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Parasite: Scourge of Peasants Caught in Chiapas Conflict

August 22, 1995

LA NUEVA ESTRELLA, Mexico (AP) _ Marin Gomez pouted as the village health care worker pointed to the yellow-and-red scabs forming over the boy’s left ear, the mark of an insect-borne parasite slowly eating his flesh.

``I treated it with antibiotics, but it didn’t do any good. I’ve never seen anything like this,″ said Liandro Hernandez. ``If he doesn’t get some medicine for this, he will lose his ear.″

Gomez, 9, has been diagnosed with leishmaniasis. Though treatable, the $40 cost of the drug that combats the disease is a small fortune for the people of La Nueva Estrella.

The disease has infected dozens of the 10,000 Chiapas peasants who fled an army crackdown in February on guerrillas leading an indigenous uprising, now in its 19th month.

Most of the peasants have returned to their homes, but health workers say at least 80 contracted leishmaniasis while hiding in the jungle.

Eighteen soldiers stationed in the jungle also were treated for the disease, Chiapas State Health Department spokesman Milton Hernandez Moguel said.

``There are probably hundreds more cases,″ said Dr. Gabriel Garcia, who works with Health and Education Services Promoters, an independent group based 60 miles west of here in San Cristobal de las Casas.

Pronounced ``leesh-muh-NIGH-uh-sis,″ the disease is caused by protozoa transmitted by a sandfly _ a bloodsucking insect slightly larger than a pinhead that, in Chiapas, breeds in jungles.

Dozens of American troops contracted the disease while fighting the Gulf War in 1991, said Dr. Richard Titus, an expert at Colorado State University in Fort Collins, Colo. Drawings in Egyptian tombs and on Maya temples suggest the disease is an ancient scourge.

The World Health Organization estimates that 12 million people have leishmaniasis, which comes in many forms but is unrelated to the infections with so-called ``flesh-eating bacteria″ that attracted much attention in the United States and Britain.

One type of the disease is highly lethal, but the form here is treatable, and begins with painful stings that fester for months. The sores sometimes disappear within six months, after the body’s defense mechanisms learn to combat the parasite’s effects, although the parasite itself may remain in the body for a lifetime.

In La Nueva Estrella, afflicted peasants will miss the critical corn harvest and bean planting seasons.

``Those who have the sores can’t work in the fields because it bothers them to walk,″ said Hernandez, the village health worker.

``The ulcers are disfiguring, and when they heal they leave a burnlike scar,″ said Dr. Richard Pearson, an expert at the University of Virginia in Charlottesville. ``The sores look like little cheese pizzas.″

Parasites on the ears, nose and lips will slowly nibble away flesh without treatment with costly medicine, Chiapas health workers say.

The Health Department’s Hernandez said the disease is under control.

But doctors who tromp the winding muddy roads to visit the poor, isolated villages dispute that.

``Government health workers hardly ever enter these areas, so they don’t register the cases,″ said Dr. Marcos Arana of the social services umbrella organization Conpaz. ``We think this is a serious problem.″

Dr. Carlos Esquinca Albores said villagers themselves contribute to the difficulty in treating the disease.

As chief of state health services in Comitan de Dominguez _ a town leading to guerrilla territory _ Esquinca said many pro-rebel villages refuse treatment by government doctors.

``We have the medication, and if they would come to us, we would be happy to treat them,″ said Esquinca, who has offered to work with non-governmental agencies to distribute medicine.

The treatment is intensive, requiring at least two weeks of daily injections.

For the moment, peasants are pinning their hopes on a shipment of the drug Glucantim, made by the French-based company Rhone-Poulenc Rorer, that Arana said is expected to arrive in villages soon.

Until it does, young Gomez’s mother, 45-year-old Manuela Hernandez, says she won’t stop worrying. ``I just want to get my son some medicine.″

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