11 Sep 2008 - Last winter, a team of Pakistani doctors working in the remote district of Dir in the far North West Frontier Province made a startling discovery: many of their patients had contracted a rare disease, cutaneous leishmaniasis. It is a parasitic disease spread by the bite of infected sand flies. It causes painful skin sores and disfiguring skin ulcers and can damage the internal organs and bone marrow.
In March, responding to calls for help from local health authorities, the International Rescue Committee dispatched a team of paramedics to the site of the outbreak, where they joined local health workers in containing what was feared might become an epidemic. The United Nations refugee agency, UNHCR, soon asked the IRC take over its malaria and leishmaniasis control program in the region.
Since then, the IRC has made the prevention of these diseases a central part of its primary healthcare programs in the region. It has also introduced new more effective methods of disease control. Previously, health workers used the mass spraying of insecticide in affected areas. This eventually led to sand flies and mosquitoes developing a resistance to the insecticide and even worse outbreaks of disease. The IRC by contrast uses insecticide treated mosquito nets and targeted select indoor spraying.
The results have been impressive, say members of the control program: Over the past six months, the incidence of leishmaniasis in two large camps for Afghan refugees has decreased significantly while there have been no outbreaks of malaria. Meanwhile, an aggressive treatment program using combination drug therapy has resulted in a 100 percent cure rate for refugees previously ill with malaria.
The IRC program is the first of its kind in Pakistan to use mosquito nets and combination therapy as part of its strategy to battle malaria and leishmaniasis.
