It is quite interesting that for several years the nodding disease has been existent in Uganda but very little is known about it in the medical world here. This reminds me of a ‘strange disease’ as described in the media, which was killing especially children only to be discovered as malnutrition.
Uganda has no disease historians, otherwise why would we have a disease running through the community for several years and every time no one knows how to diagnose it. It is a ‘strange disease.’
According to Wikipedia, ‘Nodding disease or nodding syndrome’ is a new, little-known disease which emerged in Sudan in the 1980s. It is a fatal, mentally and physically disabling disease that only affects young children typically between the ages of 5 and 15.
It is currently restricted to small regions in South Sudan, Tanzania and Uganda says Wikipedia.
This time round, the ‘nodding’ disease initial assessments by the Uganda Ministry of Health, local authorities and Civil society Organisations have found that in 2011, over 2000 children have been infected. Over 60 young of these have died while hundreds have dropped out of school.
With no laboratories to carry out tests in Uganda, samples from children have been sent to Atlanta, USA, the Ministry of Health says. But being a festive season, they are unlikely to be returned on time.
The ripple effect on the family is even bigger. Mothers who are supposed to tend their gardens stay at home to now look after sick children, so food security is threatened at the household level, and they are stigmatized. At the community level, the affected families are shunned so discussion about it is limited.
According to experts, the "nodding disease" causes seizures, and affected children become physically and mentally stunted, which can lead to blindness and even death. It has been linked to Onchocerciasis and epilepsy because it has similar symptoms.
Despite this scenario, the budget for health research for this financial year was reduced and no special provisions have been put into place to ensure additional and necessary medicines and personnel for places affected with ‘nodding disease’.
This year, Uganda has had record economic growth rates and an increasing revenue base over the past decade, yet we find that investment in health as a percentage of the national budget declined during this period and stagnated at around 8 to 9% says the ‘Right to health group’ in Uganda. Per capita investment in health in Uganda today is about 7 US$ per person when the WHO minimum recommended rate is 41 US$.
Press statement on the Ministry’s campaign against the Nodding Syndrome
24th January 2012
Ministry of Health develops Emergency Response Plan to tackle Nodding Syndrome in Northern Uganda
The Ministry of Health has developed a comprehensive Emergency Response Plan to tackle the increasing cases of Nodding Disease in the northern districts of Kitgum, Lamwo and Pader. The Plan provides an integrated response to the disease through a coordinated mechanism that will ultimately identify the cause and control of the disease syndrome to the level where it is no longer of public health importance.
The disease is characterized by head nodding, mental retardation and stunted growth. It was first reported to the Ministry of Health by Kitgum District Health Office in August 2009. Currently, over 3000 children in the northern districts have been affected by the disease. This is not a new disease. Similar cases were also reported in Tanzania and Southern Sudan.
Since 2009, the Ministry of Health has been undertaking a number of measures to control its spread. Among these is the provision of supportive treatment to the children, training of health workers, massive sensitization and conducting research on the cause and control of the disease.
Initial studies conducted by the Ministry of Health in collaboration with the Centre for Disease Control (CDC) did not indicate any conclusive cause of the disease. However, the new response plan will see an extensive research programme about the cause and spread of the diseases. This research programme will be undertaken by the Ministry of Health, CDC, universities in Uganda and other Health Development Partners.
Initial activation funding has been mobilised from the Ministry of Health budget. The National Taskforce on Epidemic Preparedness and Response chaired by the Ministry of Health is currently in the process of mobilising resources from its partners. The Ministry will in addition submit a Supplementary Budget request to the Ministry of Finance, Planning and Economic Development to support the Response Plan.
The Response Plan that has also been shared with the Acholi Parliamentary Group, provides for the procurement and distribution of medicines and other supplies to affected communities. The medicines will be dispersed to hospitals and health centres that are easily accessible to the affected communities.
The Ministry will in addition set up screening and treatment centres in affected districts. These centres will be beefed up with supplementary staff consisting of at least a psychiatric clinical officer, psychiatric nurse, nutritionist and counsellor. The designated centres will be opened by end of February. These are; Padibe Health centre IV for Lamwo district, Kitgum Hospital for Kitgum while Pajule Health Centre IV will cater for Padre District. These centres will be supported by monthly outreach programs to the affected communities.
Psychiatry experts shall also be engaged from Mulago and Butabika National Referral Hospitals, as well as other regional hospitals, to train the screening teams at the designated centres.
The Implementation of the Response Plan will be multi-sectoral involving various stakeholders at district and central level. These include; Ministries of; Agriculture, Animal Industry and Fisheries, Gender and Labour, Local Government, Education and Sports and Office of the Prime Minister as well as Universities and Research Institutions. The Ministry of Health has so far sent a request to the Office of the Prime Minister to supply emergency nutritional supplements to the designated screening and treatment centres.
The Ministry is working closely with the affected local governments and political leadership to mobilise communities to seek medical assistance from the designated screening centres. Districts have also been requested to incorporate the activities into their district plans and budgets.
The Minsitry of health is in addition working with a number of Development Partners to implement this plan. These include World health Organisation, Centre for Disease Control (CDC), UNICEF, USAID and MF-Spain.
I appeal to the Members of Parliament and district leaders from the Acoli sub-region to work with the Ministry of Health to ensure proper coordination and implementation of the Response Plan.
I appeal to affected communities to stay calm as we find a lasting solution to this problem.
The Ministry of Health informs the public that it is doing everything in its control to manage the spread of the disease in northern Uganda. I assure the public that we continue our commitment to the prevention and fighting of disease throughout Uganda.
FOR GOD AND MY COUNTRY
Hon. Christine Ondoa
Minister of Health