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HEALTH-WEST AFRICA: River Blindness Campaign Ends
By Brahima Ouedraogo
OUAGADOUGOU, Burkina Faso, Dec 19, 2002 (IPS) - The river blindness campaign, run
by the World Health Organisation (WHO) and 11 West African countries, has
ended after 28 years of operation.
River blindness, or orchocerciasis, is caused by parasitic worms;
transmitted to humans by biting flies that breed in fast flowing rivers. The
disease mainly affects those who live near rivers. Symptoms range from
severe itching and skin lesions to total blindness.
The campaign, which ended on Dec 6, has prevented 600,000 cases of
blindness, according to the World Health Organisation. And, 18 million
villagers have grown up free of the threat of river blindness. Because of
the Onchocerciasis Control Programme (OCP), thousands of farmers are now
moving to reclaim 25 million hectares of fertile river land, enough land to
feed 17 million people, says the UN health agency.
‘'The accomplishments of this programme inspire all of us in public
health to dream big dreams because we can reach ‘impossible' goals and
lighten the burden of millions of the world's poorest people,'' says WHO
Director-General Gro Harlem Brundtland, in a statement, made available to
IPS.
‘'When critics say that the next proposal is too ambitious, that it will
be too expensive, it will take too long, that funds will be wasted, that the
job will be too complicated or dangerous - tell these critics to remember
this day,'' she says.
When the campaign began in West Africa in 1974, as many as 10 percent of
the population in high impact regions were completely blind and 30 percent
had severe visual handicaps, according to the World Health Organisation.
Immediately, people in West Africa recognised that something associated
with the rivers was causing blindness and farmers began leaving their
fields. One study in the early 1970s documented that 250,000 square
kilometres of once-productive river valley had been abandoned, which
translated into an economic loss of 30 million U.S. dollars a year.
The programme initially concentrated on eliminating the vector, the black
fly. Aerial spraying of larvicide blanketed an area of 1.3 million square
kilometres, in which 30 million people lived. Week after week, helicopter
pilots snaked their way over more than 50,000 kilometres of rivers, often
flying close to trees and through narrow canyons. On the riverbanks,
hundreds of volunteers rolled up their pants legs and exposed themselves to
black flies, in order to collect flies and monitor the parasites in the
region.
The eleven countries, which have now been ‘'cleared'' of river blindness,
are Burkina Faso, Benin, Niger, Togo, Ghana, Mali, Cote D'Ivoire, Guinea,
Guinea-Bissau, Senegal and Sierra Leone.
The Netherlands, one of the programme's donors, announced it would erect
a small statue depicting a child leading a blind old man with a cane to
commemorate the end of the programme and the end of suffering for millions
of Africans.
In Burkina Faso, one of the most affected countries, 400,000 people were
infected by the parasite in 1974. Around 50 kilometres of rivers and streams
were treated with insecticides to eliminate pockets of the flies, which were
still posing problems.
In 1988, the programme added another weapon in the fight when
pharmaceutical firm, Merck offered its anti-parasite drug ivermectin free of
cost. Hundreds of volunteers drove to the end of red dirt roads to hand out
slim white pills, year after year, until communities took over the drug
distribution part of the programme. And for almost 30 years, donors
consistently financed it all.
‘'In Ghana, the results were not brilliant because a few of the country's
regions were affected, especially the north, where it was serious,''
explains Ghanaian deputy Minister of Health, Moses Danyaba. He himself comes
from the north where he remembers during his childhood seeing ‘'people
become blind or having deteriorating vision and skin diseases''.
‘'This is one of the WHO's great success stories in the history of the
elimination of disease, and I think the onchocerciasis programme should
serve as an example for other disease elimination programmes around the
world,'' says Danyaba.
About 80 percent of the people living in endemic areas, especially in the
north, were infected. Today, the rate of incidence in Ghana runs from zero
in most regions to below five percent in residual areas, says Danyaba.
Lamine Diawara, the coordinator of the onchocerciasis programme in
Senegal, believes the project's management model should be a model for
HIV/AIDS programmes. ‘'Officials should follow this model to help them fight
AIDS and other endemic diseases. The programme was distinguished by its use
of partnerships and rigorous management, community intervention, and
programme monitoring,'' he says.
About 600 Senegalese villages were affected by onchocerciasis. According
to Diawara, Senegal will continue controlling the disease and, eventually,
eradicate it.
A devolution programme, which begun 10 years ago, allows African
countries to take over and avoid a resurgence of the disease. 500 managers
have been trained in the 11 West African countries in controlling and
eradicating the disease.
The programme, which cost 600 million U.S. dollars over its 28-year life
span, will continue another two years in Sierra Leone, where operations were
curtailed during the country's civil war. The two extra years will cost 40
million U.S. dollars, according to the World Health
Organisation. (END)
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