In the sprawling Kawangware slums lives 32 year old Elizabeth Wambui Nthumbi.
She is a jobless mother of four who currently is bedridden because she
is suffering from extra-pulmonary tuberculosis. This is the second time TB has
recurred to Elizabeth. The first time she had TB she strictly adhered and
successfully completed her treatment; though whenever she got the opportunity
she could steal some time to binge on alcohol.
On finishing her treatment, Elizabeth had every reason to celebrate
according to her, and she continued her drinking sprees to make up for lost
time at the expense of her family and children. She would steal from her boyfriend, the father
of her two small children to pay for favorite pastime. His please to Elizabeth
to stop taking alcohol went unheeded and therefore he took them to his mother’s
home in the rural area hoping that Elizabeth would stop her drinking.
Elizabeth then did what only few mothers would do; she abandoned her infant children with her mother in-law and
came back to the city where she continued with her drinking stress free life.
Her youngest was barely a few months old.
However, her desire for an endless party life was short lived when the tuberculosis recurred. Currently
she has been put on treatment for the second time and has just finished her
injections and yet she is getting worse by the day. Elizabeth cannot walk, sit, stand or even
take care of herself or do basic things. Besides, she has been hallucinating, is confused and delusional. She relies on a community health worker, a cousin and neighbors to help her
with the basics of life.
She lives with her sister and a brother who are also known alcohol abusers and therefore they offer her little
help and assistance because they are completely alcohol dependent. Her eldest daughter
who was in form two at St Martin Girls High School in Kibagare, dropped out of
school despite the fact that she was being sponsored by a local Catholic
Church. Her son ran away from home and is currently a street urchin whose
whereabouts are unknown.
On entering her one roomed house at Gishagi in Kangemi, you are welcomed by the pungent smell of ammonia due to
the fact she sometimes relieves herself on her bed because she is bedridden.
At first glance you would mistakenly confuse her for someone who is in the fourth and final stage of HIV because her body
displays the HIV wasting syndrome. Elizabeth is HIV sero- negative meaning she does not have the HIV virus.
What she is suffering from is worse than HIV or any other disease, she has an alcohol problem.
“Ni vile tu hawezi kutembea lakini angepata nafasi angekuwa kwa pombe” (It’s only because she cannot move
otherwise she would have been out drinking) says Grace Waithira, her cousin.
Alcohol disorders not only place individuals at increased risk for acquiring a number of diseases, but once people acquire a disease like
TB, alcohol places them at higher risk for poor outcome and death, because alcohol can suppress the immune system. Besides alcohol can complicate TB treatment since people with drinking
problems are also less likely to be able to adhere to their TB treatment.
According to Evelyn Kibuchi the KANCO TB Advocacy Manager, people who are addicted to drugs should be well counseled
before being initiated to TB treatment in order to understand the drugs they are using on the efficacy of TB treatment.
“Alcohol should be discouraged when one is on TB treatment because it increases the frequency of urination
thus making drugs pass out in the urine before they are absorbed,” she adds
Dr Joseph Sitienei the head of TB Division echoes the same sentiments and adds that, “Alcohol and TB do not go
together and a person should not compromise because the two are can potentially
be toxic to the liver.”
For someone like Elizabeth, who suffers from a potentially
fatal and highly contagious disease, addiction can lead to drug resistant Tuberculosis
According to studies carried out by scholars from the Stop TB Department-WHO, people
who have an alcohol disorder are at greater risk for active tuberculosis. The
study showed shows that there is an association between alcohol use and the
risk of tuberculosis though they had not established the extent of this
association. The increased risk could be due to both increased risk of
infection related to specific social mixing patterns associated with alcohol
use, as well as influence on the immune system of alcohol itself and of alcohol
Suffering from alcoholism and chronic medical illness further contributes to a cycle of poverty, displacement
and socioeconomic disempowerment that often makes recovery unattainable, even
for the most motivated patients.
The question is, what is the Government, Civil societies and bodies set up to address issues on TB and Drugs
doing about people like Elizabeth?