An MSF team arrives in Genareros, an indigenous community on the outskirts of Tame, the capital of Arauca region. Photo by Mads Nissen/MSF
Jair lives in the indigenous community of Genareros, Colombia. He is one of seven children - four of them, including Jair, were found to have Chagas disease. The youngest two completed their treatment in April 2010, just as Jair is about to start his. Photo by Mads Nissen/MSF
Everyday life in the indigenous community of La Esperanza (Hope). This is one of the 10 communities where MSF has screened for Chagas disease as part of the healthcare activities carried out through mobile clinics until May 2010. Photo by Mads Nissen/MSF
At the end 2009, MSF integrated Chagas screening and treatment into its primary healthcare services already carried out in Arauca, a conflict-affected region in Colombia bordering Venezuela. The indigenous communities live in adobe houses with thatched roofs, which offer an ideal environment for the spread of the pito insects, and hence Chagos disease.
A father and son in the indigenous community of Genareros - the first community to receive Chagos treatment. Eleven of 97 children sampled were found to have the disease. Photo by Mads Nissen/MSF
Chagas screening in the indigenous community of Genareros, Arauca region.
Photo by Mads Nissen/MSF
After a patient is confirmed to have Chagos disease through a blood serum test, they have a medical check before they start treatment. This is important because, if the patient has already developed serious cardiac complications, there is little to be done to treat the disease. Photo by Mads Nissen/MSF
After patients are confirmed to have Chagas disease, they are given a medical check up and start on a two-month long treatment. This is important to check whether the patients have already developed the disease. "If the person has developed a serious cardiac complication, for example, there is little we can do to treat the disease", said Dr. Rafale Herazo, medical responsible for MSF project in Arauca.
The MSF team carries out weekly medical follow up to check for side effects and any difficulties with complying with the treatment. This is the first time MSF has treated Chagas diseas in a conflict context. "It is a real challenge, because the treatment requires constant follow up during two months, and there is always the concern that we will be unable to reach a community due to security constraints or because an armed group declared a general stopping of the road movements in the region", said Patrick Swartenbroekx, MSF field coordinator in Tame.
Local authority workers spray houses in Roqueros. Killing the insects that cause Chagos is essential and MSF lobbies the health authorities in Arauca to conduct regular spraying of insecticide
Photo by Mads Nissen/MSF
Chagas disease is endemic in most Latin American countries. It is caused by the trypanosoma cruzi parasite and transmitted mainly by the "kissing bug" or "pito", a blood-sucking insect common in rural areas and city outskirts where people live in adobe houses made of clay and straw. Transmission is also possible from mother to child, through blood transfusions, organ transplants and contaminated food. Patients with Chagas disease may live for years without presenting any symptoms. If untreated, however, the disease can lead to serious health problems, mainly heart and intestinal complications, and even death.
In April 2010, MSF celebrated its first success: all 11 children diagnosed with Chagas in Genareros have completed their treatment. But much remains to be done in fighting this silent disease.