Bill & Melinda Gates Foundation

From Neglect to Care

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January 29, 2014

Traveling and working in some of the poorest areas of the world allows for a greater understanding of why more than one billion people are at risk from neglected tropical diseases such as soil-transmitted helminthes (STH). Resources that prevent infection by intestinal worms like proper sanitation facilities, clean water and even soap are scarce. Often, families can’t afford shoes for their children – which can stop worms from entering the body. Many households do not have running water so it isn’t possible to turn on a faucet to wash hands.

Equally important, too few families understand the basic facts of how infection occurs or how to prevent it.  This was the story of Neang, a fifth grader at Oporn Primary School in a rural area outside Phnom Penh, Cambodia. Her teacher saw the telltale signs of STH infection. “She was very skinny, tired and had a big belly from worm infection,” she told Helen Keller International.

 Often, families can’t afford shoes for their children – which can stop worms from entering the body. Many households do not have running water so it isn’t possible to turn on a faucet to wash hands.STH rarely kills, but infection and reinfection was taking its toll on Neang’s body. She was undernourished and lethargic. Without energy and nutrients, she wasn’t able to focus in school. Without care, there was a good chance her growth would be stunted, she wouldn’t develop to realize her full potential or be able to earn a good income as an adult. This would perpetuate an endless cycle of poverty.

A long-standing partnership between Johnson & Johnson, Helen Keller International and the Cambodian government paved the way for Neang to begin to thrive. At school, Neang received deworming medicine, and learned how to prevent infection in the future. Teachers emphasized the importance of washing her hands before eating, drinking water only after it had been boiled, and wearing shoes when walking or playing outdoors. Neang learned how using sanitation facilities would stop the worms from spreading to other people, and that by taking medicine twice a year and practicing preventative measures, she could stop the cycle of reinfection.

One year after Neang participated in this life-changing program, she is healthy and energetic – with a brighter future ahead of her. How is she helping break the cycle of infection in her community? She told Helen Keller International that she shares the leaflets she gets with her parents and relatives so they can learn about STH and how to prevent it. “And I make sure I take my medicine when the school distributes it,” she said.

In a survey with students in Cambodia before they had been treated and received the STH prevention education at school, just 28 percent of students in grades four to six knew about STH, its causes and ways to prevent it. By the end of the project, all of these students could demonstrate some knowledge of STH. Most of them knew to wear shoes outdoors (95 percent), and to wash hands with soap before eating (90 percent). And almost all of them reported that they went home and shared this information with their families and in the community.

By pooling our expertise and resources to implement comprehensive treatment and education programs, we can change behaviors that improve health.These numbers are a sign of things to come. They show us that by pooling our expertise and resources to implement comprehensive treatment and education programs, we can change behaviors that improve health.

Two years ago this week, leaders from across the public and private sectors came together to endorse the London Declaration on Neglected Tropical Diseases, joining hands to pool their knowledge and resources to protect children and families around the world from 10 neglected tropical diseases, including STH. They were motivated by the fact that these diseases had been underestimated and under-funded for far too long.

Today, with new research and medicines in the pipeline thanks to the Declaration, the international health community is coming together to set forth metrics that will measure progress and ensure that medicines are reaching children in need. And galvanized by the Declaration, new partners are coming forward to lend their expertise to expand access to water, sanitation and hygiene education – all of which could lead to the elimination of these diseases as global public health problems.

Neang is showing us what’s possible when you understand the facts. When families have access to medicine, and to the care and knowledge needed to prevent infection and improve their family’s health and nutrition, everyone has a chance at a healthier and more productive tomorrow.

 
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