Page last updated at 09:04 GMT, Thursday, 18 June 2009 10:04 UK

Mass action beating river blindness

By Nik Wood
BBC News, Burkina Faso


Song of praise for African heroes

The Burkinabe village of Limanya is dancing, scores of children in bright yellow and blue T-shirts wave their hands and women with babes in arms sway to the music.

Even the elders are on their feet singing to the words: "Dance with me, shake your body and celebrate, Africa's unsung heroes."

The words come from a pair of giant speakers, blasting the song across this remote area of southern Burkina Faso, one of the world's poorest countries.

One day my own eyes started itching... then I noticed that my eyeballs had sunk into my forehead and I eventually went blind
"Pa" Dabire Dabouyir

On the microphone is Amity Meria, a singing star in Burkina Faso and the author of a song that aims to highlight the campaign to rid her country, and many others in Africa, of a debilitating disease.

Over a period spanning more than a decade, more than 600,000 community distributors have joined the campaign to eradicate the scourge of river blindness across sub-Saharan Africa, and drugs to prevent the disease have been distributed to over 54 million people.

The campaign is thought to be the world's largest mobilisation of medical volunteers.

"I love them, I really love them for what they have done for Africa," says Dr Uche Amazigo, referring to the volunteers who have taken part.

This is an Africa success story that may provide a method of combating other diseases such as malaria and HIV/Aids.

Senior medical officials from 12 African countries have just met to discuss the proposal of embedding this community-led approach into the curriculum for trainee doctors and nurses.

River blindness, or onchocerciasis, is caused by a parasite that is spread from human to human by the black fly, which once flourished along river beds where there is fast-flowing water.

Sunken eyeballs

Eighty-eight-year-old "Pa" Dabire Dabouyir, who lives close to Limanya, grew up with a father who was blind.

Uche Amazigo
We celebrate stars in the world, but the community volunteers are the real stars
Dr Uche Amazigo

He also contracted the disease as a young man.

"One day my own eyes started itching," he said.

"Then my whole body started itching. I went to the clinic and they gave me some drugs but then I noticed that my eyeballs had sunk into my forehead and I eventually went blind."

The flies were largely killed by a huge helicopter spraying programme in the 1970s but the parasite they spread can stay in the body for many years, so a continued course of drugs is required to prevent the condition.

Some 35 million people are currently infected with river blindness, and about 140 million people in Africa are at risk of infection.

Dr Amazigo is the director of the African Programme for Onchocerciasis Control (APOC), which was set up in 1995 to eliminate river blindness as a disease of public health importance in Africa.

There were two major challenges facing the programme.


River blindness can be prevented by taking the drug ivermectin, developed by the US company Merck.

But those hit by the disease tend to be the poorest in Africa and they simply could not afford to buy the treatment.

Then there was the sheer scale of distribution.

River blindness was affecting people in 30 different countries and was mostly found in remote areas, so a huge distribution network was required to ensure that people received the medication on a regular basis.

Unprecedented scale

Again, the funding was not there to pay for a medical project on that scale.

Soma Nestor

Initially it was difficult because some people refused the drugs
Community volunteer Soma Nestor

The decision was made to set up a network of community volunteers.

Villagers themselves would appoint a person they respect and trust to distribute ivermectin.

The project began to grow across the sub-Saharan region and when Merck announced that it was making ivermectin available free in Africa for as long as it took to eradicate onchocerciasis, the campaign began to score huge successes.

The volunteers are not paid. In return for their work they either receive food from the villages where they work or relief from community tasks in their own villages.

Soma Nestor is a community volunteer in Limanya, who remembers the early days of the community project.

"Initially it was difficult because some people refused the drugs, but now we have won their trust and we move house to house and some people even rush to us," he says.

"They know we are helping them and their children not to go blind."


The community approach is not new, but it has never been undertaken on this scale.

The fact that it may now be used to distribute other drugs to fight malaria or HIV/Aids - and to hand out bed nets that prevent people being bitten by insects carrying disease - is causing excitement in African medical circles.

"We celebrate stars in the world, but the community volunteers are the real stars for what they have done for their people and they should be recognised," says Dr Amazigo, as the sun goes down on Limanya and the singing continues.

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