Two of our founding members, Dr. Alon Friedman and Dr. Merav Hagar Shamir first visited Zambia in 2009 to attend a conference about stigma of epilepsy. They returned several times to visit the South Luangwa National Park, in Eastern Zambia.
During one of their visits in 2018, upon talking with locals, they learned that epilepsy was very common in this region. Alon was a doctor and professor of Neuroscience who studied epilepsy, and Merav was a veterinarian neurologist and professor who studied epilepsy in animals. Their friend, Mr. Billy Nkhoma connected them with Mr. Andrew Malunga, a local nurse working at the Kakumbi Rural Health Clinic. Andrew was very ambitious and committed to combatting the substantially high rates of epilepsy and large diagnosis and treatment gaps in this region. Together, Andrew, Alon, and Merav assembled a team and began this project.
From left: Andrew, Billy, Alon, Merav
About Mfuwe and the National Park
Mfuwe is a settlement in the Kakumbi Chiefdom, part of the Eastern Province of Zambia. It is located beside the South Luangwa National Park, which serves the tourism industry and wildlife conservation in the Luangwa Valley. The Park covers an area of 9,050 km and is unfenced and bordered to the west by a steep escarpment and to the east by the Luangwa River.
Epilepsy is one of the most common chronic neurological disorders. Astoundingly, 80% of the 65 million individuals with epilepsy worldwide reside in low and middle income countries.
The high prevalence of epilepsy in developing countries has been reported due to:
1) Infectious diseases of the nervous system (e.g. neurocysticercosis, cerebral malaria, HIV )
2) High incidence of brain injuries
3) Genetic syndromes resulting from consanguineous marriages
In developed countries, over 90% of individuals are treated with anti-seizure drugs (ASDs). However, in developing countries, less than 50% are treated. In Zambia, fewer than 20% of individuals are treated. Such low rates are believed to be due to:
- Insufficient resources
- Low numbers of medical professionals
- Distance from medical teams
- Avoidance due to stigma
From March 2019 to February 2020 under the leadership of Mr. Malunga, who serves today as the Director of the Mfuwe Epilepsy Foundation, a team of health workers conducted a door-to-door survey of 15,290 people living in Kakumbi Chiefdom, in the Eastern Province of Zambia. Screening revealed that 1,435 participants (9.4%) reported at least one symptom consistent with epilepsy. These results suggest that the prevalence of epilepsy is higher in the Kakumbi Chiefdom compared to urban areas in Africa or the global north.
Diagnosis and Treatment
Our team makes biannual visits to the Kakumbi and Chilanga Rural Health Clinics to confirm diagnosis, provide initial treatment for patients with epilepsy. Clinical visits are led by Mr. Andrew Malunga and assisted by local healthcare workers and neurologists, EEG technicians, and students from Canada, Israel, and Germany. Over 100 patients have been examined, confirmed for epilepsy diagnosis, and treated.
An education program was initiated when our team visited Ms. Christin Sinyangwe, the Mambwe District Education Board Secretary, to present the foundation’s initiative to reduce stigma towards people with epilepsy in the Kakumbi Chiefdom. With the approval and blessing of the district director, the foundation will initiate meetings with school directors, teachers and learners to improve the knowledge about epilepsy, seizure first aid and encouraging inclusive education for children with epilepsy. We aim to reduce the stigma and promote the integration of patients with epilepsy into society.
Mfuwe Epilepsy Center
We purchased a plot of land within walking distance of the Kakumbi Rural Health Clinic. We are planning on building the Mfuwe Epilepsy Center for the diagnosis, treatment, rehabilitation, and education of patients with epilepsy and their families. The Center will take a holistic approach to diagnosing epilepsy, collaborating with traditional healers to combine traditional medicine with "conventional medicine" to improve compliance and reduce stigma. It will also invest resources in training healthcare workers both in person and online. The Center will ultimately follow up with more than 500 patients annually and develop community programs to facilitate overcoming education gaps, and through rehabilitation will encourage adults with epilepsy to join the work force in the village.