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Under the Big Tree: Extraordinary Stories from the Movement to End Neglected Tropical Diseases
Powerful stories of the debilitating effects of neglected tropical diseases throughout the world, highlighting the successes and challenges of those fighting to eliminate them. Neglected tropical diseases (NTDs) affect over one billion of the world's poorest people. More than 170,000 people die from NTDs each year, and many more suffer from blindness, disability, disfigurement, cognitive impairment, and stunted growth. Yet NTDs are treatable and preventable, and the annual cost of treatment is incredibly low. In Under the Big Tree , public health leader Ellen Agler and award-winning writer Mojie Crigler tell the moving stories of those struggling with these diseases and the life-saving work that can be―and has been―done to combat NTDs. They introduce readers to people from all walks of life―from car washers in Lake Victoria and surgeons on motorbikes to under-resourced local nongovernmental organizations (NGOs) and Big Pharma scientists―as they chronicle what has been called the largest public health program in the world. On the one hand, the solutions are deliver medication to people who need it and leverage local systems to offer prevention, treatment, and education. On the other hand, solutions are navigating local and national politics, delivering treatment to some of the most remote, vulnerable communities, and coordinating global and local donors, international NGOs, thousands of health workers, and millions of citizens. Drawing on interviews with major players in the NTD world who share their cutting-edge research and frontline experiences, Under the Big Tree is a moving introduction to the science, the tactics, and the partnerships working to address these terrible diseases that affect the most vulnerable people in the world. With a foreword by Bill Gates, this book fascinates, inspires, and gives readers concrete steps for further engagement.
240 pages, Hardcover
First published January 15, 2019
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Displaying 1 - 11 of 11 reviews
May 7, 2020
This book focuses on five major tropical diseases (including parasites) which, unlike HIV and malaria, haven't had such a high profile. Having said that, the Sunday Times has done a good job over the years of informing me about Ghanian river blindness, Guinea worm and more. This book doesn't address Guinea worm which is a major let-down. The subject is referred to twice briefly; this like most of the diseases is one of a parasite, water borne, transmitted by foul water. The worm doesn't even have a vector unlike the flies and snails referred to here. What we are told, is that it has been eliminated from many countries to a few tens of cases, and will soon be eradicated.
Trachoma, schistitis, river blindness, lymphatic filariasis, elephantiasis, roundworms, whipworms and hookworms are the major issues addressed. We used to ask the nuns in school who'd been to the Missions, why the children we saw in African charity posters had big swollen tummies and thin arms. "Oh, when they get food or water they take in a lot in one go," we were told. Of course, the kids really were filled with worms, which did away with any good from food they were sent. We were forced to hand over pocket money in order to feed parasitic worms.
We learn about Merck, Sharp and Dohme developing ivermectin as a cattle wormer and sending it out for free to reduce river blindness. (While extremely creditable, I can imagine this might give a firm great leverage if a government wanted to tax them or split them up, say; and if MSD stopped, who would do it? We're warned that horse worms can become immune to vermifuges so it's best to rotate medicines; if the human parasites become immune, what then? Not explored.)
The author puts much emphasis on training nurses and helpers and teachers and getting the tablets out there in mass dosings. She also emphasises carrying out surveys of areas - governments didn't know how many schools they had, and gave an incorrect answer. The same governments, we note, which didn't care whether people had sewerage and fresh water, or even knew how to dig latrines in a land not short of manual labour (no shovels?). We're not told the most obvious factors - like if a parasite is water borne, you must treat and clear and provide latrines in the villages at the head of the river first and work down the river, or everyone will just reinfect everyone else. We are told that in one area, women only washed once a month because their men didn't want them to be clean in case other men got attracted. Hence the bullied women, of course, got more diseases.
The stories of illness are probably horrendous to experience as patient or helper, but we can take hope from the efforts being made. But no negatives are experienced, it seems. No roadblocks by gun-waving shakedown merchants, no kidnappings and ransom demands, no threats from poachers, terrorists or rival tribal gangs, no swaggering army men trying to take drugs for black market, no beheaded animals left at the clinic by witchdoctors, no threats from people whose children died, no doctors catching cholera or blood poisoning, no officials demanding bribes to release goods from storage, no control freak men threatening violence because women are being given soap and education. Obviously, if it's all going well, that's great. But given the parlous state of some of the developing world, which hasn't got to grips with shoe production and distribution, I find that unlikely and I think much may have been glossed over in case it stops donations.
We do learn about a firm which donates money and investigates how to get the most value per dollar, rather than just throwing money at a glitzy charity presentation or dinner. I agree with this approach. I don't like funding five star hotels and club class flights for officials when girls need bicycles to get to school and sanitary pads to stay in school. Well done to all the ordinary, hard-working, thoughtful people in this book. Well done too to Bill and Melinda Gates whose Foundation funds much of the work. I enjoyed the short foreword by Bill Gates who got interested after a safari holiday.
I borrowed this book from the Royal Dublin Society Library. This is an unbiased review.
Trachoma, schistitis, river blindness, lymphatic filariasis, elephantiasis, roundworms, whipworms and hookworms are the major issues addressed. We used to ask the nuns in school who'd been to the Missions, why the children we saw in African charity posters had big swollen tummies and thin arms. "Oh, when they get food or water they take in a lot in one go," we were told. Of course, the kids really were filled with worms, which did away with any good from food they were sent. We were forced to hand over pocket money in order to feed parasitic worms.
We learn about Merck, Sharp and Dohme developing ivermectin as a cattle wormer and sending it out for free to reduce river blindness. (While extremely creditable, I can imagine this might give a firm great leverage if a government wanted to tax them or split them up, say; and if MSD stopped, who would do it? We're warned that horse worms can become immune to vermifuges so it's best to rotate medicines; if the human parasites become immune, what then? Not explored.)
The author puts much emphasis on training nurses and helpers and teachers and getting the tablets out there in mass dosings. She also emphasises carrying out surveys of areas - governments didn't know how many schools they had, and gave an incorrect answer. The same governments, we note, which didn't care whether people had sewerage and fresh water, or even knew how to dig latrines in a land not short of manual labour (no shovels?). We're not told the most obvious factors - like if a parasite is water borne, you must treat and clear and provide latrines in the villages at the head of the river first and work down the river, or everyone will just reinfect everyone else. We are told that in one area, women only washed once a month because their men didn't want them to be clean in case other men got attracted. Hence the bullied women, of course, got more diseases.
The stories of illness are probably horrendous to experience as patient or helper, but we can take hope from the efforts being made. But no negatives are experienced, it seems. No roadblocks by gun-waving shakedown merchants, no kidnappings and ransom demands, no threats from poachers, terrorists or rival tribal gangs, no swaggering army men trying to take drugs for black market, no beheaded animals left at the clinic by witchdoctors, no threats from people whose children died, no doctors catching cholera or blood poisoning, no officials demanding bribes to release goods from storage, no control freak men threatening violence because women are being given soap and education. Obviously, if it's all going well, that's great. But given the parlous state of some of the developing world, which hasn't got to grips with shoe production and distribution, I find that unlikely and I think much may have been glossed over in case it stops donations.
We do learn about a firm which donates money and investigates how to get the most value per dollar, rather than just throwing money at a glitzy charity presentation or dinner. I agree with this approach. I don't like funding five star hotels and club class flights for officials when girls need bicycles to get to school and sanitary pads to stay in school. Well done to all the ordinary, hard-working, thoughtful people in this book. Well done too to Bill and Melinda Gates whose Foundation funds much of the work. I enjoyed the short foreword by Bill Gates who got interested after a safari holiday.
I borrowed this book from the Royal Dublin Society Library. This is an unbiased review.
January 31, 2019
A thoughtful and inspiring account of a vital public health mission!
When was the last time you thought about neglected tropical diseases? If you are like me, it was never. Not until I read this book, that is.
I was deeply moved by this fascinating and life-affirming book by an author who is passionately dedicated to the treatment and eradication of diseases that affect an alarming number of people worldwide. This engaging book is full of heart and profound hope as we follow the efforts of individuals who come together to surmount obstacles to save and improve the lives of people affected by neglected tropical diseases. This book will challenge you -- as it did me -- to work to make the world a better place in any way we can.
When was the last time you thought about neglected tropical diseases? If you are like me, it was never. Not until I read this book, that is.
I was deeply moved by this fascinating and life-affirming book by an author who is passionately dedicated to the treatment and eradication of diseases that affect an alarming number of people worldwide. This engaging book is full of heart and profound hope as we follow the efforts of individuals who come together to surmount obstacles to save and improve the lives of people affected by neglected tropical diseases. This book will challenge you -- as it did me -- to work to make the world a better place in any way we can.
May 12, 2019
Really interesting book which gives the perspective of donors in funding Neglected tropical disease. It takes a case study approach to show the incredible progress which has been made. The book teaches you more than you want to know about intestinal worms.
My only criticism would be it takes an overly positive approach to the problem and focuses on successes while merely alluding to the failures. A failed attempt to vaccinate Leishmaniasis is mentioned but there is no explanation for what went wrong.
The case study approach is great to illustrate real world stories but left me wishing this was combined with a more macro view particularly when discussing health system strengthening.
My only criticism would be it takes an overly positive approach to the problem and focuses on successes while merely alluding to the failures. A failed attempt to vaccinate Leishmaniasis is mentioned but there is no explanation for what went wrong.
The case study approach is great to illustrate real world stories but left me wishing this was combined with a more macro view particularly when discussing health system strengthening.
January 10, 2021
This is a wonderful jumping-off point for learning about neglected tropical diseases and the people, organizations, and partnerships leading the effort to end them. It's a people-centric story that provides enough context without diving into too much scientific detail. The descriptive narrative takes readers around the world to different countries where these diseases of poverty are endemic and offers both an on-the-ground level perspective and a wider view of the many industries and governments at play.
November 17, 2022
Under the Big Tree is a non-fiction of where treatment for neglected tropical diseases (NTDs) stands in the period of 2000 to 2020, particularly in the underdeveloped countries of the world. It is a compendium of fascinating and heroic stories of people finding the funding for the medical treatments for NTDs and of the many amazing people and their efforts in reaching the sufferers with the treatments available. There is so much good happening in this book that you can't help feeling optimistic and positive after reading it.
August 3, 2023
The stories in this book are why I’m in the career field I’m in. This books provides an accessible account of what NTDs are, their history, and their current status. I wish this book described a more realistic idea of the difficulties that are faced in providing treatment of these diseases in these cultures, economic levels, and in countries that don’t always welcome outside aid. Nonetheless, this book is a great way to learn more about NTDs and where we are in the effort to eliminate them.
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February 3, 2021
A great perspective on the history of NTDS. The authors explains any of the technical, or science, in an easy to understand, relatable way. There is a good mix of history and more recent progress over the 5-10 years and great representation from experts in the global North and South. Would recommend for anyone who is interested in learning more about NTDs or wants to understand more their progress as a global program.
April 26, 2019
Great book. Easy to read. A great source of knowledge for the non-experts and full of empathy and compassion and humbleness. Loved it!
September 19, 2019
This book gives a personal approach and perspective to the fight against NTDs. A stark contrast to other readings I've done.
November 4, 2019
Good introduction to neglected tropical diseases with a nice balance of stories, science, and lessons learned.
October 13, 2023
You’re all getting this for Christmas
Displaying 1 - 11 of 11 reviews