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Under the Big Tree Neglected tropical diseases NTDs affect over one billion of the world's poorest people More than 170000 people die from NTDs each year and many suffer from blindness disability disfigurement cognitive impairment and stunted growth Yet NTDs are treatable and preventable and the annual cost of treatment is incredibly lowIn Under the Big Tree public health leader Ellen Agler and award winning writer Mojie Crigler tell the moving stories of those struggling with these diseases and the life saving work that can be and has been done to combat NTDs They introduce readers to people from all walks of life from car washers in Lake Victoria and surgeons on motorbikes to under resourced local nongovernmental organizations NGOs and Big Pharma scientists as they chronicle what has been called the largest public health program in the worldOn the one hand the solutions are simple deliver medication to people who need it and leverage local systems to offer prevention treatment and education On the other hand solutions are complex navigating local and national politics delivering treatment to some of the most remote vulnerable communities and coordinating global and local donors international NGOs thousands of health workers and millions of citizensDrawing on interviews with major players in the NTD world who share their cutting edge research and frontline experiences Under the Big Tree is a moving introduction to the science the tactics and the partnerships working to address these terrible diseases that affect the most vulnerable people in the world With a foreword by Bill Gates this book fascinates inspires and gives readers concrete steps for further engagement

6 thoughts on “Under the Big Tree

  1. says:

    This book focuses on five major tropical diseases including parasites which unlike HIV and malaria haven't had such a high profile Having said that the Sunday Times has done a good job over the years of informing me about Ghanian river blindness Guinea worm and This book doesn't address Guinea worm which is a major let down The subject is referred to twice briefly; this like most of the diseases is one of a parasite water borne transmitted by foul water The worm doesn't even have a vector unlike the flies and snails referred to here What we are told is that it has been eliminated from many countries to a few tens of cases and will soon be eradicated Trachoma schistitis river blindness lymphatic filariasis elephantiasis roundworms whipworms and hookworms are the major issues addressed We used to ask the nuns in school who'd been to the Missions why the children we saw in African charity posters had big swollen tummies and thin arms Oh when they get food or water they take in a lot in one go we were told Of course the kids really were filled with worms which did away with any good from food they were sent We were forced to hand over pocket money in order to feed parasitic worms We learn about Merck Sharp and Dohme developing ivermectin as a cattle wormer and sending it out for free to reduce river blindness While extremely creditable I can imagine this might give a firm great leverage if a government wanted to tax them or split them up say; and if MSD stopped who would do it? We're warned that horse worms can become immune to vermifuges so it's best to rotate medicines; if the human parasites become immune what then? Not explored The author puts much emphasis on training nurses and helpers and teachers and getting the tablets out there in mass dosings She also emphasises carrying out surveys of areas governments didn't know how many schools they had and gave an incorrect answer The same governments we note which didn't care whether people had sewerage and fresh water or even knew how to dig latrines in a land not short of manual labour no shovels? We're not told the most obvious factors like if a parasite is water borne you must treat and clear and provide latrines in the villages at the head of the river first and work down the river or everyone will just reinfect everyone else We are told that in one area women only washed once a month because their men didn't want them to be clean in case other men got attracted Hence the bullied women of course got diseases The stories of illness are probably horrendous to experience as patient or helper but we can take hope from the efforts being made But no negatives are experienced it seems No roadblocks by gun waving shakedown merchants no kidnappings and ransom demands no threats from poachers terrorists or rival tribal gangs no swaggering army men trying to take drugs for black market no beheaded animals left at the clinic by witchdoctors no threats from people whose children died no doctors catching cholera or blood poisoning no officials demanding bribes to release goods from storage no control freak men threatening violence because women are being given soap and education Obviously if it's all going well that's great But given the parlous state of some of the developing world which hasn't got to grips with shoe production and distribution I find that unlikely and I think much may have been glossed over in case it stops donations We do learn about a firm which donates money and investigates how to get the most value per dollar rather than just throwing money at a glitzy charity presentation or dinner I agree with this approach I don't like funding five star hotels and club class flights for officials when girls need bicycles to get to school and sanitary pads to stay in school Well done to all the ordinary hard working thoughtful people in this book Well done too to Bill and Melinda Gates whose Foundation funds much of the work I enjoyed the short foreword by Bill Gates who got interested after a safari holiday I borrowed this book from the Royal Dublin Society Library This is an unbiased review

  2. says:

    A thoughtful and inspiring account of a vital public health missionWhen was the last time you thought about neglected tropical diseases? If you are like me it was never Not until I read this book that isI was deeply moved by this fascinating and life affirming book by an author who is passionately dedicated to the treatment and eradication of diseases that affect an alarming number of people worldwide This engaging book is full of heart and profound hope as we follow the efforts of individuals who come together to surmount obstacles to save and improve the lives of people affected by neglected tropical diseases This book will challenge you as it did me to work to make the world a better place in any way we can

  3. says:

    Really interesting book which gives the perspective of donors in funding Neglected tropical disease It takes a case study approach to show the incredible progress which has been made The book teaches you than you want to know about intestinal wormsMy only criticism would be it takes an overly positive approach to the problem and focuses on successes while merely alluding to the failures A failed attempt to vaccinate Leishmaniasis is mentioned but there is no explanation for what went wrong The case study approach is great to illustrate real world stories but left me wishing this was combined with a macro view particularly when discussing health system strengthening

  4. says:

    Good introduction to neglected tropical diseases with a nice balance of stories science and lessons learned

  5. says:

    This book gives a personal approach and perspective to the fight against NTDs A stark contrast to other readings I've done

  6. says:

    Great book Easy to read A great source of knowledge for the non experts and full of empathy and compassion and humbleness Loved it

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