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Friday, Jul 25th

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Hepatitis Spreads in Northern Arakan

A 45-year old patient named Abdul Hamid from Buthidaung has been suffering from pain in his stomach for over one year. He has been receiving treatment from local doctors, but has not had any positive results. He recently traveled to Bangladesh, where his wife was going to sell ornaments.

Hepatities

“After arriving in Bangladesh and expending a huge amount of money, I was tested by an expert doctor at a private clinic, where I was found to be positive for hepatitis C,” Hamid said. “I am surprised and disappointed to know this. On suspicion, my wife was also tested, and she is also infected with hepatitis C. Later, I realized that my wife was victimized by me because I didn’t have knowledge about hepatitis.”
 
“I have had to spend a lot of money for test fees, and I have to buy injections and tablets for six months of continuous treatment. The injections are very expensive. I have to inject one vial per week, four vials in a month.”
 
“It is also necessary to keep the vials in a box of ice, and it is difficult for me to keep them in an ice-box as there [in northern Arakan State], we have no facility to get ice or electricity for refrigerators,” he explained.
 
“One vial is sold in Bangladesh for Taka 22,000, and I have to buy 24 vials for Taka 528,000, and for my wife Taka 528,000, in total 1,056,000 Taka, equivalent to Kyat 10.56 million, excluding other expenses.” [One Taka= 10 Kyat]
 
“Besides, I have to spend more money for medicine tablets, to pay doctor’s fees, to pay for border passes, and for traveling expenses. How can I get this huge amount money?” he asked with great disappointment.
 
Like Hamid, there are many patients with hepatitis B or C in Maungdaw, Buthidaung, and Rathedaung Townships.
 
Another patient named Sayed Ahmed (55), who hails from Buthidaung Township, said, “Six months ago, I came to Chittagong, Bangladesh, accompanied by my wife, and I was tested at CRCS Private Clinic, where the doctor found that I was positive for hepatitis C. Before coming to Chittagong, Bangladesh, I took treatment in Arakan State, but I did not get any improvement. The doctor advised me to go to Chittagong. So, I came to Bangladesh for treatment. After getting the medical report, the doctor gave me some tablets and injections, which are very expensive. The doctor also advised me to come again to Bangladesh after one month. I am not able to buy those medicines as I am poor, so I bought only some homeopathic treatments and returned home.”
 
Ms. Salma Khatun (50), the wife of Sayed Ahmed, said, “One month later, my husband became very weak, so I again hurried to Bangladesh with my husband and three children. After arriving in Chittagong, all the family members including me were tested in the clinic, and we were also found to be infected with hepatitis C, so we are very disappointed. After buying medicine for my husband, we went back home. We did not get any medicine for our children or for me, as we have no money left after buying medicines for my husband.”
 
“However, on the way to home, my husband died in Bangladesh while going to Teknaf from Cox’s Bazar. We had to try to cross the Naff River with his body, and we faced many difficulties. However, at last, we crossed the Naff River and reached Buthidaung Town. But the dead body was not allowed to be carried to our home, so he could only be buried in a cemetery outside of the town,” Salma Khatun continued.
 
Another patient named Salay Ahmed (35), the son of Abdu Khader, who hails from Maungdaw Township, said, “I came to Chittagong for medical treatment as I have pain in my liver while walking. I managed my journey only after selling all of the arable land that I have. I have three family members -- my wife, a child, and me. After arrival at Chittagong, I was tested at the CRCS Clinic, where I learned I am with hepatitis C. Seeing the report, I returned home after buying medicine from a local herbal shop as I am not able to take medical treatment for six months because of the large. There are many patients who have been taking only local herbal treatment in our village.”
 
Recently, a young woman named Latifa, who hails from Yanma Village of Buthidaung Township, came to Bangladesh to see the doctor because of pain in her stomach. Her father and mother are already deceased, and she has only two young brothers in her home. However, with the help of her elder sister, she was admitted to Cox’s Bazar Hospital, where she was found to have hepatitis C. One week later, she was released from the hospital after not being able to afford the expenditure. However, on the morning of October 26, she died in a relative’s house without ever receiving proper treatment. Like her, there are many people with hepatitis B or C who have died without any treatment in northern Arakan State because of poverty and the scarcity of medicines.
 
When a doctor at Chittagong’s CRCS Private Clinic was asked why so many of the Rohingya people who visit the clinic are affected by the hepatitis C virus (HCV), he said that it was very strange, as nearly 80 percent of Rohingya patients who have been tested at the clinic are affected by HCV. He said it is possible that the government has been doing something against the Rohingya community, as another community in northern Arakan – the Rakhine – has not been affected by HCV.
 
While some patients with hepatitis B or C who have wealthy relatives abroad are able to get medical treatment from Bangladesh, poor people are not able to afford proper treatment will most likely die in the near future.
 
Recently, some of the people who have died of hepatitis in Buthidaung Township include Abdu Salam from Buthidaung Town, Rashid from Buthidaung Town, Sultan Ahmed, the son of the late Maulana Ahmed Hussain of Yanma Village, the wife of Master U Hla Aung of Ngaran Chaung Village, Ms. Salma Khatoon of Badana Village, Ms. Latifa, the daughter of Sultan Ahmed, who hailed from Taung Bazar, and Moulvi Jamir Hussain, the son of the late Mono Meah, who hailed from Taung Bazar.
 
According to local elders of Arakan State, the dangerous viral hepatitis is spreading rapidly in northern Arakan, especially in the areas of Maungdaw, Buthidaung, and Rathedaung Townships.
 
According to a doctor from Rangoon, hepatitis is multiplying among the Muslims (Rohingya) community because they take ablutions for prayer from lakes or ponds in northern Arakan. If an infected person has a wound in his leg or hand, the virus can spread to other persons who take ablutions from the same lake or pond.

Sources said that hepatitis or inflammation of the liver caused by related viruses (A, B, C, D, and E) affects millions of people around the world.

Many of these people do not have adequate access to health care, increasing their risk for premature death from liver cirrhosis and liver cancer. Most people who have been infected are unaware of asymptomatic infections until they reach the end stage of liver disease. Experts say that awareness and knowledge are the key factors to prevent and control the huge burden of hepatitis.

There is also a vaccine against hepatitis A, which is transmitted through contaminated food and drink, and commonly affects children.

Hepatitis C is the most fatal variation of the virus, which can remain long dormant and has no vaccine to prevent it. The ways to prevent these viruses are safe blood transfusions, the use of sterile medical instruments, safe sexual practices, and safe delivery practices for pregnant women and vaccinations of newborns.

If someone is diagnosed with hepatitis, especially hepatitis B or C, they can be terrified with the misinformation that they will invariably reach the end stage of liver disease. But many of them are just carriers, and only need to receive check-ups at regular intervals. When liver functions are impaired due to viral activity, there are antiviral drugs to control viral activity and limit liver damage, according to doctors.

“The crisis is compounded by lack of awareness about the disease among the local people, the scarcity of drugs for treatment, and the lack of testing equipment at the local hospitals. Some people may be infected, and can continue to spread the infection.”

Chronic hepatitis B and C are “among the leading causes of avertable deaths” in the areas.
 
“These viruses are 30 times more prevalent than HIV in Burma, Bangladesh, Bhutan, East Timor, India, Indonesia, The Maldives, Nepal, North Korea, Sri Lanka and Thailand. However, due to the often asymptomatic nature of these infections, about 60 percent of infected individuals remain unaware that they are infected, until they show symptoms of cirrhosis or a type of liver cancer, and this may take over 20 years,” according to a statement released by the World Health Organization (WHO) on July 22.
 
“More than five million people in South and Southeast Asia will die from viral hepatitis over the next decade as experts warn of a rampant epidemic that has already taken more lives than malaria, dengue, and HIV/AIDS combined in the past 10 years."

“More than 130 million people from 11 Asian countries carry hepatitis B and C, out of a total of 520 million globally.”

The report also adds, “More than half of the total deaths attributed to hepatitis E, which can be contracted by eating or drinking contaminated food or water, occur in this region”.

“The population of Burma is subjected to some of the world’s lowest government healthcare spending. The government budget announced in Burma earlier this year allocated less than 3% of total annual spending to healthcare and education combined. Infectious diseases borne in Burma are carried to neighboring countries by the thousands of migrants that cross the border each year.”

“Lack of public awareness and the lack of government interest in finding accurate data for these areas compounds the problems. The government must do public awareness regarding the disease with the cooperation of local NGOs,” said a local officer of the health department from Buthidaung Township.

“To boost awareness among the public, information needs to be aired on radio and TV for the general public so that people can go and get themselves tested,” said a doctor from Maungdaw Town.