Posts Tagged ‘MDA’

Stephanie’s Story

June 28th, 2010

by: Christopher Glass

It’s about 6am on my last day of a week-long trip to Haiti.  I’m sitting in my hotel room in Port-Au-Prince waiting to be picked up to go the airport and I’m listening to the city wake up. My hotel room is quiet. No TV. No cell phones. When I close my eyes and listen I hear car horns beeping, pigs grunting and roosters crowing all in a matter of moments.

I’m sitting here thinking about all the things I witnessed and all the people I met– wonderful people who greeted me with a smile and a handshake. People walking down the street who waived to me when we made eye contact.

I slept well last night; thankfully I had a room with air conditioning since the high temperature has been hovering around 100 degrees. I missed that during our trip to Jacmel to watch the start of our second Mass Drug Administration (MDA) this month.

The MDA is part of the Neglected Tropical Disease (NTD) intervention in Haiti. This program started well before the earthquake, we’re distributing medicines to eliminate or control Lymphatic Filariasis (commonly known as Elephantiasis) and Soil-transmitted Helminths, particularly nasty intestinal worms.  IMA World Health’s role is to coordinate the boots on the ground- among other things. But I’ll get into more of that later.

I’m having a difficult time writing this blog entry because I have so much to say and so many photos to post. I feel like I could ramble on forever about this country and our work here but one story comes to mind. I’ll leave you with this image.

Her name is Stephanie.

She is 18 years old and she’s suffering from a severe case of Lymphatic Filariasis. (LF) We met her by accident; we took a wrong turn and ended up on a back street in Jacmel. When I saw her we stopped the car and I spoke with her with the help of Dr. Abdel Direny, a Haitian-born co-worker and friend who helped make this trip a success.

Stephanie

She says her parents are alive and living in Jacmel but want nothing to do with her; she sleeps at her grandmother’s home but is sent out during the day. She sits on this street and begs for money from strangers. I’m told the wall is where she spends her time.

I asked her if she was going to school– she can’t, there’s not enough money. Her section of street is about 500 yards from one of our distribution points. We offered to drive her to get some of the medicines for her leg but she declined saying she had already gone to a clinic and taken some medicine for her foot. Dr. Direny thought it may have been some pain medicine but wasn’t sure.

She sounded apprehensive about our pills. Dr. Direny did his best to explain their benefits and we asked her several times to take the medication but the best we could get was a promise that she’d go the next day. I hope she does.

The medicine distributed by IMA World Health for LF probably won’t reduce the swelling but it will get rid of the worms in the blood stream causing it. According to Dr. Direny, our Program Director in Haiti, she is very young to have such an advanced case, the medicine could still be a great help to her.

She needs access to a hospital capable of teaching her how to deal with her leg. It’s called Morbidity Management. IMA is connected to this, teaching people how to care for swollen limbs like this by washing and daily maintenance. Sometimes the swelling will go down.

This takes me back to the Mass Drug Administration. If she could have taken the pills at a younger age, she wouldn’t have developed the swelling. Her life would be dramatically different.

As I write this post, IMA World Health is distributing medicine to more than 1 million people in the month of June in Haiti. This is a huge number to wrap your mind around but consider this– they are doing it with a network of roughly 4,000 community volunteers.

This work is truly being done in a partnership with the Ministries of Health and Education and other implementing partners. IMA’s funding is from USAID through RTI and there is a huge community effort to make this a success. It’s great to see a partnership of this size working in a country facing so many obstacles to face in the months and years to come. There are so many people working hard to improve the lives of people they may never know. People like Stephanie.

If you would like to learn more about IMA World Health and follow updates on our work go to www.imaworldhealth.org.

Christopher Glass is the E-Communications Officer at IMA World Health

Millions Treated for NTDs in Burundi

March 12th, 2010
A few of the many Burundians treated in the December 2009 MDA

A few of the many Burundians treated in the December 2009 MDA

By Indra Struyven

In December 20009, the Burundi NTD Control Program successfully treated 3.6 million preschool and school-age children and 115,008 pregnant women in the ongoing battle against neglected tropical diseases (NTDs). The program also successfully trained 1,467 health care workers for diagnosing and treating NTDs in its third year of operation.

The main target of this mass drug administration (MDA) was one of the most prevalent and debilitating group of parasitic infections, namely the soil-transmitted helminthiases (intestinal worm infections). These are diseases that cause anaemia, malnutrition, pain, and physical and mental underdevelopment in children.

Béoline Nsengiyumva, now free of worms

Béoline Nsengiyumva, now free of worms

One person who benefited from this MDA is Béoline Nsengiyumva. Béoline is a 14 year old girl living with her family in Mukungu, Makamba province in Burundi. She’s in her 5th year of primary school, has a very joyful and cheerful demeanour, and, like many of her schoolmates, was afflicted with soil-transmitted helminths. The parasitic disease caused her to suffer from exhaustion, nausea, and abdominal pains, forcing her to miss school and make frequent trips to the local health clinic. But that was all before she received treatment in December, Since Béoline has become healthy again.

Another key part of a MDA is education to prevent getting infected again in the future. Béoline is learning the importance of hygiene. When asked if she knows how prevent intestinal worm infections, she says that she has to wash her hands. Simple steps such as using the latrines at her school and wearing shoes can go a long way towards preventing future re-infection.

The Burundi NTD Control Program organized the MDA in partnership with several other programs from the Ministry of Health, UNICEF, the Schistosomiasis Control Initiative, CBM and the Global Network for Neglected Tropical Diseases.

IndraIndra Struyven is a medical doctor. She completed the diploma course of tropical medicine in London (LSHTM). Currently she’s working for CBM,  as a technical assistant to the Ministry of Health in Burundi, to assist the team of the Ministry in their fight against NTD’s. Before she was working as a GP in Dar es Salaam.

Clearing the Air on MDA

November 19th, 2009

Last night, Alanna Shaikh of Global Health Basics brought an interesting article to our attention: following mass drug administration (MDA) to treat lymphatic filariasis in Indonesia, “…nine people were dead last week and nearly 1,000 had fallen ill with symptoms such as nausea, dizziness, muscle soreness and vomiting. Hundreds were hospitalized.” She rightfully asked us, “what happened here?”

As it turns out–and it’s a topic we don’t cover much on our blog or website–these symptoms, even for populations in the thousands, are to be expected for MDA.  Like treatment for many other NTDs, when you treat for LF with the drugs DEC and albendazole, infected people will commonly exhibit symptoms including headache, nausea, and fever; those who are uninfected will likely experience minimal side effects.  Additionally, when treating populations en masse, it is probable that some may die from other causes within the treatment period; the correlation between receiving NTD treatment and death may just be coincidental or related to un-screened conditions.

The fear and hysteria that occurred in Indonesia is a reminder that effective media, education, and sensitization campaigns are critical in ensuring a successful MDA campaign.  We are fortunate to have drugs that are safe and effective for wide population demographics, but individuals and communities must feel comfortable taking the drugs and must anticipate the (highly normal) side-effects if we expect them to return in the coming years for treatment.