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Empower remote African villages to eliminate riverblindness

Our goal
Achieve and maintain recommended treatment coverage rates for control then elimination of onchocerciasis and other NTDs
The Challenge

Description of the 'Empower remote African village to eliminate riverblindness':

Imagine a child living in a village so remote he/she has no access to basic medical care, even communication with the outside world beyond the village is very difficult. Imagine many in the village are already blind and totally dependent upon children to assist with almost all of their daily needs for survival. Many adults in his/her family and other families in the village endure the constant misery of unrelenting itching , teary eyes, disfiguring, visual impairment and eventually blindness, all characteristic of onchocerciasis, also commonly known as Riverblindness. Children, 5 years of age or younger, not yet infected by the parasitic worm causing the disease that is transmitted through the bites of small blackflies living and breeding along rivers and creeks, they become fulltime caretakers for their blind adult relatives. With this consuming daily engagement, these children have no time left for schooling, making them doomed for illiteracy and perpetual poverty (Fig. 7). Once the children are old enough to start doing the types of daily chores adults do along infested rivers with onchocerciasis-carrying tiny blackflies, they will get the disease and without help, they also will eventually be blind. The life cycle of Onchocerca volvulus, the causative agent of riverblindness is provided (Fig. 7a), showing the ocular and skin manifestations in humans (definitive host), and the black fly (intermediate host).

Do you know that with your help, this village can be protected from this ravaging disease for one year?

Yes, you can do it right now. For every minimum donation of $250, an average village of 500 people, given a single annual dose of Mectizan provided free by its manufacturer, will have the devastating skin manifestations of this disease eliminated or significantly reduced, progression of the disease toward vision impairment or blindness will stop, and transmission of the disease - either getting the disease from someone or giving the disease to someone else through the bites of the backfly will be prevented. That is at the cost of 50 cents per person.

Leveraging Johnson & Johnson's CaringCrowd matching program, you can spare 2 such villages for one year with a single $250 donation.

The "Empower remote African villages to eliminate riverblindness" project provides a wonderful opportunity to interested and caring individuals or organizations to participate and contribute to the ultimate goal of eliminating onchocerciasis as major public health and socio-economic problem in the Democratic Republic of Congo (DRC). A minimum donation of $250 is sufficient to provide needed assistance to an average village of 500 people among over 5,000 onchocerciasis-endemic villages included in the regions of the DRC served by UFAR and its partners. This level of donation is sufficient to 1) ensure proper and adequate training and retraining of community workers (CWs) assigned to the village, one CW for every 100 villagers, 2) provide CWs with motivational incentives, i.e. t-shirts (Fig. 8), hats, buttons and certificates expressing sincere appreciation and gratitude of job well done, 3) provide village chief with a token of appreciation for his/her support and commitment, e.g. UFAR 'gold' medal depicting a blind adult being led by a child (Fig.9), and 4) equip CWs with a practical local means of transportation to facilitate mass drug distribution in their community (Fig. 10).

You matter more than you know

Make a Difference. Empower, Help people in DRC villages appropriate the riverblindness elimination project as their own to the finish line.

Riverblindness: A Terrible Neglected Disease is not only preventable, it is on its way to Elimination.

For the Democratic Republic of Congo (DRC) with a population of approximately 70 million people, 27 million are at risk of getting riverblindness, 13 million are infected and 70,000 are blind from the disease. The infection rates in endemic regions range from 20% to over 90%. In 1998, a team from the World Health Organization (WHO) was taken by a small airplane to Ebango Bango, a remote village located in the Sankuru province of DRC where it was determined that over 90% of the inhabitants were blind from this terrible disease.

The good news is that Mectizan, the only effective and safe drug approved for riverblindness and is administered as a single annual oral dose on a community-based mass treatment setting, can indeed interrupt transmission of the parasite and achieve elimination of the disease. Administered for 10 consecutive years in endemic areas with recommended treatment coverage rates and the disease can be eliminated. The drug is free from its manufacturer who has pledged to continue providing it free as long as it's needed for worldwide elimination of riverblindness.

The major hurdle to overcome is to ensure the distribution of the drug to the millions of people who need it, the majority of them living in remote villages poorly accessible or inaccessible by motor vehicles, and to achieve and maintain recommended treatment rates for therapeutic and geographic coverage of 80% and 100%, respectively.

Community Distributors/Community Workers: The high efficacy and safety profiles of Mectizan and its convenience for a single annual oral dose regimen make it well suited for large-scale mass distribution programs in remote communities by selected individuals in rural communities trained and empowered to play a major role in managing their own health and well-being.

Community workers (CWs) or community drug distributors (CDDs) are the backbones of the community-directed and community-based strategy for mass distribution of Mectizan for onchocerciasis and of several other drugs for other neglected tropical diseases (NTDs), including lymphatic filariasis (LF), schistosomiasis (SCT), soil-transmitted helminths (STH) and trachoma (T). They are selected from within their community to lead the annual drug distribution campaign for the benefice of the community. Traditionally, CWs work as unpaid volunteers, receiving only small compensations from the people they serve. The increasing presence in recent years of other public health programs such as those for HIV/AIDS and malaria that provide relatively large incentives to their community workers has resulted in some instances in significant attritions among onchocerciasis CWs for the attractive high paying or rewarding jobs. The new "Empower remote African villages to eliminate riverblindness" approach was conceived as a way of reducing the attrition rates among our volunteers as well as to help the country and communities play a leadership role and appropriate the project as their own, for the goodness of the community.

Benefits to Donors: Deep-seated satisfaction and gratification for contributing to the success of a very worthy project. A certificate for acknowledgement and appreciation for the donation (Fig. 14), a photo of the village chief (Fig. 15) and/or a GPS-based map showing the location of the village (Fig. 16) are the usual small tokens offered to the donors.

Benefits to Communities: Improved treatment coverage achieved by well-trained CWs, ensures attaining a healthier community, improves the well-being of the population, and ensures progress toward disease elimination. The appropriation by CWs and community leaders of the disease elimination goals and efforts as their own would make the program more sustainable.