By Dr. Adrian Hopkins, Director, Mectizan Donation Program
River Blindness, or to give it its medical name, Onchocerciasis, is a devastating disease where it is highly prevalent and people are exposed just by living in the area.
In 1993 I was seconded by CBM to work as the Technical Advisor to the Central African Republic government for the national Onchocerciasis Control Programme and blindness prevention programme. Based in the NW of the country, where the disease is most prevalent, proved to be an unforgettable experience. Villages along the Ouham River were full of people who were blind or partially sighted, people suffering from epilepsy and everyone had continuous itching. In one village half the adult population were blind or visually impaired. Children, who should have been at school, were being robbed of their childhood having to constantly lead around a parent. Everybody was scratching due to unrelenting skin irritation. Not only were everyday lives a misery but people died much younger as a result. In one “Sentinel Site” where we examined everyone in the village for the parasite, and for eye and skin disease, I discovered that there were only two people older than myself in the whole village and I was still in my forties!
A blind village chief in NW Central African Republic with his children
What a difference Mectizan made to these communities. Because these people were highly infected Mectizan caused some reactions due to the massive destruction of parasites in the skin. Visiting one village a month after the treatment I was worried by their descriptions of their reactions, severe itching (worse than usual) joint pains, fever, swellings I was told I had made them ill for three weeks. I asked with trepidation if they would take Mectizan next time round. There was no hesitation and the answer was 100% positive. Why I naively asked? Because after three weeks of suffering, getting rid of our worms, we have never felt better in our whole lives, we can work harder and enjoy life so much more!
How sad that in areas like these civil unrest has prevented the regular treatment in the last few years and instead of being on the verge of eliminating the disease the population face the possibility of a return to the situation in the early 1990s.
I caught onchocerciasis living in this area. I have been able to take my Mectizan as required. I don’t itch anymore. I am not worried about going blind from onchocerciasis. Already great strides have been made in controlling the disease. The disease is almost gone from the Americas. Studies show transmission has been interrupted in a few areas in Africa already. Now we need to make sure that the 120 million people, mostly in Africa, who are at risk of getting the disease get the treatment they need.