For Alba Lucia Morales Castro, health education adviser with the Onchocerciasis Elimination Program for the Americas (OEPA)--the Carter Center-sponsored river blindness elimination organization in Latin America--the joy of working in the field is its own reward.
With OEPA for more than a decade, she has a long history of dedicating herself to the people she serves. While studying bacteriology at the Universidad del Valle in Cali, Colombia, she also found time to organize the women of her community into a collective, through which she promoted women's rights and child nutrition.
"When I finished in the university, I worked in the lab for three or four years, but I needed to continue working with people," she says. "So I went on to earn a public health masters, so that I could work outside of a lab."
After working for public health programs in her native Colombia, focusing on leishmaniasis and malaria, she took her current position with OEPA in 1997 and moved to Guatemala.
"In this work, I am happy, because I can go and work with the people and then come back to the office," she says. "We have resources to work with the people, to support their activities in the field."
Morales' greatest challenge in the final push against onchocerciasis is to ensure that people in the communities remember the importance of taking Mectizan®, donated by Merck & Co. Inc., which effectively and safely treats and prevents river blindness by killing the microfilariae--offspring of the adult worms, which mature from larvae transmitted through black fly bites--in the human body. Untreated, the microfilariae irritate the skin and cause intense itching, skin discoloration, and rashes. If the microfilariae enter the eyes, they cause inflammation and irritation, which can cause diminished vision and potential blindness.
By encouraging local health staff in their educational efforts, Morales hopes to help people understand that the disease may still be present in their bodies, even though there is no visible sign of it, so they must continue using the drug that treats and prevents it.
"The disease is every day less present in the communities," she says. "So for the program, the most important thing to do is health education, both for the health workers and the communities."
Thanks to the innovative educational methods she has seen used in the six river blindness-endemic countries in the Americas--Brazil, Colombia, Ecuador, Guatemala, Mexico, and Venezuela--Morales is confident that OEPA will reach their 2015 goal for stopping transmission. To-date, no new cases of blindness resulting from river blindness have occurred since the program reached its goal of treating 85 percent of at-risk populations in the Americas with Mectizan® twice-annually.
"This program is a very important case in international public health, to show that the challenge is possible," she says. "We can be a model for the international public health community."
The Carter Center leads efforts to eliminate river blindness from the Western Hemisphere, working with including Guatemala's national onchocerciasis program, The Lions Clubs International Foundation, Merck & Co. Inc., the Centers for Disease Control and Prevention, PAHO, and the Bill & Melinda Gates Foundation.
Morales talks to children during a health education lesson in El Xab, Yepocapa district, Guatemala. Other than distributing Mectizan®, the drug that prevents onchocerciasis, health education is the most important task for the teams dedicated to eradicating river blindness.
As part of a health education activity on onchocerciasis, health workers hang a piñata of a black fly--which spreads the disease--while school children look on in anticipation.
Morales checks a woman's head for nodules caused by microfilariae: offspring of the adult worms, which mature from larvae transmitted through black fly bites.
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