A recent Epidemiology and Disease Control Division (EDCD) report on Visceral leishmaniasis (VL or kala-azar) puts the number of Nepalis at risk of contracting the disease at 8,007,323, which is nearly a third of the country’s population. Only a year ago, the number of those at risk stood at 5,616,489. This is so because earlier VL was seen only in 12 districts of Tarai. But in the course of one year, the disease has mysteriously spread to nine Hilly districts (in places as far apart as Dhankuta and Rukum), although, ironically over forty million rupees has been spent in Nepal to eradicate VL in the last three years.

Spread through sandfly of the Phlebotomus genus, the parasite migrates to internal organs like liver, spleen and bone marrow. If left untreated, the disease invariably results in death of the host. The sandfly larvae can grow virtually anywhere in warm and damp conditions — on organic matters, trees, walls, garbage. This makes eradication of kala-azar an arduous task, and may render the joint efforts of India, Nepal and Bangladesh to root it out by 2015

futile. The sharp rise in number of people at risk to VL has been linked to lack of awareness, extreme poverty and open border with India. But these are mere speculations. Unless the real culprits are soon found, a catastrophe may be unavoidable.