Is Nodding Disease an Acholi disease? First the rules to the answer

It is probably true that ninety percent of Ugandan drivers parachuted to a say Durban or San Francisco would fail to drive.

A traffic officer told me the other day, while I have him a ride from the Entebbe to Kampala about how during “ one of our courses” the many “trainings” the police go two officers were asked to step up and identify random road signs. “ We were very embarrassed when they couldn’t. Some of us volunteered that they had just been seconded to the traffic section and were still new,” he said.

If traffic policemen do not know road signage what rules are they applying? Our travel together begun after he flagged me down- and claimed only one of my headlamps was functioning.  This was not true.

The law must be written. This is both a tradition and a function. It allows for rules to be applied blindly by public institutions and for those rules to be known widely within the realm. In Uganda however it is often the unwritten rules that are at work. This may explain why traffic policemen happily direct the traffic, impose fines and testify in the rare traffic offense (often fatal or where damage has occurred) without much questioning. Road signs are not the only beacons of action on the road.

If you are ever on the Gayaza road past now the famous market of Kalerwe (famous for its riotous stall owners) do stop when goats, boda boda’s, chicken carrying bicycles and other road users surge across the metal barrier from one side of the market to the other. And drive on if when approaching a roundabout the person with the right of way stops to let you pass.

Like many an African country, Uganda may not have reduced its rules into effective systems that are uniform but this does not mean they do not exist.

The big question is if we should use road signs from Europe or codify the rules to allow goats cross the road. This should probably be a short post. Had it not been the crazy traffic today I would have gone straight to another puzzle for which local knowledge is important. Yesterday I interviewed Hon. Beatrice Atim Anywar, a broad shouldered activist and woman MP from Kitgum who is at the center of many controversies in Uganda. One of them is the mysterious nodding disease epidemic, which has affected amongst others her district and two others (Gulu and Pader). These districts have one thing in common.

They hosted the main internally displaced people’s camps during the long Northern Uganda conflict. However geography and the recent history of the war have rarely featured in reasonable explanations as to what is causing the disease. Instead as Ms Atim moved to declare Northern Uganda a disaster area- this time because of nodding disease, the government in a reply of the old tag of war responded through Hon. Richard Nduhuura with a statement on how much money had been spent in dealing with the situation. Hon. Nduhuura’s statement uses the word “treatment” several times.

The problem is that nodding disease has no treatment because its cause remains unknown or undisclosed. Ms Atim ( also known as Mama Mabira) told me after the show that worryingly nodding disease syndrome had been recorded with adults. Hitherto the condition was prevalent with children under 15. “ In Agwang sub-county where the first cases were reported three men aged 18, 35, and 48 have nodding disease. Its in a place called Tumangu” she said.

If nodding disease actually affects adults the condition may well be worse. “ It is thought that weapons or some weapon used there during the war caused it,” she said volunteering one of the common perceptions about the disease and the war before it. Is nodding disease an Acholi disease? Will it spread beyond the war areas?

Do we not really know what is causing it?  The reaction to this condition over time reveals something about Uganda and Ugandans. Even diseases have rules and until they pose a threat, like Aids, to certain constituencies – well they remain as in this case a humanitarian curiosity with political ramifications.

 

 

 

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2 Responses

  1. Many misconceptions about Nodding Disease prevail, and for good reasons as information on neglected tropical diseases are not usually shared in popular media. But on a thorough literature search you will find that it was first described in southern Tanzania as early as 1962, and in 1983 in Liberia. In South Sudan the disease was reported in the 1990s, and an article in The Lancet in 2003 describes how hundreds of children were sick. So it is not an Acholi disease, and cannot ‘spread from there’.

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