Timir Chachrabartee :
Leprosy-affected people are facing discrimination in different aspects of their lives such as education, employment, marriage, family and social life, health care, housing and even religion due to wrong perception about the disease in our society. Being deprived of their rights, they are undergoing untold sufferings.
If disabled due to the disease, the victims fail to perform work, maintain family, face problem in social participation, get isolated from family and friends. They are deemed as burden on family and society, deprived of various opportunities and depend on others. If not addressed properly, leprosy can bring serious economic and social consequences. Hence, it is essential to free our country from leprosy.
But there are challenges ahead us. The challenges are: ensuring early case detection and smooth supply of multi-drug therapy (MDT) all over the country, ensuring more attention, including increasing budgetary allocation, by the government to leprosy issue, taking steps so that all concerned can take part in the eradication programme.
These also include raising awareness by eliminating stigma for increasing self-reporting, developing capacity of health professionals so that they can provide proper services, taking treatment facilities of leprosy complications to nearby location of the affected people, and undertaking necessary steps for broadening the scope of study on leprosy in medical colleges.
Due to lack of proper attention to leprosy by the government, the programme has been dependent on NGOs now, but NGOs are unable to cope with the situation due to their fund shortage. International assistance to NGOs is decreasing since the government declared ‘elimination’ of the disease in 1998. Due initiative by the government is a must if we want success in the eradication programme.
Early case detection, the most important step in eradication of the disease, can be achieved by community participation for which vigorous information education communication (IEC) activities are required.
But the detection work is being hampered due to lack of adequate number of health workers. The government has required manpower and other facilities. The detection work can be done effectively if the government uses its health workers across the country after imparting necessary training to them.
Due to stigma, employers often dismiss leprosy-affected persons from jobs, owing to fear about the communicable nature of the disease. The affected people might be refused employment, while the self-employed sometimes lose customers. When people with leprosy become unemployed, they are no longer be able to support their families, losing familial and community respect. In addition, they might not be permitted to take part in public and religious activities.
Delay in seeking treatment can lead to disabilities, which reinforce stigma. Even when they are cured, stigma can continue to hinder the resumption of normal life. Negative perceptions of leprosy can continue to represent a barrier to reintegration in family life, employment and communities.
Stigmatization can be removed through education, awareness and advocacy. All stakeholders can play a role in helping people understand the disease. It is important to co-opt religious leaders in spreading awareness about leprosy. Often, fears are rooted in superstition, and religious leaders have the power to assuage these worries.
Specific interventions are needed to reduce stigma in the health services. The impact of leprosy on the socio-economic situation should not be underestimated. There is some evidence that interventions to improve people’s socio-economic status help to reduce stigma.
Positive images, experiences and role models should be used to break down existing stereotypes depicting people affected by leprosy as pitiful and disgusting.
Rehabilitation is an integral part of leprosy eradication. It must begin as soon as the disease is diagnosed. The cheapest and surest rehabilitation is to prevent physical deformities and social and vocational disruption by early diagnosis and adequate treatment.
Integration of leprosy into the general health service may greatly enhance the scope of leprosy service. By integration, discrimination against leprosy will be removed and the patients have access to the services of ophthalmologists, surgeons, physiotherapists, and general physicians.
“Leprosy, caused by Bacteria (germs), affects skin, inner lining of organs and nerves. If not treated in time, it can spread from person to person. Annually on an average over 3500 new leprosy cases are detected in the country in the recent years. About 10 percent of them later become disabled due to lack of timely treatment”, according to The Leprosy Mission International-Bangladesh (TLMI-B).
A leprosy affected person may develop disabilities if treatment is started late, taken irregularly and not completed. The disabilities can be prevented by practicing self-care and already existing disabilities can be corrected and affected part can be made functional by reconstructive surgery.
Leprosy services continue to be needed and should be strengthened and made more responsive to the diverse needs of the affected persons where possible, including to some of those formally declared ‘cured’.
The affected people need support and encouragement of their families and communities so that they are able to take the treatment regularly and are able to lead a normal life.
It should be our vision to make a leprosy-free society where there is no new leprosy case and all the needs of existing leprosy affected persons having been fully met. We need a national strategy that should envision delivering quality leprosy services through greater participation and meaningful involvement of the affected people and right-based approaches in leprosy services. The strategy should be as follows:
Early new case detection and their timely and complete management, quality leprosy services in an integrated setup by qualified health workers, prevention of impairment and disability associated with leprosy, rehabilitation of people affected by leprosy,
including medical and community-based rehabilitation, reduction of stigma and discrimination through advocacy, social mobilization, IEC activities, ensuring social inclusion and strengthening referral centers for complications management.
It also includes meaningful involvement of people affected by leprosy in leprosy services and addressing human right issues, promoting and conducting operational researches/studies, monitoring, supportive supervision including onsite coaching, surveillance and evaluation to ensure/strengthen quality leprosy services, strengthening partnership, co-operation, coordination with local government, external development partners, civil society and community-based organizations.
The following measures are important in the eradication of leprosy:
Health education should be directed towards the patients and their families, and the general public. The patients and the families should be educated about the need for regular treatment, repeated examination of contacts and self-care regarding the prevention of disabilities.
It is needed to generate awareness among people that leprosy is curable, regular and adequate treatment is essential to obtain cure and prevent disabilities.
People should be made aware that leprosy is not a hereditary disease, it is a bacterial disease like tuberculosis. Leprosy treatment is available for free across the country. It can help remove some of the social stigmas associated with the disease. Health education aims at ensuring community participation in order to achieve these objectives.
It is difficult to envisage effective leprosy eradication without a significant improvement in the socio-economic conditions of the affected communities. The economic and social problems of the patients and their families should be identified and met.
Leprosy eradication is a long term activity. Therefore, planning and programme management are essential ingredients. An important aspect of leprosy eradication is to assess the impact of the control operations on the endemicity of the disease, and to compare results between different times and places. Indicators are required for such an evaluation. It is important that these indicators can be easily used.
(The writer is a journalist)
Leprosy-affected people are facing discrimination in different aspects of their lives such as education, employment, marriage, family and social life, health care, housing and even religion due to wrong perception about the disease in our society. Being deprived of their rights, they are undergoing untold sufferings.
If disabled due to the disease, the victims fail to perform work, maintain family, face problem in social participation, get isolated from family and friends. They are deemed as burden on family and society, deprived of various opportunities and depend on others. If not addressed properly, leprosy can bring serious economic and social consequences. Hence, it is essential to free our country from leprosy.
But there are challenges ahead us. The challenges are: ensuring early case detection and smooth supply of multi-drug therapy (MDT) all over the country, ensuring more attention, including increasing budgetary allocation, by the government to leprosy issue, taking steps so that all concerned can take part in the eradication programme.
These also include raising awareness by eliminating stigma for increasing self-reporting, developing capacity of health professionals so that they can provide proper services, taking treatment facilities of leprosy complications to nearby location of the affected people, and undertaking necessary steps for broadening the scope of study on leprosy in medical colleges.
Due to lack of proper attention to leprosy by the government, the programme has been dependent on NGOs now, but NGOs are unable to cope with the situation due to their fund shortage. International assistance to NGOs is decreasing since the government declared ‘elimination’ of the disease in 1998. Due initiative by the government is a must if we want success in the eradication programme.
Early case detection, the most important step in eradication of the disease, can be achieved by community participation for which vigorous information education communication (IEC) activities are required.
But the detection work is being hampered due to lack of adequate number of health workers. The government has required manpower and other facilities. The detection work can be done effectively if the government uses its health workers across the country after imparting necessary training to them.
Due to stigma, employers often dismiss leprosy-affected persons from jobs, owing to fear about the communicable nature of the disease. The affected people might be refused employment, while the self-employed sometimes lose customers. When people with leprosy become unemployed, they are no longer be able to support their families, losing familial and community respect. In addition, they might not be permitted to take part in public and religious activities.
Delay in seeking treatment can lead to disabilities, which reinforce stigma. Even when they are cured, stigma can continue to hinder the resumption of normal life. Negative perceptions of leprosy can continue to represent a barrier to reintegration in family life, employment and communities.
Stigmatization can be removed through education, awareness and advocacy. All stakeholders can play a role in helping people understand the disease. It is important to co-opt religious leaders in spreading awareness about leprosy. Often, fears are rooted in superstition, and religious leaders have the power to assuage these worries.
Specific interventions are needed to reduce stigma in the health services. The impact of leprosy on the socio-economic situation should not be underestimated. There is some evidence that interventions to improve people’s socio-economic status help to reduce stigma.
Positive images, experiences and role models should be used to break down existing stereotypes depicting people affected by leprosy as pitiful and disgusting.
Rehabilitation is an integral part of leprosy eradication. It must begin as soon as the disease is diagnosed. The cheapest and surest rehabilitation is to prevent physical deformities and social and vocational disruption by early diagnosis and adequate treatment.
Integration of leprosy into the general health service may greatly enhance the scope of leprosy service. By integration, discrimination against leprosy will be removed and the patients have access to the services of ophthalmologists, surgeons, physiotherapists, and general physicians.
“Leprosy, caused by Bacteria (germs), affects skin, inner lining of organs and nerves. If not treated in time, it can spread from person to person. Annually on an average over 3500 new leprosy cases are detected in the country in the recent years. About 10 percent of them later become disabled due to lack of timely treatment”, according to The Leprosy Mission International-Bangladesh (TLMI-B).
A leprosy affected person may develop disabilities if treatment is started late, taken irregularly and not completed. The disabilities can be prevented by practicing self-care and already existing disabilities can be corrected and affected part can be made functional by reconstructive surgery.
Leprosy services continue to be needed and should be strengthened and made more responsive to the diverse needs of the affected persons where possible, including to some of those formally declared ‘cured’.
The affected people need support and encouragement of their families and communities so that they are able to take the treatment regularly and are able to lead a normal life.
It should be our vision to make a leprosy-free society where there is no new leprosy case and all the needs of existing leprosy affected persons having been fully met. We need a national strategy that should envision delivering quality leprosy services through greater participation and meaningful involvement of the affected people and right-based approaches in leprosy services. The strategy should be as follows:
Early new case detection and their timely and complete management, quality leprosy services in an integrated setup by qualified health workers, prevention of impairment and disability associated with leprosy, rehabilitation of people affected by leprosy,
including medical and community-based rehabilitation, reduction of stigma and discrimination through advocacy, social mobilization, IEC activities, ensuring social inclusion and strengthening referral centers for complications management.
It also includes meaningful involvement of people affected by leprosy in leprosy services and addressing human right issues, promoting and conducting operational researches/studies, monitoring, supportive supervision including onsite coaching, surveillance and evaluation to ensure/strengthen quality leprosy services, strengthening partnership, co-operation, coordination with local government, external development partners, civil society and community-based organizations.
The following measures are important in the eradication of leprosy:
Health education should be directed towards the patients and their families, and the general public. The patients and the families should be educated about the need for regular treatment, repeated examination of contacts and self-care regarding the prevention of disabilities.
It is needed to generate awareness among people that leprosy is curable, regular and adequate treatment is essential to obtain cure and prevent disabilities.
People should be made aware that leprosy is not a hereditary disease, it is a bacterial disease like tuberculosis. Leprosy treatment is available for free across the country. It can help remove some of the social stigmas associated with the disease. Health education aims at ensuring community participation in order to achieve these objectives.
It is difficult to envisage effective leprosy eradication without a significant improvement in the socio-economic conditions of the affected communities. The economic and social problems of the patients and their families should be identified and met.
Leprosy eradication is a long term activity. Therefore, planning and programme management are essential ingredients. An important aspect of leprosy eradication is to assess the impact of the control operations on the endemicity of the disease, and to compare results between different times and places. Indicators are required for such an evaluation. It is important that these indicators can be easily used.
(The writer is a journalist)
