Amidst risks posed by drought, joint response brings scabies under control

By Paul Schemm

ADIGUDOM, Ethiopia, 27 April 2016 – For Kibrom Mekonnen, the itching was the worst at night, all over his hands and chest and keeping him awake.

“When I slept it just kept itching,” said the 14-year-old, sitting in the examination room at the Adigudom Primary Hospital in Hintalo Wejarat Woreda (district) in the Tigray Region. “But I was afraid if I started scratching, it would get worse.”

Scabies response in drought-affected areas
Kibrom Mekonnen, 14, listens as a nurse explains how to use the special soap and medication to combat scabies. ©UNICEF Ethiopia/2016/Balasundaram

Kibrom’s instincts were right because he has scabies, a contagious skin infection caused by mites that burrow along the top layer of the skin, lay eggs, hatch and spread throughout causing terrible itching.

The real danger, however, can be in the scratching which opens up sores in the skin.

“By itself, it is irritating and itchy but it also exposes you to other infections,” explained UNICEF Heath Specialist Yayneshet Gebreyohannes. “It can result in systemic infections if left untreated.”

Drought brings scabies revival

Scabies has actually been fairly rare in Ethiopia for the past several years, but with the sharp drop in the availability of water due to the worst drought the country has faced in decades, it reappeared.

Casual contact, a handshake or even a hug, is not enough to transmit the mites. There has to be prolonged skin contact or sharing of clothes, which means that outbreaks often happen within the tight confines of homes and schools.

With less water available to wash and maintain personal hygiene, there have been outbreaks in the country.

In the Tigray Region for instance, there were 27,000 new cases reported between October last year to March this year, and nearly 10,000 of those were in Kibrom’s woreda.

Since then however, there has been a significant drop in the number of cases due to the Government leadership and solid response and also UNICEF support to prevent and treat the disease.

In addition to providing medicated soap and permethrin lotion to treat the disease, UNICEF has distributed brochures and teaching guides to educate people about how to combat it and most importantly, not to stigmatize the victims.

Stopping the itch

Kibrom thinks he was infected by a visiting relative, about his age, when the latter visited from a rural village and shared Kibrom’s bed about a week earlier.

Scabies response in drought-affected areas
Kibrom applies sulphur ointment, one of the methods used to treat scabies, to his hands. UNICEF has partnered with the Federal Ministry of Health in its scabies response and has provided permethrin lotion, medicated soap and brochures and guides to inform communities about the diseases. ©UNICEF Ethiopia/2016/Balasundaram

The nurse examines his hands where telltale rashes have appeared in the folds of the skin at the joints.

She walks him through the three-day treatment of soap and medication and promises to visit his family home to advise them on precautions to be taken and provide medication for the rest of the family.

For instance his clothes will have to be treated with boiling water, as will his bed linens and many of the fabrics in the house.

Kibrom is lucky in that his home has piped water, but when water is unavailable, health workers advise people to tie clothes into plastic bags for three days – the lifespan of the mite.

Kibrom is also lucky because his area was targeted by the information campaign so that someone at school identified his condition and explained to him what the horrific itching was all about. Otherwise, he might have just tried to endure – and possibly infected others.

“I kept thinking it was going to go away on its own,” he recalled.

The scabies response is part of UNICEF’s health, communication, and water, hygiene and sanitation  response for drought and flood-affected populations. UNICEF also provides financial support, supplies including medicines and vaccines, and technical assistance to the Government for the prevention and treatment of major causes of childhood illnesses and deaths such as acute watery diarrhoea and other diarrhoeal diseases, vaccine preventable diseases, as well as other diseases such as meningitis.

27,000 People to benefit from Multiple Village Clean Water Supply Project in Tigray

Young girl fetchs water from a new water point built by the support of UNICEF
The Ebo clean water project benefits 27, 000 people in seven villages including 15, 000 school children with clean water in their school and households. Young girls now can attend school regularly without spending more time looking for water. ©UNICEF Ethiopia/2015/Bizuwerk

Ebo, Raya Azebo woreda, Tigray 11 February 2015: A multiple clean water supply scheme in Ebo, Raya Azebo woreda of the Tigray National Regional State goes operational today. The project will benefit 27,000 people in seven villages including 15,000 school children with clean water in their school and households.

The Ebo clean water project, with a total cost of 20 million Ethiopian Birr, is a unique project as it not only demonstrates how investments in long term sustainable water supplies can reduce the carbon emissions from water trucks, but also contributes to making Ethiopian towns and villages greener and healthier for women and children. The project shows how resilient water supply solutions can be implemented in areas where there is low average rainfall and difficult hydrological conditions. In addition, it is 70 per cent cheaper than water trucking which has been the practice previously in the villages.

The Regional Government of Tigray and the woreda Administration of Raya Azebo actively partnered with UNICEF Ethiopia to undertake a detailed technical groundwater assessment to locate deep groundwater which could be exploited for this water supply scheme. UNICEF also called on its large national and international expertise to provide high technical support and mobilised funds from UNICEF Germany to finance the construction of the entire water supply scheme.

Multiple clean water scheme inauguration
H.E Ato Alemayehu Tegenu, Minister of Water, Irrigation and Energy and Ms. Anupama Rao Singh, UNICEF Ethiopia Representative a.i. cut the ribbon inaugurating the Ebo multiple water supply scheme facilities. ©UNICEF Ethiopia/2015/Bizuwerk

Inaugurating the project, Minister of Water, Irrigation and Energy, H.E Ato Alemayehu Tegenu said, “We went to every corner of the possible system to make the voice of water and sanitation heard. And to promote synergies between all those whose mandate mattered to water. Now, our country has made tremendous progress over the past decade in the water and sanitation sectors and lowered the incidence of water-borne diseases significantly. We now have the opportunity to witness such a breakthrough, made possible through the committed effort of the government, development partners, NGOs, the private sector and the community. Raya Azebo Multiple Village Clean Water Supply Project in Tigray region is one of the exemplary project, providing the community with reliable access to safe water.”

UNICEF Ethiopia Representative a.i. Ms. Anupma Rao Singh said, “UNICEF will increase its technical and financial support to the water supply and sanitation sector in the Tigray Region. We also reaffirm our commitment to finance another 3 multiple village water supply schemes similar to the Ebo scheme with the aim of alleviating the burden of water collection for tens of thousands of women and children in the Tigray region.”

Ethiopia has made substantial progress in improving access to water supply and sanitation coverage since 1990. The recent National WASH Inventory data helps to confirm that, with the 2015 prediction of 57 per cent water supply coverage, Ethiopia is well on track to meet the water target of halving the 86 per cent of the population without water. The completion of such cost effective schemes is an indication that the country is now heading into innovative approaches to address people especially the hard to reach areas who are without access to safe water services.