This is Part 4 of a five-part multimedia feature, Dispatches from Mwanza, about Weill Cornell Medicine's collaboration with Weill Bugando School of Medicine to improve health care in Tanzania, the U.S. and around the world.
Dr. Jennifer Downs, an infectious disease expert at Weill Cornell Medicine, drove around a bend on a dirt road in Tanzania when the vast expanse of Lake Victoria appeared. She had arrived in Igombe. The fishing village is the first place she'd ever seen such a massive burden of schistosomiasis, a parasitic worm infection that affects more than 250 million people worldwide. People get infected just by touching contaminated water.
Dr. Jennifer Downs of Weill Cornell Medicine is collaborating with Tanzanian researchers to treat schistosomiasis, a parasitic worm infection affecting 250 million people worldwide.
"That's why it is so, so hard to prevent," said Downs, M.D. '04, M.Sc. '11.
Lake Victoria is infested with it.
Twice the size of Maryland, Lake Victoria is the second-largest freshwater lake in the world and a primary source of water for Tanzania, Uganda and Kenya; the parasite in it puts lives at risk across the continent.
Downs chatted in Swahili with women carryingg basins of lake water on their heads for their family's bathing and laundry. Others stood knee-deep in the lake, filling their buckets. A baby in a sling slept on one woman's back.
The parasite larva burrows through unbroken skin and grows into a flatworm that lays hundreds to thousands of eggs per day. A species of the Schistosoma worm is particularly brutal for women. The eggs lodge in the vagina and cervix, causing severe lesions that do not heal and symptoms that resemble sexually transmitted infections. The damage may also increase the risk of infertility, HIV and the virus that causes cervical cancer.
Left untreated, various species of the parasite can cause fatal liver disease and blockage in the ureters that leads to kidney failure - all for lack of sanitation and safe water.
"It's a horrifying disease," said Downs, who has spent much of her career at Weill Bugando School of Medicine, Weill Cornell's long-time collaborator in Tanzania. "If 5% of the U.S. population had this, there would be a public outcry. And 50% of people in Tanzania are infected."
Dr. Jennifer Downs, (center) the Ehrenkranz Family/Orli R. Etingin, M.D. Associate Professor in Women's Health and associate professor of medicine at Weill Cornell Medicine, looks at schistosomiasis test strips in a lab at Mwanza Intervention Trials Unit in Mwanza, Tanzania, with Dr. Jane Maganga, (left) a research scientist at MITU, and Loyce Mhango (right), a lab technician at MITU.
As the Ehrenkranz Family/Orli R. Etingin, M.D. Associate Professor in Women's Health at Weill Cornell, Downs and her team are conducting a five-year study funded by the National Institutes of Health on female genital schistosomiasis (FGS) - a disease that persists in 70% of women even after treatment. The work is also providing leadership opportunities for researchers in Tanzania.
When Downs first visited Igombe in 2009, she conducted a study that found 85% of residents are infected with a species of Schistosoma that attacks the gastrointestinal tract.
"It broke my heart," said Downs, who is also associate professor of medicine at Weill Cornell. "As I learned more about the effects of the parasite, not only in the gastrointestinal tract, and the damage for women, and all the ensuing complications, like increased risk of getting HIV and infertility, it just further compelled me to commit my career to it."
