Adelante 2: Cross-Border Exchange and Training Experience on Chagas Disease Now Underway

Marta Solís was concerned about something that she couldn’t find a clear answer about. She had been affected by Chagas disease. Oddly, however, after having received treatment, her tests “did not come back negative”.

Her doubts were recently cleared up when she and several colleagues attended training workshops in the Paraguayan Chaco. At these workshops—the first activity of a triangular cooperation initiative co-financed by the ADELANTE Window—Marta gained a better understanding of the dynamics and progression of the infection.

Health challenges are one of the ties that bind those of us who live in Bolivia and Paraguay. We launched this initiative as a means of sharing the knowledge and experience we have acquired in the fight against Chagas disease. Because we live alongside one another in similar endemic regions—such as the Chaco, where Marta Solís is from—this exchange will help to strengthen the comprehensive management of Chagas disease on both sides of the border. Moreover, the experience of non-endemic areas, such as Spain, where migrants from our countries are cared for, adds further knowledge to this initiative.

Health challenges are one of the ties that bind those of us who live in Bolivia and Paraguay. We launched this initiative as a means of sharing the knowledge and experience we have acquired in the fight against Chagas disease

In late September of this year, we started our first training workshops at the Irala Fernández Health Centre in the Paraguayan Chaco, with the participation of professionals from all three of the countries involved. Bolivian colleagues from the Chagas Platform of Juan Misael Saracho Autonomous University (UAJMS) in Tarija shared the knowledge they had acquired about Chagas management and care. These professionals have more than 10 years of experience with the Platform for the Comprehensive Care of Patients With Chagas Disease, developed by ISGlobal in collaboration with CEADES and the Bolivian authorities in three areas of Bolivia, including Tarija.

“It was in Tarija that adults were first treated, since the rest of the system used to treat only children,” explained Dr Lourdes Ortiz, who coordinates the Tarija Chagas Platform and participated in the training workshops.

Also in attendance was Alejandro Palacios López, head of the Tarija Chagas Platform’s medical team, who explained that research and the evidence generated in recent years have enabled professionals to have “clearer protocols for the comprehensive care of our patients”. This has strengthened the comprehensive approach to Chagas disease and, according to Palacios, the old paradigm of not treating infected people is now disappearing.

Ana Ángela Daza, head of the Information, Education and Communication (IEC) area in Sucre, noted that the workshops were not one-way training exercises but rather an exchange, because “staff from both countries have innovative experiences that can be taken into account to continue educating the population affected by Chagas disease”. Daza summed up the lessons she had learned, citing key concepts such as education, listening to patients, paying attention to suggestions from other professionals and the importance of educational materials that health personnel can use to inform the affected community.

A Neglected Disease

Because Chagas is a neglected disease, greater efforts are needed in all areas, including research and diagnosis. Rudy Basco, a biochemist and laboratory manager for the Tarija Chagas Platform, remains surprised at the challenges still facing Chagas research “more than a hundred years after the disease was discovered”. After participating in the exchange organised in Paraguay, Basco commented that, beyond the technical aspects, the most important thing was the response of people affected by Chagas disease in the communities with the fewest resources, “who value the work we do with them”.

Because Chagas is a neglected disease, greater efforts are needed in all areas, including research and diagnosis

Vidalia Lesmo, head of Paraguay’s national Chagas programme, celebrated this first training experience involving the two countries, held in a highly endemic area like the Paraguayan Chaco, and expressed hope that the initiative could be extended to other areas affected by the disease. She highlighted the youth of the professionals who took part in this pilot initiative, which she described as undeniably “good news” for the continuity of the efforts and the commitment to fighting Chagas disease in her country. Her programme recently published its first guidelines on the management of Chagas disease, so the workshops served to strengthen the knowledge and application of these guidelines among frontline staff.

It is important to mention the additional challenge posed by COVID-19 with regard to the Chagas problem. Without international cooperation and the support of the health authorities in the affected countries, an initiative like this one would not have been possible. Moreover, the European Union’s ADELANTE 2 programme also contributes to the United Nations 2030 Agenda for Sustainable Development (SDGs) in these countries, specifically with regard to Sustainable Development Goals (SDGs) 3 and 4, which relate to health and well-being.