2018.06.21 塞拉利昂如何战胜热带疾病

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塞拉利昂如何战胜热带疾病
常识是答案的一部分

2018年6月21日


作者：数据团队

塞拉利昂是世界上最贫穷的国家之一。从1991年到2002年，它遭受了一场毁灭性的内战，夺去了7万人的生命，破坏了卫生系统。2014年爆发的埃博拉病毒使其所剩无几，大量医生和护士死亡。因此，该国只有约400名医生来治疗其700万人口。腐败也使这个国家的疾病更加严重。大多数人不得不向医生和护士行贿以获得基本治疗。

尽管如此，塞拉利昂在抗击被忽视的热带疾病（NTD）方面做得比非洲其他地方几乎更好。15年前，多达一半的人口感染了导致盘尾丝虫病或河盲症的蠕虫。海伦-凯勒国际(Helen Keller International)的玛丽-霍奇斯(Mary Hodges)说，东南地区的许多村民曾经认为人们在30岁之后失明是非常正常的，该慈善机构致力于解决失明和营养不良问题。然而，到2017年，只有2%的人携带这种蠕虫，而且十年来没有新的盘尾丝虫病致盲病例的记录。预计将在2022年左右消除。


塞拉利昂取得这一非凡成就有几个原因。矛盾的是，一个原因是非传染性疾病的发病率特别高。管理该计划的约瑟夫-科罗马博士说，由于整个人口都接触到至少一种非传染性疾病，政府在早期就将其作为优先事项。而且，塞拉利昂没有单独处理这些疾病，而是一次性地处理它们。每年，它向每个有风险的人提供治疗四种主要疾病的药物。大致在同一时间对人们进行治疗，减少了他们相互感染的机会。这也节省了资金，因为卫生工作者可以对每个村庄只访问一次，而不是一年访问几次。

终止污名化也很重要。由专家、受害者和当地领导人组成的广播节目回答了听众关于他们所关心的问题的电话，这有助于打破误解，鼓励人们接受治疗。霍奇斯博士说，如果村民认为河盲症是由黑蝇引起的，那么仅仅向他们讲授河盲症是由巫术引起的，是没有用的。




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How Sierra Leone is beating tropical diseases
Common sense is part of the answer

Jun 21st 2018

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By THE DATA TEAM

SIERRA LEONE is one of the world’s poorest countries. From 1991 to 2002, it suffered a devastating civil war that claimed 70,000 lives and wrecked the health system. What little remained of it was gutted by an Ebola outbreak in 2014, which killed lots of doctors and nurses. As a result, the country has only some 400 doctors to treat its 7m people. Corruption also makes the nation sicker. Most people have to pay bribes to doctors and nurses for basic treatments.

Nonetheless, Sierra Leone is doing better at beating back neglected tropical diseases (NTDs) than almost anywhere else in Africa. Fifteen years ago as much as half the population was infected with the worm that causes onchocerciasis, or river blindness. Many villagers in the south-east used to think it was perfectly normal for people to go blind after 30, says Mary Hodges, from Helen Keller International, a charity that works on blindness and malnutrition. Yet by 2017 only 2% of people carried the worm, and there had been no new cases recorded of people going blind from onchocerciasis in a decade. Elimination is expected by about 2022.


There are several reasons why Sierra Leone has pulled off this remarkable feat. Paradoxically, one is the extraordinarily high prevalence of NTDs. Because the entire population was exposed to at least one NTD, the government made it a priority early on, says Dr Joseph Koroma, who managed its programme. And instead of dealing with these diseases separately, Sierra Leone tackles them all at once. Each year it provides drugs for four major diseases to everyone at risk. Treating people at roughly the same time reduces the chances of them reinfecting one another. It also saves money because health workers can visit each village only once instead of several times a year.

Ending the stigma is also important. Radio programmes where panels of experts, victims and local leaders answer calls from listeners about their concerns have helped to break down misconceptions and encourage people to get treatment. It is no good just lecturing villagers about how river blindness is caused by the black fly when they think it is witchcraft, says Dr Hodges.