SCI. We will be featuring excerpts from Jessica’s experiences in Burundi; below is the first entry from her notes:
Sunday June 19, 2011- Arrival in Bujumbura
Keith Walker and I met up in DC and traveled together from Dulles Airport to Addis Ababa to Nairobi to Bujumbura….
Map is an edited Google Map
About 16 hours. We reached the airport in Bujumbura which looked something like a building out of the cartoon Superfriends. Several large bubbles, or igloos, or something. I’ve not seen anything quite like it before.
When we arrived at the hotel, we met up with our soundman Kenny Geraghty, who had flown in from Capetown, South Africa earlier in the day.
Our family was together again.
(From l tor: Film Crew: Keith Walker, Jessica Stuart, Kenny Geraghty)
Kenny, the gentle giant- hysterical- warm-and has more experience in his pinky than most have in a lifetime. Keith is the most ridiculously talented and relentless shooter that makes all the women blush. And then there is me. Even though we only meet up in bizarre places in the world, every time we are together it’s like coming home.
We are traveling together this time to document the work of the Global Network and its partners, working to eliminate Neglected Tropical Diseases around the world.
NTDs ravage countries like Burundi. They affect the poorest of the poor- the bottom billion, often invisible to the outside world. The amazing thing- these diseases are preventable and treatable- for less than $1.25 a day.
I still can’t get over how utterly cruel NTDs are. One has to look way below the surface, to the bottom poorest billion in the world to find them. These diseases keep children out of school, are debilitating and disfiguring, and cost billions of dollars a year in lost worker productivity. These diseases cause stigma in the community. They are the cruelest of the cruel.
Lush agriculture in Northern Burundi.
Burundi has its own political and infrastructure issues, along with such sickness. Civil War and Genocide plagued the country for years. It was only in 2008 that a peace agreement was made between internal warring factors. The country is filled with kind and curious peoplepeople who want work and prosperity NOW. They want to put the “crisis” (as they call it) behind them. Burundi is beautiful. Everywhere we look there are tea plantations, coffee farms, rice fields, banana trees, and pineapples. This is a country that could prosper on its own. But something like Neglected Tropical Diseases keeps the people down.
I’ve learned the entire country of Burundi is at risk of infection by at least one STH (Soil Transmitted Helminthes- or worms). Half the country is at risk for schistosomiasis, and trachoma is a serious public health problem.
Read more: Personal Perspectives: Inside look at Burundis national NTD prgoram
December 1st, 2009
Schistosomiasis Control Initiative at Imperial College, London
An estimated 120 million people in sub-Saharan Africa are currently infected with one of the seven most common NTDs, schistosomiasis, and many more are at risk. Of these, over 40 million are female. One of the complications of one type of schistosomiasis (S. haematobium) is that the worms and their eggs invade the female genital system and can cause visible lesions. These lesions associated with S. haematobium infection in the female genitals are mucosal grainy sandy patches that are usually associated with bleeding, especially “contact bleeding” during pelvic examination or sexual intercourse (Hotez et al 2009 PLOS NTDs pE340).
So an estimated 40 million females (approximately 28 million of whom are school aged) in sub-Saharan Africa are at risk of having lesions on the cervix due to untreated schistosomiasis infection, and as a result, women with cervical lesions are at much higher risk of contracting HIV during intercourse than women without these lesions. Indeed, a cross-sectional study from a rural Zimbabwean community revealed that women aged 20 to 49 with genital schistosomiasis exhibit a three-fold risk of having HIV relative to women without the infection (Kjetland EF, et al. Association between genital schistosomiasis and HIV in rural Zimbabwean women. AIDS 2006; 20: 593-600).
Read more: Simple Mathematics on World AIDS Day: Schistosomiasis and HIV
November 18th, 2009
As Policy Associate for the Global Network, my brain is filled on a day-to-day basis with jargon like R.O.I. and vertical vs. horizontal and congressional budget justifications. So to some extent, my attendance at todays ASTMH clinical pre-course on NTDs felt like listening to experts speaking in another language, or at least in a distant dialect. Micro-array analysis and allelic distortion and microfilaremia flew throughout the day, reminding me of the tremendous gaps between the technical and advocacy worlds of global health, both in the words we use and in the techniques through which we hope to achieve progress.
But relying back on my global health education, I was still able to take much away from the course, and I particularly enjoyed a number of anecdotes shared throughout the day:
- Dr. Alan Fenwick of the Schistosomiasis Control Initiative joked about Prince William of the UK acquiring schistosomiasisa rare tropical disease to the British tabloids, but one that impacts over 200 million people globally.
- Dr. David Freedman of UAB told the story of a Peace Corps Volunteer in Sierra Leone who was infected with onchocerciasis for over a year upon return to the US before she received proper diagnosis and treatmentall the while suffering from itching, rash, and even an internal, muscular nodule.
- Dr. Paul Emerson from the Carter Center spoke movingly about trachoma. He showed a picture of a young woman with early stages of infection; she was not yet blind but was suffering incredible pain as her eyelashes constantly scratched her cornea. As a result, she could not work, farm, cook over an open fire, or even stand to be in the bright sunlight for long periods of time, leaving her physically, mentally, and socially depressed. As he reminded us, blindness is the most overt consequence of trachoma, but it is not the full story.
Leaving the course, I was most impressed by those who were able to take vast clinical knowledge and make it relevant even to the most wonky policy audience members. Because at the end of the day, even the most meaningful research on NTDs will not motivate corporations and governments to act unless we as advocates can compel them to do so.