Meagan Young, who is finishing up her masters in public health, was a huge help in organizing our lice and scabies project. She has worked closely with one of our medical directors and physicians, Dr. Thomas. They have been planning the steps on how to eradicate lice and scabies from an entire village after treating every village member. Meagan looked through hundreds of medical charts from different villages, tracking to see how many people have been diagnosed with lice and scabies in the past. This gave us an idea of which villages needed the most help in the Toledo district of Belize. Meagan and Dr. Thomas communicated with village council members and the ministry of health to get things started and completed an IRB (Institutional review board).
WHO (World Health Organization) has had success with this approach to eliminate lice and scabies in the Solomon Islands and Australia, treating Aborigines. We are hoping to do the same by following their approach.
The village we treated had a census of 500 people. We were ready for a long day. But the actual number of people we treated that day was 628!!!
We started early in the morning and split up into teams. There were medical students, physicians, pharmacists, and our Hillside student lesion all helping out.
Our plan of attack: Permethrin 0.5% spray used on hammocks, bedding, clothing, etc. Permethrin 5% lotion was used on kids under 15kg. We rubbed the lotion all over their body. Head to toe. This treats scabies and lice. First dose of ivermectin is given to everyone over 15kg plus an additional dose (that will be taken in one week). To remind people of taking their second dose of ivermectin, the village church made an announcement the next week.
My job: Permethrin bather and educator. All families are given plastic bags to put any items that are difficult to wash. It’s best to leave the bag of items out in the sun for about 2-3 days to kill the bugs. Families were also given laundry detergent and encouraged to wash any clothing lying around that may be infected. I also explained what lice and scabies are and how to treat for them. Every family received a small flyer about this.
Some families would say, “We don’t have lice or scabies.” We would then explain that you may not have it, but your next-door neighbor might. That’s the importance of treating every person in the village. Prevention is key.
Everyone was welcoming and okay with us coming into their home. I had fun bathing the small children in permethrin. Most of them would giggle and laugh. It was interesting to see how people lived in the village. One thatched roofed house only had one hammock, but there were 6 family members. The kids told me they slept on the floor. That seemed to be the norm. The kids had smiles on their faces and genuinely seemed content with what they had.
It was a long hot day walking from house to house. We worked for a total of 9 hours. We hope to treat other villages in the near future. Follow up work will be done in 2-3 months to see how successful we were in treating lice and scabies. It was a great experience!
