Saturday 25 January 2014

CONCERN AS LIVER DISEASE CASES RISE



GASTROLOGICAL and digestion medical practitioners in the country are increasingly worried following the rising cases of people suffering from liver cancer brought about by Hepatitis B, C and Cirrhosis or liver shrinking.
Speaking exclusively to the ‘Daily News on Saturday,’ the Muhimbili National Hospital -based East Africa Gastroenterology and Digestive Oncology Training Centre Head, Dr John Rwegasha said that prolonged alcohol use and to some extent the wrong nutrition were other causes of liver complications.


Dr Rwegasha said that when the centre started operating in 2011/2012, it dawned on them of the magnitude of the problems in the country in that they received an average of 50 patients daily and now they have 300 operations on a monthly basis.

He said that all signs were showing that when the centre expand and have all the required equipment and human resources, there was no doubt in his mind that this figure would not only double but even triple.

“This centre is expected to be opened officially in May, this year. It is both a treatment and training centre. Before, we had a smaller centre that was ill equipped and manned and so by the time we started seeing patients, many came with diseases that were already at terminal stages,” he explained.
The state of the art facility is a joint project by the Muhimbili National Hospital, the Muhimbili University for Health and Allied Sciences, the Ocean Road Cancer Institute and the German Foundation which has injected modern equipment of over 1bn/-.

According to the World Health Organisation website, Hepatitis B is a potentially life-threatening liver infection caused by the hepatitis B virus. It is a major global health problem. It can cause chronic liver disease and chronic infection and puts people at high risk of death from cirrhosis of the liver and liver cancer.

Hepatitis B virus can cause an acute illness with symptoms that last several weeks, including yellowing of the skin and eyes (jaundice), dark urine, extreme fatigue, nausea, vomiting and abdominal pain.

“Our biggest challenge at the moment is that many of our patients have come very late. We need to create awareness and let people know that we have a state of the art facility and there is hope as long as one comes to be checked early,” he said.
Dr Rwegasha said in the increased cases they were getting, they had started seeing a new phenomenon where diseases that were traditionally known to be for the older generation were now being seen among the youth and that interested them very much.

Ulcers and the shrinking of the liver that cause one to vomit blood, according to the specialist, were other causes that are common.

“Thanks to advanced technology that is available in some countries, liver transplants can be conducted using a relative with the same blood type. The one liver that has been removed easily grows back after some time and within weeks, both members are back on their feet, the only problem is that these procedures are very expensive,” he said.

Many ailing Tanzanians fail to be referred to countries like India where this technology is available because of the high costs. Bringing this technology into the country would greatly improve the quality of life for many people.

Dr Rwegasha recalls an episode where he shed tears after attending to a woman with a shrunk liver for over two weeks, but later died because she wasn’t able to raise 60,000 US Dollars (approximately 96m/-) for the operation alone excluding transport and other costs.

“The shrinking of the liver causes the backing up of blood flow in the veins of the stomach and esophagus eventually leading to the enlargement of veins which cause them to tear and bleed, something that is not only life threatening but also shows up as vomiting blood,” he explained.

While there are many saddening stories from the centre, Dr Rwegasha was exceptionally thrilled to reveal that they had recently acquired an Endoscopic retrograde cholangiopancreatography (ERCP), that enables them to diagnose and treat conditions of the bile ducts and main pancreatic duct.

For the case of esophagus cancers, another disease that is common among Tanzanians, the physician said that they had acquired 10 self expandable plastic stents each worth 2m/- that helps patients to swallow food with better ease.

Dr Rwegasha advocated for the need for a national health insurance scheme that isn’t only limited to the working class but also those of the informal sector.

“What we need is to have some form of health tax for everyone and the funds go into a pool and this will help sustain some of the services. Take the stents, for example, we currently have ten, each is 2m/-, once they have been used, we will have to sit and wait,” he said with a frown.

Health financing in any country is paramount for the assurance of having sustainable services, this is something that the government through a number of ways is striving to achieve.

SOURCE..DAILYNEWS

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