'White death' in Argentina: The hunger of poverty feeds tuberculosis

'White death' in Argentina: The hunger of poverty feeds tuberculosis

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In a poor Buenos Aires suburb, Cristian Molina's jeans and denim jacket hide his unhealthily slight frame, his legacy from years of a poor diet that left him susceptible to the tuberculosis infection he contracted earlier this year, a disease of poverty that is making a comeback in Argentina.

Molina, 26, lives in the shantytown of Lujan near the wealthy capital with his parents, six siblings and four nephews. Doctors think one brother contracted the disease in prison and then spread it around the family when he returned home.

. Buenos Aires, Argentina. Reuters/Magali Druscovich
Mariela, an infectious disease specialist intern, analyses an X-ray of 24-year-old patient Jorge, who is undergoing treatment for TB.

Cases of the "white death" illness, closely linked to malnutrition and poor housing, have been on the rise since the turn of the decade as Latin America's third largest economy has been battered by repeat recessions and inflation.

Currently, fast-rising prices and recession are driving more people below the poverty line and stoking homelessness and hunger.

. Buenos Aires, Argentina. Reuters/Magali Druscovich
Dr. Laura Lagrutta and Dr. Nicolas Castiglioni, both pulmonologists, who specialise in children with tuberculosis, talk inside Lagrutta's consultation room at Dr. Raul Vaccarezza Institute.

The poverty rate stood at above 35% in the first half of the year, hurting Argentine President Mauricio Macri, who is expected to lose the general elections this Sunday.

"Tuberculosis is the collateral damage of poverty," said Laura Lagrutta, an Argentine respiratory specialist focused on treating children with the disease.

. Buenos Aires, Argentina. Reuters/Magali Druscovich
Lucas (center), 24, a former tuberculosis patient, visits patients Jorge (left), 40, and Arturo Maldonado, 25, who have both been hospitalised for tuberculosis in Muniz public hospital. Lucas works for the Masantonio Organization where he visits tuberculosis patients with no family, helping them with their TB treatment and recovery.

According to the latest figures from the World Health Organization, there were 10,320 reports of new and relapsed TB cases in Argentina last year. The number of cases, which had dropped steadily since the 1980s, started to rise again after around 2010.

Tuberculosis kills 5,000 people every day globally and is one of the world's biggest killers.

. Buenos Aires, Argentina. Reuters/Magali Druscovich
A patient gets some fresh air in the hallway of Koch Pavilion, a hospital unit that is exclusively used by TB patients at the Muniz public hospital.

Farm-rich Argentina is still better off than some of its South American neighbors, including Brazil and Peru where incidence of the disease is higher. But the infection rate in Argentina is rising worrisomely.

Marcela Natiello, coordinator of the national TB and leprosy control program, said a declining trend since the 1980s had reversed in 2013, linked to "multiple and complex causes."

. Buenos Aires, Argentina. Reuters/Magali Druscovich
Arturo Maldonado, 25, who is from Peru, is treated for tuberculosis at the Muniz public hospital.

"TB primarily affects the most vulnerable populations, with low economic resources, residing in poor, badly ventilated and overcrowded environments," she said, adding that over half of all cases were in the populous area around Buenos Aires.

Doctors said the rise in the number of cases was straining some hospital wards where patients with TB are being treated.

. Buenos Aires, Argentina. Reuters/Magali Druscovich
Dr. Decarolis who specialises in patients with HIV and tuberculosis, visits patients that have been hospitalised in isolation for both diseases at the Muniz public hospital.

Patricia Figueroa, a social worker at the Muniz public hospital, said the facility was struggling with overcrowding as it faced a growing number of TB patients, which she described as "a record in recent history."

"Due to overcrowding, the hospital is discharging patients with low risk of contagion in order to receive high-risk ones, something very dangerous," she said, adding that the hospital was looking at how to add more beds to other wards to accept more people.

. Buenos Aires, Argentina. Reuters/Magali Druscovich
View of Villa 31.

In slums around the country Reuters spoke to many people with the disease, who all described living in cramped and insecure housing and lacking an ample supply of nutritious food.

In Villa 31, a populous shantytown neighborhood in the capital, Luli, 19, has gone through a year of treatment since contracting the disease while she was pregnant. She says her now-months-old baby luckily did not get infected.

. Buenos Aires, Argentina. Reuters/Magali Druscovich
Luli plays with her son at her home.

Luli lives in a flat with one bedroom, a kitchen and no bathroom together with her son and partner. The three sleep in one room. "We are constantly moving from one house to another because of the high price of the rent," she said.

. Buenos Aires, Argentina. Reuters/Magali Druscovich
A sample that tested positive for tuberculosis is seen from a microscope.

Daniel, 40, who lives in the same area, is also being treated for HIV, which made him more vulnerable to tuberculosis. He is largely immobilized with an injury to his hip as well as scarring on his lungs.

. Buenos Aires, Argentina. Reuters/Magali Druscovich
Brigida Simaniz checks her son's homework in her apartment in the shantytown of Bajo Flores.

Brigida Simaniz finished her TB treatment in May. She lives with her two children in the shantytown of Bajo Flores in Buenos Aires, all three sharing a single bed. She feared passing the infection to her kids.

"I was scared when they told me the diagnosis because I did not know it existed. I always followed the treatment as the doctors said for fear of infecting my children," said Simaniz, who works in a textile workshop earning 70 pesos ($1.19) an hour.

"Even though it was cold at night," she said, "I opened the windows of the room to circulate the air."

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Slideshow

Oscar moves a patient back to his hospital room at Muniz public hospital.
. Buenos Aires, Argentina. Reuters/Magali Druscovich

Oscar moves a patient back to his hospital room at Muniz public hospital.

Brigida Simaniz (not pictured) watches over her son Nicholas, 7, as he is examined by Dr Laura Lagrutta.
. Buenos Aires, Argentina. Reuters/Magali Druscovich

Brigida Simaniz (not pictured) watches over her son Nicholas, 7, as he is examined by Dr Laura Lagrutta.

Luis Barraga, 40, who has tuberculosis, waits for his lunch to be served in his hospital room at the Muniz public hospital. Luis was living on the street when he was admitted, weighing 45kg. In the two weeks that he had been there, his weight had increased to 60kg.
. Buenos Aires, Argentina. Reuters/Magali Druscovich

Luis Barraga, 40, who has tuberculosis, waits for his lunch to be served in his hospital room at the Muniz public hospital. Luis was living on the street when he was admitted, weighing 45kg. In the two weeks that he had been there, his weight had increased to 60kg.

Nora Costa (left) the director of Dr. Abel Cetrangolo Mycrobacteria Laboratory and her colleague Liliana Neira conduct tuberculosis lab tests at the laboratory.
. Buenos Aires, Argentina. Reuters/Magali Druscovich

Nora Costa (left) the director of Dr. Abel Cetrangolo Mycrobacteria Laboratory and her colleague Liliana Neira conduct tuberculosis lab tests at the laboratory.

Jonathan, 28, a former tuberculosis patient, waits for laboratory results at the Muniz public hospital.
. Buenos Aires, Argentina. Reuters/Magali Druscovich

Jonathan, 28, a former tuberculosis patient, waits for laboratory results at the Muniz public hospital.

Lucas, 24, a former tuberculosis patient, talks to a colleague during his lunch break at Masantonio Organization where he works and visits tuberculosis patients with no family, helping them with their TB treatment and recovery.
. Buenos Aires, Argentina. Reuters/Magali Druscovich

Lucas, 24, a former tuberculosis patient, talks to a colleague during his lunch break at Masantonio Organization where he works and visits tuberculosis patients with no family, helping them with their TB treatment and recovery.

Lucas talks to a colleague during his lunch break.
. Buenos Aires, Argentina. Reuters/Magali Druscovich

Lucas talks to a colleague during his lunch break.

Tuberculosis medication belonging to Cristian Molina is laid out on a table.
. Buenos Aires, Argentina. Reuters/Magali Druscovich

Tuberculosis medication belonging to Cristian Molina is laid out on a table.

Molina prepares to go to church.
. Buenos Aires, Argentina. Reuters/Magali Druscovich

Molina prepares to go to church.

Molina drinks a cup of mate with his siblings Xoana (left) and Manuel.
. Buenos Aires, Argentina. Reuters/Magali Druscovich

Molina drinks a cup of mate with his siblings Xoana (left) and Manuel.

Molina stands in the grocery store that he and his family own, which is part of the house that they live in. In the last two years, Molina's family have had to close the shop six times due to not being able to afford merchandise to stock the shop.
. Buenos Aires, Argentina. Reuters/Magali Druscovich

Molina stands in the grocery store that he and his family own, which is part of the house that they live in. In the last two years, Molina's family have had to close the shop six times due to not being able to afford merchandise to stock the shop.

Molina travels to visit his family.
. Buenos Aires, Argentina. Reuters/Magali Druscovich

Molina travels to visit his family.

Johanna, 26, who has tuberculosis, travels on a train to visit her daughter.
. Buenos Aires, Argentina. Reuters/Magali Druscovich

Johanna, 26, who has tuberculosis, travels on a train to visit her daughter.

Johanna gets ready to go out with friends.
. Buenos Aires, Argentina. Reuters/Magali Druscovich

Johanna gets ready to go out with friends.

Johanna talks with a friend in Villa 31 shantytown.
. Buenos Aires, Argentina. Reuters/Magali Druscovich

Johanna talks with a friend in Villa 31 shantytown.

Johanna plays with her daughter Mora, 10. After eight months of treatment, Johanna had been cured of tuberculosis and was searching for a job in the hopes that she could find a place to live with her daughter.
. Buenos Aires, Argentina. Reuters/Magali Druscovich

Johanna plays with her daughter Mora, 10. After eight months of treatment, Johanna had been cured of tuberculosis and was searching for a job in the hopes that she could find a place to live with her daughter.