Ref.: (LML) Early detection is the critical part
From: Geeske Zijp, Mongo, Chad
Dear Pieter,
Our best wishes for a happy and blessed New Year. May many leprosy affected patients heal without disability with or without leprosy reaction.
Thank you so much Dr. Cairn and Dr. Arry.
We are having the same vision: early detection and treatment and we add: early detection of leprosy reaction and treatment.
Many patients are still not detected and treated, and worse, many leprosy reaction patients are not detected and treated correctly. Our experience in the republic of Chad is that motivation overrules all other components of support to leprosy control and disability prevention. We can train (and pay!) that many nurses and doctors in leprosy and its consequences but there is no result when there is no motivation to do the work. Whatever financial input we offer for training and management we still see patients (and especially reaction cases) being misdiagnosed and becoming disabled and rejected for that.
Fortunately, some patients start seeking help where the staff is motivated, receives the patients in a friendly manner, assures follow up and carries out nerve assessments so as to detect and treat leprosy reaction early, but this kind of staff is rare, distances are enormous and patients most often poor.
Yes, when a patient with severe leprosy reaction gets healed, he or she will become a perfect example for the community and new patients will come forwards through that example. This is a very good opportunity to implicate leprosy affected persons in the awareness process (and this is to be recommended). But it is not enough. We need staff to do their work.
Our question is: how can we motivate the appropriate staff to get (or stay) interested and to take on their responsibility to search (case detection), treat and follow up patients without extra external stimulation (read: financial incentives)? And continue to do so?
It is a question we are struggling with and it would be good to develop some thoughts together.
Geeske Zijp, Programme Manager for TLM-Chad
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.
Contact: Dr Pieter Schreuder << editorlml@gmail.com
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