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June 16th, 2008
03:31 PM ET

Cameroon's diseased children

By Dr. Sanjay Gupta
CNN Chief Medical Correspondent

In a small town called Akonolinga, about an hour outside Yaounde, the capital of Cameroon, a strange disease is going around that primarily affects children. It starts as an ulcer on the skin that quickly spreads. Untreated, it can start to affect the bones and eventually even get into the bloodstream. If it gets to that point, there is little that can be done, and the child will often succumb to the disease. They try everything in this small village town to not let it get to that bad. They scrape away the skin, cutting out the diseased areas. They give injections of various medicines, and they keep people in hospitals for months. I met a young boy named Naturale, who had to have his left arm amputated at the shoulder. I almost cried when I met him. By the time he came into see a doctor, the disease was too far gone, his bones literally crumbling. As I visited the clinic, I learned the name of the disease: Buruli. I also learned something that stunned me — what many in this town believe is the origin of Buruli: Witchcraft.

It goes like this — as a punishment for taking something or some other trivial thing, these children had been cursed by witches and sorcerers living in the nearby areas. Take someone else’s mango for example, and soon after the child will get an ulcer. In Naturale’s case, he was born out of wedlock, and the witches in the area thought it would be better if he were dead. I was told they cursed him with a particularly severe infection, and he barely survived. Now he stays at the hospital trying to shield himself.

Now, if you think what you are reading is too far-fetched, you may be interested to know I sat down with Ph.D-level medical anthropologist, Karen Saylors, who explained all of this to me. Along with researchers associated with Johns Hopkins, she is studying Buruli.

Buruli ulcers have been reported in more than 30 countries, according to the World Health Organization. With the increasing geographical spread since 1980, WHO is working to improve surveillance and develop better tools to control the disease. Karen introduced me to traditional healers who knew all about placing a hex on someone and even how to cure the disease with herbs and a piece of bark.

While Karen and her colleagues don’t really buy into the idea of witchcraft, they also recognize what a widespread belief it really is here. Instead, Karen has busied herself studying the possibility that Buruli may be spread from animal to human. As it has many similarities to a staph infection, which can cause flesh to be ulcerated and seemlingly “eaten,”, the doctors are using powerful antibiotics with good success. Karen has even studied the particular traditional medicine herbs, which are often effective. What she found was that particular plant had some of the same ingredients found in streptomycin, an antibiotic.

As a doctor, it was amazing to see how this disease has been deciphered. It was also a fascinating glimpse into the connection between animals, plants and humans. Not only is the Buruli-causing pathogen most likely from an animal, but the medication used to treat it is from a local plant. And, if we look deep enough, we find this is in fact the case with many diseases.

Today, I will be in the wilderness of DRC, specifically a village called Lodja. We will be visiting a monkeypox surveillance clinic. I promise to report back on how the locals here are working to contain the virus so it doesn’t spread around the world. I can’t help be struck by the fact that we are in the middle of a very strong interface between man and animal. It has been here for millions of years, but it is only now that we are starting to understand its awesome culture, power and possible danger.  revised 6/19/2008

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soundoff (40 Responses)
  1. Dr.Paulinus C Fultang

    DR.Gupta,
    It is rather unfortunate that your report on the issue relating to sick children in Cameroon are not based on any researched scientific finding but on stories of witchcraft.It degrading of your status to publish issues based on local circulated rumours as though they were authenticated by research.You need to review your article.
    Thanks
    Dr.PC Fultang

    June 18, 2008 at 05:49 | Report abuse | Reply
  2. Lauren R., USA

    How terrible for those children. I'm guessing that beliefs like that had some kind of origin hundreds or even thousands of years ago with the need to keep the sick away from the healthy for the greater good; the witchcraft part probably comes from the need to reduce the urge to assist their own. But how terrible that this stupid ideology still persists today. Far from doing any greater good, this kind of warped thinking in a modern society tends to spread like its own disease, infecting all, with little hope of eventual remission.

    June 18, 2008 at 11:03 | Report abuse | Reply
  3. GF

    It's astonishing to read about such horrific diseases that exist in these jungles. I for one couldn't bring myself to visit for fear of catching something.

    June 18, 2008 at 11:54 | Report abuse | Reply
  4. Mary Beth Medford

    This is in response to the Dr. Fultang,
    As a nurse, I realize how important it is to understand the feelings and beliefs of people, in order to help them get well. The witchcraft stories are important to recognize and acknowledge, so the proper tools can be used to help people. I appreciate the researchers for paying attention to what the local people believe, and by not ignoring their beliefs, hopefully this disease can become extinct.

    June 21, 2008 at 03:55 | Report abuse | Reply
  5. Anon MD

    Also in response to Dr. Fultang,
    If you read the article carefully, it's apparent that none of the scientists actually believes that the diseases are caused by witchcraft, and rather they are trying to find out what bacterium is the actual cause as well as treating the ulcers quite sensibly with antibiotics. In addition, they are looking for antibiotic properties in the local plants that have traditionally been used to treat the illness with some reported efficacy–quite a rational thing to do [and I've worked in (Western-style, rigorous, scientifically-driven) drug development in both small and large pharma].

    I agree with Mary Beth that it is very important to understand what the villagers believe about the disease–only by taking a medical history in a context that they understand will one get any useful information regarding onset, symptoms, course, etc. It is then up to the scientist to separate fact from superstition, develop an effective treatment, and somehow convince the villagers to actually accept the treatment. By showing respect for their beliefs and thus developing trust, one will be able to more easily accomplish one's goals.

    June 23, 2008 at 01:48 | Report abuse | Reply
  6. Nancy

    Dr. Sanjay Gupta,

    While in Cameroon, did you check on the situation with the sulfuric acid gases that come out of some of the lakes and kill people and animals?
    Do you remember a few years ago (1998?) when thousands were killed during the night from the gas that comes out of the lake? A good refresher of this on-going natural disaster that has probably been going on for hundreds/thousands of years can be read in a 2003 article in the Smithsonian magazine. A pipe was placed by a U.S. organization to help the gas vent out slowly and safely, but is it still in place and really working? The caretaker of the pipe is a local man who lost his family in the last disaster. Doc, we need someone to report on this story.

    Nancy
    Georgia

    July 3, 2008 at 00:10 | Report abuse | Reply
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    i had an ulcer last year because i am fond of skipping meals and working too hard. it was quite painful.,:

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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.