Muhammad Usman, 27, is from Lahore, a city that does not normally have high rates of cutaneous leishmaniasis (CL). However, after travelling to Multan in July 2023, where leishmaniasis (CL) is more common, nodules started appearing on his face. Usman sought medical attention at a government hospital in Lahore, where a biopsy was conducted for diagnostic purposes. The results did not show the Leishmania parasite.
“I was admitted to the hospital, and it dragged on so long that one day I asked to leave. Back home, my family grew very worried as nodules multiplied on my face; my condition was worsening at that time”. Usman could feel the changing behavior of people around him.
“Some people refused to shake hands with me, they tried to avoid me, but I didn’t take any notice”.
He returned to the hospital and did another biopsy, this time at a private lab: the test revealed that it was cutaneous leishmaniasis. The doctor in Lahore had heard about MSF’s leishmaniasis services in Khyber Pakhtunkhwa and Baluchistan, so he referred Muhammad to Peshawar, over 500 km away, for treatment. “The doctors told me they didn’t have the medicines and told me to try in Peshawar. I am so thankful that the treatment here worked wonders. The staff took good care of me, and other patients were so encouraging; some even supported me financially,” Usman said. MSF’s clinic in Peshawar offers ambulatory services to CL patients. It is based in the Naseerullah Babar Khan memorial hospital. Normally patients come in for treatment but are not hospitalized, however, the authorities made an exception in the case of Usman as he could not afford a hotel for the duration of the treatment. “I had never seen so many sores on someone’s body in my seven years dealing with CL patients,” says Muhammad Feroz Shah, 34, a medical technician with MSF since 2016. “The first time I met him, he was upset and uncertain about his chances of recovering. I encouraged him and assured him that he would get better soon,’’ Feroz said. “We were dressing the wounds every day. It was a very painful practice, and for Usman, it was even more painful because his lesions were so hard. It was so difficult to remove them, and it would take around 30 to 50 minutes daily to remove the crust and dress each lesion. He used to bear the pain, hoping to get well soon,” says Feroz.
Usman spent around 37 days in Peshawar. He is now back in Lahore after completing the treatment and is feeling much better. “For 28 days, they administered injections and then gave me oral medications,’’ he says, My health kept improving thanks to the treatment. My family is delighted to see that my face has cleared up”.
Usman is hopeful that within two or three weeks, the remaining marks on his face will also disappear. “I had to stop working at the farm in the last seven to eight months, and now I will be able to pick it up again; I am thinking about getting married soon once these spots disappear.”
“Usman was happy with his recovery, and so were we. When he was discharged from the hospital, he came to me, thanking us, and he was so delighted and excited. Although it was a difficult treatment experience, it was a good one as well because the result was the recovery of Usman,” Feroz said.
Usman’s only complaint is that he wished there had been a facility providing treatment for leishmaniasis in his hometown, so he wouldn’t have had to travel this far. Still, he is grateful for the treatment he received in Peshawar. “The CL healthcare workers took good care of me, and now I feel I’ve recovered. They are really nice people, and so were the other patients – kind and supportive,” he adds.
“I’m not ashamed of getting this disease that is just like any other diseases, so no big deal… Just go to a quality health centre like MSF’s clinic in Peshawar, where you can get free and quality treatment,” he says.
MSF has been offering CL services in Pakistan since 2008. Presently it runs five CL diagnostic and treatment centres in collaboration with the health authorities: three in Quetta district of Balochistan: Kuchlak health centre, Mohtarma Shaheed Benazir Bhutto General Hospital and Bolan Medical Complex Hospital and two in Khyber Pakhtunkhwa: in Bannu’s Khalifa Nawaz Gul teaching hospital, and in Peshawar Governmental Naseer Ullah Khan Babar Memorial Hospital with a satellite treatment centre in Rural Health Unit in Badaber.
