BARINGO COUNTY, KENYA—Ten-year-old Lopeto Losile looked confused.
He sat on a wooden bench in the lobby of the Chemolingot Sub-County Hospital, located 165 miles northwest of Nairobi. His lanky frame was draped in a red and black shawl, and his short, brown hair was disheveled.
His mother, who sat beside him, kept crossing and uncrossing her legs.
Losile had recently tested positive for visceral leishmaniasis, the second-most deadly parasitic disease after malaria, which attacks the spleen, liver, and bone marrow.
Visceral leishmaniasis infects an estimated 300,000 people annually and causes 20,000 deaths every year, according to the World Health Organization. But many people have never heard of it because it’s a neglected tropical disease suffered primarily by the most impoverished and marginalized populations in the world.
For most of the developed world, leishmaniasis is a distant threat. And treatment in remote places like Baringo County is sparse, if accessible at all.
But Losile, in a few hours, would slip into a hospital gown and receive the first of seven daily injections of a drug called Ambisome to treat the disease and save his life.
He might not have received treatment had it not been for Richard Wamai, a global health professor at Northeastern who has been conducting research on leishmaniasis in rural Kenya for the past eight years.
Wamai has spent the past five years raising money to help build a new wing, guesthouse, and research center at the Chemolingot Sub-County Hospital for people suffering from leishmaniasis.
On July 26, the new research and treatment center opened, and Losile became the first patient. The ward includes 16 new beds, bringing the total number of beds to 29, and an upgraded, three-room laboratory comprised of state-of-the art equipment.
“The mission is to eliminate diseases and poverty in neglected communities through targeted investments in population health, ecological interventions, and education,” said Wamai, who is also an associate professor of cultures, societies, and global studies at Northeastern. “We are changing the narrative by training health workers, screening people, campaigning for behavior change, and lobbying for policy change.”
When Baringo County Gov. Stanley Kiptis cut a ribbon to officially open the new facility, Wamai was among a throng of researchers, medical professionals, and government officials who cheered.
Wamai described the opening of the new center as a “dream come true after years of hard work.”
“The facilities will make it easier for researchers and clinicians to work on eliminating the disease, and serve as a future center of excellence for visceral leishmaniasis programming in Kenya and other endemic areas in East Africa,” he said.
The new center will make it easier for people like Daniel Tuwit to receive treatment for leishmaniasis. Tuwit, a county representative for Ribkwo Ward, where the hospital is located, recalled how he had to make the 200-mile trek from Chemolingot to Nairobi to get the care he needed to cure his case of the disease when he was a boy.
“As a county government, we are going to ensure that we support this program,” Kiptis added. “We are going to upscale re-engagement to ensure that our people do not suffer.”
Dr. Kefa Bota, a pharmacist who works for the Ministry of Health in Kenya, said Losile would survive his case of visceral leishmaniasis. “He’ll be OK,” he said.
Leishmaniasis is transmitted to people by sand flies, which are found throughout the tropics. In Kenya, they’re a particular threat to children in rural areas who love to play around the termite towers that soar 10 feet or more above the arid ground. Sand flies often take over abandoned termite towers, which means the kids who play near them are constantly at risk of being bitten.
As part of his research trip to Chemolingot in July, Wamai oversaw a team of 27 clinicians and healthcare workers who provided education and disease screening to the Pokot tribe that populates this swath of northern Kenya.
They visited the villages of Seretion and Chesakam, where they provided treatment and administered drugs to treat maladies including fevers, coughs, and malaria, which kills more than 10,000 people in Kenya each year.
They also screened four dozen people for visceral leishmaniasis. One of them was Losile, whom they transported to the Chemolingot Sub-County Hospital after he tested positive for the disease.
Wamai worked with the School of Public Health at the University of Nairobi, the World Health Organization, the Kenyan Ministry of Health, and the community-based organization Kaperur to build the new research center, which was funded by the Izumi Foundation in Boston and the Probitas Foundation in Spain.
He said that he wanted the new facility to be built in a location that made it easier for the villagers to reach. Up until now, they have had to travel 50 miles to the Kimalel Health Center to seek treatment for the tropical disease.
Not only is this expensive, but tribal conflicts can make victims reluctant to accept treatment, said Joseph Wang’ombe, a professor of health economics at the University of Nairobi who helped Wamai raise the money to build the new facility.
“This is the right location for this center, as it is the people who are neglected and not the disease,” Wang’ombe said.
Over the past five years, Wamai’s team has provided health education to more than 8,000 villagers in East Pokot; screened more than 3,500 villagers for visceral leishmaniasis; and trained more than 50 health workers to treat people who have the disease. They have also sampled 6,000 sand flies, provided food to over 2,000 households, and distributed more than 1,900 test kits to rapidly diagnose leishmaniasis.
Wamai’s research has revealed that poverty and malnutrition contribute to leishmaniasis, but the devastation caused by the disease also prevents villagers from overcoming extreme hardship.
“The way to end this vicious cycle is to have an integrated and holistic approach to disease interventions that addresses the social determinants of diseases,” said Hellen Nyakundi, who manages Wamai’s research program in Kenya.
Wamai didn’t come to this work as an outsider. He grew up in a rural Kenyan village with no electricity, running water, or indoor toilets. He got his first pair of shoes when he was 13.
“I would say I’m from humble beginnings,” he said. “I was the seventh among eight children. My parents earned a living from coffee farming.”
Wamai came to Northeastern in 2009 to continue his research on AIDS prevention in Africa, and teamed up with Northeastern professor Michael Pollastri in 2010 to tackle leishmaniasis from an interdisciplinary perspective. The two co-founded the Integrated Initiative for Global Health at Northeastern to study especially neglected diseases.
In 2011 and 2012, Wamai and Pollastri received a total of $100,000 from Northeastern to conduct preliminary field research in Kenya needed to win major grants from the National Research Fund in Kenya, the National institutes of Health, and other private sources.
As Wamai conducts research on visceral leishmaniasis in Kenya, Pollastri attacks the problem in his Northeastern lab, where he is developing a new oral medicine to treat the parasitic killer. There is currently no vaccine and the available medicines can have significant side effects.
“Clinics such as the one in Baringo County are especially needed because medicines currently used are so toxic that patients require careful monitoring,” said Pollastri, who runs the Laboratory for Neglected Disease Drug Discovery at Northeastern and serves as the interim dean of the College of Science. “Our hope is that one day we will have much safer drugs that are as effective as these and better tolerated.”
Wamai invites Northeastern students to participate in his research trips to Kenya, where they work on independent projects, help run mobile clinics in the villages, and get a better understanding of the African nation that no textbook could provide.
Students who helped run mobile clinics and health education campaigns in Chemolingot in July said that their experiences have helped them find their career path.
“I’ve seen that due to poverty and illiteracy, our work is really needed here,” said Sukanya Mittal, who is studying behavioral neuroscience. “I have confirmed that this is somewhere I’d like to work.”
This story was originally published on News@Northeastern on August 12, 2019.