Over 550 Women’s Lives Transformed To‐Date With Action On Fistula

Astellas today announces that, just over a year on from the launch of Action on Fistula, 582 Kenyan women with obstetric fistula have successfully been treated with life changing reconstructive surgery. One woman treated had waited 51 years for surgery, and the age range of individuals helped so far spans from seven to 90 years old.

Action on Fistula is led by the charity Fistula Foundation and funded by Astellas Pharma EMEA. By mid2017, the initiative aims to transform the lives of more than 1,200 women in Kenya living with this condition and to build capacity in the country to deliver ongoing surgeries in the long term.

Ken Jones, President & CEO of Astellas Pharma EMEA, said, “Fistula is a condition that devastates the lives of women. In addition to the physical impact of incontinence, it leaves many women ostracised from their families and communities. Action on Fistula has been created to reach and treat women suffering the consequences of this condition.

“We know that one of the key obstacles to treating women in Kenya is the lack of appropriately trained surgeons. Action on Fistula is addressing this need by increasing the capacity for fistula surgery in Kenya and we are delighted that over 550 women have already been treated.

“We look forward to continuing our relationship with the Fistula Foundation so that many more women can receive this life changing treatment in the future.”

Access to services for women suffering from obstetric fistula is being extended through a new national Fistula Treatment Network, with four treatment centres already enrolled and providing fistula surgeries.

Gynocare Fistula Centre, in Eldoret, is the first treatment unit in Kenya to be accredited by the International Federation of Gynecology and Obstetrics (FIGO) and the first two surgeons supported by Action on Fistula have begun training to become experts in fistula treatment.

In order to ensure that women living with fistula in rural communities can be helped, Action on Fistula is running a major outreach programme, with community workers being trained to identify and encourage patients to access treatment. Five local organisations have trained 136 community health workers, conducted 850 outreach activities and reached 60,000 community members in 18 counties.

Kate Grant, CEO, Fistula Foundation, comments, Together with Astellas Pharma EMEA, we are already transforming lives in Kenya. Women are receiving life changing care faster than they would have otherwise, medical facilities are better equipped to help treat more women, and our outreach partners are expanding their reach into more rural, remote parts of the country, where they are identifying and referring new patients for treatment.

“In addition, because of the programme, dedicated surgeons in Kenya now have access to advanced training provided in partnership with the International Federation of Gynecology and Obstetrics.”

An obstetric fistula is a hole between the vagina and rectum or bladder that is caused by prolonged obstructed labour when emergency care is unavailable, causing either faecal or urinary incontinence or both conditions. Whilst virtually eradicated in developed countries, the United Nations Population Fund (UNFPA) estimates 3,000 new cases of obstetric fistula occur annually in Kenya, with approximately one to two fistulas for every 1,000 deliveries.

Obstetric fistula sufferers are too often subject to severe social stigma due to odour, which is constant and humiliating, often driving the patients' family, friends and neighbours away. Stigmatised, these women are also often denied access to education and employment and left to live lives of isolation and poverty. Untreated, fistula can lead to chronic medical problems including ulcerations and kidney disease.

Alongside funding this programme, Astellas is actively encouraging and enabling employees to fundraise to support fistula treatment and welcomes other interested parties to contact the Fistula Foundation. For every €350 raised, an additional woman can receive life changing surgery.

Euro 15 million programme launched to disseminate icipe technologies

The International Centre of Insect Physiology and Ecology (icipe), and partners, have launched a Euro 15 million programme, to support the adoption of the Centre’s technologies and strategies for improved cereal, horticulture and livestock productivity by an estimated 350,000 additional farmers and pastoralists in Kenya, Ethiopia and Tanzania.

Titled, Integrated Biological Control Applied Research Program (IBCARP), the initiative will be funded by the European Union (EU) through a Euro 12 million grant, with additional funds from icipe’s core funds and other sources. IBCARP was inaugurated during an inception meeting held recently at icipe, attended by over 40 technical experts of cereal, horticulture and livestock farming and value chains from all across the globe.

“In Africa’s predominantly mixed crop-livestock farming systems, cereals are the main staple food and cash crop for millions of households. In addition, the production of fruit and vegetables offers one of the most important opportunities for income generation, employment creation and improvement in food and nutritional security. Livestock provide a valuable source of nutrition as well as opportunities for income generation. However, productivity of cereal, horticulture and livestock in the region is low, resulting in food insecurity and poor livelihoods. Therefore, addressing the constraints of these three sets of produce is critical for food security, economic growth and poverty alleviation in Africa,” observed Mr Steve Wathome, Programme Manager, Agriculture and Rural Development, EU Delegation to Kenya, during the inception meeting.

icipe Director General, Dr Segenet Kelemu, noted: “IBCARP will be implemented through four projects, which are focussed on: the Centre’s climate-resilient push-pull technology for the control of weeds and pests; fruit fly integrated pest management (IPM) technologies; the tsetse fly repellent collar technology and research towards the control of vectors of camel diseases.”

Push-pull is a platform technology developed over the past 20 years by icipe in collaboration with Rothamsted Research, United Kingdom, and partners in eastern Africa. This simple cropping strategy simultaneously addresses the five key constraints of cereal–livestock mixed production systems in SSA – insect pests (stemborers), the parasitic weed Striga (and other weeds), poor soil fertility, soil moisture management, while also fulfilling the need for high quality animal feed. Over the past four years, icipe and its partners have developed a climate-smart version of push-pull to extend its application to drier areas of the continent, and in relation to the increasingly dry and hot conditions associated with climate change.

Through IBCARP, icipe will address the key limitations to scaling up the climate-smart push-pull, and also continue to adapt it to the key agro-climatic conditions and farmer practices. In effect, the Centre will move closer to achieving its goal of making the technology accessible to millions of smallholder farmers living in the drier regions of Africa,” explains Prof. Zeyaur Khan, Leader of the push-pull project. 

The icipe fruit fly IPM packages are aimed at reducing yield losses and the huge expenditure incurred by farmers to purchase pesticides, in trying to deal with the plethora of these devastating pests. They are also intended to mitigate the health and environmental risks associated with the use (and misuse) of such chemicals. Overall, icipe’s goal is to increase the competitiveness of fruit from SSA in local and international markets, and to elevate the income and livelihoods of people involved in the value chain, especially women and the youth.

“Although fruit flies attack a variety of fruit, IBCARP’s focus will be on mango production, based on its importance to smallholder farmers. icipe’s aim is to make the IPM packages accessible to over 10,000 smallholder mango growers, while also strengthening the capacity of national and private sectors partners to continuously monitor and detect alien pest fruit flies, to reduce the risk of their entry, establishment and spread in SSA. Additionally, the Centre will conduct new research to expand its IPM packages, with the aim that the new strategies, though initially intended for mango, could also be used for the management of fruit flies on other crops,” indicates Dr Sunday Ekesi, Leader of the icipe African Fruit Fly Project. 

The icipe tsetse fly repellent collar technology is a critical component in the sustainable control of the tsetse transmitted trypanosomiasis (nagana) parasite, which causes a fatal disease that kills millions of cows every year. The collars contain a blend of chemicals identified from water buck, an animal that is present in tsetse fly infested areas, but which is not fed on by the flies. Worn around the neck of cattle, the repellent collars provide substantial protection to cattle. 

 “In pilot sites, for instance in Kwale County along the Kenyan coast, the tsetse repellent collars have been shown to have a significant impact on the livelihoods of farmers. They have reduced the rate of nagana by more than 80%, meaning that the cows are generally healthier, therefore producing more milk and meat, and draught power to cultivate land. As a result of their effectiveness, the demand for the collars is very high among farmers,” explains Rajinder Saini, of icipe’s Animal Health Theme.

He adds that through IBCARP, icipe  will collaborate with private sector partners to scale-up the mass production and rollout of the tsetse repellent collar technology, backed by a viable business plan for its commercialisation, packaging and wider dissemination. The first step will be to secure the registration of the technology in IBCARP’s three target countries: Ethiopia, Kenya and Tanzania. icipe will rely on the support of government and commercial partners to achieve this goal. The Centre will also integrate the use of the technology with other approaches, and in the development of effective barriers to stop flies from reinvading tsetse controlled areas. In addition, the repellent collars technology will be evaluated for use in the control of vectors of human African trypanosomiasis (known more commonly as sleeping sickness).  

icipe will use the experience and knowledge gained through the development of technologies for the control of savannah tsetse flies – which, in addition to the repellent collars, also include traps and odour baits – to initiate new research for the control of camel disease vectors in arid and semi-arid lands of SSA. Specifically, the focus will be on surra, a parasitic disease of camels and other mammals caused by trypanosomes, transmitted by biting flies.

“Currently, there is limited understanding of the actual vectors involved in surra transmission and no vector control technologies are available. In addition, there is poor diagnosis of the disease, as well as increasing resistance to drugs,” Dr Saini notes. 

 Stakeholders attending the IBCARP inception meeting commended the programme, noting one of its key strengths to be the harmony with agricultural policies of the countries in which it is being implemented.

“Most national agricultural agendas position increased productivity of staple cereals, horticulture and livestock as central to equitable rural development and poverty reduction. In Kenya, for instance, Vision 2030, the country’s current development programme, is very specific on this connection,” commented the Director of Veterinary Services in Kenya, Dr Kisa Juma Ngeiywa.

The Hon Joanne Nyamasyo, the Minister of Agriculture, Livestock and Fisheries, Kwale County, added: “IBCARP’s actions and projected outcomes are supported by evidence. In Kwale County, for instance, we have witnessed the dramatic changes among farmers using the tsetse repellent collars. It is therefore welcome news that such technologies will reach more farmers, in existing project sites and beyond.”

As further observed by Dr Agol Kwai, Animal Health Expert in the Intergovernmental Authority on Development, Centre for Pastoral Areas and Livestock Development,  icipe’s intervention on camel surra disease is particularly significant in countries where the animal is economically important. This is because research on the disease has so far been neglected, leading to severe problems in its management. As a result, in many cases, the animals are simply allowed to die when they become infected with surra.

“The four icipe projects bring together a comprehensive package that integrates weed, pest and soil fertility management in cereal and horticultural crops, livestock fodder production, and animal health, while ensuring environmental sustainability. This makes IBCARP well aligned with the EU thematic programme on food security,” concluded Mr Wathome.