Nur-E-Alam Siddique :
Leprosy, the world’s oldest disease, has been synonymous with stigma and discrimination due to the hideous deformities it produced. The most important step in eradication of any communicable disease is to knock out the last case. This can be achieved essentially by community participation for which vigorous information, education, communication (IEC) activities are required. It is only the enlightened public that can provide the solution to any social or public health problem.
Global leprosy strategy aims at detection of all new cases before they develop disabilities and prompt initiation of treatment so as to ensure they are cured without any residual disability. This will have an impact on the transmission of infection in the community. Efforts need to be made to reduce deformity through early detection, self care, physiotherapy and reconstructive surgery and developing sound surveillance systems.
According to The Leprosy Mission International-Bangladesh (TLMI-B), the current reality is that there is a need to sustain and provide quality leprosy services to all persons through general health services, including good referral system. All these provisions in the integrated health care approach will go a long way in further reducing the stigma.
The Enhanced Global Strategy for further reducing the disease burden requires endorsement and commitment from everyone working towards the common goal of reducing the disease burden due to leprosy and its detrimental physical, social and economic consequences to move closer to achieving the common dream of “world without leprosy”.
Early detection and treatment with Multi-drug therapy (MDT) remains the best strategy for preventing the occurrence of disabilities. Other measures include training of leprosy patients to perform self-care practices, providing them with protective aids and referring the cases for surgery if indicated. Counselling and holding care and concern camps for prevention of disability (POD) are very much integrated with the prevention of disabilities. The problem, in social, economic and human terms is enormous and will need many partners to solve it, including the affected communities.
A comprehensive approach to rehabilitation is needed to maximize the benefit for the individual, family and society at large. Physical rehabilitation includes physiotherapy and occupational therapy, orthotics and prosthetic services, assistive and protective devices and sometimes corrective surgery. Social and economical rehabilitation aims at social integration, equal opportunities and economic advancement.
Community based rehabilitation (CBR) approach emphasizes community participation and empowerment of the individual involved. The government should have more schemes for providing financial support to disabled persons. We have to ensure that persons affected with leprosy are also included in these schemes.
Persons affected by leprosy, who are in need of rehabilitation, should have access to any existing (general) rehabilitation services. Similarly, where leprosy specific rehabilitation services are available, people with other disabilities should be given access. This facilitates integration, helps to break stigma and promotes sustainability of rehabilitation services. Harmonization of rehabilitation services provided by public and private sectors would be crucial in making such services a realty.
The ultimate goal of all these rehabilitation activities is empowerment of the disabled by providing them with the tools they need to attain independence and self-determination.
TLMI-B said, “For sustainable prevention of disability the ownership of prevention of disability has to pass to people and communities. Advocacy must play an increasing role to bring about change. It involves influencing those who are responsible to ensure that leprosy is included in health care and social care, and that people affected are fully included in all aspects of society”.
Challenges
Meaningful engagement of stakeholders including persons affected by leprosy using innovative media and marketing approaches will be required in order to overcome public apathy and political neglect.
Early detection of all patients before they develop disabilities, prompt treatment with uniform MDT regimen shortening the duration and inclusion of persons affected by leprosy will be the key tenets of the global leprosy strategy for the next five years (2016-2020).
Global research agenda also needs to be developed to ensure development of new tools for interrupting transmission of infection and reduce disability burden in the community.
The primary responsibility for leprosy control rests with the government. There is a need for different approaches including levels and intensity of collaboration at the national levels. The government should act through institutional partnership with NGOs, community-based organizations as well as people affected by leprosy. The collaboration should result in support to sustainability of expertise, resource mobilization and institutional development.
Persons affected by leprosy are an important resource for leprosy programmes and have a potential role to play in leprosy control. Strategies should focus on building the capacity of affected persons in advocacy skills.
Intensified action is needed to reduce leprosy and its transmission. Promote early case detection and ensure near 100% treatment completion rates, improve disability prevention and care, strengthen patient and community awareness on leprosy, improve case management, strengthen laboratory capacity for early detection of antibiotic resistance.
Sustain leprosy knowledge among the health workforce, promote societal inclusion through addressing all forms of discrimination, empower communities through participation in leprosy control and care, promote coalition building among people affected by leprosy, support social rehabilitation for leprosy affected people with disabilities, ensure that fundamental human rights can be enjoyed by all people affected by leprosy, and policy changes to improve quality of life of persons affected by leprosy.
The following preventive measures are important in the control of leprosy:
Health Education
Health education should be directed towards the patients and their families, and the general public. The patients and their families should be educated about the need for regular treatment, repeated examination of contacts, self-care regarding the prevention of disabilities, and protection of children. Generating awareness among people that leprosy is curable, not all leprosy patients are infectious, regular and adequate treatment is essential to obtain cure and prevent disabilities, and that the patients need sympathy and social support.
It should be impressed upon them that leprosy is not hereditary, casual contact with a patient does not cause leprosy. This 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. There is a growing realization that technological advances alone cannot solve the leprosy problem, unless we succeed in involving the public in the control programme. They should be made aware that leprosy is a bacterial disease like tuberculosis and that it is curable.
Socio-economic considerations
Preventing contact with infectious cases is an accepted method of controlling the spread of any communicable disease. It is difficult to envisage effective leprosy control 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 control is a long-term activity. Therefore, planning and program management are essential ingredients. An important aspect of leprosy control 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.
It is hoped that with the efforts of all the stakeholders and strong political will, the disease will be eradicated in the near future, ensuring a better life for all the people.
(The writer is a journalist)
Leprosy, the world’s oldest disease, has been synonymous with stigma and discrimination due to the hideous deformities it produced. The most important step in eradication of any communicable disease is to knock out the last case. This can be achieved essentially by community participation for which vigorous information, education, communication (IEC) activities are required. It is only the enlightened public that can provide the solution to any social or public health problem.
Global leprosy strategy aims at detection of all new cases before they develop disabilities and prompt initiation of treatment so as to ensure they are cured without any residual disability. This will have an impact on the transmission of infection in the community. Efforts need to be made to reduce deformity through early detection, self care, physiotherapy and reconstructive surgery and developing sound surveillance systems.
According to The Leprosy Mission International-Bangladesh (TLMI-B), the current reality is that there is a need to sustain and provide quality leprosy services to all persons through general health services, including good referral system. All these provisions in the integrated health care approach will go a long way in further reducing the stigma.
The Enhanced Global Strategy for further reducing the disease burden requires endorsement and commitment from everyone working towards the common goal of reducing the disease burden due to leprosy and its detrimental physical, social and economic consequences to move closer to achieving the common dream of “world without leprosy”.
Early detection and treatment with Multi-drug therapy (MDT) remains the best strategy for preventing the occurrence of disabilities. Other measures include training of leprosy patients to perform self-care practices, providing them with protective aids and referring the cases for surgery if indicated. Counselling and holding care and concern camps for prevention of disability (POD) are very much integrated with the prevention of disabilities. The problem, in social, economic and human terms is enormous and will need many partners to solve it, including the affected communities.
A comprehensive approach to rehabilitation is needed to maximize the benefit for the individual, family and society at large. Physical rehabilitation includes physiotherapy and occupational therapy, orthotics and prosthetic services, assistive and protective devices and sometimes corrective surgery. Social and economical rehabilitation aims at social integration, equal opportunities and economic advancement.
Community based rehabilitation (CBR) approach emphasizes community participation and empowerment of the individual involved. The government should have more schemes for providing financial support to disabled persons. We have to ensure that persons affected with leprosy are also included in these schemes.
Persons affected by leprosy, who are in need of rehabilitation, should have access to any existing (general) rehabilitation services. Similarly, where leprosy specific rehabilitation services are available, people with other disabilities should be given access. This facilitates integration, helps to break stigma and promotes sustainability of rehabilitation services. Harmonization of rehabilitation services provided by public and private sectors would be crucial in making such services a realty.
The ultimate goal of all these rehabilitation activities is empowerment of the disabled by providing them with the tools they need to attain independence and self-determination.
TLMI-B said, “For sustainable prevention of disability the ownership of prevention of disability has to pass to people and communities. Advocacy must play an increasing role to bring about change. It involves influencing those who are responsible to ensure that leprosy is included in health care and social care, and that people affected are fully included in all aspects of society”.
Challenges
Meaningful engagement of stakeholders including persons affected by leprosy using innovative media and marketing approaches will be required in order to overcome public apathy and political neglect.
Early detection of all patients before they develop disabilities, prompt treatment with uniform MDT regimen shortening the duration and inclusion of persons affected by leprosy will be the key tenets of the global leprosy strategy for the next five years (2016-2020).
Global research agenda also needs to be developed to ensure development of new tools for interrupting transmission of infection and reduce disability burden in the community.
The primary responsibility for leprosy control rests with the government. There is a need for different approaches including levels and intensity of collaboration at the national levels. The government should act through institutional partnership with NGOs, community-based organizations as well as people affected by leprosy. The collaboration should result in support to sustainability of expertise, resource mobilization and institutional development.
Persons affected by leprosy are an important resource for leprosy programmes and have a potential role to play in leprosy control. Strategies should focus on building the capacity of affected persons in advocacy skills.
Intensified action is needed to reduce leprosy and its transmission. Promote early case detection and ensure near 100% treatment completion rates, improve disability prevention and care, strengthen patient and community awareness on leprosy, improve case management, strengthen laboratory capacity for early detection of antibiotic resistance.
Sustain leprosy knowledge among the health workforce, promote societal inclusion through addressing all forms of discrimination, empower communities through participation in leprosy control and care, promote coalition building among people affected by leprosy, support social rehabilitation for leprosy affected people with disabilities, ensure that fundamental human rights can be enjoyed by all people affected by leprosy, and policy changes to improve quality of life of persons affected by leprosy.
The following preventive measures are important in the control of leprosy:
Health Education
Health education should be directed towards the patients and their families, and the general public. The patients and their families should be educated about the need for regular treatment, repeated examination of contacts, self-care regarding the prevention of disabilities, and protection of children. Generating awareness among people that leprosy is curable, not all leprosy patients are infectious, regular and adequate treatment is essential to obtain cure and prevent disabilities, and that the patients need sympathy and social support.
It should be impressed upon them that leprosy is not hereditary, casual contact with a patient does not cause leprosy. This 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. There is a growing realization that technological advances alone cannot solve the leprosy problem, unless we succeed in involving the public in the control programme. They should be made aware that leprosy is a bacterial disease like tuberculosis and that it is curable.
Socio-economic considerations
Preventing contact with infectious cases is an accepted method of controlling the spread of any communicable disease. It is difficult to envisage effective leprosy control 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 control is a long-term activity. Therefore, planning and program management are essential ingredients. An important aspect of leprosy control 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.
It is hoped that with the efforts of all the stakeholders and strong political will, the disease will be eradicated in the near future, ensuring a better life for all the people.
(The writer is a journalist)
