UFAR: Defeating Riverblindness in the Congo

Bringing Hope
Defeating Riverblindness

UFAR: Giving Back to The Congo

Onchocerciasis is a skin and eye
disease caused by a parasite.

The disease is transmitted by a
small black fly that breeds in
fast-flowing water.

Risk of blindness is higher for
those living close to such rivers,
thus the name Riverblindness

It affects 18 million people in
Africa, Latin America and
Yeman.

Villages Near Riverblindness-Infested River

Villagers Farming Near Riverblindness Infested River

With Water We Live,
Without Water, We Die

The fast moving river water
gives life to the land.

It also serves as a breeding
ground to the black fly.

From a tiny blackfly…

Some people are bitten up to
10,000 times a day.

The worm lives and matures
under the skin of the victim and
give birth to millions and
millions of offspring.

The movement of these
offspring throughout the body
causes the initial symptoms.

The Irreversible Damage Begins

Nodules of worms grow under the skin

The Itching is Ferocious

Sometimes people even use rocks
to scratch themselves.

Slowly but surely all the scratching
destroys the quality of the skin.

Inevitable Eye Damage and Blindness

But ultimately, without
intervention, the worst symptom
is the loss of vision as the worms
affect the eye. And the result is
irreversible blindness.

In a Society of Survival,
Care Replaces Schooling

Once established, it cannot be cured.

But treatment in the early
stages prevent blindness

With Intervention, There’s Hope

The onchocerciasis control program was
formed in the mid 1970s. The goal was to
break the cycle of transmission.

Phase Two Approach:
Community-Directed Treatment
with Ivermectin
– Annual dosing, combined with minimal follow-up
requirements
– Communities are empowered to manage their own health
through a partnership between community health care
workers, NGOs, national government and WHO/APOC.
– Passive distribution:
• Health centers or clinics
• Mobile clinics

CDTI Plan for Success

– The project is defined by the National Government
– It is funded primarily by the World Health Organization and
African Program for Onchocerciasis Control. With significant
funding by the Non-Governmental Development
Organization (UFAR). The National Government funds a
minor portion initially, increasing its investment in
subsequent years.
– The NGDO and the Government are responsible for technical
and administrative management of the project.
– Community-Directed approach leads to a high degree of
acceptance and success.
– The CDTI program is implemented by the Community
Distributors, working with APOC, NGDO and the
Government
– This approach provides for program sustainability and
integration with other healthcare interventions

Local Involvement
Local Commitment

– Sensitize village chiefs and community leaders
– Train local medical staff
– Local medical staff of doctors and nurses then
select and train village-based community
distributors
– Community distributors are compensated by the
villagers insofar as possible for their work

Mectizan (Ivermectin)

Microfilaricide


– Prevents worsening of vision and blindness
– Prevents itching and disabling skin lesions
– Improves skin condition and self-esteem,
culturally especially important for women
– Promotes resettlement back into previously
deserted farm land
– Improves school attendance and literacy for
children and labor productivity for adults
– Effective against scabies, mites, lymphatic
filariasis and intestinal worms


– History: Discovered by Merck in the 1970s
and developed for human use in the 1980s
– Activity: Rapidly kills microfilariae but not
adult worms
– Clinical application: Established as the first
extremely safe and highly effective drug for
treatment of onchocerciasis
– Availability: In 1987 Merck began providing
Mectizan free of charge for as long as needed
to control and eliminate onchocerciasis as a
public health problem worldwide

CDTI Riverblindness Projects in DRC

2004: 117 approved
projects in 19 countries,
treating 38 million
people per year in
88,000 communities

April, 2005: 411 million
treatments distributed

Kasongo

Helping people gain access to
medicine does not begin and end
with a free drug.

Kasongo Region
Size: West Virginia, or three
times the size of New Jersey

Population: 914,155 (3
Territories, 8 Health Zones and
116 Health Centers)

Prevalence of onchocerciasis:
40-59%

Aerial view of a section of Kasongo

Villages at Risk

With few public wells… ….water comes from the river

The UFAR Task: Treating CDTI Kasongo

Health Zone Health Population Villages
Name Centers
Kasongo 19 173,613 232
Kunda 22 193,955 279
Samba 9 90,293 121
Lusangi 14 128,573 165
Salamabila 13 109,048 191
Kabambare 10 76,256 134
Kampene 15 102,338 132
Pangi 14 67,333 97
Totals 116 941,409 1,351

United Front Against Riverblindness

― Mission: Bringing the CDTI Program to the Kasongo Region
― UFAR is managed by a multi-disciplinary 12-member Board of
Directors and a three-member Executive Committee.
― Board members are unpaid volunteers, blessed with a strong
sense of stewardship and a commitment to improve the lives of
the less fortunate.
― Registered as a tax-exempt charitable organization both in US
(September 2004) and DRC (August 2005)
― Goal: Control and eradicate Riverblindness in CDTI Kasongo,
in partnership with other players.

It takes a village to raise a child, sometimes it
takes a global village to save one.

This could not have come about without partners.
Official NGDO Group Members for Onchocercaisis Control
– Christoffel-Blindenmission (CBM, Germany)
– Helen Keller International (HKI, US)
– Interchurch Medical Assistance (IMA, US)
– Lions Clubs International Foundation (LCIF, US)
– Light for the World (LW, Austria)
– Mectizan® Donation Program (MDP, US)
– Mission to Save the Helpless (MITOSATH, Nigeria)
– Organisation pour la Prévention de la Cécité (OPC, Fce)
– The Carter Center (CC, US)
– Sight Savers International (SSI, UK)
– United Front Against Riverblindness (UFAR, US)
– US Fund for UNICEF (US)

Challenges

― Accessibility to Kasongo: Extremely difficult by road, railway
or waterway
― Traditionally held views: Superstition, curse
― Co-incidence of loiasis (lymphatic filariasis) causes adverse
reaction to Riverblindness medicine
― Insecurity: Conflict and post-conflict areas
― Sustainability: Compensation of Community Distributors
— Fundraising: 20 – 25% of total CDTI Kasongo budget

Kasongo Airfield

Dr. Ntumba, pilot Umambudi and Dr. Shungu

No Roads at All

It took nearly four hours to get out of this mess

Crossing Congo River on Canoe
Drs. Shungu and Ntumba

CDTI Kasongo

Coordination Team
– Project coordinator: Dr. Arthur Nondo
– 2 Administrative assistants: Epando & Muteba
– Driver and Sentry
Medical Team
– 8 Doctors
8 Nurses
56 Assistant Nurses
10,755 Community Distributors

CDTI Kasongo Office

These new motorbikes
Dr. Arthur Nondo,
will be invaluable in the
CDTI Office Director
treatment distribution

UFAR Office in Kinshasa

The office must double as a hotel room for Dr. Shungu

Community Meeting with
Chiefs, Village Leaders and local NGOs

Community Sensitization
and Motivation

Dramatic play addresses
traditional and modern views

Confronting old beliefs
with new information

Training Doctors and Nurses

Doctors and nurses are
trained in disease treatment
and on the CTDI approach.
They in turn will train the
distributors before treatment
can begin.
Symptoms of adverse reaction
include swelling of the eye,
severe diarrhea, resulting in
dehydration and weakness,
and ‘red eye’ (subconjunctival
hemorrhage).
Dr. Temor trains doctors and nurses

Training Sessions

Dr. Ntumba, now the DRC
Minister of Health for West Kasai

Training Community Distributors

It is critical that everyone take the medication. If some people do
and some don’t, the disease will never leave the village.

Source of hope: Community Workers

At the village level, bringing the drug to the people and
educating them as to the real causes of riverblindness and the
benefits of medication are the mission of health care workers
and community-based distributors.

Challenges

— Accessibility to Kasongo: Extremely difficult by road, railway
or waterway
— Traditionally held views: Superstition, curse
— Co-incidence of loiasis (lymphatic filariasis) causes adverse
reaction to Riverblindness medicine
— Insecurity: Conflict and post-conflict areas
— Sustainability: Compensation of Community Distributors
— Fundraising: 20 – 25% of total CDTI Kasongo budget

Conflict and Displacement in Congo

The Democratic Republic of Congo
remains one of the world’s worst
ongoing humanitarian crises.

A presidential election in 2006 has
given rise to a democratic
government.

But still, more than 1,000 people die
each day from conflict-related causes
such as disease, malnutrition or
violence. In Kasongo, people are
returning home. The conflict
Corruption within the government is confined to a region 300
and pervasive state weakness allows miles north of Kasongo.
members of the national army and
members of armed groups alike to
perpetrate abuses against civilians.

Meager Pay for Distributors

Community distributors are paid For the poorest villages, UFAR
by villagers, who pay with whatever must pay the distributors, who
they have … rice, peanuts, plantains, sometimes must travel door-to-
fresh wild game or poultry. door to reach everyone.

The 2007 UFAR Mission

Health Zone Name Health Population Villages
Centers
Kasongo 19 173,613 232
Kunda 22 193,955 279
Samba 9 90,293 121
Lusangi 14 128,573 165
Kabambare 10 76,256 134
Kampene 15 102,338 132
Pangi 14 67,333 97
Totals 116 941,409 1,351

Launch Ceremony CDTI Kasongo
25 June 2007

Launch Publicity Opening Remarks

Opening Remarks by the
Governor’s Representative

The launch ceremony was broadcast by radio throughout the region

Community Leaders Show the Way

Dose is easily determined Medical personnel and community
by height. leaders take the treatment first,
signifying safety and acceptance.

And the Treatment Begins

Mectizan was distributed door-to-door in 363 villages
over the next 10 days by
2,000 trained community distributors.

The 2008 UFAR Mission

Health Zone Health Population Villages
Name Centers
Kasongo 19 173,613 232
Kunda 22 193,955 279
Samba 9 90,293 121
Lusangi 14 128,573 165
Kabambare 10 76,256 134
Kampene 15 102,338 132
Pangi 14 67,333 97
Totals 116 941,409 1,351

The UFAR Mission
in the Years Ahead

— 2007 Kasongo health zone:
100,000 people 1,000,000

— 2008 Kasongo and Kunda
health zones:

Population
263,000 people
— 2010-2024 8 health zones:
263,000
1,000,000 people
100,000
— 10 – 15 years to 2007 2008 Beyond
eradicate the disease

Riverblindness: Only the First Step

WHO-Proposed Additional Projects for UFAR
Integration of riverblindness control with other healthcare
interventions
— Prevent childhood blindness (vitamin A)
— Control of intestinal worms
— Provision of clean water (wells)
— Malaria control (mosquito nets)

UFAR Mission Budget

Treatment Cost: Less than One Dollar Per Person

UFAR 2008 Mission Budget

Field Office Personnel
11,000 14,100 Capital
Personnel

Operations Equipment Capital Equipment

42,715 32,360 Supplies
Communications
Training

Supplies Travel
Operations
8,625 Field Office
Travel
3,465 Training
20,925 Communications
11,285

How Many People
Can You Help Treat Today?

— The average village contains 500 people
— Half of these people already have riverblindness
— The average American family spends around $1,600 a year on
vacations
— A house cat costs nearly $1,000 a year, on average
— American coffee drinkers spend more than $175 on coffee per
year
— Riverblindness treatment costs less than $1 per
person

It has been said
that when faced with a great challenge,
you must do the thing that you think
you cannot do.

How to Contribute

By Check
Please make your tax-deductible donation
payable to UFAR
Send your check to:
UFAR
13 Carnation Place
Lawrenceville, NJ 08648
By Credit Card
Please visit the UFAR website:
http://www.riverblindness.org

When we join hands,
we can defeat this dreadful disease!
www.riverblindness.org

UFAR: Defeating Riverblindness in the Congo

Recommandé

Recommandé

Contenu connexe

Similaire à UFAR: Defeating Riverblindness in the Congo

Similaire à UFAR: Defeating Riverblindness in the Congo (20)

Dernier

Dernier (20)

UFAR: Defeating Riverblindness in the Congo