Malawi's Battle Against River Blindness

Sheikh Yusuf carries medication, a measuring stick and a treatment register from household to household. His work shows how community trust extends Malawi's river-blindness campaign to the last mile.

River blindness can cause severe itching, skin disease and permanent vision loss. Malawi works to interrupt transmission through repeated mass drug administration campaigns, with trained community distributors carrying ivermectin from household to household.

In November 2023, I followed Sheikh Yusuf, a community elder and volunteer distributor who has supported the campaigns since 2016. He begins each working day with three essential tools: medication, a measuring stick and a treatment register.

"I don't want to see anyone suffer from this debilitating disease. We must all do our part to protect our community."
— Sheikh Yusuf

Health-related storytelling requires careful attention to representation and privacy.

The work prioritised informed participation, contextual reporting, and respectful documentation. Rather than reducing individuals to examples of disease or intervention, the project focused on preserving their humanity, agency, and lived experience.

Care was taken to ensure that images and narratives reflected the complexity of people's realities rather than simplifying them into symbols of either vulnerability or success.

The stick helps him determine dosage. The register records each treatment. His standing in the community helps him explain the medicine, respond to concerns and reach people who may not attend distribution at a central point.