No medicine for leishmaniasis in Badakhshan
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
"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
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.
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.
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
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