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"What is it?"
Cutaneous Leishmaniasis (cue-TAY-knee-us LEASH-ma-NIGH-a-sis) is a parasitic disease spread by the bite of infected sand flies. The Leishmania is a single-celled parasitic protozoan that spends part of its life cycle in the gut of a sand fly and part in the blood and other tissues of a vertebrate.
Leishmania's period of incubation is not certain; sores can appear in the first week or not for months after the initial bite of an infected female sand fly. The sores develop into ulcers often looking somewhat like a volcano, with a raised edge and central crater. The sores can scab or not scab, be painful or not painful, and can cause similar cutaneous lesions to those produced by other diseases such as cutaneous tuberculosis, syphilis, leprosy and skin cancer, among others.
Leishmaniasis is found in parts of over 80 countries. Most of those countries are in the tropics or subtropics, but the settings in which leishmaniasis is found range from rain forests in Central and South America to the deserts of West Asia. For instance, leishmaniasis is present in Iraq and was contracted by a number of the troops involved in the 2003 invasion of that country and its subsequent occupation. The soldiers nicknamed the disease the Baghdad boil.
Cutaneous leishmaniasis is the most common form of the disease, causing numerous sores on the body which will self-heal in from several months to a few years, but leave unsightly, even deforming scars. If not treated, the cutaneous disease can also result in mucocutaneous leishmaniasis where skin ulcers spread causing tissue damage to (particularly) nose and mouth.
Two common therapies, both containing antimony—a potentially toxic heavy metal—are: meglumine antimoniate (Glucantim®) and sodium stibogluconate (Pentostam®). (Antimony, Atomic number 51, is a trivalent and pentavalent metalloid element used especially in alloys and semiconductors, but also in medicine as a constituent of some antiprotozoal agents.) It is not understood how this metal acts against the parasite; it may disrupt its energy production or trypanothione metabolism. In many cases the drugs don't work or become progressively ineffective with repeated use—patients are known to have received over a hundred of these shots, yet still exhibit the sores.
(Follow the links above to discover more about Leishmaniasis, Black Salve, etc.)
A small child's first visit is documented for his progress photos.
ARENOSA: Beginning a New Clinic (report by TC McVey)
During the clinic days in Cacao, a number of people expressed interest in learning the treatment so they could help people in their own villages. The first such person Dee Braden taught was Pascuela (click HERE for image), who brought her grandchildren to the clinic for treatment. It took them 3 hours to reach Cacao via horse and taxi, yet they still showed up every Wednesday. After 6 weeks of observing and practicing the treatment, Dee gave Pascuela the necessary supplies to help the victims in her remote village, Nueva Paraiso.
Sr. Marcelino, the representative of the Cacao area, enlisted five other nearby women who wanted to learn how to run the Cacao clinic. So, during the month of August, they learned and practiced. By September, Dee felt they were ready to handle it, and that we were ready to move on.
Just to be sure, on our last Wednesday in Cacao, the new women did all the work while Dee supervised. Since there was little for me to do, I sat in the garden and chatted with some of the patients waiting to be treated.
One 86-year old gentleman, Sr. Cirilo, told me he'd had leishmaniasis for 12 years! He said that it made him miserable, and made him crabby with his family and friends. It also prevented him from getting a good night's sleep, and from being able to walk long distances. The day I talked with him was his third visit to the clinic, and he was so happy with his improvement that he couldn't stop thanking me. The parasites were gone, he was sleeping through the night, and walking was no longer a problem. His son was with him and said his father was a new man.
It's moments like that which make everyday at the clinic the best day ever. We were all sorry to leave the kind people of Cacao, especially our favorite patients who brought us fruits, vegetables and orchids from their gardens.
¡Muchas gracias, amigos y amigas!
Well, as it turned out, Sr. Marcelino had also been talking about starting new clinics to his fellow representatives from the mountain areas. So, when we asked him about it, he gave us some names of villages that needed help. One was chosen and we said "Ciao!" to the people of Cacao.
The next Wednesday, Sept. 6, we set out in two cars loaded with people and supplies for the mountain village of Arenosa. On the way, we picked up Sr. Marcelino's assistant, Pedro Pablo, who was supposed to guide us to the new town, but whose memory of the route proved a little sketchy.
Going to new places in Panama is always an adventure and this was no exception.
As it turned out, there are two Arenosas very near to each other and we, of course, found ourselves in the wrong one. We had asked for directions along the way, and were given them, but unknowingly to the wrong town. We'd had a feeling something was wrong, though, because we weren't climbing mountain roads. In fact, we were in some lovely lake country around Lake Gatun, and there were some very expensive looking homes.
So, we turned around. It seemed like we had gone almost all the way back to the Pan-Am highway before we found the correct turn and started climbing to the Arenosa in the Capria mountains. The misadventure made us an hour late, but upon our arrival we were greeted by Sr. Roberto, who had been waiting for us. There were only a few patients there, however, so he went off to round up some more. By noon we had treated 35 patients, all of whom were children, except one adult.
Some of the children on that first day were students who came with their teacher from the nearby school. They were treated and sent home with instructions, but none of them came back for followup treatment the next Wednesday. We now realize that we can't treat children without their parents there to hear and understand how the treatment works. A few of those students came back with their parents on the third Wednesday, so we hope more will do the same as people see the results.
And, with our initial patients, there have been some wonderful results. In fact, we've released several of them after only 3 visits. But, as it turns out, there is some skepticism in the area toward expats who say they will come and help, then never show up. Unfortunately, we are being lumped into that group. We think it will take awhile for the locals to realize that we are for real and will stick it out. As it is, they keep asking us when we will be back, and we keep telling them every Wednesday for as long as it takes. In time, they will figure out that we mean it.
The rainy season is upon us now and on Sept. 13, just as we were finishing with last patients in Arenosa, we were pummeled by a two-hour downpour. It took us 5 hours to get back to Altos! Torrents of rain, roads of mud, slipping and sliding, flooding, five river crossings, one flat tire, squirrelly four-wheel driving...we just had to laugh our way through it. (Check out the video of the rivers we crossed HERE!)
Mothers and children wait for treatment in Arenosa.
Website: © 2007 McVey Design
Week One:
Hernan came to the Cacao clinic with several sores on his right cheek.
Week One:
Black salve was applied to the area and covered with vaseline to keep the salve moist during the first week's application.
Week Two:
At Hernan's second week visit all the parasites came out with the removal of the dressing, but it I was painful for him.
Week Three:
Hernan's spirits were up on his third visit, however, as the sores were healing quickly and causing less discomfort.
Week Four:
By Hernan's fourth visit his wounds were well on their way to healing, so he was sent home with a clean bill of health.
This site describes how a bloodroot mixture commonly known as Black Salve is being used for the treatment of Cutaneous Leishmaniasis in remote villages of the Republic of Panama.
This site describes how a bloodroot mixture commonly known as Black Salve is being used for the treatment of Cutaneous Leishmaniasis in remote villages of the Republic of Panama.
This site describes how a bloodroot mixture commonly known as Black Salve is being used for the treatment of Cutaneous Leishmaniasis in remote villages of the Republic of Panama.
This site describes how a bloodroot mixture commonly known as Black Salve is being used for the treatment of Cutaneous Leishmaniasis in remote villages of the Republic of Panama.
This site describes how a bloodroot mixture commonly known as Black Salve is being used for the treatment of Cutaneous Leishmaniasis in remote villages of the Republic of Panama.
This site describes how a bloodroot mixture commonly known as Black Salve is being used for the treatment of Cutaneous Leishmaniasis in remote villages of the Republic of Panama.
