Voice of America - November 30, 2006
Cathy Majtenyi
Nairobi

On the eve of World AIDS Day, Kenyan doctors and activists are calling on the Kenyan government to declare tuberculosis a national disaster and enact special legislation to deal with the highly contagious disease. Tuberculosis, known as the "poor man's disease," claims an estimated 300 Kenyans each day. Cathy Majtenyi files this report for VOA from Nairobi.

Mutinda Kithuku is an HIV-positive high-school teacher, husband, and father. He also has tuberculosis, or TB, the most common cause of death for people living with HIV/AIDS.

Kithuku describes the time four months ago when he collapsed at school, feeling like he was going to die. He headed straight for the doctor, who gave him some bad news.

"When I went there, they found that three-quarters of my left lung was filled with some fluid. In fact, it was very, very difficult for me to breathe," he said. "So I was immediately admitted. They had to withdraw the fluid for me to get some relief. And immediately I was started on TB drugs."

"So currently I'm on TB drugs, I've taken them for four months," continued Kithuku. "But I tell you, it's a hard job. I have to take them for eight months, two tablets every day. I took three tablets for two months, and then after that I've been given two tablets that I have to take for the rest [of the] six months."

Some 108,000 Kenyans like Kithuku were diagnosed with TB last year. More than 60 percent of TB patients are also HIV positive.

But the unsettling reality is that the number of TB cases officially reported represents only a portion of the TB scourge that lurks in Kenyan society.

Dr. Despaul Muthama, with the ministry of health's National TB Control Program, explains the problem and what his department is trying to do about it.

"Having said that we detected 108,000 cases, this is estimated to represent only 50 percent of all tuberculosis cases in the country," he said. "We are trying to increase our efforts so that we can detect [and] to increase the percentage of patients which we detect. We have already started to strengthen our TB diagnostic services so that we can be able to reach more and more people. We have an advocacy campaign to try and send the messages to all corners of this country so that people know about the availability of tuberculosis services and that they can be offered these services free of charge."

But those measures do not go far enough in containing and treating the disease, say some doctors and activists.

Dr. Ignacius Kibe, who is stationed at St. Mary's Hospital in Nairobi, estimates that some 300 Kenyans die of TB each day.

"I'm calling upon the government to declare TB a disaster without wasting any other time. The civil society is calling for a TB bill. We have an HIV-AIDS bill, which up to now has not been actually ratified by parliament," he said. "We are now requesting for a TB act, which, among other things, should highlight the patient's rights to treatment. Our government should reduce the bureaucracy that is there in procurement in drugs and other diagnostic process and equipment that go to assist TB patients."

Tuberculosis is an infectious disease of the lungs transmitted by bacteria contained in droplets of water released into the air when an infected person coughs or sneezes.

The most common symptoms include chronic and persistent coughing and weakness.

Once diagnosed, patients must adhere to a strict regimen of drugs to get rid of the disease. If they do not take the drugs as prescribed, the disease could become immune to the treatment.

Only about five percent of people with a healthy immune system who are exposed to the bacteria actually develop the disease. An HIV-positive person, however, is 50 times more likely than an HIV-negative person to develop active TB.

But most people do not know that they are suffering from the disease or are not even aware that they have been exposed to the infection.

The ministry of health's Dr. Muthama estimates that at least half of the Kenyan population carries the TB infectious bacteria and may unwittingly be passing it along to others, especially people whose immune systems are weak.

TB has become known as the "poor man's disease." Dr. Kibe of St. Mary's Hospital explains how slums such as Kibera in Nairobi are breeding grounds for the disease, yet no one in any part of Nairobi, or elsewhere in Kenya, is really safe.

"When 10 young men sit and sleep in a 10 x 10 room in Kibera, the chances that one picked [up] TB in the course of his day and coughs the whole TB at night, some of it drug-resistant TB, some of extremely drug-resistant TB which up to now has no cure, so you can see the dangers we are in because of our slums," he said. "Those people in the slums, finally, work in the Stanley Hotel; they work in your homes. And what happens, they bring TB to your loved small ones, because they are your maids."

Developing countries are hardest hit by TB. Kenya is currently ranked 10th among the nations most affected by TB in the world, a statistic many Kenyans are striving to reverse.

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