Women and NTD Elimination in Indonesia: Wita’s Story

One rainy Saturday evening in 2014, Wita Larasati and her husband ventured to their local mosque. They were answering their mayor’s personal call for all eligible residents to take treatment for lymphatic filariasis (LF), a painful and disfiguring parasitic infection. At the mosque, health workers asked the couple to complete a registry form and read an informational brochure before taking the pills.

Wita lives in Depok City, a city of almost 2 million people that lies south of Indonesia’s capital city, Jakarta. Like 82 million other Indonesians, Depok residents are at risk of contracting LF, even though the disease can be eliminated in an area after five rounds of preventative treatment among all eligible residents. The mayor’s personal appeal aimed to increase the number of people who received LF treatment – and ultimately to eliminate the disease from the city.

Unlike many others, Wita had in-depth knowledge of neglected tropical diseases (NTDs) like LF before she was called to take the drugs herself. Since 2013, she had worked as a monitoring & evaluation specialist with ENVISION, a USAID project led by RTI International that aims to control and eliminate NTDs in Indonesia and 18 other countries.

“NTDs have a very dramatic impact on women’s lives, and we are also often disproportionately impacted by these diseases. At the same time, women play a key role in ensuring our families stay healthy. So it’s very important that women feel comfortable taking the treatment. As a woman, I know I can help to influence and educate my friends and neighbors to take the drugs and ensure their families do the same.”

So when the mayor asked those who took the treatment to go one step further and go door-to-door to help increase the number of people reached, Wita answered that call also: “After working with ENVISION for a year, I was inspired to help distribute the drugs as a volunteer. As a member of my community, I felt that the success of this year’s mass treatment campaign was one of my responsibilities as well.”

Virtually all – over 95% – of community drug distributors (CDDs) in Indonesia are women – a higher percentage than any other ENVISION-supported country. While the number of female CDDs varies widely between countries, on average about half of CDDs trained between 2012 and 2015 with USAID support were female.

With one of her neighbors, Wita knocked on the doors of 30 homes in her neighborhood in Depok. Before distributing the treatment, Wita asked family members to complete a registry form similar to the one she filled out at the mosque. She also explained how and when to take the medications, as well as the why the mass treatment campaign was critical to protect the community from LF.

“People in my community were very thankful that they were given a clear explanation about the importance of taking it up. Some of them did not know why they have to take the drug,” said Wita. “I faced quite a lot of questions. People wanted to know how kaki gajah – LF in Bahasa Indonesia – was transmitted; why they had to take up the drugs every year although they felt healthy; and whether a person could be cured after contracting kaki gajah.”

Wita continues to be a critical part of the ENVISION team in Indonesia, using her volunteer experiences to inform her training and supervision of mass drug administration. She has a better understanding of the questions the drug distributors get asked since she herself volunteers as a drug distributor in her community.

“I fight NTDs partly as my job and partly as a volunteer. But most women are out in their communities purely as volunteers. They not only contribute to drug distributions, but many also educate and support their communities on a wide variety of health issues, particularly related to maternal and child health. These women are my inspiration to continue fighting NTDs and fighting for a healthy future for Indonesia.”

USAID from the American People   RTI International