3. The Teacher, the Heart and the Paradoxes
María Elda Bermúdez Quintero is 63 years old and has been a teacher for 40 years, almost all of them at this school. She contracted Chagas many years ago and remains affected by it although she received treatment 17 years ago, and there were no side effects. But she has been told that the disease already affected her liver and heart. The size of her heart is slightly larger than normal. But she laughs, and says:
“If I have a big heart, it will be to love that much more”.
Since she received the treatment, she has been feeling well and has been attending her check-ups regularly. Due to her involvement in raising awareness, her school is one of the many PRTCs (community triatomine collection points) where the vector control teams come to on a regular basis to collect the disease transmitting bugs called ‘pitos’ (triatomines) that are found.
On the other hand, she has two daughters, 33 and 20 years old, an 8-year-old grandson and a 3-year-old granddaughter, none of them have been tested for Chagas. When we ask her why, she is hesitant to answer.
“I don’t know. Maybe because they thought I had recovered already, and that it wasn’t a problem anymore”.
This is one of the paradoxes that we find when visiting Boyacá together with the vector control team. The perception that Chagas is not a cause for concern can reduce people’s attentiveness to its detection, control and care.
The disease is transmitted via different routes in addition to the vector route. For example, it can be passed from mother to child, by blood transfusion or organ donation, or through oral transmission. Although acute cases are detected, most patients in the Tenza Valley are chronic.
A Comprehensive Health Care Route for Chagas (RIAS) has been implemented for several years now in the departments with the highest incidence of the disease in Colombia. Thanks to this pilot project, developed in collaboration with DNDi, the number of persons diagnosed and treated has increased until 13-fold and 5-fold respectively. This shows that it is possible and crucial to diagnose and provide early treatment at the first tier of healthcare.
Report compiled during field visits by Javier Sancho and Ulrich-Dietmar Madeja. Images from Jorge Martinez.
To arrive on time to interrupt Chagas disease: