This situation is repeated around the country every day, every night. At least 65 per cent of all Rwandans suffer from intestinal worms, according to new research completed last month by the country’s Neglected Tropical Diseases (NTD) programme.
The parasites cause diarrhea that is a leading cause of death among children in developing nations, according to Action Against Hunger. Despite this danger, the disease does not receive as much attention as malaria, HIV/AIDS or Tuberclosis. That’s about to change. Next month the government will launch a major education campaign to eradicate the disease.
Martha Nizeyimana suspects malnutrition is the cause of the parasites’ infection to her children. But the disease does not come from malnutrition. It instead causes it.
The parasites are found in communities with poor hygiene where human feces get into soil or water used for drinking and irrigating crops. Dirty hands also spread parasite infestation. Intestinal worms cause persistent diarrhea that leads to dehydration, malnutrition, weight loss, stomach pain, loss of blood in bodily excretions and death.
No wonder Nizeyimana and her husband always expect to take their children to a hospital for de-worming at any time. The family is exposed to easy contamination. Their kitchen is two meters from their pigs’ stable. The toilet and the cows’ stable are nearby.
“We do our best but it is too difficult for us to insure the hygiene,” said Nizeyimana’s husband. He said his children used to play in the area near by the kitchen and the pigs, yet he can’t always be around to see whatever they do.
All four of Nizeyimana’s children have been at Nyamagabe Health Center for de-worming since last year.
“We can’t escape these worms in this rural area,” she said as she fed her son at home in Murico village, sometimes with a spoon, sometimes with hands that she didn’t bother washing since she arrived at home from the hospital. “We can’t get a complete diet and …we are too poor.”
Her husband does not agree that the family lacks enough to eat. Felicien Munyaneza says that he makes sure they eat enough oil and vegetables and he does not believe that his family lacks vitamins.
“I can not go to the bar when I didn’t buy enough food for my children,” he said.
He thinks the contamination is encouraged by the way his wife cooks food and he wonders if she needs to learn more about recipes and a complete diet. His family spends at least Rwf 2000 every year on drugs to treat their children’s intestinal worms.
Nurses at Nyamagabe Health Centre in Nyamagabe District of the Southern Province of the country said that intestinal worms are the second most frequent problem of patients, after respiratory diseases. The same situation is found at Kigeme Health Centre, another hospital in Nyamagabe District.
“A lot of sensitization on health education is still needed in Rwanda,” said Etienne Hakizimana who has been a nurse at Nyamagabe Health Centre since 1979.
She says government needs a strong strategy to sensitize people about hygiene to decrease the risks of contamination.
This is what the government has started doing. Last year it launched a program to deal with all neglected tropical diseases, including intestinal worms. The first step, according to Malick Kayumba, was to figure out where the problem is.
Kayumba is the information officer for Access Project, a Columbia University program that is helping the ministry of health combat tropical diseases. Kayumba said the research on intestinal worms is almost done. In August the government will launch a campaign both to treat those who are infected and to stop the spread of the disease.
Even though the research isn’t finished, it is clear that the problem is enormous.
“You can go in schools and find that 100 per cent of the children are all infected and this has huge consequences,” Kayumba says.
Text adapted from the Rwanda Initiative