Cameroon's "cursed" children
[cnn-photo-caption image=http://i.cdn.turner.com/cnn/2008/images/06/16/art.guptatreating2.jpg]
Dr. Sanjay Gupta BIO
Chief Medical Correspondent
In a small town called Akonolinga, about an hour outside Yaounde, the capital of Cameroon, a strange disease is going around that primarily affects children.
It starts as an ulcer on the skin that quickly spreads. Untreated, it can start to affect the bones and eventually even get into the bloodstream. If it gets to that point, there is little that can be done, and the child will often succumb to the disease.
They try everything in this small village town to not let it get to that bad. They scrape away the skin, cutting out the diseased areas. They give injections of various medicines, and they keep people in hospitals for months.
I met a young boy named Naturale, who had to have his left arm amputated at the shoulder. I almost cried when I met him. By the time he came into see a doctor, the disease was too far gone, his bones literally crumbling. As I visited the clinic, I learned the name of the disease: Buruli. I also learned something that stunned me – what many in this town believe is the origin of Buruli: Witchcraft.
It goes like this – as a punishment for taking something or some other trivial thing, these children had been cursed by witches and sorcerers living in the nearby areas. Take someone else's mango for example, and soon after the child will get an ulcer. In Naturale's case, he was born out of wedlock, and the witches in the area thought it would be better if he were dead. I was told they cursed him with a particularly severe infection, and he barely survived. Now he stays at the hospital trying to shield himself.
Now, if you think what you are reading is too far-fetched, you may be interested to know I sat down with Ph.D-level medical anthropologist, Karen Saylors, who explained all of this to me. Along with researchers associated with Johns Hopkins, she is studying Buruli.
Buruli ulcers have been reported in more than 30 countries, according to the World Health Organization. With the increasing geographical spread since 1980, WHO is working to improve surveillance and develop better tools to control the disease. Karen introduced me to traditional healers who knew all about placing a hex on someone and even how to cure the disease with herbs and a piece of bark.
While Karen and her colleagues don't really buy into the idea of witchcraft, they also recognize what a widespread belief it really is here. Instead, Karen has busied herself studying the possibility that Buruli may be spread from animal to human. As it has many similarities to a staph infection, which can cause flesh to be ulcerated and seemlingly "eaten,", the doctors are using powerful antibiotics with good success. Karen has even studied the particular traditional medicine herbs, which are often effective. What she found was that particular plant had some of the same ingredients found in streptomycin, an antibiotic.
As a doctor, it was amazing to see how this disease has been deciphered. It was also a fascinating glimpse into the connection between animals, plants and humans. Not only is the Buruli-causing pathogen most likely from an animal, but the medication used to treat it is from a local plant. And, if we look deep enough, we find this is in fact the case with many diseases.
Today, I will be in the wilderness of DRC, specifically a village called Lodja. We will be visiting a monkeypox surveillance clinic. I promise to report back on how the locals here are working to contain the virus so it doesn't spread around the world. I can't help be struck by the fact that we are in the middle of a very strong interface between man and animal. It has been here for millions of years, but it is only now that we are starting to understand its awesome culture, power and possible danger.
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Filed under: Dr. Sanjay Gupta • Medical News • Planet in Peril |
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To Dr. Gupta and Anderson Cooper,
Thank you for shedding more light on this terrible disease.
We pray that a cure be found soon and alleviate these children's suffering.
Abby, Houston, TX
You are reporting on a good subject but your research is poor, hence your conclusions. This article would end where it is – at cnn or the western media in general. No journal would publish this.
That said, it does not surprise me to find a "Dr Gupta" displaying such ignorance about an important subject for his own ego and that of his boss. Keep it going "Dr".
MODERATOR: Thanks for the feedback. Dr. Gupta has updated the post.
Great job Dr. Sanjay Gupta, Anderson Cooper and CNN for this spotlight. I see a great opportunity here: how can western medical science work collaboratively with traditional medical practitioners to come up with cures for some of these challenging diseases causing untold sorrow to humanity without viewing traditional knowledge systems as unscientific and primitive? This article clearly shows the potential.
Annie May, how juvenile can you get with your comments! Its amazing that this kind of writing can be put on the web to be viewed. If you have been a victim of scam, then you must have succumbed to a personal greed for unearned money. I do believe to make such sweeping and malicious comments on a whole country is childish to say the least
Yes, I do agree with Emmanuel on that view. It is true that like in all societies 1st, 2nd countries, '3rd' world countries have what people (depending on where they live)term strange cultures and diseases but Africa has been labelled once too many times as a dark and unpleasant corridor to nowhere good. How about reporting the pleasant effect of our extended family systems that cares for every and all members of the society that is sadly lacking in the West? It puzzels us to hear that a person died and was mummified and was found sitting in front of his tv after several months and his neighbors and relations did not know. And we should realise that everyone is entitled to his spiritual beliefs. If the priest believes and tell his congregation that condoms cannot halt the spread of Aids, he should be allowed to air his views. Matter of fact, only abstinence in the issue of sexual promiscusity is a sure answer to the spread of HIV. Condoms have been reported to fail havent they? There is a definitely a better picture to show of Africa that can also increase the viewership ratings than gloomy and dark images of Africa.
Dr Gupta, as a Cameroonian I must say thank you for tugging the reluctant and “hardly talked about” country to the spotlight but I am afraid that is the furthest the entreaty of gratitude takes me. While a doctoral student in Cameroon, I studied the ethics (and legitimacy) of traditional medicine and came to understand that the native customs and beliefs (which may suit the catchword “witchcraft”) are based on a value system that is legitimate in its own right; and many physicians and researchers have attested the effectiveness of the drugs administered by native healers (may be not always the therapy). In fact, many drugs administered in many contemporary “conventional” clinics the world over are based on the knowledge (that is never protected by law) of these healers. The problem is the inability to sift the good ideas from the world of bad ones and this is due to poor political stewardship and (extremely) corrupt leadership and anarchy. That is what you should have reported on given that you direly lack information on the disease you are talking about (origin/record/treatment/current research) and queerly, you make a very spurious connection between humans/plants/animals: wonder why. And also, why didn’t you talk of the Australian experience? Luckily, a few persons above have directed you to the WHO. Seems you report about the suffering of other people as a means of achieving your own redemption (on both personal and business bases).
Sasha – be careful not to make assumptions or worse draw conclusions solely on names of places, given that most of these names were not given by the locales but by colonial administrators seeking to identify a place using (whatever) local name. Yaoundé, the capital of Cameroon, for example translates (approximately) into one of the many languages as “the place where peanuts are sold” and an anecdote tells us that a colonial administrator got the word from an old woman who did not understand his question (what’s this place called?) and told him where she was walking to (the place where peanuts are sold).
I do not understand why some Africans have to interpret the objective analysis of the situation in Cameroon as negative reporting. If we feel alot of negative things are being said about Sub-Saharan Africa and there are lots of positive things to say, in my opinion, we should just talk about the positives. The author of this article was mainly explaining the findings of their research and what should interests us is on the pros and cons of their findings. It is no secret that we often interpret natural illnesses as being caused by some traditional stereotype. My cousin died of a similar illness. All his legs were infected from the time i knew him and he often cried the whole day.
Buruli is not as new as it has been presented in this report. Let us not have the impression that it is first discovered in Cameroon. There are cneters in Ivory Coast that have been dealing with this disease for years now. Our researchers may try to get in contact with these centers. Thanks for the report.
World Health Oganisation (WHO) should please come to the aid of those children affected by these dieases. A powerfull reasech to the local plant in guestion will also be a help.
The Buruli ulcer (also known as the Bairnsdale ulcer) is an infectious disease caused by Mycobacterium ulcerans. The genus also includes the causative agents of tuberculosis and leprosy; Mycobacterium tuberculosis and Mycobacterium leprae, respectively.
Hmmm...I wonder if Carol is willing to elaborate on the reasons *why* she labels the Gupta article 'sensationalist and misleading'.
From another comment, I gather the disease has been around for some time "first discovered in East Africa and well documented in other countries".
Yet another refers to the pygmies of the rainforest of Cameroon as having antibodies vs the ebola virus, an indication that it had to have been around for some time, just 'new to us in the west'.
If someone would do the research and document problems of this or any other nature for the western public, it might go a long way towards building our knowledge and understanding of the things that exist in our 'global village'.
Emmanuel, sadly, in Africa, there are not that many positives to report on. As for your idea of the stock markets in Africa, I think you have a great imagination.
Africa is a deseased continent. The desease is selfindulgence. The cure is self restraint. BUT Africans have an allergy to serf restraint.
Africans want to indulge in unprotected sex, they want to indulge in political killings, they want to over indulge in corruption and greed, they want to indulge in laziness, they want to indulge in Africa time. The symptoms of the above is HIV/AIDS and other related, deadly deseases, hundreds of thousands of murders and displaced people, food shortages and extreme poverty. These symptoms are made worse by the UN and other aid agencies who teach these people that it is okay not to care about themselves and that it is okay not to work because the big trucks will bring the food to their doorsteps. It teaches them that it is okay to jut kill whomever you like because troops will be brought in to protect you. It is okay to have sex without protection because the world will rush to you with anti-retrovirals and celebraties will come and adopt your orphant when you die of AIDS.
Africa should be left to sort out its own mess. Without interference from outside these deseases will run their course and will eventually dissapear.
Hello Mr. Cooper,
I was watching you two days ago (June 14) and heard you say in one of your reports that "AIDS started in Cameroon". I would love to know where you pulled that information from.
Regards,
EKO
Thanks for the good job you just accomplished. I wish that CNN should also show the good things; cities and towns they have seen in this place. I have realise one thing; CNN have never shown Timber,cocoa,coffee,oil etc, that are carried away from African countries ( Cameroon ) to the western world. Every time that CNN goes to this countries is to bring home bad things. I really appreciate your job and I wish that you make an effort to show the world how Africa is being exploited and nothing returns.
May God bless this young inocent boy.
"Buruli is a common disease that has been around for many years... and WHO reports Cameroon as endemic for this... and the cause is not an "unidentified microbacteria" but Mycobacterium ulcerans... He should have shown more respect for Cameroonians by talking with a Medical professional." Quote from a Cameroonian medical professional.
Dear Dr. Gupta,
I am dissappointed by the multiple inaccuracies in this report.
1. Buruli ulcer is not just being discoverred. It was first described over a century ago (1897).
2. It is not isolated to tropical Africa but has been described in the Americas and Asia as well.
3. It is not likely caused by some microbic organism but we know that it is caused by Mycobacterium ulcerans.
4. This idease is highly treatable with agents like rifampin and streptomycin which are also effective against other mycobacteria
Granted you are not a specialist in tropical diseases, a simple google click, a search on the CDC or WHO website or a call to the CNN US office for a facts check could have avoided some of the falsehoods.
I am tempted to doubt the credentials of Dr. Karen Saylors if she, being a buruli reseacher could not give you the right facts about buruli.
While I applaud your efforts to bring attention to some of the world's neglected illnesses, as a physician, you are a scientist and accuracy of facts must always reign over journalistic sensation. In this case most of your facts are plain wrong.
Richard, MD
NC, USA
MODERATOR: Thanks for the feedback. Dr. Gupta has updated the post.
I use Dr Sanjay Gupta's comments in quotes to show how his artcile is very misleading;
'As I visited the clinic, I learned they had given this disease a name: Buruli.'
Now, the name Buruli was NOT coined by the people of Akonolinga. In the 1960s, many of such cases occurred in Buruli County (now called Nakasongola District) in Uganda and that is where the disease got its name from. And I will trace the history of Buruli Ulcer (BU) below.
'As a doctor, it was amazing to see this previously unrecorded disease slowly become deciphered.'
This is not true. The first recorded cases of this disease were in 1897 by Sir Albert Cook, a British Physician working at the Mengo Hospital Kampala, Uganda. Again in 1948, Professor Peter MacCallum in Australia described this disease in six patients in the Bairnsdale area near Melbourne; He and his team were the first to isolate the causative organism. That is why in Southern Australia , BU is still referred to as Bairnsdale Ulcer.
In the 1960s, due to the occurrence of many cases in Buruli district, it was named as such. And since 1980, the disease has rapidly emerged in many parts of the world such that in 1997, after encountering patients with the disease while visiting Cote D’Ivoire, Dr Hiroyosh Nakajima who was then Director-General of WHO announced the deployment of a coalition of international efforts against Buruli Ulcer. In February 1998, WHO formed the Global Buruli Ulcer Initiative (GBUI) to coordinate BU control and research and in July 1998 WHO organised the first BU conference.
In May 2004, the world Health assembly adopted Resolution WHA57.1 on BU and today more than 40 NGOs, Research Institutions and foundations are participating in the GBUI.
How then can Sanjay Gupta describe BU as ‘Previously unrecorded disease’?
He says;
'It was also a fascinating glimpse into the very real connection between animals, plants and humans. Not only is the Buruli causing pathogen likely from an animal, but the medication used to treat it is from a local plant.'
I find it amazing that someone who potrayed such limited knowledge on Buruli Ulcer already knows that there is a connection between animals, plants and humans. The causative organism for BU is the bacteria Mycobacterium ulcerans which is of the same family with the causative organism for TB and Leprosy and this was discovered way back in 1948 by Professor Peter MacCallum and his team in far away Australia. Current evidence shows that the infection is transmitted through abraided skin after contact with contaminated water or soil while the evidence for transmission by insects is still very weak; however, the scientific community waits anxiously for this evidence because this will mean it is the first Mycobacteria to be transmitted by insects.
I find the next paragraphs fascinating;
‘Now, if you think what you are reading is too far fetched, you may be interested to know I sat down with an educated medical anthropologist with her PHD, named Karen Saylors, who explained all of this to me. Along with researchers associated with Johns Hopkins , they are studying the origins of Buruli.’……
‘Instead, Karen has busied herself studying the possibility that Buruli may in fact be a microbacteria that is zoonotic, spread from animal to human.’
I wonder the methodology the medical anthropologist will use to make this link and if her training gives her the competence to make that link.
Now the Doctor said this;
‘As it has many similarities to a staph infection, which can cause flesh to be ulcerated and "eaten" appearing, the doctors have started using powerful antibiotics with good success.’
Doctors did not just ‘start’ using antibiotics for BU. Combination antibiotics for the treatment of BU has been known for ages; after all it is a Mycobacterial infection . And should I remind Sanjay Gupta that World Health Assembly resolution 57.1 chapter2.2 encourages member states to intensify research to develop tools to diagnose, treat and prevent Buruli Ulcer. I wonder if he bothered finding out if Cameroon , as a member state of the WHA, is complying with this resolution. Maybe he should consider looking up Cameroon's plan of action presented at the WHO annual meeting on buruli ulcer , 15 -17 March 2006
And as to the cause, Sanjay Gupta says this;
‘I also learned something that stunned me — what many in this town believe is the origin of Buruli. Witchcraft’.
Medical myths just like myths in many other discplines are nothing new and that happens the world over. And if Sanjay Gupta had taken the time to find out the African’s cosmology of Health in an attempt to understand some aspects of their culture; an aspect of Medical sociology which is vital for any doctor venturing into Africa in whatever capacity, then he wouldn’t have been stunned!
And of course Sanjay Gupta drew his conclusion on the supposedly transmission of Buruli Ulcer from animal to humans;
‘And, if we look deep enough, we find this is in fact the case with many diseases.’
Obviously, what this unresearched article is suppose to prove!
MODERATOR: Thanks for the feedback. Dr. Gupta has updated the post.
The belief that diseases are a result of wrongdoing or witchcraft happens more often than we would like to acknowledge.
Any of you that are familiar with the charity, The Smile Train, probably know that children born with cleft palate (also referred to as "harelip" because the patient's upper lip resembles that of a rabbit, or "hare") are often ostracized, left to die, or marked as "evil" for their birth defect.
This disability, though not intrinsically fatal, often is, because the entire village may shun the child, sometimes leaving them to die.
Fortunately, volunteer doctors, enabled by donations, can easily correct this condition with surgery.
Many of our modern drugs come from herbal rememdies. Willow bark was a crude forerunner to aspirin. Digitalis, a heart medication used to control irregular heartbeat, is derived from the foxglove plant. Some natural remedies rival modern drugs – if you're feeling a little blue, St. John's Wort has been reported to have properties similar to many pharmaceutical anti-depressants.
Thanks for reporting Sanjay. It's good to be able to turn on the tv and see something informative.
I have worked in Cameroon for 14 years establishing a humanitarian HIV/AIDS program before there were even HIV tests avilable . You barely did your homework...this is a sensationalist and misleading article although interesting to the ignorant, focusing on an entity which is barely relevant. You should have contacted those who have spent years there before you went to generate an accurate picture.....
MODERATOR: Thanks for the feedback. Dr. Gupta has updated the post.
I read your report about the small village called Akonolinga – cameroon. I just want to thank you for the spot light. This is another way to expose the regime. It is outragous that Sanjay Gupta and AC will travel to Cameroon before we know what's actually going on . But the most ironic side of it is the U.S government still has a very strong economic ties with the Biya regime.
thanks sanjay and AC
Esapa Njang (nguti) U.S.A
Dr. Gupta,
Thank you for posting such an informative, fascinating report on not only the disease and what is being done to get it under control but the people's religious beliefs about how people got it. Its intriguing that the traditional medicine has a combination of herbs and bark that resemble streptomycin. I am looking forward to seeing your reports that you have done on these diseases. With climate change we will be seeing a lot of diseases that originally were confined to the tropics. The more we can find out now hopefully the better off we will be.
Annie Kate
Birmingham AL
What interesting comments. The American home health care worker whose own health failed as her patient's improved and who believes she had a spell put on her by her patient's nephew is particularly interesting.
I believe Ebola and Marburg originated in primates and is spread by bush meat. A west African lady in NYC was arrested last year for importing bush meat but saying it was baskets or something. She bsaid she wanted it to help celebrate family events, like birthdays and baptisms etc. Luckily she was found out and stopped.
While this disease Buruli may have been known before Dr. Gupta's piece, I never heard of it before in any of its incarnations and am curios to learn more about the herbal cures, as well.
As an incoming college freshman looking to study tropical diseases in the future, i find this article extremely intriguing. Dr. Gupta and the work he has done is quite inspiring, and I applaud him and his team. And for all my fellow Cameroonians who are criticizing the overwhelming reports of disease in Africa, diseases are there and we cannot just ignore them. Of course it is our home country, but there are still many things such as unknown or undocumented diseases that are keeping many underprivileged Africans crippled, and often dead. Therefore, if anything, we should be grateful that foreign doctors and researchers are taking an interest in our plight, and doing something to help.
Thank you for the interesting article. This disease, and the way it is associated with witchcraft, bears a striking resemblance to Kuru in Papa New Guinea.
Pls forward the article to someone at Bill Gates foundation – maybe they can step in, just like President Carter;s foundation stepped in to help with the terrible Guinea worm that inhabits people there, and eventually bursts through their skin, sometimes several feet long – another absolutely horrifying tropical parasite, that ends up can be cured by a few cents worth of treatment.
As a cameroonian everything is related to voodoo , curse and black magic . But you will be surprised that even high bp, , diabete and cancer are nothing else than a curse and when it comes to someone that does not like you.
I also like the Dr. But man easy on the comments. It's like your kissing his butt, Good story.
I've always wanted to do work in other countries, helping those who may not be able to help themselves, finding out about other cultures and just making a difference instead of living a selfish lifestyle, this report only reinforces that.
God love Naturale. He thinks the reason he is getting punished for something his parents did. As if he doesnt have enough problems at the minute.
Thanks for the information. Hopefully medicine, or the environment can help the children!
Thanks, Jean-Louis.
Wikipedia has an article also.
I am a Cameroonian living in the United States and am pleased with your detailed report on the disease – Buruli. Great idea to bring ailments like that to light because one never knows where real treatment can come from. But I have one comment I have always remembered each time I watch reports on CNN about Africa. Nearly all these reports talk about the bad side of Africa. It makes me realize why the question "Is Cameroon a jungle?" keeps coming to me from most of my US born pals. Most of what these guys know about Africa is from TV and most of what the TV shows about Africa is Zoos, jungles, HIV, poverty, misery... Yes, these things exist but there is some good stuff about that continent too. The big cities, the ease of movement around town, the people... You guys can also do some reports on good stuff too. Thanks.