Skin-Eating Disease Spread in the Middle East

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June 9, 2015
Amuda, Syria

A remarkable increase of people infected by Leishmaniasis is reported across the Middle East. As the ongoing conflict in Syria is causing the migration of thousands from the countrysides, many refugees and residents are exposed to the parasitic disease which is transmitted to humans through the bite of infected sand flies which breed in rubble and trash. The disease causes horrible open sores and well as disfiguring skin lesions.

Leishmaniasis, commonly known among Syrians as “Aleppo pimple”, had previously been contained in Aleppo and neighboring cities. However today’s refugee crisis has triggered a huge outbreak with hundreds of thousands affected in Syria and neighboring countries that are hosting Syrian refugees.
Reports indicated that ISIS-controlled territories, specially in Raqqa, Deir Azzor and Hasaka, are the regions most affected by Leishmaniasis.

Script

  1. soundbite (Arabic)
    Ali, Patient: 01:08 :: “My name is Ali, we are from Aleppo. I got infected and I had 11 pimples when we were still in Aleppo. I went to the pharmacist and I got a treatment, all pimples were gone but this one. I tried to cure it unsuccessfully. I came here to Amuda to cure it with injections. this infection is very dangerous, it does’t go easily.”
  2. soundbite (Arabic)
    Ali, Patient: 01:42 :: “My sister also is infected, she was bitten by an insect and got this pimple. We gave her the treatment in Aleppo and the pimple disappeared, but it appeared again now and it’s deep inside here cheek. She just got the injection now. I hope she gets better”.
  3. soundbite (Arabic)
    Raman, Patient: 02:43 :: “My name is Raman and I am from Amuda, I got the infection four months ago. At the beginning I thought it was because of my shoes I didn’t know that this was Leishmaniasis, I also went to the pharmacist who told me that the shoes is causing the pimple but then he discovered that this was Leishmaniasis. Currently I am receiving the treatment in this medical center.
  4. soundbite (Arabic)
    Haifa Mirzo, Medical Assistant: 04:14 :: “We are treating cases of Leishmaniasis on a daily basis. We are receiving patients between 9:00 am and 3:00 pm. We are able to treat people here but we are very short in medication. We need bigger quantities of medications as the number of patients is increasing fast. Since morning we received 10 cases, 6 of which is almost cured.”
  5. soundbite (Arabic)
    Dr. Juan Hajji Mohamed, Regional Director of the Leishmaniasis Treatment Centers: 05:08 ,: “Leishmaniasis comes from parasites, and it is transferred through an insect known as “Sand Fly”. Leishmaniasis hits humans and animals and specially rodents and dogs. We have two types of Leishmaniasis. Cutaneous Leishmanias is also known as “Aleppo Pimple” and was spread in Aleppo. It is mainly a visible pimple on the skin but causes no pain or friction. The second type is the Internal Leishmaniasis which is also spread by the same insect, the Sand Fly. This form of Leishmaniasis is not visible on the skin, meaning that when bit by the insect, the parasites are formed inside the body organs such as the liver, the spleen or even the bones. The Symptoms of the Internal Leishmaniasis are mainly fever for more than 2 weeks and swell of the liver, once the patient have these symptoms he should ask for a diagnosis for Internal Leishmaniasis.” “The Internal Leishmaniasis is deadly if not treated, unlike the the Cutaneous Leishmaniasis which we are treating to prevent any future marks. Internal Leishmaniasis is definitely deadly.” “Sand Flies come to the persons that is infected with Leishmaniasis and bite him, and in this way it is transferred to another person. The Leishmaniasis pimple is not transferred from person to another by touching it is transferred exclusively by Sand Flies. The disease is rapidly spreading in our area because of many factors, most importantly the exodus. Refugees from Aleppo who already had Leishmaniasis, came to safer areas where there were no Leishmaniasis cases. Sand Flies are present in these areas and this caused a spread of the disease.” “Sand Flies are mainly present in areas where there are destroyed buildings, marshlands and trash. All these are factors that helped the spread of Leishmaniasis in our area.” “Usually the treatment from Leishmaniasis takes three to four weeks. We give injections around the pimple twice a week. We used to give the injection once a week, but following instructions from the World Health Organization we are giving the injection twice a week, over 3 to 4 weeks. For Internal Leishmaniasis the treatment is daily. We give injections on a daily basis over 20 days. To protect ourselves from Leishmaniasis first we advise sleeping under a mosquito net and spraying anti-mosquito chemicals. We also advise clothing that covers all the body even in summer. The Leishmaniasis patient should cover his pimple, especially at sunset and until the morning, as this is the time when the insect is active, and it is very important to cover the pimples.” “In 2013 the Directorate of Health indicated 4,000 cases. In 2012 the cases went up to 12,000, so it doubled in 2015, and the number of infection is rapidly increasing every year. The statistics that we have here from September 2015 until now indicate that we have 3,500 cases. Of course the number of cases is way more than that but we only have access to limited areas.”
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