Do Africans fear Western medicine? Thomas Land on the outbreak of polio in northern Nigeria and how past medical experiments in Africa have made some Africans distrustful of Western medicine.
WHO experts say a year-long pause in the vaccination campaign enforced by the Kano administration created the conditions for the emergence of a rare, mutated form of the polio virus, which has now infected 69 children. The boycott exploited a deeply felt scepticism of Western medicine current throughout the continent.
That scepticism is reinforced by recurrent healthcare catastrophes in Africa occasionally resulting from criminal conspiracy, observes an eminent American doctor in an important new book, entitled Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from colonial time to the present. The WHO has just launched a global campaign to improve the safety of patients--and especially those in Africa--from a very wide range of medical malpractices, including the use of dirty syringes that can spread the HIV/Aids virus. Polio has no cure but it can be prevented through vaccination. It is a disease of the nervous system that affects mostly children and can lead to permanent paralysis and death. The infection spreads through water contaminated by sewage. Polio was conquered in Europe after the Second World War. The WHO estimated in 1990 that a global campaign to eradicate the disease from Africa and the other developing continents was to succeed within 15 years. The emergence through the boycott of a large unprotected population pool in West Africa, according to the WHO, has now created a huge setback.
In a well vaccinated population, the new mutant form of the virus would not cause a major infection risk, says Dr. Bruce Aylward, the WHO director in charge of the global polio eradication campaign. The new virus strain identified in northern Nigeria originates from the vaccine received by children in the crippled Kano campaign. The vaccinated children passed it on to unvaccinated people vulnerable to the infection. Dr. Aylward believes the disaster occurred because only 30-40% of the local children had been vaccinated. The result, says the WHO, is the biggest such outbreak ever recorded in the region including some 1,300 mutant as well as "wild" polio infection cases, spreading to nearby areas hitherto considered free of the disease.
The boycott followed claims made by Islamic clerics that the vaccination campaign was a covert plot against the local population. They said this was in line with several previous, well documented cases of Western medical conspiracies against Africans. On this occasion, the WHO has managed to persuade the worried clerics that the polio vaccine was safe. But many local people remain unconvinced.
Even before the Kano outbreak, Harriet A. Washington, Fellow of Harvard Medical School, raised the alarm over the likely outcome of the boycott that had begun five years ago in Nigeria as well as Chad and Burkina Faso. She is the author of a landmark study on vicious medical experiments conducted by Europeans on Africans (Medical Apartheid, Doubleday/USA, 2007).
She describes widespread fear of Western medicine throughout Africa generated by a series of well publicised criminal events. She writes: "In March 2000, Werner Bezwoda, a cancer researcher at South Africa's Witwatersrand University, was fired after conducting medical experiments involving very high doses of chemotherapy on black breast-cancer patients, possibly without their knowledge or consent.
"In Zimbabwe, in 1995, Richard McGown, a Scottish anaesthesiologist, was accused of five murders and convicted in the deaths of two infant patients whom he injected with lethal doses of morphine. And Dr. Michael Swango, ultimately convicted of murder after pleading guilty to killing three American patients with lethal injections of potassium, is suspected of causing the deaths of 60 other people, many of them in Zimbabwe and Zambia during the 1980s and 1990s.
"The most notorious is Wouter Basson, a former head of Project Coast, South Africa's chemical and biological weapons unit under apartheid. Dr. Basson was charged with killing over 200 blacks in South Africa and Namibia, from 1979 to 1987, many via injected poisons. His lieutenants testified in detail and with consistency about the medical crimes they conducted against blacks ... One of their chief goals was to find ways to selectively and secretly sterilise Africans." But Basson was acquitted.
Harriet Washington argues that even the most idealistic medical workers can sometimes justify the worst expectations of Africans. Well-meaning Western caregivers can sometimes use incompletely cleaned or unsterilised needles, simply because nothing else is available, she says. And such needles "can and do spread infectious agents like HIV--proving that Western medical practices need not be intentional to be deadly."
Hence the global research and development programme to reduce the risk of harm done by medical staff to their patients. The project to construct international research networks linking medical scientists with policymakers has just been launched at a major conference in Porto, Portugal, by the WHO World Alliance for Patient Safety in association with the European Union.
The idea is "to translate research findings into tangible actions that can save lives", says Sir Liam Donaldson, chief medical officer for England and chairman of the WHO patient safety alliance. This is how the WHO quantifies some of the challenges:
* The rise of antimicrobial resistance has led to healthcare-associated infections affecting some 1.4m people at any given time. They include perhaps a quarter of all patients in the developing countries and 5-10% in the rich world.
* As much as one half of all medical equipment is unusable or only partly usable in the developing countries, and surgical care there is constrained by poor facilities, lack of trained staff, inadequate technologies and limited supply of drugs and materials.
* An estimated 5-15% of HIV infections in developing countries are due to unsafe blood transfusions. About 60 countries are not able to screen all donated blood for one or more infections including HIV.
* Up to 40% of injections worldwide are given using syringes and needles reused without sterilisation. In some countries of Africa, this proportion is as high as 70%. Unsafe injection practices cause an estimated 1.3 million deaths a year.
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|Date:||Jan 1, 2008|
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