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By Henry Owino
West Pokot County, Kenya – Beyond the classic symptoms of fever, weight loss, and enlarged spleen and liver (hepatosplenomegaly), visceral leishmaniasis (kala-azar) quietly devastates women’s reproductive health. It brings fear, stigma, and delayed pregnancies—often overlooked effects that are reversible with early treatment. Talk Africa’s health and science journalist, Henry Owino, visited the endemic West Pokot region and filed this report.
In the sun-scorched villages of Kacheliba Sub-County, the disease moves quietly, settling into homes and bodies long before it is diagnosed. For many women, it announces itself not only through relentless fever and wasting but through missed menstrual cycles, delayed pregnancies, and the unspoken fear of infertility.
Months pass in silence as women struggle to understand their bodies. Families question them, and some, ignorant of the disease, blame the use of modern contraceptives—a practice their culture seldom advocates. Others cite the infiltration of Western lifestyles or unhealthy diets high in processed foods as the cause.
Despite public awareness campaigns and free treatment at Kacheliba Sub-County Hospital, many families suffer silently. Illiteracy, community detachment, and deep-rooted cultural beliefs continue to steer women away from biomedical care and toward traditional remedies.
This situation is devastating. Visceral leishmaniasis strips communities of health, trapping impoverished rural populations in a cycle of sickness, poverty, and death. It reduces productivity and peace of mind, turning a treatable disease into a slow-moving crisis.
The Pokot people hold traditional beliefs regarding maternal health, often considering pregnant women vulnerable and sometimes attributing illness to spiritual causes like witchcraft. Unscrupulous herbalists and magicians exploit this, swindling money from desperate clients with promises of cures or curse removal, often leaving victims in worse financial or physical states. Some women have died in their care.
A Narrow Escape from Death
Monica Lomoler, 28 and a mother of four, came frighteningly close to becoming a statistic. By the time she reached Kacheliba Sub-County Hospital, her abdomen was distended, her body consumed by weeks of high fever and rapid weight loss. Her dangerously enlarged spleen and liver were clear signs that visceral leishmaniasis was close to claiming her life. She survived because she arrived just in time, aided by DNDi Community Health Promoter Isaac Nyeris.
Diagnosed and treated for nearly a month, Lomoler was recuperating at home with fortnightly check-ups. Before falling ill, she had one child. After repeated bouts of sickness—unaware it was visceral leishmaniasis—she was unable to conceive a second child. As time passed, her husband considered taking another wife. The pressure distressed her deeply, leading her to spend large sums on herbal treatments.
“After many failed attempts, I lost hope and resigned myself to my husband marrying a co-wife,” Lomoler recalls.
Neighbors suggested she might have lupus and urged her to seek a hospital diagnosis, but she declined. “I became sick frequently and thought it was due to a second pregnancy that never came. I lost one pregnancy because of this disease without knowing. Even then, I believed it was witchcraft and only visited traditional healers,” she explains with regret.
Lomoler relied on herbs for nearly five months before her condition became critical. “I went three years without conceiving. My husband grew impatient and even suspected I was secretly using contraceptives,” she discloses.
Community Misconceptions
About 15 kilometers away, 27-year-old Katherine Nasipae from Alale Ward traveled to Kacheliba Sub-County Hospital seeking help for a maternal health issue. Through community mobilizer Nyeris, she learned that visceral leishmaniasis treatment was available there—information that changed her life.
Nasipae did not hesitate after learning about the disease’s impact on young women. “I became very thin and tired all the time,” she says. “My periods stopped, and people started talking. Some said I could not give birth. I didn’t know this disease could do that.”
Health workers say such stories are common. “When visceral leishmaniasis attacks, the body prioritizes survival,” explains Edwin Abner, a Clinical Officer and Laboratory Technician at Kacheliba hospital. “Severe anemia and malnutrition interfere with ovulation. Pregnancy becomes difficult not because a woman is infertile, but because her body is too weak. Once treated, many recover fully.”
In a culture where motherhood is tied to identity and respect, delayed pregnancy can expose women to blame and isolation. “Women suffer silently,” says Phillip Ng’etich, a Community Health Promoter in Sigor. “They are questioned by families, yet the real problem is a treatable disease. Awareness is still very low.”
Early Diagnosis and Treatment
According to David Kiptanui, a Clinical Officer at Kacheliba hospital, visceral leishmaniasis, like malaria, can cause temporary infertility through severe physiological stress, anemia, and chronic inflammation that disrupts the endocrine system.
“The systemic infection impacts the body’s ability to maintain a normal reproductive cycle,” Kiptanui explains. Intense inflammation suppresses the hormonal axis necessary for ovulation and menstruation. Severe anemia and malnutrition can lead to amenorrhea, as the body redirects energy from reproduction to survival.
“Since the parasites target the spleen, liver, and bone marrow, chronic infection can impair the endocrine system, including reproductive glands,” he adds. In pregnant women, the disease often leads to miscarriage or premature delivery.
A Disease of Poverty
Visceral leishmaniasis disproportionately affects women in arid regions with limited healthcare, poor housing, and malnutrition. Although treatment may be free, transport costs, lost income, and long hospital stays create catastrophic financial burdens, deepening poverty.
Young women of reproductive age are at higher risk of temporary infertility during the illness. “Time is especially precious, as a woman’s fertility window is biologically limited,” says Dr. John Odero Ong’ech, an Obstetrician and Gynecologist at Kenyatta National Hospital. “Illnesses like this can temporarily delay pregnancy. Early treatment protects health and future motherhood.”
Local Administration and Donor Partnership
Area Chief Joshua Loinet of Suam Location explains that for years, the community believed the disease was witchcraft, curable only by traditional healers. This belief denied many, especially women, biomedical treatment. Some women became permanently infertile or suffered miscarriages.
“It was not until DNDi established a research and treatment center here around 2011 that the situation began to change,” Chief Loinet admits. DNDi has worked with partners to build infrastructure, train health workers, and conduct clinical trials.
Isaac Nyeris, a DNDi-trained Community Health Promoter, notes significant progress. “Years ago, I found patients writhing in pain outside their homes. Now, more residents come to the hospital in time, following sensitization and free treatment.”
Local health workers report that with early diagnosis, most women regain their strength and fertility. Raising awareness remains critical to ensure women do not suffer silently from a preventable, treatable disease.
Lomoler’s survival is a testament to timely treatment and a stark reminder of how many women come dangerously close to death. Her story exposes the fragility and promise of life in endemic communities, where survival depends on early recognition, swift care, and empowering women with knowledge.
The Regional Burden
According to Linet Atieno, Head of Communications at DNDi Nairobi, visceral leishmaniasis is a neglected tropical disease (NTD) and one of the deadliest parasitic killers after malaria. Over 70% of the global burden is in East Africa, with the highest prevalence in Sudan, South Sudan, Ethiopia, Kenya, Somalia, and Uganda. If left untreated, it is fatal in over 95% of cases.
DNDi focuses on research and development for neglected diseases, including visceral leishmaniasis, sleeping sickness, and Chagas disease, which primarily affect remote, underserved communities.
Henry Owino is a Nairobi-based health and science journalist reporting on public health, gender, and neglected tropical diseases in East Africa.
