Of the country’s population of 84 million, about 50 million are at risk of and need treatment for neglected tropical diseases (NTDs). But people on the ground have been working tirelessly to protect communities.
One of the NTDs Sightsavers treats in the DRC is lymphatic filariasis (LF), a leading cause of physical disability. The latest figures from the World Health Organization (WHO) suggest that there are 120 million people infected with LF worldwide, and in 2017 an estimated 42.6 million people in the DRC needed treatment for it.
Transmitted via mosquito bite, LF affects the lymphatic system and can cause painful disfigurement and swelling of various body parts. These debilitating symptoms can mean people are unable to work, and the associated stigma can have a devastating impact on those affected, as well as their families and communities.
Health workers in the DRC, supported by Sightsavers, have been treating LF since 2016 through the UK Aid Match Onchocerciasis and Lymphatic Filariasis Elimination programme. And although the programme ended in 2019, our work to eliminate and control these diseases continues under UK aid’s flagship NTD programme, Ascend.
Through the programme, the Ascend partners aim to reach more than 32 million people in the DRC and provide an estimated 5,500 surgeries for LF in three years.
Dr Diana Joana Kaningini (pictured above), from the DRC Ministry of Health, explains: “In our country we have extreme poverty and that comes with a lot of disease. That’s why we really need to eliminate NTDs like lymphatic filariasis… when people cannot work they go even deeper into poverty.”
Two patients benefiting from the programme are 23-year-old Edwina and 46-year-old Marie Claire (pictured above). Both work in fields and live with the painful symptoms of LF.
Edwina says: “I can’t work that hard anymore. When I am cultivating the land it is painful, too painful.”
Marie Claire has experienced the pain of LF for over 10 years, and the stigma that often comes with it: “People are rejecting me and criticising me. It breaks my heart that people are treating me this way. They even tell my husband to divorce me but he does not care.”
Lymphatic filariasis can be easily prevented with antibiotics, and although people suffering from advanced LF cannot be cured, their symptoms can be eased through practices of care to help manage the swelling. The challenge is reaching those who need treatment.
On top of extreme poverty, people living in remote regions of the DRC also face ongoing armed conflict and an Ebola outbreak. This causes many health workers to feel too unsafe to go into these regions and treat people. Thankfully, there are health workers who are determined to help join the fight against NTDs – like Lokoto, a nurse in the Katanga province.
“I became a health worker because I really want to help the population. I arrive here early in the morning and clean the clinic and arrange documents. Then I start to see patients,” Lokoto says.
When a patient is affected with swelling of the limbs, a symptom of LF known as lymphoedema, there are specific ways in which their symptoms can be relieved.
“When we treat patients, we need to explain to them what the problem is,” adds Lokoto. “It is an important aspect of treatment to teach people how to care for the swelling and ways to prevent them from further infection. We teach them some exercises and to sleep with the leg higher. We also teach them how to clean the leg to decrease the chance of infection.”
In men, lymphatic filariasis can cause painful scrotal swelling, known as hydrocele. As the swelling progresses it can also prevent those infected from being able to work and can lead to further stigma from society.
“I tried to hide my condition, but they could see it… I used to be a primary school teacher but the [swelling] became bigger until it was impossible for me to teach at all. I became ashamed and had to leave my job,” says Patrick, a hydrocele patient from the Katanga Province.
But hydrocele can be treated with a straightforward surgery that helps to relieve the pain.
Patrick underwent surgery and states that now he has no more pain. “I feel comfortable, I can even do hard work. If there are other people with this condition, they must follow my path. Don’t be afraid… I am hopeful to start again, that I can teach again and start over.”
Now that communities have been receiving treatment, there is hope, and people are more willing to come forward and be treated.
“The people are so happy for us to help them… [Before] people could not walk into the village but now people are walking everywhere after we treat them,” says Dr Diana.
“If we can eliminate this disease, we can all have a better life.”