<HTML><BODY style="word-wrap: break-word; -khtml-nbsp-mode: space; -khtml-line-break: after-white-space; "><BLOCKQUOTE type="cite"><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">Date: Tue, 8 May 2007 18:09:12 -0400 (EDT)</SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">From: ProMED-mail <<A href="mailto:promed@promed.isid.harvard.edu">promed@promed.isid.harvard.edu</A>></SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">Subject: PRO/AH/EDR> Leishmaniasis - Afghanistan</SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 14px/normal Helvetica; min-height: 17px; "><BR></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">LEISHMANIASIS - AFGHANISTAN</SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">***************************</SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">A ProMED-mail post</SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"><<A href="http://www.promedmail.org">http://www.promedmail.org</A>></SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">ProMED-mail is a program of the</SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">International Society for Infectious Diseases</SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"><<A href="http://www.isid.org">http://www.isid.org</A>></SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 14px/normal Helvetica; min-height: 17px; "><BR></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">Date: Mon 7 May 2007</SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">Source: Reuters Foundation Alertnet [edited]</SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"><<A href="http://www.netscape.com/viewstory/2007/05/06/disfiguring-skin-disease-plagues-afghanistan/?url=http%3A%2F%2Fwww.alertnet.org%2Fthenews%2Fnewsdesk%2FISL156505.htm&frame=true">http://www.netscape.com/viewstory/2007/05/06/disfiguring-skin-disease-plagues-afghanistan/?url=http%3A%2F%2Fwww.alertnet.org%2Fthenews%2Fnewsdesk%2FISL156505.htm&frame=true</A>></SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 14px/normal Helvetica; min-height: 17px; "><BR></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 14px/normal Helvetica; min-height: 17px; "><BR></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">The 10 year old Afghan girl has big eyes, a shy smile, and a dark lesion</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">speckled with blood on her right cheek. The girl has leishmaniasis, a</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">disease caused by a parasite transmitted by a tiny sandfly that can lead to</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">severe scarring, often on the face. The girl, wearing a purple tunic,</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">trousers, and pale blue shoes, answers "no" softly when asked if the sore</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">hurts. But her father is worried about the lesion, the size of a big coin.</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">"Of course, this doesn't look good," the father said, at a leishmaniasis</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">clinic crowded with children with sores in the Afghan capital, Kabul. [The</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">man] said he first noticed a mark on his daughter's face 2 months ago. "It</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">was a very small dot but it grew and grew. If it grows any more it will</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">cover her whole face."</SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 14px/normal Helvetica; min-height: 17px; "><BR></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">Leishmaniasis isn't a priority for the government and its aid donors,</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">grappling with shocking rates of infant mortality, tuberculosis, malaria,</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">and trauma.</SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 14px/normal Helvetica; min-height: 17px; "><BR></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">The most common form of the disease is not fatal but it causes untold</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">misery. Victims with scarring on their faces are stigmatized: children are</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">excluded at school and girls often won't be able to find husbands. Long</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">neglected by the rich world, the disease is attracting a bit more attention</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">in the west, if not more funds. Some foreign troops in Afghanistan and Iraq</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">have also been bitten by the sandflies and developed the disease. NATO (the</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">North Atlantic Treaty Organization) saw about 150 cases in Afghanistan in</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">2005 and about 12 last year [2006], a spokeswoman said. NATO camps have</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">been fortified to try to stop the sandflies and soldiers are warned to keep</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">sleeves rolled down, to use insect repellant, and to watch for bites.</SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 14px/normal Helvetica; min-height: 17px; "><BR></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">Kabul, battered and neglected for years, has the world's worst outbreak of</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">leishmaniasis, health experts say. "It's out of control, absolutely out of</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">control," said Reto Steiner, a medic with the German Medical Service which</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">helps run the Kabul clinic. "You won't control it until the sanitation has</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">recovered." The deep ulcers caused by the parasites will heal if left</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">untreated, but that invariably involves disfigurement and can take many</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">months. That has given rise to one of the diseases many nicknames:</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">'saldana', or one-year sore. Though present in all Afghan cities, it is in</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">Kabul's crowded neighborhoods that the disease has exploded and spread to</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">hundreds of thousands of people.</SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 14px/normal Helvetica; min-height: 17px; "><BR></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">"When we have one case in a family, of course, it's not only one case: it</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">will be all the family and even the neighbors," said health ministry</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">official Abdullah Fahim. The sandflies that spread the parasites are</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">carried by animals including dogs and a species of gerbil, as well as</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">people. The insects often breed on waste land and in rubbish. Although they</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">don't fly well, the insects infest the cracks and crevices in people's</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">homes from where they emerge to bite exposed parts of the body -- noses,</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">chins, cheeks, and hands -- as people sleep, from late spring to autumn.</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">"It's a disease of destruction," said Toby Leslie, a researcher from the</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">London School of Hygiene and Tropical Medicine. "It will thrive in post-war</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">areas and areas where there's poor sanitation, poor community services."</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">Cutaneous leishmaniasis is not fatal although a less-common form, visceral</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">leishmaniasis, can cause organ failure and death. "Leishmaniasis is one of</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">the top neglected diseases, certainly outside Africa, and it just doesn't</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">attract the funding that's needed," Leslie said.</SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 14px/normal Helvetica; min-height: 17px; "><BR></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">Doctor Faquir Amin says he's been treating leishmaniasis since the 1960s.</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">Refugees returning from abroad are particularly susceptible as they have no</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">resistance, he said. "No one's taking care of it. The people are coming,</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">it's crowded, the people are susceptible and the disease is increasing,"</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">Amin said at his Kabul clinic. "It is not a killer disease but mentally</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">people suffer. We have to deal with it." The sores are treated with a</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">course of injections, or cauterized to kill the parasites. Amin's clinic</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">has the only laser cauterizing machine in Afghanistan. Electric cauterizing</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">machines are also effective and much cheaper.</SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 14px/normal Helvetica; min-height: 17px; "><BR></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">Prevention is also key, experts say. Bed nets impregnated with insecticide</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">are being distributed to stop malaria and they will also stop sandflies</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">spreading leishmaniasis. But only a few nets are being distributed compared</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">with the number needed. "The ministry is battling to get funds and no one's</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">interested. It's impossible to get funds," said Health Ministry adviser</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">Kathy Fiekert. "This is an issue that needs to be addressed."</SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 14px/normal Helvetica; min-height: 17px; "><BR></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">[byline: Robert Birsel]</SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 14px/normal Helvetica; min-height: 17px; "><BR></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">- --</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">communicated by:</SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">ProMED-mail</SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"><<A href="mailto:promed@promedmail.org">promed@promedmail.org</A>></SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 14px/normal Helvetica; min-height: 17px; "><BR></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">[A survey in 2003 by HealthNet International in Faizabad, Badakshan</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">province, Afghanistan, found that 8.3 per cent of the surveyed people had</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">cutaneous leishmaniasis lesions (see ProMED-mail: Leishmaniasis -</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">Afghanistan 20030909.2267). The last WHO (World Health Organization) update</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">on the situation, from 22 May 2002, estimated that there were 200 000 cases</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">in Kabul alone, but it may well have deteriorated since then. The average</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">life expectancy at birth for male and females in Afghanistan is 42 years</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">(2005) and the annual expenditure on health per capita is USD 14 (2004)</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">(see WHO</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"><<A href="http://www.who.int/whosis/database/core/core_select_process.cfm">http://www.who.int/whosis/database/core/core_select_process.cfm</A>>). - Mod.EP</SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;">A map of Afghanistan is available at</SPAN></FONT><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"> </SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" size="4"><SPAN class="Apple-style-span" style="font-size: 14px;"><<A href="http://www.un.org/Depts/Cartographic/map/profile/afghanis.pdf">http://www.un.org/Depts/Cartographic/map/profile/afghanis.pdf</A>>. - CopyEd.MJ]</SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><BR class="khtml-block-placeholder"></DIV></BLOCKQUOTE></BODY></HTML>