Beyond Mass Treatment

IMO's pursuit of health has manifested itself in Burundi, most recently in our fight against intestinal parasites in the rural hillside community in Bubanza that we have come to embrace.

Intestinal parasites are a major global issue. According to the World Health Organization (WHO), approximately two billion people worldwide are infected with intestinal parasites. Nearly 900 million pre-school and primary school age children live in areas where these parasites are intensively transmitted and are in need of treatment and preventive interventions.

In January of this year we performed our own testing within Bubanza to establish a baseline of information from which to plan our medical strategy and gauge its success. This Rapid Appraisal involved testing randomly selected primary school-aged children for intestinal parasites, anemia, malaria, and height-for-age and weight-for-age. The results, though alarming, were anticipated: nearly 65% tested positive for intestinal parasites, just shy of 90% were anemic, almost 35% had malaria, and on average these children were dramatically below the threshold of height and weight set by WHO.

Even more alarming than the results themselves, however, is that these same children received anthelmintic medication as part of the national anti-parasite program barely one month before our testing took place. This type of intervention – mass drug administration two or three times a year – falls in line with the current WHO recommendations towards control of intestinal parasites, but if two-thirds of the children have intestinal parasites a month after being treated for them, treatment alone is obviously not enough.

We have the unique opportunity here to go beyond mass repetitive treatment and have established the goal to do so. Our strategy is threefold:

  • Treatment of current infections with Albendazole together with vitamin A
  • Immediate prevention of (re)infection by providing each child registered in school with a pair of new, specifically-sized shoes
  • Sustained prevention of (re)infection by introducing and fostering behavioral changes through health education and instruction

This past week saw the launch of IMO's on-the-ground action towards reaching this goal in Bubanza. We started by hosting a meeting with the parents of the children registered in the hillside community's two schools. We shared the results of the testing specific to their children, we described the lifecycle of intestinal parasites and how they hinder health, and we spoke at length about the solution to this problem, including the power and ability that they themselves have to impact their health and the health of their children. The dialogue flowed both ways as the parents shared their realities of life, allowing us to turn our expertise into practical knowledge.

Saturday morning parent meeting.

Each of the 470 children in the two schools received the anthelmintic Albendazole along with vitamin A, were fitted for their new pair of shoes, and engaged in an introductory health and personal hygiene lesson. Every child also went home with a bar of soap, a hand towel, a bottle of water, and the awareness of each item’s significance.

Teaching about germs.

Teaching about the life cycle of  intestinal parasites, which includes open defecation.

Demonstrating and practicing proper hand washing technique.

Students receiving their fitted pair of shoes.

Students washing their feet before donning their new shoes.

Not only do the parents here have the desire and determination to see their children healthy, they now have the means and know-how to make it happen.