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Caption: Bilharzia. Doctor examining the swollen abdomen of an 11-year-old boy with intestinal schistosomiasis (bilharzia). Bilharzia is caused by blood flukes (Schistosoma sp.) that penetrate the skin when someone is in infected water. The flukes have reached the blood vessels of his intestines, leading to liver and spleen enlargement. Other symptoms include anaemia, diarrhoea, dysentery and liver cirrhosis. This boy's growth has been stunted by the disease: he is only 120cm tall and weighs just 22kg. Photographed at the Hunan Institute of Parasitic Diseases, China, in 1999.

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