Leprosy eradication can ensure a better future

The National Leprosy Elimination Programme (NLEP) needs to promote voluntary reporting by increasing community awareness regarding early signs of leprosy, curability with treatment and availability of treatment

Leprosy is one of the world’s most stigmatized diseases. Still today people affected by leprosy can be marginalised, excluded and mistreated by the communities and societies they live in. It is an issue of basic human rights and we need to tackle both the superstitions and myths that lead to injustice as well as the denial of equality and human rights. People affected by leprosy are most empowered when they are accepted back into their communities with a sense of pride, dignity and self-worth. 

In Bangladesh, leprosy is still a health problem. Through curable with timely and full treatment, and its treatment and test are free in the country, the disease continues to inflict sufferings on our people.
According to The Leprosy Mission International-Bangladesh (TLMI-B), annually, on an average about 4,000 new cases are detected in the country in the recent years. About 10 percent of the victims later become disabled due to lack of timely treatment. Being disabled, they lost earning capacity for their families. But it is possible to check the disability, caused by leprosy, if it is diagnosed early and treated regularly and completely.
According to an unofficial estimate, about 3000 to 3500 leprosy patients take medical services from hospitals in the country for two months every year. It means that we have to spend a lot of money for the purpose. It is essential to eradicate the disease as people are facing both social and economic problems due to the disease.          
“Leprosy is an infectious disease of the skin and nerves. The main symptom of leprosy is disfiguring skin sores, lumps, or bumps that do not go away after several weeks or months. The disease targets the nervous system, which includes the feet, hands and face”, said TLMI-B.
It is needed to eradicate the disease on an emergency basis. Taking necessary steps for detecting new leprosy cases can play an important role in the drive. The government should play the leading role in this regard, otherwise, the objective would not be achieved, said the rights activists.     
Among the different methods of active case detection, priority should be given to the survey of family contacts. The contact survey should be undertaken immediately after detection of any case in the family and subsequently registration of the leprosy case if identified.
National Leprosy Elimination Programme (NLEP) needs to promote voluntary reporting by increasing community awareness regarding early signs of leprosy, curability with treatment and availability of treatment free of cost and importance of early case detection and by providing efficient diagnostic and treatment services to all leprosy patients.      
There are pocket areas where leprosy prevalence is still high. A good number of people Released from Treatment (RFT) are not yet covered by community-based rehabilitation programme. We need to take a holistic approach, caring for the physical, social, spiritual and psychological needs of people affected by leprosy. We should work with the affected people, many of whom have few rights. 
We should develop the capacity of the victims to help them do self-advocacy. We need an environment that enables them to achieve improved and sustainable livelihood. Our goal should be to realize a sustainable improvement in the health and socio-economic development of the people disabled by leprosy. 
We want leprosy expertise retained and further developed. We need to ensure early case detection, quality and quick treatment, continuous multidrug therapy (MDT) supply, and counseling (during and after treatment) for the leprosy victims and their families. 
Referral from general medical practitioners and different medical institutions should be promoted especially in urban areas by establishing linkage with them.     
Leprosy complication and management (Simple ulcer, reactions and neuritis care)/POD, and reconstructive surgery are needed. Provision for assistive devices, good functional referral system, self-care capacity enhancement for the leprosy victims and disability care centre in the community for the affected people are also required.     We should pursue governance and clinical system at all levels of government health system that allows people affected by leprosy to have medical services at all public health centers. Integration at the basic level is understood to ensure space for leprosy treatment in all upazilla health complexes, MDT services and gradual complication management in the government health system.
We want to see a future where access to quality leprosy and other treatment is available through the government to ensure that even if TLMI-B and/or other NGO’s are not providing leprosy services, that services will still be provided and accessible at all government health complexes.   
We need advocacy to develop and promote an enabling and sustaining environment in the community/society that acknowledges and respects individually and collectively the basic human rights of every member of the society, including people with leprosy and disability, actively creates opportunity to exercise those rights and takes corrective measures in the case of violation of such rights so that each member of the society can express her/his full potential and live a meaningful life with dignity.
We can hold lobbying networking and using pressure groups to press for policy change wherever necessary, advocacy with concerned authorities for ensuring enough education on leprosy in MBBS and nursing curriculum for integration of treatment of leprosy, advocacy with government health institutions to get their staff training in leprosy care updated and work for ensuring that the affected people are not deprived of different disabled people’s facilities made available for them.
We can also hold advocacy with employers and industrialists for job opportunities for the affected people, advocacy with parliamentarians to harmonize any law anything contrary to human rights granted to all citizens by constitution and also by the Universal Declaration of Human Rights and the UN Convention on the Rights of People with Disabilities.
It seems that persons affected by leprosy (PAL) remained as service recipients or as beneficiaries. It is very much important to change this view and transform them as partner. Representatives from organizations of PAL should be included in planning, monitoring and evaluation at both local and central level. The core theme should be “transformation of patients’ attitude from beneficiary to partnership”.           
We need awareness programme for reducing self-stigma as well as social stigma. It will increase social acceptance of the victims. 
Awareness and capacity building of the families of the affected people on leprosy and leprosy complication are important. 
For awareness, we can use different means such as the mass media, orientation and teaching with people affected by leprosy, federations and associations, seminars with religious leaders, community leaders, human rights activists, national day observation with leprosy message, meetings with different types of stakeholders and slide shows, street play, street rallies and posters with leprosy message.
We need to take steps so that the affected people in Bangladesh can be included into general society with equivalent access to resources, services, rights and dignity in society, which will eventually lead to a Bangladesh without leprosy. 
Leprosy robs many people of their health, happiness and human rights. We should bring healing, inclusion and dignity to the affected people, their families and communities. We should not stop until the disease is finally defeated.      
We can get a better Bangladesh when there is no leprosy in the country. The eradication will end the sufferings, faced by many people, and save the huge amount of money being spent for the disease. Besides, it will prevent disability, caused by leprosy, paving the way for the people to contribute to the country’s development.       

The writer is a freelancer

Leprosy eradication can ensure a better future

The National Leprosy Elimination Programme (NLEP) needs to promote voluntary reporting by increasing community awareness regarding early signs of leprosy, curability with treatment and availability of treatment

Leprosy is one of the worlds most stigmatized diseases. Still today people affected by leprosy can be marginalised, excluded and mistreated by the communities and societies they live in. It is an issue of basic human rights and we need to tackle both the superstitions and myths that lead to injustice as well as the denial of equality and human rights. People affected by leprosy are most empowered when they are accepted back into their communities with a sense of pride, dignity and self-worth. In Bangladesh, leprosy is still a health problem. Through curable with timely and full treatment, and its treatment and test are free in the country, the disease continues to inflict sufferings on our people. According to The Leprosy Mission International-Bangladesh (TLMI-B), annually, on an average about 4,000 new cases are detected in the country in the recent years. About 10 percent of the victims later become disabled due to lack of timely treatment. Being disabled, they lost earning capacity for their families. But it is possible to check the disability, caused by leprosy, if it is diagnosed early and treated regularly and completely. According to an unofficial estimate, about 3000 to 3500 leprosy patients take medical services from hospitals in the country for two months every year. It means that we have to spend a lot of money for the purpose. It is essential to eradicate the disease as people are facing both social and economic problems due to the disease. Leprosy is an infectious disease of the skin and nerves. The main symptom of leprosy is disfiguring skin sores, lumps, or bumps that do not go away after several weeks or months. The disease targets the nervous system, which includes the feet, hands and face, said TLMI-B. It is needed to eradicate the disease on an emergency basis. Taking necessary steps for detecting new leprosy cases can play an important role in the drive. The government should play the leading role in this regard, otherwise, the objective would not be achieved, said the rights activists. Among the different methods of active case detection, priority should be given to the survey of family contacts. The contact survey should be undertaken immediately after detection of any case in the family and subsequently registration of the leprosy case if identified. National Leprosy Elimination Programme (NLEP) needs to promote voluntary reporting by increasing community awareness regarding early signs of leprosy, curability with treatment and availability of treatment free of cost and importance of early case detection and by providing efficient diagnostic and treatment services to all leprosy patients. There are pocket areas where leprosy prevalence is still high. A good number of people Released from Treatment (RFT) are not yet covered by community-based rehabilitation programme. We need to take a holistic approach, caring for the physical, social, spiritual and psychological needs of people affected by leprosy. We should work with the affected people, many of whom have few rights. We should develop the capacity of the victims to help them do self-advocacy. We need an environment that enables them to achieve improved and sustainable livelihood. Our goal should be to realize a sustainable improvement in the health and socio-economic development of the people disabled by leprosy. We want leprosy expertise retained and further developed. We need to ensure early case detection, quality and quick treatment, continuous multidrug therapy (MDT) supply, and counseling (during and after treatment) for the leprosy victims and their families. Referral from general medical practitioners and different medical institutions should be promoted especially in urban areas by establishing linkage with them. Leprosy complication and management (Simple ulcer, reactions and neuritis care)/POD, and reconstructive surgery are needed. Provision for assistive devices, good functional referral system, self-care capacity enhancement for the leprosy victims and disability care centre in the community for the affected people are also required. We should pursue governance and clinical system at all levels of government health system that allows people affected by leprosy to have medical services at all public health centers. Integration at the basic level is understood to ensure space for leprosy treatment in all upazilla health complexes, MDT services and gradual complication management in the government health system. We want to see a future where access to quality leprosy and other treatment is available through the government to ensure that even if TLMI-B and/or other NGOs are not providing leprosy services, that services will still be provided and accessible at all government health complexes. We need advocacy to develop and promote an enabling and sustaining environment in the community/society that acknowledges and respects individually and collectively the basic human rights of every member of the society, including people with leprosy and disability, actively creates opportunity to exercise those rights and takes corrective measures in the case of violation of such rights so that each member of the society can express her/his full potential and live a meaningful life with dignity. We can hold lobbying networking and using pressure groups to press for policy change wherever necessary, advocacy with concerned authorities for ensuring enough education on leprosy in MBBS and nursing curriculum for integration of treatment of leprosy, advocacy with government health institutions to get their staff training in leprosy care updated and work for ensuring that the affected people are not deprived of different disabled peoples facilities made available for them. We can also hold advocacy with employers and industrialists for job opportunities for the affected people, advocacy with parliamentarians to harmonize any law anything contrary to human rights granted to all citizens by constitution and also by the Universal Declaration of Human Rights and the UN Convention on the Rights of People with Disabilities. It seems that persons affected by leprosy (PAL) remained as service recipients or as beneficiaries. It is very much important to change this view and transform them as partner. Representatives from organizations of PAL should be included in planning, monitoring and evaluation at both local and central level. The core theme should be transformation of patients attitude from beneficiary to partnership. We need awareness programme for reducing self-stigma as well as social stigma. It will increase social acceptance of the victims. Awareness and capacity building of the families of the affected people on leprosy and leprosy complication are important. For awareness, we can use different means such as the mass media, orientation and teaching with people affected by leprosy, federations and associations, seminars with religious leaders, community leaders, human rights activists, national day observation with leprosy message, meetings with different types of stakeholders and slide shows, street play, street rallies and posters with leprosy message. We need to take steps so that the affected people in Bangladesh can be included into general society with equivalent access to resources, services, rights and dignity in society, which will eventually lead to a Bangladesh without leprosy. Leprosy robs many people of their health, happiness and human rights. We should bring healing, inclusion and dignity to the affected people, their families and communities. We should not stop until the disease is finally defeated. We can get a better Bangladesh when there is no leprosy in the country. The eradication will end the sufferings, faced by many people, and save the huge amount of money being spent for the disease. Besides, it will prevent disability, caused by leprosy, paving the way for the people to contribute to the countrys development. The writer is a freelancer