Instead, he uses his skills to spread information about drug distribution and medical aid, as part of an ongoing battle to stamp out debilitating diseases.
We first meet Robert as he’s preparing to host a discussion show to publicise an upcoming mass drug administration (MDA) project, which will distribute vital preventative medication to communities in Uganda’s Bunyoro region. This is one of the key methods used to control neglected tropical diseases (NTDs), which affect more than a billion people worldwide.
Two NTDs in particular are currently being targeted in Uganda. Onchocerciasis, also known as river blindness, is spread by the bite of infected black flies and can cause visual impairments, skin disease and blindness. Lymphatic filariasis is a parasitic disease transmitted via mosquito bite that causes painful disability and disfigurement, often characterised by the abnormal enlargement of body parts. The associated stigma of both diseases can have a devastating impact on those affected, as well as their families and communities.
These diseases can be controlled using medication: communities in at-risk areas must be given several doses over the course of a number of years, and the entire community must be treated. Yet in remote areas, it can be tricky to spread the word about forthcoming drug distribution programmes and raise awareness about the importance of taking the medication.
This is where radio comes in. Today, is Robert welcoming three guests into his studio: district health officer Patrick Baguma, Ugandan Secretary of Health Titus Ariyo, and district onchocerciasis co-ordinator William Mugayo. They will discuss the signs and symptoms of river blindness, explaining how mass drug administration can help to eliminate the disease, before inviting listeners to submit questions that they will answer on the air.
“There’s about a 70 per cent level of awareness in communities of these diseases and treatments,” explains William. “Radio creates awareness. It allows people to ask questions, and it spreads awareness among a bigger group of people. Most families have a radio set and listen to programmes – we do our shows at peak times, such as 8pm, when most families are at home and listening.”
Yet it’s not as straightforward as simply reading a pre-prepared script. The radio content must be carefully tailored for the audience, taking into account the wide cultural diversity of the listeners.
“The main challenge is that Masindi is a multi-ethnic district, and we have people settling here from outside areas such as Sudan, Kenya and the Congo,” says William. In an attempt to overcome this, the radio messages are broadcast in four languages to reach as wide an audience as possible. This is particularly important for newcomers to the region, such as Sudanese refugees – while long-term residents are usually familiar with the drug distribution programmes, newcomers are often unaware of their importance.
“Radio is similar to community meetings,” explains Ugandan health secretary Titus Ariyo. “The Sudanese speak English, so radio can help to bridge the communication gap. It also helps to sensitise them about the programme.”
Mr Ariyo says radio is a cost-effective way to spread health messages because it avoids having to send teams out into the field, and its influence on local communities is invaluable. “People trust the messages because they believe it’s a reliable source, not from a third party,” he explains. “This is because we represent those communities and they bring us in as community representatives.”
“For rural communities the information coming from a radio station is taken as a true message,” adds William. “The district health officer and secretary of health are important people in the community, so their message is trusted. Some people can’t read or interpret advertising pictures, but when people listen to the radio there is a sense of understanding.”
The approach seems to be working: it’s 14 years since Uganda started using mass drug administration to distribute medication, and the campaigns have now become an annual activity in the community. People are aware of the importance of taking the medication, and the risks they face if they don’t. As a result, incidences of disease have fallen, and residents are no longer fleeing from areas where NTDs were once rife.
“Before, civil servants and teachers would not go to these areas,” explains William. “There was wasted land and a suffering and diseased community. But the mass drug administration has reduced morbidity from onchocerciasis. People are no longer running away and land is now occupied. People are growing food and income levels have increased.
“Since the programme started, there have been improvements in education and literacy. People are now growing sugar cane and forming cooperatives and saving-and-loan groups. There have been improvements in social service delivery, health, education, water and sanitation.”
Thanks to drug distribution, river blindness has already been eliminated from 15 of Uganda’s 17 districts. The goal is to continue until it is eliminated completely. This, explains William, will mean people won’t need to spend so much money on medication, enabling them to feel more empowered and less reliant on healthcare. “There would be a more productive community,” he says. “There would be improvements in social life, and less poverty.”
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