Karel Prinsloo is an award-winning South African photographer who has spent 25 years largely working in Africa. Originally a news photographer, he has covered numerous conflicts and crises and was Chief Photographer for Associated Press covering East and Central Africa for over a decade. Today, Karel works mostly for NGOs as a freelance photographer and is based in Johannesburg.

In January 2015, Karel was commissioned by MSF to cover an outbreak of kala-azar (also known as visceral leishmaniasis, a deadly parasitic disease caused by sandfly) in MSF’s field hospital in remote Lankien, South Sudan.
 
“I used to be very concerned about being on the frontline, covering regional conflicts from my Nairobi base. Years of feeding the daily news wires had started to get repetitive though. I knew what to expect and the kinds of pictures I’d take.  I had covered the region for so long – DRC, Sudan, and Somalia – I was becoming quite sensitised: another refugee camp, another gruesome attack, another crisis.

My move to freelance photography, working mostly for NGOs across the continent has given me a whole new insight into photography. Whereas before I’d be traveling through snapping men with guns, today I’m sitting with the survivors quietly talking, feeling their pain or joy. I see much more of the long-term impact that conflict has on people, the defenseless, the poor, the children unable to escape.  It’s much more personal and I’m more sensitive than ever as a result. Becoming a father recently has also changed my outlook. I see my daughter in all the children I meet and think ‘What if this was her…?’”

Karel Prinsloo South Sudan
Kala patient Ruai Puot Malow (56) sits next to another patient at the Médecins Sans Frontières hospital in Lankien, South Sudan, 13 January 2015. 

As a news photographer, I’d often seen MSF teams in the field. Between us photographers and MSF, we’re usually the only ones staying when things get really bad.
 
In January last year, I was asked rather urgently by MSF to cover a serious outbreak of kala-azar in parts of Jonglei State, South Sudan. I’ve been to South Sudan countless times, and you can always gauge what’s happening in the country by the state of Juba airport. This time, the airstrip was lined with fighter planes and military personnel – a sign of the ongoing conflict which started in December 2013. Violence has displaced many people in Jonglei State province into areas where kala-azar is prevalent, and where little nourishment or protection is available. 
 
Kala azar is a fatal but completely treatable disease. With many health facilities closed or destroyed by the conflict, people were traveling vast distances to get help at MSF’s hospital in Lankien, which had expanded to include tents. It’s very hard for the families who come alo;ng to support the patients. Their journey is so long to get there that they live next to the hospital for months on end during the treatment.
 

Karel Prinsloo South Sudan
Kala azar sufferer Ruai Puot Malow (56 years) is assisted by his wife Yakuony Jock Deng (right) and a relative at an MSF hospital.

One morning, I caught sight of Ruai aged 56, being bathed by his wife Yakuony outside the hospital tent. He was in a very frail state and she was gently sponging him, helping him along. It was such a tender moment that I hesitated to take a photo. This image is of Yakuony (right) with an assistant helping Ruai back to his mattress after his bath. I was struck by the way they were supporting him. I took the picture from behind so as not to invade his privacy.
 
Later that day, I sat outside the hospital tent with a group of patients trying to keep cool. Temperatures get up to 38 °C in the shade in Lankien and inside the tents, it’s even hotter. You get very tired. At one point, one of the men suddenly sunk over with his head on his hands. He was obviously experiencing some kind of deep anguish. Both the disease and its treatment is very unpleasant, including months of painful daily injections directly into the muscles in your backside. I felt this was a powerful picture showing his helplessness against the overwhelming pain. 
 
When I take photos, my automatic response is to become very focused on my own safety; I can’t do anything for anyone if I’m not safe. Then I think about the subject and the mechanism of photography. I like to make people aware of my presence by sitting or talking to them for a while. It’s a very personal space that you’re intruding on and you want to feel their acceptance.

Karel Prinsloo in South Sudan
A kala-azar patient rests at a Médecins Sans Frontières hospital in Lankien, South Sudan, 13 January 2015.

I approach my photography from a news perspective, with straightforward, clean images. I find that overly artistic shots just confuse viewers. I avoid cluttered backgrounds, or extreme angles and lenses. I use minimal equipment and lenses that see like the eye does, avoiding distortion. The only editing I do is adjust the brightness and contrast, as you would in any dark room. The only reason I’m there is to tell people’s stories, so I try to take the most honest picture of what’s happening in front of me. It’s my way of conveying their message to the world.
 
I know I’ve saved lives through my photography, sometimes just by being there with a camera. Once I was in LRA territory, in northern Uganda with a colleague. We were covering the aftermath of a huge attack. A little boy wearing a scout uniform had been picked out as an LRA soldier and the crowd rushed over to beat him. They had killed someone earlier that day. We literally grabbed the child out of the mobs’ hands and said, “He’s with us.” He wouldn’t have survived otherwise.
 
If you can save even just one life, that’s the most amazing thing."
 
Read more of MSF's activities in South Sudan