Posts tagged kala azar

Kala Azar: Still Waiting
Photo:Kala Azar in South Sudan 2012 © John Stanmeyer/VII
Fatal NeglectKala Azar: Still Waiting 
Some three decades ago, a mystery disease spread throughout Sudan and what is now South Sudan, decimating communities, sewing fear, and killing scores. It turned out to be kala azar, also known as visceral leishmanaisis, a disease that is spread by the bite of a sandfly and that is, as this episode showed, fatal if not treated.
MSF began caring for kala azar patients during that epidemic and has continued to do so through the present day, in both Sudan and South Sudan, and in other East African nations where the disease appears, as well as in South Asia. The needs are different in the different locations, because the strains of the disease found have their own particular characteristics. What unites them, however, is that the people trying to combat the disease are hamstrung by shortcomings in targeted research and development that has resulted in a lack of suitable diagnostics and treatment regimens.
MSF has successfully adapted its treatment protocols over the years in order to bring shorter, less toxic, and less painful options to patients, but as VII Photo’s John Stanmeyer saw on a recent trip to MSF projects in South Sudan, a great deal remains to be done in order to provide better, more specialized, more accessible treatment and testing, and to prevent further devastation.

Photo:Kala Azar in South Sudan 2012 © John Stanmeyer/VII

Fatal Neglect
Kala Azar: Still Waiting 

Some three decades ago, a mystery disease spread throughout Sudan and what is now South Sudan, decimating communities, sewing fear, and killing scores. It turned out to be kala azar, also known as visceral leishmanaisis, a disease that is spread by the bite of a sandfly and that is, as this episode showed, fatal if not treated.

MSF began caring for kala azar patients during that epidemic and has continued to do so through the present day, in both Sudan and South Sudan, and in other East African nations where the disease appears, as well as in South Asia. The needs are different in the different locations, because the strains of the disease found have their own particular characteristics. What unites them, however, is that the people trying to combat the disease are hamstrung by shortcomings in targeted research and development that has resulted in a lack of suitable diagnostics and treatment regimens.

MSF has successfully adapted its treatment protocols over the years in order to bring shorter, less toxic, and less painful options to patients, but as VII Photo’s John Stanmeyer saw on a recent trip to MSF projects in South Sudan, a great deal remains to be done in order to provide better, more specialized, more accessible treatment and testing, and to prevent further devastation.

Photo: Francis Gatluak, one-time MSF patient, now the manager of the tuberculosis program at MSF’s hospital in Leer, South Sudan. South Sudan 2012 © John Stanmyer/VII Photo
The Patient Becomes the Healer
Three decades ago, when Francis Gatluak was a boy, civil war forced his family to flee their small village in Unity State, in the northern reaches of what is now South Sudan. He was diagnosed with kala azar, a disease that thrives in poor, unstable areas with limited health care.  
Francis endured the difficult SSG treatment at MSF’s nearby camp, and recovered. Since he spoke some English, the staff asked him if he would stay and work with them as a translator. He did this for a few months, developing a desire to do more. “I started to learn about how I can help the patient,” he says. “If there are people who can give medication, I can also help to do the job, and help the community.”
Today, he is a nurse in his twenty-third year working with MSF. He has gone on MSF assignments in other African countries and recently returned to the Leer hospital, where he is now in charge of the tuberculosis ward. And he recently traveled to Washington, DC, to speak on the organization’s behalf when MSF was awarded the highly-esteemed 2012 J. William Fulbright Award for International Understanding.

Photo: Francis Gatluak, one-time MSF patient, now the manager of the tuberculosis program at MSF’s hospital in Leer, South Sudan. South Sudan 2012 © John Stanmyer/VII Photo

The Patient Becomes the Healer

Three decades ago, when Francis Gatluak was a boy, civil war forced his family to flee their small village in Unity State, in the northern reaches of what is now South SudanHe was diagnosed with kala azar, a disease that thrives in poor, unstable areas with limited health care.  

Francis endured the difficult SSG treatment at MSF’s nearby camp, and recovered. Since he spoke some English, the staff asked him if he would stay and work with them as a translator. He did this for a few months, developing a desire to do more. “I started to learn about how I can help the patient,” he says. “If there are people who can give medication, I can also help to do the job, and help the community.”


Today, he is a nurse in his twenty-third year working with MSF. He has gone on MSF assignments in other African countries and recently returned to the Leer hospital, where he is now in charge of the tuberculosis ward. And he recently traveled to Washington, DC, to speak on the organization’s behalf when MSF was awarded the highly-esteemed 2012 J. William Fulbright Award for International Understanding.

Fighting Neglect: Kala azar

Kala Azar is a neglected tropical disease responsible for 50,000 deaths every year.Kala azar is a disease that, if left untreated, is 100 percent fatal. To break the vicious cycle that leaves tropical diseases like Kala azar neglected, existing programs that diagnose and treat patients need to be expanded and medical research to develop simpler, more effective tools needs to be supported.

Learn more about Kala Azar and other neglected diseases.

I immediately transferred him from the Feeding Program to the ICU and started our most aggressive Kala Azar treatment. He was so sick. It was questionable if it was possible to bring him back from the brink. But slowly, and with a few terrifying setbacks, he sat up, he ate, he smiled and then he walked.
Canadian Physician Lorna Adams writes about the many challenges she faced working in MSF clinics in South Sudan.
In Somalia, Maryan walked ten miles with her malnourished child on her back to get lifesaving emergency care. Two-year-old Deng was brought to a Doctors Without Borders/Médecins Sans Frontières (MSF) hospital in South Sudan where he was treated for kala azar – a deadly tropical disease. Sanna was pregnant when the floods in Pakistan hit and left her without clean water or food. 

Together, Doctors Without Borders and our donors provided these women and children and many thousands of people like them with the emergency medical care they needed to survive. But as we head into 2012, your support is critical as we prepare to respond to the medical needs of people facing natural disasters, deadly diseases and conflict. 

Will you help us save more lives in the year to come?

In Somalia, Maryan walked ten miles with her malnourished child on her back to get lifesaving emergency care. Two-year-old Deng was brought to a Doctors Without Borders/Médecins Sans Frontières (MSF) hospital in South Sudan where he was treated for kala azar – a deadly tropical disease. Sanna was pregnant when the floods in Pakistan hit and left her without clean water or food.

Together, Doctors Without Borders and our donors provided these women and children and many thousands of people like them with the emergency medical care they needed to survive. But as we head into 2012, your support is critical as we prepare to respond to the medical needs of people facing natural disasters, deadly diseases and conflict.

Will you help us save more lives in the year to come?

Bihar State is one of the poorest and least developed areas of India. Agriculture is the main economic engine, but most people don’t own land and must work long hours for little money. Bihar State is an epicenter for kala azar - a parasitic disease that is nearly always fatal when left untreated.

Complicated kala azar cases are treated at the hospital, including patients suffering from severe anemia, HIV, and severe acute malnutrition, as well as pregnant women, infants, and the elderly. 

Simple cases are treated on an outpatient basis. Patients receive four intravenous doses of the drug liposomal amphotericin B (LAmB). But there are many research projects searching for a better treatment.

Photo: India 2011 © Anna Surinyach/MSF

Bihar State is one of the poorest and least developed areas of India. Agriculture is the main economic engine, but most people don’t own land and must work long hours for little money. Bihar State is an epicenter for kala azar - a parasitic disease that is nearly always fatal when left untreated.

Complicated kala azar cases are treated at the hospital, including patients suffering from severe anemia, HIV, and severe acute malnutrition, as well as pregnant women, infants, and the elderly.

Simple cases are treated on an outpatient basis. Patients receive four intravenous doses of the drug liposomal amphotericin B (LAmB). But there are many research projects searching for a better treatment.

Photo: India 2011 © Anna Surinyach/MSF

When kala azar patients also have HIV, the two diseases form a vicious circle that is difficult to break. HIV-positive patients have fewer defenses to fight the kala azar parasite, so treatment failure is more common. At the same time, kala azar further weakens the defenses of HIV patients, increasing their risk of contracting opportunistic infections.

Photo: India 2011 © Anna Surinyach/MSF

When kala azar patients also have HIV, the two diseases form a vicious circle that is difficult to break. HIV-positive patients have fewer defenses to fight the kala azar parasite, so treatment failure is more common. At the same time, kala azar further weakens the defenses of HIV patients, increasing their risk of contracting opportunistic infections.

Photo: India 2011 © Anna Surinyach/MSF

Bihar State, in northeastern India, is a major epicenter of the parasitic disease visceral leishmaniasis—also known as kala azar. Doctors Without Borders/Médecins Sans Frontières (MSF) works in Bihar’s Vaishali district to treat this complicated and deadly disease. 

Kala azar is a tropical disease that comes from the parasite Leishmania, which is transmitted by the bite of a sand fly. The disease usually affects people who have poor living conditions. Once infected, a fever develops, the liver and spleen grow bigger, the patient loses weight, and their immune system is weakened. Without treatment, this disease leads to death in almost 100 percent of cases.

Last week, a four year test of drugs to treat the disease was announced in an effort to find more effective treatment. Currently, the first-line treatment used in India is injectable pentavalent antimonials, but the parasite has now developed resistance to these drugs so that they are no longer effective for almost 65 percent of patients in the area. There are also other disadvantages of antimonials, such as the length of the treatment – it takes 30 days of painful injections - and its potential toxicity.

Photo: Anna Surinyach/MSF

Bihar State, in northeastern India, is a major epicenter of the parasitic disease visceral leishmaniasis—also known as kala azar. Doctors Without Borders/Médecins Sans Frontières (MSF) works in Bihar’s Vaishali district to treat this complicated and deadly disease.

Kala azar is a tropical disease that comes from the parasite Leishmania, which is transmitted by the bite of a sand fly. The disease usually affects people who have poor living conditions. Once infected, a fever develops, the liver and spleen grow bigger, the patient loses weight, and their immune system is weakened. Without treatment, this disease leads to death in almost 100 percent of cases.

Last week, a four year test of drugs to treat the disease was announced in an effort to find more effective treatment. Currently, the first-line treatment used in India is injectable pentavalent antimonials, but the parasite has now developed resistance to these drugs so that they are no longer effective for almost 65 percent of patients in the area. There are also other disadvantages of antimonials, such as the length of the treatment – it takes 30 days of painful injections - and its potential toxicity.

Photo: Anna Surinyach/MSF

Kala Azar is a neglected tropical disease responsible for 51,000 deaths every year. MSF Health Advisor Koert Ritmeijer explains that while treatment for the disease is lengthy, once cured, individuals cannot contract the disease again. Left untreated, the disease is 100 percent fatal.

Kala azar—or visceral leishmaniasis—is a treatable but largely neglected disease. Southern Sudan is currently facing a massive kala azar epidemic. This is a region where three-quarters of the population has no access to basic medical care, and the health system is unable to deal with an emergency on this scale.

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(Source: doctorswithoutborders.org)

While southern Sudan prepares for the upcoming referendum, a medical emergency is affecting the country. This year, the region is suffering the worst Kala Azar epidemic in 8 years.

We are all very concerned about the returnees who are coming back to their villages in southern Sudan to vote in the referendum in January … they’re returning to kala azar-affected areas and have lost their acquired immunity to the disease.
Jane Boggini, MSF’s medical team leader in Southern Sudan in the article Kala Azar in Southern Sudan: “We Are Concerned About The Returnees”
Jane Boggini is a nurse from the U.S. who has completed more than 20 missions with Doctors Without Borders/Médecins Sans Frontières (MSF) since 1999. Boggini is currently working as the medical team leader of the MSF emergency response team responding to an outbreak of the neglected disease kala azar in Malakal, Upper Nile State, in Southern Sudan. In this article she writes about the work MSF is doing in Southern Sudan: Kala Azar in Southern Sudan: “We Are Concerned About The Returnees”

Photo: Sudan 2010 © MSF

Jane Boggini is a nurse from the U.S. who has completed more than 20 missions with Doctors Without Borders/Médecins Sans Frontières (MSF) since 1999. Boggini is currently working as the medical team leader of the MSF emergency response team responding to an outbreak of the neglected disease kala azar in Malakal, Upper Nile State, in Southern Sudan. In this article she writes about the work MSF is doing in Southern Sudan: Kala Azar in Southern Sudan: “We Are Concerned About The Returnees”

Photo: Sudan 2010 © MSF