Kala-azar: We don't know where it comes from but it kills a lot of people

Mursi tribe at Jinka hospital. Parents and caretakers with children outside of the ward. They cook foods they prefer on wood fires. [MSF]

Worse than expected

After receiving the alert, an MSF team travelled to the South Omo Valley. What the team found was shocking: an alarmingly high number of kala-azar cases amongst this relatively small population with no access to health care at all. The MSF assessment team also found a high number of people suffering from severe acute malnutrition caused by kala azar - both children and adults.

"We don't know where it comes from but it kills a lot of people," Bicolshe, a community member later told MSF. Another patient, an elderly man named Samakaoulu Kumuhuli Data, shared that he had lost two wives and five children because of the disease.

MSF teams began preparing an emergency response. Mobile clinics started visiting the community to actively find kala-azar cases and provide urgently needed primary health services. Many people were seeing a doctor or nurse for the first time, and most had never been vaccinated.

"This is [an] important thing because these people haven't had any medical service previously. This is the first time most of them - even as old as 60, 70 years - the first time for a clinic visit," shared MSF doctor, Tamirat Bantule. "We have also found several malaria cases... and a lot of cases with nutritional anaemia. We are going to refer them back to the hospital."

When a patient is identified with kala azar, they are referred to the Jinka hospital about fifty kilometres away. Within a few weeks, the capacity of the hospital to treat kala azar was overwhelmed and MSF teams, alongside staff from the Ministry of Health, set up tents to provide additional space, eventually running a dedicated kala azar ward within the hospital. Despite the complex and painful diagnosis and treatment of the disease almost all patients treated so far have recovered.

"I decided to take my son to the mobile clinic. The doctors referred us to the hospital here. He got treated. At first, I thought he would die but he made it," said Bicolshe, the mother of a young kala-azar patient who was treated at Jinka hospital.

Will it be enough? Malnutrition and other infections are also a concern

With a severe drought affecting large parts of Ethiopia for several years, kala azar is not the only life-threatening risk faced by the many indigenous groups struggling to survive in the South Omo Valley. "People still alive will die because of hunger," warned Samakaoulu Kumuhuli Data during a mobile clinic visit. "There is nothing to eat. Only the wild leaves to eat. This is what makes us worried."

As well as kala-azar and chronic hunger, MSF is concerned about possible measles, cholera and outbreaks in a population that has missed out on routine vaccinations. MSF teams have extended active case finding and primary health care services provided through mobile clinics to various parts of the South Omo Valley while continuing to increase the capacity to diagnose and treat kala azar at the Jinka hospital.

This story was done in conjunction with Medecins Sans Frontieres (MSF).