August 29, 2014

Field Notes: Burundi & the END to Neglected Tropical Diseases

Last week, I headed to Burundi with Jessica Dimmock on a project for The END Fund to look at  neglected tropical diseases (NTDs). With the threat of airport closures and quarantines due to Ebola, we made our way to Bujumbura without delays or setbacks. One of our greatest concerns was being stranded on our return through Nairobi, where Korean Airlines had already cancelled all flights as a health precaution.

While ebola was stealing the headlines, we were on a mission to document diseases that take hundreds of thousands of lives each year throughout the developing world. Neglected tropical diseases are diseases of poverty. They are preventable and curable with access to clean water and medicine. Seven years ago, The END Fund decided to make Burundi a case study for the best possible practices in public health. Their approach is to harnesses private capital to make sure that medicines donated by pharmaceutical companies actually reach the people who need them most. From there, they partner with local governments and other NGOs to take a comprehensive strategy to eliminate NTDs.

Burundi, the fifth poorest country in the world, struggles with an epidemic of parasitic diseases. During our visit, we documented a mass drug administration, where hundreds of school children received medicine for schistosomiasis and intestinal worms. We also filmed locals washing clothes, collecting water and bathing in rivers infested with parasites because there were no clean sources of water. One woman defiantly filled a jug with filthy water in front of our cameras, and then raised the jug to her lips to guzzle. She then returned home where a small child took several gulps from the same jug. She was well aware of the health hazard, but she wanted to demonstrate the reality of having no access to clean water.

While the challenges in Burundi seem insurmountable, the impact of education and treatment were evident everywhere we visited. In villages plagued by poverty, we witnessed mothers insisting their children wash their hands with soap before eating. We heard stories of children who died before the widespread availability of drugs since 2007. Through the efforts of the The END Fund, trachoma levels have been reduced by 90% in Burundi, and schistosomiasis and intestinal worms have been brought under control so they don't have to be fatal.

In a country with virtually no tourism and limited natural resources, Burundi is generally off the international radar. Wherever Jessica and I went, we created a stir. Other than NGO workers, we appeared to be the only foreigners for miles. The Ministry of Health had provided us with a police escort throughout our stay, not because our lives were in danger, but because we attracted such big crowds it made it difficult to work. The police proved to be incredibly helpful at dispersing crowds and keeping the children quiet.

Despite our crash course on NTDs,  the day before our departure Jessica and I were seduced by the waters of Lake Tanganyika. We should have been wary given all we had witnessed, but after five intense days of shooting, we decided to take our chances and hazard the water for a refreshing swim. Portions of Lake Tanganyika carry the parasite that causes schistosomiasis, but we were assured that if we contracted the disease, the medication is safe and effective....we double checked before taking the plunge. Our colleagues from The END Fund, on the other hand, opted to sit on the shore and watch from a safe distance. Hopefully, we won't regret the impulse.