Reaching refugees: Leaving no one behind in the fight against NTDs

RTI | Int'l Dev
Jun 19, 2018 · 4 min read

By Sharone Backers, RTI International, Chief of Party, for USAID’s ENVISION and MMDP Project activities in Ethiopia

What does it mean to beat neglected tropical diseases (NTDs)? It means reaching all of those in need with NTD prevention, treatment, and care, including refugees.

Bersila Fancis holds up her food ration card provided by UNHCR Ethiopia.
Photo Credit: RTI International/Yonas Getachew

Walking through Tsore Refugee Camp in western Ethiopia, I watched as Peter, a health worker and a refugee himself, zigged and zagged through the tidy block of homes. The grid of houses was well-organized into zones and blocks but, to an outsider, it seemed very complicated.

I was part of a team visiting the camp to check the eyes of women, men, girls, and boys in Tsore for signs of trachoma, an NTD that, upon repeated infection, can cause the eyelashes to turn inward and ultimately lead to blindness. This visit was very personal to me; I have a background in refugee studies and believe strongly in addressing refugee health.

Peter, Sharone, and the survey team meet with families in Tsore refugee camp to check for signs of trachoma. Photo Credit: RTI International/Yonas Getachew

We followed as Peter led us from home to home where we often found women cooking, collecting wood, or tending to their children. Lucky for us, Peter was a seasoned expert in the camp’s organization since he had called Tsore home for more than three years. At each home, our team flipped people’s eyelids to check for signs of trachoma.

Opened in 2015, Tsore is home to more 12,000 refugees (as of May 2018, according to UNHCR) and is just one of several camps in Ethiopia’s Benishangul-Gumuz region. Together, the UN Refugee Agency (UNHCR) and Ethiopia’s Administration for Refugee and Returnee Affairs (ARRA) support Ethiopia’s 26 refugee camps, home to more than 920,000 people who have been displaced by years-long conflicts in the region. The majority of refugees come from South Sudan, Somalia, Eritrea, and Sudan. Thankfully, Ethiopia’s welcoming policy has led it to be one of the largest hosts to refugees globally.

Peter fled Sudan in 2014, arriving in Ethiopia alone. Now a young man in his twenties, Peter serves his role as health worker with great enthusiasm. As he led us, Peter shared about missing his home in Sudan. He also shared the joys of becoming a health worker in Tsore, a position which has given him opportunities to help others and learn new things. From his interactions, it’s clear that he’s gained the trust of his community. He has made the most of a new home and a new job, and we are lucky to work with him in the fight against NTDs.

Left: Peter, a health worker in Tsore, leads our team house to house during a trachoma impact survey. Right: Nama Faya, a refugee living in Tsore, is checked for signs of trachoma.
Photo Credit: RTI International/ Yonas Getachew

Through ENVISION, USAID’s global flagship NTD project, RTI International has assisted Ethiopia’s efforts to control and eliminate neglected tropical diseases, including trachoma, since 2013. In addition to supporting Ethiopia to provide treatment for NTDs and to assess the impact of NTD efforts in four regions, we expanded our efforts in 2016 to assess the prevalence of NTDs in all refugee camps in the Gambella and Benishangul-Gumuz regions. When the results showed the need for treatment, ENVISION stepped up support for Ethiopia’s national NTD program to ensure treatments were provided.

For many years, the global fight against NTDs has been about scaling up efforts. While these efforts to scale have been a notably successful and enormous undertaking, our current efforts requires us to innovate further to reach some of the hardest-to-reach areas. Disease elimination is, by its very nature, about health for all, and that includes refugees.

That’s also true of our work globally through ENVISION, as we work to expand treatments to refugee populations. Currently, the ENVISION team has the privilege of working with refugees in Ethiopia, Uganda, and Cameroon. In all three countries, we are supporting ministries of health to ensure all people in need of NTDs interventions are reached.

But reaching refugees with NTD prevention, treatment, and care is also about something bigger. I believe that addressing the health of refugees is about human dignity. When refugees receive education, are provided with a safe space to live, and can access the health services they need, we take steps towards ensuring refugees can thrive — wherever they might need to call home.

On World Refugee Day, we stand #WithRefugees and remind people everywhere that leaving no one behind is key to economic growth, advancing national security, and improving global health. I’m proud to be part of this effort, and I would like to thank UNHCR and ARRA for facilitating and supporting efforts our efforts to understand, prevent, and treat NTDs in refugee camps.

View of homes in Tsore refugee camp.
Photo Credit: RTI International/ Yonas Getachew

ENVISION is an eight-year project funded by the U.S. Agency for International Development (USAID) aimed at providing assistance to national NTD control programs for the control and elimination of seven targeted NTDs: lymphatic filariasis, trachoma, onchocerciasis, schistosomiasis, and three soil-transmitted helminths (roundworm, hookworm, whipworm). ENVISION contributes to the global goal of reducing the burden of targeted NTDs so that they are no longer a public health problem.

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