Background about Wad-Alnemair village:
Sennar state: located southeast Sudan (360 kilometers, 7 hours) from Khartoum the capital of Sudan is one of three states with the highest number of cases reported in the Mycetoma research center, the other two states being AlGazira and White Nile states.
Wad Alnemair is a village in East Sennar locality, and it has the highest prevalence of mycetoma cases in Sennar state. The number of families in this village is 403, with a total population of 2017 person. There are 88 documented cases of Mycetoma living in Wad Alnemair village according to a house to house survey conducted by the MRC on March 2016.
Wad-Onsa is another village in eastern Sennar, it is close to wad
Alnemair village and has a recently established medical center designed to detect and provide care for mycetoma patients, to provide a nearby access to health care for patients who can’t afford to travel and refer those in need of further care to the MRC.
During a field trip that was made to Sennar state by the Mycetoma research center (MRC) in March 2016, several villages have been visited and many factors were observed that are implicated in making Mycetoma so prevalent in Sennar state and specially Wad-Alnemair village:
- Due to the favorable environmental conditions, different kinds of thorny trees and plants grow in that area. These thorny plants are used by the locals for building animal houses (Zaraeb) adjacent to their houses. They use these thorns as building material because it is easy to collect and use and provide a cost effective alternative.
- But, as we previously said, these thorns are the commonest cause for trauma by which the mycetoma disease is introduced, and using them for building animal houses inside the village is predicted to be the principal cause for the wide spread of the disease. Not to mention that the animals themselves may be hosting the disease, and breading them inside the houses aids in the transmission of the disease.
- Due to the low socioeconomic status of the locals and the lack of knowledge about the disease and its form of transmission, their daily life routines include a lot of risky behaviours and disregard to safety measures. For example, most of the locals there work in farmi
ng, and almost all of the farmers prefer to work in the farms barefooted and without protecting their hands.
- Another risky behavior that was observed is the use of animal waste to protect the houses during rainy seasons. In addition to that, many of the children in the village go to school and play in the fields barefooted, and they also help their parents in the farm work. This can explain the fact that the most affected ages are the young adults, and that Mycetoma is most reported among farmers.
- Waste is collected and disposed of regularly throughout the year except for rainy seasons. During rain
y seasons waste is taken into the animals’ house to lay there and to be re-used later by ‘Al-Qamaier’. This can attract flies and rodents which transmit diseases back to the community, it may also be a cause of pollution of water and soil.
- To determine the factors that are linked to the transmission of Mycetoma and change it with alternatives that are socially accepted, friendly to the environment and help in the control of Mycetoma.
- To measure the effect of each environmental intervention at a time to know the contribution of factors separately.
- To raise the community awareness about the disease and change the behavior in a matter that prevents them from acquiring the disease.
- the project aims to address and study the effects of two environmental factors in the transmission of Mycetoma, which are:
1-Protective footwear for students and farmers
2- Elimination of thorns from animal houses
The project will be divided into two phases and an intervention will be implemented for each factor separately, in order to study the effect each factor has on the transmission of Mycetoma.
Phase one: Protective footwear for students and farmers
- Providing students in need with shoes to wear to school, and farmers with shoes and gloves to work safely in the farms:
- Involving teachers and parents in the intervention by enforcing regulations to prevent students from coming to school barefooted.
- Providing health education for farmers to emphasize the importance of protecting the hands and feet while farming and cultivating the fields, and making sure their children are protected as well while helping them in the fields.
- Organizing community campaigns to clean up the fields in which children play and practice sports from harmful objects and thorns.
Phase two: Elimination of thorns from animal houses:
- The aim of it is to replace thorns as an ingredient for building the animal houses with a cost effective material safe for both man
and animal, and to relocate the animal houses from inside the village to a known agreed upon location just outside the village with easy access t
o all the locals, in order to decrease the chance of disease transmission from animals.
- Wad alnemair village contains 47 units for cows and 98 units for goats and sheep. The coming list contains the suggested materials:
- Zinc metal roofing system
- Bamboo sticks
- Net fences
- Accompanying programs:
- A well prepared educational program, targeting all age groups with appropriate materials (brochures, posters, films and projected material) will be delivered to population at the field trip.
- Training a group of well known activists on how to deliver a decent amount of information about mycetoma and the best way to deliver it “picking the right time and place”, then it will be their duty to convey this information to the people.
- Students of universities from the area can be trained to talk about mycetoma because people of rural areas are likely to listen to them as they have a good social status in the villages.
- Act shows, poems and commercials about mycetoma can be broadcasted through the local radio and sure it will aid in the delivery of our massage.
- Training of local medical personnel in the area on the identification, management, and referral of cases of mycetoma.
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