Assisting a marginalized community to lead a better life: 25 years of work in Gedarif State by the Institute of Endemic Diseases, University of Khartoum

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EL Hassan, A M
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For the last 25 years my colleagues and I have been working in Gedarif State on endemic diseases. The area is endemic for visceral leishmaniasis, post Kala-azar Dermal Leishmaniasis (PKDL) , mucosal leishmaniasis, malaria, measles, leprosy, whooping cough, acute upper respiratory infection, malnutrition and diarrhoeal diseases. They were the main causes of morbidity and mortality. Although our main mission was applied field research on leishmaniasis, we soon recognized that there was far more to do than just research. Kala-azar was rife. Sodium stibogluconate (SSG) for treating Kala-azar was only available in the hospitals and was sometimes in short supply. A black market for SSG was flourishing, the drug was very expensive and it was sometimes just water sold as the drug. Parents would buy a few MLs of the drug too small to be effective and inject the drug themselves. Due to poor health services we worked in collaboration with Ministry of Health and the community, in diagnosing and treating several diseases that one meets in a primary health care setting in a poor community. Our objective was to introduce simple technology to diagnose these diseases early, collect epidemiological data and to treat patients locally as outpatients. With the help of MSF Holland we started an applied field research project on the epidemiology, diagnosis and management of VL and PKDL. Health education was part and parcel of our program. This was in the form of public lectures, small group discussions and interaction with individual patients. Drugs for Neglected Diseases Initiative (DNDi) came to our help in Sudan and East Africa. DNDi established the Leishmaniasis East African Platform (LEAP) between Sudan, Ethiopia, Uganda and Kenya to improve on health facilities, develop effective drugs for visceral leishmaniasis and train health workers. They established a modern hospital with teaching facilities and modern laboratories in Dooka and another in Kassab village in Gedarif State. Details will be given. The changes that occurred in providing health services and in research are remarkable and will be detailed in the presentation.
Assisting , marginalized ,community ,better life