Can the current health delivery system in India manage the leprosy burden?

Leprosy Mailing List – November 16^th, 2009

Ref.: Can the current health delivery system in India manage the leprosy burden?

From: B. Vijayakrishnan, Secunderabad, India

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Dear Dr Noto

I appreciate Dr Ganapati’s call and appeal inviting attention to the real problem associated with leprosy in the Indian context (LML Nov. 8^th , 2009). The numbers coming out every year on prevalence and new case detection rate (NCDR) in the recent past tend to belittle the actual size of the problem and attention needed by people affected by leprosy from the health sector. As he observes “visible disabilities were present to an extent of about 26.4 per 10,000” in the rural area and the health system is indifferent to this problem. It is a huge number of people at the receiving end of this cruelty.

However let us also address another question which could be very uncomfortable for all leprosy workers and NGOs: “Are we blowing up the problem for our own existence?” As Dr Ganapati reports in his address at the Indian Association of Leprologists (IAL), “Out of 573 new leprosy cases only about 15.8% sought treatment at these health posts, remaining reporting directly to Bombay Leprosy Project (BLP) clinics.” If BLP clinics were not existing what would have happened?

A Public Health specialist answered to this question (with the same indifference), ‘many of them would have self-healed’. Among those who did not self heal would seek health later. And I think the crux of the whole leprosy debate in the wake of ‘elimination’ lies here: how much of it we could accept? If we consider everyone of them as a human being we would not like them to be in this situation with the advanced research facilities and knowledge we have now. If the leprosy workers and organisations (be it government or non-government) do not try to solve this – I am sure others will not mind it. It is not just the numbers we are dealing with – but the enormous suffering, pain and pangs in people which could have been avoided. Leprosy NGOs have a big role to play not only in offering services but also strengthening health systems and sensitising the general health staff to the needs of people affected by leprosy in India especially in the states where many people need such services.

If the people affected by leprosy were a little more aggressive (considering the huge number in India) I feel that they would have handled a lot more advocacy by themselves.

Regards,

Vijay

India Representative, Fontilles