Cutaneous leishmaniasis in Bara, a remote town,nestled within Khyber tribal district, has emerged as a pressing public health emergency.
This debilitating disease, caused by the bite of sandflies, has already affected nearly 2,700 individuals in the past year alone, with cases rising at an alarming rate. Children with conspicuous sores on their faces and hands wander aimlessly, their wounds stark evidence of the rapid spread of leishmaniasis in Bara. Women, however, bear their suffering in silence.
While leishmaniasis does not kill, its physical and psychological scars linger, often for a lifetime. The ongoing outbreak of leishmaniasis in Bara has exposed glaring gaps in healthcare infrastructure. Despite the provincial government’s allocation of 4,000 vials of Glucantime—the standard treatment for leishmaniasis—not a single dose has been delivered to Bara’s Tehsil Headquarters Hospital. Each day, an estimated 40 patients arrive at the hospital, only to return home untreated. “The injections are too expensive for most families,” a hospital worker admitted, speaking on condition of anonymity. “Without government support, we cannot meet the demand.”
The failure to provide timely treatment has left the local population disillusioned. “This happens every year, yet the authorities remain indifferent,” said Naveed Afridi, a community advocate. “Our children are suffering, and we are powerless to help them.”
Understanding Leishmaniasis
Leishmaniasis is caused by the bite of sandflies, which thrive in warm, unhygienic environments.
According to Dr. Nazma Habib, a zoology professor at Peshawar University, sandflies are small, rarely flying higher than three or four feet, making children their primary victims. “The disease manifests as persistent skin lesions that can last up to a year,” Dr. Habib explained. “Although not fatal, it significantly impacts the quality of life, especially for children.” The impoverished living conditions in Bara, characterized by mud-brick homes and proximity to livestock, provide the perfect breeding ground for sandflies. Infected individuals, particularly children, often face stigma and social isolation.
“The scars left by the disease are devastating, especially for young girls,” said Dr. Muhammad Nawaz, a dermatologist. “These marks can only be treated through costly plastic surgery, which is out of reach for most families.”
A Disease of Poverty
The World Health Organization categorizes leishmaniasis as a “disease of poverty.” The outbreak of leishmaniasis in Bara underscores the lack of healthcare access and sanitation in marginalized communities.
In Bara, women are particularly vulnerable. Many delay seeking treatment due to cultural norms, which prioritize men and boys for medical attention. “Women often endure the disease in silence, only seeking help when the situation becomes dire,” said a local health worker. Compounding the issue is the reliance on home remedies, which are often ineffective.
Many people turn to traditional methods rather than visiting a hospital, allowing leishmaniasis in Bara to progress unchecked. The crisis is not confined to Bara. Between 2014 and 2018, over 186,000 cases were reported across Pakistan. The disease first emerged with the influx of Afghan refugees and has since become endemic in parts of Balochistan and Khyber Pakhtunkhwa.
Despite the challenges, there are glimmers of hope. Last year, a community-led initiative in Landi Kotal treated over 1,000 patients, providing a model for grassroots action. “Community engagement is critical” said Rahat Shinwari, a social activist.”But the scale of this crisis requires government intervention and international support.”
As winter sets in, the visible symptoms of leishmaniasis in Bara—open sores and inflamed wounds—become harder to ignore. Yet, for the residents of this forgotten town, the scars of neglect run deeper. Without immediate action, the outbreak threatens to spiral further, leaving an already vulnerable population grappling with a preventable disease.
