Ronnie Polaneczky: SAND FLY

A sand fly (magnified below) - an insect that bit the son of Robin Zaborowski (above) in Afghanistan - causes leishmaniasis, a disabling and sometimes deadly tropical illness.
A sand fly (magnified below) - an insect that bit the son of Robin Zaborowski (above) in Afghanistan - causes leishmaniasis, a disabling and sometimes deadly tropical illness.
Posted: October 05, 2010

WHEN HER SON Richie Gegeckas enlisted in the Army in 2008, Robin Zaborowski knew that he'd eventually go to war.

So, when Gegeckas, 24, a specialist with the 10th Mountain Division, out of Fort Drum, N.Y., deployed last March for Afghanistan, Zaborowski entered the limbo in which so many mothers of war-zone soldiers reside: a place of tremendous pride, simmering worry and constant prayer for her child's safety.

"You know the worst that can happen. You think about gunshots and bombs," says Zaborowski, a 21-year Philly police officer. "I never thought he could be hurt by a fly."

But her strapping son has lost 15 pounds in the past two weeks, his lymph nodes are swollen and he's having trouble walking. He has contracted leishmaniasis, a parasitic disease spread by the bite of infected sand flies.

On his right leg, the spots where those flies attacked are marked by two hideous open sores that have worsened since Gegeckas sought medical help on his base near Mazar-e-Sharif.

The lesion on his calf is the size of a quarter and about a quarter-inch deep; the crater on his swollen thigh is more than twice that width and depth. Both are getting bigger by the day.

And from 7,000 miles away, Zaborowski, a mother of three sons, has been on a frantic mission to get her eldest boy the medical attention he needs.

According to Zaborowski, her son doesn't recall when he was bitten (leishmaniasis can take weeks to incubate), but Gegeckas visited the base doctor in early September, when he noticed two irritated spots on his leg. The doctor said that the spots were either mosquito bites or ingrown hairs, and sent him on his way.

About five days later, when the spots had become infected-looking, Gegeckas returned to the doctor, who prescribed an anti-fungal cream and told Gegeckas to keep the spots covered.

"A week later, the doctor removed the bandages and the spots were horrible," says Zaborowski. "The doctor said, 'They don't look good,' " says Zaborowski, quoting her son. "Richie was like, 'No s---. That's what I've been telling you.' "

Gegeckas was sent to a larger clinic an hour away, where he had blood work and a biopsy and was told to return to his base to await a diagnosis.

"I told him, 'No, you stay there!' " says Zaborowski, who has been in constant touch with Gegeckas via phone and Facebook these past weeks, becoming more alarmed about his worsening condition. " 'Tell them

you're not going back until they know what you have and how to treat it.' "

Eventually, the diagnosis came - leishmaniasis.

"We've seen about 1,500 cases among Iraq veterans," says Col. Glenn Wortmann, chief of infectious disease at Walter Reed Army Medical Center, in Washington.

"There have been fewer cases [among soldiers] in Afghanistan, since fewer soldiers have deployed there, but that number could change" with the surge of troops to the country.

Small lesions can be left untreated. Though irritating, they will usually heal within 10 weeks. The difficulties come when sores larger than a quarter do not show signs of closing on their own, said Wortmann, who has treated soldiers flown from the war zone to Walter Reed for precisely that reason.

The best drug to treat them is not licensed for that use by the FDA. It can be obtained only from the Centers for Disease Control and Prevention and given through the use of research protocols, which is how it's administered at Walter Reed. Like other medicines used to treat leishmaniasis, though, it's "problematic," said Wortmann.

"All the therapies have significant side effects" - among them pancreatitis, hepatitis, severe muscle aches and abnormal heart rhythms. "Most patients tolerate the side effects well. But some have severe reactions. So it's a balance of deciding whether to use the medicine versus letting a skin sore remain open, which is not lethal."

That judgment is best made by doctors who recognize the disease when they see it, who know when to leave it alone and who know when it's grown beyond their treatment capabilities.

Zaborowski doesn't know if that's the case with her son, only that he doesn't seem to be getting better.

After weeks of worry, last week Zaborowski contacted U.S. Rep. Patrick Murphy, whose director of military and veteran affairs, Mike Brown, placed a call on her behalf to the Pentagon.

"There are two sides to every story," Brown told me. "We wanted to alert the Army to Mrs. Zaborowski's concerns so they could look into her son's case."

Within 48 hours, a general visited Gegeckas at the clinic, said Zaborowski. " 'We know what's wrong with you, we're going to give you medicine and send you back to the base,' " she says he was told.

"But I don't want him to take any medicine for this unless he's in a hospital being watched. We don't know what the side effects could be," says Zaborowski.

"I'm not saying he has to be flown home for treatment. But he should be treated in a place where they know what they're doing."

When any soldier agrees to put himself in harm's way for his country, I think that's the least he deserves.

It shouldn't take a Mama Bear back home to fight for it.

E-mail or call 215-854-2217. For recent columns: Read Ronnie's blog at

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