United Front Against Riverblindness

522 views
442 views

Published on

UFAR presentation I created to support public speaking engagements. The presentation was intended to inform US audiences about the disease and its impact to people and communities in the region of the Democratic Republic of Congo where UFAR is responsible for treatment.

Published in: Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
522
On SlideShare
0
From Embeds
0
Number of Embeds
5
Actions
Shares
0
Downloads
0
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

United Front Against Riverblindness

  1. 1. Bringing HopeDefeating Riverblindness
  2. 2. UFAR: Giving Back to The CongoOnchocerciasis is a skin and eyedisease caused by a parasite.The disease is transmitted by asmall black fly that breeds infast-flowing water.Risk of blindness is higher forthose living close to such rivers,thus the name RiverblindnessIt affects 18 million people inAfrica, Latin America andYeman.
  3. 3. Villages Near Riverblindness-Infested River
  4. 4. Villagers Farming Near Riverblindness Infested River
  5. 5. With Water We Live, Without Water, We DieThe fast moving river watergives life to the land.It also serves as a breedingground to the black fly.
  6. 6. From a tiny blackfly…Some people are bitten up to10,000 times a day.The worm lives and maturesunder the skin of the victim andgive birth to millions andmillions of offspring.The movement of theseoffspring throughout the bodycauses the initial symptoms.
  7. 7. The Irreversible Damage BeginsNodules of worms grow under the skin
  8. 8. The Itching is FerociousSometimes people even use rocksto scratch themselves.Slowly but surely all the scratchingdestroys the quality of the skin.
  9. 9. Inevitable Eye Damage and Blindness But ultimately, without intervention, the worst symptom is the loss of vision as the worms affect the eye. And the result is irreversible blindness.
  10. 10. In a Society of Survival,Care Replaces Schooling
  11. 11. Once established, it cannot be cured. But treatment in the early stages prevent blindness
  12. 12. With Intervention, There’s HopeThe onchocerciasis control program wasformed in the mid 1970s. The goal was to break the cycle of transmission.
  13. 13. Phase Two Approach: Community-Directed Treatment with Ivermectin– Annual dosing, combined with minimal follow-up requirements– Communities are empowered to manage their own health through a partnership between community health care workers, NGOs, national government and WHO/APOC.– Passive distribution: • Health centers or clinics • Mobile clinics
  14. 14. CDTI Plan for Success– The project is defined by the National Government– It is funded primarily by the World Health Organization and African Program for Onchocerciasis Control. With significant funding by the Non-Governmental Development Organization (UFAR). The National Government funds a minor portion initially, increasing its investment in subsequent years.– The NGDO and the Government are responsible for technical and administrative management of the project.– Community-Directed approach leads to a high degree of acceptance and success.– The CDTI program is implemented by the Community Distributors, working with APOC, NGDO and the Government– This approach provides for program sustainability and integration with other healthcare interventions
  15. 15. Local Involvement Local Commitment– Sensitize village chiefs and community leaders– Train local medical staff– Local medical staff of doctors and nurses then select and train village-based community distributors– Community distributors are compensated by the villagers insofar as possible for their work
  16. 16. Mectizan (Ivermectin) Microfilaricide
  17. 17. Mectizan (Ivermectin)– Prevents worsening of vision and blindness– Prevents itching and disabling skin lesions– Improves skin condition and self-esteem, culturally especially important for women– Promotes resettlement back into previously deserted farm land– Improves school attendance and literacy for children and labor productivity for adults– Effective against scabies, mites, lymphatic filariasis and intestinal worms
  18. 18. Mectizan (Ivermectin)– History: Discovered by Merck in the 1970s and developed for human use in the 1980s– Activity: Rapidly kills microfilariae but not adult worms– Clinical application: Established as the first extremely safe and highly effective drug for treatment of onchocerciasis– Availability: In 1987 Merck began providing Mectizan free of charge for as long as needed to control and eliminate onchocerciasis as a public health problem worldwide
  19. 19. CDTI Riverblindness Projects in DRC2004: 117 approvedprojects in 19 countries,treating 38 millionpeople per year in88,000 communitiesApril, 2005: 411 milliontreatments distributed Kasongo
  20. 20. Helping people gain access to medicine does not begin and end with a free drug.Kasongo RegionSize: West Virginia, or threetimes the size of New JerseyPopulation: 914,155 (3Territories, 8 Health Zones and116 Health Centers)Prevalence of onchocerciasis:40-59%
  21. 21. Aerial view of a section of Kasongo
  22. 22. Villages at RiskWith few public wells… ….water comes from the river
  23. 23. The UFAR Task: Treating CDTI KasongoHealth Zone Health Population VillagesName CentersKasongo 19 173,613 232Kunda 22 193,955 279Samba 9 90,293 121Lusangi 14 128,573 165Salamabila 13 109,048 191Kabambare 10 76,256 134Kampene 15 102,338 132Pangi 14 67,333 97Totals 116 941,409 1,351
  24. 24. United Front Against Riverblindness― Mission: Bringing the CDTI Program to the Kasongo Region― UFAR is managed by a multi-disciplinary 12-member Board of Directors and a three-member Executive Committee.― Board members are unpaid volunteers, blessed with a strong sense of stewardship and a commitment to improve the lives of the less fortunate.― Registered as a tax-exempt charitable organization both in US (September 2004) and DRC (August 2005)― Goal: Control and eradicate Riverblindness in CDTI Kasongo, in partnership with other players.
  25. 25. It takes a village to raise a child, sometimes it takes a global village to save one.This could not have come about without partners.Official NGDO Group Members for Onchocercaisis Control – Christoffel-Blindenmission (CBM, Germany) – Helen Keller International (HKI, US) – Interchurch Medical Assistance (IMA, US) – Lions Clubs International Foundation (LCIF, US) – Light for the World (LW, Austria) – Mectizan® Donation Program (MDP, US) – Mission to Save the Helpless (MITOSATH, Nigeria) – Organisation pour la Prévention de la Cécité (OPC, Fce) – The Carter Center (CC, US) – Sight Savers International (SSI, UK) – United Front Against Riverblindness (UFAR, US) – US Fund for UNICEF (US)
  26. 26. Challenges― Accessibility to Kasongo: Extremely difficult by road, railway or waterway― Traditionally held views: Superstition, curse― Co-incidence of loiasis (lymphatic filariasis) causes adverse reaction to Riverblindness medicine― Insecurity: Conflict and post-conflict areas― Sustainability: Compensation of Community Distributors— Fundraising: 20 – 25% of total CDTI Kasongo budget
  27. 27. Kasongo Airfield
  28. 28. Kasongo AirfieldDr. Ntumba, pilot Umambudi and Dr. Shungu
  29. 29. Mai Mai Bridge
  30. 30. Lutundula Bridge
  31. 31. Bridges not made for vehicles
  32. 32. Poor Roads
  33. 33. No Roads at AllIt took nearly four hours to get out of this mess
  34. 34. Crossing Congo River on Canoe Drs. Shungu and Ntumba
  35. 35. CDTI KasongoCoordination Team – Project coordinator: Dr. Arthur Nondo – 2 Administrative assistants: Epando & Muteba – Driver and SentryMedical Team – 8 Doctors 8 Nurses 56 Assistant Nurses 10,755 Community Distributors
  36. 36. CDTI Kasongo OfficeThese new motorbikes Dr. Arthur Nondo,will be invaluable in the CDTI Office Director treatment distribution
  37. 37. UFAR Office in KinshasaThe office must double as a hotel room for Dr. Shungu
  38. 38. Challenges― Accessibility to Kasongo: Extremely difficult by road, railway or waterway― Traditionally held views: Superstition, curse― Co-incidence of loiasis (lymphatic filariasis) causes adverse reaction to Riverblindness medicine― Insecurity: Conflict and post-conflict areas― Sustainability: Compensation of Community Distributors— Fundraising: 20 – 25% of total CDTI Kasongo budget
  39. 39. Community Meeting withChiefs, Village Leaders and local NGOs
  40. 40. Community Sensitization and Motivation
  41. 41. Dramatic play addressestraditional and modern views
  42. 42. Confronting old beliefswith new information
  43. 43. Challenges― Accessibility to Kasongo: Extremely difficult by road, railway or waterway― Traditionally held views: Superstition, curse― Co-incidence of loiasis (lymphatic filariasis) causes adverse reaction to Riverblindness medicine― Insecurity: Conflict and post-conflict areas― Sustainability: Compensation of Community Distributors— Fundraising: 20 – 25% of total CDTI Kasongo budget
  44. 44. Training Doctors and Nurses Doctors and nurses are trained in disease treatment and on the CTDI approach. They in turn will train the distributors before treatment can begin. Symptoms of adverse reaction include swelling of the eye, severe diarrhea, resulting in dehydration and weakness, and ‘red eye’ (subconjunctival hemorrhage).Dr. Temor trains doctors and nurses
  45. 45. Training Sessions Dr. Ntumba, now the DRCMinister of Health for West Kasai
  46. 46. First UFAR Doctors and Nurses
  47. 47. Training Community DistributorsIt is critical that everyone take the medication. If some people do and some don’t, the disease will never leave the village.
  48. 48. Source of hope: Community WorkersAt the village level, bringing the drug to the people andeducating them as to the real causes of riverblindness and thebenefits of medication are the mission of health care workersand community-based distributors.
  49. 49. Challenges— Accessibility to Kasongo: Extremely difficult by road, railway or waterway— Traditionally held views: Superstition, curse— Co-incidence of loiasis (lymphatic filariasis) causes adverse reaction to Riverblindness medicine— Insecurity: Conflict and post-conflict areas— Sustainability: Compensation of Community Distributors— Fundraising: 20 – 25% of total CDTI Kasongo budget
  50. 50. Conflict and Displacement in CongoThe Democratic Republic of Congoremains one of the world’s worstongoing humanitarian crises.A presidential election in 2006 hasgiven rise to a democraticgovernment.But still, more than 1,000 people dieeach day from conflict-related causessuch as disease, malnutrition orviolence. In Kasongo, people are returning home. The conflictCorruption within the government is confined to a region 300and pervasive state weakness allows miles north of Kasongo.members of the national army andmembers of armed groups alike toperpetrate abuses against civilians.
  51. 51. Challenges— Accessibility to Kasongo: Extremely difficult by road, railway or waterway— Traditionally held views: Superstition, curse— Co-incidence of loiasis (lymphatic filariasis) causes adverse reaction to Riverblindness medicine— Insecurity: Conflict and post-conflict areas— Sustainability: Compensation of Community Distributors— Fundraising: 20 – 25% of total CDTI Kasongo budget
  52. 52. Meager Pay for Distributors Community distributors are paid For the poorest villages, UFAR by villagers, who pay with whatever must pay the distributors, whothey have … rice, peanuts, plantains, sometimes must travel door-to- fresh wild game or poultry. door to reach everyone.
  53. 53. The 2007 UFAR MissionHealth Zone Name Health Population Villages CentersKasongo 19 173,613 232Kunda 22 193,955 279Samba 9 90,293 121Lusangi 14 128,573 165Salamabila 13 109,048 191Kabambare 10 76,256 134Kampene 15 102,338 132Pangi 14 67,333 97Totals 116 941,409 1,351
  54. 54. Launch Ceremony CDTI Kasongo 25 June 2007Launch Publicity Opening Remarks
  55. 55. Launch Ceremony CDTI Kasongo
  56. 56. Opening Remarks by the Governor’s RepresentativeThe launch ceremony was broadcast by radio throughout the region
  57. 57. Community Distributors
  58. 58. Community Leaders Show the WayDose is easily determined Medical personnel and community by height. leaders take the treatment first, signifying safety and acceptance.
  59. 59. And the Treatment BeginsMectizan was distributed door-to-door in 363 villages over the next 10 days by 2,000 trained community distributors.
  60. 60. The 2008 UFAR MissionHealth Zone Health Population VillagesName CentersKasongo 19 173,613 232Kunda 22 193,955 279Samba 9 90,293 121Lusangi 14 128,573 165Salamabila 13 109,048 191Kabambare 10 76,256 134Kampene 15 102,338 132Pangi 14 67,333 97Totals 116 941,409 1,351
  61. 61. The UFAR Mission in the Years Ahead— 2007 Kasongo health zone: 100,000 people 1,000,000— 2008 Kasongo and Kunda health zones: Population 263,000 people— 2010-2024 8 health zones: 263,000 1,000,000 people 100,000— 10 – 15 years to 2007 2008 Beyond eradicate the disease
  62. 62. Riverblindness: Only the First StepWHO-Proposed Additional Projects for UFARIntegration of riverblindness control with other healthcare interventions — Prevent childhood blindness (vitamin A) — Control of intestinal worms — Provision of clean water (wells) — Malaria control (mosquito nets)
  63. 63. Challenges— Accessibility to Kasongo: Extremely difficult by road, railway or waterway— Traditionally held views: Superstition, curse— Co-incidence of loiasis (lymphatic filariasis) causes adverse reaction to Riverblindness medicine— Insecurity: Conflict and post-conflict areas— Sustainability: Compensation of Community Distributors— Fundraising: 20 – 25% of total CDTI Kasongo budget
  64. 64. UFAR Mission BudgetTreatment Cost: Less than One Dollar Per Person
  65. 65. UFAR 2008 Mission Budget Field Office Personnel 11,000 14,100 Capital PersonnelOperations Equipment Capital Equipment 42,715 32,360 Supplies Communications Training Supplies Travel Operations 8,625 Field Office Travel 3,465 Training 20,925 Communications 11,285
  66. 66. How Many People Can You Help Treat Today?— The average village contains 500 people— Half of these people already have riverblindness— The average American family spends around $1,600 a year on vacations— A house cat costs nearly $1,000 a year, on average— American coffee drinkers spend more than $175 on coffee per year— Riverblindness treatment costs less than $1 per person
  67. 67. It has been saidthat when faced with a great challenge, you must do the thing that you think you cannot do.
  68. 68. How to ContributeBy Check Please make your tax-deductible donation payable to UFARSend your check to: UFAR 13 Carnation Place Lawrenceville, NJ 08648By Credit Card Please visit the UFAR website: http://www.riverblindness.org
  69. 69. When we join hands,we can defeat this dreadful disease! www.riverblindness.org

×