By Clayton Ajello, Global Network for Neglected Tropical Diseases.
This blog was originally posted on Impatient Optimists.
For 22-year-old Claribel, making ends meet is a challenge. She and her family live in a remote, marginalized community in the Dominican Republic with little access to health services and clean water – conditions which place Claribel’s family at risk for contracting neglected tropical diseases (NTDs) such as intestinal worms. Claribel’s three children, Altagracia (6), Wardin (3) and Nismael (2), eat arroz con habichuelas (rice and beans) for nearly every meal, and they rarely have access to essential protein and vegetables.
While Claribel’s children are eating enough calories, they still suffer from undernutrition because their diets are deficient in the essential vitamins and minerals necessary for proper physical and mental development. At the same time, they are also suffering from intestinal worms – also referred to as soil transmitted helminths (STH) – which cause, aggravate and intensify the loss of nutrients, especially vitamin A and iron.
Plagued by both undernutrition and NTDs, the children have low energy and sometimes cry for no apparent reason. Intestinal worm infections place these children at greater risk for vitamin A deficiency (VAD) because the worms prevent their bodies from absorbing what little vitamin A they have in their diets.
Unfortunately, Claribel’s story reflects a global problem. Millions of children across Latin America and the Caribbean, Asia and Africa suffer from deficiencies in Vitamin A, iron and other critical nutrients that their bodies need to grow and fight illness in addition to NTD infections. The combined effects are devastating, resulting in impaired growth, decreased cognitive function, anemia and even death.
This is why organizations like Global Network for Neglected Tropical Diseases, pharmaceutical companies and many other global partners are working together to address intestinal worms and undernutrition. This partnership, called the STH Coalition, is helping children across the world reach their full potential through a multi-sectoral approach, leveraging delivery platforms and expertise from the health, education, nutrition and water and sanitation community.
Delivering deworming treatments with Vitamin A supplements and other nutrition interventions has shown promising health outcomes, including reduced anemia, lower child mortality, improved child growth and development and overall improved nutrition. In the long-term, this integrated approach can reduce school absenteeism and improve worker productivity.
Just one dose of vitamin A, twice a year, can reduce mortality rates by up to 24 percent.
For at-risk children from six months to five-years-old, just one dose of vitamin A, twice a year, can reduce mortality rates by up to 24 percent. Moreover, for children 12 months of age or older, simultaneous administration of a single dose of a deworming treatment, like albendazole, kills worms living in a child’s system.
For Claribel’s children, Altagracia, Wardin and Nismael, the benefits of this integrated approach are clear. Thanks to the support of Vitamin Angels and global partners, the children received both vitamin A and albendazole. Lately, they have been more energetic and Claribel is grateful for the change she is seeing in her children. Inspired by her desire to see her children succeed, Claribel is now taking classes to receive her high school diploma and dreams that her children will one day find a good job doing something that makes them happy.
Claribel is now taking classes to receive her high school diploma and dreams that her children will one day find a good job doing something that makes them happy.
The international development community has the opportunity to act now in order to foster future success stories. By focusing new energy toward eliminating the policy, program and resource gaps that hinder existing efforts to end both intestinal worms and undernutrition, global partners can accelerate impact. Simply put, the development community should embrace a coordinated, integrated response to address both problems. Given the strong momentum behind the fight to end NTDs and the growing unified movement to end undernutrition, now is a propitious time to identify synergies in policies, leverage delivery platforms and foster greater collaboration across sectors to deliver high-impact health and nutrition solutions to families like Claribel’s.
In 2005, an alarming 39 percent of children were stunted in Maharashtra state, the second largest state in India with a population of over 100 million people. By 2012, a survey revealed that this number dropped to 24 percent among children under the age of two. A recent report published by the Institute of Development Studies (IDS) examines why this unprecedented reduction in stunting occurred.
Stunting is a condition that causes irreversible damage and occurs when a child does not receive the right kind of food and nutrients. Stunted children often have weaker immune systems leaving them more susceptible to infections and making them five times more likely to die from diarrhea. Infections caused by neglected tropical diseases (NTDs) are closely linked to malnutrition. Intestinal worms, for example, are among the underlying causes of stunting, anemia, loss of key nutrients like Vitamin A and iron, and overall poor nutritional status. Not only does India have more children suffering from NTDs than any other country in the world, they are home to the highest number of stunted children under the age of five.
Historically, Maharashtra state’s high levels of income inequality have contributed to malnutrition and stunting in children. Even though Maharashtra is one of the wealthiest states in India, children who are stunted are not benefiting from this growth. Stunting impairs a child’s growth and perpetuates poor health and nutrition, preventing them from growing into their full physical and economic potential. Children who are unhealthy and lack access to proper diets, safe water, healthcare and sanitation facilities are trapped in a perpetual cycle of disease and poverty.
According to the authors, a number of key factors, working in tandem, contributed to Maharashtra state’s reduction in stunting. The launch of the state’s Nutrition Mission and the National Rural Health Mission created strong political will to improve nutritional status of young children. Because NTDs can contribute to malnutrition, Maharashtra state’s Nutrition Mission Action Plan ensured that deworming tablets were distributed to children at risk for intestinal worm infections. And promisingly, the number of children receiving deworming treatments more than doubled, increasing from 8 percent to 19 percent. Maharashtra’s efforts towards addressing NTDs is a positive step in the right direction to lower the occurrence of stunted children and subsequent malnutrition among young children.
IDS also noted that other important factors in the reduction of stunting include: a favorable political, social and economic environment; strong economic growth; robust poverty reduction performance; and improvements in women’s empowerment and health. In the same manner, addressing NTDs requires a multi-pronged approach. In addition to deworming, creating an enabling environment for children will amplify the possibilities for the future, particularly by simultaneously improving access to clean water, sanitation and hygiene and delivering key nutrition interventions like Vitamin A alongside deworming treatments.
While the rapid decline in stunting in Maharashtra state was unique, we congratulate them on embracing a comprehensive approach to tackling this issue and remain hopeful that other states endemic for NTDs and malnutrition will feel encouraged to follow their lead.
This was not your average school day in Sierra Leone. On July 8th, 2013, thousands of children in the Western Area Rural District arrived to class and received a life-changing packet of pills. While small and unassuming, these pills change lives and have the power to protect each child from debilitating and painful neglected tropical diseases (NTDs).
Sierra Leone is home to some of the poorest health conditions in the world. Intestinal worms affect the entire population of the country – leaving millions of children sick, tired, anemic and undernourished. But thanks to you, we were able to ensure more than 58,000 of these children remain healthy and protected from NTDs for an entire year! Here’s how we did it together:
This April we END7 was able to support our partners on the ground in Sierra Leone this July.
Helen Keller International and the government of Sierra Leone distributed deworming medicine to treat and protect 58,365 children against NTDs. But this was no easy task.
The distribution of deworming medicine took place at multiple schools in the Western Area Rural District of the country. Zonal advisors and teachers across the region had to be trained in pill distribution and mass drug administration (MDA) in order to carry out the task at hand. Once training was completed, the teachers were ready to distribute medicine to thousands of children, and the children were ready to go to school to receive the life-saving medicine on July 8th. Together, we created 58,365 success stories in just one school day.
But that’s not where this story ends. The government of Sierra Leone is continuing the task of treating every child in the country against NTDs. Sierra Leone’s Neglected Tropical Disease Control Program plans to control and eliminate these diseases by 2015 and is working aggressively to do so. Even more, Helen Keller International, who’s been working in the country since 2002, is dedicated to seeing the end of NTDs in the country. Throughout HKI’s 12 years in-country, they’ve completed surveys on the prevalence of NTDs in Sierra Leone in addition to providing training and education so that Community Directed Distributors can distribute multiple treatments at the same time. We know our collective efforts will make a big difference in the lives of children living in Sierra Leone.
The July MDA in Sierra Leone demonstrates the effectiveness of NTD treatment when coordinated through already established institutions like local schools. Because children are so vulnerable to the effects of NTDs, school systems offer a unique and effective way to provide treatment to children who are infected or at risk of infection.
To date, END7 funds have contributed to several school-based deworming programs. But with your help, we can double – or even triple(!) – the number of school kids reached across the world! Will you donate? Together we can see the end.
Globally, more than half a billion children are infected with neglected tropical diseases (NTDs), hindering their development and ability to learn. Parasitic worm infections like whipworm, deprive children of the essential nutrients they need to grow and act like, well, the rambunctious children they’re supposed to be!
Watch and share this video from END7:
Instead of being able to walk to school, concentrate in class and socialize with friends, they’re suffering from severe anemia, malnutrition, fevers and intestinal pain caused by these often chronic and simultaneous infections.
It costs approximately 50 cents to treat and protect one child against the seven most common NTDs for a year. But that’s not all we need to ensure that this generation’s future politicians, mathematicians, teachers, peace builders and problem solvers get to class.
We need you. With your support, you can help us at the END7 campaign build awareness for these devastating infections and their cross-cutting solutions. By watching this short video and sharing with your friends, you can help so many kids get the education they deserve.