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HEALTH-DR CONGO: Konzo Still Leaving Women and Children Paralysed

KINSHASA, Dec 1 2011 (IPS) - Nadine Mbwol suffers from konzo, an epidemic paralytic disease that affects the lower body. “I lost my marriage because of this disability,” she says sadly.

Many people in the Democratic Republic of Congo (DRC) believe that this disease, which affects many young, female victims like 20-year-old Mbwol, is caused by witchcraft.

“But it’s not true,” says Dr Pierre Makadi-Nkeni, who works at the hospital “Le bon berger”. “Konzo is not caused by a curse or witchcraft as many people believe in all the provinces where the disease occurs,” he says. In the DRC, many rural territories like Kahemba, Feshi or the province of Bandundu are severely affected by konzo.

“Konzo is a spastic (sudden and painless) paralysis which causes permanent and incurable paralysis of the lower body,” says Dr Banea Mayambu, the director of the National Nutrition Programme (PRONANUT).

The disease occurs mainly during the dry season when the rural population is primarily eating a bitter form of insufficiently processed cassava. The first outbreak of the epidemic disease was reported in 1936.

According to Dr Emery Kasongo, head of the konzo study project at the NGO “Action contre la faim” (ACF), about 60 percent of total daily energy in the DRC is provided by fufu, a cassava-based pasta.

Konzo is caused by the regular consumption of cassava, which exposes the human body to cyanide, a poison contained in cassava. Up to now, this disease has reportedly affected about 70,000 people.

Dr Makadi-Nkeni explained that konzo is not an infectious disease caused by a virus or a bug of some kind. “There is no medical treatment or any traditional healing. It is currently incurable and the only way to stop the disease is prevention.”

Unfortunately, “the local belief that considers konzo a disease caused by witches is a real barrier to effective action against the disease,” says Damien Nahimana, head of the surveillance and research division at PRONANUT. As a result, konzo remains a major public health problem in the areas where it occurs.

Speaking about the nutritional situation in the DRC, Cesarine Kuwa, konzo nutrition expert at PRONANUT who worked previously with ACF to conduct a study in Bandundu province, underlined that the situation is worrying, particularly for children under five.

“Eleven percent of children suffer from acute malnutrition, 43 percent from chronic malnutrition, while 24 percent are underweight. These deficiencies are the result of insufficient calories, and especially a lack of micronutrients and protein due to poorly diversified meals based on cassava.”

Bernard Masukidi, a shopkeeper, adds: “For economic reasons, the cassava chips we buy in some villages are not very well treated.” Indeed, people usually shorten the duration of steeping (putting cassava in water to remove toxic elements), which should be four days during the rainy season and five days during the dry season.

“By means of an epidemiological survey and interviews about eating habits, I have established a link between the occurrence of konzo and the consumption of cassava.

“Thus, of the 6,764 people surveyed, we identified 110 konzo patients, and 24 deaths could be directly attributed to this disease,” says Dr Kasongo.

“It all started in 1974 with the paving of the road from Kinshasa to Kikwit, about 900 km east of Kinshasa,” local pastor Bernardin Mutombo told IPS. The new asphalt road cut the journey from Kikwit to Kinshasa from one week to just one day.

The road resulted in an immediate increase in demand for cassava. Facing the pressure of the market, traders have forced the villagers to change their working methods.

“Konzo disease often affects children and women of childbearing age since the ethnological and sociological considerations surrounding the distribution of food, through their standards and taboos, maintain too many privileges for men,” says Kuwa.

Habits and taboos in some areas exclude women and children from the consumption of certain foods such as meat which may provide protein.

“To prevent konzo, it is important to consume foods rich in protein and other nutrients,” advises ACF expert Paul Bahati. Unfortunately, farmers in need of cash prefer to sell their products without keeping anything for their own households.

Bahati says the solution to nutritional deficiencies in the villages where konzo remains a major problem depends on development and diversification of agricultural systems and economic growth.