No medicine for leishmaniasis in Badakhshan Province

FAYZABAD, 10 June 2008 (IRIN) - Public health facilities in Badakhshan Province, northeastern Afghanistan, have run out of medicine to treat a disease which causes facial disfigurement and social stigma - leishmaniasis. The number of patients has risen sharply over the past two weeks, provincial health officials said. If left untreated, the disease can have a fatality rate as high as 100 percent within two years, according to the World Health Organization (WHO).

"Every day about 70 people come to us for leishmaniasis treatment," Momin Jalali, the director of Badakhshan health department, told IRIN on 9 June. "But we have not had any medicine for two weeks."

Health officials in Kabul said they were aware of the needs in Badakhshan Province but they had no medicines available to dispatch to the province.

"For the time being we do not have the medicines to send to Badakhshan," said Abdullah Fahim, spokesman for the Ministry of Public Health (MoPH), adding that proposals for the required medicine had been submitted to donors.

Najibullah Safi, programme manager of the national malaria and leishmaniasis control centre in Kabul, said about 1,000 anti-leishmaniasis ampoules were sent to Badakhshan earlier this year.

"More will be sent as soon as we receive them from donors," Safi said.

A nationwide problem

Cutaneous leishmaniasis is a major health problem in Afghanistan where over 300,000 cases were confirmed in 2007, according to MoPH statistics.

However, several cases of visceral leishmaniasis - a severe form in which the parasites migrate to the vital organs - have also been confirmed. In Kabul alone - often referred to as the capital of leishmaniasis - about 200,000 people were infected by the parasite in 2007, health officials said. The parasite is also prevalent in Kandahar, Khost, Takhar and Badakhshan provinces.

The leishmaniasis parasite is transmitted by the bite of female phlebotomine sandflies and mostly causes facial injuries, permanent scars and facial disfiguring, health specialists said.

"Expensive" treatment

Public health providers in Badakhshan Province said they were advising patients to seek medicine from private drug stores where the medicine was available.

However, the medicine is not available for all.

"The medicine is expensive and poor families cannot afford it," said Jalali of Badakhshan's health department, adding that a single anti-leishmaniasis ampoule costs about US$4. As a result, many patients have decided to endure the disease until the medication is available in Kabul.

Social stigma

Women and children are particularly vulnerable to the disease, health specialists said. Young girls and women who experience the disfiguring effect of leishmaniasis, especially in facial areas, often suffer social stigma. "Women and children are particularly affected and in some cases women may be treated as outcasts by their communities," the WHO said in a report.

About 2,000 students in different parts of Badakhshan, most of them girls, have reportedly been absent since the leishmaniasis outbreak started at the beginning of May, provincial officials said.

"Several men have cancelled their engagement to fiancées facially disfigured by leishmaniasis," Jalili told IRIN.    

Source: Integrated Regional Information Networks (IRIN), a project the Office for the Coordination of Humanitarian Affairs. IRIN is UN humanitarian news and information service, but may not necessarily reflect the views of the United Nations or its agencies.

[This report does not necessarily reflect the views of the United Nations]