MICHELE NORRIS, host:
This is ALL THINGS CONSIDERED from NPR News. I'm Michele Norris.
ROBERT SIEGEL, host:
And I'm Robert Siegel. This week, NPR is reporting on so-called neglected diseases: debilitating infections that have been wiped out in most of the world but that stubbornly persist in poorer nations. Today we have a story about one doctor who fights these diseases, spending months away from his family, sometimes in dangerous places, helping people who are struggling to survive. NPR's Joanne Silberner has this report on what makes him tick.
JOANNE SILBERNER: Fifty-three-year-old Frank Richards is a get-it-done kind of guy who doesn't worry very much, but there was that one time back in 1995, in a nameless hotel in Nairobi.
Dr. FRANK RICHARDS (Infectious-disease Specialist): I really began to wonder if this was the business that I wanted to be in.
SILBERNER: A physician colleague had just come out of war-torn Sudan and stopped by Richards' hotel room.
Dr. RICHARDS: I'm on the floor with my backpack, stuffing things in, and this guy is sitting on the edge of the bed talking about this bloody experience with the guerillas. And he hadn't been injured, but several people had been injured, and with each thing I'm stuffing in my backpack, I'm stuffing each item more reluctantly as the story gets more and more terrifying.
SILBERNER: Richards had a seat on a cargo plane going into southern Sudan the next day. When he was in school, such tales had the ring of adventure, not terror. The tales came from one special teacher.
Dr. RICHARDS: My epiphany, if you will, my a-ha moment was in my second year of medical school at Cornell University, 1977.
SILBERNER: Infectious diseases with professor Ben Kean.
Dr. RICHARDS: Dr. Ben Kean was a character who reminded me of W.C. Fields. He was kind of short and stout, his eyes were squinted, and he smoked a cigar.
SILBERNER: Kean classes were stories.
Dr. RICHARDS: His stories would deal with the Far East or Africa, or here we are in Latin America, or even when I took care of the Shah of Iran. All of his stories almost could begin: once upon a time in a faraway land.
SILBERNER: It was everything Richards wanted in a career: distant lands, strange cultures, and for 24-year-old Frank Richards, there was one more very important aspect to Professor Kean's class.
Dr. RICHARDS: At the end of the day, it was about justice. It was about how and why we're here to help others.
SILBERNER: Luckily terrifying moments have been rare, and Richard's days are filled with opportunities to help in faraway places.
Dr. RICHARDS: One of the things I really enjoy about this job is I get to hop in a four-wheel-drive vehicle and drive the back roads of some beautiful places.
SILBERNER: This morning, Richards is in central Nigeria heading to the village of Seri to see whether a program to prevent malaria is working. It's beautiful in the rainy season, all wildflowers and trees and grasslands so green it hurts your eyes, but right now, Richards is worrying about the people here.
Dr. RICHARDS: We are passing houses that have no screens in the windows. The doors are open, and the eaves are open, and that means to me that mosquitoes are easily able to enter and to bit the people inside.
SILBERNER: And those mosquitoes, of course, carry malaria. We drive by a field of grass with a pond in the middle.
Dr. RICHARDS: A pond of quiet, standing water is a pond that has schistosomiasis.
SILBERNER: Richards is trying to protect people from what he calls horror movie diseases. They're caused by parasites that eat away at internal organs. Schistosomiasis is one of them. It's a parasitic disease that attacks the intestines and bladder. Most of these parasites spend part of their lifecycle in water or rely on insects that do, and water in this part of Africa not only harbors parasites, it can also be impassible.
Unidentified Man #1: (Unintelligible).
SILBERNER: The narrow dirt road that leads to the village of Seri goes through a small cornfield. There's a ravine with a rain-swollen river at the bottom, one that wasn't there last week. We can't go any farther. The ravine is pretty steep. Everybody gets out to talk about whether it's safe to try to drive through the water. As usual, Richards is thinking about a whole different threat, a parasitic disease called river blindness.
(Soundbite of running water)
Dr. RICHARDS: So that's the sound of river blindness. It would be right in this rapidly flowing water that the black fly would breed, not in the still part. It needs the rocks and the rapids to flow.
SILBERNER: Someone suggests placing some heavy boards over the deepest part of the ravine. In the end, caution prevails and we back a quarter mile down the narrow dirt path and take a 45-minute detour.
Unidentified Man #2: (Speaking foreign language)
Dr. RICHARDS: Yeah, that's why the driver isn't here.
SILBERNER: Finally after two and a half hours, we arrive at the small village of Seri. Local health workers are waiting.
Unidentified Man #3: How are you?
Dr. RICHARDS: Frank Richards.
Unidentified Man #4: Bueno.
Dr. RICHARDS: How are you? Good.
SILBERNER: The men are out in the fields. The women are ready to show us their homes.
Dr. RICHARDS: Well, I'm very interested in having a look at, if people will let us, to go to a few houses and see about the bed nets that were distributed here.
SILBERNER: Bed nets that protect people from mosquitoes that carry malaria, if only they will use them properly. We walk past a sleeping pig. Richards notes that it might have a tapeworm infection that can cause seizures in humans. And we come to five, thatched-roof huts surrounded by a simple stick fence.
Dr. RICHARDS: So is this one household?
Unidentified Woman: This is one...
Dr. RICHARDS: All of these buildings.
Unidentified Woman: Belong to one family.
Dr. RICHARDS: Okay.
SILBERNER: The huts are dark, airless, hot and full of cobwebs. The women and children crowd in to watch the American.
Dr. RICHARDS: Okay, so we have one, two, three, four, five, six...
SILBERNER: Richards finds a lot of bed nets.
Dr. RICHARDS: Thirteen. Oh, this is great. I'm really happy. I'm very happy that net is hanging up.
SILBERNER: The bed-net campaign targets children, who are especially vulnerable to malaria. A village health official hands Richards a notebook that says who has bed nets, who has children, and who has bed nets and children.
Dr. RICHARDS: You're holding this old, tattered notebook with pages that have been worked on through the years, different color inks, stains, torn pages, wet from having been out in the rain.
SILBERNER: He imagines one of the community health workers, a father, sitting in a dark hut with a candle, his kids trying to get his attention, shooing them away so he can make entries in the ledger.
Dr. RICHARDS: And that's what this book is about, and it's also about the power that exists in these communities, that these communities are not helpless.
SILBERNER: That conviction that people need just a little help to help themselves is part of the reason Richards decided to get on that cargo plane to southern Sudan in 1995. He had promised to help, and he had to keep his promise. Today, Frank Richards is back in Atlanta, where he's on the staff at the Carter Center, after spending six of the last seven weeks in Nigeria, Uganda and Ethiopia. Joanne Silberner, NPR News.
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