Disfiguring skin disease plagues Afghanistan

By Robert Birsel

KABUL (Reuters) - The 10-year-old Afghan girl has big eyes, a shy smile and a dark lesion speckled with blood on her right cheek.

The girl has leishmaniasis, a disease caused by a parasite transmitted by a tiny sandfly that can lead to severe scarring, often on the face.

The girl, Sahima, wearing a purple tunic and trousers and pale blue shoes, answers "no" softly when asked if the sore hurts.

But her father is worried about the lesion, the size of a big coin.

"Of course, this doesn't look good," the father, Najibullah, said at a leishmaniasis clinic crowded with children with sores in the Afghan capital, Kabul.

Najibullah said he first noticed a mark on his daughter's face two months ago. "It was a very small dot but it grew and grew. If it grows any more it will cover her whole face."

Leishmaniasis isn't a priority for the government and its aid donors, grappling with shocking rates of infant mortality, tuberculosis, malaria and trauma.

The most common form of the disease is not fatal but it causes untold misery. Victims with scarring on their faces are stigmatized: children are excluded at school and girls often won't be able to find husbands.

Long-neglected by the rich world, the disease is attracting a bit more attention in the West, if not more funds.

Some foreign troops in Afghanistan and Iraq have also been bitten by the sandflies and have developed the disease. NATO saw about 150 cases in Afghanistan in 2005 and about 12 last year, a force spokeswoman said.

NATO camps have been fortified to try to stop the sandflies and soldiers are warned to keep sleeves rolled down, to use insect repellant and to watch for bites.

"DISEASE OF DESTRUCTION"

But it's Afghanistan's poor who are most vulnerable.

Kabul, battered and neglected for years, has the world's worst outbreak of leishmaniasis, health experts say.

"It's out of control, absolutely out of control," said Reto Steiner, a medic with the German Medical Service which helps run the Kabul clinic.