Photo taken on May 16, 2025 shows Ali Baloch, a minder, feeding a medicated meal to Malika, an elephant who has tuberculosis, at the Safari Park in Karachi. A team of Pakistani doctors is treating the stubborn sisters at least 400 pills each a day. RIZWAN TABASSUM / AFP via Getty Images

A team of doctors and vets in Pakistan has developed a novel treatment for a pair of elephants suffering from tuberculosis that involves feeding them at least 400 pills a day.

The jumbo effort by staff at the Karachi Safari Park involves administering the tablets -- the same as those used to treat TB in humans -- hidden inside food ranging from apples and bananas to Pakistani sweets

The amount of medication is adjusted to account for the weight of the 8,800-pound elephants.

But it's taken Madhubala and Malika several weeks to settle into the treatment after spitting out the first few doses they tasted of the bitter medicine and crankily charging their keepers.

"Giving treatment for TB to elephants is always challenging. Each day we use different methods," said Buddhika Bandara, a veterinary surgeon from Sri Lanka who flew in to oversee the treatment.

"The animals showed some stress in the beginning, but gradually they adapted to the procedure," said Bandara, who has helped more than a dozen elephants recover from the illness in Sri Lanka.

Ali Baloch, a minder, wakes early each day to stew rice and lentils, mixed with plenty of sugar cane molasses, and rolls the concoction into dozens of balls pierced with the tablets.

"I know the pills are bitter," the 22-year-old said, watching the elephants splashing under a hose to keep cool.

Karachi's history of TB in elephants
Four African elephants -- captured very young in the wild in Tanzania -- arrived in Karachi in 2009.

Noor Jehan died in 2023 at the age of 17, and another, Sonia, followed at the end of 2024. An autopsy showed she had contracted tuberculosis, which is endemic in Pakistan.

Tests carried out on Madhubala and Malika also came back positive and the city council -- which owns the safari park -- assembled a team to care for the pachyderms.

Bandara said it's not uncommon for elephants to contract the contagious illness from humans, but that Sonia -- and now Madhubala and Malika -- had shown no symptoms.

"It was surprising for me that elephants have TB," said Naseem Salahuddin, head of the Infectious Disease Department at the Indus Hospital and Health Network, who was enrolled to monitor staff.

"This is an interesting case for me and my students -- everyone wants to know about the procedure and its progress," she told AFP.

The team of four minders wear face masks and scrubs when feeding the elephants to avoid contracting a disease that infects more than 500,000 humans a year.

Karachi Safari Park has long been criticized for the mistreatment of captive animals -- including an elephant evacuated after a campaign by American singer Cher -- but is hoping its last two elephants will overcome the illness with a year-long treatment plan.


Photo taken on May 16, 2025 shows Ali Baloch, right, a minder, preparing medicated meals for Madhubala and Malika, elephants who have tuberculosis, at the Safari Park in Karachi. A team of Pakistani doctors is treating them at least 400 pills each a day. RIZWAN TABASSUM / AFP via Getty Images

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