Sierra Leone Poised for Liberation from “Bigfut” [A Photo Essay]
Lymphatic filariasis, sometimes referred to as elephantiasis or ‘bigfut’ in Krio, can lead to the devastating enlargement of body parts, cause pain, severe disability, and social stigma. We are helping communities not only eliminate this devastating disease but treat those already suffering from physical disabilities caused by chronic disease. 
After two decades, transmission of this disease has ended in all but one of Sierra Leone’s districts. Helen Keller Chief Program Officer Shawn Baker and Communications Officer Alpha Sesay, accompanied New York Times columnist Nick Kristof and his “Win-A-Trip” student journalist, visited to understand their pain, challenges, and resilience. 
Lymphatic filariasis destroyed Rukoh Kanu’s ability to work, and her husband left her after she was accused of witchcraft. Two drugs – Ivermectin and albendazole – and support from health workers to manage her ‘bigfut’ have reduced her pain enough so she can undertake household chores and care for her family. 
Yeabu Fornah has lived with lymphatic filariasis for over a decade. Once a leading farmer, she can no longer work because of the disease. Despite her pain and struggles, she remains courageous and optimistic for the future of her community, noting that today, there are fewer cases. 
Kadiatou Sankoh developed ‘bigfut’ more recently. She continues to farm as best she can, but can no longer travel to sell her farming products in Sierra Leone’s capital city, Freetown. Kadiatou’s family helps to support her, but she hopes for additional healthcare to ease her pain and symptoms. 
In men, the disease can cause swelling of the scrotum, called hydrocele. Gibrila Turay’s scrotum swelled larger than a football, making it difficult to work in the fields. Further, his wife divorced him, leaving him to care for their two children. Surgery helped Gibrila reclaim his health, life, and dignity. 
Aiah Sam is the Neglected Tropical Disease Focal Point for the district and a key partner of Helen Keller, helping to put an end to the transmission of lymphatic filariasis. Through mass drug administration, we help distribute critical medication to break the cycle of transmission of the disease. 
Sulaiman Tarawalie is one of 30,000 Helen Keller trained health workers eliminating lymphatic filariasis in Sierra Leone, making sure all eligible people in his community receive annual treatment. When asked what motivates him, he simply replied, “Knowing what I could do for my community, how could I not?” 
Together with FHI 360 through USAID’s Act to End Neglected Tropical Diseases (NTDs) | West Program and the Ministry of Health and Sanitation, we have successfully ended transmission of lymphatic filariasis in 15 of the country’s 16 health districts, freeing millions from this debilitating disease. 
Further, Sierra Leone has just launched a sustainability plan for the control of ‘bigfut’ and other neglected tropical diseases. Dr. Musa Kabba, Deputy Chief Medical Officer and Sugandh Juneja, Helen Keller Sierra Leone Country Director took part in this important milestone in Sierra Leone’s journey in tackling these debilitating diseases.
Once upon a time, lymphatic filariasis plagued the entire country of Sierra Leone. The parasite-borne neglected tropical disease, transmitted through mosquitos, causes severe swelling and painful enlargement of body parts. In Sierra Leone’s Krio language, the extreme swelling of legs is called “bigfut.”
Although it is preventable and treatable, once it reaches the stage of elephantiasis, lymphatic filariasis cannot be reversed. In addition to severely impairing someone’s quality of life and making it nearly impossible to earn a living, the disease attaches devastating social stigma to those who suffer from it.
Fast forward to today, however, and people all across this West African nation are reclaiming their futures. More than 30,000 community healthcare workers across Sierra Leone have worked tirelessly to educate people about “bigfut,” distribute medication to prevent it, ease pain for those already suffering from the disease, and stop its transmission.
This progress is made possible with the generous support of FHI 360 through USAID’s Act to End Neglected Tropical Diseases (NTDs) | West Program, The END Fund, Sierra Leone’s Ministry of Health and Sanitation, and our generous community of donors.
We were privileged to have New York Times journalist Nick Kristof join Helen Keller Chief Program Officer Shawn Baker and Communications Officer Alpha Sesay on a recent visit to Sierra Leone. Kristof has featured Helen Keller’s path to eliminating lymphatic filariasis in Sierra Leone in his column.
Photo credits:
- 1, 3-10: Alpha Sesay, Helen Keller Intl
- 2: Malin Fesehai, The New York Times
