406 Where There Is No Doctor 2011
LEISHMANIASIS
This disease is found in Africa, India, and the Middle East, and in southern Mexico,
Central America and South America. The infection is carried from person to person by
a small sand fly which infects a person when it bites.
Some forms of the disease cause damage inside the body (visceral leishmaniasis,
kala–azar, dumdum fever). These are very difficult to recognize and the treatment is
very complicated and expensive. If possible, seek medical help.
Other forms affect mainly the skin (cutaneous leishmaniasis, tropical sore, Delhi boil,
espundia, forest yaws, uta, chiclero ulcer). These are easier to treat.
Signs of leishmaniasis of the skin:
• 2 to 8 weeks after being bitten, swelling appears where the fly bit.
• The swelling becomes an open sore, usually with pus.
• Sores can heal by themselves, but may take several weeks to 2 years.
• Sores become infected (with bacteria) very easily.
Treatment:
♦ Clean the sore with cool, boiled water.
♦ Apply a hot, moist cloth to the sore (not so hot that it burns the skin) for 10 to
15 minutes.
♦ Do this 2 times a day for 10 days. This ‘heat treatment’ often brings a complete
cure.
♦ If the sore looks infected (red and painful), also give antibiotics (see p. 351).
GUINEA WORM
Guinea worm is a long, thin worm that lives under the skin and makes a painful sore
on the ankle, leg, or elsewhere on the body. The worm, which looks like a white thread,
can be over a meter long. Guinea worm is found in parts of Africa, India, and the
Middle East.
Guinea worm is spread from person to person, like this:
1. Infected person with
open sore wades into a
water hole. The worm
pokes its head out
of the sore and lays
thousands of eggs
into the water.
2. Tiny
water-fleas
pick up the
worm eggs.
3. Another person drinks
some of the water. The
fleas, with the worm
eggs, are swallowed.
4. Some of the eggs develop slowly
into worms under the skin, but
at first the person feels nothing.
About one year later, a sore forms
when an adult worm breaks
through the skin to lay
its eggs.