How to make Bangladesh leprosy-free
Leprosy is an infectious disease but the risk of developing the disease is low
Mohammad Rana Hossain
Though curable with timely and regular treatment and its test and treatment are available free of cost across the country, leprosy remains a health problem in our country. The disease continues to inflict sufferings on our people in different ways. According to the Leprosy Mission International-Bangladesh (TLMI-B), annually on an average about 4,000 new leprosy cases are detected in the country in the recent years. Of them, about 10% become disabled due to lack of proper and timely treatment.
We can defeat the disease by raising awareness among the general public by means such as word of mouth, experiences shared by former patients, school activities, quizzes and essay competitions with prizes, public talks, announcements, plays, puppet shows, posters and leaflets, religious leaders, local public representatives and the mass media. There will be positive impact on eradication of the disease if the means can be used in a proper way.
Awareness Raising Activities (ARA) through the means can inform public about the importance of the leprosy issue and also create a congenial atmosphere, motivating the authorities concerned to take necessary steps for eradication.
Rights activists said there are four key messages for the general public, which can be disseminated for awareness:
Curable: Leprosy is an infectious disease but the risk of developing the disease is low. It can be cured with drugs that are widely available and are free-of-charge.
Early signs of leprosy are pale or reddish skin patches, with loss of sensation; early detection with appropriate treatment helps to prevent disability from leprosy.
No need to be feared: The disease can be managed just like any other disease; affected people should not suffer any discrimination. Treated persons are no longer infectious.
Support: Affected people need the support and encouragement of their family and community, firstly, to take the multi-drug therapy (MDT) and any other treatment as prescribed, and secondly, to be able to live as normal a life as possible.
Leprosy is a chronic infectious disease caused by Mycobacterium leprae. It usually affects the skin and peripheral nerves. Leprosy is a leading cause of permanent physical disability. Timely diagnosis and treatment of cases is the most effective way of preventing the disability. Failure to take timely treatment results in disability, said doctors.
Leprosy still remains poorly understood and often feared by the general public, although it is not highly contagious and its very effective treatment is available.
The two most important components of the leprosy eradication programme are: timely detection of new cases and ensuring that all new patients who start MDT complete the full course of treatment within a reasonable period of time.
The ARA can be helpful in creating a situation conducive to voluntary reporting. Public education and community awareness are crucial to encourage individuals with leprosy and their families to undergo evaluation and treatment. It can inspire people for early diagnosis and complete treatment to minimise the likelihood of the disabilities.
Early case detection and treatment is the key to achieving eradication as detection of leprosy cases early in the community will lead to depletion of source of infection in the community and so interrupt the transmission of the disease, said TLMI-B.
World Health Organization (WHO) Strategy possesses two major components---early case detection and treatment of all patients. The core elements of the strategy focuses on improving community access to treatment by the general health services including: capacity building to enable all health facilities to diagnosis and treat leprosy; ensuring easy and uninterrupted access to free MDT by improving logistics; and motivating people to seek timely treatment by creating increased community awareness of the early signs and by changing the social perception of leprosy.
The ARA can highlight the matters to aware public on the necessity of timely treatment and prevention of leprosy to alleviate the sufferings of the patients. It is an effective way to persuade target audiences to go for the treatment, or to remind them of related information. Besides, it can also keep the public updated about the leprosy situation, consequences of neglecting the treatment, the rights of the affected people and motivate the government for ensuring the rights of the victims and their families.
The ARA can empower people to fight leprosy through removing prejudice and ensuring treatment and proper medical services. It can inform a large number of people about the availability of test and treatment of leprosy at free of cost across the country and whereabouts of the treatment centres. It can teach self-care skills and promote new health behaviours to the leprosy patients, and increase community acceptance of the leprosy
victims.
Leprosy has always been linked with stigma. For many people stigma is synonymous with leprosy. The fact that most of those with untreated leprosy end up with severe deformities and disfigurements has contributed to the stigma. The disease and its associated deformities are responsible for social stigma and discrimination against patients and their families in many societies.
The stigma and discrimination is due to lack of understanding and knowledge about leprosy - which increases misconceptions about the diseases transmission and treatment. Some studies have concluded that stigma affects many aspects of the lives of people affected by leprosy. The stigma is an important hurdle in self-reporting. Sometimes, the affected people, especially women, want to hide the disease and decline to take treatment voluntarily due to the prejudice.
Sumon Halder, country director of TLMI-B, said if the misconceptions about leprosy are not changed, it will be difficult to eradicate leprosy as a public health problem. A new environment free of stigma and fear needs to be created for early
diagnosis and treatment of the leprosy cases towards a leprosy free country.
The ARA can reduce the stigma and misinformation surrounding leprosy and promote social inclusion. To make the ARA more convincing, relevant quotations from our Constitution and other relevant international documents, which called for ensuring the rights of all the people without any discrimination, can be used.
There are some problems such as dearth of necessary manpower and quality health services, lack of specialized medical services and experts for leprosy, scarcity of funds for the leprosy programme, which are hampering the anti-leprosy programme.
It seemed that due attention is not being given to the leprosy issue now. The ARA should portray the existing situation on leprosy with comments from concerned sources and experts for motivating the authorities concerned to take necessary actions for redress. More action and investment on leprosy will drive down the diseases burden. Through the ARA, it is possible to draw the attention of the countrys policymakers to the issues, mentioned above. If steps are taken for carrying out the ARA properly and continuously, there will be a positive result regarding the diseases eradication programme. The ARA should be geared towards the goal of the eradication, to ensure that the physical and social burden of the disease continues to decline throughout the country.
The writer is a freelance journalist
