Sunday, October 25, 1998 Published at 12:34 GMT
South Africa's war on TB epidemic
South Africa is suffering from a TB epidemic
By Southern Africa Correspondent Jeremy Vine
In South Africa's rural hospitals a wracking cough is a sure sign of tuberculosis. Without treatment the disease is invariably fatal.
Now, a Northern Province hospital has slashed the death rate for TB with a simple but effective treatment that has raised the cure rate from 40% to 80%.
The remedy is a six month course of tablets - but there is a hitch: patients can't stay in hospital all that time and the nurses know that many will go home, feel a bit better, and then stop taking their pills.
DOTS stands for directly observed therapy, short course: and it is proving highly effective.
The shopkeeper is given a checklist and the tablets - if the patient doesn't turn up to take them the shopkeeper will ring the hospital.
Nurse Emily Mafri says this is being repeated across the region and is saving many lives.
"A patient can see that she is being supported by the community and the shopkeeper and she can see that it's very important for her to complete the course of treatment," she says.
A disease of poverty
But traditional healers are being blamed as well.
The people who used to be called witch doctors still do a roaring and lucrative trade.
One local healer uses a bag of bones and other odds and ends to diagnose his patient's condition. The way the bones fall onto the ground will say what's wrong with them.
"This one has dust inside" he explains. "You put it in boiling water and then the patient drinks it."
Johannes Maisane drank quite a lot of 'dust' until realising he was about to die of TB and went to hospital instead. The doctors put him on a DOTS course which means a daily walk to the local grocer to collect his tablets.
One cured many more to go
His life has been saved - two more weeks and he will be completely clear of TB.
But the man behind DOTS, Dr John Millard, is not celebrating yet because there is still an enormous TB epidemic.
"It's going to put an enormous strain on the health service, on the doctors, on beds, on nurses and the supply of drugs," he says
"It's a very serious problem which could affect the economy of the whole country."