Each month, END7 honors one student who has made a significant contribution to our growing movement of student advocates dedicated to seeing the end of NTDs. We are very proud to introduce our November 2015 Student of the Month, Jessica Ellis, a sophomore biology major at the University of Texas at Austin. Jessica is the president of END7 at UT and a member of the END7 Student Advisory Board. She shares:
“I discovered END7 at UT during my freshman year, the day that I quit the track team and was frantically looking for new activities to get involved in at a campus organization fair. Right away, I was hooked by the idea of ending seven diseases, and was blown away by the statistics about NTDs and developments in the control and elimination effort that I learned about at END7 meetings. The scale of this effort and potential for transformation of entire communities through disease elimination fit with my view of – and hopes for – the world.
“By the end of my freshman year, I knew that my involvement in global health and NTDs couldnt just be an extracurricular activity for me. I wanted to do as much as I could for this cause as a student, and hopefully someday make it my career. So, it’s been really exciting to serve as the president of END7 at UT and as an END7 Student Advisory Board representative this year.
“In October, I had was given the incredible opportunity to travel to Philadelphia to attend the American Society of Tropical Medicine and Hygiene (ASTMH) annual conference with the support of a scholarship from the END7 campaign. I got to hear presentations by NTD experts from all over the world at the event, and left the “NTD bubble” I had been immersed in for three days excited to communicate this information back on campus. I shared much of the new information I learned a talk I gave at an event hosted by UT student organization Advocates for Awareness, trying to instill the sense of urgency and excitement around this cause that I took away from my time with the powerful global health community that I met in Philadelphia.
“It was definitely a busy fall semester for END7 at UT. We hosted two new (and hopefully annual!) events on campus. We held an evening advocacy event – lit by candles, Christmas lights, and the iconic UT Tower – and collected more than 100 messages from students urging the UN to prioritize NTDs in the Sustainable Development Goals with a target and indicator. We also organized a variety of student organizations from across the UT campus to come together and fundraise for non-profits on Giving Tuesday. I cant wait to see what these events turn into over the next few years. Next semester, we are looking forward to hosting our annual benefit concert – a must for any non-profit hoping to fundraise in music-loving Austin!”
We are so grateful for Jessica’s commitment to the fight against NTDs, and we are excited to see our involved in END7’s work, contact the END7’s student outreach coordinator at Emily.Conron@sabin.org to learn how you can get started!
The Philippines’ deworming campaign this year, Oplan Goodbye Bulate, was incredibly successful. More than 11 million children were dewormed in the campaign, beginning July 29, 2015, with most areas of the country reaching at least 75% of the children enrolled in public schools, the WHO recommended target for mass drug administrations (MDAs) for soil-transmitted helminths (STH). The Department of Health has planned for the school-based deworming program to occur biannually, with deworming days every July and January.
The Philippines was heralded in the third progress report of the London Declaration, Country Leadership and Collaboration on Neglected Tropical Diseases. Along with Bangladesh, Brazil, Honduras, and other NTD-endemic countries, the Philippines has demonstrated laudable leadership in mobilizing domestic resources to support their own NTD programs. Of the entirety of the Philippines’ NTD program budget, an impressive 94% is domestic.
The leadership demonstrated by the Philippines is particularly exciting considering the NTD burden in the Western Pacific Region and worldwide. While NTDs exist in 122 countries, an overwhelming majority of the burden rests on a handful of countries, including the Philippines. Ten countries are home to roughly 70% of the global population that requires treatment for NTDs, including the Philippines, which ranks as having the eighth-highest burden globally.
Intestinal parasites, including soil-transmitted helminths, are a significant health burden in the Western Pacific Region. According to the WHO, 32 of 37 countries and areas in the region are affected. If Oplan Goodbye Bulate continues successfully, the Philippines could soon meet the WHO target, significantly reducing the NTD burden in the Western Pacific Region — and worldwide.
To learn more about how the Philippines accomplished this recent success, we spoke with Division Chief of the Infectious Disease Office, Dr. Leda Hernandez, about Oplan Goodbye Bulate.
Q: Congratulations on your successful deworming campaign – an effort that reached over 11 million school-aged children in one day. What do you think contributed to this impressive accomplishment?
The Philippines’ deworming campaign done by the Department of Education and Department of Health has been ongoing since 2006, using established guidelines and protocols. There is one major difference between previous campaigns and the July 2015 National School Deworming Day (NSDD). This year’s Oplan Goodbye Bulate campaign was conducted in one day simultaneously all over the country. Then, we have one week of “mopping up,” which means that we make sure to treat children who were absent on the campaign day.
Q: What did the departments observe about this year’s deworming campaign, compared to previous ones?
The final report was issued 30 days after the one day launch, held on July 29, 2015. Approximately three months of effort was concentrated on one day, making the NSDD more efficient and practical. Another difference was that this was teacher administered and health worker supervised. There are at least three important lessons that we learned from this experience.
First, a lot of resources (time, money and manpower) can be saved by strategically integrating and harmonizing the implementation period. Secondly, timeliness of reporting can be significantly improved to promptly elicit available evidence-based data for decision making. And thirdly, the Integrated Helminth Control Program can now focus on integration of complimentary interventions such as water, sanitation and hygiene (WASH) and social and behavior change communication (SBCC), because of the time and financial savings.
Q: You created short videos and flyers about Oplan Goodbye Bulate to spread the word about the campaign. Why were these communication materials important to encourage participation? Were there other materials and outreach efforts that helped raise awareness of NTD treatment?
Advocacy and a lot of lobbying were vital to influencing local government unit participation. The Department of Interior and Local Government offered its people to provide manpower (health workers) to supervise the mass drug administration especially in geographically disadvantaged and isolated areas. Team work and collaboration by the three government agencies, support from partners, plus active community participation made a lot of difference and became our winning formula for good public service delivery.
However, as you know, misinformation can have damaging effects. It made us realize how fast information can spread like wildfire and that we should be prepared for that. However, it also made us realize that working together and solving issues early on was one of the strengths of this organization in times of crisis.
Q: Can you describe a particular community that has seen remarkable progress?
All regions were competitive and showed enthusiasm to beat their own previous records. There was a spirit of healthy competition and a desire to perform better, which is a good sign for everybody. All regions are now looking forward to the next round where they can apply good practices that they learned from one another during our consultative meeting last October.
By Alice Carter
Normally, we don’t like to talk about bathrooms. That is a private space that most of us would largely like to avoid thinking about. But on World Toilet Day, we give thanks for our sanitary facilities and celebrate the invention of the toilet, which has saved countless lives as a disease control mechanism, and gives us privacy to, you know, go.
There is a Sesame Street art show in New York. All of these types of events are celebrations for the often overlooked efficiency of the mundane technology that is a toilet, but also are opportunities to spread awareness of just how precious our access to toilets really is. One in three people around the globe don’t have access to adequate sanitary infrastructure, leaving them at increased risk for neglected tropical diseases (NTDs) that are spread through contact with fecally-contaminated soil. Half of the people who practice open defecation globally live in India, where 1.1 million liters of human excrement enter the Ganges River every minute. Recognizing the toll that open defecation takes on health, education and economic output, the government of India is trying to increase access to sanitation infrastructure and put an end to open defecation.
Prime Minister Modi has pledged that India will be open defecation free by 2019, and under his leadership the government has set up incentives for toilet construction and usage. Swachh Bharat Abhiyan — the Clean India Mission — is a sanitation campaign run by the Indian government, with the joint objectives of reducing open defecation and changing behavior to increase the use of sanitary facilities. Prime Minister Modi launched Swachh Bharat on Mahatma Gandhi’s birthday in 2014. The government also plans to raise Rs 3,800 crore (approximately 550 million USD) from the public to support this initiative, which gives subsidies for toilet construction and helps villages become certified as open defecation free. As of August 2015, 8 million toilets have been constructed as part of the campaign.
Unfortunately, it is tricky to measure the prevalence of open defecation and people’s toilet usage. Simply constructing a toilet in every home and school won’t make people start exclusively using toilets, especially if they don’t know the benefits of sanitation infrastructure and the risks of open defecation. For this, public awareness campaigns are also needed, and people need to be given plenty of reasons to use the toilet exclusively. One motivating factor for people to switch from open defecation to toilet use is awareness of the health risks of open defecation.
In communities that continue to practice open defecation, children playing outside or walking to school with no shoes can be exposed to contaminated soil, putting them at risk for infection by soil-transmitted helminths (STH). Similarly, clean drinking water sources and uncooked fruits and vegetables can be contaminated, increasing the risk of infection.
On the other hand, access to a household latrine has been found to reduce the risk of infection with STH by 40%. Nadia, a district in West Bengal, India, was the first district to be certified as open defecation free, and has since noted a decreased incidence of diarrhea and malnutrition. Reduced NTD infection is a strong indicator of the success of the Swachh Bharat campaign. Including an NTD indicator in Swachh Bharat would give the mission concrete targets to measure exclusive toilet use in communities where the campaign has built toilets, and it would help spread awareness of the negative health impacts of open defecation.
Perhaps on Gandhi’s 150th birthday, in 2019, India will have achieved its goal of ending open defecation. He would be proud, as he often stressed that a societys approach to private and public sanitation reflects its commitment to true freedom and dignity.
- NTD Links to Water, Sanitation & Hygiene in India
- Impacts of Water, Sanitation & Hygiene on NTDs
- Key Issues: Water, Sanitation and Hygiene
By Piet deVries, Senior WASH Advisor, Global Communities
Everything changed with Ebola.
For four years, Global Communities had been busy creating access to safe sanitation for communities in Liberia, helping to fight the spread of disease and improve health outcomes. Utilizing Community-Led Total Sanitation, we were making consistent progress, beginning work through the USAID-funded Improved Water, Sanitation and Hygiene (IWASH) program in 2010 in the three Liberian counties of Nimba, Lofa and Bong. Our program gained the support of the national government, and we worked with them to develop their sanitation strategy to improve the health of rural communities across the country. By early 2014, we had helped 284 communities become “open defecation-free” and were working with more communities.
Suddenly we and our partners in the Liberian County Health Teams and the Ministry of Health found ourselves at the center of a maelstrom. To combat Ebola, we scaled up our community engagement work, training community leaders who were already working to prevent open-defecation in how to provide information about Ebola prevention. As the epidemic swelled, our community engagement approach shifted again, focusing on acceptance of vital services like dead body management, and eventually, health screenings. In just a few months, our work scaled up from three to all 15 Liberian counties.
It was during this time that we received reports of an astonishing statistic. All 284 open defecation-free communities were reporting that they were also Ebola-free — despite being located in some of the regions hardest hit by the virus.
Was there a link between being open defecation-free and Ebola-free? Or between our program’s process and Ebola resistance?
Earlier this year, we employed two independent public health consultants to conduct research into the informal reports we had received. They came back with extraordinary findings. Focusing their research on 551 households in Lofa County, they established with a representative sample that the communities that had reached open defecation-free status were indeed Ebola-free.
They also found that communities that had only started the Community-Led Total Sanitation process — but not reached full open defecation-free status — were 17 times less likely to experience a single case of Ebola. This suggests a statistically significant correlation between our work to become open defecation-free and being Ebola-free.
Still, it would be wrong to assume that these findings mean that simply becoming open defecation-free stops Ebola. Rather, they suggest that people who had been exposed to the program’s education were far more likely to develop healthier behaviors and practices that lead to Ebola resistance — especially when led by a member of their own community.
Perhaps most encouraging, these behavior changes don’t just defend against Ebola. By utilizing CLTS, individuals can help prevent a variety of water, insect-borne and diarrheal diseases, including many neglected tropical diseases. In addition, such methods are inexpensive; in Liberia, incentives of only $130 per community can result in far better sanitation practices. Make household latrines, hand washing facilities, garbage pits and dish racks available, and you have a safe, hygienic and resilient community.
Disease spreads at the community level, and only by engaging with the community to create sustainable change can we hope to control and eliminate many of the diseases that are so prevalent in the developing world. CLTS does just that, and any focus on water and sanitation must recognize the importance of empowering communities to make wise decisions to help improve their health.