In the span of less than a week, an estimated 3,239,000 school-aged children across the country were treated for intestinal worms and more than 90,000 children were treated for schistosomiasis. “When a child is ill, he/she misses school. To look after that child, one parent will have to skip work. This is a small example of how important it is to have a healthy population. As a result, we have devoted an entire week to treat mothers and children for some of the most prevalent diseases so that they are healthy enough to have a better future”, said Dr. Fidel Ngabo, Coordinator of Maternal and Child Health Task Force, Ministry of Health.

This Herculean effort to combat two of the most prevalent and harmful parasitic infections in Rwanda was the second campaign led by the Ministry of Health in collaboration with Columbia University’s Access Project and other partners.  Taking place at 1,998 sites across the country from March 24-27, 2009, the campaign was a component of the Rwandan Ministry of Health’s Mother and Child Health Week.

Nationwide surveys conducted by the Ministry of Health through TRAC Plus and the Access Project in 2007-2008 revealed that intestinal worm infections, also known as soil-transmitted helminths (STH), have an overall prevalence of 66% among children between the ages of 10 to 16 years in Rwanda. Survey results also found an overall prevalence rate of 2.7% for schistosomiasis, with prevalence reaching 70% among children living in close proximity to lakes Burera, Ruhondo and Muhazi. and surrounding swamps.  If left untreated, STH and schistosomiasis can have devastating impacts, including stunted physical and mental development; liver, intestinal and bladder damage; chronic fatigue; anemia, and – in some cases – death.  “Children are often absent from school because they don’t feel well. Some have stunted growth especially those under 10 years and often appear weak. Sometimes, even when they are in school, they can’t pay attention and have difficulty concentrating and learning”, said Consolata Nduwamariya, head teacher at Remera Primary School in Musanze District.

STH and schistosomiasis are the most common parasitic infections worldwide, causing sickness in close to one billion people.  Despite their high prevalence, these diseases had been largely ignored by the international community until a few years ago.  They are now among the ailments now referred to as “neglected tropical diseases.” Almost all cases occur in the poorest and most vulnerable members of society. These infectionsy keep people – and entire countries – from reaching their full potential.  Tommy Thompson, the former U.S. Health and Human Services Secretary and Global Ambassador of the Global Network for Neglected Tropical Diseases, emphasized the importance of prevention and treatment when he said: “To have a better future and participate in the development of your country, you have to be in good health.” The improvements in intellectual development and cognition that follow treatment of STH and schistosomiasis have been shown to have a substantial impact on income levels later in life.  In fact, in Japan, successful de-worming programs in the 1950s are considered one reason for the country’s subsequent economic boom.

The cost of STH and schistosomiasis treatment is low – estimated at less than 50 cents (US) per person per year for drug procurement and distribution.  This low investment and high return has led the international donor community to label the treatment of neglected tropical diseases such as STH and schistosomiasis a “best buy” in public health. The administration of drugs and education to more than three million school aged children in Rwanda last month required a relatively small financial investment.  The positive impact, however, will be significant and endure for years to come.  With continued focus and attention on preventing and treating these devastating infections, an entire generation can grow up smarter and stronger. “De-worming so many children is very beneficial to the country’s development because Rwanda’s future lies in their hands,” said Bosenibamwe Aimé, Governor of the Northern Province.

Information on the NTD Control Program: The twice-yearly Mass Drug Administration campaign is the Access Project’s largest intervention in its NTD Control Program.  The Access Project, in partnership with Rwanda’s Ministry of Health, began the NTD Control Program in 2007.  In addition to de-worming campaigns, the NTD Control Program includes epidemiological and operational research, training of school teachers, community health workers, journalists and local district authorities, and behavior change communications in the communities, schools and health centers. Funding for the NTD Control Program is provided by Geneva Global Inc. through the Global Network for Neglected Tropical Diseases.

Information on the Access Project: Columbia University’s Access Project improves the health of impoverished people, communities and countries. In Rwanda, it does this by applying business and management skills to community health centers to increase the quality of critical health services.  The Access Project works in 79 health centers in six districts of Rwanda and is currently building two health centers in the Bugesera district. 

For more information on neglected tropical diseases, please contact
• Dr. Jackson SEBEZA, TRAC Plus/EID Unit Acting Director; +250788306093 or sebeza@yahoo.com
• Dr. Denise MUPFASONI, NTD Program Coordinator: +250788305957 or denisem@theaccessproject.com or visit our website: www.theaccessproject.com.