Covering herself from head to toe in a traditional burqa, Asia, a young woman, was reluctant to reveal her disfigured face to doctors at the dermatology ward of the headquarters hospital in Ghilnai, Mohmand district, Khyber Pakhtunkhwa.
However, the medical team managed to examine his scarred face after some effort.
Cutaneous leishmaniasis (Cutaneous Leishmaniasis), which is a neglected disease and has been increasing steadily in the northwestern region of the country over the past several years.
Leishmania exists in three forms, including Cutaneous Leishmaniasis (CL), Visceral Leishmaniasis (VL) and Mucocutaneous Leishmaniasis (MCL).
According to an estimate by the World Health Organization (WHO), seven to one million new cases of Leishmania occur worldwide every year. According to experts, the disease affects some of the world’s poorest people and is linked to malnutrition, displacement, poverty, weakened immune systems, climate change and lack of financial resources.
Fazal Rahim, Leishmania Focal Person at Gholnai Headquarters Hospital, says: ‘The anxiety shown by Asia is not unusual for us as a response to the psychological trauma experienced by Leishmania patients, especially women. is common.’
He added that apart from severely damaging the skin, it also causes discomfort and affects the majority of the face of the body, causing psychological trauma to the patients.
Fazal explains that this infection causes a severe grief and mental trauma especially among young women, which is in line with the social norm of prioritizing beauty for a decent marriage. ‘This infection causes shame, depression, anxiety and self-loathing. It also shakes the confidence of patients, especially young girls, who are very concerned about their appearance.’
Dr. Rafiq Hayat Malizai, district health officer of Mohmand district, a hotspot of leishmania, said that more than four thousand patients of this disease were registered till June 2023 and the emotional impact of this disease is also seen in male patients.
Dr. Rafiq said that given the psychological trauma of leishmaniasis on the minds of patients, the treatment is giving preference to the young over the elderly, while among the young, girls are given priority over boys in using the limited resources of glucan time injection, which is a skin disease. There is an effective drug against Leishmania and it is being imported by the World Health Organization.
Similarly, school-going children are given priority in treatment provision over out-of-school children to avoid any disruption in learning due to any problems caused by classmates.
In a research study conducted by Bibi Sakina, a student of MPhil in the Department of Zoology, University of Peshawar, the effects of psychological stress on the minds of patients were also observed.
This study, considered the first in Pakistan regarding the psychological and social impact of Leishmania, observes that Cutaneous Leishmaniasis is not fatal, but unfortunately the disfigurement caused by this infection leads to general stigmatization and It adversely affects the social and economic well-being of patients.
In this regard, the research conducted through interviews with 130 patients in the Kuwait Teaching Hospital in Peshawar was highlighted. One of the most commonly identified stigmas is that affected young women face difficulties in finding jobs and getting married.
The survey revealed that patients have negative effects on their family, professional, personal and social lives and believe that the disease has significantly altered their natural beauty.
During interviews with 130 patients, about 37.69% reported that they always had negative feelings of hopelessness and anxiety. The study also made a startling finding that there is increasing evidence that leishmania infection among school-age children in endemic areas leads to school absenteeism.
Dr. Hafsa Usman, a dermatologist serving in Peshawar, says that most patients are more interested in removing the scar than treating it, which indicates psychological stress. He warned of an increase in the number of Leishmania patients in Khyber Pakhtunkhwa as people from adjoining districts like Khyber, Mohmand, Bajaur and Nowshera are coming to Peshawar in large numbers for treatment.
The Khyber Pakhtunkhwa Public Health Department’s epidemiological records also reflect a steady increase in the number of Leishmania cases over the past three years, with 3,177 in 2021, 18,180 in 2022 and 19,458 by August 2023.
In 2018, the southern region of Khyber Pakhtunkhwa witnessed a sudden outbreak of Leishmania affecting more than 28,000 people, prompting an international medical humanitarian organization, Doctors Without Borders (MSF), from Balochistan province to Khyber Pakhtunkhwa. Helped thousands of patients by providing free medical care till
Hafizullah, a mason by profession, said that eight members of his family, including an elderly mother and children, are affected by Leishmania and I can afford to bring all of them from Cherat (Nowshera) to Peshawar Hospital to continue treatment on a daily basis. Can’t even.
Hafeezullah, while consoling his three-year-old daughter after receiving Glucin Time injection at Naseerullah Khan Babar Memorial Hospital, said that they visited various health facilities in Nowshera but did not get regular injection. Finally, he made a difficult decision to come to Peshawar on a daily basis to bring all the sick family members to the Nasirullah Khan Teaching Hospital in turn on a motorcycle for treatment.
A vial of glucantime is available in the open market for Rs.2,000. “It is impossible for me to buy eight doses on a daily basis to treat eight members of the affected family,” he added.
Faqir Hussain, supervisor of the Dermatology Ward at Naseerullah Babar Hospital, says that they are getting about eight to 10 new patients on a daily basis.
Faqir said that almost all patients are treated with glucantime which is given according to the body weight of the person. A 20 kg child needs one ampoule per day for 20 to 28 days while an 80 kg person needs four five ml ampoules per day.
Dr. Halima Khalid, a member of MSF medical staff in Peshawar, said that since 2018, MSF has treated about 12,000 Leishmania patients in Khyber Pakhtunkhwa and 37,927 in Balochistan since 2008.
‘Despite the increase in the number of patients, MSF plans to expand CL activities in Khyber Pakhtunkhwa district.’
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MSF is also planning to depute a psychiatrist at Naseerullah Khan Babar Memorial Hospital in Peshawar to observe the symptoms of psychological stress in most of the patients and provide them with proper counseling, Dr. Halimah said.
In Kirk district, where nearly 10,000 leishmania cases have piled up, focal person Dr. Asad Zahoor said: ‘Apart from arranging treatment for leishmania infection from dermatologists, the government is also helping the mental health of patients by arranging psychological counseling. should also be paid attention to.
About 5,300 new and follow-up patients remain until September 2023.
Asad said that being a doctor, he gives some comforting words to the patients to give them hope for a speedy recovery, but proper counseling by psychologists is necessary to reduce the burden on the patient’s mind.
He also suggested free treatment of cosmetic deformity in public sector hospitals as most of the patients are poor and cannot afford plastic surgery.
Ajmal Khan, who works with the Integrated Vector Control Programme, suggested that ‘the hotspots of Leishmania are mostly in the southern districts of Khyber Pakhtunkhwa, especially in the newly merged districts where there is no entomologist and the government has no control over the infection. Filling these gaps should be seriously considered to prevent the vectors responsible for spreading the disease.’
He also suggested that people should be made aware of preventive measures like use of nets, repellents, insecticides, fumigation, waste management to reduce fly breeding sites and proper hygiene. Be careful.
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2024-08-31 22:22:34
