Dr Aklilu Lemma and the battle against bilharzia (schistosomiasis)

 Dr Aklilu Lemma and the battle against bilharzia

(schistosomiasis)

Schistosomiasis (also known as bilharziasis) is a common parasitic

disease. It affects 200–300 million people in Africa (including

Ethiopia), South America, Asia and parts of the Caribbean. It is

caused by parasitic flatworms which spend part of their lifecycle in

freshwater snails and part in humans. Anyone washing, working

or playing in shallow fresh water is at risk. Once inside a person,

the parasites mature and produce eggs which are passed out in the

urine and faeces. Tey also infest the blood vessels, liver, kidneys,

bladder and other organs. Te body sets up an immune reaction

and an infected person can become weakened and ill for many

years.

Some of the most important work in fnding a way of controlling

this parasite, which is effective but does not cost too much, was

carried out by Dr Aklilu Lemma, one of Ethiopia’s most renowned

biologists.

Dr Aklilu began his work in 1964, when he was investigating the

freshwater snails that carry the schistosomiasis parasite around

Adwa in northern Ethiopia. He saw women washing clothes in the

water and he noticed that downstream of the washing party there

were more dead snails than anywhere else he had collected. Te

women were using the soapberry, Endod (Phytolacca dodecandra),

to make washing suds. Dr Aklilu collected some live snails from

above the washing party and asked one of the women to give him

some of her Endod suds. Not long afer the suds were put in the

snail container, the snails all died. Tis was the start of years of work

for Dr Aklilu.

Back in the laboratory he showed that if the Endod berries were

dried, crushed and diluted in water they would kill snails at very low

concentrations. Other scientists carried out similar investigations

and got the same results. If the freshwater snails can be controlled,

the spread of schistosomiasis can be greatly reduced. Te World

Health Organisation recommended a chemical molluscicide (i.e. a

compound that kills molluscs including snails) but it was extremely

expensive. Endod works well, it is cheap, it is well known by local

people who are likely to use it and it is environmentally friendly as

it breaks down naturally within about two days.

Dr Aklilu Lemma worked for many years to convince scientists all

around the world that his ideas would work. Trials using locally

collected Endod showed that using the molluscicide worked. Before

the water was treated, 50% of children 1–6 years old were infected.

Afer treatment only 7% were infected by the flatworm. Dr Aklilu’s

results were published in journals around the world. He found the

best species of the soapberry plant and developed programmes for

local communities to treat their own water. Eventually people were

convinced and the use of Endod-based molluscicides is spreading

throughout Africa and beyond. Hopefully a combination of Endod

water treatment to kill the snails, improved hygiene, clean water, wells and medicine for affected people will mean that Ethiopia

can be free of this terrible disease. If we succeed it will be largely

due to the work of Dr Aklilu Lemma. He has been honoured and

recognised in many different ways both in Ethiopia and around the

world for his work.

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