Neglected Tropical Diseases in Photos & Stories
Boda, 12 years old, at the water supply line. Tsiroanomandidy district, Madagascar, December 2017. Water, sanitation and hygiene (WASH) is critical in the prevention and care for all neglected tropical diseases (NTDs). Large inequalities in access to WASH continue to persist: at least 2 billion people rely on water supplies that are unsafe, and an estimated 3 billion people have no access to basic handwashing facilities at home (WHO 2021).
Haimanot is a mother of three children. She does daily labour for a living. Here she is washing her 5 year old son's face at a new utility tap that was installed for her and her neighbours Face washing is one of 4 activities in the SAFE strategy to prevent and treat trachoma, along with surgery for advanced disease, antibiotic ent, and environmental management Photo by Finote Selam, taken in Amhara, Ethiopia, August 2018
Mary Khobiri, 34, nurse and midwife, washing her hands at Mangamba Health Centre, Machinga, Malawi, April, 2019. Clean water and sanitation in health care facilities prevents the risk of secondary infection for patients. I.8 billion people use health care facilities that lack basic water services; 800 million use facilities with no toilets; and one third of health care facilities globally do not have soap and water for handwashing to support patient care (WHO, 2021)
The photograph below shows leprosy field research being carried out in Bangladesh in 2018. Lab technicians Marfa and Santos are examining an M. Leprae bacteria smear through a microscope. Despite a country-wide COVID-19 lockdown in Bangladesh starting in late March 2020, screening for leprosy was able to continue, as did emergency service for people with leprosy to support multi-drug therapy and management of the disease, including wound and ulcer treatment.
Brijnandan has lymphatic filariasis (LF), also known as elephantiasis. LF is spread by a microfilaria parasite carried by the aedes aegypti mosquito.
Due to delays in getting the correct treatment, his condition advanced, and he eventually needed injections to heal severely infected ulcers The swelling in his leg is now permanent.
Brijnandan lives in an area where LF infections are a regular occurrence and information is widely available about LF as a non-communicable disease. However at the time of this photo, his wife and children were afraid to be near him. Brijnandan doesn't see his grandchildren, and he lives in a small shack built off the side of a brick home where the rest of the family sleeps.
India, 2015
Sisters Mbulu, 17 & Mputu, 14, live in the Democratic Republic of the Congo. Both children received treatment for leprosy. Photos by Tom Bradley, 2014
At 14 years old, Mputu noticed patches all over her body.
“My legs were very weak – I couldn’t stand up.”
“When I see other young girls, their hands are good, they play games. But I can’t. My friends have asked about it...they say things behind my back, which hurts.”
Mbulu, 17 years old at the time of this photo, was in grade 5 when she noticed patches on her skin. “There was a patch on my neck. Much later, I remember we went to Kananga (about 2 days away) for drugs, but they didn’t have any, so we came back [home].” She was eventually diagnosed with leprosy and received the multi-drug therapy (MDT) required to treat the infection.
The photo on the left is of Mbulu & Mputu with their parents. At the time of this photo, the family lived in close proximity to The Leprosy Mission where they were able to access prompt drug therapy and ongoing care.
"I was very affected when my daughters were sick ” Their father says “We were very relieved when the disease was finally identified and could be treated ”
This is a photo of Mputu’s class Her parents hoped she would become a nurse Her sister Mbulu studied to become an electrician, while also helping her mother sell produce at the local market.
18-year-old Awal is one of 10 siblings Awal was 6 when he first noticed swelling and blistering on his arm. It worsened over the course of a year of traditional treatment He was eventually hospitalized for a year to treat buruli ulcer, where he received antibiotics and wound care, followed by skin grafting at the Baptist Medical Centre Awal continued to need further surgery and physiotherapy. Ghana, 2016. Photo by Tom Bradley.
At 6 years old, Ishmael developed a buruli ulcer that began as swelling in his knee. While the infection was not initially identified as buruli ulcer, Ishmael was eventually admitted to the local hospital for antibiotic treatment and wound care. He was hospitalized for 18 months, enduring multiple surgeries and blood transfusions Ishmael continued to have follow-up surgeries, physiotherapy and wound care. Ishmael had difficulty accessing his school, and took care of his younger brother while the rest of his family worked on the farm. Ghana, 2016. Photo by Tom Bradley.
Buruli ulcer, caused by Mycobacterium ulcerans, is a chronic debilitating disease that mainly affects the skin and sometimes other soft-tissue and bone. The organism belongs to the family of bacteria that causes tuberculosis and leprosy, which provides an opportunity for collaboration with these disease programmes. However, M. ulcerans is an environmental bacterium and produces a unique toxin – mycolactone. The mode of transmission to humans remains unknown. Currently, early diagnosis and treatment are crucial to minimizing morbidity and preventing long-term disability.
Elina from Munkala village in Zambia, was diagnosed with trachoma, the leading infectious cause of blindness globally. Although she lives more than 120 km away from the nearest hospital, she was able to access treatment with surgery to treat trichiasis (the painful late stage of the disease) and antibiotics to eliminate the bacterial infection with the help of Operation Eyesight. In addition to these measures, Operation Eyesight also promotes hygiene education and environmental change, including restoring and building new wells and latrines for communities affected by trachoma, to tackle the root causes of this disease.
An adolescent girl receiving a weekly iron and folic acid (IFA) tablet at school in Elkala village, Gujarat, India, as part of the program supported by Nutrition International. March 2020.
In addition to Weekly IFA Supplementation, during the biannual state deworming rounds, Nutrition International teams support district level planning meetings and conduct field monitoring of the rounds, along with other development partners. Gujarat, India, March 2020.
Emebet, a Health Extension Worker, distributes antibiotics which help treat and prevent trachoma, the world s leading infectious cause of blindness. For more than two decades, Orbis and its partners have been tackling trachoma in rural communities across Ethiopia, reaching millions of families each year through mass drug administration (MDA) programs. Southern Nations, Nationalities and Peoples Region, Ethiopia, December 2020.
With the help of tens of thousands of local community health workers and volunteers, like Bekelech (right) and Belaynesh (left), Orbis has administered over 94 2 million doses of antibiotics to treat and prevent trachoma and performed more than 190,400 trichiasis surgeries to relive suffering and restore sight. Southern Nations, Nationalities and Peoples Region, Ethiopia, December 2020.
With the support of their local partners, Orbis has effectively eliminated trachoma in 38 districts throughout Ethiopia. Despite facing significant challenges during the pandemic, Orbis was the only NGO to fully deliver their planned MDA programs in 2020, giving people like Degnew and his young daughter, Tsion, the chance to live a life free from blindness Southern Nations, Nationalities and Peoples Region, Ethiopia, December 2020
Climate change in Madagascar is expected to affect the transmission of schistosomiasis as water access patterns change with increased droughts and floods Contact with untreated water containing freshwater snails hosting Schistosoma haematobium puts people at risk of infection. Women and girls are at risk of developing a chronic form of the disease called female genital schistosomiasis (FGS). The FAST Package, funded by Grand Challenges Canada is hosted by a research team at the Bruyère Research Institute and the University of Ottawa. This team works closely with le Ministère de la Santé in Madagascar and its partners to prevent schistosomiasis and improve access to treatment for women and girls Photo by Alison Krentel, May 2022
A river flowing through Weija District in Ghana has snails that carry the schistosomiasis parasites, putting people using the water source at risk of infection Working with the University of Health and Allied Sciences in Ghana and the Ghana Health Service, the FAST Package team strives to understand water usage, lived experiences with female genital schistosomiasis and health seeking behaviour. August
Health care workers participate in training on how to identify Female Genital Schistosomiasis in patients.
This training was provided through the FAST Package, a Grand Challenges Canada-funded project All trainees will go on to train health care workers in the skills that they have learned throughout Ghana. Weija, Ghana, February 22, 2022
Monica Nkrumah, Principal of a Nursing and Midwifery Training College in Berekum, Ghana, recently received training as a subject matter expert about how to identify Female Genital Schistosomiasis in patients In this photo, she shares her learnings with nursing students so that they can identify and treat FGS in their clinical practice An estimated 56 million women and adolescent girls are affected by FGS in Sub Saharan Africa Accra, Ghana, March 18, 2022.
Before completing her research in Misungwi, Claudia tested positive for schistosomiasis haematobium, having had exposure to water contaminated with snails -a vector for which schistosoma complete their life-cycle.
A health worker uses rapid diagnostic tests (RDTs) for malaria and schistosomiasis This child (out of frame) tests positive for schistosomiasis and malaria co-infection
Training on how to use ODK (Open Data Kit) on tablets, an open-source mobile data collection platform.
In the field collecting household-level data on risk factors for exposure to malaria and schistosomiasis among children Photo curtesy of PhD candidate Claudia Duguay pictured on the far right, Misungwi, Tanzania, January 2022.
A child is examined at an MSF Facility in Benazir Bhutto Hospital, Quetta, Pakistan, by Dr. Shakeel Ashraf, a dermatologist. Dr Ashraf conducts the initial diagnosis of patient’s skin conditions, including leishmaniasis The cutaneous form is a skinNTD that causes legions and ulcers on soft-tissue that can be disfiguring. Photo taken by Khaula Jamil, October 17, 2018.
MSF staff clean the lesion of a patient admitted to the MSF cutaneous leishmaniasis treatment centre at Nasserullah Khan Babar Memorial Hospital in Peshawar, Pakistan.
Zakia Bibi, 45, who has had a recent pregnancy, waits for treatment at the MSF cutaneous leishmaniasis treatment centre at Nasserullah Khan Babar Memorial Hospital in Peshawar, Pakistan She has a large lesion and disfigurement on her foot due to delayed treatment of cutaneous leishmaniasis, because the first-line treatment in Pakistan is meglumine antmoniate, a drug that is not always safe for pregnant women.
Photos taken by Nasir Ghafoor, November 1, 2020.
Aguek Deng, 14, and her mother are from Mabunny, near Agok market.
Aguek was bitten on the arm by a snake while she was sleeping on the floor under a mosquito net. She cried out, but her mother didn’t know why. She has a disability and is non-verbal. When they came to the Agok Hospital the swelling had spread to her shoulder. She was given an antivenom and also had surgery to help treat her snake-bite injury. PostOp ward, Agok Hospital, South Sudan, November 1, 2018.
Venomous snake bites can be difficult to treat and they can be deadly, especially when the correct antivenom isn’t available. They can cause paralysis, tissue and organ damage, and permanent disability. Children are affected the most due to their small body mass. An MSF staff holds the snakebite register. In this register, MSF staff record details about snakebite patients, their antivenom treatment and their 28day follow-up visit to check for any side-effects from the antivenom.
Agok Hospital, South Sudan, November 1, 2018.
(Left) Rolayo, a lab technician from the Nigerian Institute for Trypanosomiasis and Onchocerciasis Research takes a selfie after setting up a blue biconical tsetse fly trap, the vector of Human African Trypanosomiasis (HAT, or sleeping sickness) on a surveillance trip on 17th March, 2021 in Oyo State, Nigeria The surveillance team navigates poorly maintained roads to reach people living in rural, remote areas where there is a higher burden of sleeping sickness (bottom right, left).
In Nigeria, HAT is transmitted to people through the bit of a tsetse fly carrying Trypanosoma brucei gambiense. The trypanosomes first multiply in the subcutaneous tissue, blood and lymphatic system, before crossing the blood-brain barrier to infect the central nervous system. Without treatment, sleeping sickness is usually fatal.
(Left) Rolayo, a lab technician from the
