This is the first report in a four-part series that explores the social determinants of living with and in proximity to lymphatic filariasis, a neglected tropical disease.
In Ganjam district, Odisha, a 65-year-old woman briskly hikes her saree up to her thighs and begins her daily routine under the watchful eyes of the area anganwadi and healthcare workers. Living with filaria for 40 years has made M. Satyanarayana Essu comfortable with an audience.
First, she gently lifts a circular, fluid-filled edema, or swelling, on her left leg and slowly begins to soap the lesion within it, then the rest of the leg. She then hoses down her leg with several mugs of water and repeats the careful application with medicated cream. In the background, a pipe drips water into an open gutter surrounding the house.
Lymphatic filariasis, better known as filaria or elephantiasis, is a neglected tropical disease by virtue of the fact that it most often affects individuals who face severe poverty, poor living conditions, and marginalization. Globally, almost 900 million people across 49 countries are at high risk of developing filaria, with 650 million Indians at risk of developing the disease. 90% of filaria cases in India come from only eight states — Uttar Pradesh, Bihar, Jharkhand, West Bengal, Chhattisgarh, Maharashtra, Madhya Pradesh, and Odisha.
Caused by mosquito bites that carry parasitic filarial worms, the disease is incurable — causing long-term pain, high risk of other infections, and socio-economic consequences for those who live with it. Living with filaria can cause chronic pain, a hindrance to movement via walking and running, and a greater risk of infections due to lesions on the leg. It can only be managed via patient care but is medically preventable via the administration of a two-drug regimen(Diethylcarbamazine Citrate and Albendazole) or a three-drug regimen ( Ivermectin, Diethylcarbamazine Citrate, and Albendazole). These medications are offered for free annually by the Indian government’s Mass Drug Administration program.
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Beyond medicine, a major hope for preventing filaria and other neglected tropical diseases is water — specifically eliminating open, dirty water bodies from living areas and ensuring greater access to clean water for afflicted individuals. Open water bodies like wells, puddles, and gutters are common in village areas — making them a breeding ground for mosquitoes that spread the disease. However, treatment and care for filaria are highly dependent on having frequent access to clean water, which is an uphill battle, as access to the same is severely limited due to poverty and resultant poor living conditions, and a lack of sustained initiatives that aid sanitation habit formation.
The problem is not a lack of…