Nicholas Mutale & Lubasi Sundano
In the southern African country of Zambia, approximately 1.2 million people are at risk for trachoma, a disease unknown in many parts of the world.
Lubasi Sundano and Nicholas Mutale are on a mission to ensure that future generations of Zambians never face this problem.
“We work in NTDs – neglected tropical diseases, but we’re going to change this first word – neglected!” said Sundano, Chief of Communicable and NTDs for the Ministry of Health of Zambia. “The day that we finish the [trachoma] elimination dossier, good Lord, that will be the best day! We’ll look back and say, that was teamwork.”
Nicholas Mutale, Executive Director of Lions Aid Zambia, collaborates with Sundano on surveys to determine trachoma prevalence and on mass drug administrations (MDAs), which are large-scale public health campaigns used to treat and prevent trachoma – with the aim of eliminating the disease by 2025.
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Once the world’s leading infectious cause of blindness, trachoma is a painful eye disease caused by a bacteria spread by flies and person-to-person contact. An antibiotic called Zithromax® can prevent and treat the disease and is donated by Pfizer through The Task Force’s International Trachoma Initiative (ITI) which manages the distribution. The challenge is getting the treatment to the people who need it and ensuring funding for that part of the work. Trachoma occurs primarily in remote and rural areas lacking access to safe and clean water, which contributes to conditions of poor sanitation and hygiene.
“The western part of Zambia is one of the areas that is seemingly difficult from a geographic perspective,” said Mutale, describing the landscape where trachoma is most endemic. “Lots of sand and challenging terrain. It’s not easy to get from one health facility to another.”
Along with geographic challenges, in 2020, the restrictions of the pandemic prevented MDAs and surveys from being completed.
They were rescheduled for 2021 when, suddenly, one of the key donors of the program announced that they would be unable to fulfill all their funding commitments. Thanks to the strong partnership between the Ministry of Health and Lions Aid Zambia, Mutale and his team were able to work alongside Sundano’s team to conduct MDAs in 12 districts and surveys in seven districts in June 2021 before the funding ended.
“We have to continue to find ways of how we can resolve some of these challenges,” said Mutale. “If we don’t do anything about it, how many people are going to lose their sight because of trachoma? That’s what inspires us.”
To keep the work going, Mutale, Sundano, and their partners at ITI approached the Bill & Melinda Gates Foundation for funding to support the MDAs and surveys. In just three months, the proposal was submitted, reviewed, accepted, and the contracts signed, which will equip the Ministry of Health and Lions Aid Zambia to complete MDAs in 10 districts and surveys in 33 districts by the end of 2022.
Sundano credits community health workers who work in very difficult conditions for the progress being made.
“They are the reason the programs actually go on,” she said. “Even if we did the planning, without them, people would not be able to take the medication and have their eye lids corrected, surgeries done, graded. They are the foot soldiers who are the ultimate heroes and key to our success and achievements attained.”
With the respect and camaraderie of long-time collaborators, Mutale added his thoughts.
“There are a number of surgeons who have to go out in the villages, identify cases, undertake surgery for those cases at the expense of what I would call a luxurious life,” he said. “They could have chosen not to work in Shangombo, it’s 1,000 km from Lusaka…So these are the people who are heroes to me, people who are willing to sacrifice the luxuries to support their fellow Zambians to eliminate trachoma.”
Photo 1 courtesy of Sumon Ray for International Trachoma Initiative. All other photos courtesy of Nicholas Mutale, Lubasi Sundano, Yanjanani Phiri and Juliet IIunga for Lions Aid Zambia, and Rosemary Pearson-Clarke.
Photo 1 courtesy of Sumon Ray for International Trachoma Initiative. All other photos courtesy of Nicholas Mutale, Lubasi Sundano, Yanjanani Phiri and Juliet IIunga for Lions Aid Zambia, and Rosemary Pearson-Clarke.