Transforming lives in Mozambique: surgical treatment for patients with neglected diseases in Mogovolas district

Nampula, July 21 , 2023 – Médecins Sans Frontières/Doctors Without Borders (MSF) is collaborating with the District Services of Health, Women and Social Action in Mogovolas and the Provincial Services in Nampula, Mozambique, to deliver surgical treatment for hydrocele, one of the chronic complications of the neglected tropical disease (NTD) lymphatic filariasis (commonly known as elephantiasis).  

To date, approximately 600 patients have been identified to undergo a surgical procedure in Nampula, following comprehensive medical consultations to evaluate their overall fitness. This procedure represents a life-changing hope for patients who have endured the pain and disability, as well as social stigmatisation, associated with lymphatic filariasis. 

In the last weeks, the first four patients have already successfully undergone surgical procedures. 

At the Mecutamala health center, MSF and Ministry of Health doctors performing comprehensive medical consultations to evaluate overall fitness of patients who have been identified to undergo surgical procedures for Hydrocele. ©Pierre-Yves Bernard
At the Mecutamala health center, MSF and Ministry of Health doctors performing comprehensive medical consultations to evaluate overall fitness of patients who have been identified to undergo surgical procedures for Hydrocele. ©Pierre-Yves Bernard

Hydrocele is an abnormal accumulation of fluid around the testicles, which causes an enlarged scrotum and impacts the patient’s quality of life, potentially leading to disability. Primarily affecting adults over 45 years of age, it is a non-malignant condition. 

This surgical treatment initiative is part of MSF’s efforts to strengthen the capacity of Mozambique’s national health system in preventing, diagnosing and treating NTDs such as lymphatic filariasis, bilharzia and scabies, as well as vector- and water-borne diseases. These diseases are highly prevalent in Nampula province and are exacerbated by extreme climate conditions.  

As a first step in the treatment process, patients are identified at the community level by community health workers or at primary healthcare units, where they undergo clinical analysis to confirm the presence of hydrocele and to ensure eligibility for surgery. The patients are then transported to Marrere General Hospital in Nampula where they receive further screening by an anaesthetist prior to the surgery. 

Victorino Anacleto with other patients who have been identified to undergo surgical procedures for Hydrocele at the Mecutamal health center. Sadia, an MSF health promoter, explains to the patients the consultation process and the next steps in their treatment journey. ©Pierre-Yves Bernard
Francisco Marioso, MSF laboratory technician, is taking blood samples of patients as part as the comprehensive medical consultations to evaluate their overall fitness and to ensure eligibility for surgery. ©Pierre-Yves Bernard
Lymphatic filariasis brings about physical [health] consequences, economic burdens and social stigma. It results not only in long-term disabilities, but also affects the mental health of patients as the disease impacts fertility, mobility and the ability to earn a living.
Zélie Antier
MSF Project Coordinator

Antier hopes this surgical initiative will raise awareness about lymphatic filariasis as well as other NTDs, and facilitate knowledge sharing based on MSF’s experience in the province, ultimately leading to improved treatment and control measures for NTDs in the future. 

Victorino Anacleto, 52, a resident of the Muepane community, is among the first patients scheduled for surgical treatment following the final evaluation phase, including assessment by an anaesthesiologist. Anacleto expresses his hope: “I am delighted to have been selected for the second phase of evaluation. I am fully committed to following the doctor’s recommendations so that I can benefit from the surgery.” 

Each surgery generally takes one hour and is performed on an outpatient basis. However, patients will require short-term hospitalisation due to the distance of the facility from their homes, and will receive weekly follow-up appointments after their discharge. MSF is committed to providing holistic healthcare support to the patients until they are recovered. 

The Meluli River, which flows alongside the town of Nametil in the Mogovolas district of Nampula province, is the main water source of the region. People come here to wash themselves, their clothes and sometimes even their cars and motorcycles. By doing so, people can contract schistosomiasis. They become infected when larval forms of the parasite – released by freshwater snails – penetrate the skin during contact with infested water. Transmission occurs when people suffering from schistosomiasis contaminate freshwater sources with faeces or urine containing parasite eggs, which hatch in water. ©Pierre-Yves Bernard

Since 2022, MSF has been closely collaborating with Mozambican health authorities to prevent, diagnose and treat NTDs in the Mogovolas district. Mobile teams play a vital role in implementing primary health activities in the area, promoting best practices, offering training and guidance, and providing essential hospital supplies to ensure access to quality healthcare. 

Mozambique ranks among the countries that are most vulnerable to the climate change. Since 2022, Médecins Sans Frontières (MSF) teams have been actively responding to climate-sensitive diseases in the Nampula province of Mozambique. The primary objective of our activities is to address the gaps in the healthcare system, in relation to neglected tropical diseases such as lymphatic filariasis and schistosomiasis, as well as vector-borne diseases like severe malaria and dengue.  

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