Tetanus is a cruel killer

Life has never been the same for my family since October when my nine-year-old nephew was diagnosed with generalised tetanus at St Francis Hospital Nsambya. 

Umar Muwonge stepped on a rusty nail while playing. Without knowing the gravity and risks it carried, my mother, who took care of him, washed the wound and applied some basic first aid. Yes, with her experience of raising six children, that was enough for the little boy to get back on his feet. But that was not the case. 

Instead, it was the start of Muwonge’s two-month journey in the Intensive Care Unit (ICU), 50 days of which he spent in an induced coma. 

The disease was life-threatening to little Muwoge and imposed a massive financial burden on his single mother and the entire family.

We bore the stress of seeing our little one fighting for his life on a ventilator and meeting hospital bills for the two months. 
Many friends and strangers have supported us financially, but the bill is too huge to handle. Due to the high cost of drugs and other required services, we spent at least Shs3.5m daily at a private facility. Yes, we opted for a high-end private facility for lack of choice. 

We were frustrated by both faith-based and public hospitals. At Nsambya hospital, we were informed that the ICU doesn’t admit tetanus patients because they require an isolated ICU with little noise and light.

Afterall, a neurosurgery camp was happening at Mulago National Referral Hospital, and the ICU was filled. The only available isolated ICU bed was at TMR International hospital. 

We, therefore, had to take a quick decision to either bear the financial implications or let Muwonge die. Like any parent would do, we chose the former and started crowdfunding on top of our little savings. One by one, we sold our assets. 

I dropped out of university, where I was pursuing a Masters course to support the family. The would-be tuition would do a lot to offset the bill. Despite all the efforts, we still had an outstanding Shs235m [about $66,700] when Muwonge was discharged for home care in January this year. Despite the huge debt hovering over our heads, it is still a miracle that the little one survived.

Muwonge is one of the rare cases of people who survive tetanus in Uganda due to the high cost of treatment and inadequate equipment. In most cases, tetanus is a death sentence as most of the people told us that we almost lost hope.

“Try your best, but I have never seen anyone surviving tetanus,” a close relative said when she visited the hospital. Maybe she was ignorant, but even a senior doctor friend held a similar opinion.

“He [Muwonge] is nine years? Those don’t survive, “he assured me. Thankfully, the believer in me didn’t lose hope, and indeed, God has proven me right.

Knowing that a free tetanus vaccine jab which at worst costs Shs2000 at a private facility, could avert all this agony and save the many lost lives, is more painful.

However, there is a widespread lack of knowledge that tetanus, unlike other childhood immunisable diseases, requires a booster jab, especially in case of an open wound.

During this time, I heard families lamenting stories of their children and some adults who have succumbed to the disease. Worse still, health workers are equally ignorant. Two cases resulted from a surgery and an accident where health workers did not give the tetanus jab.

At one hospital, I was shocked to see the doctors getting every prescription from the internet before attending to my nephew. It was also until I asked why tetanus immunoglobulin (HTIG) was not administered yet; it is supposed to be given as soon as possible that the doctor prescribed it.

Thanks to my basic healthcare knowledge. A single dose of HTIG goes for Shs1.2m at a private pharmacy where we bought it (too high for an average Ugandan)

Ultimately, we need to create awareness about tetanus and prevent this unnecessary financial distress and preventable deaths in most cases. 

According to the Centre for Diseases Control and Prevention (CDC), tetanus is an infection caused by bacteria called Clostridium tetani. When the bacteria invade the body, they produce a poison (toxin) that causes painful muscle contractions.

Another name for tetanus is “lockjaw”. It often causes a person’s neck and jaw muscles to lock, making it hard to open the mouth or swallow. CDC recommends vaccines for infants, children, teens, and adults to prevent tetanus.

Ms Lilian Namagembe is a journalist and a communication specialist.
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