WINDHOEK - Agonising back pain, fatigue, jaundice, nausea and loss of appetite are some of the symptoms that 27-year-old Philemon Sackaria hand to endure last year before he was diagnosed with hepatitis E.
The disease, which is more common in areas with poor hand washing and lack of clean water, has been described as an epidemic, as more cases are reported to the authorities. Sackaria is among 4 000 Namibian men, mostly from Windhoek’s informal settlements, battling the virus. “I could not sleep at night, as my body was in intense pain. And you cannot sleep on one side for long, as the body aches. I could also not sit, as my lower back was in pain,” Sackaria narrated to New Era from his home at Ehambo dhaNehale close to the Havana informal settlement. “I went to Black Chain clinic, and a nurse drew my blood and gave me feedback instantly that I tested positive for hepatitis E virus. They injected me and gave me tablets that I took three times a day for a week.” Like many local people, Sackaria has expressed grave concern over the outbreak of the epidemic, which has since spread to other regions, including Omusati.
The outbreak of hepatitis E in the country, according to the latest report issued last month, indicated that a majority of the cases are among males, with 4 167 men testing positive, compared to 2 896 women. The least affected are children under one year, representing 0.11%. The report also shows that the majority of those affected are between the ages of 20 and 39. “Males are more likely to eat food from street vendors than females. Males are also less likely to wash their hands before eating,” read the report. Cumulatively, up to 29 December, a total of 7 063 hepatitis E virus cases were reported since the outbreak began. This includes 1 731 laboratory confirmed, 4 345 epi-linked and 987 suspected cases. A total of 59 deaths have been reported nationally and among those are 24 maternal deaths. The virus cases have been reported mainly from informal settlements such as Havana, Goreangab in Windhoek, DRC in Swakopmund and similar settings in other regions where access to potable water, sanitation and hygiene is a serious challenge.
When asked if Sackaria had an idea of how he might have contracted the virus, he replied that it was difficult to say, especially living in an informal settlement where there are serious sanitation challenges. In fact, Sackaria shares a shack with his older brother, which is located near a riverbed. However, because of the lack of public toilets in the area, residents are forced to go for open defecation in the riverbed. Sackaria also pointed to his neighbour’s makeshift toilet waste that flows in front of their house, which he said may have contributed to him contracting the virus. Sackaria called on the City of Windhoek to increase the number of communal toilets and taps. The young man further advised whoever might experience symptoms to seek medical attention immediately. “If you suspect you might have the virus and stay at home for a week, you might die. Seek medical attention instantly,” he advised. When questioned if there are campaigns held in the area on hepatitis E, Sackaria responded in the negative. However, New Era spotted health assistant workers doing community work it the area. An assistant refused to share the work and challenges they face. The family health senior health programme officer in the ministry of health, Petra Ipinge, told this publication that Khomas region has 92 community health workers in five constituencies, namely Tobias Hainyeko, Samora Machel, Moses Garoeb, Khomasdal and Windhoek Rural. “Each community health worker is responsible for his/her catchment area with a minimum of 100 households and 500 individuals. Areas covered in each constituency are basically informal settlements, as they are far from health facilities,” said Ipinge. She said the role and responsibilities of health extension workers are to conduct community education on facts regarding the diseases, including determining its causes, signs, symptoms, treatment and prevention. Ipinge said they assist members of the public to construct private latrines and handwashing facilities. She said the health extension workers also compile weekly report on hepatitis E activities carried out and send to the health facilities for the regional surveillance officer. She further highlighted some of the challenges they experienced: “Some hepatitis E patients abuse alcohol, which worsens their conditions,” she remarked, while adding street vendors are also not adhering to hygiene tips given to them, putting people who buy food from them at risk of the disease.
Meanwhile, the latest official report on the outbreak indicated, during the period of 16 - 29 December last year, a total of 82 hepatitis E virus cases were reported countrywide, compared to 63 cases reported during 2 - 15 December 2019.
“The outbreak has become protracted and continues to spread to other regions ongoing active transmission of the virus. Inadequate wash intervention in some informal settlements still persists.” The health ministry declared the virus outbreak on 14 December 2017 in Khomas, and it spread to other regions around April 2018.