Tropical disease specialist and this year’s Homer G. Phillips lecturer Dr. Frank Richards Jr. received an award of merit for bettering the human condition from Washington University School of Medicine.
Richards is director of Parasitic Disease Control Programs at the Carter Center in Atlanta.
In addition to promoting peace, the Carter Center works globally to eliminate diseases of poverty, which is also the life’s work of the University City native. Richards said he developed the river blindness program at the Carter Center, cited in former President Carter’s Nobel Peace Prize in 2002.
“I am as close to the front lines of public health and tropical public health as you can get,” Richards said in his lecture, which was sponsored by the Office of Diversity Programs at Washington University School of Medicine.
Health treatment issues facing urban communities in the U.S. have similarities to problems of urban settings in countries located along and below the equator. Poverty, mistrust, stigma and cultural norms make it difficult to seek or accept treatment for illnesses from outsiders.
While answers to some health problems lie with awareness and preventing illness in the first place, poverty casts a long shadow that breeds disease and hinders access to care.
Richards says when the program to control river blindness (onchocerciasis) were started by the World Bank in the 1970s in West Africa, half of the adults in some communities were blind, unable to care for themselves, their family or to raise crops.
“And kids spent their time leading their blinded parents around, taking care of them,” Richards said.
The illness spreads through the bite of a small black fly that spreads parasitic roundworm larvae into the body at the point of entry. The adult female worm can live in nodules under the skin for several years, and as its offspring makes its way to the eyes, it causes intense itching, eyesight damage and often blindness.
His lecture topic, “Diseases of Poverty: A Deployer of Available Tools,” examined how tropical disease workers got creative and used rural village members to successfully treat this preventable disease. “Community-Directed Distributors” live in the remote villages and give safe medicines to villagers to prevent river blindness. Richards described it as a public-private partnership – finding a way to get the medicines out if they are available and free.
“That is, taking these medicines from port to the end of the road, where these conditions exist, and then providing what we call a mass treatment, where everybody in the community is treated once or twice a year with these very safe and effective medicines, which prevent, in this case, river blindness,” he said.
This begs a question: Could community-directed distributors work in U.S. inner cities to prevent and treat illnesses that are rampant in St. Louis and other African-American communities – for example, HIV and other sexually transmitted diseases?
Could dedicated individuals from the ‘hood educate and offer known safe and effective medication?
An answer may be found in the work Richards and a colleague did on kinship structure and healthcare improvement in Sub-Saharan Africa.
“This approach ensures trust, equity, equality of health care delivery at the community level and I think that is what we are talking about, not only internationally, but locally,” Richards said.
“The way we work is through communities, through partnerships, empowerment and development of confidence and trust – over a long period. Not a two-year project; not a five-year project; but 20-year projects.”
He said community-directed health care is always about coalitions, communities making decisions for themselves and empowerment.
The Carter Center assists health ministries in 11 countries on two continents. Through the center, health ministries in the African nations of Cameroon, Ethiopia, Nigeria, Uganda and Sudan receive health education and Mectizan, a medicine donated by pharmaceutical maker Merck & Co.
Mectizan kills the black fly parasite’s larvae inside the body, preventing them from nesting in the eyes and causing blindness.
The Carter Center works with the Lions Club and health ministries in Brazil, Colombia, Ecuador, Guatemala, Mexico, and Venezuela to control river blindness in Central and South America.
Just last week, the Carter Center received two new half-million-dollar pledges – $500,000 toward the Onchocerciasis Elimination Program for the Americas and toward its Guinea Worm Eradication Program from the OPEC Fund for International Development.
