Kala-Azar or visceral leishmaniasis (VL) is a chronic disease caused by an intracellular protozoan (Leishmania species) and transmitted to man by bite of female phlebotomus sand fly.

Indigenous people have been trained to provide a culturally appropriate Kala-Azar control programme for the tribal population of Kandaran under Malda District of West Bengal. Cultural resistance to modern medicine has been overcome and the influence of village witch-doctors has been countered. Kala-azar awareness programs in the villages imparted information on the
treatment and control of the disease explaining that the disease could not be controlled by witch-doctors.

Persons who had had fever for more than 3 weeks underwent examinations for total and differential counts of white blood cells, haemoglobin concentration, aldehyde test, and thick and thin blood smears for the detection of malaria parasites. The patient was referred initially to the local Block Primary Health Centre, it was often found the patient was coming back before completing their treatment. After initial investigation and counseling with the patient revealed socio-economic factor as well fear of taking the painful “Sodium Stibogluconate” injection which  was given intramuscularly. In this context, SHIS took a bold step in acquiring the only oral drug available “Miltefosine”, which was given on the concept of ‘Direct Observation Treatment’, the result was dramatic, result was astounding. Patients were now happy as they can stay at their home and can work in the field as well as can take the medicine in time.

Clinical cure was achieved through few number patients became afebrile and their spleens returned to normal size. But still there are some cases where patients’ spleens are not returned to normal size, though they have completed the entire course of the treatment without any fail.

SHIS has also started to distribute “Insecticide Treated Bed Nets” free of cost for the poor tribal villagers. Emphasise has been given in the educative, preventive and curative backed up by diagnostic and referral services.

The project is in the 1st phase of the programme and it has already starting to create ripple in the Kala-Azar affected area of Malda. Thanks for the constant support from Irish Aid of Irish Embassy for their timely intervention in this required situation had made impossible, possible.

	The initial success of this 3 year project has already drawn attention of various media, health officials and social activist as a “Ideal Project”. Out of the following suspected Kala-Azar every each one was diagnosed positive. Out of which, only 10 were given the revolutionary drug Miltefosine, of which 8 were cured fully, 2 are still undergoing treatment.
In regards to Tuberculosis all the patients have been treated under Direct Observation Treatment (DOTs) of Revised National Tuberculosis Control Programme, Govt. of India.