Culex, anopheles, aedes and mansonia mosquitoes spread the disease, which may take three to ten years to manifest itself.

About 35 lakh people of the 32 districts have been suffering from lymphatic filariasis, which causes enlargement of the entire leg or arm, the genitals and breasts and damage to the kidneys and lymphatic system.

During a recent visit at the highly filariasis-prone districts in Nilphamari and Lalmonirhat, it was found that a huge number of people have contracted the disease, but most of them know nothing about it as there is no effective awareness campaign in this regard.

"I don't know how I was infected with the disease. Many people in our village are suffering from the disease," said 65-year-old Mohir at the Filaria Hospital in Nilphamari. He who hails from Tepadiriram village in Kishoreganj, Nilphamari.

Alima Begum, 45, of Syedpur upazila, who came to hospital for treatment on June 21, has been suffering from the disease for the last 25 years. But it was too late as her condition reached a point beyond cure. About 33 percent of the population of Nilphamari have contracted the disease.

Who are the sufferers?

The poorest of the poor are the main victims of the disease as they have less capacity to resist infections due to lack of proper nutrition.

Women make up over 50 percent of the patients as they suffer from malnutrition, said Dr Moazzem Hossain, director of Filaria Hospital, the lone hospital of its kind in the world. The hospital is located at Dhalagach in Syedpur, Nilphamari.

At a briefing on June 21, Dr Moazzem said all the districts along the border of Rajshahi division have a large number of people infected with the disease and Nilphamari, Panchagarh and Lalmonirhat districts have a high prevalence rate.

JOCV activities

The Japan Overseas Cooperation Volunteers (JOCV) members are playing a significant role to make people aware about the disease in five high prevalence districts, including Nilphamari, Panchagarh, Thakurgaon, Dinajpur and Lalmonirhat, in collaboration with the district civil surgeon offices.

Masao Koda, a JOCV official, explained their activities to eliminate filariasis in line with the World Health Organisation's (WHO) goal to eliminate the disease from the world by 2020.

"Our goal is to eliminate the disease from the five districts by 2010 through disseminating information about the disease and its treatment," Koda said.

"We go from village to village in the district to make the people aware about the disease and take care of the infected hand or leg," said Hiroko Ito, another JOCV member.

At Lalmonirhat, JOCV member Masato Emoto organised a training workshop for the local NGOs on June 22 so that they can run the awareness campaign in this regard.

Government step
To eliminate the lymphatic filariasis by 2015, the government has supplied medicines to people in 10 northern districts with foreign assistance. All the 32 districts will be brought under the programme by December next, said Dr Moazzem.

Japan International Cooperation Agency (JICA) will provide the medicines for the next phase of filariasis elimination programme.

Dr M Sohrab Hossain Sarkar, civil surgeon in Lalmonirhat, said, "There is no allocation of funds for the filariasis elimination activities. We need funds and inter-sectoral involvement, including government and non-government organisations."

Only JOCV members are working to raise awareness among the people in the district, he said.