Liver disease or ‘sik bilong ples’

THE increasing number of liver disease cases in Eastern Highlands has seen the need for more awareness to be carried out especially in villages, a researcher says.
Dr Issac James Tikindi, a graduate from the Divine Word University (DWU) medical school, while doing his residential training at the Goroka Hospital, developed a keen interest in the high number of patients with liver disease.
According to the Mayo Clinic, the liver sits just under the rib cage on the right side of the abdomen and is essential in digestion and ridding the body of toxins.
Liver disease is any condition that damages the liver and prevents it from functioning which can be inherited (genetic) or be caused by a variety of factors that damage the liver such as viruses, alcohol use and obesity.
Overtime the conditions that damage the liver can lead to scarring (cirrhosis) which can lead to liver failure, a life-threatening condition but early treatment may give the liver time to heal.
Tikindi said liver disease was what the local people refer to as bel solap sik (swollen stomach disease) or sik bilong ples (disease of the village) which some believed was a result of sorcery.
“Since it is believed that the disease is caused by sorcery and doesn’t require medical intervention, people do not visit the hospital until the condition worsens and they are about to die that they show up at the hospital,” he said. “It is a terminal disease which means there is no cure and it will eventually lead to death.
“When patients come to the hospital at the late stage, they can be given palliative care until they die.
“Liver disease is preventable.
“It is important that awareness about the disease is made so that people can take preventative measures or seek medical treatment early for survival.”
As part of creating awareness on different diseases, from the observations made in the hospital, Tikindi conducted researches and presented his findings as short write-ups posted on the various social media platforms.
He conducted a brief research with the purpose of creating more awareness on liver disease from December to February last year.
Tikindi said of the 50 patients that were admitted at the Goroka Hospital’s emergency ward, 15 had liver disease.
He said most of the people with the liver disease were between the ages of 25 and 30 and a lot of them were men.
“Many of these patients were from Lufa, Okapa and Henganofi districts and included child-bearing women,” he said.
“The main causes of liver disease (or liver failure) of the patients observed during the research period was hepatitis B.
“When examinations were done on all the patients that presented with liver disease, they all had hepatitis B.
“Hepatitis B is sexually transmitted and can also spread through other body fluids.
“Mothers who have hepatitis can pass it to their babies in pregnancy, labour or nursing so it is important that a child is immunised.”
Tikindi said hepatitis B was preventable through vaccination.

Facts on liver disease from the Mayo Clinic – symptoms
Liver disease does not always cause noticeable signs and symptoms but if they do occur, they may include: skin and eyes that appear yellowish (jaundice); abdominal pain and swelling; swelling in the legs and ankles; itchy skin; dark urine colour; pale stool colour; chronic fatigue; nausea or vomiting; loss of appetite; and, a tendency to bruise easily.
A visit to the doctor must be made if there is any persistent signs and symptoms and if you have severe abdominal pain.

Causes
The main cause of liver disease include infection by parasites and viruses.
The viruses that cause liver damage can be spread through bodily fluids such as blood or semen, contaminated food or water or close contact with a person who is infected. The most common types of liver infection are hepatitis viruses, including hepatitis A, hepatitis B and hepatitis C.
Other causes include: immune system abnormalities; genetics; cancer and other growths; chronic alcohol abuse; fat accumulation in the liver; certain prescription medications; and, certain herbal compounds.

Risk factors
Factors that may increase your risk of liver disease include: heavy alcohol use; obesity; type two diabetes; tattoos or body piercings; injecting drugs using a shared needle; blood transfusions (before 1992); exposure to other’s blood and body fluids; unprotected sex; exposure to certain chemical toxins; and, a family history of liver disease.

Prevention
Preventative measures and strategies include: drinking alcohol in moderation; avoiding risky behaviours such as unprotected sex; getting vaccinated (hepatitis A and B vaccines); using medications wisely; avoiding contact with other’s blood and body fluids; and, washing hands before eating.
Keeping food safe by washing hands before eating and brushing your teeth; safe use of with aerosol sprays; protecting skin when using toxic chemicals; and, maintaining a healthy weight.