A Different Tale of TB in Kenya

RENEE MONTAGNE, host:

Commentator Pius Kamau believes that Andrew Speaker is fortunate to be able to get that treatment for tuberculosis. Pius Kamau is a doctor practicing in the U.S. He grew up in Africa, where tuberculosis takes a terrible toll.

Dr. PIUS KAMAU (Cardiothoracic Surgeon; Columnist, The Denver Post): For years, my father had coughed, lost weight, suffered from fever and chills. It was the '50s, and this was common for the poor in Mombasa where we lived. But I remember the frightening day when his bloody cough heralded the beginning of the long journey from diagnosis to prolonged therapy.

I was 10 or 11 when my childhood came to an end. The diagnosis suddenly transformed him from a supporting father to one our family had to support. TB's manifestations were a profound mystery to me then. Now as a physician, I know a little more about it. TB was endemic, the lack of education, poor ventilation, crowding, malnutrition and poor hygiene were ideal conditions for its spread.

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There are only a few government-run hospitals, and only a lucky few patients were treated with streptomycin, isoniazid and para-aminosalicylic acid - the three anti-TB drugs available then. In my mind's eye, I just see my father isolated in a TB ward, a gaunt, emaciated shadow of a man shuffling down the hallway to his hospital bed.

The facility lacked running water and reliable electricity, but had willing and capable personnel. Father's TB wasn't cured, as it should have been. Doctors had to collapse his chest wall, a procedure common in those days to protect the lung which had been destroyed by TB.

For my father, the end of a long dark tunnel was total disability and eventually death. In Africa today, the death rate from TB is ever accelerating. Many Africans suffering from TB have few resources. Indeed, often the community acts as a reservoir for the bacteria.

It's strange to think that just years ago, we believed TB had almost been eradicated. Then the HIV-AIDS pandemic dealt a blow to the immunity of the community. TB and malaria joined HIV-AIDS to account for devastation to the human race as seldom witnessed. It's now obvious the fight against AIDS must include a war against these two old enemies.

Andrew Speaker is fortunate to live in a land where the best medicines money can buy are available to him. Most likely, he'll be cured. There are too many places on this earth where millions suffering from TB beg to be treated.

Valiant attempts by many, including the Gates and Clinton Foundations, are making a dent with education and therapy. But TB is always a crouching tiger waiting to spring.

MONTAGNE: Commentator Pius Kamau is a surgeon and a columnist with The Denver Post.

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