Leprosy aid  

Situation and background 

What is leprosy?

Leprahilfe - SituationLeprosy is a chronic infectious disease caused by bacteria. It is usually spread from person to person in respiratory droplets. The disease is normally only transmitted where people live in close physical contact with a sufferer who is not in receipt of medication. Infection occurs generally among people who live in overcrowded places with poor hygiene.

In contrast to the general perception of the disease, leprosy is not a highly infectious condition and a healthy immune system is normally able to deal with the pathogen before any symptoms occur. However, small children are most at risk of infection. Leprosy affects many people who are already suffering from symptoms of deficiency. Eighty per cent of the world population is actually immune against leprosy. The incubation period is between three months and forty years, while most people show first symptoms about ten years after infection. They include depigmentation of the skin, numb sores and skin lesions.

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Left untreated, leprosy can be progressive, causing permanent damage to the peripheral nervous system and tissue, resulting in impaired sensibility and motor functions. Muscles become stiff so that hands and feet become deformed. As numbness in limbs sets in, people suffering from leprosy are at higher risk of accidental injury. Poor hygiene might cause infection of the wounds so that tissue is destroyed to such an extent that amputation is the only remedy.

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The skin of people suffering from leprosy tends to be dry and cracked. The infection also destroys the mucous membranes. Faces are often disfigured by knobs, deep furrows, skin sores and damaged nerve ends. Since the Middle Ages, these symptoms are commonly referred to as "lion's face". In many cases, the eyes become infected as sufferers loose the blink reflex. As a consequence, people with leprosy often go blind. As they have also lost their sense of touch, they are doubly disabled.

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Leprosy is curable

There is now medical treatment available that is effective at any stage of the disease. The World Health Organisation recommends treatment by MDT (Multi Drug Therapy). To be treated, patients need to take this drug for about one to two years. Where the disease is diagnosed early, six months of treatment is normally sufficient.

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Many people suffering from leprosy have had the condition for ten years or more. As a consequence, they might have lost fingers and tows and are unaware that they can actually be cured, as nobody ever told them about the treatment.

Social stigma

Leprahilfe - SituationWhile the physical symptoms can be severe, people with leprosy often report that the social stigma is the worst consequence of their condition. They are shunned by others, including members of their family, and are forced to live in complete isolation from society. The fear of infection and other myths surrounding the condition are widespread among people who lack education and information about the disease. As a consequence, people suffering from leprosy who often are seriously disabled by the disease, obtain no help from communities. People with leprosy simply lack the resources to overcome this stigma without assistance from the outside. The journey through life of our patients follows a dreadful pattern: All beggars we currently look after come from extremely poor families. Many grew up in small villages without electricity or clean drinking water. Most were however married with families, worked hard, had a home, friends and a social life – in other words, led a normal life.

Most of our patients were involved in agriculture, working as labourers on large plantations. Some worked in road construction or were rickshaw drivers. Their usually large families lived in small, straw-roofed clay houses in frugal yet relatively dignified conditions. One day, they detected whitish, numb spots on their skin. During work, they were more and more prone to injury. Their hands and feet became increasingly numb, and after some time, their limbs showed first signs of deformation. At that point, most of them realised with utter terror that they were suffering from leprosy.

The moment their condition became visible to others, they died a social death and had no choice than live in complete isolation from their community. Today, human dignity is only a vague memory for them. Sufferers are forced to leave their families, are evicted from their home and loose their job from one day to the next. They cannot sell their produce and are shunned by their community. All they can do is move to the nearest bigger town were they invariably end up on the streets. They have become "Untouchables" in society. Nobody wants to have anything to do with them, and they sink into complete passivity. To survive, they need to beg on the streets, as nobody will ever offer them a job. At that point sufferers have now lost all control over their fate and all hope for their future.

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There is no support available to them. As most beggars are illiterate, they have no access to information, unless it is brought to them. Many doctors and hospitals still refuse to treat people suffering from leprosy. Most sufferers live in very unhygienic conditions and are malnourished. As they have no money, they cannot treat their sores, wounds and commonly occurring secondary infections. Their physical health deteriorates rapidly, and they suffer the mental anguish of absolute hopelessness and helplessness.

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The social stigma attached to their condition forces them into a life deprived of all dignity. Disfigured, disabled and dirty, they sit on the edge of the street, without even a glimmer of hope of a better life.


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Climate conditions

The local climate and weather conditions are harsh. During the hot season in April, May and June, temperatures rise to between 42 and 48 °C. The summer months bring monsoons with daily downpours flooding the streets. As nobody give them shelter, the beggars have no option than sit in the rain for hours, waiting for the showers to cease. Heat and wetness obviously take a toll on health in general, wounds cannot heal properly and the dirty water causes further infections. Many beggars even develop dermamyiasis on their feet, where larvae develop under their skin.

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Autumns are normally quite agreeable, with temperatures around 30 to 35 °C. From December, the temperature tends however to drop suddenly down to 4 °C, with cold winds prevailing well into January. February and March bring some respite with nice spring weather and temperatures around 30 to 33 °C. To ease their suffering during the monsoon season and in winter, we provide people suffering from leprosy with 3x4 metre plastic sheets, solid fuel and warm blankets.

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