ROBERT SIEGEL, host:

From NPR News, this is ALL THINGS CONSIDERED. I'm Robert Siegel.

MICHELE NORRIS, host:

And I'm Michele Norris.

NPR has been reporting this week on so-called neglected diseases. Two hundred million people in developing countries have a disease called schistosomiasis. African nations are particularly hard-hit. Despite those numbers, the disease is not an international health priority. It's debilitating, especially for children, but it rarely kills. NPR's Joanne Silberner traveled with doctors in central Nigeria who are trying to keep the disease from spreading.

JOANNE SILBERNER: Dr. Julie Gutman and her colleagues drive through the rain toward the village of Fobur in central Nigeria.

Dr. JULIE GUTMAN (Carter Center): So we're driving across the country, and there's a very large lake on the left-hand side.

SILBERNER: Children swim in the lake, and it's very possible the lake contains the parasite that causes a disease called schistosomiasis. It damages the intestines, the colon, the liver and the urinary tract. It causes pain, fatigue and anemia. Schistosomiasis rarely kills, but it significantly stunts the growth and development of children.

With the support from the Carter Center in Atlanta, Julie Gutman will test kids in 30 villages to find out how many of them are infected, but even getting to a single village along muddy roads in the pouring rain is proving difficult.

Dr. GUTMAN: Yes, now you can see the problem of doing work in the rainy season.

SILBERNER: That's what I was just thinking. It would've been nice if we'd come earlier and been done before it started to rain.

Gutman scouted the village of Fobur the day before. She stopped at the house of the village chief to ask him to get the children to come to the local school at 10 a.m., but it's 10 and there are only a handful of children here.

Medicine for schistosomiasis costs just 20 cents per child per year, but that could be hundreds of thousands of dollars in this region alone, not easy money to find when AIDS and malaria are epidemic in the region.

Dr. GUTMAN: The overall goal of the study is to see if intestinal schistosomiasis is an issue in Plateau state because if we don't find a high prevalence in any of the 30 villages we test, then it's something that we don't at this point need to worry about, and we can focus our efforts on other problems.

SILBERNER: It's a half hour past the time the kids were supposed to be here. A couple of dozen have arrived. Few are the age Gutman needs for her survey - 10 to 15 years old. A Nigerian health official who is part of the team tries to keep the kids entertained by leading them in one of their favorite songs.

Unidentified Children: (Singing) If you're happy, and you know it, clap you hands.

(Soundbite of clapping)

Unidentified Children: (Singing) If you're happy, and you know it, clap you hands.

(Soundbite of clapping)

Unidentified Children: (Singing) If you're happy, and you know it, and you really want to show it, if you're happy, and you know it, clap your hands.

(Soundbite of clapping)

SILBERNER: Gutman has another village to test this morning, and then an afternoon in the lab - so she tries to get things moving.

Dr. GUTMAN: So we've asked the chief t go to the village and bring some more children. Since it's raining, we've had less children than normal.

SILBERNER: Schistosomiasis is hard to diagnose. It causes cramping and anemia, but lots of things do that. So to determine if the kids have schistosomiasis, Gutman gives the children cups to bring her stool samples. In the first village she went to with her team, the kids got very excited about the red cups.

Dr. GUTMAN: The problem is that the cups are far too nice. They've got cups that lids that seal. Why would they bring them back, you know?

SILBERNER: They didn't use them as intended, and they didn't bring them back, so Gutman adopted a new tactic.

Dr. GUTMAN: We tell them that we have a present for them when they bring the cups back, that even if they bring the cup back empty, they will still get their present so that we preserve our quantity of cups.

SILBERNER: Finally enough children have come. They crowd onto the small wooden benches in one of the classrooms. The bright red cups on the teacher's table up front stand up like Christmas toys in the unpainted room.

Dr. GUTMAN: I'm doctor Julie.

Unidentified Children: Dr. Julie.

Dr. GUTMAN: Salud.

Unidentified Man: (Unintelligible).

Unidentified Children: (Unintelligible).

Unidentified Man: Clap your hands.

(Soundbite of applause)

SILBERNER: A local health official explains what the kids need to do with the cups, and that causes plenty of giggling.

(Soundbite of laughter)

Dr. GUTMAN: It's obviously a funny subject because it's stool, and it's feces, and the word in Hausa for feces, the polite word is biyangeta(ph), which means behind the house.

SILBERNER: Gutman slaps on a pair of gloves and starts labeling the cups with the date and a number.

Dr. GUTMAN: And we divide them up evenly between the boys and the girls to get a better sample so it's not all one sex.

SILBERNER: Fifteen boys and 15 girls will be given the cups. When they bring the cups back tomorrow with a stool sample, they'll each get a ballpoint pen. The children line up to get cups and give their names and ages.

Unidentified Man: (Unintelligible), what about you? (Unintelligible).

SILBERNER: In a way, the day is a success.

Dr. GUTMAN: Definitely to me, as long as we get 30 children here and 30 cups back tomorrow with stool in them, that's what we need to be able to say that we checked enough children of their village. And I think considering that it's raining outside, the number of people here, I'm very happy with.

SILBERNER: The stool samples will go to a lab in a nearby city. A couple of days of lab work later, Gutman has bad news: Many of these children have schistosomiasis.

Dr. GUTMAN: We found 11 positive children, so that is greater than 30 percent. So all of the schoolchildren in that area will be treated.

SILBERNER: That is if local health officials or donors can come up with the money. Joanne Silberner, NPR News.

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