Helen Keller International (HKI) has trained members of the Kombra Network (KN) as part of preparation for an upcoming campaign against Neglected Tropical Diseases (NTDs).
The campaign which entails mass drug distribution is scheduled for February and targeting people in four districts.
NTDs are viral, parasitic and bacterial diseases that affect poor countries. They include Lymphatic Filariasis (LF) or Elephantiasis, which is also called ‘bigfut’ in the local krio language; Onchocerciasis, also known as River Blindness; Schistosomiasis; the African Sleeping Sickness; and Chagas disease.
In Sierra Leone, four NTDs – LF, Onchocercasis, Schistosomiasis and Soil-Transmitted Helminths – are known to be endemic. And they are the target of the Integrated Neglected Tropical Diseases Programme (INTDP) of the Ministry of Health and Sanitation (MoHS), which is supported by local and international partners by HKI.
The upcoming campaign, which has been slated for the second week of February, entails the administration of drugs for LF in the four districts of Bombali, Karene, Koinadugu and Falaba, which are still said to be having transmission of the disease. The treatment comprises a combination of Albendazole and Ivermectin tablets. Volunteers will also administer Ivermectin tablets only as treatment for Onchocerciasis in the eight other districts, excluding the Western Area Urban and Rural.
LF, alongside other NTDs, is a leading cause of disability worldwide, according to the World Health organization (WHO).
Like malaria, the anopheles mosquito serves as vector of the organism that causes LF. But unlike malaria, LF takes a longer period to develop and manifest itself in its victim – between 10 and 20 years. The symptoms of the onset of LF include swollen legs, swollen breasts and hernia, which start occurring after 10 years of infection.
Rapid treatment is crucial to stop development of the disease. Full blown infection is irreversible, and at this point patients can only get treatment to suppress pain and further growth of the parasites in the victim. Treatment for LF patients is also important to prevent infection of people they live with.
The training for the Kombra Network is part of a collaboration between Helen Keller and the local NGO FOCUS 1000 and it is geared towards supporting the upcoming campaign to increase the country’s treatment coverage. The participants included the 12 members that make up the National Executive of the Kombra Network and staff of FOCUS 1000 in the four LF districts.
A country requires a minimum of 65 percent treatment coverage to be considered as having effective epidemiological coverage of NTDs. Assessment for this is done every two years. The next assessment is slated for 2022.
The four LF districts in Sierra Leone have failed the assessment three times, according to officials. The last assessment was done in November 2020, when Kailahun and Kenema districts passed, bringing the total number of districts which have passed the test in the country to 12.
The training was designed to capacitate the participants on the distribution process. The sessions touched on the reality of NTDs, vis-à-vis their prevalence in the country, as well as efforts being undertaken by the government and its partners as part of global efforts to end transmission of the diseases which are said to be causing suffering for over one billion people globally, with most of those needing intervention found in developing countries like Sierra Leone.
Helen Keller hopes to use the Kombra Network’s wide presence in the country to reach usually difficult-to-reach parts of the country.
Mohamed S. Bah, Coordinator of the NTDs Programme at Helen Keller, said over the last 10 years they have been distributing medications but that they have been facing challenges in the four LF districts where either communities are hard to reach or certain groups of people have been reluctant to comply with the treatment due to misconceptions and sociocultural factors.
The involvement of the Kombra Network, Mr Bah said, was necessitated by the role traditional healers play in influencing health seeking behaviors in communities.
“We found out that a lot of Sierra Leoneans go with the idea that ‘bigfut’ is caused by witchcraft and traditional healers play a lot of role in their treatment,” he stated.
Bah explained that not only does the treatment by traditional healers add to the predicament of the victims, but it causes delay which makes it impossible to prevent a full blown infection in many cases.
“We see that traditional healers are a stumbling block because while we try to get the people to seek proper treatment, they go to the traditional healers. And we see that the only way to resolve that it to bring them on board,” Bah added.
The beneficiaries of Saturday’s training will be deployed across the four LF districts to train up to 200 volunteers, mostly traditional healers and religious leaders, who will go into the communities to administer the drugs during the campaign which is scheduled to last for five days.
Mohamed Bailor Jalloh, CEO of FOCUS 1000, said the training marked a progress in the collaboration between FOCUS 1000 and Helen keller.
“The main objective of what we are doing is to save lives, which is the main important thing,” he said.
This will be the first time distribution of drugs for NTDs will take place as a campaign.
Writing and editing by Kemo Cham