Tuberculosis

Scaling Mont Blanc: A story of resilience for TB Patients

Scaling Mont Blanc to raise funds for tuberculosis (TB) treatment in Senegal, Riccardo Alagna's climb mirrors the challenges TB patients face, including unexpected hurdles and the critical support of a dedicated team. The determination of people beginning their months of TB treatment to recover is what provided his inspiration, explains Alagna.

“I knew it was going to be tough. But I just thought about how strong TB patients have to be when they start out on their six months of TB treatments…and that was the push I needed.”

Riccardo Alagna, QIAGEN’s Associate Director of Medical Affairs, reflects on his attempt to scale Mont Blanc – and the months of intensive training before it – in order to raise money for the Stop TB Italia NGO’s work in Senegal. “There’s a real parallel between climbing and starting TB treatment. The long journey to the summit mirrors the grueling six-month regimen of multiple antibiotics in TB treatment, which involves severe side effects and strict adherence. You have to stay determined,” says Riccardo.

On the first day of the two-day climb, everything went smoothly, Riccardo’s climbing partner and their guide overtaking other parties of climbers to reach the top of the first ridge before the Dôme du Goûter, a 4,000 meter peak in the Mont Blanc massif. On the second day, however, they were a mere 500 meters from the summit when they had to turn back.

“These things happen in the mountains,” says Riccardo. “It’s the last meters that count, and of course they’re the most challenging. When the sun started to rise my climbing partner began having nausea and headaches from the altitude.”

They had breakfast at midnight and began climbing at 1 a.m., aiming to reach the peak in time to safely descend. However, his partner soon experienced stomach pain and mental blackouts, exacerbated by adrenaline, lack of sleep, oxygen, and biting cold. "It's hard to imagine if you see a sunny picture, but believe me, it was freezing." he says. “So you need to keep moving otherwise you freeze.”

“You have this really long, sharp ridge, and if the snow is melting it’s too dangerous even for the guide to go through, not to mention non-experts like us.” They’d reached the very last bivouacs before the summit, so going any further would mean not being able to call for a helicopter if they got into difficulties. 
Riccardo "Ric" Alagna, Associate Director of Medical Affairs at QIAGEN and a volunteer with STOP TB Italia, is dedicated to fighting tuberculosis, using his background in microbiology and project management to support TB treatment efforts in rural areas such as Senegal. An experienced climber, Ric trained hard for his Mont Blanc climb, driven by the cause he was supporting. "I knew it was going to be tough. But I just thought about how strong TB patients have to be when they start out on their six months of TB treatments…and that was the push I needed." Usually, he hikes with his dog, Frida (pictured), but she sat this one out.
We were all ready and determined, but unfortunately high-altitude climbing doesn’t forgive. We were climbing with headlamps, it was minus 15 degrees and very windy. So when we arrived at the ridge, I saw his face and thought, ‘it’s done’.

STOP TB - Inspiration behind the hike

Turning back wasn’t a reflection of failing, but rather a testament to making wise decisions in the face of danger. And more importantly the fundraiser for STOP TB Italia was a success. “I didn't have any experience in Alpinism before my decision, but I decided to link it with fundraising in the way people do with things like the New York marathon.”

STOP TB Italia is dedicated to fighting tuberculosis in Italy and abroad. In 2017, it established an agricultural cooperative in rural Senegal managed by former TB patients. This project generates revenue for treating new patients and aiding their reintegration, despite the stigma they face. However, funding issues, exacerbated by COVID, prompted a goal to raise €6,000 to build a new water well.

The water in the aquifer is now being analyzed, and the infrastructure, including the pump and irrigation system, is expected to be completed by October 2024.

He also had a personal goal: “I'm a sporty guy. I did triathlon, so cycling and swimming are my sports, but I was also a smoker for many years. At the end of last year, I decided I needed to quit. So I wanted to trick my mind, and you can’t climb Mont Blanc if you smoke! So I quit smoking the next day and started training like crazy. And then came the fundraising idea, so I thought I can’t miss this opportunity,” he says.

The guide hadn't mentioned that only one in five climbers reach the summit on the Italian side. “He said, ‘Guys, you took the really hard way without any experience and you got really close.’ We saw people coming down from the French side, and they were all smiling and relaxed.”

Physically, Riccardo and his partner are fine now, apart from some knee pain. “That’s because you need to go from 4,300 to 1,500 meters in one day. On the last day, after starting walking at 1am we finished at 7.30 in the evening, so it was a really, really long day.” His backpack was also heavy with a banner displaying the names and logos of fundraising donors. “I felt every gram.”

There are two ways to approach the summit of Mont Blanc, the Italian route and the French route. “We were on the Italian side, which is the most challenging. We were six people overall – three climbers in addition to us – and they also pushed back because they were too slow.” It’s almost always a question of time since delays would mean heading back when the snow warms up and starts melting, making the steep peaks incredibly dangerous. However, the main mission of raising funds for the STOP TB initiative in Senegal was a success.
STOP TB Italia have built this circular economic system where former patients work in the cooperative and the revenue is then used to buy treatment for the new cases in the village.

From the bench to the field

Riccardo grew up in Palermo and was deciding on universities when the family doctor mentioned a new molecular biology course in English at the Università di Pavia, near Milan. “This was unusual – we always studied in Italian – so I said, ‘why not?’”

It was here that he “fell in love” with TB. “I didn’t like the basic research at the university because they told you that diseases are just pathogens, whereas in reality, especially for public health issues, the pathogen is just a piece of the puzzle when it comes to the burden of disease.” Then came a guest lecture by the head of the WHO’s global TB program in Geneva. “He didn’t touch on the pathogen at all. Instead, it was all about social conditions and the risks of developing the disease. It blew my mind because I was always interested in looking at many things at the same time. Then he told me that the Milan hospital, which is the WHO collaborating center, was looking for a biologist.”

Riccardo was put to work in the lab “pipetting and all those things, and after a while I said to the head of the laboratory, ‘this is not my life. I need to get in the field and see the reality.’” Soon, he was on his way to Djibouti, followed by a year in Burkina Faso and Ivory Coast, and a decade of return visits to Africa working in TB laboratory access.

Riccardo has been in the TB field for 13 years now – three at QIAGEN, and before that a decade at the San Raffaele Scientific Institute, a WHO collaborating center in Milano. It was here that he also began volunteering for STOP TB Italia, using his expertise as a microbiologist to help out on the project management and laboratory side of things.

“In countries like Senegal they lead some of the public health projects for tuberculosis control, and I'd been working for many years as a consultant for the WHO and Global Fund for strengthening TB laboratory access. It’s about understanding where we need to place more effort and money for increasing access.”

He still visits Senegal annually to help with Stop TB Italia’s doctor training courses. “We have volunteer doctors coming from Italy to train the doctors there about tuberculosis control and patient management, and I do the diagnostic side.”

It’s also something of an initiation test for the prospective volunteers, he explains. “People who work in TB in low-incidence countries don’t know how it works in these contexts. We need people volunteering and this helps them understand the conditions they’ll work in if they go to a high-burden country.”
STOP Italia TB has been working in the Dioffior district of Senegal to help address lack of access to treatment and information, and the fear and stigma associated with tuberculosis. TB remains a major public health challenge in Senegal, with an estimated incidence of 136 cases per 100,000 people. The country is yet to achieve the WHO targets of 70% case detection and 85% cured rates, which would reverse the epidemiological trend and contain the spread of infection.
People in low-resource countries are presenting at a really late stage of the disease. They recover in the first month, but they won’t be able to work or have any social life. And then you have the stigma, especially in a small village where everyone knows each other and everyone knows TB is related to poverty and living conditions.

Really seeing the difference

Stop TB Italia has achieved a lot with limited funds. “They lobbied villagers and the minister of health, eventually securing a 2000-square-meter field donated by the village head. They built a circular economic system where former TB patients work in the cooperative, and the revenue funds treatment for new cases in the village.”

The project's success led to more people seeking treatment. “The system is working, but it took three or four years to see returns from the cultivation because you need time.” Water is crucial. “The problem in Senegal is that a lot of the water is salt water, so you need to find suitable water for agriculture. Then they found this well, which initiated the need for funds.”

Operating in parts of Senegal is challenging. “We’re doing the most that’s possible,” he says. “In remote places, facilities are just a building with one nurse, not a doctor. They have minimal resources and refer patients with TB symptoms to the health center... With this small project, I’m proud to donate because I know the people and can see where the money goes.”

With both climbing and TB treatment, nothing prepares you “apart from being there,” he says. “The climb was an amazing experience and an important lesson. But what matters is the commitment to the cause.”

“When I got back, I reflected on our decision to turn back, which parallels TB treatment – unexpected problems, social stigma, and treatment issues. We turned back as a team, just as you need community support in TB treatment.” The importance of seeing it through to the end is crucial. “After a month of treatment, you start to feel better. That’s one of the most dangerous things because you think there’s no reason to continue.”

So will he be trying again next year? “Of course, and from the Italian side again! My brother is now saying he’ll come as well, so we start training in January.  I’ve learned that if you wait and listen to other people, you won’t do anything. So, if it’s TB treatment or anything else –whatever’s possible, do it.

“And I’m still not smoking!” he adds with a laugh. 

Ric carries a flag showcasing all the sponsors who supported his climb up Mont Blanc. "My backpack was heavy with a banner displaying the names and logos of fundraising donors. I felt every gram,” he says. Despite some knee pain from the grueling hike, Ric and his climbing partner are in good health, while the €6,000 raised will fund a new water well in Senegal. This well will support an agricultural cooperative run by former TB patients, generating revenue for ongoing treatment and aiding in their reintegration.

July 2024

Other stories