THE SILENT KILLER IN SIERRA LEONE; LIVER DISEASE

SIERRA LIVER FOUNDATION (SiLiFo)

SiLiFo (Sierra Liver Foundation) is a voluntary, non-profit organization promoting awareness and prevention of liver diseases. It offers help, information, and supports to those suffering from liver disease and their families. In addition, SiLiFo reaches out to support programmes involving diagnosis, prevention and treatment of liver- related diseases.

SiLiFo is relentlessly working towards bringing perceptible change in public awareness about hepatic diseases. With a vision to help control chronic and advanced liver diseases

The aim of this Foundation is to provide  Counseling, Awareness raising for Liver health, seek aid or support from donors to fellow compatriots (Children men and Women) who are in need as the case maybe and to meaningful contributes to the diagnoses, treatment cure and eradication of Liver Disease and socio-economic development of our post-war and Ebola country Sierra Leone.

The objectives of this Foundation shall be:  

·         To bring together Researchers, professionals who teach the Awareness of Liver Health Issues needs and opportunities of mutual interest; and to facilitate information sharing. 

·         To discuss, develop, sponsor, and promote educational and training programs and activities that will advance the practice of the Care for the Liver and Liver disease Prevention

·         Educate the general public and encourage medical practitioners regarding all aspects of prevention and treatment of liver disease.

·         Support patients suffering from liver disease and all those involved in caring for them.

·         Influencing people to help formulate public health measures aimed at preventing liver diseases.

·         Support research into the causation, diagnosis, prevention and treatment of diseases of liver.

·         Promote the concept of organ donation in general and help the setting up of a liver transplantation program in particular

LIVER DISEASE

It is estimated that liver diseases are among the top five killer diseases in Sierra Leone, causing thousands of deaths every year. Besides, there are those who suffer from chronic liver problems, needing recurrent hospitalization and prolonged medical attention, which leaves them physically, mentally, emotionally and financially devastated.

On the other hand there are millions of cases of hepatic diseases, which go unreported or are reported when the matters have gone out of hand. Utter Poverty coupled with lack of education and awareness, prevent people from seeking medical advice until it is too late. In addition, high cost of treatment pose as major obstacle in convincing people about taking treatment.

Studies have indicated that some liver related diseases like Hepatitis B and Hepatitis C virus could proliferate into an epidemic much larger in scale than the dreaded HIV. However, these diseases being Silent Killers with long gestation periods do not attract the attention of the Government or the other influential bodies. The needs of patients with liver- related disease have been grossly underestimated and largely ignored. Committed to address these issues, Silifo (Sierra Liver Foundation) was established in 2015, thorough the consorted and co-operative efforts of a patient and some Lab Tecnicians who noticed the lack of such organization in Sierra Leone.

Since its inception Silifo has attempted to spread awareness about preventable hepatic diseases and reaching out to people suffering from chronic or advanced diseases through:

·         Various educational and training programmes including seminars,

·         Patient support groups

·         Mobilizing funds for providing treatment to patients at considerably subsidized rates

·         Campaigns for promoting organ donation and other activities.

·         Campaign to Vaccinate Hepatitis B vaccine to all medical students and para-medical entrants.

However it will be a long time before the efforts will significant results are yet to be seen in bringing down the incidence of liver diseases. With Sierra Leone’s population up to Seven Million and keeps growing every minute the task seems enormous. Encouraging individuals to participate in their own preventive health- care can prevent many serious diseases. Proper information and care can help reverse the ill- effects of neglect and ignorance in many cases. SiLiFo has taken the first step. Your support can help us make lasting change in the lives of millions. Join hands with SiLiFo in this fight to make Sierra Leone free of liver diseases.

GOVERNMENT IRRESOLUTE OVER LIVER DISEASE STRATEGY

Government has failed to make good on any pledge to combat liver disease and instead risks reversing recent progress in tackling alcoholism in the country by dropping poverty as a yardstick and allowing many Alcohol producing Companies all over the country which has physically, mentally and internally damaged the lives of many Sierra Leoneans. 

In the Post-Ebola there are certain things that were left out to address. Many homes suffered from the Ebola outbreak in Sierra Leone, Many homes which were quarantined and many survivals now suffers some kids of Liver Related Problems because the Chemicals which were used affected many internally and are now acting on their livers. The Chlorines, Sanitizers, and other chemical where sometimes over used or wrongly used by some of the workers.  Lab Technicians, Volunteers, medical workers, burial team, Swipe Team etc were in some ways not using the Personal Protective Coverings.  Most of these people

Liver disease, the only major cause of death still increasing year on year in the Sierra Leone, is largely a result of lifestyle issues such as alcohol, drug-taking and obesity that doctors say are preventable.

To tackle the Spread of the liver Disease, there are certain measures which the Government can put in Place 

·         Political Interference

·         Poverty & it Related Causes

o   Prostitution

o   Poor Hygiene

o    

·         Alcoholism

o   Uses  & Effects

o   Government Policy on Alcohol

·         Drugs and Drugs Abuse

o   Uses  & Effects

o   Government Policy on Alcohol

·         Post Ebola Effects

·         Testing & Diagnosing Equipments

POLITICAL INTERFERENCE:

The sufferers of liver disease often have little or no political voice - it is therefore up to politicians to speak up and out on the need for action on what is a largely preventable and treatable disease. The Members of parliament representing their people should try to know the health conditions of their people even though there are ministers responsible for that. Let them encourage Awareness campaign groups to campaign against Drug Abuse and Alcoholism. And to pass a bill on free testing and treatment of liver Related Diseases just like that of HIV/AIDS. Let the politicians encourage government for the allocation of Funds for the Research, Diagnose, widespread use of antiretroviral drugs, for free because it’s a highly effective (and cost effective) way of reaching those affected. With this all those who are undiagnosed will be diagnosed, this can help in preventing the spread of the disease. Almost all those people infected with HCV can be cured with oral treatment.

POVERTY & LIVER HEALTH

During my Research, I met with ordinary Sierra Leoneans and healthcare professionals to address the Sierra Leone’s growing epidemic of Liver Disease, which is today the First most common cause of premature death in the country. Specialists in the field have warned of a poverty-based health crisis. Liver disease is now the only major cause of mortality and morbidity on the rise in Sierra Leone.

Liver disease-related mortality can be attributed to many primary causes: alcohol, which accounts for 37-40% of cases in the Sierra Leone; Hepatitis B (HBV) which is contracted through blood, semen (Sex) Hepatitis C virus (HCV), which in 85% of cases is contracted through intravenous drug use, Post-Ebola effect.

In my research, the North and West region of the country has the highest rates of liver disease in the country, the East which borders two neighboring countries Guinea and Liberia next and the South.  I have heard firsthand about the tight link between liver-related illness and deprivation. As a region the North and West have been disproportionately hit by austerity measures introduced by the All People Congress Party government, ranking highest in terms of hardship/poverty, long-term unemployment for most people migrating the region in search of work, and young people born in the region but lacks the knowledge to do the work wanted by the companies are out of work.

Some of the reasons to the high rate of infected persons when contacted other authorities are

·         For the past years, the North has been the area for new companies and Non Governmental Organizations. So many youths including men and women and even under aged School going girls ran there in search of work and money. So many exchange Sex for what they want and because of that, HBV is rapidly spread within the region

·         That almost every weekend the big towns and cities are full because most government officials go there to spend the weekend.

·         

That when these people meets at these various places, each and every one prepared well for giving and receiving, the men prepare well to meet the women and the women prepare well to get more money; To break down the above bullet, (Meaning), The men takes enough drugs and energizer to enjoy the money they should give the ladies, the ladies in turn takes enough Alcohol or drugs to have strong energy to receive the men and to have more men

·         

Receiving these infections from the north will easily spread to the entire country because majority of the people return back to the city where people from all over the country meet in School, colleges, Market places etc.

·         

For the youth men, most of them followed the big men for their daily survivals, and most of them are given strong drugs and Alcohols to keep them awake and to give some of them minds to do all kinds of things including violence and preventing violence. Moreover, the Low Tax on Alcohol importation, the Almost TAX FREE for Alcohol Production Companies in Sierra Leone make it easier for Alcohol Consumption to go on the Increase.  

This is an incapacitating condition that is cutting short the lives of thousands of Sierra Leonean and African citizens every year. Yet there are several measures which, once in place, can have impressively swift and far-reaching results for liver health

 

ALCOHOL ABUSE , ADDICTION  EFFECTS

Alcohol abuse is a chronic, often relapsing disease in which an individual has a pattern of excessive alcohol consumption despite the negative consequences in an individual’s life. These consequences can include social ramifications, interpersonal relationship challenges, domestic and child abuse, problems with job performance, legal issues, and negative health benefits. Despite knowing these consequences, someone who abuses alcohol is unable to cease problem drinking

Many people who are alcoholics develop a tolerance to alcohol that requires them to drink more often and in larger quantities in order to achieve the desired level of drunkenness. Some alcoholics find that their body has become so accustomed to alcohol in the body that it develops a physical dependence upon it

With the inundation of alcohol in our society as synonymous as “letting loose,” it can be a real challenge to determine when drinking socially becomes a problem. When alcohol prevents an individual from fulfilling work or scholastic obligations and interpersonal relationships begin to crumble, an alcohol problem is in the making. When thoughts of drinking, obtaining more alcohol, and spending most days recovering from the effects of drinking have become a way of life, alcoholism may have developed.

There are Signs, Effects & Symptoms but I am going to focus only on the effect which has some relations to Liver Disease

Effects

The effects of long-term alcoholism can impact nearly every facet of an individual’s life. Virtually no aspect of an alcoholic’s life is untouched by this chronic, relapsing disease. Some of the effects of alcoholism may include:

·         Cirrhosis

·         Domestic violence

·         Aggressive and negative thought patterns in children of alcoholics

·         Worsening depression

·         Decline in cognitive abilities

·         Changes in brain structure and function

·         Burden of caretaking for drinking falls to friends and family

·         Divorce

·         Organ system damage

·         Heart disease

·         Irreversible brain damage

·         Other substance abuse

·         Job loss

·         Financial ruin

·         Homelessness

·         Social isolation

·         Suicidal thoughts, behaviors, and attempts

With all the above effects of Alcoholism, our main concern here as a Liver Health Foundation is the Cirrhosis which is a deadly Liver Disease Problem. Cirrhosis is the most common complication of chronic hepatitis. Cirrhosis can be detected with simple tests, but the liver biopsy is the best way to diagnose it. Cirrhosis occurs as the liver is destroyed and it is associated with liver failure, a life-threatening condition. The signs of cirrhosis include retention of fluid (swelling of the abdomen or lower extremities, fatigue, nausea, and weight loss. Later, confusion and jaundice occur due to the accumulation of chemicals normally removed by a healthy liver

Government Policy on Alcohol

·         Because alcohol is made locally on a Tax Free or Low Tax Rate system that is why its less expensive and therefore people take it in excess with a cost less than a Dollar.

·         Government should barn the advertisement of Alcohol and put a high tax on importation of Rums and Alcohol.

·         Government should declare Non-Public Consuming Item.

·         That ANY ONE found drunk on the street should be kept in a Cell for 3 Days.

HEROIN ABUSE & ADDICTION AND IT EFFECTS

Heroin is a highly potent, fast-acting opiate narcotic which makes heroin one of the most abused illegal substances. Heroin is a derivative of morphine, which is a naturally-occurring opiate. When used heroin is said to create a rush of pleasure and overall wellbeing. After about a few hours the high wears off leaving the user eager to obtain more of the substance in order to get those pleasurable feelings back.

Heroin is especially dangerous as when the drug is bought on the street, it’s likely to be mixed with other substances. Sometimes the heroin is cut with substances such as cornstarch or baby powder, other times it is mixed with toxic substances such as arsenic or quinine. There is no way to know what the heroin bought off the streets is mixed with which can lead to overdose and death. Heroin is consumed in a number of different ways such as smoking, injecting, and snorting. All methods result in the substance reaching the brain at different rates of time.

After a while heroin addicts develop a tolerance to the drug which means that they require more and more in order to experience the desired high or rush. Soon heroin addicts spend all of their time, energy, and money trying to obtain the drug. The results of heroin abuse can be totally devastating, including consequences such as financial problems, relationship difficulties, decline in work or school performance.

There are Signs, Effects & Symptoms but I am going to focus only on the effect which has some relations to Liver Disease

Effects

The effects of heroin abuse and addiction can be devastating and affect all areas of an individual’s life.  Some effects of heroin addiction include:

·         Irritability

·         Depression

·         Loss of appetite

·         Liver damage

·         Respiratory depression

·         Difficulty swallowing

·         Circulatory problems

·         Nausea and vomiting

·         Intense sweating

·         Sleep apnea

·         Joint pain

·         Chills

·         Body weakness

·         Runny nose

·         Increased blood pressure

·         Increased respiratory rate

·         Tachycardia

·         Anxiety

·         Unsteady gait

·         Suicidal ideation

·         Trouble with the law

·         Incarceration

·         Respiratory arrest

·         Coma

·         Death

Marijuana Abuse & Addiction Signs, Effects & Symptoms

Marijuana is a mixture of dried shredded leaves seeds and flowers from the Cannabis sativa plant, also known as hemp. The plant is related to hops and nettles and can be found growing wild in many places in the world. Other names for weed include grass, pot, weed, Mary Jane, MJ and reefer. The leaves and flowers (buds) or the plant are dried and crushed. Most often they are rolled into handmade unfiltered cigarettes and smoked but some smoke it in pipes or water pipes called bongs.

Over 400 chemicals are found in the plant Cannabis sativa, which includes a chemical resembling a penicillin-like antibiotic. The derivatives from the plant can be used for medicinal or recreational uses.

There are Signs, Effects & Symptoms but I am going to focus only on the effect which has some relations to Liver Disease

Effects of Marijuana Use

·         Magical or “random” thinking

·         Short-term memory loss

·         Anxiety and depression

·         Red eyes

·         Constant, mucus-filled cough

·         Decreased respiration rate

·         Liver Damage

·         Dry mouth

·         Inability to appreciate the consequences of one’s actions

CODEINE ABUSE & ADDICTION SIGNS, EFFECTS & SYMPTOMS

Codeine is a short-acting narcotic prescribed by physicians most often used for the treatment of pain relief. Codeine can be highly addictive and provides the user with an overall sense of calm and feelings of pleasure. When codeine is used it enters the brain and causes the release of neurotransmitters that stimulate the reward center of the brain, leaving the user feeling intense feelings of wellbeing and pleasure. This kind of pleasure can lead to both psychological and physical dependence.

There are Signs, Effects & Symptoms but I am going to focus only on the effect which has some relations to Liver Disease

Effects

Although codeine is a prescription drug the abuse of codeine can cause significant damage to an individual’s life. Some of these effects may include:

·         Acute pancreatitis

·         Major depression

·         Liver Damage

·         Kidney damage

·         Financial problems

·         Legal issues

·         Domestic problems

·         Job loss

·         Heightened pain sensitivity

·         Uncontrollable muscle twitches

·         Muscle spasms, cramps, and pain

·         Loss of productivity at school or work

·         Impaired social relationships

·         Seizures

·         Incarceration

·         Respiratory depression

·         Bradycardia

·         Cold, clammy skin

·         Decreased muscle tone

·         Coma

CHLORINATED HYDROCARBON

As a class, the chlorinated hydrocarbons are potent central nervous system depressants or stimulants. They also cause greater liver and kidney damage compared to other organic solvents. Many have been shown to cause cancer in laboratory animals; due to widespread industrial use, the issue of carcinogenic risk to humans is one of the most controversial issues in regulatory toxicology. The chlorinated hydrocarbons have been implicated in causing sudden death at high exposure levels possibly related to the development of heart arrhythmias (ventricular fibrillation).

Exposure to chlorinated hydrocarbon compounds in the occupational setting is primarily through inhalation. Skin absorption is variable and usually insignificant, although dermal absorption following prolonged or extensive skin contact can cause systemic toxicity.

History: An individual presenting with acute effects of chlorinated hydrocarbon toxicity may have symptoms of dizziness, headache, nausea, vomiting, sleepiness, fatigue, "drunkenness," slurred speech, vertigo, disorientation, depression, and loss of consciousness. Additional symptoms include sore nose, sore throat, and cough.

Chronic effects of chlorinated hydrocarbon toxicity include dermatitis (red, dry, cracked skin), neurobehavioral dysfunction (headaches, mood changes, memory loss, difficulty concentrating, decreased attention span, and fatigue), liver damage (abdominal pain, nausea, jaundice, abnormal liver function tests) and kidney damage (weakness, fatigue, polyuria, glycosuria, electrolyte abnormalities). Both liver and kidney damage may result from severe acute poisoning.

Physical exam: The main signs of chlorinated hydrocarbon toxicity are central nervous system (CNS) effects such as depression or excitation, agitation, lethargy, intoxication, confusion, and unconsciousness. There may also be signs of respiratory distress, visual hallucinations, cardiac dysrhythmias, and seizures.

Tests: Measuring the amount of the chemical in the breath is one way of testing for either trichloroethylene or tetrachloroethylene exposure. The breath test, if it is performed soon after exposure, can detect if the individual has been exposed to a small amount of trichloroethylene. Because it is stored in the body's fat and slowly released into the bloodstream, tetrachloroethylene can be detected in the breath for weeks following a heavy exposure. Both trichloroethylene and tetrachloroethylene and trichloroacetic acid (TCA), a breakdown product of both chemicals, can be detected in the blood.

These procedures are useful only if the exposure is recent (within weeks or less), because both solvents are rapidly eliminated from the body. In addition, samples of blood and urine tests can be used to identify the chemicals and their breakdown products in individuals suspected of being exposed to both trichloroethylene and tetrachloroethylene.

A chest x-ray or ECG monitoring may be necessary.

Edward Jeffrey Boima

Executive Cordinator, 

Sierra Liver Foundation

http://silefo.webs.com