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INSIDE AFRICA

Combating Disease in Africa

Aired February 17, 2007 - 12:30:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

FEMI OKE, CNN ANCHOR: Hello, I'm Femi Oke, and this is INSIDE AFRICA, your weekly look at life and news on the continent, coming to you this week from Soweto, South Africa, which you can see just behind me. It's the home to the largest hospital in the Southern Hemisphere. Take a look at the 174 hectares of it. It's called the Chris Hani Baragwanath Hospital, set up in 1942 by the British as a military hospital to treat patients from World War II.
At the time one of the biggest diseases that was treated here was tuberculosis. We'll see how much things have changed in today's program.

Today, we're taking a look at some of the victories and the struggles against age-old diseases like measles and also malaria. But we start first with tuberculosis.

(BEGIN VIDEOTAPE)

OKE: It's a respiratory infection that kills more than 1.5 million people each year. South Africa has some of the highest number of TB cases in the world. Last year, an outbreak of this usually treatable disease killed almost everybody who contracted it. Doctors say this new strain is prompted by a deadly cocktail of men and medicine.

Jacob Malafi (ph) sits in his yard waiting to take his medicine. He's one of thousands of people in South Africa who has tuberculosis. But with daily home care, he'll be back on his feet in a few months. Jacob Malafi (ph) is lucky. He has normal TB that can be treated at home.

James coughs a lot when he talks. He has a serious form of tuberculosis that does not respond to normal drugs.

UNIDENTIFIED MALE: Drugs are useless for me, to run away from this treatment, and do other things, maybe (inaudible) a lot of money from myself, and then die tomorrow as the result of this disease.

OKE: Like other patients in this isolation hospital, he is here for four months of painful treatment.

Tuberculosis is caused by a germ that floats in the air and can be inhaled by anybody, but it's treatable as long as you take your medicine. If you stop taking the medicine too early, the disease can develop into drug-resistant forms of TB which can kill you.

DR. NORBERT NDJEKA, ODENDAAL SOUTH TB HOSPITAL: These are man - man- made conditions. The main reason why these conditions occur is inappropriate TB treatment, or maybe the patient defaulted previous TB treatment.

OKE: There is a stigma about getting TB in South Africa, as it often goes hand in hand with HIV/AIDS. James doesn't want me to show his face, but he's not embarrassed to admit he caused his own suffering.

UNIDENTIFIED MALE: Sometimes I take my pills. Sometimes I'm too busy, I don't have the time. Sometimes I'm too drunk to take them.

OKE: Dr. Ndjeka shows me around a new hospital unit, which specializes in drug-resistant TB. This is South Africa's answer to tackling the growing number of cases of extreme tuberculosis.

The worst form of TB is extensive drug-resistant tuberculosis, or XDR. Darius Lebang has it and he allowed us to film in his room.

If you look up in the ceiling, extractor fans are there as well, also helping to draw out the germs. Now, you're not sharing this room with anybody for a very special reason, so that you don't spread your TB to anybody else?

DARIUS LEBANG, EXTREME TB PATIENT: Put on my mask, so I won't - I won't infect somebody who is next to me.

OKE: The number of cases like Darius' are growing. And local health authorities can forcibly detain an infectious TB sufferer with a court order.

NDJEKA: The best way to treat these XDR patients is to isolate them from the others. They shouldn't be allowed to - to live in the community.

OKE: It's a controversial response to South Africa's TB crisis, but doctors say it wouldn't be necessary if patients took their medicine.

(END VIDEOTAPE)

OKE: In eastern Africa, livestock is often the backbone of local economies. Every so often, an outbreak of deadly Rift Valley fever sweeps through, devastating livestock and at times killing and permanently disabling local people with blindness and other complications. Now, it's happening again. Christian Purefoy has that story.

(BEGIN VIDEOTAPE)

CHRISTIAN PUREFOY, CNN CORRESPONDENT: This fence protects this Kenyan village from old enemies, but it's useless against the new and deadly enemy, affecting both young and old, an outbreak of the viral Rift Valley fever that swept through Kenya, killing a reported 150 people. The last outbreak, in 1997, killed nearly 500 people.

UNIDENTIFIED MALE: (inaudible).

PUREFOY: Rift Valley fever was first isolated in 1930, in this part of Kenya. Now, it's back. Both the Ministry of Health and the U.S. Centers for Disease Control want to know why.

DR. ROBERT BREIMAN, U.S. CENTER FOR DISEASE CONTROL: If you knew that an outbreak was going to occur, there are some things that can be done, especially on the livestock side, that would prevent subsequent transmission to humans, and that's using a vaccine that's available for animals.

PUREFOY: Rift Valley fever at best is a mild fever, but it can be fatal, leading to inflammation of the brain or hemorrhagic fever. It has tell-tell symptoms.

DR. CAROL BAO, EPIDEMIC INTELLIGENCE OFFICE: As I reported that the child had developed symptoms about three days ago, onset, febrile, (inaudible) bleeding, epistaxis, which is a nosebleed. But it appeared that the child actually was coughing up blood. So I wasn't clear which one it was. And as the child's eye started to turn yellow, which is usually an indicator of jaundice, right about the same time.

PUREFOY: Rift Valley virus is most often transmitted through humans through livestock, bitten by mosquitoes that carry the virus. So it when it strikes, it also cripples the local economies.

SAMUEL IKESU, FARMER: We are depending on the livestock. So we just don't have any other sources, which we can survive with. If we don't have - if we don't have means of selling this cattle.

PUREFOY: The disease is commonly contracted when people handle and ingest infected meat. There is a vaccine, but it's not commercially viable for humans. So early detection is essential.

RAHAB RANDALL, REGISTERED CLINICAL OFFICER: I'm trying to educate them on what they should do, what they shouldn't do, and something about the symptoms, so that they may come (inaudible) for treatment.

PUREFOY: The samples gathered this time are sent back to Nairobi, to the CDC's new testing lab, for clues about how Rift Valley fever starts and spreads.

BREIMAN: If you could forecast well, and you could - you could focus those resources well, you probably could come up with ways to prevent large outbreaks like this in the future.

PUREFOY: No one is expecting Rift Valley fever to be stamped out any time soon, but every time it reappears, experts learn a little more about preventing and containing it.

Christian Purefoy, CNN, Baringo, central Kenya.

(END VIDEOTAPE)

OKE: It's impossible to talk about disease in Africa without talking about HIV/AIDS. With two-thirds of the world's HIV cases and 80 percent of the deaths, the virus has hit sub-Saharan Africa harder than any other region in the world. And this week, I spent some time in the HIV/AIDS clinic at this hospital. I want to show you how medical staff and patients are fighting the disease.

(BEGIN VIDEOTAPE)

DR. ALLISON RUSSELL, CONSULTANT: We see as many patients as possible. We run Tuesday, Wednesday, Thursday and Friday. We'd love to run five days a week, but just we don't have the capacity, and we certainly have the number of patients, but we have no capacity. And a big issue now is to get as many patients identified who are HIV-positive, and who qualify for treatment, and to get them onto antiretrovirals.

UNIDENTIFIED FEMALE: I get very ill, and then I was diagnosed, about (inaudible) 2001. And then started to treat my (inaudible).

OKE (on camera): So, Julia, your job involves inflicting pain on people all day long. How is that?

JULIA TSHABALALA, PHLEBOTOMIST: But there is nothing I can do, because without taking the blood (inaudible). Because we've got to know what's wrong with the patient.

UNIDENTIFIED MALE: And they simply (inaudible) HIV, because all my body (inaudible). Because HIV is a killer.

RUSSELL: But the patients are fantastic, and they do wonderfully well, many of them. And yeah, it's terrific to see that. And they -- they're very generous about not getting unhappy about the fact that the conditions here -- they wait too long, they are uncomfortable.

UNIDENTIFIED FEMALE: If you use to have plans, you must (inaudible).

UNIDENTIFIED FEMALE: Yeah.

UNIDENTIFIED FEMALE: Life goes on.

UNIDENTIFIED FEMALE: And to those other ones who are afraid to come, they must come, because it's their future.

(END VIDEOTAPE)

OKE: And I want to say a very special thank you to the medical staff and the patients at the HIV/AIDS clinic.

Now, coming up after the break: It's one of the most preventable and curable infectious diseases in the world, yet malaria kills hundreds of millions of people every year. After the break, we take a closer look at some of the people who are trying to change the status quo. See you soon.

Earlier this month, a 17-year old Egyptian girl became the 12th victim to die from the bird flu in Egypt. That, combined with the death of a 22- year old woman in Nigeria, and reports of several other human cases, are raising concerns about a possible bird flu pandemic in Africa. The issue was the center of a gathering of more than 100 experts at a World's Health Organization meeting in Cairo this week.

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: The largest ever East African coffee conference opened in Ethiopia this week, with Starbucks promising to double its purchases of East African coffee over the next two years. The announcement follows a trademark dispute between Starbucks and the Ethiopian government, which is trying to ensure growers benefit from high consumer prices on specialty coffees. A quarter of Ethiopia's nearly 80 million people depend on coffee, and East African producers grow about half of the world's specialty coffee. In spite of this, most coffee growers in Africa still live in poverty.

(END VIDEOCLIP)

OKE: Hello again. You're watching INSIDA AFRICA from the Chris Hani Baragwanath Hospital in Soweto, South Africa.

Now, it starts with just a tiny mosquito bite, but the effects of malaria are huge, killing more than 300 million people every year. There are simple solutions to prevent infection. The only trouble is, in Africa, where 90 percent of the cases occur, most people can't afford them. Isha Sesay has more on the celebrities who are trying to change that.

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UNIDENTIFIED MALE: Please, you must protect yourself.

ISHA SESAY, CNN CORRESPONDENT: These are perhaps the most well-known African faces, and they're now the voices advocating prevention.

This Africa-wide public information campaign features some of the top international Africans football players, speaking directly to millions of Africans. Their new mission is to educate Africans in preventing malaria. So far, their fight has triggered a global response.

SERENA WILLIAMS, INTERNATIONAL TENNIS STAR: We're here and we can make a statement, and we could fight different diseases, and we can fight poverty and we can beat this.

SESAY: This means constantly reminding people how malaria kills a child in Africa every 30 seconds. 3,000 children every day, and almost a million lives a year. Across the sub-Saharan Africa, malaria is the number one cause of death for children under five. However, health organizations say it takes only simple measures to limit this mosquito-borne disease.

YVONNE CHAKA CHAKA, UNICEF SPOKESWOMAN: Once people are open-minded, educated, empowered, they will know what is right for them, and they will do things correctly, and I'm sure we can accomplish our mission by combating malaria.

Hello. My name is Yvonne Chaka Chaka.

SESAY: Yvonne Chaka Chaka is one of the many African musicians and performers who has long joined the fight.

There are also many non-Africans who have taken the stance in saving millions of lives.

BONO, SINGER/ACTIVIST: All of us are in an agreement that this can be a generation that can end extreme poverty. And by that, we mean kind of, you know, stupid, daft poverty, where 3,000 kids are dying every day of a mosquito bite in Africa, you know, of malaria. We can fix stuff like that.

SESAY: The idea is to use music and sports as a vehicle to help solve the problem of malaria.

CHAKA: I've gone to different homes and I've seen people hanging these nets and sleeping under them, and they have also testified that, yes, we're not getting bitten by mosquitoes any more. So for me, that is a successful story.

SESAY: In the absence of any vaccine, the message of these celebrities is slowly resounding across Africa, that small preventive measures can bring big benefits in the battle against malaria.

Isha Sesay, CNN, Atlanta.

(END VIDEOTAPE)

OKE: The quest for a vaccine against malaria has long been under way. And now, a new initiative led by African doctors is said to show some promise. Jim Clancy has more.

(BEGIN VIDEOTAPE)

JIM CLANCY, CNN CORRESPONDENT: Dr. Salim Abdulla and Dr. Seth Owusu- Agyei are at the forefront of the fight against the ancient scourge of malaria. They're among a group of African doctors who've been working tirelessly to test a new vaccine across the continent.

DR. SETH OWUSU-AGYEI, KINTAMPO HEALTH CTR., GHANA: Malaria is an African problem. If we talk about where the effects of malaria is extremely debilitating, we find it in Africa.

CLANCY: Thanks to funding from the Bill & Melinda Gates Foundation, these two doctors are now working for their ultimate goal - a malaria vaccine.

DR. SALIM ABDULLA, IFAKARA HEALTH RESEARCH CTR., TANZANIA: At least on the initial phases, there is a potential to reduce severe disease from malaria in children using one candidate vaccine, the RTSS, that we're now developing.

CLANCY: Researchers say in one trial in Mozambique that involved some 2,000 participants, the vaccine reduced severe malaria cases by 50 percent. They say if those numbers can be achieved right across the board, it could save millions of children across Africa. But how long will it take?

OWUSU-AGYEI: We think in the next five years. It means (inaudible) the way, we're (inaudible). We should be able to have a vaccine that can be registered.

CLANCY: That might be very optimistic indeed. In a new global strategy, the world's leading international health organizations say an interim landmark would be develop and license a vaccine that provides 50 percent immunity by the year 2015.

ABDULLA: (inaudible) are working every day, day and night, making sure that we do it as soon as this can be done. So this one clearly is one of the most promising malaria vaccines that have been developed so far.

CLANCY: The truth is, any level of success could prove to be a giant leap against this diseases that's taken the lives of millions and millions across the years.

Jim Clancy, CNN, Atlanta.

(END VIDEOTAPE)

OKE: When INSIDE AFRICA returns, we look at some major medical success stories. Also, coming up - saving lives and looking good doing it. I caught up with the sexiest man and doctor in South Africa. It's getting hot in here. Stay with us.

(COMMERCIAL BREAK)

OKE: Guinea worm's Latin translation is Affliction with Little Dragons. The parasitic worm infection occurs mainly in Africa, and is obtained by drinking stagnant, contaminated water. The disease causes long-term suffering and far-reaching after-effects, such as crippling farm production and lowering school attendants.

Now, thanks to a two-decades-long campaign led by former U.S. President Jimmy Carter, Guinea worm is on the verge of being eradicated. Its (inaudible) has spearheaded an effort that has cut cases from 3.5 million in 1986 to less than 11,000 cases today.

While Guinea worm has almost been eradicated, great strides are being made against another very old disease. Isha Sesay has more on the battle against measles.

(BEGIN VIDEOTAPE)

SESAY: It's a highly contagious disease that claims the lives of nearly 345,000 people around the globe each year, and the majority of children under the age of five. While measles has been largely eliminated in Western Hemisphere, it continues to afflict millions, predominantly in Africa. But now, there is good news:

DR. PETER STREBEL, WORLD HEALTH ORGANIZATION: This goal was established back in 1999, when annually we estimated about 800,000 measles death, and by the end of 2005, reduce that to approximately 350,000 deaths worldwide.

SESAY: Measles deaths on the African continent dropped by 75 percent, clearly highlighting that Africa holds the key to this major public health success story.

The massive achievement there is a result of immunization drives, spearheaded by the American Red Cross, U.S. Centers for Diseases Control and Prevention, the U.N., UNICEF and the World Health Organization.

GERRY JONES: For less than a dollar, you can vaccinate a child in Africa. Less than a dollar. We should tell our communities that we're saving lives.

SESAY: But this success story is not just about measles. The ongoing vaccination campaigns are actually contributing to the reduction of child deaths from other causes such as malaria and malnutrition, by opening up vital channels of additional life-saving interventions.

JONES: Our next goal is to reduce worldwide measles deaths by 90 percent, by the year 2010.

SESAY: That will be quite a challenge, but after the success achieved in Africa, health officials are optimistic they've got more than a fighting chance.

Isha Sesay, CNN, Atlanta.

(END VIDEOTAPE)

OKE: Excuse us. I was just chatting to Dr. Jane Benjamin (ph) in the casualty unit. Dr. Jane actually knows our next guest. He was voted by "Cosmo" readers as South Africa's sexiest man. His name is Dr. Gareth Tjasink, and I think I'm not giving it away, he is a doctor. I think I need a private consultation.

(BEGIN VIDEOTAPE)

OKE: It's the last day of Dr. Gareth Tjasink's internship. Soon, he'll be doing surgeries without supervision. But today, he's getting some help.

Gareth, have you done that procedure before?

DR. GARETH TJASINK: No, that was my very first time. But I've seen this about 100 times before. So, and I didn't even do the more complicated part. I just did the simple paste and stick, you know. If you can stick with (inaudible), skin graft to bend (ph).

OKE: But there is something a little different about this doctor, and it's not his bedside manner. Gareth Tjasink is a full-time doctor and a part-time model and actor. In South Africa, this ad campaign has turned him into a huge celebrity.

You don't wear many clothes in this campaign, do you?

TJASINK: No, and somehow I spent the rest of my time as a doctor trying to reestablish that credibility.

OKE: It's hard to believe when you see the doctor doing his rounds that he also has the sort of physique that's earned him the title South Africa's sexiest man. Dr. Gareth works at the Chris Hani Baragwanath Hospital in Soweto, South Africa. It's the largest hospital in the southern hemisphere.

TJASINK: This is (inaudible) that you can get a lot of gratification doing. It's not frivolous (inaudible) basic necessities.

OKE: When an interesting assignment comes up outside of medicine, Dr. Gareth negotiates some unpaid leave. He took time off last year to take part in "Survivor: South Africa."

UNIDENTIFIED MALE: In a slingshot contest for immunity, Vanessa narrowly lost to Gareth, who took home the immunity necklace once more.

UNIDENTIFIED FEMALE: We've had quite a lot of comments. People will run in and say, ah! (INAUDIBLE). That is the guy on "Survivor."

OKE: So what's next for South Africa's model doctor?

TJASINK: I'll finish off my degree and then go further in my career with medicine. I've studied too long not to pass it up for something more frivolous.

OKE: But I couldn't resist asking him to do one last frivolous thing.

Doctor, I'm feeling (inaudible).

(END VIDEOTAPE)

OKE: I just want to add, that was a truly fascinating and educational report.

That's it for this week's show. I hope you'll join me again INSIDE AFRICA next week, when we hope you let our program be your window to the continent.

I'm Femi Oke. Until the next time, take care.

END

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