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MSF in Bolivia, 2012
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The prevalence of Chagas disease in Narciso Campero province, Bolivia, is more than 40 percent in the general population, but doubles to 80 per cent for people aged over 45. Access to treatment, however, is difficult: most health facilities charge fees, and people tend to live a long distance from centers offering diagnosis and treatment. Screening is vital because Chagas can be deadly. Although people may live for years without symptoms, the disease can ultimately cause debilitating complications. Heart failure is the most common cause of death for adults. These complications require complex clinical treatment, which is not usually available locally. New, simpler models of care are needed so that patients can get the treatment they need at their local health centre. Doctors Without Borders/Médecins Sans Frontières (MSF) staff carry out screening and treatment for Chagas in the communities of Aiquile, Omereque and Pasorapa, in Narciso Campero province, and offer training to health staff. In 2012, MSF signed an agreement with the Bolivian organization Puente de Solidaridad and the local hospital, which allows patients with heart and intestinal complications to be referred to the hospital for specialist treatment free of charge.
Production of Medication Guaranteed
In 2011, benznidazole, the most commonly used medicine for Chagas, became unavailable when the world’s sole manufacturer of the drug, based in Brazil, ceased production. After intensive lobbying, production of the medicine resumed and delivery has been guaranteed for 2013. In November, MSF introduced a pediatric formulation of benznidazole for younger patients, developed by the non-profit research and development organization, the Drugs for Neglected Diseases initiative (DNDi).
Angel, 55 years old, lives in Chujllas, a small rural community in Cochabamba department.
I wasn’t feeling well. I had some palpitations when I was sleeping. I went to the hospital in the town of Aiquile for a diagnosis. The results were that I had Chagas. But it was impossible for me to keep going to Aiquile for treatment. Six months went by and a friend told me that MSF was coming to Chujllas. “This is very important,” I said, “we mustn’t miss this opportunity.”
The whole community met with the doctors. By that time I didn’t feel like working or even eating. I started treatment. I recovered. I hope others follow the treatment, as I am feeling very well now.
At the end of 2012, MSF had 67 staff in Bolivia and Paraguay, which is run as a joint program. MSF started working in the country in 1986.