The World Hepatitis B Day is commemorated every year on 28 July in honor of the birthday of Nobel Laureate Professor Baruch Blumberg, who discovered Hepatitis B virus. This important day is marked globally to create awareness and understanding about viral hepatitis, its complications and how to prevent it. Viral Hepatitis can cause both acute and chronic liver conditions, killing a total of about 1.4 million people annually. However, until now, Hepatitis has been largely ignored or unknown particularly in developing countries and the underprivileged communities.

Therefore, the World Health Organization has designated this year’s theme as “Hepatitis: Think again”. The key message conveyed by this official theme centered on the following five main issues: awareness, prevention, vaccination, stigma and taking part. This year’s theme emphasizes the need to think again about the unknown facts of this silent killer disease and to resolve the emergent public health challenges related to hepatitis particularly through the collective efforts of the policy makers, healthcare workforce and the general public.

In the context of the exile Tibetan population, Department of Health, CTA recognizes Hepatitis B as a major public health problem. High cost of the Hepatitis B screening tests along with costly treatment lead to huge economic burden to the infected individuals in addition to loss of lives, associated disabilities and poor quality of life. Lack of accurate prevalence data about Hepatitis B was a significant hurdle for the Health Department to further plan appropriate initiatives to control Hepatitis B among the Tibetan community. Therefore, the Health Department in collaboration with John Hopkins University conducted a cross sectional prevalence study of Hepatitis B in 2013 among a representative sample of 2769 people in a Tibetan settlement in South India. As per the preliminary findings, the prevalence of chronic Hepatitis B is 8.9% among the screened people.

To reduce the burden of Hepatitis B, the Department of Health is actively engaged in planning and implementing Hepatitis B control initiatives. Under the Mother and Child program, all children under five years of age are being provided free Hepatitis B vaccination and Hepatitis B immunoglobulin. The role of screening for Hepatitis B and providing vaccination to children above 6 who might not have received vaccination is of particular importance because youth who are infected with Hepatitis B are at increased risk for chronic Hepatitis B and liver cancer.  Therefore, we are going to implement a new pilot project, “Hepatitis B Control Project among School Children” this year to screen, and vaccinate a total of 2000 school children between the ages of 6 to 18.

Furthermore, we implemented a Hepatitis B needs assessment at Sonamling Tibetan settlement in Len and Jhangthang areas in Ladakh, India in May 2014, in collaboration with University of Rochester and University of Hawaii. It was aimed to understand the perceptions and level of awareness about Hepatitis B among the local Tibetan population in Ladakh. The findings of this study will give important qualitative understanding about the community’s knowledge, attitudes and stigma about Hepatitis B. The findings will also assist the Department of Health in evidence based planning of future hepatitis B control program for the Tibetan community particularly in providing assistance for screening and treatment support among the needy people.

In addition to these above mentioned efforts, the most important way to control Hepatitis B among our community is through prevention and better awareness about Hepatitis B. Health Education Section of the Department of Health will continue to work to build greater awareness about Hepatitis B through mobile health education, health education sessions by field health workers and publishing of educational brochures in both Tibetan and English. Therefore, on this day, I would like to request all Tibetans to:

  • Learn and Educate about Hepatitis, particularly Hepatitis B
  • Get tested for hepatitis B and to seek clinical guidance at your respective health centers in case you need treatment.
  • Take precautions like avoid sharing of potentially contaminated items, such as needles, razor blades, and tooth brushes.  It is important to always have protected sex with your partner.
  • If you are tested positive for Hepatitis B and are pregnant, it is very important to have your newborn receive Hepatitis B Immunoglobulin just after birth to prevent acquiring Hepatitis B infection from the mother.
  • If someone in your family is infected with Hepatitis B, it is important for other family members to get screened and vaccinated appropriately.
  • Lastly, protect yourself, your family and most importantly your children from Hepatitis B by getting vaccinated and complete the three doses of Hepatitis B vaccination at your health center.

I encourage every Tibetan to commit yourself to understand more about viral hepatitis and how to prevent it. I am confident that through the collective efforts of the Central Tibetan Administration, general public, monastic communities, school administration and NGOs, we would be able to strengthen and mobilize the Hepatitis prevention and awareness with the larger goal of eliminating Hepatitis B from the Tibetan community.

 

Dr.Tsering Wangchuk

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