Addressing NTDs in Gisagara District: A Holistic Approach to Hygiene and Public Health

By Xaverine Cyiza.

An ambitious campaign to eradicate Neglected Tropical Diseases (NTDs) has been launched in Gisagara district, marking the commencement of a nationwide effort. Spearheaded by media engagement, the initiative seeks to raise awareness and implement effective measures to combat NTDs, beginning with a focus on hygiene.

This weeklong campaign, which commenced on January 21, 2024, aims to enlighten Rwandans on the multifaceted role of hygiene in various aspects of their lives.

Grace Abazayahora, a resident of Gisagara, vividly recalls the challenges the community faced, particularly concerning intestinal worms derived from contaminated stools in forested areas where farmers used to defecate.

The introduction of uphill toilets, a collaborative effort between the Rwanda NGOs Forum on Aids and Health Promotion and Rwanda Biomedical Centre (RBC), has proven instrumental in mitigating issues related to intestinal worms and diarrhea.

“We have successfully addressed the issue of unsanitary conditions around the forests encircling the marshland. Presently, we have access to nearby toilets, eliminating the need to resort to open defecation in the forest,” remarked Abazayahora.

Improved Water Infrastructure

Cansilde Mukeshimana, another resident, emphasizes the transformation in water accessibility, noting that water shortages are no longer a significant burden. Access to clean water near households has not only facilitated improved hygiene practices but has also alleviated the challenges associated with fetching water from distant marshlands.

Hygiene Advocacy Among Cooperatives

Nathan Hitiyaremye, NTDs-WASH Coordination Officer, Malaria Division in Rwanda Biomedical Centre, urges inspectors within rice and tea farming cooperatives in Gisagara to prioritize hygiene beyond financial considerations.

He emphasizes the importance of incorporating hygiene assessments into their inspections, particularly focusing on the cleanliness of cooperative toilets. Hitiyaremye underscores the need for every cooperative member to take a worm’s tablet, emphasizing the role of cooperative presidents in reinforcing this responsibility.

Agatha Mukamusoni shares the profound impact of water facilities in Gisagara, highlighting the challenges faced by children who had to trek long distances to fetch water.

“With the introduction of water facilities, life has become more manageable, and citizens can now perform essential tasks such as cooking, washing, and irrigating kitchen gardens without the burden of water scarcity.” She said.

Jean-Paul Habineza, the vice-mayor of Gisagara district in charge of finance and economic development, sheds light on the prevailing NTDs in the region, with a particular focus on intestinal worms, Podoconiosis, snakebites, and dog bites.

The district emphasizes health post accessibility, boasting 14 health centers and 2 district hospitals. Citizens are encouraged to seek testing and treatment for NTDs, with a strong emphasis on compliance with hygiene guidelines to prevent the spread of these diseases.

Transitioning from Toilet-Based Fertilizers

Mayor Habineza outlines district plans to encourage the use of organic manures over toilet-based fertilizers to combat intestinal worms in crops. The initiative also involves ensuring that full toilets are filled with soil. The district has actively worked towards altering citizens’ mindset regarding cohabitation with domestic cattle to prevent the spread of jiggers.

Nathan Hitiyaremye acknowledges the persistent challenge of mindset towards eradicating NTDs, with some individuals still practicing open defecation. He stresses the importance of using toilets properly and discourages painting toilet walls with defecated remains. Poor hygiene, he notes, contributes to many NTDs cases, including tenia and other intestinal worms.

In partnership with the World Health Organization (WHO), Rwanda Biomedical Centre (RBC) distributes albendazole to children aged between 1-15 years old every six months of the year. Recognizing the vulnerability of mature individuals to intestinal worms, the government has increased the budget for worm drugs to cater to a broader demographic, from children to the elderly.

Addressing Specific NTD Challenges

Jiggers, a persistent issue, is identified as a threat resulting from poor hygiene. The campaign encourages citizens to maintain hygiene on their bodies, clothes, houses, beds, and overall living spaces to prevent the spread of jiggers.

Additionally, snakebites in the eastern and western provinces are acknowledged as a burden, with the recommendation to seek emergency treatment at health centers rather than relying on traditional medicine.

The comprehensive efforts in Gisagara district illustrate the synergy between hygiene awareness, water accessibility, and healthcare initiatives in combating NTDs.

Gisagara district’s multifaceted approach to combating Neglected Tropical Diseases (NTDs) has yielded tangible results. With 70.8% water access coverage and a commitment to reaching 100% by 2024, partnerships with the African Development Bank and organizations like Water for People showcase a dedicated pursuit of universal water access. The distribution of albendazole to over 1 million children aged 1-15 reflects a proactive stance, emphasizing the government’s commitment to comprehensive healthcare for all.

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