The Indian Government has claimed that leprosy has been eliminated from India. This gives the impression that leprosy has been eradicated from India. Later, by way of clarification the Government has defined what they mean by elimination. To the Government elimination means that leprosy prevalence has been reduced to one per ten thousand of the population at which level it has become simple enough to be tackled by the public health system, and no longer needing special leprosy institutions.
The prevalence of one per ten thousand of the Indian population, which exceeds a billion, is not a small number – one hundred thousand!
But the Government does not state this explicitly. Their claim that leprosy has been eliminated has led to the impression that leprosy has been eradicated and become extinct.
World Health Organization has believed the Indian Government’s claim and echoed this all over the world. The whole world has been led to believe that India has eradicated leprosy. This has resulted in drying up of funds that can be raised by international leprosy relief agencies.
Many of the Indian NGOs (Non-Governmental Organizations) depended on these international leprosy relief agencies for survival. Once these sources stopped their aid, they ‘closed shop’. But new leprosy cases continue to occur though at a much lower level but these centres are no longer there to meet the continued challenge.
PERMANENT AND IRREVERSIBLE ANAESTHESIA.
About 25% of leprosy patients had developed deformity and disability including insensitivity in their hands and feet. This loss of sensitivity is permanent and irreversible.
Even the best of treatment cannot restore the sensitivity. Nerves once destroyed are destroyed forever. That means even after the so-called complete treatment and cure, they continue to suffer from anaesthesia of hands and feet.
The cured-patient continues to be vulnerable to accidental injuries, the pain of which he doesn’t feel and for which he does not seek treatment, leading to infection, gangrene, and amputation. This Damocles’ sword hangs over the heads of such patients all their life. These patients need medicare for such infection, ‘until death parteth them from the world’.
But to the Government these vulnerable patients are no longer patients. Any one who has had one full course of Multi-Drug Therapy (MDT) is considered cured and removed from the register.
Unfortunately Mycobacterium-caused permanent disability has not removed them from its register!
As long as these 25% of vulnerable leprosy subjects are still in this planet, the Government Hospitals, and NGO Hospitals should continue to extend treatment for these people.
These ulcer-prone patients and new leprosy patients would have gone to these NGOs if they had continued to serve them. But they have ceased to be OR they are operating at a much lower key. There are exceptions but they are precious few.
The leprosy patients of the two districts of Tirunelveli and Thoothukudi fall back on St.Luke’s for treatment. But over the last five years the flow of money from leprosy relief agencies to St.Luke’s has gone down from 75% to 10% of the total budget. Even this ten percent will be tapered off to zero percent over the next few years.
St.Luke’s has to double/treble its efforts to be able to deliver leprosy service at the original level. We are badly in need of support from friends who understand the chasm between the Government claim and the ground reality.