Communities where the program has been implemented demonstrate increased awareness around LF and lymphedema patients, and this has been shown not only to decrease stigma for those suffering from the chronic infection but also to increase community acceptance of LF prevention efforts, such as mass drug administration. The program has been so successful that the Ministry of Health and National NTD Program plan to carry out the CASA model throughout the country.
Volunteers go to where the patients are in their communities rather than treating them after they arrive at a medical facility. “We realized it’s difficult for the person (living with LF) to get to the hospital,” said Jonathan Rout, CASA Program Manager, who was recently in Washington, D.C., to connect with colleagues at the Neglected Tropical Disease NGDO Network.
It’s painful and often difficult for people with severe swelling to travel. They also sometimes lack the support system to arrange for their transportation. “We bridge the gap,” Rout said.
Lymphatic filariasis is not only a health issue but also a development issue.” – Jonathan Rout, CASA Program Manager
CASA trains local task force members, family members and health activists in the principles and practices of lymphedema self-care through home-based, foot care management. The volunteers then go door to door, seeking out people who are suffering. In some cases, they have found people who have been cast out, living with farm animals.
Upon finding someone who needs care, program participants check the affected areas for infection and lesions. Then they wash the area and teach the person, or their loved ones, how to care for and maintain the condition. The education includes washing techniques, explaining how exercise can increase mobility, why they need to keep their extremities elevated and how proper shoes can help. If they find someone having an acute attack, they consult a village health worker for antibiotics or refer them to the local hospital.