101 out of 140
communes have achieved
global standards for no
longer needing MDA
In Haiti, an end to LF is in sight
IMA World Health’s history in Haiti stretches back to 1998, when we partnered with the Haitian Ministry of Health and others to open a clinic to treat lymphedema, one of the debilitating symptoms of lymphatic filariasis, or LF. Since then, IMA has supported health in Haiti in a variety of ways but we have not taken our eyes off the disease that took us there.
LF is a mosquito-borne, neglected tropical disease that can cause severe physical disability and social stigma. But today, after years of continual hard work and cooperation among a score of government agencies, donors, partners and community members, Haiti is on the verge of eliminating LF as a public health problem.
IMA began distributing preventive treatment for LF in Haiti through mass drug administration in 2007. Elimination of the disease requires at least 65 percent of the population to receive five rounds of consecutive annual dosages of medicine, every individual counts. Many challenges have threatened to disrupt progress along the way, from the January 2010 earthquake—which trapped IMA President and CEO Rick Santos beneath a collapsed building for more than two days before his rescue—to cholera outbreaks and political instability. Despite these challenges and more, we continually make LF elimination a priority and treat millions each year.
The road to elimination has been long and arduous but it certainly has not been lonely. IMA is proud to be among the dedicated team that has worked toward this historic achievement in public health—from the Haitian Ministry of Health, USAID, U.S. Centers for Disease Control and Prevention and the pharmaceutical partners that have donated drugs, to the volunteers who knock on their neighbors’ doors and the teachers who ensure their students receive treatment. While there is still work to do until the 2020 elimination goal, the finish line is in sight and each of us is stronger for having our partners run alongside us.
IMA communes that have achieved criteria for stopping MDA
communes that have passed TAS
$13.54 million funded to date | USAID | 2011–2019
The ENVISION project, led by RTI International, aims to eliminate lymphatic filariasis and control soil transmitted Helminthes in Haiti. ENVISION is a collaborative effort at every level; IMA works alongside donors and the Haiti Neglected Tropical Disease Control Program, a joint effort between the Ministry of Health and Population and the Ministry of Education, to provide mass drug administration of two safe drugs, diethylcarbamazine and albendazole, in 9 of Haiti’s 10 departments—treating 3,243,074 million Haitians, including 805,092 school-aged children, in the last year.. To reach a population this size, IMA has trained approximately 20,000 community leaders, promoters and distributors to educate the population about LF, persuade the highest number of households possible to participate in preventive treatment for the disease, and conduct MDA through community distribution posts and schools.
As Haiti works toward the goal of eliminating LF by 2020, the LF surveillance work takes on an increasingly important role. IMA and the Ministry of Health have carried out 22 LF transmission assessment surveys (known as TAS) to date, including nine such surveys in 55 communes this year. The logistically complex surveys are carried out in hundreds of schools and communities across two-three weeks to determine if disease transmission has been disrupted.
On May 5, 2016, the project hosted a “WASH Fun Day” where students presented their own poems, plays and songs to reinforce healthy hygiene practices. The event was supported by Episcopal Relief & Development, and Make-A-Wish® Alaska and Washington, thanks to the generous donation of 13-year-old Allison, who following a heart transplant donated her wish to IMA and partner TOMS to help children in Haiti.
Photo by Jennifer Bentzel
Healthy Schools, Successful Children
(Sante nan lekol, se sikse timoun yo)
$1.96 million | Episcopal Relief & Development | 2015–2018
Much of Haiti lacks basic water and sanitation infrastructure, and its schools are particularly in need. According to a Ministry of Education report, more than 74 percent of Haiti’s schools lack a source of clean water, 84 percent lack treated drinking water and more than 40 percent lack functional toilets or latrines. IMA World Health and member agency Episcopal Relief & Development are working together to improve students’ health, school participation and educational success through water, sanitation and hygiene interventions in 60 public and Episcopalian schools in the Southeast, South and Grand’Anse departments. Launched in 2015, the project aims to provide or build latrines, reservoirs, water filters, and handwashing stations in schools as well as establish frameworks that enable schools and communities to sustain progress and maintain the infrastructure beyond the project’s lifespan. Construction has begun and will continue into the next fiscal year. Of equal importance is the goal of improving WASH behaviors of students, teachers and communities to prevent disease. At project startup, IMA conducted a baseline survey in all three departments to assess students’ understanding and practices and used this information to tailor WASH education and behavior change programming at schools. Mentored by project trained teachers and school directors, students have formed 70 school health clubs to raise awareness around WASH, model healthy behaviors and maintain a healthy school environment. The long-term hope is that working with youth in schools will promote improved hygiene practices within the wider community.
community members reached with sanitation and hygiene information
students reached with WASH interventions
Children are enrolled for a transmission assessment survey at Trou du Nord, in the northern part of Haiti, in 2015.
Photo by Dr. Alaine Knipes
A national partner keeps the pressure on eliminating LF
In a country facing many public health challenges, the buy-in and leadership of the National Program to Eliminate Lymphatic Filariasis—an arm of the national Ministry of Public Health and Population—is critical to keeping LF elimination goals on track, such as training thousands of community drug distributors prior to MDA, supervising drug distribution activities and providing laboratory technicians to help IMA carry out pre-TAS and TAS activities. This year the NPELF, along with IMA and the CDC, worked to update Haiti’s national morbidity management and disability prevention plan, a critical resource for estimating the number of people living with active disease such as lymphedema or hydrocele, training health professionals and institutions across the country in managing these conditions and improving the quality of life for LF patients.