Gorilla Journal 28, June 2004
Conservation Through Public Health
Conservation Through Public Health (CTPH) is a grassroots, non-profit,
non-governmental organization founded by Ugandans in December 2002. Its
mission is to promote conservation and public health by improving primary
health care to people and animals in and around protected areas in Africa.
The overall vision of CTPH is to prevent and control disease transmission
where people, wildlife and livestock meet, while cultivating a winning
attitude to conservation and public health in local communities. We decided
to start our programs in Uganda because we saw a great need to integrate
conservation and public health.
While working as a veterinarian for UWA in 1996 I was called to deal with
the first scabies skin disease outbreak in the Katendegyere group of mountain
gorillas. This gorilla group had been visited by tourists for 3 years.
The severity of the disease was age and size related, with the infant
and juvenile being worst affected followed by the adult female and then
the silverback. Scabies is caused by Sarcoptes scabiei mites that
burrow under the skin and cause intense itching, hair loss, and white
scaly skin. Working together with Liz Macfie of International Gorilla
Conservation Programme (IGCP) and Richard Kock of Kenya Wildlife Service,
we immobilized the juvenile gorilla, Kasigazi, and took skin samples,
which we strongly suspected to be scabies. Kasigazi was treated with Ivermectin
anti-parasitic. We later returned to immobilize the shy mother to treat
the infant, which had lost over 75% of its hair, was very thin, crying
and too weak to hold onto its mother, Nyabitono. She dropped the infant,
which had died, the day after she was given her treatment and we were
able to perform a fresh post-mortem on the infant, Ruhara, which gave
us further confirmation on the scabies mites after laboratory diagnosis
- Ruhara's skin was covered with them.
After successfully treating this group and checking on all the other groups
in Bwindi, we started to ask ourselves where the scabies could have come
from. Physicians had told us that the most common skin disease in low
income groups of people in Uganda is scabies. Why? Because it is a disease
of poor hygiene and crowded conditions. This particular gorilla group
left the park periodically and went to forage in people's gardens,
raiding their banana crops. Many of these people live very far away from
water and do not often wash their clothes. Gorillas are curious and could
have touched contaminated clothing, allowing the mites to spread through
the group during grooming. The fact that the infant was so severely affected
meant that the mite was new to the group and the most likely closely related
host was humans.
In early 2000, we organized participatory rural appraisal health education
workshops with local communities on the risks of human and gorilla disease
transmission with the aim of improving their health and hygiene. Not only
did they have scabies, but they also did not cover their rubbish heaps
and many of them did not have proper pit latrines. I teamed up with the
Bwindi Community Conservation Warden Benon Mugerwa, Community Conservation
Ranger Johnson Twinomugisha, IGCP Field Officer Stephen Asuma, and Robert
Sajjabi and Benon Nkomejo, the district health assistants. Before we began
we were worried that the communities would think that we care more about
animals than people.
But we were pleasantly surprised. Communities that benefited from gorilla
tourism were very willing to listen to us and put forward very good recommendations
on how to improve the situation. They saw the benefits of improving their
health and hygiene not only for themselves, but also to protect a sustainable
source of income from gorilla tourism. Before mountain gorilla tourism
came along, these poor, rural communities had very little hope of overcoming
their poverty. Now, mud huts that were once selling local brew have been
transformed into flourishing trading centers because of the traffic associated
with tourism. UWA has employed many people; bandas have been built for
the community to accommodate low budget tourists and other income generating
projects. Additionally some of the tourism revenue is shared with communities
surrounding the park, and used to build schools, clinics and roads.
During these workshops I realized that communities that had many tourism
benefits were very different from those that did not. It was clear that
not only was poor health and hygiene affecting public health and wildlife
conservation, but it was also affecting sustainable ecotourism.
This case study was the root of an idea to start an NGO that promoted
both conservation and public health for the benefit of both. I went on
to do a Zoological Medicine Residency and Master at North Carolina State
University and North Carolina Zoological Park. During this time I got
the opportunity to carry out field surveys on TB at the human/wildlife/livestock
interface in Bwindi Impenetrable and Queen Elizabeth National Parks. These
surveys highlighted how much TB, another disease of poverty, was a public
health challenge in Uganda.
Together with my husband Lawrence Zikusoka, Founder and Director of ICT
(Information and Communication Technology) for Development, and Steven
Rubanga, Founder and Chief Veterinary Technician, we formed Conservation
Through Public Health.
CTPH held a strategic planning workshop with stakeholders in September
2003 at the Institute of Tropical Forest Conservation in Ruhija,
Bwindi. The North Carolina Zoological Society funded the workshop. The
workshop brought together stakeholders from the government, NGOs, private
sector including tour operators, universities and schools.
The workshop came out with six strategic objectives, to guide our programs
and activities for the next few years. Some of these include public awareness,
strengthening community health outreach including TB treatments and improving
health monitoring and disease surveillance of wild and domestic animals.
So far, CTPH has formed Memoranda of Understanding with UWA and the CISCO
Networking Academy for Least Developed Countries Initiative of Makerere
University's Department of Women and Gender Studies. We opened an office
in the capital city, Kampala, and share a building with IUCN, the World
Conservation Union, and the Wildlife Conservation Society. We are very
privileged to have Hope Walker join the CTPH team as our US Representative
and Director of Marketing in November 2003.
Conservation Through Public Health urgently seeks financial and in-kind
support from interested individuals and organizations, and will soon be
starting a membership program.
Gladys Kalema-Zikusoka
For more information visit www.ctph.org or sign into info@ctph.org for regular updates.
Photo:
Angela Meder
Banana plantation close to the village in Buhoma
Dr. Gladys Kalema-Zikusoka studied Veterinary Medicine
and then worked for UWA from 1996-2000. This involved setting up veterinary
programs for gorillas and other wildlife. After specialized training she
carried out research on TB. Now, she founded Conservation Through Public
Health.