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South Sudan: Worst Kala Azar Outbreak in 8 Years

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Joe DeCapua

A medical aid group says as south Sudan nears a referendum on independence, it faces many serious health problems.

Doctors Without Borders, also known as MSF, says south Sudan is currently experiencing the largest outbreak of kala azar in eight years.  The parasitic disease is transmitted by the bite of sand flies and attacks internal organs, such as the liver and spleen.  The disease is often fatal if untreated.

Nurse Jane Boggini, who works in Malakal in Upper Nile state, says, “This year…we’re seeing an extremely high number of cases.  We have within our Doctors Without Borders treatment sites…treated over 2,300 patients.”

That compares to a few hundred cases at this time last year.   Boggini says there could be several reasons for the increase, including high rates of malnutrition.

“Our nutritional programs have seen a 50 percent increase in the number of children.  So we have children who are in a weaker state than before.  We also have people who are returning from the north.  They’re coming back … and these are people who have not been exposed to kala azar in the past.  So, possibly that’s another reason,” she says.

Treatment

Children and the elderly are most vulnerable to the disease.  Doctors Without Borders uses several different treatment methods.  One is a drug that must be administered daily for 30 days.

“In other words, patients have to stay close to the treatment center,” she says, adding, “It’s quite painful.  So they have to come and leave their villages.  They have to stay near the health center and that means disruptions for the family. They have to leave their children behind.”

When treatment is given in a hospital for more serious cases, two medications are administered, one by IV or intravenously.  However, she says, “The medication has to be refrigerated.  Now this means we can’t use it in these outlying areas because there is no electricity.”

There is also a two drug combination that the medical aid group uses for kala azar, which can shorten treatment to 17 days.

Besides the parasite disease, MSF says there are a high number of malaria and diarrheal cases in south Sudan.  And at certain times of the year there is a rise in respiratory infections.

Logistics and supplies

Boggini says it can be difficult to access those in need in rural areas, just as it is difficult for sick people to reach clinics.  “That’s probably the biggest problem we have,” she says.

All the medicals supplies must be flown in.  She says, “It’s a large logistical problem working here.”

Doctors Without Borders has been working in Sudan since 1979, with 27 projects in 13 states.

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