Barefoot on the Shoreline of Masonga
By Jonathan Delp 

When choosing a method of the most adventurous ways to die young...

I stood by an enormous eight-foot anthill, bordering the lakeshore village of Masonga, Tanzania. I decided death by fire ant had to be right near the top, up there with the heavyweights like hang gliding off the peak of Kilimanjaro without safety straps. Maybe death by fire ant isn’t the most realistic, but death by Schistosomiasis?

Sure, that’s every day here. But Schisto isn't sudden like a train or a bullet. Schisto is the killer where a fisherman wakes up at 35 and is fatigued. He's been fishing since 17 and infected since 20. 15 years of eggs being released into the bloodstream and embedded in vital organs and he wakes up one day as a young father of four, with the cirrhosis liver of a 70-year-old alcoholic. 
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And that’s how MAMA found itself walking a dirt path to the shoreline of Lake Victoria, trying to learn two things...

How great was the need and what could we do?

The local fishermen were suspicious at first of a group of random Americans browsing their shoreline for conversation about "Kichocho", or Schistosomiasis, or Bilharzia, the parasite with all those fancy names wreaking havoc in all the worst ways. We small-talked. They fished at night, and so during the afternoon, they lounged on stumps and rocks in the village. After getting to know us a little better, they decided the best way to describe their struggle was simply to live it for us. On their boat, they showed us how they fish at night with a lantern to lure the fish, with a thick, heavy mesh net they cast in a 50-meter radius. 

The fishermen were artists of the liquid cool. We could not believe this was humanly possible, but it was described, and then reinforced by multiple sources later, that the men would often have to dive down with a stick to find the fish and direct them towards the net. They would stay underwater for up to ten minutes. TEN MINUTES.

They had mastered this lake. They caught Nile Perch that ran a couple hundred pounds, and they did it in a wooden twenty-foot boat no larger than a life raft with an outboard motor slung on the back. This was their domain, and the only thing they could not conquer was the disease that plagued them because a dollar in pills was too much. 

Okay, here's the rundown on Schistosomiasis:

First off, it's gross. And it's not obscure. The WHO estimates over 200 million people are currently infected, mostly in Africa. The larvae live in snails along the shoreline. And since not even snails like to serve as nests for something that looks like it should be put into a blender and thrown into a volcano, the larvae leave the snails to grow. Like a good action flick, there's a timeline. They have about 24 hours to find a human host before their energy fades and they die.

They find human skin and penetrate. They grow into a feature-length worm, a "schistosome". I'm going to get nerdy for a minute. The male finds a female and they become a mated pair in the bloodstream. Romantic, right? They circulate, a couple of freeloaders on vacation, and they lay hundreds and thousands of eggs.

The human body isn't going to go down without a fight. We're resilient. So, the immune system creates a granulomatous response, little sandy nodules to every egg that coat the lungs and the liver and the bladder. These nodules are fibrotic and form scar tissue on all the worst places. 

These embedded eggs cause cirrhosis, cervical cancer, searing abdominal pain. It causes malnutrition in children. It causes a chronic cough in the lungs, extreme fatigue, and it's been studied that they make humans more susceptible to HIV, as the eggs drill through inner tissue, leaving it raw and vulnerable. 

The men are far from uneducated on the condition -- in fact, you could call them scholars of Schistosomiasis. But they cannot afford to abandon the water that keeps their families fed, and they cannot afford the roughly 50 to 80 American cents it would cost to treat themselves.

While we were there, they immediately asked if we had brought Praziquantel. We said no, but we would return, and in force. MAMA is currently gathering a team for February 2020, and the plan is to deworm 1,500 individuals along the lakeshore. We need your help to do this. The investment is small with an enormous impact. A grown person needs 4 to 6 pills, which protects them for a year. Of course, it doesn't just affect the fishermen -- children bathing and playing, mothers washing clothes. The lake is a life force. Water is precious, and so should be their peace of mind.

We awkwardly jumped off the boat onto shore. Pearl-white lake ducks and Crowned cranes flapped their great wings and lounged along the shoreline. From Masonga, you could look in three directions and see Uganda to the Northwest, Kenya to the Northeast, all as you stood in Tanzania. If they wanted to, they could say they fished three countries in a day.  

Back along the dirt path, we walked into the village, past burlap mats of fish laid out for sale along the shoreline by the village women. A group of children were fascinated by the visitors and walked with us. They were curious and alive, lungs full of a breeze that melted off the lake and saturated the village with electric vitality. They had each other, and they had community. 

They are the future, and the sons of those who pulled nets from the lake, muscle lean and taut with experience, generations of work and grit. They are the recipients of circumstance. Born on the lakeshore of Lake Michigan, Lake Erie, the Finger Lakes, they would worry only about how much they caught and their favorite way to cook it. 

I had stood next to the giant anthill, pondering morbidly on different ways to die. Jokingly, but still morbid. And as the children raced around the shoreline, yelling and laughing, you could see both the vibrancy and the struggle. Looking across a horizon spanning three countries, it was hard to want to think about anything that could make one die.

The only thing to think was, how easy it could be for them to live.