In most rural areas health care services are insufficient. During socio-economic and health surveys in rural Tanzania connected to a RAP Project Affected Persons (PAPs) within the Project site disclosed that they suffered from a variety of health issues including filarisis, chest infections, malaria and diarrhea.

A member of Bozi Community studies his acceptance form.

Malaria and Diarrhea are common diseases stemming from the poor quality of drinking water,  lack of hygiene and no prevention against mosquitos, that spread the Malaria virus. Filariasis  is the second most common vector-borne parasitic disease after malaria, is found in over 80 tropical and subtropical countries. WHO estimates that 120 million people are infected with the parasite, with one billion at risk. One third of those living in Africa.

The Tanzanian President Kikwete describes the illness in the following way: “As a person who comes from a country and an area that is endemic with Lymphatic Filariasis, I know how saddening and debilitating the disease can be. Sadly, the physical disabilities caused by the disease are accompanied by social stigma and economic hardship. The cycle of poverty that is perpetuated by this disease is continuous and keeps people trapped with no chance of escape. The disability caused by this disease renders those afflicted unproductive and unable to contribute to national and their individual economic progress.”

IDC took those concerns serious. Within its mandate to ‘improve living conditions’ through resettlement and that the resettled population did not impact on the limited health services within the host communities IDC approached various partners to help it carry out a health programme, which could also serve as a baseline study for the client to measure improvement for the monitoring and evaluation process.

IDC initiated a health intervention together with a local research institute backed by the Swiss Tropical and Public Health Institute. This was also supported by the Client who provided the high logistical costs associated with reaching out to isolated communities.

Hospital Staff takes blood through finger pricking

The initiative was designed to benefit the Project Affected Persons (PAPs) and surrounding communities whilst enhancing the image of the Project proponent and to contribute to an African-European Research Initiative on Co-infections of Poverty Related and Neglected Infectious Diseases.

The study was part of the IDEA Program funded by the European Commission and jointly administered by the Swiss TPH and the Ifakara Health institute. The study aims to assess correlations and dependence between worm infections and HIV Aids and Malaria. The program – ethically approved by the Government of Tanzania and the Swiss TPH – enabled each participant tested positively access to free treatment.

IDC together with the field workers of the Ifakara Institute held various meetings in each participating community explaining procedures and stressing the voluntary nature of the participation. Each community was given one week for testing whereby a small amount of blood was taken from each participant and analyzed for HIV Aids, Malaria and Filariasis. The medical team was further accompanied by a specialist, who interviewed each participant for symptoms of Tuberculosis. All patients with alarming symptoms and the patients tested positively during the blood tests were enabled transportation and free treatment in the local hospital.

Consultation with professional health workers

The initiative was a success on three levels:

On the community level
Most PAPs living within the Project site of the client where out of reach of local dispensaries and health services. The clinical staff were for many participants the first contact with schooled and experienced health professionals. A personal one on one counseling session for each person provided information on further treatment and opened ways of dialogue. For example, members of the local pastoralist community do usually not partake in the formal Tanzanian health sector due to traditional beliefs and an insufficient command of the lingua franca Swahili. The screening created an avenue of opportunity and helped to break down barriers in interaction. Several members received referrals to larger hospitals to receive treatment for illnesses not related to the study such as eye and ear problems.

The Research Institute
The members of the research institute discovered areas in their direct vicinity, which had never been visited by a field member due to a lack of transportation and knowledge. Suitable participants could be recuited for the IDEA project. The exercise also created awareness among the hospital staff for the still immense need for an expansion of medical services in the rural areas. Furthermore,  the Filariasis component of the programme used state-of-the-art diagnostics, which had never been applied in Tanzaina before according to the Ifakra Institute. Until very recently, diagnosing lymphatic filariasis had been extremely difficult, since parasites had to be detected microscopically in the blood, which was only possible during night screenings due to the “nocturnal periodicity” of the parasite that restricts their appearance in the blood to the hours around midnight. This time a newly developed simple “card test” was applied to detect circulating parasite antigens by using only finger-prick blood droplets taken anytime of the day.

The client
The Project Proponent committed itself to the allocation for one field car for the duration of the study and one of IDC’s field interns to accompany the hospital staff to the villages. For a minimum amount of resources the image of the client could be enhanced in the community, as people realized, that words have been followed up by actions. This was a major component of trust building between the local communities and the foreign company investing in the area.

Due to the success of the programme, it was extended to the main host community and also to the communities of a nearby salt works.