Barnabas Atwiine
11 January 2009
opinion
Kampala — I wish to respond to an opinion that appeared in The New Vision of January 2, in which Ellady Muyambi alleges that there is evidence that indoor spraying of DDT against malaria will kill more people than malaria. Muyambi grosses over the statistics of malaria by saying that it kills 800,000 Africans, mainly children under five per year.
He forgets to add that 320 Ugandans die daily of malaria. This translates into about 120,000 people per year.
Malaria alone is responsible for about a-third of child mortalities in Uganda, and is the leading cause of consultations and in-patient admissions in almost every health facility in Uganda.
Ugandans spent sh25b on treating malaria in 1999, according to the health ministry website. Illnesses and funerals due to malaria account for most absenteeism from work and school in Uganda, crippling the economy and the education system.
As a doctor, I see malaria kill, maim and devastate people's lives everyday.
More resources in health facility budgets are allocated for malaria than any other disease, and malaria takes the most time and energy of health workers than any other condition in Uganda.
Consequently, we cannot, as a nation, attend adequately to other conditions like heart and kidney diseases, because most efforts, time and funds are spent on mere malaria!
Muyambi quotes the 2007 Stockholm convention that encouraged cautious use of DDT. Of course, DDT, like all other drugs, has side effects, both on human and environmental health.
Antiretroviral drugs, which have been widely used to improve the lives of many people living with HIV/AIDS, are theoretically dangerous, with serious and possible life-threatening side-effects. But when used with the right precautions, they are practically harmless. It is for similar precautions that DDT is meant for indoor spraying.
Muyabi concludes by saying evidence from South Africa, which extensively used DDT against malaria in the early 90s, suggests that most of the environmental effects of spraying are irreversible. Why doesn't he quote one example of a disease that causes more than 320 deaths, mains children, causes miscarriages, squanders family incomes and causes untold suffering in South Africa daily.
We should be wary of people acting as fronts for pharmacies, drug factories and other companies who fear that eradicating malaria will run them out of businesses and jobs. DDT was sprayed out-door for many generations in Uganda, in the early 60s. I have not heard of any catastrophe that has resulted from its use. The many people that were alive during that time are some of the healthiest Ugandans today.
Northern Uganda has the leading incidence of malaria in Uganda.
It is disheartening that some unscrupulous tobacco growers and other business people secured a court injunction against the spray of DDT in this area. They should know that the little money they make out of their hazardous tobacco is lost in treating malaria.
About two months ago, I watched the Parliament debate about the spray of DDT. Men like Maj. Gen. Elly Tumwine an army MP, urged the Government to start the spraying programme.
I was tempted to believe that finally something would be done about malaria. But two months down the road, nothing has happened. It is embarrassing that 46 years after independence, we have still failed to tackle an illness that kills most Ugandans.
The writer is a medical doctor at Kisoro Hospital
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I wish to respond to an opinion that appeared in The New Vision of January 2, in which Ellady Muyambi alleges that there is evidence that indoor spraying of DDT against malaria will kill more people than malaria. I would like to clarify that Muyambi does not allege, and the likes of Barnabas Atwine need not to only look at there mere malaria statistics that are not backed by any current scientific findings. The statistics which Atwine uses have appeared for long, and we do not know whether these figures are static. What current studies have been done concerning this? What evidence is there to show that all these die of malaria, even when our health centres have no capacity to diagnose simple Malaria? I have a feeling that such figures may be influenced by other diseases especially among children where any fever is taken to be Malaria. It is still hard to determine what kills most, although Atwine claims that Ugandans spent sh25b on treating malaria in 1999, we do not know how much Uganda will need to treat the adverse effects of DDT. We lucky Malaria can be treated what about effects of DDT which can not be treated at all. I would advise that Doctors and medical personnel get much more involved in DDT research and come out with a clear figure before subjecting us to poison. Why should Ugandans be used for such a biological test before ascertaining the likely impact.