Important note: Information in this article was accurate in 2006. The state of the art may have changed since the publication date.
Sunday Times (Johannesburg) - September 10, 2006
Bongani Mthethwa
The hearse was soon followed by another, carrying another body.
In the past, bystanders would have been moved by the solemn atmosphere. But these people have become too familiar with the horrors of death - from Aids-related causes, from faction fights, from the political clashes of the '90s.
So, on Friday, the people of Msinga went about with their usual chores, perhaps unaware of the new killer in their midst: extremely drug-resistant tuberculosis (XDR-TB), a virulent strain of the disease.
The XDR-TB is not only resistant to the most commonly used medications, it has also refused to respond to second-line drugs as well. The disease is exceptionally difficult to treat, with all but one of the 53 patients - including six health workers - who were diagnosed with the strain recently having died within 25 days of infection.
And doctors have almost given up on the survival chances of three other people under monitoring. "We don't expect much of a favourable outcome," said Dr Oladayo Ojo, medical manager at the Church of Scotland Hospital on Friday.
Ojo attributed the outbreak of the most lethal strain of TB to the high levels of poverty in Msinga and surrounding areas.
"We need to address the poverty issue here," said Ojo. "Other problems are housing issues, overcrowding and illiteracy - people not understanding how to circumvent these issues."
Early this year, a total of 176 people died in the area after they were diagnosed with multi-drug-resistant TB - another extremely dangerous form of TB which was identified at the University of KwaZulu-Natal in 1995 - and the even more dangerous, highly drug-resistant TB.
"But when your immune system is very weak and you're not eating well, it's easy to be infected by TB - which is an opportunistic disease. If a patient has adequate nutrition and eats well, they can fight XDR-TB."
He urged the community to make use of the 14 clinics in the area rather than flocking to the hospital, which put a lot of strain on it.
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