“It happened while I was on my way home from the market at 8:00 p.m.,” says Noon Makor Arop, a Doctors Without Borders/Médecins Sans Frontières (MSF) health promoter and community engagement supervisor in Abyei, South Sudan.
“I didn't realize it was a snake initially, but I soon felt pain and swelling in the bite area. I rushed to the hospital where my colleagues from MSF were working and I was treated with antivenom, recovered, and was discharged.”
Around 1.5 billion people worldwide — nearly one-fifth of the global population — require medical intervention for neglected tropical diseases (NTDs) like snakebite every year. There are 21 NTDs recognized by the World Health Organization (WHO), ranging from parasitic and bacterial infections to envenoming.
While progress has been made in controlling some NTDs in a few countries, the situation is worsening in some contexts due to funding cuts, conflict, climate crises, and fragile health systems.
NTDs are often fatal if left untreated, and some cause severe disfigurement and stigma. They disproportionately affect the most marginalized and displaced communities and frequently trap people in cycles of disability, social isolation, and poverty. Many of these diseases are preventable or treatable, but continue to be neglected.
Noon Makor Arop, MSF health promoter
From snakebite survivor to MSF health promoter
I have encountered many patients suffering from snakebites both in hospitals and in the community. Some of them have undergone serious surgeries because they arrived late at the hospital, often due to their reliance on traditional treatment methods.
In rural areas, health facilities often do not have high-quality antivenom, which is frequently unavailable or prohibitively expensive. For example, in Abyei, antivenom can only be found at Ameth Bek Referral Hospital, through the support of MSF teams. As a result, many patients miss the “golden hour,” which is critical for effective treatment.
Treating snakebite in South Sudan
Snakebite is a major public health emergency in countries like South Sudan, which has some of the lowest levels of ecological research on snakes, but a high number of reported snakebite cases. The risk of snakebite is at its peak between May and October each year due to climate-related changes like floods and heavy rains.
“Snakebite is frequently among the top 10 reasons for hospitalization in many hospitals across South Sudan,” says Noon. “This situation is exacerbated by extreme environmental conditions and a fragile health care system. In 2025 alone, MSF treated 197 patients for snakebites in just two hospitals in two areas, including Abyei, where I work.”
The WHO estimates that 5.4 million people are bitten by snakes every year. Around 138,000 people die annually as a result, while nearly three times as many survivors are left with permanent disabilities, including limb loss and long-term physical and psychological consequences. In MSF-supported hospitals globally, teams treat between 500 and 1,000 snakebite patients each year, often under extremely constrained conditions.
Noon’s tips to avoid and treat snakebite
To avoid a snakebite:
- Use light at night.
- Wear closed-toe shoes, especially in tall grass.
- If you see a snake, stay calm and move away.
In case of snakebite:
- Stay calm and avoid fast movement to slow the spread of venom.
- Remove jewelry or tight clothing before swelling occurs.
- Immobilize the injured limb with a splint or sling, keeping it at or below heart level.
- Do not use a tourniquet, which can cause limb loss.
- Avoid cutting, sucking, or icing the wound.
- Do not attempt to catch or kill the snake for identification.
- Get to a health facility as soon as possible.
Snakebite deaths and disabilities are largely preventable. What is missing is not the knowledge or the tools, but the political commitment and sustained investment to act now.
Despite having the highest mortality of all 21 NTDs, snakebite envenoming remains severely underfunded and overlooked. Investments in prevention, treatment, and access to safe antivenom are disproportionately low, even though effective solutions exist. Ensuring timely access to quality, affordable polyvalent antivenom, combined with proper clinical training and patient follow-up, would drastically reduce deaths, permanent disabilities, and the need for costly interventions such as intensive care, blood transfusions, surgery, or long-term rehabilitation.
Noma in Nigeria: Beyond the scars
An MSF-supported hospital in northern Nigeria is one of the few hospitals in the world where survivors of noma, a neglected tropical disease that affects the face and mouth, can access treatment.
“I remember when I was in primary school, only my cousin would agree to sit with me,” says Hussaini Usman.
Born in the northern state of Kebbi, Usman contracted noma as a kid. He was lucky to survive but faced abuse and discrimination as he grew up, and found it difficult to find a job. He was turned down based on how he looked.
“Some people were thinking that maybe God is punishing [me],” he says.
His experience is not unique. Noma survivors regularly report facing discrimination and social isolation, especially given the lack of public awareness about the disease.
MSF teams and staff from the state ministry of health are working to change this at the Sokoto Noma Hospital in northern Nigeria. There, MSF’s approach places equal emphasis on lifesaving medical care, rehabilitation, and community engagement to promote early diagnosis and reduce stigma. Noma survivors and their caregivers are able to access free care and a supportive environment. Between 2014, when MSF began supporting hospital activities, and 2025, MSF supported more than 1,600 major reconstructive surgeries for 1,074 patients.
“We take great care to ensure that our — usually young — patients and their caregivers feel comfortable and supported during what can be a traumatic period of their lives,” says Rosewiter Marunza, outreach medical team leader.
In 2023, a global campaign – led in part by MSF – secured noma a place on WHO’s official list of NTDs. This has opened new streams of funding and expanded awareness of the disease, which primarily affects children aged 2 to 6 years old and can lead to facial disfigurement and death if not treated immediately. The disease is often associated with extreme poverty and particularly impacts children with malnutrition and poor oral hygiene.
“The disease unfortunately can have a long-lasting stigma,” says Haruna Yohanna, nurse team supervisor. “I’m hopeful that in the years to come, this will go away as more people learn about what noma is and isn’t.”
For Usman, treatment and surgery at Sokoto Noma Hospital led to significant changes in his life, including the way he sees himself compared to others. Today, he works as a hygiene agent at the hospital, supporting patients and maintaining a safe care environment.
“Some of the people who were unable to associate with me have now started associating with me,” says Usman. “I have confidence now to join the congregation.”
Cutaneous leishmaniasis care in Pakistan
Cutaneous leishmaniasis is a significant public health burden in Pakistan, causing skin lesions and ulcers on exposed parts of the body. While it is not life-threatening, it can cause severe physical disfigurement, and lead to stigmatization and discrimination which negatively affects patients’ mental health and self-esteem. According to the WHO, an estimated 600,000 to 1 million new cases occur worldwide annually, but only around 200,000 are reported. Despite the high disease burden, access to timely and effective treatment remains limited in Pakistan.
“Meglumine is one of the most efficient treatments against cutaneous leishmaniasis, however, it is not produced in Pakistan,” says Dr. Abdulwahab Mohamed, MSF medical coordinator in Pakistan. “Its supply largely depends on imports, which often arrive irregularly and in insufficient quantities. Since the COVID-19 pandemic, supply disruptions have become more frequent, making sustainability of care a serious challenge. Government facilities often run out of stock before replacements arrive, putting patients at risk of delayed or missed treatment.”
“Many times, people waste months visiting different doctors without healing,” says Tahir Zaman, a patient from Karak. “For example, my mother and elder brother spent six to seven months receiving spray treatment in Karak, but instead of improving, their condition worsened. Finally, we brought them to Peshawar to start proper treatment.”
Besides access to meglumine, there is an urgent need for sustained political commitment, strengthened surveillance, and community-based interventions that can reduce transmission, prevent disfigurement, and assist the affected individuals to live a dignified life, particularly children and young people in endemic settings like Pakistan.
MSF has been providing cutaneous leishmaniasis diagnosis and treatment services in Pakistan since 2008. Our teams are also exploring alternative treatment options and supporting drug research in collaboration with the University of Peshawar, alongside clinical trials in Quetta, Balochistan. To support capacity-building, MSF provides targeted training to Ministry of Health staff and other health workers to improve diagnosis, treatment quality, and long-term sustainability of care. In 2025, MSF screened over 11,000 patients for cutaneous leishmaniasis across its facilities, with over 7,000 patients starting treatment in Khyber Pakhtunkhwa and Balochistan.
