Dedicated to fighting river blindness in his native Cameroon, Carter Center epidemiologist Philippe Nwane employs creativity and innovation to monitor the debilitating parasitic infection.
The late afternoon sun has begun to set as Philippe Nwane, 38, carrying a long plastic tube, walks slowly through a sweet potato field near a remote village in western Cameroon. He approaches a local stream and finds what he has been hunting for all afternoon-a spot where hundreds of buzzing black flies thicken the air.
Collecting Flies, Containing River Blindness
Nwane sat down on a rock on the river bank and rolled up his pants to attract flies to his bare legs. As the Simulium flies landed on him seeking their blood meal, he carefully sucked them into his self-styled "aspirator."
He repeats this action over and over again, capturing dozens of flies and seemingly never tiring of the arduous task. The local villagers accompanying him-just trained that morning and armed with their own aspirators-have been working for hours alongside Nwane to collect hundreds of flies that he will take to the Carter Center's lab in Yaoundé.
River blindness — or onchocerciasis — is widespread in Cameroon, with an estimated 5.1 million people infected, and approximately 62 percent of its population at risk for infection. Nearly 60,000 people are believed to suffer some degree of visual impairment from the disease.
The goal of the fly collection is to check on the progress being made in the village against the debilitating parasitic disease river blindness, which is transmitted through the bites of these black flies that often breed in swiftly flowing rivers.
"I try to capture the flies before they bite me," he jokes, a sly smile crossing his face. The bites cause painfully itchy welts that even Nwane, who grew up in a river blindness-endemic village, has never quite gotten used to.
The villagers have been hard at work conducting health education and distributing once-annual treatment of Mectizan® (donated by Merck & Co., Inc.) to prevent the disease's excruciating skin rashes and vision damage. If fewer flies carry the parasite, it means the humans they bite are not as burdened by the disease as before.
From Shoe Soles to Disease-Fighting Tools
The first in his family to receive an education, Nwane currently is working on his doctorate in entomology (the study of insects) and has been an epidemiologist for The Carter Center since 2009. He first learned about the Center when he was conducting field research on malaria mosquitoes in northern Cameroon. He was later recruited to carry out entomological studies to help facilitate disease monitoring for onchocerciasis and malaria.
However, only a short time into his new job, Nwane found the aspirator in his field office required a lot of energy to use.
"When you have an object, you should look at it and ask, 'Does it work for me'?" Nwane says. "You should try to find a way to make it work better, cost less to make, or more practical to use."
Nwane started reinventing tools when he lived on his family's farm in Nsingmbongo, Nyanon District, where he is one of five children. On the farm, he created a hoe typically used by women and made a more effective tool out of boxes and other simple materials he had available at home.
So, he created an aspirator for the River Blindness Program using the soles of women's shoes, among other materials, to seal the plastic container carrying the flies. His new aspirator is so popular, he's made about 100 of them for use throughout Cameroon and even in other river blindness efforts in Sudan. He also has created mosquito traps using bed nets.
Fighting River Blindness in Cameroon
In the early 1990s, the River Blindness Foundation began assisting Cameroon's Ministry of Health to distribute Mectizan in North province. The Carter Center assumed the River Blindness Foundation in 1996 and in partnership with the Lions Clubs International Foundation began working in Cameroon's West province the same year.
River blindness is controlled throughout Cameroon and has nearly been eliminated in the North region through the efforts of The Carter Center-in partnership with the Lions Clubs International Foundation-and innovative staff like Philippe Nwane.
In 2009, more than 1.6 million people in Lions-Carter Center-assisted areas in North and Western regions of Cameroon received mass Mectizan treatments from nearly 44,000 trainers.
The work has been making a big impact. Onchocerciasis is now controlled throughout Cameroon: a study conducted in North region in 2009 found that after 17 years of annual Mectizan treatment, there were dramatic reductions of infection rates and disease burden, especially among young children. Despite these successes, there remains a real risk for blinding onchocerciasis to reemerge, and annual mass drug administration efforts must continue.
Hoping For Even Greater Success
"In my home village, they used to believe river blindness was caused by an invisible force or spirit," he says. "But with health education and distribution of Mectizan, people now know it's a disease and program efforts are working."
Yet, Nwane hopes for even greater success.
"I would like to see the entire country get rid of river blindness one day," he says. With continued hard work from Nwane, the national program, village volunteers, and perhaps even a few new inventions, Cameroon is well on its way to finishing the job.
Read more about river blindness prevention in the latest issue of Eye of the Eagle (PDF)
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All photos: Carter Center/ K. Callahan
Carter Center Epidemiologist Philippe Nwane has created more than 100 aspirators—like the one he holds above—for Carter Center river blindness staff, using local materials, such as women's shoes.
The aspirators are used to collect the black flies that transmit river blindness. The flies are later brought back to labs and studied to determine how efforts to fight the parasitic disease are working. "When you have an object, you should look at it and ask, 'Does it work for me'?" Nwane says. "You should try to find a way to make it work better, cost less to make, or more practical to use."
The Carter Center is a leader in the fight to eliminate the debilitating parasitic infection river blindness—one of the major causes of preventable blindness in the world—in the Americas and where possible in Africa. The Center has been working in Cameroon in partnership with the Cameroon Ministry of Health and Lions Clubs International Foundation since 1996.
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