High up in the Peruvian highlands, where the air is thin but determination runs deep, a quiet battle is being waged against echinococcosis, one of the neglected tropical diseases listed by the World Health Organisation (WHO). This zoonosis, which affects nearly a million people worldwide, is transmitted from animals to humans, with dogs and sheep acting as its main vectors. 

In the town of Combapata, dogs wander erratically through the plaza, sniffing through rubbish or crossing paths in silent journeys. They are part of the urban landscape, as much as the houses or cars, and might go unnoticed were it not for the crucial role they play in the spread of the disease. The parasite responsible for echinococcosis lodges in the intestines of dogs after they consume the viscera of infected sheep. The parasite's eggs are then spread through the dogs' faeces, contaminating the environment, including food and crops. 

Aware of this reality, Probitas, in collaboration with its local partner ABC Prodein, has adopted an integrated approach to tackle the disease. The strategy combines community action, health education, and control of risk factors. Efforts are focused on improving slaughterhouse facilities (known locally as camales) to prevent infected viscera from being given to dogs. Meanwhile, in local schools, puppet workshops are held to teach children the importance of deworming their pets and maintaining good hygiene practices. 

“Children are the best messengers,” says Sister Martha de Prodein, who uses puppets to tell the story of a dog, a sheep, and a nurse, captivating the attention of the youngest members of the community. Here, there is no child who does not play with a dog, and no child is exempt from the risk of infection. Through these puppet shows, children learn the importance of deworming their dogs, washing their hands, and encouraging their parents not to feed sheep offal to dogs. The aim is for children to take this message home, convincing adults of the need to change deeply rooted habits. 

But efforts do not stop in the classroom. For adults, video screenings and educational talks are organised to raise awareness. Additionally, a dog deworming campaign has been launched, led by local officials like municipal engineer Juan Carlos Rodríguez. His initiative has made it possible to treat hundreds of dogs in Combapata and surrounding communities. His efforts have set an example for neighbouring municipalities, which are now looking to replicate the experience. 

A multi-sectoral approach is essential in this fight. During our visit to the project, we held meetings with the mayors of the towns involved, researchers from the Continental University, technicians responsible for slaughterhouse control, veterinarians, and those in charge of deworming sheep and dogs. 

Coordination between municipalities, universities, veterinary teams, and health personnel not only facilitates the deworming of dogs but also allows for the active monitoring of human health. This is achieved through research into the prevalence of the disease in communities. To this end, ultrasound screening campaigns are conducted to detect hydatid cysts in at-risk individuals. At the health centre in Pomacanchi, situated 3,700 metres above sea level, family members of previously diagnosed patients are invited to undergo these tests. 

“I left with my heart at peace,” confesses an elderly woman — a mamita, as they are affectionately called locally — as she leaves the ultrasound room. She has just been informed that she does not have any cysts. She speaks in Quechua with her family and smiles, a mix of nervousness and relief evident on her face. 

The fight against echinococcosis — or hydatidosis, as it is also known, due to the hydatid cysts it causes — is long and complex. But each successful activity represents a small victory. From Sister Martha’s puppets to Rodríguez's deworming campaign, every effort contributes to the final triumph. 

Anna Veiga, director of Probitas, remarks, "Although the disease acts silently, the response from these communities is strong and determined. Here, in the heights of the Peruvian highlands, it is clear that with education, commitment, and collaboration, even the most invisible diseases can be overcome."