Tuberculosis compounds Borno communities’ trauma as residents endure terror-induced poverty

Fuelled by poverty, hunger, and other insurgency-orchestrated problems, the spread of tuberculosis in Borno State is constituting a matter of serious concern to experts, Uthman Abubakar writes

For only God knows the length of time, Hadiza Idris of the Dala ward in the Jere Local Government Area of Maiduguri metropolis has been gnawing about her health and changing physique.

All she knew was that she was regularly troubled by severe cough, ulcer, fever, and severe weakness of the limbs. She often had to be helped up by her husband, children, or any other relation around her whenever she wanted to visit the lavatory or do some household chores she could do.

 She never knew that those ailments were symptoms of a more serious ailment. When in December 2023 her condition deteriorated and she could not stand up. She was feeling so dizzy that she would fall whenever she tried to stand up. She had to be helped and supported by someone.

She, consequently, had to go to the Borno State Chest Diseases Centre. There, she was promptly diagnosed with Tuberculosis. This was the underlying ailment that triggered the string of ailments she had before.

 She was promptly placed on the required treatment. To recover, drugs which she must take for six months were given to her.

Tuberculosis is eating deep into the population of the Borno State which is already troubled by Boko Haram and ISWAP terror.

 The worst hit, according to experts, are the ten local government Areas in the Northern Borno Senatorial District.

 The World Health Organisation, at its 13th Joint Operations Review in Yola, Adamawa State, November 2023, squealed over the alarming prevalence of TB in Borno State.

 “The rate of tuberculosis in Borno is worrisome. It means that Borno could be a ticking time bomb for tuberculosis explosion in Nigeria,” WHO’s Head of Mission/Country Representative in Nigeria, Walter Mulombo, was reported to have revealed.

 Governor Babagana Zulum, represented at the Yola Review convergence by the state Commissioner of Health, Prof Baba Malam-Gana, was reported to have compared the worrisome tuberculosis situation in his state to the devastating consequences of the Boko Haram insurgency that had destroyed 50 per cent of the state’s healthcare facilities and equipment.

Dr Bukar Bintube, Consultant Pulmonologist at the Borno Chest Diseases Center, speaking to newsmen recently, said, “WHO said that the rate at which tuberculosis is spreading in Borno State is going out of control, particularly in Northern Borno. This is not farfetched because of the Boko Haram insurgency that displaced people from their original homelands, coupled with low socioeconomic standards and hardships.”

 Dr Bintube continued, “Because we observed that most patients with chest diseases are from Northern Borno, we investigated and found out that there is inadequate medical personnel there. There is an acute shortage of healthcare personnel there.”

 Dr Bintube would not mention the exact number of TB patients in the state but revealed that every Monday the health facility received between 40 to 50 old and new TB patients, most of them from Northern Borno.

This, The PUNCH observed, is mildly suggestive of the picture in other tertiary and secondary healthcare facilities in the state.

 Lamenting the Consultant Pulmonologist queried why the state was experiencing new cases of TB.

“What worries us now are the new cases. Why should there be new cases? It means there is a high rate of poverty in the society. This means the disease is spreading among people more than expected,” he said.

 He suggested, therefore, that apart from providing more equipment to the Center, the state government should also adequately equip and employ more staff in all local government healthcare delivery facilities to enable them to tackle TB prevalence in poverty-ridden rural communities.

 Complaining about the inadequacy of drugs, Dr Bintube disclosed that since 2020, when Governor Zulum directed the state Ministry of Health to provide drugs to the centre, up till date, no agency of the government had approached the centre with the drugs.

“The drugs we have been receiving are mostly from the Netherlands TB and Leprosy Control Programme. WHO has also provided us with a screening machine,” said the pulmonologist.

 He called on all stakeholders on health especially federal and state parliamentarians from Northern Borno Senatorial District to consort with the state government in all efforts at tackling the situation.

 Other patients recount their battle with the disease.

 Bukar Bulama, a motorcycle rider in Bulumkutu Kasuwa, Jere LG speaking on his TB experience said he thought he was having fever or flu when the crisis started.

 “When I started feeling the symptoms over five months ago, I thought it was just fever or flu, with a mild cough. My condition became serious to the point where a friend alerted me that it was mere hunger. When it got worse, I was down with a fever and severe weakness of the limbs and I was rushed here (the Center). I feel I have now fully recovered,” he remarked confidently.

Explaining further he said, “I am just taking the drugs for the mandatory six-month period to elapse.”

Halima Modu, of Gomari Costain, Maiduguri metropolis, recovered from tuberculosis but was again infected after about a year due to what she described as her failure to heed the doctor’s advice on the dos and don’ts of not contracting the disease.

 “I recovered from TB over a year ago, but I infected again partly due to poverty but, if I must be frank, mainly due to my negligence on the advice the hospital gave us. I have been mixing with a lot of relations and friends, most of them poor people, and I didn’t mind even sitting close to them even while most of them were coughing, especially at weddings. I cannot tell you where exactly I contracted it again, but I believe it could be at one of such gatherings. I suffered severely when I again contracted TB if I must confess, the suffering was more severe the second time.”

Halima has been taking drugs for about three months and is eager to complete her treatment by the end of March.

A 50 years old widow promised herself, “I will strictly heed the dos and don’ts now, which I already know, especially wearing a face mask at gatherings where I cannot trust the health of the people I mingle with, and taking more beans meals, because I hardly can afford meat or fish.”

 At London-ciki, Musa Usman, 34, has been on TB treatment for about two months now as a first-timer.

 “When I had a severe fever, cough, and weakness of the limbs, about three months ago, I only thought I was suffering from severe pile, neglecting the fact that I was also coughing mildly, and I was also breathing with mild difficulty.

 “It was not until the day I coughed out catarrh mixed with blood, that it dawned on one of my friends that I could have contracted tuberculosis. He recalled the case of one of his elder sisters at Ruwan Zafi ward, who has since recovered from the disease.

 “He took me to the Maryam Abacha Hospital because I was too weak to take myself there.

 “My spit was examined and my chest ex-ray was taken; it was confirmed that I had contracted tuberculosis.

 “I initially thought I had contracted an incurable ailment until the medical personnel at the hospital consoled me that it was curable like every other curable disease and so long as I would take the drugs and eat strictly as advised I would be cured in six months.”

 Usman admitted that he was now fast regaining strength in his limbs and breathing better.

Hassana Adamu, the centre’s pharmacist, confirmed that TB cases are on the rise in Borno State due to poverty because the bacilli (bacteria) spreads with hunger.

Expressing his concerns about those who returned to the centre for treatments Adamu said lack of sufficient awareness and stubbornness were the reason they contracted the diseases again.

 Adamu said, “Most patients who get cured still get re-infected by the disease probably due to lack of sufficient awareness.

“Many of the patients don’t take the administered drugs strictly as prescribed,” she complained,

Hassana confessed, “Infection is on the increase in the state due to poverty. The tuberculosis bacilli spread in the body until it settles at the lungs when it finds the person hungry.”

 She explained that tuberculosis treatment takes place in two phases – the intensive care phase where the patient takes the drugs for two months, and the continuation phase where he or she takes the drugs for four months to complete the six-month treatment.

 “Tuberculosis drugs are free,” she stated.

With the grave situation, the Chairman of the Borno State chapter of the Nigerian Medical Association, Prof. Bukar Bakki harped on the need for increased public awareness across the state to ease early detection and effectively control the spread of TB.