Europe South Asia Asia Pacific Americas Middle East Africa BBC Homepage World Service Education



Front Page

World

UK

UK Politics

Business

Sci/Tech

Health

Education

Sport

Entertainment

Talking Point
On Air
Feedback
Low Graphics
Help

Sunday, October 25, 1998 Published at 12:34 GMT


World: Africa

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%.


[ image: This shopkeeper makes sure the patient takes their medicine]
This shopkeeper makes sure the patient takes their medicine
Millions of poor, mainly black South Africans are infected with TB and the health ministry acknowledges the illness has reached epidemic level.

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.


BBC Southern Africa Correspondent Jeremy Vine examines the successes of Directly Observed Therapy
But at the Jane Furse Hospital, staff believe they are winning the battle, with a method of treatment called DOTS that is staggeringly simple.

DOTS stands for directly observed therapy, short course: and it is proving highly effective.

Community care


[ image: Bad sanitation is one cause of the disease]
Bad sanitation is one cause of the disease
In one village the nurses have recruited a shopkeeper near the home of one patient who is willing to make sure she takes her TB pills.

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


[ image: Diagnosis from a bag of bones]
Diagnosis from a bag of bones
TB spreads like wildfire through these poor rural areas because of bad sanitation and cramped living conditions.

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.

Traditional medicine


[ image: Traditional cures have proved ineffective]
Traditional cures have proved ineffective
Whatever the diagnosis, the healer has a whole cabinet of traditional medicines, including some that he says will combat TB. Most of them are in old vodka bottles.

"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


[ image: Johannes Maisane takes a daily walks to collect his pills]
Johannes Maisane takes a daily walks to collect his pills
"I'm very grateful" he says. "I now feel much better and can walk 15 miles without a problem."

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."



Advanced options | Search tips




Back to top | BBC News Home | BBC Homepage | ©




Africa | Americas | Asia-Pacific | Europe | Middle East | South Asia



Relevant Stories

03 Sep 98 | Health
Poverty aids rise of superbugs

02 Jul 98 | Health
Drug resistant TB poses major health threat

10 Jun 98 | Latest News
Breakthrough in TB battle

26 May 98 | Medical notes
Tuberculosis





Internet Links


Medical Research Council of South Africa

World Health Organization: Global Tuberculosis Programme

Stanford University Center for Tuberculosis Research

Columbia University Medical Informatics: Tuberculosis Resources

University of Cape Town: Action TB

Tuberculosis fact sheet

TB Net


The BBC is not responsible for the content of external internet sites.




In this section

Dam builders charged in bribery scandal

Burundi camps 'too dire' to help

Sudan power struggle denied

Animal airlift planned for Congo

Spy allegations bug South Africa

Senate leader's dismissal 'a good omen'

Tatchell calls for rights probe into Mugabe

Zimbabwe constitution: Just a bit of paper?

South African gays take centre stage

Nigeria's ruling party's convention

UN to return to Burundi

Bissau military hold fire

Nile basin agreement on water cooperation

Congo Brazzaville defends peace initiative

African Media Watch

Liberia names new army chief