Monday 6th November Part 1

Our first visit was to the onchocerciasis coordinator, Dr Koroma. The oncho (river blindness) programme in Sierra Leone
had been disrupted for 12 years due to the conflict. There had been some administrative problems in 2005, so 2006 is the first year for some time that there has been a distribution. The evidence gathered is that the disease has returned with a vengeance – if anything it is worse and more widespread than before the war.

The lesson here is clear – we must not be tempted to think that because river blindness has dropped to 0.8% of world blindness we can now stop supporting Mectizan® distribution. If we do this the scourge will return.

Treatment for river blindness relies on treating as many people as possible to stop transmission. It is not the case that someone who is treated is protected – they are only protected if the vast majority of the people nearby have been treated too. This is why we have issues around border areas – a village can be re-infected if we don’t treat the next village across the border.

Next year Sierra Leone will be combining river blindness and
lymphatic filariasis treatments. (confusingly in many places river blindness is referred to as ‘filaria’). This is the beginning of the major push by the World Health Organization (WHO) for the integration of treatments of a wide range of so called ‘neglected tropical diseases’ or NTDs. They are starting with lymphatic filariasis and river blindness as the drug treatments are closely related.

After the visit to Dr Koroma I met with the Country Office staff. What an incredibly warm welcome! I was very touched. We had a brief meeting to give me some of the history of the office, which had remained open all through the war. People had slept at the office on mattresses, in rat infested conditions. It really brought home to me how much some of our overseas staff are prepared to sacrifice for Sightsavers.