"Advocacy, in general, is important but it is crucial that it reaches where the results of advocacy are needed most - the community members, their sultans and their elected representatives," Girija Sankar, Head of Neglected Tropical Diseases (NTDs) at CBM.
I understand advocacy as a concept - to advocate means to make a case for something, to justify the need for something. However, the further the act of advocacy is from the outcome, the more difficult it is to grasp the need for advocacy. I am usually advocating for our work to prevent and treat Neglected Tropical Diseases (NTDs) thousands of miles away from the target populations - the communities participating in NTD treatment campaigns in countries such as the Democratic Republic of Congo or South Sudan.
In June 2022, I had the opportunity to observe advocacy work where it matters most - in the small county of Yambio in Western Equatoria State, home to less than one million people. While preparing for the visit in Juba, the capital of South Sudan, everyone I met praised the greenery and cooler temperatures of my next stop, Yambio. They were right. The twin-engine 19-seater turbocharged plane flew us over miles upon miles of resplendent green forests and grasslands.
We were in Yambio for two reasons.
- The first reason was straightforward - to raise awareness (or advocate for) the upcoming annual Mass Drug Administration (MDA) round against onchocerciasis (oncho) and lymphatic filariasis (LF) using ivermectin and albendazole.
- The second reason was to advocate for continued support for NTD interventions by the state and countries. There had been concerns around a treatment campaign the previous year that was not one that CBM had had any involvement with but the outcome had nevertheless eroded a certain amount of trust amongst the stakeholders. In addition to CBM colleagues, we had with us the NTD programme leaders from the National Ministry of Health in Juba.
When mistakes happen, even if you are not responsible for them, the aggrieved must be allowed all the time they need to voice their displeasure - an excellent lesson in public health diplomacy that we learned from Mr Yak Yak Bol, the NTD coordinator for South Sudan.
Yak and his team listened patiently as first Ms Rose Obede, the state’s Director General for Health Services, then her boss, the State Minister of Health, and later his boss, the Governor of Western Equatorial, each shared their concerns about the challenges in the praziquantel campaign last year.
It helped, of course, that the meeting with the Governor was held outside his home, in an open courtyard where the early morning breeze cooled frayed tempers. Once the state and local authorities felt they were heard, they acknowledged the efforts of the national programme and partners in visiting the state and preparing the ground for the next round of MDAs for oncho and LF, which are directly supported by CBM.
The next day, the District Governor, with support from the National Ministry and CBM, organised a day-long workshop for Sultans (Community Leaders or Chiefs ). Here we advocated for the need for MDA so that future generations are not blinded by preventable causes. The workshop was attended by the Ministers of Information, Education, Health and the Commissioner and the Mayor of Yambio county. Suffice it to say that everyone in the state administration now knows about onchocerciasis, schistosomiasis and lymphatic filariasis.
The Sultans learnt about the need for prevention and treatment efforts and appreciated that as community leaders, they play a critical role in mobilising support for the programmes.
Later in the afternoon, we promoted the upcoming MDA to the residents of Yambio town at a football match and traditional dance performance. The traditional dancers danced and the football players kicked off with gusto. The commentator peppered his energetic commentary with messages about oncho and ivermectin. Apparently, the equatorial rain gods were also listening, because the clouds unleashed a torrential downpour that lasted for several hours.
With support from CBM, WEQ will launch and complete the 2022 annual round of MDA for oncho and LF by the end of June 2022 - a success for advocacy and for all the community members who are vulnerable to the impact of these diseases. Our visit to Yambio demonstrated that advocacy, in general, is important, but it is crucial that it reaches where the results of advocacy are needed most - the community members, their sultans and their elected representatives.