LEPROSY – AN AGE-OLD DISEASE THAT TODAY ALMOST SEEMS UNREAL

Leprosy is a chronic, bacterial infectious disease which is contracted by droplet infection. Prolonged, close skin-to-skin contact with an untreated patient and inadequate hygiene, especially in overcrowded areas, are prerequisites for transmission. The risk of infection is much lower than previously thought – it largely depends on the immune system of the individual, yet children are more likely to contract the disease. Leprosy mainly affects people who have grown up with a variety of deficiency symptoms. In fact, 80% of the world's population is immune to leprosy. The incubation period can range from 3 months to 40 years, but usually takes about 10 years. Early symptoms include skin lesions, depigmentation, and numbness. Later on, patients suffer from issues with the peripheral nervous system leading to tissue loss and disturbed motor function. Muscles may stiffen up and hands and feet may be deformed. In addition, numbness makes leprosy patients insensitive to pain and heat, which increases the risk of unnoticed injuries. Due to poor hygiene, those wounds easily become infected, which further accelerates tissue loss and often leaves no choice but amputation. Furthermore, people affected by leprosy sufferer from dry skin. Especially, mucous membranes in the mouth and throat are destroyed. Knot formation, skin reactions, and nerve disorders can lead to major disfigurement of the face – a phenomena often called the “lion's face” (facies leonina). Eyes can become inflamed and dry due paralysis of the blinking reflex. As a result, leprosy patients can loose their eyesight, which leaves them deeply troubled, especially if their sense of touch is weak as well. 

Leprosy is curable at all stages of the disease

For a patient at the initial stages of the disease (first six months), the leprosy treatment recommended by the WHO is a multi-drug therapy (MDT) lasting for one to two years, with a daily doses of medication. Many people who have been suffering from the illness for 10 years or longer, have already lost fingers and toes, actually do not know that leprosy is curable – they have never been told.

Leaving everything behind 

One of the hardest repercussions of leprosy is often the isolation from family and society. No one was born with leprosy, but when it happens it usually means a radical break in someone’s life. The fear of contagion and prejudices about the disease create a painfully deep gap between the sick and the rest of society. It is basically impossible for a person affected by leprosy to manoeuvre these challenges on their own. The life stories of our patients were actually quite similar: They came from poor families, lived in small villages with no electricity or running water, many were were married, had a vibrant family life, work, a place to call home, and social contacts. Most of them worked in agriculture, some were road builders, or rickshaw drivers. Typical for rural areas in India, large families shared a small thatched one-bedroom hut, mostly made out of clay. 

The moment they discovered the first symptoms of leprosy and realised they had contracted the disease they felt pure horror. As soon as they would show visible signs of their illness, they knew they would die a social death and remain socially dead throughout their lives. And sadly, this is what happened to them up to a point where dignity only became a memory of the past. They had to leave their families, give up their homes and work life, were cut-off from all social contacts, and could no longer sell any products or their work force. They moved to a larger city and began to live on the street. They had literally become “untouchable”. Forced into inevitable inaction, from now on, they only thing they could still do was begging, since no one would give a job to a leprosy patient. There was no outside support at all and even many doctors and hospitals refused medical care. They were degraded to a nameless, disfigured and mutilated being, sitting in the dirt of the roadside or river bank with no hope for change.