Campus News

November 2, 2010

Report From: The Carter Center

Fighting river blindness with ingenuity, persistence

Philippe Nwane, an epidemiologist for The Carter Center, created an aspirator for the River Blindness Program using the soles of women's shoes, among other materials, to seal the plastic container carrying the flies.

The late afternoon sun has begun to set as Philippe Nwane, 38, carrying a long plastic tube, walks slowly through a sweet potato field near a remote village in western Cameroon. He approaches a local stream and finds what he has been hunting for all afternoon—a spot where hundreds of buzzing black flies thicken the air.

Nwane sat down on a rock on the riverbank and rolled up his pants to attract flies to his bare legs. As the Simulium flies landed on him seeking their blood meal, he carefully sucked them into his self-styled "aspirator."

He repeats this action over and over again, capturing dozens of flies and seemingly never tiring of the arduous task. The local villagers accompanying him—just trained that morning and armed with their own aspirators—have been working for hours alongside Nwane to collect hundreds of flies that he will take to The Carter Center's lab in Yaoundé.

The goal of the fly collection is to check on the progress being made in the village against the debilitating parasitic disease river blindness, which is transmitted through the bites of these black flies that often breed in swiftly flowing rivers.

"I try to capture the flies before they bite me," he jokes, a sly smile crossing his face. The bites cause painfully itchy welts that even Nwane, who grew up in a river blindness-endemic village, has never quite gotten used to.

The villagers have been hard at work conducting health education and distributing once-annual treatment of Mectizan (donated by Merck & Co. Inc.) to prevent the disease's excruciating skin rashes and vision damage. If fewer flies carry the parasite, it means the humans they bite are not as burdened by the disease as before.

The first in his family to receive an education, Nwane currently is working on his doctorate in entomology and has been an epidemiologist for The Carter Center since 2009. He first learned about the Center when he was conducting field research on malaria mosquitoes in northern Cameroon.  He was later recruited to carry out entomological studies to help facilitate disease monitoring for onchocerciasis and malaria.

However, only a short time into his new job, Nwane found the aspirator in his field office required a lot of energy to use.

"When you have an object, you should look at it and ask, 'Does it work for me?' " Nwane says. "You should try to find a way to make it work better, cost less to make, or more practical to use."

Nwane started reinventing tools when he lived on his family's farm in Nsingmbongo, Nyanon District, where he is one of five children.  On the farm, he created a hoe typically used by women and made a more effective tool out of boxes and other simple materials he had available at home.

So, he created an aspirator for the River Blindness Program using the soles of women's shoes, among other materials, to seal the plastic container carrying the flies. His new aspirator is so popular, he's made about 100 of them for use throughout Cameroon and even in other river blindness efforts in Sudan.  He also has created mosquito traps using bed nets.

In the early 1990s, the River Blindness Foundation began assisting Cameroon's Minemistry of Health to distribute Mectizan in North province. The Carter Center assumed the River Blindness Foundation in 1996 and in partnership with the Lions Clubs International Foundation began working in Cameroon's West province the same year.

In 2009, more than 1.6 million people in Lions-Carter Center-assisted areas in North and Western regions of Cameroon received mass Mectizan treatments from nearly 44,000 trainers.

The work has been making a big impact. Onchocerciasis is now controlled throughout Cameroon: a study conducted in North region in 2009 found that after 17 years of annual Mectizan treatment, there were dramatic reductions of infection rates and disease burden, especially among young children. Despite these successes, there remains a real risk for blinding onchocerciasis to reemerge, and annual mass drug administration efforts must continue.

"In my home village, they used to believe river blindness was caused by an invisible force or spirit," he says. "But with health education and distribution of Mectizan, people now know it's a disease and program efforts are working."

Yet, Nwane hopes for even greater success.

"I would like to see the entire country get rid of river blindness one day," he says. With continued hard work from Nwane, the national program, village volunteers, and perhaps even a few new inventions, Cameroon is well on its way to finishing the job.

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