meningitis outbreak kills 931: UNICEF

AFP/File – A doctor vaccinates a girl against meningitis in 2007. A meningitis outbreak has killed 931 people in …



DAKAR (AFP) – A meningitis outbreak has killed 931 people in four West African countries since January, with most deaths occurring in the continent's most populous nation Nigeria, the United Nations said Wednesday.

"Four countries of West Africa are affected with a total of 13,516 cases and 931 deaths," the UN children's agency UNICEF said.

"Nigeria is the most affected with 9,086 cases and 562 deaths. Niger reports 2,620 cases and 113 deaths. Burkina Faso reports 1,756 cases and 250 deaths. Mali reports 54 cases and six deaths."

UNICEF warned that the authorities in Nigeria, where public health facilities are abysmal and poverty rampant despite its huge oil riches, faced an uphill task in tackling the crisis.
"In Nigeria, case management and a mass vaccination campaign are underway. The stock of vaccine may be insufficient regarding the epidemiological trends, especially in the districts in the north," it warned.

Health authorities placed northern Nigeria on a state of high alert in January following a meningitis outbreak in the town of Zinder in neighbouring Niger.

Nigeria's largest northern state of Kano has been the worst hit thus far.

Meningitis causes inflammation of the lining of the brain and spinal cord and has long wracked Africa, the world's poorest region.

According to UNICEF, it can spread through sneezing and coughing. The disease mainly affects children and young adults aged 1-30, it said.

"The so-called African meningitis belt stretches from Mauritania in the west to Ethiopia in the east and is home to about 350 million people," UNICEF said.

"Outbreaks occur every year between December and May. The dry season, with strong dusty winds and cold nights make people more prone to respiratory infections and facilitates the spread of bacteria."

The biggest recorded outbreak of epidemic meningitis in Africa occurred in 1996 with over 250,000 cases and 25,000 deaths.

Even when the disease is diagnosed early, five percent to 10 percent of patients die, typically within one or two days of the onset of symptoms, according to the World Health Organisation. Most victims suffer irreversible neurological consequences.

The current WHO recommendation for outbreak control is to mass vaccinate every district in an epidemic phase, as well as nearby areas in alert phase. It estimates that a mass immunisation campaign can avoid 70 percent of cases.

Outbreak response also includes active surveillance and case management and support to community awareness programmes.

Once the disease is contracted, it can be treated in its early stages with antibiotics. WHO recommends oily chloramphenicol as the drug of choice in areas with limited health facilities.
UNICEF said mass vaccination drives were currently underway in Niger and Burkina Faso.

Sunday, March 8, 2009

NEWS: Uganda’s lung cancer cases rise

from NEW VISION


Uganda’s lung cancer cases rise

LUNG cancer in Uganda has increased by ten-folds, according to the latest reports from the Uganda Cancer Institute. The 1970’s records show that there were about 10 patients that would be diagnosed with cancer, annually. There are now 30 to 40 patients admitted at the institute in Mulago, annually. Lung cancer; is just one of diseases caused by tobacco smoking and chewing, of which Dr. Margaret Mungherera, a consultant, says are on the increase. She explains that most of the people dying of lung cancer in Uganda are always in their prime productive years. Tobacco, according to the Uganda Heart Institute, is a risk factor for six of the eight leading causes of deaths. Mungherera said this during the ‘Tobacco Usage Fight’ workshop, organised by Uganda Health Communication Alliance, at Hotel Triangle in Kampala on Wednesday. She said treatment of tobacco related diseases is too expensive, adding that it costs approximately $5,000 (about sh10m) to treat one patient every year. There are 30-40 lung cancer patients receiving care from the Institute, a cost of sh300m to sh400m, annually. Treatment in South Africa costs about $15,000 (about sh30m), per patient. The World Health Organisation estimates that by 2030, 10 million people will die of tobacco related illness, 70% of these deaths occurring in developing countries like Uganda. A survey conducted in the Department of Oral Surgery at Mulago found that 70% of the victims of cancer of the mouth had a history of smoking.

Saturday, March 7, 2009

NEWS: Two more children found with polio

this article is from NEW VISION


Two more children found with polio


Friday, 6th March, 2009

TWO other children in Amuru district have tested positive for the Polio virus, according to initial results. The district health officer, Dr. Patrick Odong, said more blood samples have been taken for testing. Odongo confirmed that the initial tests on the samples from the two children done at the Entebbe Research Institute returned positive for polio. The two bring to three the children who have tested positive for the disease that was believed kicked out of Uganda 12 years ago. The country had been declared free of the disease until last month when a 16- month-old tested positive. The latest victims are aged 24 and 22 months and are from Labongogali camp. Odongo said the sick children can be treated to mitigate the effects of the disease. “We are waiting for them to pass the acute stage, which is very painful, then we can send them for physiotherapy. “It can help them walk,” Dr. Odongo said. A polio vaccination exercise is to be launched again on Tuesday October 10, 2009. Last year, the health ministry launched an immunisation drive when polio was reported in DR Congo. The districts under threat were Kanungu, Kisoro, Rukungiri, Kabale, Kasese, Bushenyi and Mbarara.