Fit and filariasis-free
MANILA, Philippines - The images are morbidly riveting: breasts enlarged like massive jackfruits, basketball-sized testicles, and legs like swollen tree trunks. These are among the disfiguring effects of lymphatic filariasis (LF) or elephantiasis, a chronic and parasitic disease that results when a person is bitten by an infected female mosquito.
Transmission is simple and occurs when a carrier mosquito bites a victim and deposits small larvae into his blood stream. The individual may not know that he is infected because the signs and symptoms of LF are similar to that of ordinary infections. These include fever and inflammation of the lymph nodes. However, as the disease progresses and the parasites circulate with the blood and lymphatic system in a span of five up to 15 years, other symptoms include inflammation of the lymph vessels, body and leg pains, and rice-water colored urine (Chyluria). Disfigurement occurs when the lymph vessels are blocked, resulting in the enlargement of affected areas such as the arms, legs, breasts, and genitals
Since filariasis is endemic in 44 provinces in the Philippines, the disease is a worrisome menace. The World Health Organization has, in fact, estimated that there are 200,000 cases of LF in the country, with around 22 million Filipinos at risk. As a cause of permanent long-term disability, the disease can seriously affect lifestyle and productivity because it causes pain in the affected body parts, affects mobility, affects ability to work, and causes shame and stigma.
Fortunately, programs are in place to combat the disease. In line with a global project to eliminate LF, the Department of Health has partnered with local government units, the Department of Education, and private donors to eradicate it. With the Coalition for the Elimination of Lymphatic Filariasis (CELF), they have embarked on an eradication program that treats whole communities once a year for a period of five years. As a key contributor to the program, the pharmaceutical company GlaxoSmithKline (GSK) has committed to donate the drug albendazole until the disease is completely eradicated. To date, GSK has donated a total of 122.3 million tablets of albendazole in the Philippines, amounting to P1.223 billion. Daisy Cembrano, GSK vice president for public affairs, says, “Filariasis affects those who can hardly voice their need. Health is a universal human right and the milestones in health will stay. We realize that eliminating LF presents significant opportunities and inequalities in health.”
The drive against LF has resulted in some positive gains. In 2009, the WHO and DOH declared the provinces of Sorsogon and Southern Leyte “LF-free.” The latest success story is Biliran, which achieved LF-free status this year. On a recent visit to the Visayan province, we met up with local health officials who spoke about the key factors in the drive to eliminate LF.
“Cooperation was intrinsic,” says Dr. Edgardo M. Gonzaga, director of the Center for Health Development. “There was an institutionalization of health zones and support from the local government units.” He mentions that support from the Department of Education was important too, since albenzadole was administered in the schools. “Our goal is that there should not be a single case of LF,” he continues. To maintain its LF-free status, “sentinel sites” from highly endemic areas are chosen for periodic spot checks.
Part of the problem, says program coordinator Leonido Olobia, is lack of awareness. “People do not think they have the disease in areas where LF has no visible effects.” To address this, awareness programs were undertaken in communities and schools, and surveillance studies are done periodically. To prevent re-infection from neighboring provinces, border operations in the form of monitoring and awareness drives are also part of the agenda.
A simple ceremony was held to celebrate the milestone achieved by Biliran as the third LF-free province in the country. At the program, Biliran Governor Rogelio Espino said, “Biliran in the past years has shown marked interest in improving health conditions. Achieving this feat is not easy, and sustaining the same needs continuous and concerted effort.” However, he admits, “Funding is really a perennial pothole for smaller LGUs like us.” Undoubtedly, GSK’s commitment to provide free drugs is a big help. And again, this success story in the field of health proves that when government and private corporations work hand in hand, significant inroads are achieved towards improving peoples’ lives.
