World Leprosy Day

By: Srimoyee Chatterjee

World Leprosy Day is celebrated on the last Sunday of January, and aims to raise awareness about a disease that many people believe is extinct.

Leprosy is an infectious disease caused by the bacterium Mycobacterium leprae, also known as Hansen’s bacillus (in honor of Gerhard Hansen, the Norwegian physician and bacteriologist, discoverer of the disease, in 1873). The bacillus reproduces very slowly and the average period of incubation and appearance of the signs and symptoms of the disease is approximately five years.

The initial symptoms are light or dark spots or nodules on the skin, resulting in skin lesions and loss of sensation in the affected area. Other symptoms include muscle weakness and tingling in the hands and feet. When cases are not treated at the beginning of signs and symptoms, the disease can cause progressive and permanent sequelae, including deformities and mutilations, reduced limb mobility and even blindness.

The disease mainly affects the skin, the nerves, the mucosa of the upper respiratory tract and the eyes. In some cases, symptoms may appear as early as nine months after contamination, and in other cases, they may take up to 20 years. Leprosy is not highly infectious and is transmitted through close and frequent contact with untreated infected people. Leprosy is curable and the treatment offered reduces considerably the chances of death.

Stigma and Leprosy

Leprosy has been associated with stigmatization throughout history despite being one of the least contagious of infectious diseases. The fear of leprosy leads to the stigma and discrimination and is due to lack of understanding and knowledge about leprosy — which increases misconceptions about the disease’s transmission and treatment. The stigma of leprosy has great and widespread consequences on both patient and family. The fact that most of those with untreated leprosy end up with severe deformities and disfigurements has contributed to the stigma.

These type of negative attitudes creates a barrier to treatment, hindering efforts to stop the disease transmission at a global scale. Stigma, prejudice, and discrimination can prevent people with the symptoms of leprosy from seeking and accessing medical help, which delays diagnosis and treatment. Every year, more than 200,000 persons are diagnosed with leprosy worldwide.

While the disease is easily curable if detected early, around 6 million treated people affected by leprosy experience life-long disabilities or discrimination, or both. Many live in some of the world’s poorest and most marginalized communities.

Individuals affected by leprosy often experience rejection, shame and social exclusion from work or school. Due to the discrimination and the stigma, that they are subjected to by society, Patients often suffer from mental illness like depression and anxiety.

Fighting the stigma of leprosy

In spite of the persistence of an intensely negative attitude towards leprosy, it is important to realize that vigorous educational efforts on a community basis do lead to perceptual changes over time. The community leaders need to be motivated through intensive and continuing exposure to the truth about leprosy, to do their part in getting rid of the pervasive shroud of horror surrounding the condition. The greatest need of today in this field is to change these viewpoints and promote early diagnosis and treatment, which in turn are virtually guaranteed to prevent deformity and disability in affected individuals. This will go a long way in breaking the vicious cycle of stigma-concealment-lack of treatment disfigurement and disability-stigma.

Fighting against the disease not the patients

A careful examination of the theoretical and practical approaches of the past can provide vital insights for the future. To reduce the burden, it is important to develop a holistic and multi-pronged approach that includes key policy changes, a public education campaign, sustainable livelihood programs, skill training workshops and bringing in other medical stakeholders to generate employment, identify interventions to dispel stigma and mainstream the affected people.

Policymakers, health professionals, civil society and public health activists — each of them needs to act as a change agent through their representational, legislative and activists roles to win the war against leprosy. Moreover, well-paying jobs must be made freely available to all leprosy patients, so that they can build up their self-esteem and become financially independent. This will enable all those who are willing and able to gain access to skill development programs, and embolden them to take their place in society. This is called socioeconomic rehabilitation, and it will play a crucial role in changing the public :attitude towards leprosy.

We will like to conclude by wishing a very Happy World Leprosy Day to everyone. Leprosy is something we need to fight with together to make this world a healthier place to live. On the occasion of World Leprosy Day, we must join our hands to fight against this disease that is a threat to humans.