and Ismaeel Naar Millions of Syrians enduring yet another year of a devastating civil war face another natural disaster – an epidemic of a flesh-eating disease. Cutaneous leishmaniasis, a tropical disease that had previously been contained in Syria, is now reportedly spreading across the Middle East as millions flee their shattered homeland. The disfiguring infection, which can lead to severe scarring on the skin, is a parasitic disease spread by bites from infected sand flies. With the ongoing conflict overwhelming the country's medical facilities — along with the chronic lack of clean water — the situation has created a breeding ground for sand flies that carry the disease. In 2013, around 82,000 people in Syrian were estimated to carry the disease, according to figures by the Syrian-American medical society. Residents of the country's two largest cities, Aleppo and the capital Damascus, made up most of the victims before the war. Today, the regions most affected by leishmaniasis are the Daesh (the so-called IS) strongholds of Raqqah, Deir Azzor, and Hasakah. "Because these places are not historical hotspots of cutaneous leishmaniasis, this change might be attributed to the massive human displacement within Syria and the ecologic disruption of sand fly habitats," according to a study released in May by the US-based Centers for Disease Control and Prevention. Souheil Habbal, a Syrian-American doctor who returned to his homeland in 2013 to combat the epidemic when it first broke out, said that while the war in Syria continues, the disease will continue to spread. Before the war, the Syrian government would frequently spray areas in the north of the country — the area with the most disease-laden parasites — but that all stopped in 2011 when unrest began. "The new generation in Syria will bear the lasting scars of this disease through their lives that will forever remind them of this ugly war," Habbal said. Insecticides are usually sprayed as a way to kill the sand files, stopping them from infecting civilians with the disease. "The government, they used their helicopters — or whatever they used to spray with – but now they filling the helicopters with bombs instead," he added. Low in the list Since the war, medical priorities have changed dramatically in Syria. Habbal explained that medical priority is given to war casualties or those who suffer from chronic ailments such as diabetes – placing leishmaniasis low on the overflowing priority list. Syria's crumbling infrastructure is one of the culprits behind the spread of the infection. "There is trash everywhere which attracts rodents who are hosts of the parasite," Habbal said, adding that the mosquito-like parasite that carries the disease is too small to see, that "you don't even feel the bite." Medical expert Waleed Al-Salem, a consultant at the Saudi Health Ministry, told Al Arabiya English that non-profit organizations in Syria are struggling to contain the disease. "The problem right now is that the best treatment option of leishmaniasis is very expensive and rights groups need backing and funding from sources like the Gulf," he said, adding that the treatments currently used are not effective. With several parts of Syria siege by President Bashar Al-Assad's regime, Salem explained that for many access to medical treatment for the disease is difficult. "The Syrian regime also has to open up the areas as vaccines and treatments aren't getting to the people," said Salem. Beyond Syria In September 2012, a leishmaniasis outbreak began among Syrian refugees in Lebanon, according to the Center for Disease Control and Prevention. The epidemic was documented in refugee camps in eastern Lebanon and later expanded to camps throughout the country. Yet contrary to media reports, the disease is not contagious. "Leishmaniasis can only be transmitted by sand flies. So if an infected refugee from a Middle Eastern country goes to Germany, there are zero chances of transmission because there are no sand flies in Germany," he said. — Al Arabiya News
