Door to Door

Door to Door Community by Community, includes a graphic with a family being treated by health volunteers while standing in front of the doorway of their home.

Going Door to Door For NTDs

Lisa Rotondo stands in front of a doorway in Burkina Faso during her time as a Peace Corps Volunteer

By Lisa Rotondo, Director, USAID’s Act to End NTDs | East program at RTI International       

Have you ever gone door to door for something? Maybe it was for a school fundraiser, political campaign, holiday caroling, or for work. Even in the digital age, it’s still a common grassroots technique used around the world for a variety of purposes, including for public health.

I remember my first time going door to door for a health campaign.

It was in Pissila, a rural community in Burkina Faso where I was posted as a U.S. Peace Corps volunteer from 2001 to 2003. During the annual national immunization day campaign, I accompanied a nurse and community member to distribute the polio vaccine and Vitamin A supplements. After training, we joined other distribution teams going door to door to ensure the community had access to these important health services. It was hard work, under the relentless sun and heat of the Sahel, but truly gratifying, as I recall being warmly received at each door we entered.

Now, as director of a global USAID project dedicated to ending neglected tropical diseases (NTDs), I’m awed by the power of this simple act.

For health volunteers delivering medicines for NTDs, the days are long, the conditions difficult, but the motivation and drive to support one’s friends and neighbors are universal. Whether they’re working in a marketplace, under a tree, or at the doorway of a home, these volunteers work hard to measure doses, explain side effects, and give out medicines to protect the health and well-being of people in their communities.

And their efforts multiply, community by community. As treatment campaigns are conducted routinely over a period of years, the threat of painful and debilitating diseases like trachoma, lymphatic filariasis, and onchocerciasis are gradually erased from everyday life.

Teams make their way house to house during a trachoma impact survey in Bac Kan province, Vietnam. Photo credit: RTI International/ Nguyen Minh Duc

During the COVID-19 pandemic, many things have changed in the fight against NTDs. Community-based activities now look different with masks, even more handwashing, social distancing protocols, and other safeguards. What remains unchanged is the true cornerstone of NTD success: The commitment and tenacity of those on the frontlines.

Around the world, millions of people contribute to efforts to eliminate NTDs in their communities. Mothers, teachers, lab technicians, public health officials, health volunteers — the roles they play are many.

The dedication of these NTD fighters — even amidst an unprecedented global pandemic— is the reason why the USAID Act to End NTDs | East program is launching a new series, Door to Door, Community by Community. We’re excited to share stories of the continued fight against NTDs.


A health volunteer distributes medicine during an NTD campaign in Cross River State, Nigeria. Photo Credit: RTI International/Ruth McDowall

For more than 15 years, USAID has been supporting countries to eliminate NTDs. Through the Act to End NTDs | East program, we’ve seen incredible progress as countries scale up treatment and implement surveys to assess impact. National ministries of health have been moving fast, working to deliver NTD treatments and conduct other critical activities as quickly as possible to meet ambitious control and elimination targets.

In the last three years, Act| East has supported countries to deliver more than 70 million NTD treatments. And the impact is real, with more than 221 million people no longer at risk for LF and 99 million people no longer at risk for trachoma in the countries supported by the program.

But that speedy approach doesn’t work everywhere that NTDs affect people's lives. Now, our mission is to dig deep and do the tough, sometimes slow work of extending NTD activities to the places and populations that have not yet been reached — the most remote places, the migratory populations, the areas in conflict — ensuring that NTD services are equitable and inclusive and driving us toward elimination. To preserve the progress made to date, NTDs must also be embedded within national health systems and services.

Together — door by door, community by community, country by country — the NTD-fighting community will continue stepping up until these diseases are eliminated for good.

May we all have the passion to make change in the world that drives us to lace up our shoes and go door to door.