Sickle cell disease and Nigeria

An interesting piece on life with sickle cell disease in Nigeria (here).  An all-too-realistic account of the everyday struggle of a single mother and her daughters, in a country with rudimentary health care – or none at all – for most people.  Nigeria has the largest population in Africa – approaching 200 million - and it is estimated the 150,000 babies are born each year with sickle cell.  Only 5-10% probably live into adulthood, and those are plagued with frequent pain crises, as is the girl in this story. Having been on those streets not so long ago, I know the atmosphere as the night progresses and the streets become empty.  There is a dark cloak of anger and violence that hangs over the roadway. 

Most medical schools in the US have greatly expanded their global health programs, and students find the opportunities an exciting break from endless study.  It is important to actually feel what life means in poor countries and not romanticize the experience of "global health".  For sure, travel in low income countries is an adventure, full of strange and exotic happenings. But it is equally important to realize that life in many poor countries is not strange, exotic or adventuresome of many people who live there.  It is a bitter struggle for a chance to improve your circumstances, raise your family and remain healthy.  To be a competent citizen of the world we have to know what life is like for those made miserable by the global economic system.  We are part of the unequal balance.

Please note: The "vigilantes” referred to are the citizen's patrols that are run at night in the absence of police.  If they encounter would-be thieves they have to kill them on the spot, or else the thieves will return for revenge and kill them.  911 is not functional.

We are hoping that our own small effort to improve life for sickle cell patients – a trial of low dose hydroxyurea in Ibadan, Nigeria – will someday lead to widespread use of this important drug.