Millions of adults and children are affected by parasitic infections that, if left untreated, can cause long-term disability and blindness.
Onchocerciasis, also known as river blindness, is transmitted via the bite of infected black flies and can cause severe skin disease, visual impairments and blindness. Lymphatic filariasis is transmitted via mosquito bite, leading to painful disability and disfigurement. The associated stigma can have a devastating impact on the affected, their families and their communities.
The infections that cause both these diseases can be treated with medication. But how does this life-saving treatment reach the people who need it?
Much of the work relies on volunteers known as community directed distributors (CDDs): members of the local community who are trained to give out medication and gather data.
Ajuna Socia, aged 33, lives in the Bunyoro region in western Uganda, and has been volunteering as a community distributor for the past five years. “I wanted to help people because they were dying – I want to save my community and give them medicine. The work is important because we have saved so many lives. Some people couldn’t go to the hospital and were dying because of ignorance. So it’s easier if we take the medicine to them.”
Ajuna is one of the volunteers taking part in Sightsavers’ mass drug administration project in the Bunyoro region. Ahead of the latest distribution run she attended a training session at the Kibwoona health centre in Masindi to refresh her skills, alongside a group of 30 other volunteers. They learned about collecting data, determining drug doses for adults and children, and how to correctly administer the medication.
“The training helps me – I’ve gained so much knowledge and experience,” says Ajuna. “I used to be shy, but now I can talk to the community and teach them. I was chosen to do this because I’m good with people – I was polite, I was faithful to the community and they trust me.”
Most of the distributors work in teams: there are seven volunteers in Ajuna’s village who distribute medication, measuring people’s height to determine the correct dose and recording the results in the data register. They also venture out alone into the field to visit more remote communities. Their work is funded by the UK government’s Department for International Development as part of its UK Aid Match programme, which matched donations made by the UK public to Sightsavers in 2015.
“Once we give them the medicine, the sickness goes,” explains Ajuna. “Those who had skin rashes tell us they no longer have problems. They say they had sight problems before, but now they see well.”
Drug distribution takes place each year during April and October, and the volunteers only work during those two months. Ajuna says she prefers to work in the evenings, because that’s when most people are at home, leaving her free during the day to take care of her three children. But the work isn’t always easy.
“During the rainy season, it’s challenging,” she explains. “Sometimes people aren’t at home and you have to go back to the same house four times so your medicine isn’t wasted – they must take it when you’re there. Sometimes we work when the sun is strong. Sometimes the houses are far and we have to walk.
“Some people ask you so many questions and you have to repeat information for them. Some people think we get a salary from this work, but we don’t.”
Despite the difficulties, Ajuna is aware of the importance of her work, not only in distributing these life-saving drugs, but also in raising awareness about the diseases among local communities.