Multiple sclerosis (MS) is a nervous system disease that affects the brain and spinal cord. It can manifest itself in people from 20 to 40 years of age and can even go unnoticed. Because May is the month of the fight against MS, Panama Today spoke with one of the most important Panamanian doctors, who has devoted a large part of his career to treating people with this disorder, this is the Head of the Neurology Section of the Santo Tomás Hospital, Fernando Gracia, who estimates that there are approximately 380 known cases of the disease in Panama.
This disease mainly affects females. “Almost three times more frequent in women than in men,” he, who was also Minister of Health in Panama between 2001 and 2004, said.
The member of the Panamanian Society of Neurosurgery and Neurology ensures that the diagnosis of this disease must be certified by a specialist. “There are almost one hundred diseases that can simulate MS, so you have to study them very deeply and the diagnoses are usually not simple. It must be certified by a neurologist. In Panama at this time the Panamanian Association of Neurology has about 26 neurologists enrolled: 18 treat adults and the rest are pediatric. There are Neurologists in David, in Chitré and in Panama City,” the doctor said that these are the locations, in Panama, where people with some symptoms of MS should be referred.
Fernando Gracia stressed that the Isthmus presents a deficit of neurologists at this time. “According to the World Health Organization (WHO) there must be five to six neurologists per 100 thousand inhabitants. We in Panama are 0.8 per 100 thousand inhabitants, I believe”, the doctor also informed that a scholarship plan has been created for those who decide to enter this career.
People suffering from the disease are subjected to a high-cost treatment. The monthly expense to acquire any of the medicines necessary to combat the advancement of MS may be between $ 1,500 and $ 3,500. In Panama, the Social Security Fund (CSS) provides the treatment, free of charge, to the insured, “the Ministry of Health has purchased the same medications for uninsured patients in a somewhat limited form and they are distributed through the Multiple Sclerosis Clinics from here at the Santo Tomás Hospital and also at the Multiple Sclerosis Clinic in Chitré,” said Gracia.
So far these public entities acquire the following medicines for patients in Panama: Fingolimot, natalizumab, alentuzumab, teriflunomide.
According to the neurologist, MS has various manifestations such as “sudden vision disorders, paralysis in the extremities of the body, difficulty walking, sphincter disorders, failure to retain urine, sensory disorders, lack of sensitivity in any part of the body. These are some of the most important symptoms.”
Awareness of the disease
From the Panamanian Society of Neurosurgery and Neurology there is a campaign to raise awareness within the medical profession to adequately care for patients that reflect some type of neurological injury so that they can be referred to the specialist who can do the referential evaluation. Gracia believes that the authorities should also be sensitized, “the support must be continuous, first so that the acquisition of medicines is permanent; Second for these patients to be included in the policies and laws of disabled patients since although they may have an attack and recover fully but the disease is there and it is never known if the medications are going to be effective, patients should have some consideration although seen walking and perfectly normal they have that disease. A patient may have the disease dormant or inactive but it is there and can be reactivated. The authorities must treat these patients in a special way."
According to the doctor, one of the main factors that contribute to fighting the disease is that MS patients continue with a normal life dedicated to their daily activities. He considers the support of family members and of society itself are fundamental in this type of affectation.