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Bihar Under the Grip of Kala Azar

Thousands are dying in Bihar due to kala azar, a deadly parasitic disease transmitted by the tiny sand fly. And a former minister says he knows how to battle the scourge.

According to C.P. Thakur, a former central minister and chairman of the Kala Azar Task Force in Bihar, over 100,000 people, mostly the poor, are suffering from this disease and thousands have already died this year.

"They are dying in thousands and silently. It is unlike when dozens died due to dengue in Delhi, creating a flutter," Thakur told IANS here.

The sand fly that transmits the disease multiplies in the cow dung villagers use liberally to plaster their shanties or as cow dung cakes for fuel.

The flies survive on the sap in banana and bamboo groves and the decomposed cow dung heaps. They make their home in the straw thatches of houses.

The disease is characterised by fever, weight loss, swelling of the spleen and liver and leads to cardiovascular complications resulting in death.

"A large number of patients in flood-prone north Bihar districts hardly report to health centres and die a silent death," said Thakur, an internationally reputed expert of kala azar.

He said the official figure of 30,000 kala azar cases is far from reality.

"Those are only the reported cases of kala azar. What about those cases that go unreported in rural areas? There was no figure available about them," Thakur said.

Early this year, Chief Minister Nitish Kumar set up the task force on kala azar headed by Thakur to suggest measures to eradicate the disease by 2010.

Thakur said that continued spraying of insecticides for at least five years in a phased manner and supervised administration of Amphotericin B could eliminate the disease.

"There is an urgent need for at least 100,000 vials of Amphotericin-B to control the rising incidence of kala azar. For a complete elimination of the disease, over 500,000 vials are required," Thakur said.

Currently, 31 of 38 districts in Bihar are in the grip of the disease.

"Dengue deaths in Delhi has become a national issue, but deaths due to kala azar that has been regularly reported in rural Bihar hardly makes any news," he lamented.

Experts say poor living standards and unhygienic conditions make members of the Mushahar community of Dalits an easy prey to the disease.

The kala azar, medically known as Visceral Leishmaniasis, is also known as the poor man's disease because it affects the poorest of the poor.

According to sources in the state government, the World Bank, WHO and the Bill Gates Foundation have shown keen interest to fund the kala azar eradication programme.

Many of the worst kala azar hit areas of Bihar are the northern districts of Vaishali, Muzaffarpur, Sitamarhi, Sheohar and East and West Champaran.

Bihar last faced a kala azar epidemic in 1991 when 250,000 cases were reported. In 2000, the numbers were low but started rising from 2003.

The disease occurs in 62 countries, primarily in the developing world. Around 90 percent of world cases are found in India, Bangladesh, Nepal, Sudan and northeast Brazil.

Experts say over 60 percent of the cases in India are found in Bihar alone.


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