**3. Conclusions**

Conflicts often result in significant displacements of large populations, both civilian and military. These displacements and the accompanying violence often lead to breakdowns in infection control in medical care facilities, disruption of public health and disease control programs, reduced access to populations in need, and greater exposure to vectors and environmental hazards [28]. All of these issues have application to the disease leishmaniasis. Public health and clinical workers in endemic areas should be aware of the increased risk of disease in the conflict environment, whether that conflict be a civil war, internecine strife, or a declared international conflict.

Of utmost importance in such environments is the establishment of effective disease surveil‐ lance, especially among the vulnerable population of impoverished or displaced persons. Surveillance systems are notoriously weak in conflict environments [28]. As a result, detection and reporting of outbreaks and epidemics are often delayed or even non-existent. This may be due to the absence of laboratory facilities or the lack of expertise required to collect, process and identify specimens. Vector surveillance programs can also be important in identifying locales where disease transmission risk is particularly high, but lack of access to the popula‐ tions at risk and to the surrounding environment may prevent any meaningful surveillance. The data from such surveillance programs are essential to the allocation of limited resources for control of several diseases associated with disrupted environments, including leishmania‐ sis, but if such allocation is impossible due to the conflict, the options for disease control are very limited.

It is well-known that many military forces voluntarily implement public health assistance for conflict-affected population. In addition, the militaries may spend a great deal of time researching effective prevention and treatment of disease among their own soldier population. These efforts often have application outside the originally military funding the research. Although certain benefits can be realized from increased awareness of disease effects as a result of foreign military presence in an endemic locale, in most instances it would be difficult to contend that the local populations see benefits in public health and disease control as a result of conflict. These general remarks have particular application to the disease called leishma‐ niasis.
