To reaffirm the need for more leprosy referral centres

Leprosy Mailing List – January 10^th, 2012

Ref.:    To reaffirm the need for more leprosy referral centres

From:  Vijayakrishnan B, Secunderabad, Andhra Pradesh, India.

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Dear Dr Noto,

I thank Dr Shimelis N Doni (LML Jan. 7^th, 2012 - New Leprosy Patients at ALERT, 2009/2010) for the very useful information, which should be another warning for leprosy programmes in all countries.  It may be wiser to learn from others’ experience than to wait to have the experience to one-self.

The recommendations on training and drug supplies may be appropriate in the context of Ethiopia.  But how much the general health staff would absorb the training and make it useful for the people needing care and management of reactions, diagnosis of neural leprosy etc., is difficult to predict.  This is not to discourage training to the general health staff, but only to reaffirm the need for more referral centres where people are given high quality services in leprosy.  The staff skilled in leprosy in such centres find more meaning and respect to their skills than in general hospitals.  

I also think the recommendation of developing a contact tracing programme very important.  In fact active case finding wherever relevant and possible should be promoted – even if it causes some deformity to the monitoring graphs.

Yours sincerely,

Vijay

Vijayakrishnan B

India Representative, Fontilles

201, Royal Heights, J J Nagar Colony, Alwal

Secunderabad, Andhra Pradesh

India.

“Why Brazil is doing this?”

Leprosy Mailing List – December 17^th, 2011

Ref.:    “Why Brazil is doing this?”
From: A Ghosh, London, UK

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Dear Salvatore,

Thank you for your LML message “Why Brazil is doing this?” dated December 4^th, 2011.  It is an interesting area of discussion.  In fact my dissertation for my Master in Public Health at the London School of Hygiene and Public Health in 2008 was about this.  The title of the dissertation was: -  
“A Health Policy Report - How could changes of case definitions, ascertainment procedures, and diagnostic and registration conventions have impacted on reductions inthe prevalence of leprosy in India, reported over the last decade (taking the state of Jharkhand as a case study)?”.

Herewith are my conclusions (and in attachment the full paper).  Thank you for circulating it on the leprosy mailing list.  Any comment will be appreciated.

Best regards.

Anjan Ghosh
Specialty Registrar Public Health

Department of Health Services Research & Policy

London School of Hygiene & Tropical Medicine

15-17 Tavistock Place

London WC1H 9SH

<< 7.1    Conclusions

Declaring a disease eliminated from a country has very serious implications.  Despite more than 20 years of multi-drug therapy (MDT), leprosy has not been eradicated.  Leprosy patients are highly infectious and M. leprae can remain viable outside the human host for many months.  The mean incubation period of lepromatous disease is 10 years.  These factors make it difficult to completely eradicate the disease and there is no evidence that the global initiative has lead to the disappearance of infection or disease from any population.

Perhaps we are failing to understand some important aspect of the disease’s natural history.  With elimination declared, resources are becoming scarce for the continued efforts necessary to keep this enigmatic disease at bay.  

Integration has resulted in the loss of skilled and experienced leprosy workers and the lack of training to general health staff has further compounded the situation.  Cessation of active case detection will continue to contribute to a rise in hidden cases.  In the absence of effective IEC, campaigning and public awareness initiatives, voluntary reporting will not be effective in new case detection.

Social stigma in relation to leprosy is ingrained in society.  Fear of social ostracism and discrimination discourage patients from accessing services or even being diagnosed.  Socio-economic rehabilitation of leprosy cases is greatly hampered by this.  Ignoring the reality of the problem will not make it go away.  Declarations of elimination on paper do not magically rid a country of a disease.  Much to the contrary, it is possible the leprosy will re-emerge as a major health issue unless it is addressed according to the ground realities. >>

Request of address of Doctor with experience in leprosy in Cuba

Leprosy Mailing List – December 15^th, 2011

Ref.:   Request of address of Doctor with experience in leprosy in Cuba

From: S. Noto, Genoa, Italy

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Dear All,

We have here in Genoa a patient of leprosy that has been treated for ENL reaction.  He is going back home to “Jsla del la Juventud”, Cuba.  I am looking for the address or contact numbers of a Doctor with experience in leprosy in Cuba to whom referring the patient.

Thank you very much in advance,

Best regards,

S. Noto

Demise of Dr R Ganapati

Leprosy Mailing List – November 19th, 2011 

Ref.:   Demise of Dr R Ganapati

From: Pranab K Das, UK; J Watson, …

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Dear all,

Dear Dr Pai,

With sadness we have received the news.  Our heartfelt condolence is to be conveyed to his family and friends and most importantly to he committed team.

Professor Pranab K Das

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Dear Friends,

I am so sorry to hear of the death of the wonderful Dr. Ganapati.   His dedication to the cause of helping the leprosy affected has been phenomenal.  His manner was always gracious and patient in the extreme.  The world will be a poorer place without him.   My thoughts and prayers are with those who now mourn him.

Kind Regards,

Jean

Jean Watson OBE, Leprosy Gandhi Award recipient.

Demise of Dr R Ganapati

Leprosy Mailing List – November 19th, 2011 

Ref.:   Demise of Dr R Ganapati

From: H Srinivasan, Chennai, India; G Oehler, Nigeria; R Jerskey, Los Angeles, USA

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Dear all,

The Leprosy World lost an eminent son and I have lost another good friend in the death of Dr R Ganapati, who tirelessly worked for the well- being of the leprosy-afflicted, all his life and almost till his last breath.  Just three weeks ago he, in a mail to me, said he "tries to work as much as his heart allows" him to.  Even his heart, large as it was, could not, I suppose, cope with the workload and had to call it a day at last.

Dr Ganapati's name was synonymous with "Urban leprosy control" and whenever Bombay (now Mumbai) was mentioned in connection with leprosy, it often referred to Dr Ganapati and his work.  He was the father of the well-known Bombay Leprosy Project and in setting that up and running it he showed that good quality leprosy work could be done successfully in the urban metropolitan milieu and how that could be done.  That was not an easy task as anybody with experience in field work would avow.  Before Ganapati, it was thought an almost impossible task, and lo, there was Dr Ganapati and the impossible was shown to be successfully possible, giving a fillip to setting up other urban leprosy control projects.  Unlike many others in the field, his interest was not confined to "making the leprosy patients safe for the community by rendering them 'smear negative'  "; he was interested in their total welfare and in that I feel he served as a model leprosy worker.  His work in Dharavi, reputed to be the largest slum of Asia located in Bombay, is a glorious chapter in the annals of leprosy work in India.  

He was a personal friend of mine and I will always remember his endearing smile and the way he came forward and offered his help to my daughter when she had to spend a year in Bombay as a student.  My heartfelt condolences to Mrs Ganapati and his two daughters and to the staff of Bombay Leprosy Project for their great loss.  In the face of death, we are helpless and can only share their sorrow.

H Srinivasan

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Dear all,

Everyone at GLRA Nigeria was very sorry indeed to receive the news of the passing of Dr. Ganapati.  His tireless work at the Bombay Leprosy Project brought hope and comfort to many, and will remain an inspiration to everyone involved in the fight against leprosy.  The management and staff of GLRA Nigeria wish to convey our heartfelt condolences to colleagues, friends and Ganapati family, while we pray for God to grant his soul perfect peace.

Yours sincerely,

Gerhard Oehler

GLRA Country Representative

on behalf of German Leprosy and TB Relief Association Nigeria

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Greetings from East Godavari Dt., Andhra Pradesh, India, Salvatore, and greetings to all who read the LML....

My wife Vikerunuo ["Aruno"] and I are visiting projects in urban and rural India these weeks and we had the joy and privilege of meeting with Dr. Ramaswamy Ganapati during our sojourn in Mumbai just this past week, including at the Bombay Leprosy Project. 

His warmth, passion for serving those affected by leprosy and encyclopaedic knowledge in the field of leprosy will be greatly missed.  The twinkle in his eyes, his smile, and generosity of sharing from his extensive reservoir of anecdotes and research....undiminished since we first met, when he graciously welcomed me nearly 20 years ago to the day at the conference on "Relapses and Reactions" in Hyderabad.

In Memorium and Gratitude,

Robert Jerskey

LOTR, POD consultant

National Hansen's Disease Program

Los Angeles and San Diego

Demise of Dr R Ganapati

Leprosy Mailing List – November 15th, 2011 

Ref.:   Demise of Dr R Ganapati

From: VV Pai, Mumbai, India

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Dear All,

We deeply regret to announce the sad and sudden demise of Dr R Ganapati, Founder and Director Emeritus, Bombay Leprosy Project (BLP), on Sunday 13.11.2011.  He passed away after a brief illness and hospitalization subsequent to his earlier longstanding cardiac ailment on 13^th Nov 2011.

Dr R Ganapati passing away is a great loss to the nation particularly to the Research and Medical fraternity including social workers and leprosy patients.  His vision and mission of Leprosy Free World will be kept going by his committed team.  He is survived by wife and two daughters.  His death is deeply mourned by the Staff of BLP, Management, Well Wishers and Patients.

With kind regards,

Dr V V Pai
Director BLP

RIP Dr E P Fritschi

Leprosy Mailing List – October 27^th, 2011 

Ref.:   RIP Dr E P Fritschi

From: P K Das, UK; D D Palande, India.

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Dear Dr. Noto,

Dr, Fritchi, Ernest as I knew him, has been my friend since I came to work in Leprosy.  I continued in this field because of him who introduced and guided me to start work in rehabilitation and surgical reconstruction.  I have lost a close friend even though our contact in recent years was restricted to occasional phone calls.  Through this note i would like to convey my condolences and share in a sense of loss with all common friends.

Dinkar D. Palande 

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To All,

In the growing academician world without leprosy, one more light goes out.  With sincere and heart-felt condolence to the family and friends of Dr. E.P. Fritschi, let his soul rest in peace and tranquillity in the midst of infinity.

Pranab K Das

RIP Dr E P Fritschi

Leprosy Mailing List – October 27^th, 2011 

Ref.:   RIP Dr E P Fritschi

From: H Srinivasan, Chennai, South India

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 To all,

I am really sad to hear of the passing away of Dr Ernest Fritschi, a good friend of mine.

I have known him from his medical student days at Madras Medical College, where he was two years senior to me.  I came to know him, to some extent, in 1949 when I was in my third year (1st year in clinical medicine) and he was in his final year, when we were posted in the same medical unit for three months.  Even then one was struck by his cheerful personality and ready with combined at the same time a compassionate approach to patients and their problems.  It was not at all surprising for us to learn subsequently that he had taken to leprosy surgery as his life mission.

I later came to be in frequent contact with him, since 1962, as our professional interests coincided from then on till we retired.  The Schieffelin Leprosy Research & Training Centre, (SLRTC), at Karigiri is the glowing monument to his memory and is the concrete expression of his creativity and all round personality.  Luckily for the leprosy world, he was the right person at the right time in the right place when that institution was started in the 1950s and he made barren rocks bloom and put out beautiful flowers.

For nearly two decades his book on corrective surgery in leprosy was the sole guide and inspiration to people who aspired to learn and practice this super specialty.  While he was guided in his ideas, especially in the early days, by Dr Paul Brand, Ernest was not a blind follower of his Guru; he could stand on his own and argue differently, a not very easy feat for those who have experienced the authoritative and at the same time highly persuasive eloquence of Dr Brand.

Dr Ernest Fritschi was a simple, cheerful, humane and lovable soul with no pompous pretensions and I am proud to have known him. Long live his memory!

Dr H Srinivasan

Leprosy Reconstructive Surgeon (Retired)
25, First Seaward Road Chennai

600 041 South India

RIP Dr E P Fritschi

Leprosy Mailing List – October 26^th, 2011 

Ref.:   RIP Dr E P Fritschi

From: N Manimozhi, India

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To all,
In attachment is a picture of Dr E P Fritschi while praying for his soul resting in peace – the great legend.

Best regards,

Dr Natarajan Manimozhi

RIP Dr E P Fritschi

Leprosy Mailing List – October 25^th, 2011 

Ref.:   RIP Dr E P Fritschi

From: H K Kar, New Delhi, India

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To all,

It is a sad moment for the Global Leprosy Family on the sad demise of Dr E P Fritschi.  We lost a great leprologist and a noble person for the cause of leprosy patients.  We convey our deepest condolence to the family of Dr E P Fritschi.  Let this great great soul rest in peace.

Regards

Dr (Prof.) H K Kar
Consultant & HOD
Department of Dermatology, STD & Leprosy
P.G.I.M.E.R. and Dr Ram Manohar Lohia Hospital
Baba Kharag Singh Marg
New Delhi-110001