Pavlov Toghba works at Foya Boma Hospital, a hospital in a very rural area of Liberia. He treats people who approach him with a wide range of complaints: From malaise to toothache to high blood pressure or broken bones. Most common, however, are febrile infections, just like in Germany. "When people come, they are usually already very sick," he says. "Here, no one goes to the hospital because they have a bit of a fever, so people first try traditional remedies or just buy some tablets at the market." As in many other countries, antibiotics are freely available in Liberia. But if they are taken too often and unnecessarily, resistance to the active ingredients will develop.
Good diagnostics against antibiotic resistance
Difäm health officer Carina Dinkel trains the clinic staff at Foya Boma Hospital in the correct use of antibiotics. This includes the detection of a (bacterial) infection, choice of the appropriate antibiotic, adjustment of therapy duration, dosage and form of antibiotic administration. "At first, I didn't realise how big the problem was, especially in countries with fragile health systems," she says.
The success of the training quickly became apparent. "The workshop offered by Difäm on the correct use of antibiotics has changed a lot in my daily clinical routine," says Pavlov Toghba. "In the past, when a patient came in with a fever, I always prescribed an antibiotic - to be honest, usually even two. After all, I wanted to be sure that my patient would get better. Now I first try to find out what is triggering the fever. Can I maybe even confirm it in the lab? Then, when I am sure that my patient needs an antibiotic, I decide which one is best for him."
Asking patients precisely about their complaints, confirming diagnoses as far as possible and choosing antibiotics carefully are important steps in the right direction to counteract the development of multi-resistant germs.
Unfortunately, however, the problem is even greater. "The over-the-counter pills are popular for a wide variety of purposes. Even traditional healers like to give two to three tablets of an antibiotic. They don't know any better. After the training with Difäm, the hospital put out radio spots and organised talk shows in order to sensitise and educate people," reports Pavlov Toghba.
Global programmes against resistance to antibiotics
A global effort is needed to push back multiresistant germs and ensure that our antibiotics will still be effective tomorrow. The challenge is huge and one of the greatest hidden threats of this century to the global community.
The solution lies very concretely in Pavlov Toghba's consulting room. "I am grateful for what I learned about antibiotics in the Difäm course. It enables me to improve my work with my patients very concretely. I now give them the antibiotic that is appropriate for their illness. It is cheaper for them and they have fewer side effects. I am also happy about every recovery in children or adults who have been cured by taking the right antibiotic. It's such a good thing that these medicines work, and this should keep going on!"
