BEIRUT: A disfiguring and tough to treat boil and several other sanitary health problems are on the rise among Syrian refugees in Lebanon, as hundreds of thousands seek shelter in increasingly difficult conditions and only half have access to medical care.

Lebanese officials have reported several cases of tuberculosis and Hepatitis A in Syrian refugee areas. The aid organization Medecins Sans Frontieres has treated cases of lice, scabies and the skin disease leishmaniasis, said its Head of Mission Fabio Forgione.

“We have seen an increase in certain diseases related to overcrowding and poor living conditions,” he said.

Particularly worrisome to the aid workers is leishmaniasis, which currently cannot be treated because the needed drugs are not available.

The skin infection usually spreads through a parasite in a sandfly and begins as a small boil that grows several sizes before it bursts, leaving a disfiguring indented scar.

The infection initially sparked concerns of leprosy, which caused boils resembling those of the affliction. Forgione said MSF was working on importing the required drugs for the 16 patients the organization was caring for.

So far most of the diseases are treatable if aid workers can reach the refugees, and there isn’t a risk of a mass outbreak.

“We are not witnessing any extremely worrying kinds of outbreaks; most of the diseases are related to living conditions,” Forgione said.

The increase in health problems comes as the United Nations struggles to help over 265,000 refugees and reach many more people who have yet to seek aid. Despite the U.N. registering nearly 50,000 refugees a month, according to U.N. reports, the number of unregistered refugees continues to increase while their living conditions decline. Aid and government officials also estimate that there are between 50,000 and 100,000 refugees in the country who remain unregistered.

Most refugees now live in alternative shelters and housing, many of which are not insulated from the cold, and lack running water and sanitary facilities. Aid workers in the Bekaa Valley say sanitary conditions are noticeably worse than several months ago, and recent surveys back up their claims.

A report issued this week by MSF warns of dire and worsening conditions for refugees in the country based on a statistical survey of refugee households. The findings are stark: 50 percent of refugees are not getting the needed medical treatment because of cost and 33 percent of people have been forced to stop treatment for a health condition because of the expense. More than 12 people are often sharing a single room, the report found, some people could not afford drinking water and in several areas the majority of refugees reported receiving no aid at all.

“It remains too expensive and too difficult for many among these populations in distress to access essential medications, children’s vaccinations, prenatal and obstetric care or medical management of chronic conditions,” the report said.

Much of the health work is currently done through the World Health Organization and the Health Ministry, which works with the U.N. High Commissioner for Refugees. But the funding on the government side has begun to dwindle, and ministers say unless they receive a large influx of foreign aid they will not be able to meet health needs. The government has launched a $180 million appeal for funds to expand its aid operations and take control of aid work in the country, which includes $75 million for the Health Ministry.

Making the treatment of disease more problematic is the distribution of refugees in Lebanon. The job and low income housing markets quickly became saturated in the east and north of the country near Syria, causing refugees to head to the west and south in search of work and affordable housing.

Syrian refugees in Jordan and Turkey are mostly concentrated in camps where humanitarian organizations operate aid hubs.

Without camps in Lebanon, aid workers have to spread out to reach refugees in the cities of Sidon, Tyre, Arsal, Tripoli and every village, town and tent community in between.