5341 Elephantiasis in Haiti: hope for 400,000 sufferers (fwd)

[Bob Corbett <corbetre@webster.edu>]

From: Greg Chamberlain <GregChamberlain@compuserve.com>

   By SUSANNAH A. NESMITH

   SANTO DOMINGO, Oct 24 (AP) -- It begins with a mosquito bite, seemingly
no different from any other. But this one leaves a small worm behind. A few
years later, long after the worm has died, a part of the body begins to
swell -- and a life is changed forever.
   "Some days it hurts so bad I can't get out of bed to go to the
bathroom," says Aura De Soto, a petite 46-year-old who watched her right
leg balloon to three times its normal size. Like millions in the developing
world, she is a victim of the crippling, demoralizing and incurable disease
known as elephantiasis.
   Researchers believe the disease, which can add 100 pounds or more to a
person's weight, can be prevented if the parasite, the Filariais roundworm,
is identified and killed before it does permanent damage to the victim's
lymphatic system.
   There is a window of opportunity of several years -- though the ability
to treat in time has been limited by a cumbersome testing method that had
to be administered after a period of deep sleep during which larvae were
active in the patient's bloodstream.
   But a breakthrough new testing method can be performed anytime, and the
World Health Organization is using it in a campaign aimed at wiping out the
disease. The campaign aims to identify high-risk areas through testing,
then treat everyone in those areas with the medication that kills the
parasite.
   Experts say the effort -- launched a few months ago in India and parts
of Africa, and brought this month to the Dominican Republic and Haiti --
will cost $1 billion over five years.
   "It's been a forgotten disease for a long time because the assumption
was that we really couldn't do much about it," said Patrick Lammie of the
U.S. Centers for Disease Control and Prevention. "Only with new diagnostic
techniques and new therapies have we begun thinking about doing something
about it."
   Native to Africa, the parasite came to the Americas with the slave
trade. In the United States it died out a century ago, probably due to
sanitation and health care. The WHO estimates 700,000 people in the
Americas are affected today -- including 400,000 in Haiti and 100,000 in
the Dominican Republic, which share the island of Hispaniola, one of the
worst-hit areas. Guyana -- with an estimated 140,000 cases -- hopes to
begin treatment next year.
   "It doesn't kill, but it does," says Dr. Guillermo Gonzalvez, the
Dominican liaison to the program, struggling to capture the essence of a
condition whose psychological effect can be as bad as the discomfort and
deformity. "It kills socially. It kills economically. People are
ostracized, unable to work."
   The parasite is generally concentrated in impoverished neighborhoods
like De Soto's La Cienega, a squatter community in the flood plain of the
Ozama River in the middle of Santo Domingo. Open sewers run in front of
tin-roofed shacks. Many of the children have the bloated bellies and orange
hair that are signs of malnutrition. Few of the families have access to
safe drinking water or decent bathrooms.
   De Soto, a single mother, was a maid before she became sick six years
ago. Her meager salary sufficed to send her two older children to school.
But her youngest daughter, 11-year-old Sol Ines, now sits in their
dirt-floor shack all day because there's no money for school books and
uniforms.
   They certainly could not afford the anti-parasite drugs that are
arriving in the neighborhood this month -- if they weren't free.
   SmithKline Beecham, which is donating one of the two drugs needed, has
already delivered 475,000 tablets to Hispaniola, according to Brian
Bagnall, director of the company's program. The Bill and Melinda Gates
Foundation paid for Haiti to buy the other drug and the Dominican Health
Ministry is buying the second drug here.
   De Soto has trouble accepting that the doctors and their medicine won't
be able to cure her -- but she's happy her daughter will be safe.
   "I wouldn't wish this on anyone. Not my worst enemy. Not the devil
himself," she said.