Lal Bahadur Shah, a resident of Bakrid block in Vaishali district of Bihar, is barely able to feed his family of five daughters and a wife. He works as a daily wage labourer and earns around Rs. 2,000 to Rs 3,000 a month.

But when he found that his youngest daughter had kala azar – a deadly parasitic disease spread by the bite of a sand fly, which can kill if left untreated – he did all he could to get her treated, even if it meant foregoing his daily earnings.

“What to do, for some reason we got by. My children survived on handouts from the villagers”, says Lal Bahadur.

Lal Bahadur was lucky that he was immediately referred to Sadar hospital in Hajipur, where Medecins Sans Frontieres (MSF), an international medical humanitarian organisation, treats kala azar for free.

For many like Surinder Shah, also a daily wage labourer from Vaishali district, it took him many visits to private clinics before he got to know that his 12 year old daughter Julia was suffering from kala azar.

“When she got sick, I got her checked at a private clinic. It cost a lot of money. They told us she had malaria. She got all right after that”, says Surinder. “But the fever came back again. Then we took her to Mohua primary health centre (PHC). A madam from there referred us to Sadar hospital”.

“At Sadar, my daughter was given blood and a yellow medicine. The treatment went well. We also got food while we were there” adds Lal Bahadur. “Nurses were so good that half her sickness was treated by their love”.

MSF has been treating kala azar in Hajipur and surrounding areas since July 2007, as Bihar has the maximum number of kala azar cases in India.

Since then, MSF has successfully treated almost 8,000 patients.

“We give a lot of importance to health education geared towards prevention. These sessions focus on all aspects of disease prevention, treatment and follow-up, including hygiene education, use of mosquito nets and advice on early diagnosis and completion of treatment” says Bjorn Nissen, MSFs Head of Mission in India.

He adds, “We also support the call for a kala azar day. Not only will it lead to greater awareness about kala azar in India, a neglected disease, but we hope, it will also serve as a constant reminder that much more needs to be done before kala azar can be eliminated”.

These days, Lal Bahahdur Shah is spreading awareness about kala azar. “Kala azar is caused by the bite of a sand fly, which breeds in dirt. It is important to keep the house and its surroundings clean”, he is heard speaking to his fellow villagers.

Since 2007, MSF is treating kala azar patients in Vaishali district, Bihar. MSF operates a 50-bed ward in Hajipur Sadar hospital, a 10-bed ward in Rajendra Medical Research Institute besides offering diagnostic and treatment facilities at four Primary Health Centres in Vaishali, Goraul, Mahua and Raghopur blocks.

MSF successfully treated more than 1,400 patients between July 2010 and March 2011 with a success rate of 98%. MSF treats patients with Liposomal Amphotericin B, a relatively new and highly effective therapy for treating kala azar.

MSF’s work also includes raising awareness among communities through health education activities and patient counselling besides advocating to further improve treatment options and facilities for the affected population.

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