Deadly kala azar threatens thousands in exhausted southern Sudan

Sven TorfinnThis woman is being investigated for kala azar in an MSF clinic. Her weakness and loss of weight is typical of kala azar patients.

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BBC, Nov 8: Disease rages in war-torn Sudan

London/Nairobi - The international medical relief organization Médecins Sans Frontières (MSF) is fighting a severe outbreak of the deadly disease kala azar in southern Sudan. Exhausted by decades of war, the population is left extremely vulnerable to this disease. While peace talks go on, large parts of southern Sudan are still inaccessible to aid organizations, and diseases like kala azar continue to claim thousands of lives.

In Lankien, eastern Upper-Nile state, MSF has received over 100 admissions weekly over the last six weeks, and is currently treating 333 patients.

"It is an overwhelming scene, with so many of the people coming to the clinic every day more dead than alive", said Dr. José-Antonio Bastos, an MSF Operational Director who just returned from eastern Upper Nile. "The state of these patients is appalling. They are being carried on stretchers for days to make it to the clinic. They look pale and thin and are extremely anaemic."

A nearby MSF project in the town of Malakal is currently treating 210 patients, while an MSF project in Umm el Kher, Gadaref State, is assisting 414 cases. Reports from adjacent areas that MSF has not been able to reach so far indicate that the prevalence of the disease would be high there as well.

"There is a clear overlap of those areas where kala azar is endemic and areas of conflict," said Dr. Bastos. "Insecurity, malnutrition and poor access to health care lower the people’s natural resistance to diseases and make for an environment where outbreaks like the current one occur."

Since a couple of weeks, a second round of peace talks is taking place between the Sudanese government and the southern rebels of the Sudan People’s Liberation Army (SPLA). Until now they have yielded an accord to hold military offensives for as long as the parties are talking. "The cease-fire agreement may mean that we can soon get into areas that we have not been able to reach until now," Dr. Bastos commented.

Kala azar, or visceral leishmaniasis, is a parasitic disease that is transmitted by the miniscule sand fly. If left untreated, the illness is fatal. Although the disease is endemic in parts of Sudan, Ethiopia and Somalia and usually peaks in this season of the year, the current level of outbreak is exceptional, and shows a dramatic increase compared to the same seasons over the last years. One of the major problems for organizations like MSF is the high cost of existing drugs, and the need for more research and development efforts into new, more effective treatments.

MSF has worked in many places in northern and southern Sudan since 1978, assisting vulnerable populations with basic healthcare, emergency feeding programmes, and fighting outbreaks of infectious diseases.