World Tibet Network News Monday, June 1, 1998

Respite but no cure for the "big-bone" disease

Asiaweek, May 30, 1998

In Brief

A LITTLE-KNOWN BONE ailment is making life a misery for millions of young people in rural China. Kashin-Beck disease stunts children's growth and inflicts chronic arthritis-like pain on adults. According to Francoise Mathieu, director of the KBD Project for Medecins Sans Frontieres (MSF), the disease is common in a crescent running from the Tibetan plateau across China to Siberia. There are an estimated three million sufferers, out of 30 million people living in the endemic areas. Says Mathieu: "In some villages, we found more than 80% of the people were affected by the disease."

There is no cure yet. Scientists are still working to discover the cause of the disease, which kills cartilage. The soft tissue turns into bone as children develop. In adults, a layer of cartilage remains to help ease wear and tear at the joints. But dead cartilage will prevent the bones from growing to their full length and cause the remaining bone cells to accumulate at swelling joints.

KBD is a particularly cruel blow in the farm communities where it is more common. Livelihoods are threatened as peasants find their ability to work the land curtailed by severe pain and difficulty in grasping farm tools. "Sometimes movement of the elbow is restricted to 30 degrees instead of the normal 160 degrees," says Mathieu. But the pain can be alleviated through massage and exercises. And that's where MSF physiotherapists come in. Invariably, sufferers report that they are most handicapped when ankles are affected, says Mathieu. Some patients can't even put their feet flat on the ground, which means walking is difficult.

Several lines of investigation hold clues to the origins of KBD. According to an earlier report in The Lancet, the presence of KBD in Tibet is related to the presence of certain fungi in barley, the diet staple. The fungi multiplies easily in damp areas where barley is stored, and once seeds are contaminated, the fungi will spread through the crop during the growing season. Elsewhere, researchers are examining whether the relatively low levels of selenium and iodine in sufferers is linked to their contracting the disease.