“Trichiasis is uncomfortable and painful. But once you have the surgery, your health improves. Then you can work again without problems. It makes [me] proud to have saved someone’s sight.” —Minanta, MMDP-trained surgeon, Burkina Faso
Tens of millions of people around the world are at risk of preventable blindness from trachoma, and disability and disfigurement due to lymphatic filariasis (LF). These neglected tropical diseases are common in many parts of Africa and cause loss of income as well as stigma.
To give affected people a new chance at life by saving sight and restoring mobility, the United States Agency for International Development (USAID) made a significant investment in 2014 by funding the five-year, flagship Morbidity Management and Disability Prevention Project (MMDP) to improve the management of illness and prevent disability in select African countries. The MMDP project prioritized strengthening the capacity of the national government to deliver high-quality treatment and disease management services.1
From July 2014 through September 2019, Helen Keller International (HKI) led USAID’s MMDP Project, working primarily in Burkina Faso, Cameroon, and Ethiopia as well as at the global level. With national Ministries of Health leading program planning and implementation in each country and the steadfast support of USAID, the results have been life-changing for tens of thousands of people at risk of losing their sight from trichiasis, the painful, blinding stage of trachoma. Thousands of men and women whose social and economic well-being was jeopardized by the pain, disfigurement, and physical disability caused by lymphatic filariasis also benefitted from life-changing surgeries and health interventions.
Improving Health Systems and Lives: Key Achievements
We are proud to share the stories of many of the people whose lives were changed thanks to the MMDP program.
Across Burkina Faso, Cameroon, and Ethiopia, illustrative results of the MMDP project include:
- 2.1 million people screened for trichiasis
- 76,000 individuals received trichiasis management, primarily surgery
- 280 trichiasis surgeons trained
- 2,100 men received hydrocele surgery
- 2,200 lymphedema patients trained in self-care
- 200 hydrocele surgeons trained
Our key partners included Sightsavers in Cameroon and RTI International (with the Fred Hollows Foundation and Light For The World) in Ethiopia as well as the African Filariasis Morbidity Project and the Kilimanjaro Centre for Community Ophthalmology. These partners worked closely with the Ministries of Health and HKI to provide services.
But improving health care services to prevent blindness and to restore mobility and dignity to men and women affected by hydrocele and lymphedema is only part of the MMDP project’s story. With the Ministries of Health leading the way, the project strengthened systems to improve management of both diseases by training cadres of surgeons and other health care providers; expanding data management systems to better track people in need of care as well as people who had received services; and ensuring that all services, especially surgeries for trichiasis and hydrocele, were of the highest quality and incorporated the World Health Organization’s standards and international preferred practices.
“I no longer have any pain: now I can achieve something.”
In addition to the life-changing achievements at the country level, the project also made important contributions at the global level. By documenting lessons learned, investigating promising practices, and sharing knowledge widely, the MMDP Project improved data availability and use, filled gaps in the trachoma and LF knowledge base, contributed to operational research, and devoted considerable effort to developing tools and resources that the international community is already using in trachoma and LF programs in other countries. The MMDP project publications and knowledge resources include a surgical simulator for hydrocele surgery, a manual for training trichiasis surgeons, a resource package for photo taking during trichiasis surgery, and a training package for filaricele surgery.
The project completes its five-year mandate on September 30, 2019, thanks not only to the leadership of Ministries of Health in Burkina Faso, Cameroon, and Ethiopia and the generous financial support and technical oversight of USAID, but also to the following principal actors that contributed to MMDP’s success:
- thousands of individuals and their supportive families who entrusted their health care to the project-supported activities, contributing to the knowledge base on how best to scale up and improve morbidity management;
- dedicated community leaders, local authorities, community health workers, and volunteers who ensured widespread participation at the community level;
- devoted staff of RTI, Fred Hollows Foundation, Light for the World in Ethiopia, HKI in Burkina Faso and Cameroon, and Sightsavers in Cameroon, who spared no efforts in achieving objectives and targets; and
- WHO (including ESPEN), the Centers for Disease Control and Prevention, and the Global Alliance to Eliminate Lymphatic Filariasis, which provided timely technical guidance and sustained support and encouragement.
USAID’s investment in MMDP in each country will last beyond the project in the form of an expanded and more well-trained pool of health care providers to provide high-quality services; the adoption of internationally recognized preferred practices for morbidity management for trachoma and LF; scaled-up implementation of services to manage illness and prevent disability; stronger data systems; and most importantly, the improvement of thousands of people’s lives. The benefits of the MMDP project extend not only to the individuals who have received treatment, but also to their families and to people who will receive higher quality care in the future.
As Mamadou, one of our MMDP program participant told us, “I no longer have any pain. It’s a big change for me. Now I can work for myself. Before, I had to depend on my brothers. Now I can achieve something on my own.”
Helen Keller International remains deeply committed to the global fight to end NTDs. We are a partner in the USAID-funded Act to End NTDs I West consortium led by FHI360, which supports 11 countries. We are also leading efforts to eliminate trachoma and lymphatic filariasis in Mali and Niger through a partnership funded by the Conrad N. Hilton Foundation.
1 This commitment on behalf of the United States Government directly complemented USAID’s investment in mass drug administration to interrupt transmission of trachoma and LF.