At just 15, Ekidor Kiyong from northern Kenya’s Turkana region is battling kala-azar, a deadly disease spread by sandflies. While receiving treatment at Lodwar County Referral Hospital, his recovery brings hope, but the cost of KES 30,000 (USD 230) has left his family struggling.
Known scientifically as visceral leishmaniasis, kala-azar begins with malaria-like symptoms fever, fatigue, and headaches. If untreated, it is fatal in 95% of cases, warns the World Health Organization (WHO). In Turkana, where poverty, malnutrition, and inadequate healthcare prevail, the disease has become a symbol of intersecting crises: climate change, environmental degradation, and health inequity.
Turkana’s semi-arid terrain, marked by cracked soils and deforestation, has created ideal conditions for sandflies to breed. These tiny insects flourish in sandy, degraded land a growing issue as deforestation for firewood reshapes the region.
Experts like Kennedy Wasilwa, a clinical officer in Lodwar, highlight how rising temperatures and irregular rainfall have exacerbated the crisis. “Increased sandfly density during droughts elevates transmission risks, especially in communities with untreated cases,” he explains.
The WHO notes that Kenya sees about 1,600 annual cases of kala-azar, but the true number could be much higher. Turkana is particularly vulnerable due to limited awareness, delayed diagnoses, and an underdeveloped healthcare system.
In the remote sub-county of Loima, Charles Tukei lost his five-year-old son to kala-azar. Mistaking the disease for malaria, Tukei relied on over-the-counter medication until it was too late. His son’s death underscores the urgent need for education and timely intervention in these isolated communities.
“Most people here don’t know about kala-azar,” says Tukei. “It looks like malaria, but it’s much more dangerous.”
Kala-azar thrives in areas where environmental degradation forces people into closer contact with sandfly habitats. Cherinet Adera of the Drugs for Neglected Diseases Initiative (DNDi) notes that both deforestation and warming ecosystems are driving the disease’s spread.
“Climate change creates warmer habitats for sandflies, while deforestation disrupts ecosystems, pushing these vectors closer to humans,” Adera explains.
There’s hope on the horizon: the WHO plans to recommend a shorter two-week treatment regime, reducing hospital stays and improving accessibility. Meanwhile, DNDi researchers are using climate data to predict future outbreaks and design targeted interventions.
East Africa, home to 73% of global kala-azar cases in 2023, has committed to eliminating the disease. Countries like Kenya, Ethiopia, and Sudan aim to reduce fatalities to below 1% and cut prevalence by 90% within 12 years.
Experts stress the need for community-driven solutions. “We must involve affected populations in developing interventions,” says Adera. Awareness campaigns, sustainable environmental practices, and stronger healthcare infrastructure could transform Turkana’s fight against kala-azar into a blueprint for addressing neglected tropical diseases worldwide.
As Turkana battles this “forgotten disease,” it serves as a grim reminder of the cost of ignoring the links between health, climate, and environmental justice. But with concerted efforts and innovative strategies, the region could turn the tide against kala-azar, proving that even the harshest landscapes can nurture hope.