Wednesday 8th November

We drove out to Moyamba to visit a village in an area where river blindness was prevalent. Almost all the rivers in Sierra Leone are infested with the black fly, and it is very noticeable that there are no villages anywhere near the river banks. When driving over the rivers, somehow the beauty of the landscape took on a sinister hue, when you realise the menace associated with the waters.

The last part of the journey was undertaken by canoe, and we were welcomed by drums and singing. We went into the local schoolroom for a village meeting, to discuss concerns that the people had. The first three rows of the audience were mainly blind from river blindness, and I was shocked at how young some of them were (women in their twenties). However it was gratifying to learn that everyone knew about Mectizan®. People wanted to know why we couldn’t spray to get rid of the fly – the biting still caused great irritation. They also wanted to know what to do about a nearby village where a number of people were refusing to take the medication, as they understood the need for full community coverage. The biggest issue, as in most places we went, was that the volunteers (CDDs) wanted to be paid - but we explained that given the scale of the distribution, this was unaffordable by the government (or Sightsavers), and that it was the responsibility of the community to show gratitude in other ways. This will become a much bigger issue with the integration of Neglected Tropical Diseases.

River blindness seems a strange disease – at this village there were many blind people, yet we visited others equally near a river infested with river blindness where there were hardly any.