Causes and infection routes still unidentified
Mycetoma
is an infectious disease whose peculiar variety of germs exist in the soil and pass
on to humans through abrasions of hands and feet, and start affecting muscles
and bones. It triggers inflammation within the body at first, and the affected
area grows gradually larger over some a period of time. In the later stages of
Mycetoma, when the inflammation gets rather widespread, sufferers not only find
it difficult to manage their daily lives but also come to be bothered by acute
pain when the infection reaches as far as the bone. In the worst cases, the
victim could ultimately lose his or her life.
In the earlier
stages where patients have not yet suffered serious damage, they can be cured
of this illness with the help of appropriate medical treatments including
medication. When the illness progresses to a critical condition, however, they
might unfortunately have no choice but to have their limbs amputated. The biggest
concern about Mycetoma is that what causes the conditions mentioned above and
how the infected person contracted the illness have not been fully identified
yet.
A boy, who underwent
an operation on his hand which had been infected with Mycetoma, being attended
to by his mother. Andalus village of the White Nile State (November 16, 2017)
Sudan has
suffered from a particularly high morbidity rate of this persistent and
progressive disease, Mycetoma. This has allowed Sudan, however, to become one
of the best-prepared nations in the world with measures against its Mycetoma
infections. Despite the prevalence of the disease in Sudan, Mycetoma has not yet
become a disease widely familiar among the Sudanese, meaning that the affected sometimes
end up being given inappropriate medical
treatments. Those infected also experience discrimination in their community.
Putting
all these factors into consideration, AAR Japan launched substantial supports
to Sudan in 2013 and started to provide preventive measures against Mycetoma as
well as medical treatments to cure those infected with this illness.
Visiting door-to-door to provide knowledge and
information to local people
AAR Japan
has provided, mostly within and around Andalus Village of the State of White
Nile, activities to let people acquire greater knowledge about Mycetoma, to allow
them to understand the significance of securing the earliest possible opportunities
of getting medical treatments. These activities also include preventive
measures against this disease and have allowed seriously ill patients with
advanced infections to undergo medical procedures.
During
the three days’ campaign and activities in which I took part in November 2017,
we transmitted the knowledge about Mycetoma to 1,726 villagers in total and provided
opportunities to have surgery for 35 of the affected locals in the area.
As to the
knowledge about Mycetoma, AAR’s staff members paid visits to individual houses
and community spaces in this area and provided villagers with detailed
explanation with the help of visual aids.
Most of
the cases related to Mycetoma infections have been reported in economically underdeveloped
areas of Sudan. Andalus Village, where we performed our mission, is also
located in such an area. While it might sound steady but too slow a procedure that
we visited houses one by one and explained things in detail to locals at each
household, but we regarded it as the most efficient working method to meet and
talk to residents in person, owing to a lack of mass media such as TV sets,
radios or newspapers available in the village. The AAR Japan team thought that
the above-mentioned method would enable us to convey information and knowledge
to a good number of residents at once without giving misleading contents or creating
any misunderstanding among them.
We found
that only a few locals had known Mycetoma and all those who participated in our
activities were well-focused enough to receptively listen to our presentation during
the campaign. I felt that all of them assumed the kind of positive attitude enabling
them to absorb as much of the new information as possible, as they felt that the
information and knowledge previously available to them had been quite limited.
Our key message
for locals has gradually spread among more and more of the residents via human
routes over time.
Enlightening activity at a local elementary school in
an effort to transmit facts and knowledge about Mycetoma to pupils, while Ryohma
Yamagishi standing still and alert behind the lecturer.
Andalus village White Nile State (November 18, 2017 )
While one
of the AAR’s staff members was talking about Mycetoma in the presence of
residents one day, he found a mother who already possessed a very solid
knowledge of the conditions related to this disease. When he asked her where
she had acquired that knowledge and information, as he hadn’t expected such a
case, she said that her child had once heard another AAR staff member’s presentation
about Mycetoma and shared the information he learned. This episode has impressed
me greatly and provides evidence that the facts and knowledge about Mycetoma that
AAR prepared for locals have steadily taken root among villagers.
Surgeries were provided to patients for free
by doctors whom we had dispatched from Khartoum, capital city of Sudan.
It remains
difficult to prevent the infection of Mycetoma due to reasons such as
insufficient transmission of knowledge and information about this disease, and also
a lack of a solid medical system that can fully cope with this issue. It will
continue to be essential for the villagers to have access to medical treatments
after their initial infection, including immediate care for the affected parts
of their body. Especially in the case where the infection has grown larger as
the disease itself develops, it must be removed completely through surgery.
Additionally,
Mycetoma is not yet well known even among doctors in Sudan and medical
operations are a possible choice for the affected only in designated hospitals in
the capital city of Khartoum. Andalus village is situated far away from the capital city, which might
force the patients to stay there for several days when they seek after medical
treatments. Very few villagers can come up with the travel or accommodation funds required for their long
journey to the capital. Also, only a few people can leave home and their daily
housework chores behind them, or take days off from their occupations (mainly
agricultural fields and dairy farms), which leads to the frequent case where they
give up opportunities of getting medical treatment after having been infected with
Mycetoma, in which ultimately leads to them being in serious condition.
AAR had doctors and medical staffers dispatched from
Khartoum and provided surgeries for nothing to cope with Mycetoma. Andalus Village
of White Nile State (November 16, 2017)
To assist
with this, AAR dispatched to Andalus Village doctors and medical staffers who
had treated patients infected with Mycetoma and had them perform surgery for free
to the patients. Those who had been seriously ill enough to need surgery seemed
to have put many uneasy days behind them, as after the surgery, many of them
had a very serene and bright expression on their faces despite some lingering
pain from their operation, which fact very much attracted our attention.
In the
case of an eighteen-year-old youth who underwent the surgery, he developed
Mycetoma around the age of 10 and lately suffered from acute pain, which
deprived him of sound sleep. After the operation, he said that he was able to
have a good sleep for the first time in ages and was also able to find the food
prepared for him palatable and delicious.
He told
us that there were still many more people possibly suffering from untreated Mycetoma
in his neighborhood and he would be sure to advise them to seek professional care
and treatments at medical institutions.
A youth who had been infected by Mycetoma said, “Thanks
to the surgery, I have been able to have enough sound sleep for the first time
in ages and also been able to find meals prepared for me to be palatable and
delicious.”
Andalus Village, White Nile State (November 16, 2017)
We have
provided various activities in an effort to realize our supportive mission to
visit areas dealing with the issue of Mycetoma, and probed the status of locals’ lives individually so as to the
identify complex factors with which they were facing. They were leading
everyday lives with thr painful idea that they might continue to be exposed to
a risk of developing Mycetoma at any time in their daily environment.
The efforts
of our group and individual meetings with those living with a pressing risk of
developing Mycetoma in their daily lives have enabled us to better understand how
uneasy they have been feeling for lack of information. We further understand
how anxious they have come to feel when finding themselves without
opportunities for surgery despite their earnest wishes for medical treatment.
Our
rescue efforts could be translated as slow but steady, for we have provided the
scheme in which we try to stay closely attuned to individual circumstances of
villagers. Seeing the results of our work, I feel that such laborious efforts have
been sufficiently rewarded.
Children in the village with notebooks in their hands,
which AAR has distributed and that contain information and knowledge about
Mycetoma.
Andalus Village( November 17, 2017)
Reporter
Ryohma YAMAGISHI、AAR Japan Sudan Office
Ryohma
YAMAGISHI has worked at AAR Japan Sudan Office since July 2017.
At a college, he majored in social development and
international law.
Working for the Japanese Red Cross Society, he carried
out a research on peace formation at a graduate school. After working for the
Japanese Embassy in Bosnia as a research specialist, he has joined AAR Japan.
He is from Kyoto Prefecture.
(Profile as of the date of the article)
