Morbidity Management and Disability Prevention (MMDP) Project

Saving sight and relieving disability in Ethiopia

Helen Keller International (lead), Fred Hollows Foundation, Light for the World, Surgical Society of Ethiopia, National Podoconiosis Action Network

Ethiopia has one of the largest burdens of neglected tropical diseases (NTDs) in the world, with about 87 million people at risk for at least one NTD. Since 2014, we have supported the Ethiopian government’s ambitious efforts to control and eliminate these diseases by 2020. In addition to facilitating mass-treatment campaigns through the ENVISION project, we help improve the lives of people affected by two debilitating and painful NTDs, trachoma and lymphatic filariasis (LF). Through the USAID-funded Morbidity Management and Disability Prevention (MMDP) Project, led by Helen Keller International (HKI), we support the provision of high-quality treatment and care for Ethiopian patients suffering from these diseases. Through HKI, the MMDP project also implements activities in Cameroon, Burkina Faso, and at the global level.

Using simple surgery to prevent blindness

Trachoma is a bacterial eye infection that, in its advanced stages, can cause eyelashes to painfully scrape the cornea and ultimately lead to impaired vision and blindness.

In collaboration with the Ethiopian Federal Ministry of Health, regional health bureaus, partners, and community-level health-extension workers, we are expanding access to a simple surgery that corrects the position of the lashes, relieving patients of pain, preventing further vision loss, and improving quality of life. Local partners train surgeons to safely perform the procedure with the assistance of a state-of-the-art surgical simulator called HEAD START. They also train health-extension workers and others in the community to identify suspected cases of advanced trachoma and provide counseling to encourage patients in need to undergo the surgery. Surgeries are provided as a routine service in eyecare units and health centers, as well as via outreach opportunities and mobile teams, when surgeons travel closer to communities.

Through RTI’s work, more than 41,000 people have received sight-saving surgery. By the end of 2018, we aim to reach an additional 24,000 people–ultimately reaching about 84 percent of estimated cases in target areas.

Relieving disability caused by lymphatic filariasis

Through the MMDP Project, we also improve the lives of people affected by lymphedema and hydrocele, two conditions that can result from LF infection. Characterized by enlarged and swollen limbs and scrota, respectively, these conditions are painful, debilitating, and can seriously affect the victim’s quality of life.

Our local partners train surgeons by means of an innovative surgical simulator developed by Helen Keller International called FASTT. This ensures that surgeons use a standardized approach when performing the procedures that relieve hydrocele. So far, more than 400 hydrocele surgeries have been completed, and we aim to perform surgery on 600 patients in 2018, reaching about 87 percent of known hydrocele cases in target areas. We also train health care providers and patients about how to properly manage and care for lymphedema.

At the policy level, we helped the Federal Ministry of Health in Ethiopia to develop an action plan to eliminate LF and advocate for additional resources.

Mainstreaming NTD efforts into the health care system

Our experience has shown that integrating project activities into the broader health system leads to more efficient and effective services. For example, we have trained clinical healthcare workers to take care of lymphedema patients and post-surgery hydrocele patients in their home communities. In 2018, we will continue these training efforts and support the integration of a lymphedema management curriculum into nursing schools to help ensure that all newly trained nurses know how to care for these conditions.

We are also working with several medical schools to integrate FASTT techniques into their curricula. These mainstreaming efforts will help to ensure that every person affected by trachoma and LF in Ethiopia will receive the care and support they need long after this project has ended.

This work is a critical complement to RTI’s ongoing involvement in NTDs, allowing us to leverage our global presence and partnerships with Ministries of Health and to reach those suffering from the debilitating effects of NTDs with the high-quality treatment and care they need.