This piece was originally posted on USAID’s Medium page. See the original here.

Joel Adwel, 28, perches on a small wooden stool in Kaberamaido District, Uganda.

A man sits chopping wood. His legs are visibly swollen as a result of lymphedema caused by lymphatic filariasis.

Joel rests after chopping wood near his home. Credit: Conrad Roy, RTI International

As he chips away at a log, he thinks back to his teen years.

“I was very sick when I was 14,” he remembers. “I am not so certain if that was the start.”

But shortly after, he noticed pain in his feet and legs. It was one of the first signs that he had been infected with lymphatic filariasis (LF), or elephantiasis, one of the world’s oldest diseases. An avoidable and debilitating neglected tropical disease (NTD), the parasite that causes LF is spread from person to person by mosquitoes. Over time, the parasite larvae develop into thread-like worms within a person’s body, which can lead to severe swelling and fluid buildup in the legs, called lymphedema or elephantiasis, or in the scrotum, called hydrocele.

Since then, Joel’s swollen legs and feet have limited his work opportunities — wood working is one of the only jobs he can do.

“I wake up in the morning and must sit to do this [job]. That affects my whole family because I can’t farm,” says Joel.

A Ugandan man plays soccer with two children in his family. He has visibly swollen lower legs which are the result of a disease called lymphatic filariasis.

Joel plays football (soccer) with his family. / Conrad Roy, RTI International

His symptoms have eased since he was shown how to care for his leg with hygiene practices and regular exercise. “My favorite way to stretch my muscles is to play football,” he says.

While LF symptoms can be managed, those who suffer from elephantiasis, like Joel, cannot be cured. That’s why Uganda is on a mission to eliminate the disease from the country.

Safe, effective medicines exist to help prevent long-term infection of LF, but funding for governments to effectively deliver the treatments has not been consistently available. Over the past decade, the Government of Uganda — in partnership with USAID and others — has worked to connect Ugandans to treatment. By providing these donated, preventive medicines for multiple years to whole communities, Ugandans are closer to being free from this devastating disease.

To date, more than 72 million LF treatments have been delivered to more than 12 million people across the country with USAID support.

And it’s working. Recently, Uganda was able to stop treatment for LF nationwide, due the incredible success of these efforts. Stopping treatment is an important step on the road to eliminate the disease.

This massive task to distribute treatments was driven by community volunteers and health care providers like Dr. Achar Cerino. A father of six, Achar is the district health officer for Kotido district.

Dr. Achar Cerino, a district health officer in Uganda looks into the camera (left). Dr. Achar Cerino sits working at a desk (right).

Dr. Achar Cerino is the health officer in Uganda’s Kotido district. Credit: Conrad Roy, RTI International

“NTDs are chronic and debilitating. It affects production. You cannot be economically viable with a huge hydrocele or a very huge leg that is paining you,” shares Achar.

Achar has seen the result of efforts to eliminate LF in his district and throughout Uganda. In fact, he recalls being involved in one of the very first efforts to determine which communities would need treatment for LF in the late 1990s.

“I’m very passionate about community health,” says Achar. “The health work I do is a call[ing]. I wake early in the morning, and I go back late.”

Around the country, volunteers and health officials like Achar have led efforts to eliminate these diseases in their communities–planning and mobilizing people for treatment, teaching good hygiene practices, and sharing other important health information.

A man in Uganda with lymphedema washes his leg as part of his self care routine.

A Ugandan man washes his legs as part of a self-care routine. He has a swollen leg caused by lymphatic filariasis. Credit: Conrad Roy, RTI International

This strategy is working. Today, the 17 million people living in areas where LF was endemic in Uganda are no longer at risk for the disease.

But the work is not over. USAID’s Act to End NTDs | East program continues to support the government to ensure communities remain free from new infections. And they will keep checking for several years, resuming treatments if needed, all to ensure this disease is eliminated for good.

In the last year, government-led health teams have tested more than 50,000 people in 39 districts across Uganda through LF surveys. Children line up to have their fingers pricked, waiting 10 minutes for their results to appear on rapid tests. Each LF survey takes about two weeks to complete.

A child has their finger pricked during a check for lymphatic filariasis in Uganda.

A child has their finger pricked during a check for lymphatic filariasis in Uganda. / Conrad Roy, RTI International

Joel’s community passed with flying colors, which was no easy feat. And for Joel, he sees the global progress is affecting his own friends and family.

“And for the community, the medicines that have been taken will help them now be protected from this disease,” says Joel.

Now, the people of Uganda are on a path to freedom from a disabling disease.

It’s part of a growing global movement against a disease that once affected hundreds of millions of people.

For Uganda, this is a key step to securing a healthy and productive future free from neglected tropical diseases.

USAID’s Act to End NTDs | East is a global flagship program working to eliminate neglected tropical diseases in 12 countries in Africa, Asia, and Latin America. With USAID support, Act to End NTDs | East works with health ministries to treat communities, measure progress, and strengthen health systems to deliver NTD services.