How cultural beliefs are hindering treatment of TB in Africa

ANOTHER TRADITIONAL DOCTOR

After one week, Asha’s mother advised her to take the child to Coast General Teaching and Referral Hospital after it became evident that the ‘black magic’ was not helpful.

However, her husband opposed it, saying they should give it (black magic) more time before they go to the hospital.

They were then directed to another traditional healer called ‘Mzee Try’ in Kisauni.

“Your child has been really affected by ‘Chira’. If I give you my medication, your son should be healed within a week. He will be very healthy,” Mzee Try told them.

Chira is a belief among the coastal communities that a child would become terribly sick if one partner engages in extramarital sexual affairs.

Asha’s sister, who stays in Mwapala in Shimba Hills in Kwale county, called to ask how the child was faring.

“We told her he was still sick and in pain, and she said she knows of yet another renowned healer in Shimba Hills who could help us. The healer told us my child has been possessed by evil spirits. He will never walk or talk,” Asha said.

The traditional healer asked them to bring two cocks: a red one and a black one.

“I did not have the hens with me at that time. He administered some traditional ‘first aid’ and asked for Sh900,” she says.

“We went back after a day with the cocks. He yet again asked for three kilogrammes of rice and gave me some oil to be used for seven days. We stayed at the house of the traditional healer for a whole week. Nothing changed.”

After three attempts to visit traditional healers, Asha decided to visit Lunga Lunga Subcounty Hospital for medical attention, and the doctors referred her to Msambweni County Referral Hospital for X-rays.

“Before the xX-ray results were out, we were referred to yet another traditional healer in Mwangulo. This healer was my husband’s aunt,” she says.

The relative told them her son was possessed by seven jinis, adding that they would have to dance for a whole night to oust them.

“We were required to buy three special clothes. She asked for eight hens: one of the hens should be ‘disabled’, either without a leg, wing or eye. One should be a white cock, a black one and a red one,” she says.

Four hens were for the traditional healer and four were to be slaughtered as sacrifices.

“The healer also asked for a black goat and Sh7,540 cash money. We danced from 3pm throughout the whole night, while my child was being bathed in cold water,” Asha says.

Once back home, however, nothing changed. The situation became worse and the child stopped breastfeeding for two weeks. He was very sick.

She went back to Lunga Lunga Subcounty Hospital and was advised to go to the tuberculosis clinic. The doctors asked for the child to be admitted before they could collect the samples for testing.

The young boy was diagnosed with TB and immediately placed on medication in August.

It is now three months since Hussein started his medication and his health has really improved. He now crawls and tries to stand on his own.

PRAYERS, ‘JUJU’ MIX

At Perani village of Kwale, 67-year-old Jimmy Muli is under TB medication for a second time after he developed Multi-Drug Resistant TB.

XX

Muli says when he first contracted TB in 2018, he was placed under medication for six months and declared TB free after finishing his dose.

After five months, he started engaging in hard labour again, he said.

Around June this year, while he was busy on his farm, he felt the urge to cough. He spew some blood and had to rush to the hospital.

“I was immediately diagnosed with TB and placed on medication for one year,” he says.

Around November, he was advised to seek spiritual healing from a local pastor in Mrima area of Lunga Lunga.

Muli says the pastor advised him to put on heavy clothes because “he was suffering from cold.”

The father of nine explains that he felt better after the prayers. He parted away with Sh300 at the pastor’s place as an offering.

“After a week, I was not feeling any better and I was advised to go see a traditional doctor because there are people who are jealous of my hard work,” he narrates.

The distance from his home to the herbalist costs Sh1, 200 on a motorbike.

“I was asked to pay yet another Sh3, 800 to the traditional healer. I spent a total of Sh5, 000, but nothing changed. I wasted my money. I shouldn’t have gone to those places in the first place,” he says.

Peter Jilani, the Lunga Lunga Sub County TB and Leprosy Coordinator, explains that before devolution, most of the rural residents used to mistake TB for witchcraft due to lack of information.

“However, the number of those who associate TB with witchcraft is slowly coming down due to the campaigns we have been doing at the grassroots,” says Jilani.

He says at Lunga Lunga Sub County Hospital they are now handling more and more TB patients as locals come for testing.

“We handle TB clients from within Kwale and even from neighbouring Tanzania. I’m happy to note that we have had increased diagnosis of TB because people come for testing regularly,” he says.

Two years ago, the Lunga Lunga Sub County Hospital facility was dependent on AFB Smear Microscopy for testing of TB, which is not as sensitive as the modern technology used in diagnosis, explains Jilani.

Recently, the facility received the Truenat TB testing machine, which is a new molecular testing machine that diagnoses TB within one hour.

“We received this new machine courtesy of USAID. It has higher sensitivity compared to AFB microscopy and we have so far managed to improve our diagnostic rate,” says Jilani.

Initially, Lunga Lunga Sub County Hospital used to record about six cases of TB every month, but since they started using the Truenat TB testing machine, they have been able to double the number to 12 patients per month for the past three months.

We have increased the cases from an average of 36 cases per quarter to 48 cases every three months. This quarter of October to December we expected to have over 50 cases,” explains Jilani.

According to the TB expert, before the onset of devolution in 2013, the cases of locals associating TB with witchcraft were very rampant in Kwale County.

However, they have been carrying out regular sensitization forums to enlighten the community to understand what TB is all about.

“What we have tried so much to do is to give information at the community level down to the household level using the community health volunteers,” says Jilani.

“That aspect of constant health education has been able to curb the stereotype.”