Arete
Arete
May 30 · 6 min read

- Karel Prinsloo, Arete photographer based in Johannesburg

In early April, I set off for the Democratic Republic of Congo (DRC) to join a mission with Sightsavers, an international charity that helps people affected by avoidable blindness.

The village of Kakonkanya, near Lubumbashi, DRC. (Photo: @karel / Arete / Sightsavers)

Once in the country, I travelled with Dr Diana Joana Kaningini from the DRC Ministry of Health, and Dr. Alice Mutekwa, the United Front Against Riverblindness (UFAR) project co-ordinator in Katanga, a partner of Sightsavers.

Alice Mutekwa, the UFAR project co-ordinator in Katanga, shows some information posters at a government clinic in the village of Makulo, near Lubumbashi, DRC (Photo: Karel Prinsloo / Arete / Sightsavers)

I have seen pictures before of people living with elephantiasis (lymphedema), but nothing could prepare me for the reality of meeting patients who suffer from this disease.

The first person we met was a woman with some swelling in her leg, caused by lymphatic filariasis (LF), a disease caused by thread-like nematode worms spread by infected mosquitoes. I thought ‘Okay, this isn’t too bad’. But throughout my trip, the cases became progressively worse.

Marie Claire Mwika, who is affected by lymphedema, has her leg washed by a nurse in the village of Makulo, near Lubumbashi, DRC (Photo: Karel Prinsloo / Arete / Sightsavers)

On the second to last day, as we travelled, we came across a woman called Marie Mwape. Her leg was in really bad shape and had some open sores. Our team decided to return the following day with the necessary medication to help her.

Lymphedema patient Marie Mwape, 34, stands in front of her house in the village of Kasakota, near Lubumbashi, DRC. (Photo: Karel Prinsloo / Arete / Sightsavers)

The next morning we met her and her husband at a medical facility about 60km away from Lubumbashi. I could see that Marie was nervous, and her husband stood in the far side of the room, uncertain what was about to happen. With great tenderness, Dr Diana start to clean Marie’s swollen leg, gradually washing away the layers of dirt to show the true extent of her injuries. Along with the swelling of her leg and foot, she had several open wounds on her ankle.

Lymphedema patient Marie Mwape, 34, stands in front of her house in the village of Kasakota, near Lubumbashi, DRC. (Photo: Karel Prinsloo / Arete / Sightsavers)

She told us that she has lived with this condition for twenty years. It struck me that she was not aware of what had caused her illness, as is the case for most people who we met along the way. People typically use traditional medicine to treat the problem, as they either do not trust modern medicine or, as in most cases, cannot afford it.

Lymphedema patient Marie Mwape, 34, has her leg cleaned at a clinic near the village of Kasakota, near Lubumbashi, DRC. (Photo: Karel Prinsloo / Arete / Sightsavers)

I took a portrait of Marie as her feet was cleaned and I noticed that she was a striking woman, with only her feet giving away her terrible circumstances. She handled her situation with dignity and grace, and smiled as I photographed her. Even with the help of modern medicine, her condition is irreversible, as treatment can only stop the disease from spreading further into her body.

Lymphedema patient Marie Mwape, 34, poses for a portrait at a clinic near the village of Kasakota, near Lubumbashi, DRC. (Photo: Karel Prinsloo / Arete / Sightsavers)

This is in contrast to some of the male patients we met, who were suffering from another complication relating to LF, known as hydrocele — a type of swelling in the scrotum. Hydrocele, unlike elephantiasis, can be cured with a simple operation.

Former hydrocele patient Tshinyama Ilunbwa buttons up his son, Tresor’s, shirt with his daughter Sifa at his home in the village of Kamafesa, near Lubumbashi, DRC (Photo: Karel Prinsloo / Arete / Sightsavers)

Despite its easy treatment, the stigma and misinformation surrounding hydrocele can have a terrible social impact upon those it affects. Some of the male patients we talked to had lost their spouses, and were being shunned by their community. The operation is the first step for them in rebuilding their lives.

Lymphatic filariasis takes a terrible toll on the communities it affects, and it is indiscriminate. A person’s fate is often decided by where they live; most of the patients live near water and do not have access to health facilities. A simple bite from a mosquito and they are condemned to dealing with a life-long illness.

Children collect water from a river in the village of Kasakota, near Lubumbashi, DRC. (Photo: Karel Prinsloo / Arete / Sightsavers)

As a photographer, I found people were open to being photographed even though some of them have serious physical symptoms caused by their diseases. I always make sure they are happy for me to take their photograph, though nobody said no. However, I try as far as possible to use a longer lens, which allows me to stand further away and lessen the intrusion into their personal space. I also find it important to focus on their faces, to show them as human beings, rather than to focus purely on their disability.

What struck me most during this assignment is that the people I photographed have mostly accepted their condition, and carried on with their daily lives. They have continued to work, and care for their children and family; no time is spent thinking about why this happened to them in particular.

This type of work takes a heavier personal toll on me these days, since having had children. I see the difficulties faced not only by the people affected by the disease, but of their families too, especially children. It is unfair that people have to live with diseases like this in 2019, when so much can be gained with just a small amount of medical attention. Unfortunately, in many of these kinds of places, people just do not have any access to medicine.

More information about Lymphatic Filariasis

Lymphatic filariasis, commonly known as LF, is one of the world’s leading cause of physical disability. It is estimated that up to 120 million people in 83 countries worldwide are affected by some form of filariasis. It is caused by parasites, transmitted to humans by mosquitoes. The disease can result in an altered lymphatic system and severe swelling in the limbs (lymphedema) or scrotum (hydrocele). Patients suffer painful attacks where they often can’t work or move around. Patients can be taught to manage lymphedema so it doesn’t progress, but it’s not reversible. Hydrocele can be cured with a simple surgery.

Karel Prinsloo biography

Karel Prinsloo is an award-winning African photographer. He was born in Namibia, and has over 20 years’ experience working in Africa as a photographer. Based in Nairobi for nearly a decade for the Associated Press as their East Africa Chief Photographer and Picture Editor, he has extensive knowledge of Eastern and Southern Africa as well as the Middle East.

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Arete Stories

Arete is the expert storytelling and training agency for NGOs, UN bodies and foundations.

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