When his pain was at its worst, Bounsom Lokxayyalueb, from Lao People’s Democratic Republic, could not work or even shower himself.
Now 73, Mr Lokxayyalueb caught lymphatic filariasis, a neglected tropical disease, from a mosquito bite. More than 36 million people globally are affected by this condition, more commonly called elephantiasis, which causes swelling of the extremities.
Severe pain, which started in his knee, kept him from farming to support his family of five children.
“If it hurt too much, I stayed home. It hurt so much I couldn’t walk or go anywhere. It got to the point where I could only cry.”
Mr Lokxayyalueb was delighted by the news that Lao PDR has eliminated lymphatic filariasis as a public health problem.
While present in only one province (Attapeu) in recent decades, an assessment conducted in 2009 found lymphatic filariasis infections in up to 27.5% of village residents surveyed across several of Attapeu’s districts.
“I am happy that it is gone. I would love lymphatic filariasis to be eliminated because I don’t want anyone to get it,” said Mr Lokxayyalueb.
Minister of Health HE Dr Bounfeng Phoummalaysith, said: “We are delighted to celebrate this historic milestone and the end of a horrible disease in Lao PDR.”
WHO Representative to Lao PDR Dr Ying Ru Lo said the major public health milestone was testament to the power of leadership and collective action in public health.
It followed years of collaboration by the Ministry of Health and health workers, WHO and partners, including United States Agency for International Development (USAID), the Asian Development Bank, the Margaret A. Cargill Foundation, Family Health International (FHI 360) and RTI International.
“I would like to extend my heartfelt congratulations to the Ministry of Health and local health workers for their tireless dedication to finding and caring for every last person with lymphatic filariasis and stopping transmission of this terrible disease.”
“Achieving elimination of lymphatic filariasis is evidence of the remarkable impact that Lao PDR can have on public health with good investment and partnerships,” Dr Lo said.
Mr. Michael Ronning, USAID Laos Country Representative said, “The United States government congratulates Lao PDR for eliminating lymphatic filariasis as a public health problem. This accomplishment brings hope and enormous benefits to the Lao people now and in the future.” He added, “This is the second neglected tropical disease that we have worked together with our Lao counterpart to end and we hope to continue to do so, improving the overall health of the people of Laos and saving lives.”
By 2002, lymphatic filariasis was endemic only in Mr Lokxayyalueb’s home province of Attapeu. To eliminate it, local health authorities and partners gave preventive medication to communities who were at greatest risk.
Elimination work also benefited from activities to reduce malaria and dengue, including distribution of long-lasting insecticide-treated nets and health education programmes, which also protected people from mosquito’s transmitting the parasite causing lymphatic filariasis. Partners and donors supported activities including medication administration, monitoring and surveys to assess the disease’s spread.
Director of Sanamxay District Hospital Dr Kham-In Kongkasan, 47, and his team had to overcome many challenges to protect the community.
“Lymphatic filariasis is not easy to treat and there were many cases in our district.”
“We also had to control the disease to prevent it from spreading and affecting people’s health and household finances, because if someone is sick, they would have to spend quite an amount of time and money for treatment.”
Lymphatic filariasis, commonly known as elephantiasis, causes the enlargement of body parts, often resulting in pain, severe disability, stigma and – economic hardship.
“There was one man we encountered who had been affected, which made his legs bigger. This also affected his family because they had to spend money and time on the treatment.”
As part of elimination work, Dr Kongkasan and other health workers needed to educate people about the risks of lymphatic filariasis.
“Sometimes, when our staff visited villages and conducted health education activities, villagers didn’t understand the danger of the disease or the benefits of the medicine. We did our best to educate people.”
Dr Kongkasan sees his work in the community as contributing to the overall health and development of Lao PDR.
“I feel very proud to be able to help people and make our community and our country free from lymphatic filariasis.”
“For our country to continue to develop, it is important for people to have good health and to be free from diseases, especially lymphatic filariasis, which is not easy to recover from.”
“People are at the centre of development. For a community to be developed, our people need to be healthy enough to be able to work to improve their quality of life, support their family and serve the community.”
Surveillance and awareness work must now continue, said Dr Kongkasan, so health workers can respond quickly to any cases.
“One important thing is that people are aware. We must stay vigilant to prevent it from coming back. Just because we announce the elimination this year, it does not mean it is 100% gone and won’t be back. We have to continue monitoring and stay alert.”