Leprosy Mailing List – November 24, 2015
Ref.: (LML) Protecting Indians from leprosy
From: Rajeev B. Dudhalkar, Mumbai, India
Dear Sir,
Here I would like to draw your attention to some of the today’s disturbing issues and concerns for leprosy and me in person (Editor: see also Joel Almeida letter, LML 25-09-2015).
1. Are we emphasising on lepromatous / infectious case detection ? In the absence of ‘Skin Smear’ for the confirmation of diagnosis, one of the ‘Cardinal Sign’ for leprosy. Is there any alternative we have provided in the programme ? In India Revised National Tuberculosis Programmed (RNTCP) network of sputum laboratory within the General Health Care System (GHCS) can be very effectively utilised.
2. In the absence of promoting the infectious case detection, patch orientated case detection, awareness and grouping for treatment MB/PB how it will help in true sense control and curtail the incidence of leprosy.
3. Trouble free signs and symptoms of leprosy is the main obstacle in voluntary reporting of the early cases of leprosy and suspects in the absence of effective and sustained leprosy awareness along with dissemination of scientific facts about leprosy though press mass media and social media / network.
4. After integration of ‘National Leprosy Eradication Programme’ within GHCS it should have been more fruitful in terms of early case detection, treatment, management and providing timely quality leprosy services to the PAL (Person Affected by leprosy) through the well-established network of medial and paramedical staff of GHC system (Ref. Government of India LAW COMMISSION OF INDIA Report No. 256 ‘ELIMINATING DISCRIMINATION AGAINST PERSON AFFECTED BY LEPROSY (April 2015)’ 2.3.2 However, once the declaration the elimination of leprosy as a public health issue was made, the vertical health programme of Leprosy was merged into general healthcare system of the country. This transition did not happen as smoothly and in as well planned a manner as it should have, leading to gaps in the delivery including the detection of Leprosy, which continue to exist till today. … A major portion of these new cases of leprosy in India are of children, who face the threat of isolation and discrimination at a very young age.)
5. Instead of embedding and strengthening leprosy services with the help of effective and efficient use of existing leprosy expertise why we are still trying to withhold the verticality of the programme? By doing so we can enhance our reach to PAL and doorstep delivery of the leprosy services in turn benefit large number and getting away ‘Stigma’ attached to leprosy.
6. If there is assured full course of MDT made available like RNTCP. This will help in good treatment compliance and overcome the lapses in the distribution and shortage of MDT at the peripheral level. Because, making full course of MDT assured, made available at the time of case detection itself is very crucial for control / elimination of leprosy.
With best regards,
Rajeev B. Dudhalkar
Mumbai, India
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
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