NEGLECTED TROPICAL DISEASES – A story. Third place: global NTD storytelling competition

Story inspired by SAMUEL EDEM ITA

I come from BAKASSI. A peninsula on the Gulf of Guinea. It lies between the Cross River estuary, near the city of Calabar west of the Bight of Biafra, and the Rio del Ray estuary on the east. I grew up in this riverine town with my friends. Growing up in a village in the southern part of Nigeria comes with many adventures, we had our childhood experiences together; from bathing in the river daily, playing in the forest and building little mud houses with the moist soil after the rains. We didn’t have the best of life but we were happy with what we had. Our harvests were bountiful, and our fishermen caught big fishes. My mother always believed it to be an indication that the gods were happy with us and thus blessed us.

Things began to fall apart when strange diseases started to ravage our land. It started with Chief Nakanda, whose left leg suddenly began to swell unexplainably. Initially, he thought it was nothing serious but as time passed, the swelling increased until he was completely immobilized. He took every pill ‘dockay’ prescribed (a young man who came to the village to sell drugs as we didn’t have any health facilities in our village). The chief soaked his legs in hot water, rubbed warm red oil, tried every herb and enchantment available in the village but all to no avail. People began to say he had committed a grievous sin and the gods were punishing him for it, others said that the spirit of his new wife’s ex-husband was afflicting him as he just married a young beautiful widow 3 months after her husband’s demise.

To prevent the curse from spreading our king – King MUTANDA II declared that Chief Nakanda be banished to the outskirts of the village and no one was allowed to visit him except his wife. In our ignorance, we all agreed to this judgement, we had believed it was a curse from the gods and we needed to isolate him to avoid being affected also.

Then we suddenly discovered some other people in the village both men and women had also started to develop swollen leg sickness including our king. Could it be that they all offended the gods? The majority of them, however, were decent people with no record of societal evil of any form. When we realized that all our herbs and enchantment couldn’t help, our chiefs decided to try modern-day medicine.

Unfortunately, ours was a neglected village, we had no health facilities in our village. The travel took 8hrs to the city. I was a member of the entourage for this journey.

When we got to a hospital, we met a doctor who demanded that we waited outside while he examined our king. The doctor later said he would immediately admit the king. He asked if any of us had heard of Neglected Tropical Diseases(NTD’s)? He diagnosed our king with ELEPHANTIASIS and went further to explain in simple words what it meant. He said it belonged to the class of illnesses called NTD’s and was caused by worms transmitted through mosquito bites. He took time to enlighten us on Neglected Tropical Diseases and while he spoke I realized that my village had been plagued by different NTDs for a long time but we always attributed the diseases to curses and bewitchments.

As he spoke of Buruli ulcer, which damages skin and bones, I remembered Ekpenyong’s second son who died from a similar condition, he had an infection on his face which appeared like something was eating away his skin and we had all believed it was a bewitchment. If we had come to a hospital or maybe if we had a health centre in our community Asuquo – Ekpeyong’s son would not have died.

He also described cases of leprosy where some persons lose the sense of touch or feel in the hands and feet, with whitish skin discolouration and some eventually losing their fingers. We had all experienced this in the village but again thought it to be bewitchment. Listening to Dr Garry tore a thick veil off my eyes as regards all the strange illnesses we had in our village. When Dr Gary had finished his lecture, he asked about our source of drinking water and we told him we all drank from the stream of which we also took our baths and sometimes defecated around it. The good doctor declared it the source of most of our illnesses. There and then, I knew that my village was heavily laden with Neglected tropical diseases, most of which we weren’t aware of yet. When we inquired about what to do, the doctor assured us that NTD’s were preventable. I felt sad that we lost our sons and daughters to avoidable diseases but how could we have known when there was no one to inform us. I remembered the banishment of Chief Nakanda 7years ago to the village outskirts. The chief who by sheer hard work held the highest title in the land had sold all his land and fishing canoes to native doctors seeking a cure. He died a pauper. I thought of all the famine that we have experienced in the last 7years because we lost available manpower to illnesses and tending to sick loved ones. Poverty had increased in our land, our mothers carried gloomy faces and our fathers sat in silence for days.

We spent two weeks in the hospital and by that time, King Mutanda II was discharged for his swelling had reduced to a good extent though he was still meant to take his medications. Before we left Dr Gary had informed the state ministry of health about our village and an NTD team was mobilized to accompany us to survey the village, carry out sensitisation and treatment also.
We arrived at the village later that day and immediately rumours had spread that we brought people with a cure back home. The team was welcomed as the “Angels of life”, they lodged in the king’s palace. Every intervention strategy was employed both mass drug administration(MDA) with everyone receiving some drugs like antihelminthics for deworming and intensified disease management (IDM) – where those with specific diseases were given targeted therapy. Another team was invited to fumigate the environment ensuring that there was effective vector control to prevent a recurrence. The team dug pipe-borne water and connected taps placed at strategic points in the community, several water-cistern toilets were provided also for proper sewage management.

I write today in retrospect, for I have not spoken about the personal pain NTD caused me. I lost my mother during those 7 long years. She was pregnant: her eyes, skin and tongue were pale and she frequently complained of stomach pains. I later discovered my mother died of HOOKWORM INFECTION in pregnancy. I vowed to be like Dr Gary. To get enough education and become a doctor so I could help my people in BAKASSI. Today, I am in my 5th year at the University of Calabar, Nigeria. Telling this story gives me a mixture of sadness and great joy – my people are no longer dying to NTDs but I still wish the intervention had come earlier.

Looking at Nigeria today, a lot has been achieved in the fight against Neglected tropical diseases, we’ve penetrated dark lands, we have gained so much grounds, the government and some NGO’s have committed so much to the fight against NTD’s through sensitisation and mass treatments. In the last 15 years, cases of Neglected tropical diseases have significantly reduced in my nation but the fight is still far from being over.

NTD’s still affect more than 1billion people across the world, the majority are people living in low-income countries with each of these countries affected by at least 5 NTD’s.
Fighting NTD’s matter’ because its consequences are grave, ranging from permanent disability, social stigmatization, social isolation, blindness, poverty, loss of economic manpower, malnutrition, stunted growth, low self-esteem etc. Many of these were present in my village. We had become a ‘ghost town’. Surrounding villages no longer came to trade with us, we were losing our manpower resources. This was traumatizing.

Also, fighting NTDs will help the world achieve Goals 1, 2, 3 and 6 of Sustainable Developmental Goals (SDG’s) which are respectively; End poverty in all its forms everywhere; End hunger, achieve food security, improve nutrition and promote sustainable agriculture; Ensure healthy lives and promote wellbeing for all and all ages and ensure access to clean water.
By fighting NTDs we make the world closer to achieve the above SDG’s.

We must stop at nothing in our quest to stamp out NTDs so no one else will have to live in permanent isolation like Chief Nakanda, and our world will be a better place even for those living in the poorest countries. Together we can fight NTDs and all the pains and deformities that it brings.

Let us remember “a disease threat anywhere is a disease threat everywhere”.

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