(LML) Early detection is the critical part

Leprosy Mailing List – January 18,  2019

Ref.:   (LML) Early detection is the critical part

From:  Arry Pongtiku, Papua, Indonesia

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Dear Pieter, Thank you so much facilitating this discussion. I would like to comment LML January 10,2019, Geeske Zijp has a question how can we motivate the appropriate staff to get or to stay interested and to take on their responsibility to search case detection, treat and follow up patients without extra external stimulation/financial incentives?. I would like to share as follows: 1. My experience learned leprosy, I got a confidence after receiving a training and   handled about 20 cases in the beginning of my career in Central Sulawesi as well as actively supported/mentored by old/senior supervisor (nurse). I could diagnose leprosy, giving classification for MB / PB cases, and treatment. When we work more in the field more skilful and motivated/inspired we are. 2. Nurses/ leprosy field workers would be more motivated when he/she has more knowledge and experience to handle the cases. With role leadership by supervisor/advisor/consultant, we will grow self confidence of leprosy field workers. When he/she was able or succeed to treat the case, she/he wished to handle more. Leprosy is a treatable and curable disease. Leprosy staff will be curious when they know the process of disease transmission is. They will do contact tracing for those the index cases/family/close friends, they may get new /more cases. They will understand something beyond such as stigma of patients, ether the patient is accepted or not accepted by his/her family. If leprosy field worker can help reaction cases that supported by supervisor or able to handle disability and wound cases would be great motivation. Difficult cases such as reaction and DDS allergy may be demotivating if failed to treat therefore better communication and easy access to supervisor/consultant /experienced doctor/dermatologist are important. An illustrative book of leprosy (atlas) may be also as a friend for them in the field. 3. Meeting of leprosy field workers did not only share new information, knowledge and experience but also place to keep competitive feeling among them. " I can do this, what are you doing friends? it is the way." 4. Sharing knowledge and experience among peer of leprosy field workers will grow self motivation. In Jayapura and Biak in Papua, all leprosy field workers arranged certain time and go together to villages voluntary in examining community and giving health education including door to door/ from house to house approach. This innovation recently got an appreciation from government. 5. Routinely supervised by district supervisors and ensure availability of MDT keep the leprosy field workers motivated particularly during active case findings. 6. A leprosy field worker from one health center supported in active case findings (Rapid Village survey) at other health center areas, they will feel more appreciated. Exchange and send them in a special training would be good. 6. Beyond practice, our values can make a change and motivate to do efforts for elimination of leprosy. God will count leprosy workers efforts. In many cases, leprosy field workers' family /children are blessed. It is motivating them. 7. Financial incentive is important to keep their motivation and help for their own family. The incentive is not too high but enough for sustainability of the program. Some times they can use their incentive for transportation and share food for leprosy patients. They are not only talk but they want to give more. Geeske, despite many struggling in leprosy program, I believe many leprosy workers are very dedicated. In few cases, I am also wondering why do those people keep working for long, until their retirement or after retirement. Thank you so much, salam, Arry Pongtiku from Papua,Indonesia

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LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << editorlml@gmail.com