2018-07-30Staff Report 2 Alvine Kapitako WINDHOEK - While in school, Doctor Lilliane Kahuika was always fond of science related subjects and she knew from an early age she would become a doctor who will make a difference, this is despite growing up under trying circumstances. Today, the 31-year-old Kahuika is an epidemiologist in the Ministry of Health and Social Services. Her ultimate goal is to become a public health specialist. Kahuika who has made regular media appearances to talk about the outbreak of Hepatitis E and other diseases such as the Influenza A H1N1 recently spoke to New Era on how she ended up as an epidemiologist. “I grew up in Katutura. Life wasn’t easy. There were a lot of challenges growing up,” she said. It was the love for the science field and the desire to become a medical doctor that kept her pushing despite the challenges life threw at her. “I was a nerd in a sense. I was that girl that was interested in science, mathematics and physics. I wanted to pursue a career in STEM (Science, Technology, Engineering or Mathematics),” said Kahuika. While growing up, there were not so many role models in those fields. “We didn’t get to see so many female doctors, engineers, mathematicians or black women that had PhDs. I had a very few role models,” she added. But she looked up to former Minister of Health and Social Services, Dr Libertina Amathila for inspiration. Both Kahuika’s parents are teachers by profession and the assumption was she would follow in their footsteps because the circumstances at the time dictated they would not be able to pay for her medical studies. “I was determined to become a doctor. I knew that if I become a doctor, I would be able to make a change and impact in the lives of many people,” said Kahuika who studied medicine in Russia and Ukraine. “I studied medicine abroad because at the time we didn’t have a medical school in Namibia. I studied in Russia for three years and then transferred over to Ukraine,” said Kahuika whose husband is also a medical doctor. Specialising in epidemiology Kahuika knew that she wanted to study medicine but she did not want to practice clinical medicine for a long time. She worked as a medical doctor after her internship in 2016 before taking up her current role as an epidemiologist. The interest to work as an epidemiologist was sparked by the desire to impact many lives at the same time. Kahuika explained that with clinical medicine she only impacted one patient at a time. She says epidemiology is the backbone of public health. “We’re placing so much emphasis on curative medicine and the state is spending a lot of money on curative medicine but if we strengthen our primary prevention it won’t be as costly and many lives will be saved because not too many people will be sick. We don’t have to wait for people to get sick and spend millions treating them. Why not improve and strengthen prevention,” she said. Kahuika is currently specialising in applied epidemiology. “My aspiration is to become a public health specialist because we have very few here in Namibia and what we get to do is to treat many lives at the same time,” said Kahuika. She explained that epidemiologists study disease patterns and determinants in defined populations and how they can be prevented. “Like with the Hepatitis E outbreak, we are trying to work towards solutions and trying to figure out how we can stop this disease from spreading because as we know it’s spreading to other parts of the country,” said Kahuika. Hepatitis E has spread to the Omusati, Erongo and Oshana regions. “We want to determine how to stop this disease from spreading and preventing more people from getting sick and dying from it. So, it has a very broad impact as compared to being a clinician,” explained Kahuika. Hepatitis E She said Hepatitis E is quite serious because outbreaks are being reported in other regions. “It can really be detrimental because more people are getting sick which means we will be expecting more deaths and it’s really not good that people should be dying from a disease that’s preventable by taking simple measures,” said Kahuika. Hepatitis E hits pregnant women very hard, she said. “It’s an unusual pattern for its spread and it has gone beyond the reaches of the epicenter which is Havana and Goreangab informal settlements. That is a concern. If you look at the Erongo, the epicenter of this disease is also an informal settlement, which is DRC,” added Kahuika. They are facing similar challenges of inadequate water supply and sanitation facilities, she added. There is a need to look at this disease from another perspective, said Kahuika. There is a need to look at improving the living conditions of people nationwide. “And the fact that Namibians are highly mobile people does not help the matter. We like traveling and that’s how the disease has gone to the other regions. Most of them are linked to Havana and Goreangab,” added Kahuika. To date, 19 Hepatitis E related deaths have been recorded nationwide. Additionally, Windhoek has 1863 cases of Hepatitis E of which 118 are laboratory confirmed. The Erongo Region has 95 confirmed cases of Hepatitis E. Omusati has recorded 106 cases, 26 of which are laboratory confirmed. The Oshana Region has recorded 16 cases of which 13 are laboratory confirmed. “It’s quite alarming,” added Kahuika. Kahuika further explained that there are different thresholds for classifying disease outbreaks. For example, if a disease has been present in a country and over a period of time it has been reporting stable numbers such as 30’s and 40’s and then all of the sudden there are 100 cases that means it is not the normal trend. “So that becomes an outbreak,” Kahuika said. Before the outbreak of Hepatitis E in October last year, sporadic cases were reported. “Suddenly we saw a spike in numbers so that means it’s an outbreak. It’s based on surveillance data. There are specific thresholds for different diseases,” she explained further. For example, if Namibia was to detect one case of Ebola that would be an outbreak. “We shouldn’t have Ebola cases ideally because its spreads quickly and it kills fast. So if one case of Ebola is detected it’s an outbreak automatically because it’s not supposed to be there,” explained Kahuika. Beefing up surveillance Kahuika further said Namibia is experiencing trying times in terms of diseases and there should be more investment in public health emergencies. “It requires for us to beef up our surveillance,” said Kahuika. The country’s surveillance of diseases is currently being beefed up and this would mean a better response to the diseases, explained Kahuika. Asked on why Namibia has been experiencing outbreaks and ‘new’ diseases, Kahuika explained: “it’s not that we’re not that prepared. It’s also the fact that these outbreaks could be happening in other countries and with traveling people can bring in the diseases”. These diseases could have been there but they were not detected because the country’s surveillance was down, she added. “Our surveillance is up now and we are improving and strengthening our surveillance. We’re scanning for diseases and seeing what is circulating and what is happening and that is how we are able to detect. This is good because if you are able to detect a disease you will be able to respond to it,” said Kahuika. 2018-07-30Staff Report 2
