A bright future: Eliminating lymphatic filariasis in Vietnam
By Laura Cane, with contributions from Nguyen Minh Duc.
“My leg was getting bigger and bigger and I always felt heavy and uncomfortable,” says Truong Van Duc.
Van Duc lives in Northern Vietnam, along the Red River Delta, an area known for much of Vietnam’s rice production. Home to many rivers and streams, the wet nature of the area makes it not only favorable for agriculture, but also for mosquitoes who bring with them lymphatic filariasis (LF). Also known as elephantiasis, lymphatic filariasis is a parasitic disease that can be transmitted to humans causing fluid buildup that can lead to severe disability and disfigurement, as well as social stigma and economic discrimination against those affected.
Globally, more than 16 million people are estimated to be impacted by lymphedema from LF, with around 360 people with lymphedema in Vietnam. Truong Van Duc, 65 years old, is one of them.
A farmer and construction worker for more than 30 years, Van Duc lives with his family in Ly Nhan, a district just a two-hour drive south from Vietnam’s capital city, Hanoi. Van Duc was diagnosed with LF after he and his family noticed swelling in his left leg when he was just 17 years old.
“My swollen leg was frequently infected, giving me fever and pain,” says Van Duc. “In addition, my work as a farmer involved being in the soil, water, mud and especially during this period my country was still [facing] poverty. Soaps were luxury goods, I rarely got soap for hygiene of my limbs…”
Mr. Dinh Duy Binh, a health manager in a nearby district called Binh Luc, says Van Duc’s experience was common among many LF sufferers. Not only did many people find their working capacity limited, but infections and wounds worsened their health and psychological well-being. Self-care, including limb washing, are essential to prevent infection and additional complications.
Van Duc quickly found that LF began affecting more than just his health — his social life and economic prospects were also impacted.
“In my village, four other people also had the same disease. My neighbors and other members of my village acted normal when seeing my elephantiasis leg, but when I went out of the village, I often saw strangers pointing and talking because of my ‘big’ leg,” says Van Duc. “Sometimes I was denied employment because they were afraid of seeing my leg. I wanted to register for new military recruitment, but I was rejected because of this.”
A New Future for Vietnam
Vietnam’s efforts to eliminate this disfiguring and disabling disease date back all the way to 1960. Efforts advanced significantly when the government of Vietnam initiated its National Program to Eliminate LF, in 2001. With leadership from National Institute of Malariology, Parasitology, and Entomology (NIMPE), and technical and financial support from the World Health Organization (WHO), the country conducted mass treatment and assessment surveys in the six endemic districts, as required to meet elimination goals.
The U.S. Agency for International Development (USAID) began supporting Vietnam government’s efforts towards LF elimination in 2011, through its partners FHI 360 and RTI International, assisting NIMPE to implement transmission assessment surveys (TAS), collect data, and support drafting of the LF dossier — the document required by the WHO to provide evidence that LF had been eliminated as a public health problem.
In October 2018, the World Health Organization announced that Vietnam has successfully eliminated lymphatic filariasis as a public health problem.
After more than a half century of effort led by Vietnam and supported by an array of partners — including USAID — the people of Vietnam no longer worry about a disease that once caused disability, disfigurement, pain, social stigma, and economic loss for its citizens.
A Bright Future
Although LF has now been eliminated as a public health problem and no new cases are expected, people who already have lymphedema caused by LF, like Van Duc, are not being forgotten.
“Patients with elephantiasis are still on the management list of commune health stations. Commune health workers visit monthly to provide care to them. Besides that, LF patients and their families were also trained on self-care and how to avoid complications,” says Duy Binh.
The Vietnamese Ministry of Health and NIMPE are committed to continuing to work with the WHO, USAID, and partners to provide care for those who will continue to suffer the consequences of this disfiguring disease and ensure the health of the Vietnamese people.
Van Duc participated in a self-care training. “Since that time, my leg has rarely been inflamed and my health is better. Besides, I am really happy when my wife, children and grandchildren are always close, caring and helping me,” he says.
Although LF was and still is a part of Van Duc’s life, he says he is glad that it’s not something future generations will have to worry about.
“It is good that lymphatic filariasis is eliminated and no longer affects my community, my family, and my children. I wish all of society in general and individuals in particular try to keep the environment clean and eliminate mosquitoes to maintain this achievement and ensure no one catches lymphatic filariasis anymore.”
For more information about the elimination of LF from Vietnam, and the role played by USAID, RTI International, and other partners, learn more.
For more than 12 years, RTI International has provided technical assistance to national neglected tropical disease (NTD) programs working towards global targets for NTD control and elimination. Through ENVISION, USAIDs flagship NTD project, RTI International supports countries in all phases of NTD program implementation — from mapping disease distribution to achieving the goal of international recognition of the control or elimination of these terrible diseases. From 2012–2017, ENVISION facilitated the global distribution of more than 417 million treatments for lymphatic filariasis.
ENVISION thanks Truong Van Duc and Dinh Duy Binh for sharing their stories. Special thanks to Nguyen Minh Duc for capturing their stories and images.
