Helen Keller International and TOMS: Motivating Community Drug Distributors in Sierra Leone

August 20th, 2015

“My old shoes are worn out and I was thinking if my parents can afford to buy me another pair of shoes before the opening of school.”
– Fatmata, age 8.

Wearing her new TOMS shoes, Fatmata gets a hug from her father, a volunteer who distributes medicines to prevent NTDs in Sierra Leone. Photo: Helen Keller International

Efforts to fight Neglected Tropical Diseases (NTDs) are truly massive undertakings, since their success hinges upon the ability of national NTD programs to literally reach millions of people and provide each and every person with preventive medications.

Sierra Leone is one of many countries that has risen to this challenge. With a population exceeding 6 million people, the country’s NTD program relies on approximately 30,000 Community Drug Distributors (CDDs) to distribute NTD medications throughout its 12 rural districts.

And if recruiting, organizing and managing that many CDDs weren’t enough of a challenge, there’s one other detail that’s worth noting. Although these 30,000 CDDs must spend days, if not weeks, ensuring that their communities receive drugs that will prevent blindness, kidney and liver disease, malnutrition, and physical deformities, none receive any payment for their services.

A happy boy shows off his new shoes from TOMS Shoes in Sierra Leone. Photo: Helen Keller International

In an effort to motivate and reward the CDDs for their important work and to reduce attrition, Helen Keller International (HKI) and the National NTD Program have partnered with TOMS, a US-based, philanthropically minded company that has given away over 45 million pairs of shoes to children in over 70 countries. To date, Sierra Leone has received two shipments of TOMS Shoes—over 300,000 pairs –between 2013-2014 to distribute to the CDDS and their children.

In 2013, each CDD received three pairs of shoes for his or her family; this was increased to five pairs in 2014. Shoes were also distributed to others whose support has been instrumental to the success of the country’s NTD mass drug administration (MDA), such as community leaders, peripheral health unit (PHU) staff, and members of the district health management team (DHMT).

From a logistical standpoint, ensuring that CDDs receive these shoes is almost as complex an undertaking as conducting the MDAs themselves for Helen Keller International (HKI), the sub-grantee organization that supports Sierra Leone’s NTD Program in partnership with END in Africa’s administrator, FHI360. First, HKI helps the National NTD Program determine the total number of participating CDDs and estimate the total number of shoes needed, as well as the number of pairs per size. An order is then placed with TOMS Shoes.

Fatmata (3rd from left) pauses to take a family photo after receiving her new shoes from TOMS Shoes. Photo: Helen Keller International

Once the shoes arrive at the Freetown port several months later, they must be trucked to six distribution points throughout the country. Shoes are then divided up by district; and the districts assume the responsibility for ensuring that their PHUs receive enough shoes for all the CDDs in their areas. Finally, the CDDs receive shoes for themselves and their children.

The children are ecstatic about getting a new pair of TOMS Shoes. Eight-year-old Fatmata remembers the day she received her pair of TOMS Shoes: “My old shoes are worn out and I was thinking if my parents can afford to buy me another pair of shoes before the opening of school.” Her grandfather appreciated their value as well, noting that they’ll not only motivate Fatmata to go to school, but they’ll also help reduce her risk of hookworm infection from walking barefoot.

Despite the challenges, the National NTD Program and HKI officials agree that getting shoes to each of the CDDs is well worth the considerable effort it takes to administer the initiative. After all, the National NTD Program would not be able to conduct MDAs without the CDDs; indeed, their success hinges on the work of the CDDs. Without their commitment and hard work, millions of persons would still be suffering from preventable and treatable diseases.

HKI and Sierra Leone’s NTD Program look forward to continuing to partner with TOMS, and plan to distribute additional TOMS shoes in 2015.