Ear, Nose, and Throat Challenge in Busoga: Insight from Dr. Fred Bisso
By Claire Zerida Balungi
I watched her struggle to clean her son’s ear with a cotton swab and remembered Dr Fred Bisso’s words the previous week, “Earbuds never clean ears, they simply cause problems,” Dr Bisso said.
I stifled the urge to share my discovery on earbuds as this mother and her son queued to meet Dr Bisso, an Ear, Nose and Throat (ENT) specialist at Mulago National Referral Hospital and Team Lead of Clinical Services at Busoga Health Forum (BHF) during BHF’s September ENT pro bono clinic at Mafubira Health Centre II.
A few hours later, with her sick little son in tow, the lady arrived at the registration desk and asked for directions to Kyabirwa Surgical Centre as she handed me her son’s medical form.
“Doctor has referred my son for surgery but he is supposed to report to school, how long will the healing process take?” she asked. “Mama, I’m sorry to hear this but your son’s health comes first,” I replied and gave her assurance that her son will be well soon if she follows the doctor’s advice.”
During our ENT drives conducted every last Saturday of the month at Mafubira Health Centre II, it has been discovered that patients conceal ENT-related challenges due to limited access to professional healthcare and quite often resort to shrines for emergency care when the situation gets out of hand. Exploitation by traditional healers is then birthed from desperation coupled with myths and misconceptions about challenges that would otherwise be curable by professional medical attention.
Behavioural dispositions- a huge cause of ENT challenges
Dr Bisso attributes the rising cases of allergies to increased exposure to impurities in the water and environment, resulting from embracing western lifestyle ranging from increased mechanization to use of fossil fuels and chemicals, including directly on our bodies in the form of makeup.
He opines that allergic reactions occur against chemicals as he points to lumps and tickling sensations in throats as effects of such reactions, which have unfortunately enlisted testimonies from quack doctors who claim to cure “throat cancer” when they give patients concoctions that control the allergy.
“When you feel something gripping your throat, that is cancer,” Dr Bisso mocks a counterfeit doctor who once made his way to the airwaves.
“Throat cancer is deadly and technically diagnosed. One cannot just base on a little challenge with swallowing saliva, offer a concoction and claim they have cured throat cancer,” Dr Bisso clarifies.
The medic also urged the public to shun self-medication which he says has greatly contributed to the prevalence of ENT challenges in Busoga sub-region.
“Whereas treatment of an ear infection by an ENT surgeon can take ten days, you find someone visiting a drug shop and opening up about symptoms such as a fever and headache, leading to misdiagnosis. Think of the practice of administering eardrops on one’s own ear at a stage when they are not necessary, predisposing one to complications of the ear,” Dr Bisso said.
“There are nasal drops we do not advise anybody to use for longer than five days but they are everywhere, even in the most remote drug shop in the country. These drops can give a false impression that they are helping at the onset only to worsen the situation,” Dr Bisso adds.
He also cautioned the public against seeking advice from anybody and everybody and following it like it’s expert advice.
“There are diseases that share signs and symptoms and one can end up treating a disease different from what the patient suffers,” Dr Bisso said.
Common misconceptions around ENT
- Failure to talk among toddlers could be an indication of a hearing complication. There is ,however, a misconception that the child has a tongue tie.
- Puss from children’s ears is thought to be mother’s milk which drifted into the ear while the child was breastfeeding, and now it’s making its way back to the outside yet this is an actual infection that could spread to the brain and breed further complications.
- · Often, midwives are accused of being “ill-hearted” and not sucking out the baby’s mucus at birth when a child turns out to have a stuffy nose or breathing difficulties. According to Dr Bisso, most of these children have underlying allergies.
- Some parents describe snoring in sleep as wheezing which is a sign of asthma. They end up getting asthma medication and when their children happen to outgrow the snoring, the health worker or herbalist who prescribed the medication will claim to have cured asthma.
- In many indigenous communities, a cough lasting more than a fortnight will attract the false diagnosis of having kalimi; This is the finger-like projection popping at the back of the throat. At times people chop that natural structure claiming that it is the cause of incessant coughing. The underlying cause of the cough could still be an allergy for which people hurry to treat with irritant remedies such as lemon or ginger, making the cough worse.
Persistent ENT conditions require professional attention. Access to professional ENT care is, however, inadequate in Uganda. BHF has taken up the mantle of influencing communities in Busoga through knowledge sharing using community radios and this newspaper. Asked how they got to know about the clinic, over 70% of the participants in our ENT pro bono drives confess to hearing Dr Bisso teach on radio and later offering them the opportunity to call in and consult him on particular points.
Besides offering ENT consultation and treatment, BHF has now embarked on recruiting and skilling of more ENT specialists through refresher training and provision of ENT tools to grapple with the ENT challenge so that one does not have to trek to Mulago or Mbale to access healthcare.