Afghan Refugees Spreading
Rare Diseases In Pakistan


ISLAMABAD, Pakistan (PNS) - A rare skin disease, Lieshmaniasis, has broken out in Kurram Agency through Afghan refugees living in a camp in where the World Health Organisation has reported found 738 infected cases, mostly in children under the age of 15.
Speaking at a news conference, WHO Spokesperson Lori Hieber-Girardet said the agency is working with local health authorities in the NWFP to control the outbreak of Lieshmaniasis. WHO feared, "If proper remedial measures are not taken to contain the disease through collaborative efforts of the concerned offices and NGOs, the situation may lead to a catastrophe."
She said these cases are amongst the local population and are in addition to 1,500 cases in Afghan refugee camps. The WHO official said at least 72% of the affected are unable to access medical treatment.
To a question, Lori said Lieshmaniasis could be completely cured, provided treatment is available. "The situation is further complicated by the fact that very few local physicians can differentiate between Lieshmaniasis and other skin diseases that may mimic the skin lesion of Lieshmaniasis, she warned.
The WHO official noted that currently, the drug used in the treatment of Lieshmaniasis, Injection Glucantime, is not registered in Pakistan. She said the agency has requested its headquarters to provide emergency supplies of the drug for the local population and Afghans living outside camps.
At the same time, Lori said the UNHCR would import the drug under a one-time license provided by the Federal Ministry of Health for Afghan refugees in camps.
Giving a background, the UN official said Lieshmaniasis is a rare disease in Pakistan, but in November 2001 the provincial health department of NWFP notified WHO of a large number of cases of Lieshmaniasis in several villages of Kurram agency, one of the afghan's refugees hosting agencies.
"To help NWFP province treat the cases and to prevent further spread of the disease, WHO has sponsored a rapid survey in Kurram agency. In addition to the new cases, the survey also found 289 cured cases, explained Lori.
WHO found the disease evenly distributed amongst both the genders, and "on the average each case has contracted the disease within last 6 months." Lieshmaniasis is a disease caused by the sand fly. "When the sand fly bites the skin, the organism is transmitted to the blood," explained the spokesperson.
There are two types of the disease: urban and rural. The most common type in Pakistan is called urban or Anthroponotic Lieshmaniasis. The disease is transmitted from humans to humans. Rural or Zoonotic Lieshmaniasis comes from the interaction of man with animal. The disease can manifest itself in two forms, Cutaneous and Systemic Lieshmaniasis.
Lori said Cutaneous Lieshmaniasis, can cause a lesion anywhere on the body but the most likely sites for these lesions are the exposed parts. "The lesion rapidly gives rise to a harsh-looking large ulcer. The ulcer frequently eats the tissues and even when the ulcer heals, it leads to permanent disfigurement," she told reporters.
While Systemic Lieshmaniasis, is more rare and invariably fatal if not treated promptly. It affects the internal body organs specially spleen and liver, she said.
The WHO official said the duration of the treatment varies from 8 to 90 days depending on the severity of the disease. She said Lieshmaniasis leaves permanent scarring which socially stigmatises those who contract the disease.
To control the spread of Lieshmaniasis, WHO suggested that preventive measures similar to those used against malaria should be used. The agency also suggested use of residual insecticide spray and bed nets.
Meanwhile, UNHCR Spokesman Yusuf Hassan said during the weekend, the number of Afghans massed at the Chaman border post has risen sharply to 13,000. He said the refugees have been stuck on a desolate windswept place where temperatures drop below zero at night without proper shelter or adequate assistance for days.
UNHCR called for urgent help for the vulnerable "so that they can receive medical care.
Yusuf believed, "To avert a humanitarian disaster, we are urging the authorities to allow us to move the vulnerable especially women and children to refugee camp where they can be assisted."
At the same time, UNHCR security mission has given go ahead to the agency to resume work in the Old Bagzai refugee camp in Kurram agency. UNHCR will resume relocation of refugees to Old Bagzai today, said the spokesman.

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