Experience in Africa: Dermatology on the other side of the ocean

It is difficult to summarize an experience like this in just a few lines. Those of you who have set foot in the heart of the African continent, penetrated its entrails, will understand well what we are telling you.

Equatorial Guinea
Equatorial Guinea

Any type of reaction is to be expected, except indifference. Undoubtedly, the implementation of this study in Equatorial Guinea, where we intended to analyze the incidence of a devastating tropical dermatological disease called onchocerciasis, has been an unforgettable professional and personal experience.

Despite the hardship and exhaustion involved, the day-to-day fieldwork was tremendously enriching. The local project teams were hard-working people committed to their community who, with the right motivation and appreciation, were able to give the best of themselves every day. As we started the Land Rover, the working day began and we were on our way to the rural communities of Bioko Island, where the country’s capital is located, and where most of the health interventions have been carried out.

After our arrival at the communities, usually the community president or the health agent, true leaders of the area, were waiting for us with the best of dispositions. It was a privilege for them to have a mission from the Guinean Ministry of Health, accompanied by a team representing the Spanish Agency for International Cooperation. It didn’t matter what we were going to do there, we were simply health workers and we had decided to pay attention to them. Enough reason to collaborate with us.

Onchocerciasis: final stage
Onchocerciasis: final stage “leopard skin”.

The work in the rural area was hard but also very satisfying. Each of the individuals studied underwent a health questionnaire and physical examination, followed by skin and blood sampling. The peasants of rural Africa are affable, generous people, exhausted by life and work, but with a physical and mental fortitude worthy of admiration. Often, in the physical examination of some of them, especially the older ones, I would perceive in my hands their exhaustion, their dejected and painful bones, their gesture of weariness. In spite of all this, and considering that most of them had never seen a sanitarian before in their lives, they used to give us sincere expressions of gratitude for the work we were doing.

The second week of fieldwork focused on the urban area. The city of Malabo, capital of Equatorial Guinea, is a real asphalt jungle in the middle of Bioko Island. Those streets that opened up between the cracks of the city’s large avenues, to our surprise, were full of dark labyrinths where people survive as best they can: rubble, half-built houses, dust and dirt are the inevitable elements in the suburbs of large African cities. With the best of our dispositions, we tried to complete the quota of patients we needed, at the same time that we administered simple health advice to many of those people, who were subjected to the greatest of neglect.

Hopefully, the experience and information obtained will contribute to improve the control of this important tropical disease in a country where there is still a long way to go, also in the health sector.