The latest MSF project in Nicaragua - fighting Chagas disease - has closed, bringing to an end 22 years of MSF presence in the country.
With the inclusion of Chagas in the ten-year-plan of the Ministry of Health and a low rate of infections in one of the two municipalities where MSF was active, it is no longer necessary for the organisation to provide support.
MSF continues its Chagas interventions in Bolivia and Guatemala.
Chagas kills about fifty thousand people across Latin America every year.
In two municipalities, Esquipulas and Totogalpa, MSF has been assisting the Nicaraguan Ministry of Health in prevention, identification and treatment of the disease that is transmitted through the kissing bug, or 'chinche'. With a symposium in May and the publication of a booklet in Spanish ("Lecciones Aprendidas") and English ("Lessons Learned"), the team has transferred its knowledge and experiences to local health authorities, NGOs and other parties involved in the fight against Chagas in the country.
The project in Esquipulas ran for two years, the project in Totogalpa for seven months.
Chagas almost exclusively affects poor populations; the 'chinche' lives in the walls and roofs of huts made from hay and mud in rural areas across Latin America.
Being a poor people's disease, Chagas does not attract serious interest from the research and development divisions of pharmaceutical industries. As a result, health workers generally have to treat patients with antiquated and ineffective drugs: they do not kill the parasite in the chronic, lethal phase; are powerless against certain varieties of the parasite; and often cause serious side effects.
MSF's approach has been comprehensive. Its teams of experts have been involved in groundbreaking work in the areas of screening and treatment, but also in controlling or killing the chinche. In addition, the projects in Nicaragua contributed to the organisation's global campaign for getting neglected diseases on the agendas of governments and pharmaceutical companies.
The MSF intervention leaves an important legacy. The inclusion of Chagas in the government's ten-year health plan is an important step towards curbing the disease.
The symposium inspired a local organisation, Instituto de la Vivienda Rural, to improve 500 houses in an area strongly affected by Chagas so as to minimise the risk that children under treatment get re-infected by the bug.
In addition, the MSF team has introduced a new method for rapidly screening large numbers of people for infection.