In July 2017, Christy Petersen, CPH associate professor of epidemiology, traveled to Bihar, India, to conduct research on visceral leishmaniasis. She recently shared photos and details of her trip.

I traveled to India as a part of the Banaras Hindu University (BHU) Tropical Medicine Research Center faculty. The center is an NIH Specialized Center (P50) that is entering its 15^th year of funding located at the Kala-Azar Medical Research Centre (KAMRC).

I worked in and around a city called Muzaffarpur in the state of Bihar, which had the honor of being the last area of the world to eradicate smallpox. Bihar is in the northeastern corner of India, next to Nepal and Bangladesh, and home to the headwaters of the Ganges River. Bihar is still one of the poorest regions of India. The power is inconsistent throughout most of the day, the water isn’t potable, and raw sewage flows down the sides of the street.  As it was monsoon season while I was there, there was active malaria, Dengue, Zika, Japanese encephalitis, and other things circulating in the mosquitos, so I was sure to wear my bug spray each day.

Bihar is also endemic for visceral leishmaniasis (VL), the fatal protozoal parasite infection that is the research focus of my lab. The Muzaffarpur area had 44 new VL cases during June 2017, the month before I arrived. One of the villages I visited had 38 of 300 villagers recently seropositive for leishmaniasis; all were children under 18.

We drew crowds when we were out in the villages looking for “bimar kutta,” or sick dogs, to establish whether animals are part of the disease ecology (reservoirs). To date, this disease is believed to only circulate between humans and the vector sand flies, but in the rest of the world infection is also found in other mammals, particularly dogs and rodents as reservoirs.

I was working in the field with a team of 10 people total, myself included. This was a field team of four trained dog-catchers and three entomologists, one of whom was from the Walter Reed Army Institute of Research (the only other American present during my three weeks). Rounding out the 10 people was our driver, the PhD student from BHU whose dissertation will focus on this work, and a molecular parasitlogist who will aid us with the molecular studies stemming from these samples. She was the only other woman at KAMRC while I was there. As you might guess, as the only white woman around for miles, I was quite unusual and was the focus of many stares everywhere I went. That was probably one of the hardest things for me to adjust to as an understated Midwesterner.

Bihar was an amazing, troubling, fascinating place.