Dr Nebhullar, medical coordinator, checking malnutrition in a child during the filariasis campaign
© Veronique Terrasse/MSF
Papua is the least developed province of Indonesia. Médecins Sans Frontières began providing healthcare in the district of Asmat, on the southwestern coast of the island two years ago. In this remote area, access to healthcare is extremely limited. In July 2008, a new health campaign was launched to eradicate filariasis, a disabling, mosquito-borne disease. However, reaching the population in an area covered by thick tropical forest and accessible only by river presents many logistical challenges.
Surrounded by water, the population of Asmat live in an environment which acts as a breeding ground for waterborne diseases such as malaria, dengue or filariasis.
Lymphatic filariasis is a parasitic disease caused by microscopically small worms transmitted through the bite of an infected mosquito. “Those infected with filariasis don’t always show symptoms”, says MSF medical coordinator, Navneet Nebhullar. “However, blockage of the lymph system can cause elephantiasis, large swollen legs or breasts or in men huge swollen scrotums, which really impact the patients’ quality of life.”
“The Mass Drug Administration (MDA) of filariasis treatment to the entire population will reduce transmission and eventually eradicate the disease in the area,” explains Dr Nebhullar. Although the treatment is simple, the project is ambitious and logistically challenging. There are seven sub-districts to cover in only two and a half months and teams face punishingly unpredictable weather.
However, the biggest challenge remains actually reaching the population. Papuans are semi-nomadic and rarely stay in the village for long periods of time. “It can be frustrating. Last week nearly all the villages were almost empty”, says health promoter Reza Abel.
To ensure the campaign reaches the maximum number of people, a health promotion team is sent in advance to meet up with the head of the village and arrange the next visit, during which villagers will be given treatment. Health promoters play a crucial role in raising awareness of the disease.
MSF has been running mobile clinics for two years in the area around Sawa Erma and is now well known there. However, the team is about to expand its campaign into new districts, where the population don’t know the medical organization. “It’s both exciting and challenging. We will have to gain the population’s trust there from scratch”, stresses Abel. “The area is even more remote, so we’re in for quite a challenge ahead.”