Time for a return to Sanatoria

Editorial, Normal

The National, Tuesday 08th November 2011

OLD enemies never die.
Around the globe, our old microbial enemies are staging a major comeback.
They are teaming up with or hitching a ride on the bandwagon of new conditions. TB, for instance, is teaming up with HIV to form a formidable team against which human medicine has found no defence, a new threat helping rejuvenate a veteran campaigner against humankind, if you will.
Each re-emerging condition is marching to a different drum, making it that much harder for the world’s health systems to cope – even with familiar enemies such as malaria, tuberculosis, or the common cold.
Tuberculosis’ resistant to antibiotics is rising. On the rise too are drug-resistant malaria. The common flu, likewise, changes its coat and its level of virulence with each visit it seems. It will not be too long before one floats along with a virulence to kill millions as did the pandemic of 1918-19 that killed 22 million.
The re-emergence of these old campaigners seem to correspond with the level of attention given them, more particularly the amount of resources dedicated to doing battle with them.
As the level of resources dwindle, up rears the threat in a short of “U” syndrome.
The fight against malaria, the bane of rural Papua New Guinea, has always been hard but it was better fought in yester-years. In the days of DDT sprays and nationwide campaigns the awareness by people to fill holes, empty cans and other places where there were still waters were drained.
Awareness on TB had the same effect of mobilising the people to take preventive measures.
Today those measures are all but forgotten as attention and resources shift elsewhere to new comers like HIV and the bird flu.
Seeing TB striding the world stage again, Giovanni Migliori, head of the World Health Organisation’s collaborating centre in Tradate, Italy, is calling for a return of the sanatoria, which was used to isolate infected people before TB drugs were invented.
This is an idea that the public health system in Papua New Guinea might consider for a number of diseases including TB, HIV/AIDS and leprosy which appears also to be on the rise in PNG.
Because of the lack of facilities and personnel to detect the symptoms of these diseases early, many sufferers or carriers are often left in the community where they can transmit the infection for many months before they are detected and treated, sometimes never.
A return to sanatoria might sound harsh and inhumane but it is necessary to protect members of the community from harmful infections.
Given the choice, provided the right facilities are available, many sufferers might choose voluntary sanatorium to protect their loved ones and the whole community from being infected.
Due to the lack of
capacity to monitor trends nationwide, it might become necessary for the government to consider policy or even legislation to establish sanatoria.
This is more a global responsibility than a local one. The reason is because the entire world is today a hotspot waiting for the next pandemic to emerge. World trade and ease of travel has exposed entire communities on one side of the planet to viruses, bacteria and pests from the other side.
Whereas these collection of scavengers might have natural enemies which keep them at bay, once transmitted by human traffic or cargo to another part where they do not have natural enemies they can multiply in amazing numbers without stop.
Quarantine operations around the world can stop only a very small percentage of the unchecked flow of these free boarding deadly travellers because it is near impossible to frisk or do a complete check, medical and physical, of every traveller or cargo entering ports throughout the world on a daily basis.
It would appear that despite the best scientific efforts by man to overcome diseases and pests, it may be time to consider a return to that which was practised by our non-scientific forefathers for millennia to contain infectious diseases: Isolation.
At least in today’s world, we do not have to adopt the forced euthanasia or banishment that was associated with such practices.
Today isolation or Sanatoria might be the most humane option possible since sufferers can get better
care and they are removed from the community where they do not spread the harm.
A sanatorium, once established, would also treat patients correctly, even if it is only palliative care for the dying.