Suleiman Salum’s profession is described in this way. Suleiman Salum lives in Tasini Village in Pemba on Zanzibar Island, off the coast Tanzania. He is a farmer, but he also sells scrap.
Schistosomiasis is a parasitic flatworm-borne disease. People who are in poverty or have low access to basic services and contaminated water can be affected.
SCH can be a very painful and unpleasing disease. Children are kept out of school, and adults from working. It can lead to anemia, fatigue, and weakness.
Suleiman describes his first encounter with the disease.
Suleiman and his son Said. Image by: Unlimited Health/William Mgobelo
“I felt a bit uncomfortable while passing urine. The urine was thick, and I felt pain. I was in pain, and the color of my urine was different. I decided to go to the hospital. I was diagnosed with schistosomiasis and given medicine immediately.
Recently, I discovered that my children were experiencing the same problems.
When I returned at 7 pm, my son told me: “I have pain when I use the toilet. The urine is bloody.” [My son] also reported the same. The next morning, I took them both to the hospital. “They found out that they had the disease.”
Suleiman’s son, Said, shares his experience with schistosomiasis.
I started to feel pain and discomfort. I stopped going to my favorite lake because I didn’t feel well. I was asked to take a small container to the bathroom to collect urine samples. After the test, I was diagnosed with schistosomiasis. “I was then given medication to treat schistosomiasis, and also worms.”
Praziquantel, the treatment recommended for SCH, has mild side effects like most other medicines.
Abdallah Mbarouk Saleh, Clinical Officer. Image by: Unlimited Health/William Mgobelo
Some people indeed have problems with medication, even if they are sick, and this is especially true for children. We make parents aware of the symptoms of the disease, and we give them advice on how to administer the medication to their children,” said Abdallah Mbarouk Salesh, Clinical Officer at Tundauwa Health Centre, Pemba, Zanzibar.
As confirmed by Suleiman, there is a specific protocol to administer the drug in order to minimize any side effects.
After the test was confirmed, the children’s height was measured, and drugs were administered based on their height. They asked me if the children had eaten. They asked me if the kids had eaten. It was suggested that I feed them before giving them the drug.
I decided to give the pills to them as they went to bed after work. To make it easier for them to swallow, I broke the tablets up into smaller pieces. I checked that they were taken as prescribed by the doctor. “I did the same with the [other] anti worm drugs.”
Image by: Unlimited Health/William Mgobelo. Photo by: Unlimited Health/William Mgobelo
Unlimited Health collaborates with the Ministry of Health in Zanzibar (MoH) to eradicate parasitic diseases such as SCH so that people like Suleiman and his family can live a life free of disease.
We provide support by ensuring medicines are delivered to those in need and measuring coverage. We will also work with the MoH to refine the strategy of treating patients and to ensure that resources are targeted most effectively to those at risk.
The goal of any treatment is to save lives and prevent others from becoming infected. This will allow us to avoid further effects from this [schistosomiasis]. This is a very important thing, and it helps our communities. We need to educate people on their health as health experts and encourage those who are infected to seek treatment outside their homes.
Said is glad he’s healthy and able to play soccer. Image by: Unlimited Health/William Mgobelo
Said is happy to be able to play football again.
“I was playing games before the treatment, but I felt uncomfortable. I was very unhappy. “But now I’m happy and can continue to play games.”
His father says: “When my children are healthy, I can continue to run my business.” “When they’re sick, I’m stuck.”
Buwaiswa Lake with children swimming. Image by: Unlimit Health/Malaika Media
Unlimited Health, in collaboration with the Uganda Ministry of Health (RANAS Ltd), conducted a Pilot Project last year in Buwaiswa as well as in other nearby communities in order to identify community-specific reasons for schistosomiasis.
The results of the study will be used for the implementation of community-driven solutions as well as the provision and improvement in water and sanitation in six communities initially, with the aim to expand the program in the future.
Mobilising support for a new treatment option for Schistosomiasis
Recently, I traveled to Nairobi, Kenya, to support the Ministry of Health in its efforts to launch a social mobilization and advocacy strategy to roll out the new pediatric treatment options when approved. The activities began with a 2-day kick-off session, which was led by the Division of Vector-Borne and Neglected Tropical Diseases in the Ministry of Health. Other key partners, including research institutions such as the African Institute for Health and Development and Kenya Medical Research Institute, as well as county representatives, were also present.
Community perceptions of treatment for children
The workshop was a fascinating discussion about existing community perceptions and how social mobilization strategies for preschool-age children are currently working. It also explored what barriers can be encountered in the uptake of a potential new treatment.
The community trusts its health workers but still has reservations, especially with regard to side effects. This is based on the experiences of mass drug administration programs for schistosomiasis among school-age kids. If successfully engaged, communities and religious leaders are powerful allies. However, other health campaigns have faced serious challenges because they failed to engage key community groups effectively.
Rumors, misinformation, and barriers to treatment
Rumors that injections or medicines are being used to secretly sterilize kids or that a certain disease is the result of witchcraft have caused great damage to other health campaigns. Misinformation can undermine the success of a program if it is spread.
It is, therefore, important to tread carefully and thoughtfully. We understand that treating infants, toddlers, and children is a sensitive subject, and the introduction of a new medicine can cause some concerns.
The PPC is also committed to reducing the impact of the disease, as we know that babies and toddlers will suffer if they are not treated. It’s important to reach a common understanding with the community and caregivers for children aged six and below about the importance of a potential new treatment.
The social mobilization of the population is an important element in implementing health programs.
I believe that social mobilization is an important part of the implementation, even though it may be often overlooked. The PPC vision of reducing the global burden of Schistosomiasis is difficult to achieve if the perceptions and concerns of communities are ignored.
So, what’s next? What’s next? Once registered, this information will be used for future delivery of and access to potential new treatment options in affected communities.