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Successful combined approach for leprosy and (LF) control in Mozambique

16 August 2016

women washing their hands selfcare in Mozambiquemen at health centre in Mozambique
Photography: NLR

In April 2015 NLR started, in close cooperation with Lepra and the local government, an innovative project in Zambezia province where support to persons affected by leprosy and Lymphatic Filariasis (LF) is combined. The project is implemented in four districts: Ile, Gile, Lugela and Pebane. Training of key health staff, hydrocele operations, support to Self-​Care Groups (SCGs) and the involvement of Disabled Persons Organisations (DPOs) staff and community leaders are elements contributing to the success of this project. We have made significant achievements:

  • baseline survey carried out
  • 419 hydrocele surgeries
  • 30 persons provided with assistive devices
  • 400 special shoes, 400 basins provided to SCGs
  • training materials developed and used for training to 240 community volunteers
  • skin app for diagnoses of common skin diseases developed
  • 27 and 20 DPO members key health staff trained on combined approach
  • 1,000 in 48 SCGs supported
  • 110 radio messages broadcasted
  • 173 awareness raising sessions hold
  • 60 schools (600 teachers, 16.000 children) trained on body mapping
  • 111 community leaders trained

Fernando’s (55) story

Lymphatic filariasis can result in an altered lymphatic system and the abnormal enlargement of body parts, like hydrocele (scrotal swelling). Such body deformities lead to social stigma, as well as financial hardship from loss of income. The socioeconomic burdens of isolation and poverty are immense.

Fernando: ‘I saw my life falling in pieces since I had hydrocele 4 years ago. People didn’t want to talk with me anymore and consequently my business started facing problems. I was afraid that my wife would abandon me due to my health status and because I was hopeless about my situation. The drama changed since I was one of the beneficiaries to undergo surgery in October 2015. I saw my problem being solved in a miraculous way. At first I was afraid of going to surgery but I was encouraged to do so as I felt that I had nothing to lose. I thank the project for giving me the opportunity that I feel reborn. I plead to other people that when you get the chance to go for surgery, go without fear.’

The impact of the 10 minute surgery is proportionate to the level of stigma and discomfort caused by disfigurement. When affected men cannot walk, sit, stand or have sexual intercourse, the condition affects not only the sexual health of men but also threatens their family life and livelihoods. Surgery is a simple solution which has the potential to completely reverse health problems and the negative economic and social consequences.

Fernando Namapalo together with his family and friendsTwo men hydrocele operated

Fernando Namapalo together with his family and friends /​Two men who underwent a hydrocele surgery

Lessons learnt

Lessons learnt during the first year of the project are numerous:

  • The impact of the project has increased a lot due to the combination of support to persons affected by leprosy and LF. A large number of people can be reached because of this approach.
  • Combining persons with different disabilities, leprosy and LF in SCGs has created social care for each other and contact between these different groups which did not exist before.
  • The project is not only benefiting the four districts this project is targeting: the combined approach is also applied in the other 18 districts in Zambezia through the involvement of the local government.
  • Working with DPOs is a sustainable way of working since they are well rooted in the society. When DPOs have their own role in the project it increases their capacity and self-​esteem and helps them to reach their own goals.

A view to the future

As the combined approach leprosy-​LF proved to be successful in Zambezia province, in 2016 this approach is also being applied in the other two provinces where NLR is working, Nampula and Niassa.

Total elimination of lymphatic filariasis in 2020

NLR and its partner Lepra will strive to realize the goal of the World Health Organization’s Global Program to Eliminate Lymphatic Filariasis: total elimination of elephantiasis by 2020.

Since the start of the program in 2000, over 820 million people in 64 countries were helped with 6.2 billion preventive treatments so that the disease could not spread further. In addition, infected patients were supported with medicines and help to stop further suffering and disease development. Seven countries have now been declared free of Lymphatic Filariasis: Cambodia, the Cooke Islands, Maldives, Niue, Sri Lanka, Vanuatu and Togo.

Source: World’s Best News

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