PESHAWAR, Oct 10: A large number of Afghan people suffering from leishmaniasis, especially children and young women, feel socially ostracized and there is a high probability of their being branded untouchables.

A study showed that patients attending leishmaniasis clinics in Kabul and other cities frequently reported feeling stigmatised because of their disease or excluded from normal activities.

Leishmaniasis is a skin disease that affects over five per cent of the total population in Afghanistan. Health Net International, which operates 200 clinics in collaboration with WHO and other partners since 1993 in seven regions of Afghanistan, say that cutaneous leishmaniasis (CL) has assumed epidemic level in Afghanistan.

The disease is reported to provoke feelings of disgust and fear of contagion, and there is a common perception that it is associated with low personal hygiene and sinfulness.

During the course of treatment, patients frequently report that they feel 'marked' by the disease and that special rules of exclusion were applied to them. The number of patients being treated in Kabul is reported to be 5,000.

HNI's coordinator Naeem Durrani said that 20 per cent of the people affected by the disease did not bother to seek treatment. Experts at the Ministry of Health in Kabul blamed the increase in the incidence of the disease on the 26-year-old war and said that it had caused widespread environmental damage.

Many students were concerned that they were being looked down upon by their classmates, and they felt compelled to stop attending schools. However, a significant minority, about 25 per cent, who said that they did not face such problems, adding they were generally accepted by others.

Some patients said they were required to eat separately and were told not to share a bed with other family members. Women who suffered from the disease often reported that they were not allowed to cook. This made them feel marginalized and isolated, but the feeling was significantly reduced if substitute labour was available within the household.

"Leishmaniasis has caused a sore on my nose. It looks bad and dirty. No one from my family wants me to drink from the glass they drink from. They try to stay away from me as well. I can feel the disgust in their gestures," a woman told a health worker associated with HNI in Kabul.

"My young son once told me 'mother, you shouldn't cook. We may fall ill, too, if we eat what you cook," a woman said. Women generally felt rejected and isolated more frequently than men. One girl even said that she sometimes felt suicidal. Some women expressed anger at the situation.

A 25-year-old woman with multiple facial lesions said: "My husband has become violent ever since I got leishmaniasis. Over a month ago, when my son got infected he got so paranoid that he told me not to touch our son."

HNI's survey showed that the disease was prevalent among seven per cent or 75,000 people in Kabul alone, four per cent or 20,000 people in Kandahar while the disease's prevalence was reported to be 2.9 per cent on 29 per 1000 people.