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Field Reports

September 30, 2014

A Story from Bangladesh – Lymphatic Filariasis as a Social Issue

Reporter’s Profile
Midori Morioka
Former Japan Overseas Cooperation Volunteers (JICA)
DNDi Japan

For a period of two years I was involved in the National Programme to Eliminate Lymphatic Filariasis in Bangladesh as a Japan Overseas Cooperation Volunteer. I was placed in the Civil Surgeon Office in a district in the north-west, where many people live in poverty. I was involved in supporting the mass drug administration to interrupt the transmission of filariasis, passing on accurate knowledge of the disease and treatments as well as supporting activities for controlling the disease. I was also involved in awareness raising activities to increase the effectiveness of these initiatives.

One day, I met a man who was begging. He was walking around, showing his leg that had swollen up due to lymphatic filariasis, and collecting money from people. I introduced to him some simple self-care and hospitals where he could get treatment. He nodded as he listened to my explanation, and left. Afterward, someone from the crowd who was listening to my talk as well said some words to me that I’ll never forget. “It’s useless no matter what you say. He has no intention of seriously taking care of his leg.” Certainly the money that he got from begging was necessary for his current living situation. Indeed, it was true that he had not found another way to sustain himself outside of begging, and there was no one around to help him discover another way. For him, it was important to be able to eat tomorrow, and taking care of his leg was probably of secondary importance. Even so, he tried his best to listen to my broken Bengalese, and complained agonizingly about the pain in his leg. He said he would try to see a doctor at the hospital. Of course he had the desire within him to take care of his leg. A leg that served as means to obtain money and a wish to be healed. How could one reconcile these opposing feelings? I tried my best to understand, but I could not. But even during this time I was thinking, he was probably somewhere else, showing his leg around, begging. Right now, I’m thinking with a full stomach. However, during this time of thought, his stomach would be empty, and every day is a matter of life and death for him.
Whenever I asked patients if it’s all right to take photos of them to document the disease, unless there were religious reasons, everyone readily accepted. Despite their fears of potentially being discriminated against, they cooperated because they had a greater desire to bring attention to them, for people to know about lymphatic filariasis, and for something to be done about it. All of the patients that I met were surviving day to day with poverty and disease. That beggar is probably still out there begging. I truly felt that what these patients needed was not just treatment for disease, but also a comprehensive approach from their point of view, obtained by intimately experiencing their social lifestyles and lives.

“Filariasis in Bangladesh (Part 2)” Shizuokaken Yoboigakukyokai (SHIZUOKA HEALTH SERVICE ASSOCIATION), Kenko Shizuoka, Issue 99, 4, October 2009
“Filariasis in Bangladesh (Part 1)” Shizuokaken Yoboigakukyokai (SHIZUOKA HEALTH SERVICE ASSOCIATION), Kenko Shizuoka, Issue 98, 4, July 2009

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