A scabies-focused dissemination workshop takes place in Gambella Regional State, Ethiopia

The 5S/OSSREA team, in collaboration with the Refugees and Returnees Service (RRS) Gambella Branch and Gabella Regional Health Bureau, conducted a one-day consultative workshop with key stakeholders on November 07, 2023, at Ethiopia Hotel, Gambella Regional State.

The aim of the workshop was to disseminate and validate the research findings from the project: “Understanding how precarity and marginalization affect vulnerability to, the experience of, and response to scabies among refugees in the Gambella Region, Ethiopia,” which was carried out in the Nguenyyiel Refugee Camp from February 2022 to July 2022. And to set the stage for discussions and collaboration on scabies among refugees and similar vulnerable groups.

A total of 23 stakeholders from different sectors and structures participated in the workshop. The participants were drawn from Gambella Refugee and Retirees Service Branch, Gambella Health Bureau, and Nguenyyiel Refugee Camp.

After welcoming remarks from Mr. Leulseged Solomon, the Health and Nutrition Coordinator at Refugee and Retirees Service Gambella Branch, Professor Getnet Tadele, the Country Lead and PI of the 5S Foundation Ethiopia, delivered an opening speech. He warmly welcomed and thanked all the participants for attending the workshop, emphasizing the importance of considering the social science perspectives in addressing disease. Professor Getnet highlighted the inequalities and unfair distribution in economic, social, political, and psychological factors and stressed the importance of considering vulnerabilities in future interventions.

Professor Getnet explained that the main aim of the workshop was to share the research findings from a refugee camp in Gambella and to discuss potential interventions. He also emphasized the need for collaboration among key stakeholders to address the needs of refugees and bring about meaningful changes for scabies patients. He concluded by highlighting the importance of identifying the roles of concerned institutions such as RRS, Gambella Health Bureaus, NGOs, and other relevant stakeholders in addressing these.

The overall context of scabies in Ethiopia, intervention gaps and the need for social science

Mr. Dereje Wonde, 5S Ethiopia PhD student, presented the overall context of scabies in Ethiopia, intervention gaps and the need for social sciences.
Dereje’s presentation highlighted the following points:

• He provided an overview of the landscape of scabies in Ethiopia, including the responses undertaken by different actors to contain scabies outbreaks in the country.
• His presentation showcased that the 2015 large scabies outbreaks in the Amhara region were a watershed moment in the recognition of scabies as a public health emergency issue in Ethiopia, leading to national, regional, and local interventions to control scabies.
• The introduction of the Interim Scabies Control strategy in 2015 and the National Scabies Surveillance and control guideline in 2018 were major developments in scabies control endeavours in Ethiopia.
• The use of mass drug administration (MDA) targeting to treat the entire population when the prevalence of scabies is more than 15% and intensified disease management (IDM) when the prevalence is less than 15%.
• Scabies is conceptualized as a WASH NTD in Ethiopia and is included in the third National Neglected Tropical Diseases Strategic Plan 2021-2025.
• The interventions and activities conducted in the Amhara region to control scabies incidence, include training of health workers and health extension workers at the village level. However, he noted attitudinal challenges and a lack of collaboration with religious institutions in controlling scabies in the region.
• Biomedical-oriented scabies control strategies alone are not enough to bring sustainable control and end outbreaks, emphasizing the need for social science research to inform policymakers with culturally sensitive and context-specific evidence.

Dereje concluded his presentation by reiterating the need for social science-based research in the control of scabies.

Understanding how precarity and marginalization affect vulnerability to, the experience of, and response to scabies among refugees in the Gambella Region, Ethiopia

Mr. Addisu Tsegaye, 5S Ethiopia PhD student, presented his key research findings.Addisu’s presentation highlighted the following:

• Understanding the ethno-aetiological understanding of scabies in the camp, such as the view of scabies concerning the lack of quality water and personal hygiene, environmental and geographical factors, lack of immunity and nutrition, and God’s wrath. He showed how this perception of the cause of scabies could be related to structural issues in the camp.
• The illness experience and how it influences caregiving and women’s time to engage in socio-economic activities, such as endeavouring alternative livelihood income activities.
• Dynamics of stigma in the camp and how adults developed a sense of powerlessness to avoid contracting ubiquitous scabies in the camp while believing that it should be viewed as normal and not be stigmatized.
• Adults were critical of young people who showed shame and self-stigma for their concern about their looks lacking masculinity amid the test of minor issues when there were more pressing issues to worry about in the camp.
• There was neglect of scabies at a household level, community level, and national level, where the patients’ caregivers, community members, and national refugee and health policy lacked integration leading to a situation where the refugee health system did not match with the national standard.
• Lack of coordination between the regional health bureau and the RRS on the issue of scabies, where the disease is not reported adequately and left unaddressed in the camp.

There was then a question-and-answer session followed by a conversation between the different actors on the points raised.

Conclusion and next steps

Finally, Prof. Getnet thanked all the participants for coming and participating in the validation and dissemination workshop, emphasizing the importance of thinking, and discussing how to take the research findings further and implement them to change the lives of people in general and refugees in particular. With this remark, the workshop came to an end.