Why do I care about Chagas?

When I traveled to rural Honduras in the summer of 2008, I had never heard of Chagas disease. By the end of my trip, I was terrified of Chagas, even though I slept underneath a mosquito net in a concrete building. The gruesome mode of transmission was enough to scare me, as horror story might, but it was the silent progression of the disease that most frightened me. I was volunteering with a clinic, and most of the homes we visited were adobe or wood homes that the kissing bug loves to infest. Surely a huge segment of the population had been infected, and wouldn’t know it for years to come, until suddenly organ failure ripped them from their families.

The community we were in was very isolated from most medical care and much medical knowledge. The town our little ill-equipped clinic was in was located literally at the end of the road (which was unpaved). To get to the nearest hospital, a three-hour drive over bumpy, unpaved roads was required. The nearest big city was six or seven hours away. Villagers hiked sometimes for hours from their unmapped, tucked-away homes just to come to our clinic. I don’t know if our clinic checked people regularly for Chagas (I believe it did not), but even if it did, treatment would be nearly impossible, since the clinic was not equipped for it, and the villagers were too poor to pay much for it. Add on top of these difficulties a cultural distrust of medicine, and the toxic effects and limited efficacy of available drugs, and the challenge Chagas poses worsens.

We saw multiple children there with one red, puffy eye. We figured they had pink-eye or something innocuous until we found out that this is Romana’s sign, which sometimes pops up in children who have been infected via the eye by the Chagas parasite. Their parents, oblivious to the meaning of such a seemingly harmless symptom, and busy tending to a whole family brood, were not even alarmed enough to ask us about it. While they lived in ignorance, and we stood essentially unable to help, the disease worked silently to deteriorate these kids’ organs.

Chagas poses a huge public health challenge for some of the poorest countries in Latin America. Largely overlooked by the international community (although its spread into the U.S. blood supply may increase interest), the disease kills thousands every year while drug companies try only half-heartedly to help. While non-profits have played a large role in spurring research into treatment, and improving patient care and teaching, they do not have the resources necessary to effect large-scale improvements in public health. Considerable money needs to be invested in methods of prevention (for example, knocking down adobe houses and building concrete ones instead, or genetically modifying the disease vectors), awareness (public health outreach efforts to teach communities about how to identify and fight infestations), and treatment (developing better drugs or vaccines, or improving stem cell therapy). Yet, while Chagas continues to affect only the poorest citizens of the poorer countries, this money appears unobtainable, and the disease's horror will persist.

- Joanna Sharpless