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.
3. UFAR: Giving Back to The Congo
Onchocerciasis is a skin and eye
disease caused by a parasite.
The disease is transmitted by a
small black fly that breeds in
fast-flowing water.
Risk of blindness is higher for
those living close to such rivers,
thus the name Riverblindness
It affects 18 million people in
Africa, Latin America and
Yeman.
6. With Water We Live,
Without Water, We Die
The fast moving river water
gives life to the land.
It also serves as a breeding
ground to the black fly.
7. From a tiny blackfly…
Some people are bitten up to
10,000 times a day.
The worm lives and matures
under the skin of the victim and
give birth to millions and
millions of offspring.
The movement of these
offspring throughout the body
causes the initial symptoms.
9. The Itching is Ferocious
Sometimes people even use rocks
to scratch themselves.
Slowly but surely all the scratching
destroys the quality of the skin.
10. 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.
11. In a Society of Survival,
Care Replaces Schooling
12. Once established, it cannot be cured.
But treatment in the early
stages prevent blindness
13. With Intervention, There’s Hope
The onchocerciasis control program was
formed in the mid 1970s. The goal was to
break the cycle of transmission.
14. 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
15. 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
16. 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
18. 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
19. 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
20. CDTI Riverblindness Projects in DRC
2004: 117 approved
projects in 19 countries,
treating 38 million
people per year in
88,000 communities
April, 2005: 411 million
treatments distributed
Kasongo
21. Helping people gain access to
medicine does not begin and end
with a free drug.
Kasongo Region
Size: West Virginia, or three
times the size of New Jersey
Population: 914,155 (3
Territories, 8 Health Zones and
116 Health Centers)
Prevalence of onchocerciasis:
40-59%
24. The UFAR Task: Treating CDTI Kasongo
Health Zone Health Population Villages
Name Centers
Kasongo 19 173,613 232
Kunda 22 193,955 279
Samba 9 90,293 121
Lusangi 14 128,573 165
Salamabila 13 109,048 191
Kabambare 10 76,256 134
Kampene 15 102,338 132
Pangi 14 67,333 97
Totals 116 941,409 1,351
25. 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.
26. 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)
27. 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
36. CDTI Kasongo
Coordination Team
– Project coordinator: Dr. Arthur Nondo
– 2 Administrative assistants: Epando & Muteba
– Driver and Sentry
Medical Team
– 8 Doctors
8 Nurses
56 Assistant Nurses
10,755 Community Distributors
37. CDTI Kasongo Office
These new motorbikes
Dr. Arthur Nondo,
will be invaluable in the
CDTI Office Director
treatment distribution
38. UFAR Office in Kinshasa
The office must double as a hotel room for Dr. Shungu
39. 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. 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
45. 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
46. Training Sessions
Dr. Ntumba, now the DRC
Minister of Health for West Kasai
48. Training Community Distributors
It is critical that everyone take the medication. If some people do
and some don’t, the disease will never leave the village.
49. Source of hope: Community Workers
At the village level, bringing the drug to the people and
educating them as to the real causes of riverblindness and the
benefits of medication are the mission of health care workers
and community-based distributors.
50. 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
51. Conflict and Displacement in Congo
The Democratic Republic of Congo
remains one of the world’s worst
ongoing humanitarian crises.
A presidential election in 2006 has
given rise to a democratic
government.
But still, more than 1,000 people die
each day from conflict-related causes
such as disease, malnutrition or
violence. In Kasongo, people are
returning home. The conflict
Corruption within the government is confined to a region 300
and pervasive state weakness allows miles north of Kasongo.
members of the national army and
members of armed groups alike to
perpetrate abuses against civilians.
52. 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
53. Meager Pay for Distributors
Community distributors are paid For the poorest villages, UFAR
by villagers, who pay with whatever must pay the distributors, who
they have … rice, peanuts, plantains, sometimes must travel door-to-
fresh wild game or poultry. door to reach everyone.
54. The 2007 UFAR Mission
Health Zone Name Health Population Villages
Centers
Kasongo 19 173,613 232
Kunda 22 193,955 279
Samba 9 90,293 121
Lusangi 14 128,573 165
Salamabila 13 109,048 191
Kabambare 10 76,256 134
Kampene 15 102,338 132
Pangi 14 67,333 97
Totals 116 941,409 1,351
59. Community Leaders Show the Way
Dose is easily determined Medical personnel and community
by height. leaders take the treatment first,
signifying safety and acceptance.
60. And the Treatment Begins
Mectizan was distributed door-to-door in 363 villages
over the next 10 days by
2,000 trained community distributors.
61. The 2008 UFAR Mission
Health Zone Health Population Villages
Name Centers
Kasongo 19 173,613 232
Kunda 22 193,955 279
Samba 9 90,293 121
Lusangi 14 128,573 165
Salamabila 13 109,048 191
Kabambare 10 76,256 134
Kampene 15 102,338 132
Pangi 14 67,333 97
Totals 116 941,409 1,351
62. 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
63. Riverblindness: Only the First Step
WHO-Proposed Additional Projects for UFAR
Integration 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)
64. 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
66. UFAR 2008 Mission Budget
Field Office Personnel
11,000 14,100 Capital
Personnel
Operations 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
67. 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
68. It has been said
that when faced with a great challenge,
you must do the thing that you think
you cannot do.
69. How to Contribute
By Check
Please make your tax-deductible donation
payable to UFAR
Send your check to:
UFAR
13 Carnation Place
Lawrenceville, NJ 08648
By Credit Card
Please visit the UFAR website:
http://www.riverblindness.org
70. When we join hands,
we can defeat this dreadful disease!
www.riverblindness.org