By Michael Gwarisa in Gwanda
Approximately 48 Kilometres outside Gwanda town in Sifanjani Village, 68-year-old Reuben Sibanda sits amongst his fellow village men and women under a giant Baobab tree. They all listen attentively to the health worker educating them about Lymphatic Filariasis also known as Elephantiasis and why they should partake in the ongoing Mass Drug Administration (MDA) underway in Gwanda and Seven other districts across the country.
It’s an unusual sight under the big Baobab tree as men of all ages, who in most circles, are regarded as healthy unconscious or with poor health-seeking behaviour, have come in their numbers to get their doses.
The Mass Drug Administration program is being fronted by the Ministry of Health and Child Care (MoHCC), with technical and financial support from the Higherlife Foundation and the World Health Organization (WHO). The 10-day program is running from 16 to 28 September 2024, in Mutoko, Kariba, Centenary, Chiredzi, Gutu, Gwanda and Mhondoro.
After some time, a nurse clad in blue calls villagers to stand in the queue to get their height measured before they take the medications. The ongoing Mass Drug Administration program is also height-based. Sibanda wastes no time and takes the lead and gets his height measured before proceeding to the table where the tablets are being administered.
I have taken this medication because I want to protect myself from this disease that causes swelling of body parts,” says an elated Sibanda.
Lymphatic Filariasis is transmitted by mosquitoes of the anopheles and the culicine species. According to the Ministry of Health, the disease is prevalent in 39 of 63 districts in Zimbabwe. The current Mas Drug administration is implementing a Triple Therapy procedure where three drugs, Ivermectin, Alebendazole and Diethylcarbamazine (DEC) are being given to those above the age of five years. The use of triple therapy Albendazole, DEC and ivermectin can shorten the MDA rounds to only two or three.
Lymphatic Filariasis is one of the significant diseases that cause severe morbidity in terms in terms of disfigurement of the body. Someone with complications of Lymphatic Filariasis can present with what is known as Elephantiasis which can be swelling of the limbs and some can present with complications that can result in swelling of the genitalia. In men, it can cause a condition known as epididymo-orchitis or swelling of the Testicles.
“I am glad I have taken this medication and now I know I am protected from getting infected with the disease that I hear is highly likely to infect people from this area.”
The ongoing Mass Drug administration programs in the country target the eradication of lymphatic Filariasis and other NTDs including schistosomiasis (bilharzia) and soil-transmitted helminths (intestinal worms), across the country. Lymphatic Filariasis may also affect the male and female external genital organs.
Kwanele Tshuma, a 32-year-old woman from Garanyemba Village, Ward 13 applauded the move to bring the preventive chemotherapy to their doorstep.
“We heard this disease cases the swelling of feet as well as private organs. I think these tablets will help protect us from this disease. These tablets will protect us from infection,” she said.
A few weeks before the MDA national rollout, a team of village health workers embarked on an awareness campaign of Lypmatic Filiaris and the MDA which was on the way.
Sithobile Bhebhe, a Village Health Worker at Garanyemba Clinic said their efforts to mobilise villagers have paid off as evidenced by the huge turnout for the MDA exercise.
“We have been going door to door mobilising people and registering them. People appreciate this programme because they are afraid of the swelling of organs. In 2017 we experienced this outbreak so this is why they came out in numbers to get the tablets,” said Bhebhe.
She added that in Sibangani village where she operates, there are three village health workers and she works with 100 people and the other two Village Health workers have 56 and 60 respectively.
“We had been educated on lymphatic Filariasis,” she adds, “so we also went door to door sharing that information with the people. We told them about the symptoms and why it is important to get treatment.”
According to the World Health Organisation, Nematodes that cause Lymphatic Filariasis include Wuchereria Bancrofti which is the most common causative agent, Brugia Malayi and Brugia Timori.
Mobilisation of villagers under the ongoing Mass Drug Administration blitz is also using traditional and community leadership to cascade information easily.
Ward 13 Councillor, Maxwell Nldovu applauded the huge turnout from males which he says is usually a challenge.
“We welcome this program that has been brought to us to ensure that we are protected against this disease. We have heard that this disease causes pain and discomfort to the body and leads to swelling of body parts. Mobilising men is usually difficult however this time around, we told them of the risk they are exposed to which could lead to the swelling of their testicles hence you see all these men here,” said Councillor Ndlovu.
Meanwhile, the Higherlife Foundation initiated investment towards NTDs as early as 2012. Global NTDs data shows that about 1.7 Million people across the globe are affected by NTDs, with the African region being greatly affected, and Zimbabwe has not been spared. Zimbabwe is endemic to about 14 NTDs with one of the most prevalent being Lymphatic Filariasis.
Rebecca Mwabvu, the Head of the Global Health Program at Highlife Foundation said they have made a significant financial investment towards the Mass Drug Administration program and NTDs management in Zimbabwe.
“As we invest, we understand that as an organisation or as our key thrust, we want people to fulfil their God-given purposes and for them to do that, they need to be healthy. In terms of NTDs and elephantiasis, our organisation Higherlife Foundation and Delta Philanthropies is the major investor in this particular NTD working in partnership with our partner The End Fund,” said Mwabvu.
She added that there hasn’t been much attention towards NTDs for the past years but in terms of the nature of the diseases, if one person is affected, it may take them many years to realise that they infected by NTDs and by the time they do, it would have caused significant damage to their overall livelihood, general health and hampering productivity at work and even at school for children.
The MDA is targeting to achieve 90% coverage in all the selected districts. Data from the 2022 National Housing and Population Census shows that the population Gwanda has a population of approximately 170,000. However, excluding those who do not qualify for MDA, the program is targeting to reach around 150,000 people which is around 20,000 doses per day
Dr Nathan Chiboiwa, the Provincial Epidemiology and Diseases Control Officer for Matabeleland South said achieving a high coverage of around 90% will propel Zimbabwe to eliminate the diseases within the next three cycles.
“In the next three years, we should be repeating this program. We are pleased with the turnout of the people. So far, in terms of the past two days, we have achieved consistently above 15,000 daily dosing but this was mainly based on the urban set-up,” said Dr Chiboiwa.
He added that the greater population of Gwanda resides in the rural areas and they were glad that the turnout was huge and the 90% target was within reach.
Lymphatic Filariasis is targeted for elimination globally and also in Zimbabwe and produced in the country’s National Development Strategy (NDS1) and the National Health Strategy (NHS). Lymphatic Filiaris is caused by a parasite or worm that blocks the flow of fluid or lymphatic fluid in the body resulting in swelling of the body. In Mat South, only Gwanda South is implementing the MDA where medications are being administered to the target population aged 2 and above. It’s a whole population-based treatment using oral medications.
