Gasabo, Rwanda - Emmanuel Nyirishema vividly recalls the day his wife told him she was leaving. "My condition was a heavy cross to bear, not just for her, but for all of us," the 26-year-old potato farmer reflects.

His spouse of 5 years buckled under the weight of caring for Emmanuel and their two children, overwhelmed by the difficulties of his Podoconiosis.

Also known as nonfilarial elephantiasis, his illness is regarded as the second most common cause of tropical lymphedema, marked by swelling of the legs and the resulting disfigurement and disability.

His once strong legs were devastated by the soil-borne disease caused by walking barefoot in the irritant mineral-rich soils of Gasabo district in Rwanda’s capital, Kigali.

At just 15 years old, Emmanuel first felt the prick of the disease, with symptoms of high fever, gangrene, and itching legs that swelled to the point of rendering him unable to walk. In search of a cure, he visited a local health centre at 18, but was met with disappointment as they were unable to treat his condition.

However, with the coordinated efforts of the Government of Rwanda with support from the World Health Organization (WHO), Emmanuel's story took a turn for the better.

In early 2021, unable to move or walk, a kind policeman brought him to Kinyinya Health Centre, where he finally received the treatment, he needed. "I had suffered from terrible wounds," he said.

"I would scratch my legs in pain, as if my fingernails were insufficient to relieve the agony. But thanks to the treatment, the pain is gone. My legs are mine and there is nothing like the joy of wearing shoes again."

With WHO's expert recommendations on the Rwanda National Neglected Tropical Diseases (NTD) Strategic Plan, Emmanuel received a comprehensive treatment package. This included patient counselling, foot hygiene, skin care, wound care, bandaging, provision of socks and shoes, exercise, and regular follow-up, along with timely referrals when necessary.

Thanks to this standard of care, Emmanuel is now walking tall and proud, free from pain and disability.

Rwanda's pursuit to end NTDs like podoconiosis is gaining momentum with the government's multi-sectoral approach. The government's drive to improve treatment and community health education, is backed by vital support from WHO and other partners such as The End Fund, Merck KGaA, and the World Food Programme (WFP).

Dr Albert Tuyishime, Head of Disease Prevention and Control at the Rwanda Biomedical Centre, attributes the progress to " addressing NTDs across multiple sectors such as education, nutrition, water, animal, and environmental health."

"In Rwanda, agricultural activities are a major risk factor for Neglected Tropical Diseases (NTDs), particularly intestinal worms. It affects 41% of Rwandans, with 48% of adults being the most affected. Despite this challenge, these diseases can be defeated with sustained effort and collaboration," he concludes.

Head of NTDs at WHO Rwanda, Dr Jules Mugabo Semahore calls NTDs a persistent challenge in the country but remains hopeful saying, "Rwanda continues to take giant leaps forward."

"From lymphatic filariasis to schistosomiasis to soil-transmitted helminthiasis, NTDs still demand our attention, but I commend the Rwandan government for their tireless work in controlling and working towards eliminating these illnesses. We stand with the Ministry of Health and Rwanda Biomedical Centre in the ongoing fight to beat NTDs by 2030."

Rwanda's achievements in the fight against NTDs have been significant, including the certification by WHO of the elimination of Rhodesiense Human Africa Trypanosomiasis (sleeping sickness) as a public health threat, solidified by the Kigali Declaration signed by world leaders in 2022, committing to ending NTDs by 2030.

Emmanuel's journey serves as a testament to the progress being made and the continued importance of efforts to tackle NTDs.

The young farmer now sets his sights on a new future, one where he can share his newfound footing with a soulmate who will walk by his side, without reservation or fear, just like he has done with his bare feet.