Now (finally!) a change from mildly amusing anecdotes about my strange home life. Unfortunately, this is all about death. Here's another excerpt from my favorite local newspaper.

Meningitis Epidemic : Getting rich off the misery of the Burkinabé people.

By Ramata Soré from “L’Evenement” April 10, 2007

“What’s happening with meningitis? There seems to be a general feeling of powerlessness that condemns us to die in silence, because we can do almost nothing. The vaccines are very expensive and almost impossible to find. Even if we had the money, there aren’t enough laboratories making the vaccines quickly enough to help us. We here are more vulnerable to meningitis than to HIV/AIDS. Why? Because in the latter pandemic, even though it’s not curable, we know how to avoid it and how to live as long as possible with the illness. There is none of this for meningitis. Every year, without fail, meningitis kills thousands of us. We cannot prevent and often cannot even treat it. There are questions of money and knowledge involved….But there are also criminal elements in this story that we must find the courage to confront. We have discovered a hideous illegal business built upon vaccines. It is completely unacceptable, but tragically very common.”

The article goes on to cite several major problems:
1) The proper storage of vaccines: The article claims that vaccines are often stored at incorrect temperatures. Specifically- the “chain of cold” is being broken, often multiple times. So, the potency of the vaccines used is questionable. Why isn’t it kept cold? In part ignorance and in part due to item number two:

2) The Bidding Mafia: The need for refrigerators, appropriate vaccine transport containers, etc has led to a big business, not much of it aboveboard. The contracts don’t go to the lowest bidder. The representative of one company that bid and lost claims: “We offered the exact same items for 50 million cfa (100, 000 dollars US) less than the winning bid. It’s not right.”
And once the contract is granted, lots of the material paid for and much needed never shows up. In one case, 15 electric generators were sent, instead of 25. These are desperately needed in the rural areas that have no way to power fridges for vaccines.

3) Underestimating the problem: “One source, close to an internatonal health organisation, believes that the official figures for meningitis in Burkina are seriously off-target. Our source says that in the 11^th week of the epidemic, there were already 200, 000 cases, rather than the 10, 796 claimed by the government. With a mortality rate of 20%, that means about 4000 deaths attributable to meningitis, rather than the official figure of 801.”

4) Lack of medical training: “The government claims that all health structures in country have personnel that are qualified to diagnose and treat meningitis. Nevertheless, the reality is that there are serious problems. Many healthcare personnel can’t recognise meningitis. It’s often the case that sick people have to return several times to the clinic, insisting that they have a serious problem. Sadly, many people here die because the symptoms of malaria and meningitis are often confused. This has been documented by us at several clinics in Ouagadougou” The situation in rural areas can only be worse.

5) Improper use of vaccines: Vaccination campaigns have been going on since March, but no records are being kept. This means that some people are getting vaccinated every year. The meningitis vaccines are meant to be administered only every three years. It’s both dangerous to health and wasteful not to keep immunization records. Considering that the vaccines are in such short supply, it is particularly terrible to waste them.

6) Stolen Vaccines: “In 2003, 1000 doses of vaccine “disappeared from a Health Ministry cold room in Ouaga. A manager in charge of vaccines (Etienne Kyendrégeogo) was found to be at the origin of the theft. He and his accomplices still work at the Ministry. Some of them boast that they have even been promoted, despite their wrongdoing.

The fact that these people have gone unpunished has prompted others to imitate them. Double books are kept and the “surplus” vaccines are sold for a profit. In one district, the manager took 26, 000 doses and sold them for a profit of 3,900, 000 cfa (about 8,000 $ US). This is not uncommon. The PEV (which manages vaccines in Burkina) has no internal monitoring and misconduct is not punished.

Right now, someone who is responsible for stealing
millions from the vaccination effort is a top employee at an International health organisation.”

And I just received this in my inbox a minute ago:

U.S. Embassy, Ouagadougou, Burkina Faso Warden Message

April 19, 2006
The U.S. Embassy is issuing this Warden Message to alert you to the meningitis in
Burkina Faso.  As you may already know, this year's cyclical meningitis outbreak
has been particularly severe.  According to the Ministry of Health of the
Government of Burkina Faso, as of April 4, there already have been 19,549
cases of meningitis, 1,337 of which have resulted in death.  These totals
significantly exceed those of the last major outbreak in 1996.  The World Heath
Organization estimates that an average of 4,000 new cases of meningitis and 200
related deaths will occur weekly until the end of the forecast epidemic in late May.   
American Citizens should confirm that their meningitis A, C, Y, and W135
inoculations are up to date.  Further information on meningitis can be found on
the World Health Organization site:
http://www.who.int/mediacentre/factsheets/2003/fs141/en/