Biliary Atresia Liver Care Africa (BALCA)

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For Every Child Liver Life

Raising awareness and providing support to families across Africa impacted by the rare liver condition, Biliary Atresia.

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What is Biliary Atresia?

Biliary atresia is a rare but serious liver disease in infants.
It happens when the bile ducts inside or outside the liver are missing, blocked, or abnormally narrow. Because of this, bile (the digestive fluid made by the liver) cannot flow into the intestine as it should. Instead, it builds up in the liver, causing liver damage and scarring (cirrhosis).

What causes Biliary Atresia?

At the moment, there is no single known cause of biliary atresia. Instead, experts believe it happens because of a combination of factors that affect the bile ducts either before birth (during development) or shortly after birth.

Can Biliary Atresia Be Treated?

Yes — biliary atresia can be treated, but it cannot be cured without a liver transplant. The goal of treatment is to restore bile flow, protect the liver from damage, and help the child live a healthy life.

"Children with biliary atresia can live healthy and fulfilling lives. Regular hospital visits, blood tests, and ultrasounds will continue, but many children thrive well into adulthood, especially with early intervention and family support."
Carol Harris
Mom
About Balca

Biliary Atresia and Liver Care Africa (BALCA) is a registered non-governmental organization dedicated to raising awareness, supporting families, and advocating for improved care for children and individuals living with biliary atresia and other liver diseases. We exist to provide hope, information, and a strong support system for parents, caregivers, and patients affected by these conditions, while working with healthcare providers, policymakers, and partners to improve access to treatment and aftercare.

You are not alone

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the Symptoms

  1. Persistent jaundice: Yellowing of the skin and eyes that lasts beyond 2 weeks after birth.
  2. Dark urine: Urine may look like tea or cola.
  3. Pale/clay-colored stools: Stools may appear gray, white, or very light instead of yellow/brown (because bile isn’t reaching the intestines).
  1. Swollen belly (enlarged liver and/or spleen).
  2. Poor weight gain or slow growth (failure to thrive).
  3. Irritability or frequent crying (due to discomfort).
  4. Easy bruising or bleeding (as liver function worsens).
  5. Itchy skin (caused by bile buildup in the blood.
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Diagnosis

  1. Persistent jaundice beyond 2 weeks of age.
  2. Pale/clay-colored stools and dark urine.
  3. Enlarged liver or spleen on examination.
  1. Liver function tests: Show high levels of bilirubin (especially direct/conjugated bilirubin) and liver enzymes.
  2. Clotting and vitamin levels: To check liver health.
  1. Ultrasound: Looks at the liver and bile ducts; may show absent or abnormal gallbladder.
  2. Hepatobiliary scan (HIDA scan): A special dye is injected; if bile does not flow into the intestine, it suggests blockage.
  1. A small piece of liver tissue is taken.
  2. Under the microscope, doctors can see signs of bile duct damage and scarring.
  3. This is one of the most reliable tests.
  1. A dye is injected directly into the bile ducts to see if they are open or blocked.
  2. Confirms the diagnosis of biliary atresia before the Kasai surgery.
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Treatment Options

  1. What it is: The main surgery used to treat biliary atresia.
  2. How it works: The surgeon removes the damaged bile ducts outside the liver and attaches a loop of the baby’s intestine directly to the liver, so bile can drain.
  3. Best time: Before 2–3 months of age (earlier = better results).
  4. Outcome:
    • Some babies live for years with their own liver if the surgery works well.
    • But many will eventually still need a liver transplant.
  1. What it is: Replacing the baby’s damaged liver with a healthy one (whole or part of a liver).
  2. Sources:
    • Living donor (often a parent donates part of their liver).
    • Deceased donor.
  3. Outcome: This is the only cure for biliary atresia.
  4. With good medical care, many children go on to live healthy lives after the transplant.

Supportive / Medical Care

Even with surgery, children need ongoing treatment to stay healthy:

Nutrition:

  • High-calorie foods or special formulas.
  • Vitamins A, D, E, and K supplements (fat-soluble vitamins).
  • MCT (medium-chain triglyceride) oils for easier digestion.

Medications:

  • To improve bile flow (e.g., ursodeoxycholic acid).
  • To prevent or treat infections in the bile ducts (antibiotics).

Monitoring:

  • Regular checkups with liver specialists.
  • Blood tests and imaging to track liver health.
More info here

Biliary Atresia In Africa

Challenges in Africa

  • Late diagnosis: Many babies are seen only when jaundice is advanced, often after 3–6 months of age. By then, the Kasai surgery is less effective.
  • Limited awareness: Parents, caregivers, and even some healthcare providers may not recognize the importance of persistent jaundice and pale stools.
  • Shortage of pediatric liver specialists: Very few trained pediatric hepatologists and transplant surgeons.
  • Kasai surgery access: Only available in a handful of centers across Africa (such as South Africa, Egypt, and a few teaching hospitals in other countries).
  • Liver transplantation: Very limited — only a few countries (like South Africa and Egypt) have established pediatric liver transplant programs. In most of Africa, children needing a transplant must travel abroad, which is very costly.
  • Financial barriers: Families often cannot afford the high costs of surgery, transplants, and lifelong care.

Burden and Prevalence

  • Biliary atresia occurs worldwide, affecting about 1 in 8,000–18,000 live births.
  • In Africa, the exact number of cases is not well known, because there is little data, limited registries, and many children go undiagnosed.

Contact us today.

Address

Kibera Dr, Off Ngong’ Rd.

Phone

+254 786 285 259

Email

info@balca.org

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