Climate change and conflict drive leishmaniasis in Pakistan - Pakistan

The recent outbreak of discrimination, the spread of sand flying disease is the result of a perfect storm of Khyber Pakhtunkhwa.

Shabnam Bibi is quietly waiting for medical help. She stands in a crowded health facility in Landi Kotal, a city in Khyber tribal district of northern Pakistan. His face is a canvas of despair, with a 19 -year -old mother hesitating, revealing a major lesion. It indicates his left cheek and is spreading to his nose – a painful sign of skin infection, spread through the sand fly.

The facial lesion appeared 46 days ago. Shabnam (Baby is a common term used for South Asian women) first neglected it, but gradually it was forced to be isolated from his children. He feared the disease could affect them. Shabnam’s youngest child, a seven -month -old boy, is in his grandmother’s lap.

Two months ago, it was also cut by a sand fly, which led to a nodol on his small hand. Catching her scarf firmly, Shabnam fears her appearance, and she deeply remembers her other children.

Shabnam belongs to Shalman, a remote, hill and deprived area of this district, located inside Khyber Pakhtunkhwa province. There are many other people like this in this facility, going through similar tests: pain and poverty in the growing severe land of heat and drought.

Fighting both the physical and psychological tool of Lashmaniyas, the notorious stains around the state of Shabnam have been isolated. This is an excellent example of how neglected diseases such as Lashmaniosis can destroy not only the bodies, but also the entire life. This is especially true for the very weak groups: women and children.

A neglected disease

“Lashmaniyas is one of the eight Neglected diseasesHalima Khalid, Activity Manager for Borders (MSF) without doctors in Peshawar, says most of the poorer communications affect the poorer communities. “The lack of awareness about what this disease is ignored is. Although other diseases are widely developed for research and treatment, there are little focus on Lashmaniosis.

Initially, without early treatment, a small, painless, unsadial nodol appears, develops to become a lushmaniosis ulcerative and painful.

“Symptoms show symptoms from weeks after the cutting of the sand fly, says Nazma Habib, a professor at the University of Peshawar, who specializes in Lashmaniyas. “ She says the arrival of matters between November and March – transmission through the sandflies during the summer, then the incubation period that produces the lesions.

Epidemic Although the number of cases in less than hundreds – though contradictory reporting and under -diagnosis in remote areas, the exact number varies. Data obtained from the Khyber Pakhtunkhwa Department of Health Monitoring and Response System shows that the disease has reached the proportion of the outbreak since the disease. Between November 2018 and July 2019, 28,000 Cases were reported, followed by 3,177, 18,189 in 2021, 2022, ended 25,000 In 2023, and August 2024, another 14,000 reported.

In Khyber District alone, during October and November 2024, the Health Department registered more than 2,400 cases. Khyber Pakhtunkhwa has been recorded in a study in North Waziristan district. 2,603 Patient between October 2018 and December 2020. District border Afghanistan, where Katnius Lashmanis is common. This study highlights the spread of facial lesions in people of all ages, but the disease is the most severe in children and women.

In 2022, médecins Sans Frontiers In Peshawar and Bannu districts, each was the only organization to set up treatment centers in Khyber Pakhtunkhwa. Centers get an average of 300-500 patients daily. The growing number of cases indicated that the health department would open three more centers in the Khyber Tribal District (Landi Kotat, Jamrud and Bara).

However, the lack of necessary medicines and treatment centers in local markets – which are often located at a distance from the affected areas – prevent many people from getting timely treatment. These factors enable the disease to become more severe.

Warm In the weather 2017, a one -year -long sand fly was found in a one -year -long sandfly research in the Bajur district of Khyber Pakhtunkhwa (about 80 80 km northeast) northeast of the Khyber tribal district. The relationship. Positively with humidity and temperature.

In many factors, large -scale migration, population density and poor hygiene also encourage the increase in the sand flying population.

Khalid says, “The movement of the population affected by the climate is also helpful in its spread, as people from local areas can take the disease to non -modern territories.” Demographics Khyber Pakhtunkhwa is also conducive to the affected areas – especially with its southern and tribal districts, their mud houses, humid weather and poor cleaning.

Meanwhile, because of a decades -long war in Afghanistan The arrival of asylum seekers. This is in addition to the internal HomelessDue to 20 years of continuous conflict between groups along the Afghanistan -Pakistan border, and anti -insurgency operations within Khyber Pakhtunkhwa.

These factors have increased the range of natural resources through activities The harvest of forests And forgiving. In 1997, a large spread of Lashmaniyas Located At an Afghan refugee camp in Dir district of Khyber Pakhtunkhwa.

It is believed that more than 9,000 residents of the camp were contracted for more than a third of the 12 months. A 1999 study of the outbreak said that Lashmaniyas had never been reported before. As Khalid says, being largely displaced may be a large population of sand flying.

“Health and environment communication has never been part of the conflict strategy,” a senior Khyber Pakhtunkhwa Health Department official said. He says the health sector has been repeatedly shocked by the dispute.

Its department’s data shows that the region’s long -standing militants’ fighting is among the severely damaged infrastructure. In addition, government sanctions on the health sector have generally hindered public health awareness campaigns.

“When my friends look at me, try to keep the distance, fear that I can affect them, which causes me to suffer. So, I’m sitting alone,” 12 -year -old Sodis says. Yes. He is a lesion that covers his nose. Sodis along with his two brothers, along with his two brothers, used to distribute the floor in a two -room house in Khyber, a town in Khyber.

The honorary -bound tribal cultures of the region have a minor status of women, where the weather takes a severe and humorous turn. According to Habib, women are often banned from leaving their homes unopposed or seeking medical help, because in the tradition it is ordered that male doctors should avoid being inclined towards women.

Most doctors are consulted only once a disease is out of control. Therefore, these outbreaks affect both physical and psychological tools on women.

Habib says, “This dilemma is multi -faceted, especially in remote areas affected by Pakhtunkhwa dispute and climate disaster, where there is a lack of health care, and women cannot travel alone or they are hospitalized. I am not taken.

“The disease is not fatal, but it has severe psychological effects, especially on children and women, who often suffer from schools, society and even in the house, loneliness. Leaves and deepens feelings of anger and frustration due to his experiences in patients.

Psychological The effects are severe, especially for young girls: this stain can cultivate social notoriety and isolation, eliminate self -esteem and damage the possibility of marriage. These effects are especially harmful in a society where skin and facial beauty are considered special to girls.

Dialogue Earth discussed the solution with Dr. Qaiser Jamal of Parasiology at the University of Peshawar. He says a multi -faceted approach is essential to effective control of the disease, which includes public awareness, accessible health care and free medicines, adding: “Timely department of health. In order to start treatment and prevent complications, a quick and accurate diagnosis must be initiated. “

This article was written by Fawad Ali and was actually published Dialogue Earth The website has been reprinted with permission.

Header image: Gul Naib / Madison Sons Frontiers.

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