Leprosy still a health problem in Bangladesh

Md. Sazedul Islam

World Leprosy Day (WLD) will be observed internationally, including in Bangladesh, on January 31. WLD, which generally occurs on the last Sunday of January each year, aims to increase public awareness and knowledge about leprosy, the fact that it can be cured and to change attitudes that stigmatize and marginalize people affected by the disease. The theme of WLD this year is ‘Beat Leprosy’.  

WLD was initiated in 1954 by French philanthropist and writer Raoul Foll ereau as a way to raise global awareness of the ancient disease. Later, the initiative to observe the day was undertaken by International Federation of Anti-Leprosy Assoiations (ILEP).  Switzerland-based ILEP is a Federation of 14 international NGOs united to create a world free of leprosy.

On the occasion, ILEP calls for States to use the UN Principles and Guidelines for the elimination of discrimination against persons affected by leprosy and their family members, which were adopted by the Human Rights Council in 2010.

The WLD provides us an opportunity to review how much progress we have made in building a society that ensures the rights of the leprosy victims. 

People still look at this disease as a curse and the stigma becomes even stronger in countries where people have not been educated about the disease. The WLD is aimed at informing and educating the public on the facts of leprosy to reduce the stigma and facilitate inclusion of the affected people in society.

In Bangladesh, the disease is still a health problem. Through curable with timely and regular treatment and its treatment and test are available for free in the country, the disease continues to inflict sufferings on the people.

According to The Leprosy Mission International-Bangladesh (TLMI-B), annually on an average 3500 to 4000 new cases are detected in the country in the recent years. About 8-10% of the victims later become disabled due to lack of timely and proper treatment.

Leprosy, one of the oldest diseases recorded in the world, is an infectious disease of the skin and nerves. If not diagnosed and treated quickly it can result in debilitating disabilities, and depression. The main symptom of leprosy is disfiguring skin sores, lumps, or bumps that do not go away after several weeks or months. The skin sores are pale-colored.

There are a number of factors, which are hampering the anti-leprosy activities in Bangladesh. The disease is yet to get priority to the government, budget in this sector is far less than the requirement, and there is scarcity of trained manpower for detecting leprosy cases in the remote areas.

There is lack of awareness raising activities for dispelling stigma over the disease. As the doctors have less experience on leprosy, they find it tough to treat patients. Treatment facilities are not equally available all over the country. There is also lack of treatment facilities for complex cases in the country.

The victims are subjected to discrimination and social exclusion due to leprosy. Affected people are often shunned and isolated by those around them, said rights activists.

There are pocket areas where leprosy prevalence is still high. A good number of people released from treatment are not covered by community-based rehabilitation programme. The WLD reminds us of the important tasks that lie ahead. 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 need an environment that enables the victims 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. It is needed to ensure early active case detection, quality and quick treatment, continuous multidrug therapy (MDT) supply, and counseling (during and after treatment) for the affected people and their families.

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 centres. 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.

It is needed to ensure enough education on leprosy in MBBS course and nursing curriculum for integration of treatment of leprosy, advocacy with government health institutions to get their staff training in leprosy care updated. 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 affected people on leprosy and leprosy complications are important.

The rights activists said National Leprosy Elimination Programme (NLEP), which has been formed to make a leprosy free country, needs to be strengthened further. Steps should be taken for allocating more money for leprosy sector in the next national budget. District level Civil Surgeon offices should be provided with adequate money for its smooth functioning relating to leprosy. Due to lack of money, Civil Surgeon offices cannot function properly despite allocation of national budget for leprosy, they observed.

There are three government-run leprosy hospitals in Bangladesh, but they are not well equipped to handle the situation. Its activities are not up to the mark because of lack of quality physicians and modern equipment, and scarcity of required manpower, they added.             

We need to work 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.

Speaking at the National Conference 2019 on Zero Leprosy Initiatives by 2030 at a hotel in the capital, Prime Minister Sheikh Hasina called upon all concerned to work together so that Bangladesh could be leprosy free before 2030.  

The rights activists working in the sector, hailed the PM’s declaration as a positive step, hoping that effective steps will be taken up now to implement her announcement to achieve the target.

Leprosy is not only a health problem in the country; it has caused social as well as economic problems, resulting in violation of human rights of people. Hence, the issue needs urgent attention.

Author: Md. Sazedul Islam is the author & a freelance journalist