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enlarged spleen of kala azar suffer
Many villagers believe that illness is caused by curses, evil spirits, violating taboos, offending the gods or making trouble with deceased relatives. They have a hard time understanding how it could be any different when they see two people who are the same age and seem similar in every way except one gets sick and the other doesn't.

Many people suffer from respiratory illnesses caused by inhaling smoke from cooking and heating fires in huts with virtually no ventilation. Health experts estimate that 4 million children die worldwide from smoke-related respiratory. The illnesses are caused by inhaling carbon monoxide and particles of soot and ash — made with dung, agricultural waste and/or wood — everyday for years. Children's lungs are more sensitive than the lungs of adults. NGO workers say that one solution to this problem is to ferment the dung into methane "biogas," which is a clean fuel.

Food sold in markets is sometimes laid on pavement or dirt that has been contaminated by animal waste and other contaminates. Animals are often kept in small cages in very unsanitary conditions.

More than 80 percent of the cases of high blood pressure disease occur in the developing world, with many cases striking younger adults, according to a study by Carlene Lawes of the University of Auckland.

Eight-four percent of smokers live in developing or transitional economies. It is estimated that 7 million will die a year of smoking-related illnesses in the developing world by 2030.

Websites and Resources Centers for Disease Control and Prevention (CDC) ; World Health Organization (WHO) fact sheets ; National Institute of Health (NIH) Library Medline Plus medlineplus/healthtopics ; Merck Manuals (detailed info many diseases)

Leading Causes of Death In Low-Income Countries

According to the World Health Organization: People living in a low-income country are far more likely to die of a communicable disease than a noncommunicable disease. Despite the global decline, six of the top 10 causes of death in low-income countries are communicable diseases.[Source: Top 10 causes of death, World Health Organization, December 9, 2020]

Malaria, tuberculosis and HIV/AIDS all remain in the top 10. However, all three are falling significantly. The biggest decrease among the top 10 deaths in this group has been for HIV/AIDS, with 59 percent fewer deaths in 2019 than in 2000, or 161 000 and 395 000 respectively.

Diarrhoeal diseases are more significant as a cause of death in low-income countries: they rank in the top 5 causes of death for this income category. Nonetheless, diarrhoeal diseases are decreasing in low-income countries, representing the second biggest decrease in fatalities among the top 10 (231 000 fewer deaths).

Deaths due to chronic obstructive pulmonary disease are particularly infrequent in low-income countries compared to other income groups. It does not appear in the top 10 for low-income countries yet ranks in the top 5 for all other income groups.


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Worldwide an estimated two billion people lack access to safe, nutritious food and 800 million of them — including 300 million children — are chronically malnourished.

The WHO estimated that more than half of the child deaths in developing nations in 1995 was caused by malnutrition. The United Nations Children's Fund measures undernourishment based on three levels: 1) stunted (low height for age); 2) underweight (low weight for age); and 3) wasted (low weight for height).

Malnutrition slow growths and reflexes, causes missing teeth, dries skin, attracts flies, impairs the immune system and is linked to later conditions such as heart disease, diabetes and high blood pressure. Undernourishment can impair brain growth and development mainly through iodine and iron deficiency which can cause mental retardation, brain damage and lower IQ. Folate and Vitamin D deficiency caused by undernourishment can cause neural tube defects and poor bone formation.

Surprisingly obesity has also become a problem in the developing world. Obesity has traditionally been a sign of wealth because only the rich could afford to eat a lot.

Two of the most common diseases that strike malnourished children are kwashiorkor and marasmus. Kwashiorkor is the incongruous bloating that sometimes accompanies starvation. It turns the hair a reddish color and is caused by a lack of protein which in turn causes fluids to "push against wasted muscles." Marasmus, a disease so graphically photographed in famine areas, causes children get develop huge bloated bellies on their on their otherwise frail skeletons bodies.

About 1.6 billion people, a quarter of the world's population, are at risk of suffering from mental retardation caused by an iodine deficiency, a situation that could easily be improved with increased availability of iodized salt.

Chronic malnutrition makes children more vulnerable to common childhood intestinal and respiratory diseases, which can turn out to fatal.


Measles is a highly contagious viral disease that can led to severe diseases such as pneumonia or encephalitis and is often a complicated by middle ear infections. It was something most children endured until a vaccine became available in 1963. It has virtually been eliminated in the United States.

The main symptoms of measles are a high fever and characteristic rash. In severe cases patients can develop pneumonia, blindness and inflammation of the brain. In the developing world, until fairly recently, nearly all unvaccinated children got measles and about 10 percent of them died.

The measles vaccine is safe, effective and cheap. It only costs 16 cents, so cheap that many countries in the developing world can afford it without donations from charities and foreign governments. The vaccine has been around for about 40 years, helping to eradicate the disease in the developed world, but required political will to get it effectively introduced to the developing world.

Rubella (German measles) is another disease that has been virtually eradicated in the United States but still is a killer overseas. An estimated 100,000 babies are born blind, deaf or mentally retarded each years because their mothers were infected with rubella early in pregnancy.

Progress Against Measles

In the 1990s and 2000s child mortality has dropped below 10 million thanks mainly to measles vaccinations. In 2005, 345,000 people worldwide died from measles, 60 percent less than in 1999, beating a goal set by the United Nations and carried out by the Measles Initiative, an organization led by the American Red Cross, the U.S. Centers for Disease Control and Prevention, the WHO, the UN Foundation and UNICEF. The news was even better in Africa, where death rates from measles declined by 75 percent.

Between 1999 and 2006 measles deaths were reduced more than 90 percent. Margaret Chan, head of the World Health Organization (WHO), wrote in the New York Times, “Until recently, parents in large parts of Africa didn’t count on a baby’s future until it survived measles...Measles is one of the most contagious diseases known, It can sweep through an unvaccinated community like an evil wind, devastating young bodies already weakened by malnutrition and other infectious diseases.” The efforts between 1999 and 2005 is estimated to have saved 2.3 million lives.

Before the campaign measles struck 30 million people a year and killed about 800,000 children under the age of five annually in the developing world, including hundreds of thousands in India alone, and was one of the world's leading causes of vaccine-preventable death in children.

Important factors in controlling the disease include: 1) the availability of health services: 2) effectively using prevention strategies; 3) availability of effective vaccines; and 4) availability of good nutrition and housing.

In the United States and other developed countries the number of measles cases was reduced from millions a year to near zero. In recent years there was been some resistant to the measles vaccine after a study showed in rare cases there was a possibility the vaccine could be linked to autism. As a result measles is on the rise in the United States.


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rabies bullet
Rabies is an infectious fatal disease transmitted by a bite from infected animals, which includes dogs, bats, and raccoons, and varies from place to place. Rabies is an extremely painful disease. It works its way through the nervous system, beginning around the bite, and causes painful muscles spasms, especially around the throat and eats away at the brain and causes insanity. Victims usually die of hydrophobia (paralysis of the breathing muscles).

According to the World Health Organization (WHO) about 50,000 people die of rabies every year, including 17,000 in India, 2,000 in China and 300 in the Philippines (2004). The disease is usually transmitted by dogs but also carried by other mammals. Human to human transmission has only occurred during organ transplants.

Untreated rabies is almost always fatal. In 2004, a 15-year-old girl bitten by an infected bat at a church in Wisconsin became the first known person to survive rabies without a vaccination. After she was bitten she did not seek immediate medical and made her first visit to a month after she was bitten when she began displaying rabies symptoms such as periods unconsciousness, double vision, slurred speech and weakness in her left arm. The teenager spent 11 weeks in the hospital. Because the disease had advanced to a stage that immunization was pointless she was treated with coma-inducing drugs to protect her brain and a cocktail of drugs to protect her nervous system and boost her immune system, with the goal being to protect her brain while the disease ran its course in the body.

Rabies Treatment

There is a pre-exposure immunization for rabies. It consists of three injections (dose 2 is given seven days after dose 1 and dose 3 is given 21 to 28 days after dose 2). A booster in necessary after two years. People who get the pre-exposure immunization still have to go through post-exposure immunization if bitten by a rabid animal. The treatment gives them more time.

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rabies cycle
Survival is near 100 percent if treatment is administered immediately. Survival is near zero if treatment is not given. People who have had the pre-exposure immunization and are bitten by a rabid animal get two injections (the second three days after the first). People who have not had the pre-exposure immunization and are bitten by a rabid animal get seven injections (one big one at the bite area, another big one in the butt and then five more in the butt on days 0, 3, 7, 14 and 28).

The rabies virus can be easily killed. If you are bitten by an animal you should immediately wash the wound with copious amounts of soap and throughly clean the wound with soap and water and then disinfect it with a cotton swab dipped in a disinfectant such as Detol, or if nothing better is available, alcohol. Then seek out a doctor immediately for an anti-rabies vaccine.

Several types of vaccine are available. The ones that offers the maximum amount of effectiveness with a minimal amount of pain are the human diploid cell vaccine, imported from France, and purified chick embryo cell vaccine, imported from Germany. The latter is very expensive but can be taken in the arm rather the stomach.


Meningitis is an acute infectious disease which can prove fatal. It is characterised by severe headache, fever and rash, and is spread by poor hygiene, coughing and sneezing.

Meningitis is an infection and inflammation of the meninges, the layered membranes that cover both the brain and the spinal chord. There are two kinds of meningitis: viral and bacterial. Most cases of meningitis are viral and the symptoms are so mild victims don't realize they have the disease and don't feel the necessity to seek medical help. Most cases are caused by an enterovirus spread from hand to mouth, usually in warm weather. No vaccine is available. A treatment of antiviral medicines (not antibiotics) is usually aimed at the relieving the symptoms, usually headaches, until the body recovers naturally.

Bacterial meningitis is the more serious and potentially fatal form of meningitis. Symptoms include severe headaches, progressive drowsiness or confusion, vomiting, irritability, high-pitched crying (especially among very young children), a stiff neck and sometimes painful sensitivity to light and a sore throat. In the days before antibiotics, most victims died. Today the survival rate is 90 percent (most fatalities occur among the very young and very old). The disease is treated with antibiotics and diagnosed with a spinal tap (after a local anesthesia for pain is administered a hollow needle is inserted in the vertebrae and a small sample of spinal fluid is collected).

Image Source: Centers for Disease Control and Prevention

Text Sources: Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services; World Health Organization (WHO) fact sheets; National Geographic, New York Times, Washington Post, Los Angeles Times, The New Yorker, Time, Reuters, Associated Press, AFP, Lonely Planet Guides and various websites books and other publications.

Last updated May 2022

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