In JACMEL, Haiti — In a sunny courtyard of the Evelina Levy School for Girls, hundreds of girls in blue uniforms did their part to rid Haiti of an ancient and reviled disease.
They lined up in pairs to get three pills dropped into their mouths. They swallowed them down with a quarter-cup of water. They got a second medicine, a flavored tablet, to chew as they walked back to class.
Two middle-aged women treated 12 girls every 2 1/2 minutes, one pouring the water and the other shaking out the pills. Another woman ticked the columns for age, sex and drug on a white form with a green pen.
“Mass drug administration” is easy if your target is elementary school students. It’s harder when you want to reach nearly everyone else in a country of 10 million people.
That is the goal Haiti set this year in its campaign against a parasitic infection called lymphatic filariasis that is present in 80 percent of the country. Spread by mosquitoes, in severe cases it leads to permanent swelling of an arm or leg. That condition, called “elephantiasis,” can be grotesque and life-changing. In men, the worms can cause a swelling of the scrotum that is even more stigmatizing.
Lymphatic filariasis is a “neglected tropical disease,” the name for a group of maladies that have disappeared from industrialized countries or never existed there. Others include onchocerciasis (“river blindness”), schistosomiasis (“snail fever”), soil-based intestinal worms, and the eye infection trachoma. For 1.9 billion people, most of them poor, they are still threats.