CTPH Newsletter April 23.Indd
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Volume 1, Issue 2, March 2008 Addressing disease transmission at the human/wildlife/livestock interface in Uganda Letter from the Editor elcome to the second edition of a bi-annual CONTENTS Wnewsletter targeted 1. Introduction p2 towards policy makers, key stakeholders working on and 2. People p3 affected by interrelated conservation 3. Wildlife p4 and public health issues and interested members of the general 4. Livestock p6 public. The main focus of this edition is to give highlights of activities 5. Strengthening Cross that were implemented to address Sectoral Linkages p8 disease issues at the human/wildlife/ livestock interface in Uganda in see how we set the stage to enable a USAID (United States Agency these stakeholders to find mutually for International Development) beneficial and long lasting solutions. funded project through a ©CTPH subcontract between Conservation Dr. Gladys Kalema-Zikusoka Towards the end of 2007, there was Through Public Health (CTPH) and an outbreak of Ebola in Bundibugyo the African Wildlife Foundation Founder & CEO CTPH District, Western Uganda. The Ashoka Fellow (AWF). The subcontract was family that was traced as the source implementing activities on the complimentary funding to 1 of the outbreak was suspected to Productive Resource Investments for enhance activities on this have eaten a dead goat or monkey. Managing the Environment (PRIME subcontract; notably the John This incident highlights the many West) program. The newsletter D. and Catherine T. MacArthur challenges, which still lie ahead includes updates from local Foundation, United States Fish of us especially with reference to government stakeholders of the and Wildlife Service (USFWS), educating the local population on Public Health and Conservation USAID Population, Health and the dangers of eating animals found Technical Support Unit (PHCTSU) Environment (PHE) Initiative, John dead. working on issues surrounding Snow International, the British disease transmission between High Commission, Barclays and Thank you very much for taking the wildlife, people and livestock in their Microsoft and Colgate University. time to read our second edition of districts in South Western Uganda. the Eco-Health Africa Newsletter. Conservation Through Public Health We appreciate your interest and We are very grateful to the Uganda approached this issue by integrating support, and welcome not only your Wildlife Authority (UWA), wildlife conservation, human comments, but also contributions Kanungu and Kasese District public health, livestock health and in subsequent publications of this Local Governments, USAID, PRIME Information, Communication and newsletter. West and AWF for giving CTPH an Technology (ICT) sectors to address opportunity to test the concept of disease using a multi sectoral Best Wishes! merging wildlife conservation and approach. human public health through an innovative Tuberculosis (TB) health Through this subcontract we were model with potential to reduce the able to bring on new partners, thus increasing cross sectoral disease threat to mountain gorillas This newsletter is made possible through and other wildlife through primary understanding of the conservation support provided by the US Agency for and secondary prevention activities. challenges faced by Uganda International Development under the Wildlife Authority. I hope you enjoy PRIME West program. We also want to greatly thank reading this second edition of The views expressed do not necessarily other partners who have provided Eco-health Africa Newsletter to reflect those of USAID. ©CTPH Cattle in Katwe fishing village bordering Queen Elizabith National Park Introduction ur innovative TB health Subtask 2 involved reducing disease Subtask 4 involved strengthening model was tested by threats to wildlife through education linkages between the wildlife, 2 Oimplementing four on human and livestock disease livestock and human health sectors integrated subtasks when transmission to and from wildlife through information, education conducting primary and secondary and improving wildlife clinical signs and communication. Meetings prevention measures in people, observation. This was done through and workshops were held to share wildlife and livestock in and training of the Human and Gorilla information and experiences, around Bwindi and Mgahinga Conflict Resolution (HUGO) team as well as plan, monitor and Conservation Area (BMCA) and and park staff in both BMCA and evaluate progress at bi-annual Queen Elizabeth Protected Area QEPA, as well as sensitizing tour meetings of the Public Health and (QEPA), as well as strengthening operators on human and great ape Conservation Technical Support cross sectoral linkages. disease transmission issues. Unit (PHCTSU). Subtask 1 involved reducing TB Subtask 3 involved education and This fourth subtask also included prevalence in local communities in social mobilization of livestock developing local content with the and around BMCA by expansion of keepers bordering QEPA, through community, which was translated CB DOTS (Community based Direct establishing and training a into accessible media for community Observation of TB treatments Human and Wildlife Conflict outreach in the form of brochures, Short Course Therapy) to another Resolution (HUWI) team made up radio broadcasts, video, CDs and parish bordering the park with of community volunteers who will DVDs, the Internet and community high human and wildlife conflict, become model change agents for portals. This bi-annual newsletter as well as, incorporating scabies TB control in livestock in and around forms part of the content developed and HIV/AIDS treatment in the CB QENP. This also involved sensitizing to share experiences of this DOTS programme. This was done livestock keepers and training the innovative health model. through social mobilization of subcounty veterinary officer, as well local communities and training as, testing the HUWI cattle for TB and of community volunteers and advocating the central government traditional healers in CBDOTS and to allow euthanasia of cattle found links to gorilla health, ecotourism with TB. and sustainable livelihoods. ©CTPH Bwindi Conservation Actors drama show on TB and links to gorilla health, ecotourism and sustainable livelihoods in Bujengwe Parish bordering Bwindi Impenetrable National Park (BINP) 3 People CBDOTS expansion was conducted Ministry of Health target of 85% were diagnosed, put on TB treatment using a multi-pronged approach. treatment success (patients who and entered in the National TB CTPH worked with community completed treatment + patients and Leprosy Programme (NTLP) volunteers, traditional healers, the who recovered from TB). This effort register at the Bwindi Community surrounding community and their involved active TB case finding with Health Centre (BCHC) in Mukono leaders to sensitize them on the help from community members Parish and the Kayonza Government importance of TB, CBDOTS and links and community health volunteers Health Centre III in Bujengwe Parish. to the environment. Community from the Population Health and In total 174 referrals were made by health workers were trained to refer Environment (PHE) initiative, who PHE community volunteers, and 34 TB suspects and become community referred TB suspect patients with by other community members and volunteers. chronic coughs to CTPH. The patients local leaders. The CBDOTS program found a The 24 CBDOTS community total of 26 people positive with TB This activity volunteers, including 16 men and to add to the 26 already enrolled 8 women, were trained informally since the program began in July increased the TB by CTPH Nurse Aide; and formally 2005. CTPH staff conducted 442 treatment success through a workshop facilitated home visits, resulting in 121 by KIHEFO (Kigezi Health Care people being screened for TB, of and exceeded the Foundation), where they were which 18 completed treatment, Ministry of Health also trained to integrate HIV/AIDS 5 are still currently on treatment, target of 85% and Scabies into the TB/CB DOTS none defaulted and 3 died. This programme. We hope that these activity increased the TB treatment treatment success volunteers will become part of success rate and exceeded the the Village Health Groups of community health workers that the working with local drama group, drama shows were held in two Ministry of Health is setting up Bwindi Conservation Actors, where parishes, Mukono and Bujengwe, through Kanungu District Local each workshop was accessible to on family planning, HIV/AIDS, Government. at least two village communities scabies and the links to gorilla enabling all 11 villages in Bujengwe health, ecotourism and sustainable In remote areas such as Bwindi, parish to be reached. In total 1592 livelihoods. These drama shows where traditional African cultural people were reached including reached 1757 people including 375 practices still exist, traditional men, 683 women and 699 children. healers are the first point of call Questions asked after the drama when people get sick. They are In remote places like shows indicated that many people thus very important stakeholders Bwindi, traditional understood the health and hygiene in improving primary health care issues and how they link to gorilla to people (and animals) bordering healers are often health and sustainable livelihoods. protected areas. the first point of call when people Through the effective integration With a facilitator from Traditional get sick, and are of two community focussed public and Modern