Re 349 Re 412 So 24

S184^ International Journal of. Leprosv^ 2001

Leprosy control programs in general prioritize M1)Tfor all, secou(' priority is POD and linally rehabilita-tion. In order to improve the programs for rehathilita-tion. increase of patients responsibility for their ownhealth tuid the introduction of so-cailed care packagesare important steps to take.

The final conclusion of the analysis is that rehabilna-tion of leprosy disabled should be part of a general 1-e-habi h tation program.

Rehabilitation Department. Bach Mai Hospital, 78Giai Phong Road, Ilanoi. Vietnam Phone : 0054-4-5691533

Fax : 0084-4-8691533

Entali : [email protected]

Re 349SELE CARE GROUPS : THE A LERTEXPERIENCE, ETHIOPIA

Catherine Benhow, ALERT, Addis Abathat, Ethiopia

The first self care groups were started in the ALERT.Ethiopia leprosy control progamme in 1995. Theywere started in response to two main problems: the in-creasing number of people who were dependent on theprogramme for their wound healing despite years ofhealth education and the limited resources for tradi-tional medicai wound healing methodologies.

Group membership is voluntary and the outcomes areencouraging. The group members have taken up theirresponsihility to manage and monitor their own woundstatus and supply their own wound heatling materiais.If they wish, they may purchatse canvas shoes and PVCboots at a subsidised cost from ALERT. The resultsshow a reduction in the number of foot ulcers; most im-provement oceurs in the lirst six months of joining agroup. but that improvement is ~imante(' in the longerterm. Hand ulcers seem to come and go more cuticklyand relate to working and seasonal variations. In addi-tion. they pay more attention to their personal hygieneand appearance and some are now concerne(' abola lo-cal environmental hygiene. Qualitative outcomes in-elude: increased confidence to participate in society,restored dignity and self respect and a sense of helong-ing to the community. In December 1999 the numberof groups had expanded to a total of seventy two.

The leprosy worker has had to change his / her rolefrom that of a service provider to that of a self caregroup ktcilitator; but not ali were successful in makingthis transition.

The remaining challenge is the sustainability and for-ther development of the programme. A numher of op-tions are available to achieve 1h is goal, namely: theNational Tuberculosis and Leprosy Control Pro-gramme, community development organisations andthe Leprosy Association.

P.O.Box 165, Addis Ababa, Ethiopia Phone00251-1-711524.712792

Fax : 00251-1-711309, 711199

Email : [email protected]

Re 412REHABILITATION OF DISA BLED PERSONS

Dr..lohan PVelenut, The Leprosy Mission Interna-tional. The Netherlands

Rehahilitation of disahled persons can take many dif-lerem l'orms according to the socio-cultural and politi-cal context in which it is undertaken. Some approacheshave emphasised the restoration of the physicaltion of the client, while others have looked beyond topsychological and social well-being. Some have huiltou the expertise of professionals while others have em-phasised the caring capacity available in the familyand the commu ti ity and sought to reinforce it. Besidesproviding a wide range of possible services to disabledpersons, rehahilitation wants to change the attitudeswhich prevail in society as a whole and promote theintegration of disahled people into society with equalrights and opportunities. Four dimensions are de-scribed which can be used to characterise and definerehabilitation projects based on the objectives whichare defineel for them. Thus, types or families ofhi litation projects can be distinguished. Evaluation ofrehabilitation projects should pose questions relevamto the type of project under consideration and sh(nildthus begin with a classitication of the project as indi-cated above. Secondly, evaluation should consider theposition of people with disahilities in a particular so-ciety and how the project contributes to meeting theirneeds. Questions concerning progress and perfor-mance should at least address

1) Participation 2) Involvement of clients relatives andthe community 3) Types of services offered and theirutilisation/coverage 4) Outcome.

Questions and indicators will be presented which canbe used in the evaluation of each of these componentsof rehahi I ilati on projects.

The Leprosy Mission International, P.O.Box 902, 7301BD Apeldoorn. The Netherlands

So 24SOCIAL WELFA RE ACTIVITIES OF LEPROSYPATIENTS FOR LAST 23 EARS AT KUSHTSEVA SADAN, AGRA

Dr.V.P.Bharadwaf, K.K.Pahlral, Amar Deo Singh,1)Mil4r.s.) Madhlt Bhartuhraj, Roja Rani & SubhashJoin, Agra

Kusht Seva Sadan (KSS) in the vicinity of Taj Mahal is

69, 2 (Suppl.)^

A bst rads of Congress^ SI 85

one of de oldest Leprasoriums in Ind ia (lbunded in1861). Leprosy Patients Welfare Society (LPWS), aN.G.O., is functioning for the welfare of Leprosy pa-tients for the last 23 years. More than 60 (sixty) thousandleprosy patients have been benefited through L.P.W.S.during 23 years ai K.S.S. where they gol free boarding,

during their short or long term treatment.

During this period, Health Education Activities havebeen undertaken by L.P.W.S. with m aim to createAwareness about early sigas and other aspects of lep-rosy by organising severai meetings and functions. TheL.P.W.S. lias widely spread the message to the peoplefrom ali walks of li e that leprosy is a curable diseaseUtiing MDT and if detected and treated aí early stage,deformities and clisabilities are prevented. Such effortsof the L.P.W.S. have resulted in favourably changingthe altitudes, practices and behaviour of the people to-wards leprosy.

The L.P.W.S. lias also helped patients having reactions,bacl ulcers and complications. Those who acede(' 1-e-constructive surgery, arrangments were made at estab-lished leprosy hospitais ia the country where facilitiesfor reconstructive surgery are available. L.P.W.S. alsohelped cured leprosy patients for getting respectable,social and economic rehabilitation. The detailed activi-fies undertaken and future perspectives will be pre-sented and discussed.

P.O.Box 1158, 7 Amar Lok Colony, Agra - 282 001Phone : 0091-562-330127, 331616

So 118COMMUNITY HEALTH WORKERS INLEPROSY ELIMINATION CAMPAIGN

Dr.Anne Mattam, Damien Foundation Ilidia Trust,Chennai

Recent strategy of Leprosy Elimination Campaign(LEG) lias beca employed widely ia leprosy controlprogrammes. Various categories of personnel are beingutilised for this activity. We present our experience inBiliar in utilising the services of Community HealthWorkers. A total of 80 Community Health Workers be-loreing to a NGO in Nalanda district, B i bar. Inchawere given orientation training on screening of popu-lation for sigas of leprosy. This NGO covered a popu-lation 01.55,000 ia 54 villages. Propaganda was carriedout for one day 161lowed by a search programme (sur-vey) for one day. These workers detected 50 new casesof leprosy and 50% of tilem were Multi Bacillarycases. The cosi of detection per patient was Rupees280 0111 y. 11. a larger arca is covered, the cosi would beless. This clearly indicates that different categories ofhealth workers could be successfully utilised for LEC.

Dam ien FoUndation India Trust, 27 Venugopal Av-enue, Spur Tank Road, Chetpet, Chennai - 600 031

Phone : 0091-44-8280496

Fax : 0091-44-8230467


So 120ROLE OF TRAINED HEALTH WORKERS ANDCONIUNITY PARTICIPATION IN LEPROSYELIMINATION CAMPAIGN

As/tinia Mitra, CASP - Plan Project, New Della

Leprosy is generally considered mijust as a diseasebut a curse. This disease lias been shrouded ia mythsand mysteries causing leprosy cases to untold suffer-ings, physical, mental as well as social. Receai devei-opments about the disease and the introduction ofmodera treatment through MDT have caused a deliniteshif.t in the altitude towards leprosy cases. The magni-tude of the disease is tremendous in some countries ofAsia, Africa and Latia America. About 5,60,000 newcases are detected annually worldwide and over 70%of them arise 1.rom India alone. Today, leprosy is nolonger treated as a dreaded disease. li is cletinitely CLIN

able and no leprosy-affeeted person lias to face theproblem of any deformity if diagnosed and treated iatime. Therefore, the key to success of any leprosyelimination programme is the early detection of thehidden disease. Since the disease is attached to socialstigma. the success lies in community participation iacreating better awareness leading to volumary report-ing of the disease. lnspite of having suei] a heavy loadof leprosy in bulia, there is a dearth of proper trainedhealth workers. Health workers both at the communitylevei as well as those associated with existing healthinfrastructure need appropriate orientation and trainingtowards the disease elimination. li luas also been ob-served that most of the leprosy patients come from un-der-privileged com m un ity.

GASP-PLAN, a NGO has made a strategic survey inthe situas of Govindpuri, Sangam Vihar and Badarpurin South Deihi. lt is promoting a three prongedstrategy, i.e. LEG, SAPEL and availability of MDT to-wards elimination of the disease in the arca. Leprosy isto be eliminated as a public health problem through ac-tive participation of the community and the trainedmotivated health providers.

CASP - Plan Project, New Della

So 123SOCIAL INTERVENTION MAKING APOSITIVE IMPACT IN A LIFE DISTURBANCESITUATION OF A WOMAN WITH LEPROSY

N.B.Motekar, V.K.Joseph & Sujam Marihal BelgatimMedical Hospital, Hindalga

Leprosy perhaps is the only disease, which under thepresent law provides the grounds for spouses 10 insist

SI 86^ International fournal ofLepmsv^ 2001

on separation (Muslim Marriage Act 1939, SpecialMarriage Act 1955). The gender hias is retlected in thefact that men diagnosed with leprosy in India sufferfewer negative reactions as compared to women carneas a welcome surprise when they do happen. Involve-ment of health prolessionals ai ali leveis through inter-ventions like counselling ai individuais/ family leveiscoupled with health education and where required pro-vicling legal assistance can turn the situation in favourof the woman. A case report where team efforts re-sulted in making a positive difference in the life distur-bance situation of a woman is reported. In the paperwe describe our efforts which resulted in making apositive difference in the life of une such woman.

Beigatim Medicai Hospital, Vengurla Road, Hindalga -591 108, Belgaum District, Karnataka

Phone :0091-831-447751

Fax : 0091-83 I -446242


treatment from GHS. 59% would even prefer leprosyhospitais for 1h is pui-pose.

Much depends on new generation for success of inte-grated programme. Unfortunately their altitude seemsto thwart the prospects of the progremme. h can be in-terred that iow prevalence (ií leprosy in recent yearsthat lias inale leprosy uncommon problem for youthonly to increase heedlessness among them. Negativeau ilude of youth towards leprosy calls for inunediatecorrective measures to rejuvenate health education ac-tivities to disseminate scienti lie knowledge ahout lep-rosy & bring about positive change ziniong this groupto accept leprosy as a common health problem.The au-thors caution that if corrective steps are not taken up,the new millennium will face macabre state of socialproblems reiated to leprosy.

Durvankur, Adarsh Nagar, Nav-Kurtil, Alibag - 402201, Maharashtra Phone : 0091-2141-23744

Fax :0091-2141-22771

So 146LEPROSY IN THE NEW MILLENNIUM INPERSPECTIVE OF EDUCATED YOUTH

A.B.Prabhavalkar & DrII.V.Dongre Alibag, Maha-rashtra

Second half of the 20th century changed the entire faceof leprosy probiems prevailing in our country for cen-turies. Advances in the cheinotherapy augmented rapiddecline in prevalence rate of leprosy. Prospective elim-ination of leprosy, in the very beginning of new mil-lennium, has ensconced leprosy on the verge of inte-gration into General Health System (GHS). Thesuccess of such operational transmutation of leprosywill mainly depend on attitude of society, and youth inparticular.

This paper presents the study, undertaken to under-stand the state of readiness of educated youth to acceptleprosy as a common health problem. The study, bymeans of interviews, was conducted among 1185youths, from three places in Maharashtra, a progres-sive state of lndia, with varying leprosy endemicity,namely Mumbai. Raigad and Wardha.

Level of knowledge among this group is satisfactory.However, knowledge pertaining to infectivity andtransmission is poor. 75% of respondents felt that theproblem of leprosy is on the rise. While 69% opposedthe isolation of leprosy patients, 60% refused to haveconjugal relationship with a leprosy spouse. Similarly57% advocated separate hospital for leprosy.

In the context of leprosy services and expertise, onlyII% of respondents believe that doctor at GHS can di-agnose leprosy correctly. Moreover, 69% are notaware that treatment on leprosy is available at GHS.Siini larly, as low as 12% youth prefer to take leprosy

So 185ROLE OF NGOS IN OVERCOMING THESTIGMA RELATED TO LEPROSY

DrLopamudra Rudra, CASP-PLAN, Delhi

Leprosy is the oldest disease known to mankincl. It isdifferent from others disease that it affects the persontotally, i.e. his health, look, self-esteem, job, family,his position in the society, etc. It is a major publichealth prohlem in India carrying 58% of global patientloacl with a prevaience rate of 5.9/ 10000 (W110 Sept.99). But it is encouraging that the disease has shown adeclining trend first time in 1987 and the World HealthAssembly has taken a resolution to e I iminate it. So theconcerted effort of allconcerned can heip in overcom-ing the hurdles in controlling leprosy.

The stigma related to leprosy is the main obstacle to lisefficient elimination. The fear of rejection by thefamily & society may cause more stress than the dis-case itself and may lead to hidden cases.

NGOs have been piaying a significant role in the fieldof leprosy and in bulia there is co-operation and col-laboration with Government but still there is a lungway to go.

h has been felt that the stigma related to leprosy is dueto the deformities it causes and this can be overcomeby educating the people through effective IEC and hyproviding them the necessary informations, i.e. the dis-ease, its transmission. treatment and rehahilitation fa-cilities available and removing myths and misconcep-tions. We felt questions and answers from thecommunity should be encouraged in effective design-ing of the messages to be communicated. Workingwith the community, we realized that no programmcan succeed without community participation. Health

69, 2 (Suppl.)^ Absiracts of. Congress^ S 1 87

facilities can help but it is the community that has totake the initiative in eliminating the disease. NGOsshould try to crente a leprosy friendly environmentwhere affected people can come forward and seek vol-untary help.

CASP-PLAN Deilu, an NGO, made a survey in UrbanSlums, Sangam Vihar, 13adarpur and Govindpuri andtrained community health guides, Social workers anddoetors 00 communication and early case detection ofleprosy and lias plans to carry forward the activitiesfurther.

Dr.Lopartmelra Rudra, CASP-PLAN, Delhi

So 221EFFECTIVE SPONSORSHIP FOR SOCIALACCEPTANCE OF CHILDREN IN THESHADOW OF LEPROSY

Mrs.Sushama los/ti, Programme Officer, FELI

Leprosy has been considered primarily as a medicaiproblem. Therefore, ali Government efforts are rightlyfocussed on the early detection and treatinent. How-ever, experience has taught us leprosy is more of a so-cial problem resulting in stigmatization, isolation andloss of dignity. This affects not only the patients butalso their families. Therefore, while strengthening themedicai progranimes it is essential that attentionshould be focussed on issues like creating awareness,provision of counselling to the person affectecl as wellas the family and orientation for preventing disabilityand dehabilitation.

The recent campaign conducted by Government of In-dia has revealed that 18% of the newly affected casesare children below the age of 16; therefore if thesechildren are not protected from stigma and isolation,the future of these children will be in jeopardy.

Number of social work procedures are in vogue indealing with socio-medical issues like chilcIren in theshadow of H.I.V aids, cancer, leprosy, etc. AmongMese methods, sponsorship has been found to be avery effective methocl of dealing with such issues likeleprosy. This papei' tries to analyse the situation and in-dicates how sponsorship can be ao effective tool inpreventing dehabilitation/isolation and provides forutilizing techniqueslike case work counselling and ap-propriate cornmunication.

Mrs.Sushaina Joshi Prol.uamme Officer, FELI

Dr.Y.Aoki & DrM.Makine, Okayama, Japan

The compulsory isolation policy of Japan was estab-lished i o 1907, when Leprosy Prevention Law was en-acted. Most oU patients were compelled to be isolatedto the sanatoriums (leprosarituns), and to spencl the lifethere by tias law. Though its scientilic grouncls werescarce and it disregarded human rights, this law hasbeen kept even after the development of dapsone forprejudices of society and medicai authorities. Finallythe law was repealed in 1996, in the result of a tena-cious movement by the sanatorium residents (theywere already curai, so they are now to be cailed notpatients but sanatorium residents). However, they wereforced a clifficult situation over physical, mental. socialand economical aspects, that is, the whole life, andsuch a difficult situation 5h lias little been clarilied bynow. So in this study we try to clarify the situation inwhich the sanatorium residents in Japan have beco putby the government s isolation policy. A detailed inves-tigation by the visit interview method was done from1997 to 1999 for ali residents (1394 people) of thethree national sanatoriums and the answer was ob-tained from 818 people (64%).

Fifty four percent of the sanatorium residents recognizethat they were hospitalized compulsorily . 36% peopleof male had vasectomies. Ali men had to have vasec-tomies before they got married at one sanatorium.Twelve percent people of female !tad abortions. Almostali cases are regarded as compulsory on substance.There was no case of birth in sanatoriums, so it isthought that persistent eugenics policy for people withHansen s disease have been done. Ahnost ali membersof sanatorium residents have experienced patients work.Patients work was not for rehabilitation bui for mainte-nance of sanatoriums; it was applied compulsory andthe tendency was seen that the more work people did,the more trouble was caused in their hands.

II is thought that a lot of human rights have been vio-lated under the isolation policy in Japan. 11 is necessarythat such history will be the significam lesson of theideal way of the medicai treatment including infectiousdisease policy in the future.

Oku-komyo-en. Mushiage 6253, Oku-cho, Oku-gun,Okayanta Pref. 701 4593, Japan Phone : 0081-869-250011

Fax : 0081-869-251763


So 377So 345

THE MISTREATMENT UNDER THEJAPANESE GOVERNMENT'S COMPULSORYHANSEN'S DISEASE ISOLATION POLICY

THE TEXTURE OF OUR SOULS :TRANSFORMING THE SOCIAL IMAGE OFLEPROSY

Anwei Skinsnes /..trw, USA

S188^ hiternaliontil Jourmil of Lepro.sw^ 2001

More than 100 books and thousands of poems have heen\\Tine ]) by people who have personally l'aced the dia!-lenges of leprosy. Songs have been written and musiclias been composed. These hooks, poems and songs re-Ilect deep emotional pain but, ai the same time, presentinspiring images of dignity and strength. As suei), theyare a tremendous, largely uniapped. resource. and repre-sent a powerful ~I with which to change the social im-age of leprosy while. ai the SallIC time. providing an im-portant commentary ou the long-lasting consequences ofprejudice. discrimination and injustice.

I have sometimes clasped in my anus the trees of theforest, praying God to aniniate tilem and give n te afriend. Guascoz. France, 1803

My heart and head were full of the mystery of huinanexistence. Especially in thinking of the friends gonebefore an inexpressible sadness carne ()ver me....Shri li. shril I, the crickets chirp and

cai!, and from my heart the slow tears fali. HonainiNagata, poet and author.Japan

A man can survive a cataclysm: sul) ir the loss of hisnearest and dearest; see the whole panem of his lifesmashed to pieces, and yet remain basically un-changed; the inner texture of his soul untouched. PeterGreave, author of four books, England

There is a communion in everything related to nature.beginning with the waking of the birds in the melodi-ous and harmonious song in the almoncl trees. spreall-ing happiness in our spirit ai times of such geai need.Antonio Borges, Jr., author. Bm./Á I

1 stopped to watch the baby chickens feed a while. Andas they scrzttched in search of worms.

My gloom was gone,

And I

Found I could smile! Hayashi, Japan

RO. Box 133, Oak H li. WV 2590 I , USA Phone : 00!-304-4657365

Fax : 001-304-4657366


So 378FREEING OURSEINES PREJUDICE :LANGUAGE FORMS OPINIONS

Anwei Skinsnes hm., USA

Language forms opinions

The strong negative associations with the tern] leprosyand thoughtless use of the derogatory word leper haveresulted in many people advocating that the name ofthe disease be changed to Hansen s Disease However.the issue of terminology goes far beyond a preferencefor the term Hansen s Disease or leprosy and their

equivalents in difICrent languages. The images, lan-guage and labels used in association with leprosy orHansen s Disease have the power to either destroy aperson s lite or reallinn their humanity.

Every culture has language that is hurtfu I and languagethat promotes dignity. To promote sell-conlidence inthose individuais personally faced with the dual lengesof leprosy and to change the traditional social image ofthe disease, it is imperative to replace hurtful languagevvith language that recognizes a person as an individualseparai(' from the disease and focuses on abi 11vthan disability.

When I look hack ai my past, my soul is beckonedthe poems 1 wmte ()I' my father. There are times when1 think it would be more natural for me to write aboutmy li te as a leprosy sufferer, but my altitude of mind asa poet is inelined more to write about my existenee asa human being. Elartiko Tsuda, Japan

P.O. Box 133, Oak Hill. W V 25901. USA Phone : 00!-304-4657365

Fax : 001-304-4657366

Email : ideausa(a`inetone.net

So 49LOCAL PARTICIPATION IN URBANLEPROSY ERADICATION PROGRAMME

Sr. Franeina, Damien Foundation India Trust. Chen-nai

Community Participation is one of the most popularterms of the era specially when speaking about peopleoriented programmes. The success of any programmeis attributed to commllnity participation. Communityparticipation in leprosy eradication programme is stillrestricted to community leaders or few volunteers.

Involving organized groups in the community for lep-rosy control activities is a novel idea adopte(' in Salemurban. Tamilnadu. Incha. The organization covers apopulation of 5,50.000. The arca is divide(' into II sec-tors and lias 33 drug delivery points. Registered andunregistered organizations in the project arca (commu-nity) are roped in, motivated. trained and employed forcase detection. completion of treatment and preventiveeducation. Duriiir lhe year 1999-2000. a total of 825leprosy new patients are registered for treatment.Treatment com ! lance is more than 95%.

The experience of SI.Mary s. Salem in col laborai ingwith the service oriented groups and strategies ein-ployed in enlisting lhe ir co-operation wil I be discussedin

Damien Foundation Incha Trust, 27 Venugopal Av-enue, Spur Tank Road, Chetpet, Chennai - 600 031

Phone : 0091-44-8280496

69, 2 (Suppl.)^

Abstracts of. Congress^ S189

Fax : 0091-44-8230467

Eniail : [email protected]

So 84TRIALOGUE - A S'I'RATEGY FORCONIMUNITY/F'AMILY RASEI)REHABILITATION

fkalchttri, P.K.I?mil, ILL.SIiwoui & D. W. Desh-blinatir Bhopal

For Community Based Rehabilitation (CBR ), it is es-sentia! that community & family is educated about thescientine facts of. leprosy and convinced abou! cur-ablity. Uprooting perceived fear of infectivity, inyths& misconception is a precondition for raising leprosyaffected persons. Counseling through trialogue hasbeen tried for the same purpose. 8 issues of ostracisa-tion and 4 issues of social restriction were resolvedsuccessfully, through TRIALOGUE.

The issues were resolved in l'OD care & concerncamps. Many sittings and follow up was required toreach the goal. Individual case was of its own kind, re-quiring same strategy & approach i.e. TRIALOGUE.

Cases which were resolved belong to rural arca of dif-ferem districts. This effort not only resolved the prob-tem of ostracisation Int also prevented futui.e ostraci-sation & restrictions on social services to LeprosyAffected Persons (LAP) was also p11110 an end .

TRIALOGUE is a strategy which anus to changingcommunity attitudes and behaviour through role mud-eis. active participation in caring for leprosy elisabledas well as open and bonest discussion about fears con-cerns. prejudices and problems. This is an interactivemethod between the key playerspatients, providers andpeople around - all of whom are ou an equal footing.

In POD CARE & CONCERN CAMPS many myths &misconceptions about leprosy get resolved automati-cally because of services and action oriented activities.1)uring camp all three stake holders

i.e. patients, proviclers of services and people arounel(PPP), are active!), associated to surface the social is-sues and discuss then openly. KAP changes throughTR1ALOGUE have been sustainable. Decisions ar-rive(' ztt in this TR1ALOGUE situation is a concensusdecision leading to resolution of the issues.

The strategy is being applied in the entire state graclu-ally and health functionaries have been identilied tofunction as facilitators.

8C, Paramount Villa, Shamla Hills, Bhopal Phone0091-755-660193

Fax : 0091-755-660293

Emiti! : [email protected]

So 105A STUDY OF BEHAVIOURIAL CHANCES INSCHOOL GOING HEALTHY CHILDREN OFLEPROSY PARENTS

Dr.B.B.Maludan, DrGeeta Garg &Governnient Medical Co! lege & Hospital. Faridkot.Punjab

Leprosy is being considered a social st igma & God scurse rather t hen a disease. Not only theleprosy parentsbui their children are also discriminated in our societyin spheres nI li ie. 77 schoolgoing healthy (Inteirei]having one or hoth leprosy parents were examined tostudy the behavioural changes according to child scoreB, i.e. children behaviour questionnaire prepareel bychild psychologist. These (Inteirei] of leprosy parentswere being admitted in charitable school cum ashramswhich was providing boarding & lodging facilities tothe children which helps them not only to study in agemd environment but also to lia tu them in vocal tonalcourses. These school cum ashrams had helped toavoid social stigma attached to these chi lelren of beinghaving one or both leprosy parents. All these childrenwere in age group of 5-15 yrs. 58 children were havingnon Punjabi parents & 19 havine Punjabi parents.None of these chi lelren was having any signs & symp-toms o f leprosy nor any chilcl showed any significambehavioural changes as recorded ou chi ldren s behav-iour questionnaire. So these charitable boarding c'SJ.lodging schools for children of leprosy parents is theneed of the hum in our society to help these children tobecome responsible citizens without any social stigmaof their parents disease which retinires initiative fromthe dermatologists with active participation of socialorganisations.

Government Medical College & Hospital, Faridkot -151 203, Punjab Phone : 0091-1639-52131

So 151ASSESSMENT OF IMPACT OF SERASSISTANCE ()N THE SOCIO-ECONOMICSTANDARDS OF LEPROSY AFFECTED

B.V.Prasad, B.K.Na.vak, DrR.A.Bhuskade & V.Prab-hoka lo uno Sectinderabad

Soemo cconomic rehabilitation programine is imple-mente(' by LEPRA bulia n a project covering twotribal districts in Orissa si ice three years. The ap-proach is holistic. evolutionary and participatory. Ap-propriate systems are devised for identilication ofcl lents, assessment of needs, economic assistance andsupport through Collow up to enable the clients to re-establish normal family and social relationships. Theapproach involves fzimily and local commtmity in allstages of the programme.

150 clients were provided assistance to take^incomegenerating schemes of their choice; the State Govern-

SI 90^ h/term./tio/ui/ founiti/ of Leprosy^ 2001

ment has been a major player in the seheme of assis-lance.

The impact of SER assistance on the family and socio-economic situation of the clients has been assessed byadministering an interview schedule to 150 beneticiaries.

The results are analyzed and the findings are discussedwith special reference to the differences in impact inextent of disabilities, gender issues, rehabilitation andlocation of the clients.

P.B. No.I518, Krishnapuri Colony, West Marredpally,Secunderabad - 500 026 Phone : (()91-40-7802139,7807314

Fax : 0091-40-7801391


So 153REASONS FOR BEGGING BY LEPROSYCOLONY-MATES AND WHY THEY LEFTHOME

K.D.V.Pra.vad & K.Durga Raju The Leprosy Mission,Vizianagaram, Andhra Pradesh

Objectives : To find out the reason for begging andcauses for resorting to colony life.

Design : Cross-sectional study, by using questionnaire.

Setting : 4 leprosy colonies in Vizianagaram district ofAndhra Pradesh were taken for study.

Participants : Leprosy affected persons (RFT) living inthese colonies.

Main out-come Measures : 118 heads of families wereinterviewed, in June 1998.

Results : For 73% of them, having deformities, beg-ging became the last resort. 15% of the total inter-viewed, joined colonies dueto rejection by families.

Conclusion : Deformity and rejection by family leadmost of them to begging. All of them are interested intheir children s future, and want assistance for their ed-ucation and vocational training. If alternative source ofincome is provided, with guarantee, 15% of them arewilling to stop begging.

The Leprosy Mission, P.V.T.C.Cheeluru, Vizianagaram- 535 005, Andhra Pradesh Phone : 0091-8922-41550


So 155FACTORS INFLUENCING REGULARITY OFTREATMENT OF LEPROSY PATIENTS

Suneel R.Qamra, K.Venkaiesan. H.Kumar & N.Ku-mari, Central JALMA Institute For Leprosy, Agra

In order to understand the contributing factors respon-sible for treatment compliance or otherwise in leprosypatients, 288 patients auending the OPD of centralJALMA Institute for Leprosy. Agra were selected forthis study. Of these, 74 patients were drop-outs, 121patients were irregular and remaining 93 patients wereregular in seeking their treatinent.

These patients were interrogated in-depth to inquireabout their demographic profile, SES status, theirknowledge about disease & its associated deformities,treatment and its curative aspect and other related fac-tors such as nature of occupation, distance, timings,other sicknesses, family responsibilities & so on; so thatLhe relevem factors can be identitied which act as thebarrier in seeking regular treatment.The details of thetindings will be discussed at the time of presentation.

Central JALMA lnstitute For Leprosy,Tajganj, Agra -282 (X)1 Phone : ()091-562-331751 - Extension - 244

Fax : 0091-562-331755


So 219COMMUITY PERCEPTIONS AND THEI RINFLUENCE ON DEHABILITATION OFPERSONS AFFECTED BY LEPROSY

Sujai Suneetha, Rangamulha Ruo PV & 'Mak S.°ululam. Lepra India, Hyderabad

Leprosy not only affects the body; it also disrupts pa-tient s socio-economic & cultural balance and leads apatient Mto a state of Debbi I itation . Dehabilitation isa reduction in the social function of the individual,which is reflected in the overall quality of life, atti-tudes and actions. Societal factors play an importantrole in detemiining or preventing dehabilitation ofpeople affected by leprosy.

This study analyzed the perceptions and practices ofLhe community regarding leprosy and persons affectedby leprosy and their influenee on dehabilitation of pa-tients. 50 leprosy-affected patients were interviewedbased ou a questionnaire (55 questions) that coveredfamily relationships, vocational conditions, social in-teractions & self-esteem of the patients. For each pa-tient, two other members were interviewed (50 ques-tions) from among their family, relatives, work placecolleagues or society members. The study was con-ducted in the HYLEP urban control project of LEPRAlndia in Hyderabad. Halfof the respondents were froma high endemic arca and half from a low endemic arca.

In the high endemic area, the average dehabilitationscore for vocational interactions was highest indicatingthat the patients were well accepted in their workplaces. Next in descending order was family relation-ship; self-esteem and acceptance in society was thelowest score. In the study of dehabilitation of society,

69, 2 (Suppl.)^

A b.siracts of Congress^ S191

it was 'intiid that the l'amily members had the highestscore, followed by work colleagues, relatives and othersociety members. This shows that family membershave the highest acceptance of the pai lents comparedto the other three groups. The dehabilitation score ofpatients and society from the low endetnic arca revealalmost iilentical figures as the high endemic arca withuni)/ a marginal increase in the average values. Furtherrecommenclations based ou the study willbe discussed.

Lepra Ilidia, Blue Peter 12esearch Centre, Cherlapally,Hyderabad - 501 301 Phone : 0091-04-7264547

Fax : 0091-40-7262571

Ema i I : lepi n ia @ hcl I .vsn I .net

So 306FACTORS INFLUENCINGDISCONTINUATION OF TREATMENTAMONG PERSONS AFFECTED BY I,EPROSYIN EASTERN NEPAL

M.L.Heynders, Nepal

In preventing patients from early discontinuation oftreatment, many programmes invest itt improving thedoctor-patient re I íttionshi p, improving the patient sknowledge about the disease and its treatrnent and cre-ating informed-consent . These approaches assumethat patients take a rational decision to continue or notwith treatment and that problems hieed by the patientcan be solved. Not only these are important issues, butalso the whole context, the patient s I ife. culture, andperceived structural barriers are important. Ou basis ofthis perspective a study was conducted to investigatethe main reasons why some patients continued treat-mem and other did not. The study conducted was qual-itative and in-depth interviews were used (n=76). Thepatients understanding oh their disease and experiencewith treatment as well as their diverse situations wereinvestigated.

The linclings clearly demonstrate that the social con-tem was important in how peoplelooked ai the personaffected by leprosy. The person s ritual, eeonotnicaland political saiais was of influence in how the diseasewas experienced by the person affeeted by leprosy andin how the family and community members acted to-wards this person. Otite]: important factors which influ-cocei! the decision to continue or not with treatmentwere the perceived quality of care of. the leprosy serv-ices delivered at the HPs, the side effects experienced,the presence of visible symptoms and deformities, fear()I' social repercussions and a different notion of cure.'I'() cure the disease leprosy, a patient needs to be ableto linish his/her treatment. This study shows that deci-sinos to discontinue treatment must be regarcled as apatient s attempt to gaio control over his/her life;whereby this gaining of control can be more importantto the individual than achieving medicai cure. The pre-

sentation will focus on some of the results and espe-ciai! y on the effect of interpersonal relationships andwill show how persons affected by leprosy gaio con-trol over their li WS and thus stopped medication.

So 317PHYCHO-SOCIALASPECTS OF LEPROSY

Salda Ruchal„Sakalananda Shrestha, Muda tiGla lacre, C.Rath malha, Wan Theuvenet â: PaulRache, Anandaban Leprosy Hospital, Kathinandu,Nepal

In 1991, more than 400 Nepal' leprosy patients wereinterviewed using a WHO self reporting questionnairedesignei! to detect non-psychotic disorders. The ques-tionnaire was supplemented with questions abola thepaliem s family and social situation. The data showeda low bui signilicant levei of mental health prol)] e msamong leprosy patients (80/411, 22%) and identiliedsignificam l'actors predisposing patients to psycholog-ical stress( poor family acceptance) as well factors re-docing the risk of Inculta! illness (literacy, admission tohospital). The same questionnaire was used in inter-views with leprosy patients in 2000, and the residiscomparei! with the earlier cohort.

Since leprosy health care includes care of possible psy-chological and social problems caused by the stigmaassociated with leprosy, it is important to measure theextent oh these problems. Improved individual and so-cial acceptztnce of leprosy lias been posited to t.te theresult of the newly perceived curability of leprosy andthe decline in defonnity in the past 10 years since theintroduction oh multi-drug therapy (MDT). Howeverthis improventent lias not beco documented in anyquantitative manner. The comparison of data collectedfrom two cohorts of patients nearly 10 years apart willprov ide important information on the trends in leprosypatients mental health and social acceptance..

Anandaban Leprosy Hospital, RO. Box 151, Kath-mandu, Nepal Phone : 00977-1-290545

Fax : 00977-1-290538

Em ail : anand abai) @tu ai 1 .com. tip

So 393COM NIUNITY PA RTICIPATION IN LEPROSYELIMINATIONDr.1:Kirubakaran^ GLRA Incha,

Chennat

Community is a leria applied to society and socialgroups inhabiting a particular arca and acting togetherin lhe chief concern oh theirlives. The community con-sists oh groups oh people living in harmony and inter-dependence. Therefore The Comniunity plays a pivotal

SI 92^Imermaional .lournal of. Lepro.sy^ 2001

role in the scenario of leprosy elimination and rehabil-itation o{ the victims of the elisease, leprosy.

In order to ensure their participation. the NGOs andGovt. authorities must bring about an awareness ofleprosy at every levet and motivate the community togo hand in hand with the efforts of lhe NGOs andGovt. authorities to tackle the disease and to hring un-der control the prevalence of the disease anel minimizethe trauma that follows alongside.

What steps are taken towards community education'?Health education and social rehabilitation aspects inustbe popularized. The community must be awakened toits responsihility that el int Mation of the disease and re-habilitation of its victims hes solely with thein.This inturn will elevate the social status of the leprosy pa-tients in the COO) 11

SLI p po rt for Community Action for Leprosy Elimina-tion (SCALE) is one such community based projectla 11 it c hed to moti vate anel mobihze community achemand utilize the community resources for active supportof leprosy elimination.

SCALE aims at harnessing community volunteergroups to assist leprosy work. This project initiates ac-tive health education programmes ou leprosy to thegeneral public about every aspect of the disease. Skincamps are organised to detect hidden costs and to bringthem out for medicai care and surgical assistanee. Thisproject also promotes active involvement in welfareand rehabilitation activities in order to pave the way forquicker social assimilation. ldeas and suggestions aris-ing fruiu the coo) muni participation are periodicallyexchanged with the NGOs anel Govt. authoritiesthrough seminars which help update their piar) of action.

In short. the involvement of the community is of suchintegral importance that from the stages of detection ofthe cases, treatment and care to rehabilitation the com-munitys active participation plays ai) important func-tion which no other body can assume.

GLRA Incha, 4 Gajapathy Street, Shenoy Nagar, Chen-nai - 600 030 Fax : 0091-44-6446479


So 14NON-CONVENTIONAL METHODS OFHEALTH EDUCATION

Sudhakar Bandyopadltyay * & Mathura Prasad Ma-halo, *Grecaltes Training Centre, Calcutta, GMLF,Balarampur

The non-conventional methods of health educationbring novelty both to the leprosy workers and the au-dience which has been experienced at the BalarampurControl Unit of the Gandhi Memorial Leprosy Foun-dation in West Bengal. The methods were puppet-show, street play anel Kustha-Sainkirtan . The stories

were based on the incidents which took place local ly,played by the lcprosy workers in local dialects. Thereis scope to change the stories, characters, dialoguewhile lhe central theme, the message on leprosy re-mains the same.

Introduetion of non-conventional methods ii healtheducation along with routine activities has encouragedearly case reporting, treatment compliance andin.volvement of the social leadership in anti-leprosyactivities.

An analysis of data collected for last 8 years (1992 -1999) produces encouraging outcome. Total 386 pro-grammes were conductecl in 287 villages with an aver-age audience of 450. The effects include ou spot re-porting 241 persons with suspicious lesions. Total 322patients were rcported and registered including casesreferred by teachers, community leaders and familymembers.It also prepared grounds to solve un-favourable issues.

The above tindings suggest that non-conventionalincthods have potential contribution to create mass-awareness in leprosy anel to change behavioural pi-tem as well, especially in the rural arca.

23 Market Street, Calcutta - 700 087 Phone : 0091-33-2441297

Fax : 0091-33-2 I 64339


So 20EFFECTIVENESS OF IEC INTERVENTION INSPECIAL LEPROSY CAMPAIGN IN ANURBAN AREA OF ORISSA

K.A.Benny, P.V.Rangamullui Rao, V.Prabliakara Ruo

.laytlel. Solai Hyderahad

Moditied leprosy campaigns were conclucted in Omissawith the components of active search and contirmationinvolving General Health Care staff. One such moditiedleprosy elimination campaign (MLEC) was conduetedwith the strategy of VollIntary Report Centre approach inOrissa State three months after a similar exercise.

LEPRA India established an IEC and POD unit inBhubaneshwar urban arca to strengthen the services inBlitibaneshwar leprosy eradication uno in the arcas ofIle..alth Education and l'( )l). Voluntary rep(ming centreapproach was impleinenteel uneler the guielehnes ofGovernment of Ilidia with necessary pre-requisite IECactivities in July, 2000. 1EC activities included medi-ods of personal communication anel information cam-paign using mass media. The content of the messageconcentrated improving voluntary reporting of asesto existing health facility treating leprosy. Ali peoplewho have attended the voluntary reporting cases wereinterviewed to know the source of information to as-sess the effectiveness of IEC campaign.

69, 2 (Suppl.)^

Abstmets of Congress^ S193

151 people reported ai voluntary report as centres withsuspected signs ai leprosy. 82 patients were confirmedwith active sigas of leprosy. li Wati observed ia theanalysis that 8 people reached vai untar)' reporting cen-tres merely by seeing the direct i Ve signboards and han-tiers. ElTectiveness ai these intervention methods oflEC activities used and their reach ia urban and semiurban arcas of 13hubaneshwar city were discussed iathis presentation.

P.13.No.1518, Krishnapuri Colony, West Marredpally,Secunderabad - 500 026 Phone : 0091-40-7802139,7807314

Fax : 0091-40-7801391


So 144PERCEPTION AND HEALTH BEHAVIOUR OFLEPROSY A FFECTED GRAN'I' PEOPLE - ANOPERATIONAL RESEARCHB.Pramp Reddy, J.Pachaiah, Babo Rua, Zokaralah,And Konum Ramesh 'Volum; Swamy Reddy & AnniePaul

Secunderabad

An urban leprosy project was established ia 1989 iaHyderabad city of Andhra Prztdesh with SET strategyunder NLEP guidelines. The project covers a popula-tion of 1,98.487 ia the peripheral wards of Hyderabadcity. The study arca lias 10% migrants among the gen-eral population. The migram population is distributedia small groups. Many people from neighbouring vil-lages ai ierated in groups with family members seekingtheir livelihood. These people alone with their familiessettled ia clusters of huts ia the border of project arca.The Oca! 10 behaviour amoite these migrant groups isdifferent from residem urban population. Study wasconducted to understand the perception and social re-action among arban and migram population towardsleprosy. Data was collected through ia depth inter-views through qualitative interview techniques. Thelindings are used to formulate innovate strategiescover these population. The study lindings andstrategy for proeramme CON'CnWe are discussed.

P.B.No.1518, Krishnapuri Colony, West Marredpally,Secunderabad - 500 026 Phone : 0091-40-7802139,7807314

Fax :0091-40-780139!

Entali : [email protected]

So 145KAP AMONG GENERAL PUBLIC AND SER-VICE PROVIDERS AND PROSPECTS OF LEP-ROSY INTEG RATION

A.B.Prabharalkar & Dr 1/ ^Alibag, Maha-rashtra

The Y2K lias not witnessed. immensely promulgatedleprosy elimination. The world will enter the IICW mil-lennium, ia a month s time, encumbered with reasonablyhigh presa cace of leprosy and stzttic rate 01 New CaseDetection 1 NCD) ia various parts ai endemic regions."et. pronouncement ai lntegration ai Leprosy into Gen-

eral Health System (GHS) appears decisive. Positive al-titude of society & beneliciaries and preparedness aí ser-vice providers are pre-eininent determinants to successof. Leprosy Eradication Programme through GHS. In thiscontest, KAP Studies were undertaken among generalpublie and GHS service providers (GHS-SP) to gaugethe prospects of Leprosy Integrador] Proeramme iaRaigad District aí Maharashtra State.

The study observed satisfactory level of leprosyknowledge amplie 996 lay respondents and 488 GHS-SP. The least conlidence in GHS ia regard with leprosyexpertise is shown by general public (4%). Only 12%prefer to taken treatment from GHS. This can be at-tribute(' to the ia! criar qual ity of services people expe-rience at GHS. As many as 77% are against conjugalrelationship with leprosy spouse and 73% advocatingisolation of leprosy patients in this hi-tech cyber-age.

While 75% of GHS-SP respondents showed no reser-vation for Leprosy Integration Programme, 67%opined that such operational transmutation will helpeliminate social stigma attached to leprosy. However,they seein equally divided over their view about theneed to continuing NELP to haste') the process aí Lep-11)5)' Eradication. Althoueh 73% of GHS-SP respon-(lents were found to acquire correct knowledge of sus-pecting leprosy, 53% do not know right diagnosticsigas. Similarly, knowledge in view aí leprosy compli-cado]] is observed lar below satisfactory levei.

The paper also examines the impact of levei of KAPamong general public and GHS-SP ou pattern of NewCase Detection (NCD). The dependency on active sur-vey to detect over half of the new cases is increased by30%. in post MDT period. GHS contribution ia NCDhas leapt to double (from 8% to 16% of total NCD)against a steep fall in voluntary reporting by 44%.

Continued on next page The authors review the arcasneeding immediate attention and discuss the prospectsof Leprosy Integration Proeramme. However, the au-thors believe that the time is not yet congruous for in-tegrating leprosy into GHS. at least in the reeions withalarmingly high PR & NCDR and technically Intuo-pareci GHS-SP in terias aí leprosy espertise. lt is in-evitable at this juncture that, to achieve desired resultsaí integratell programme. priority should be given toe liminaiing dependency on leprosy ia 51h11 and torestoring hiith ai GHS for leprosy.

Durvankur, Adarsh Nagar, Nav-Kurul, Alibag - 402201, Mahantslunt Phone : 0091-2141-23744

Fax :009!-2!41-22771

S 194^ International Jour,,/ of. Leprosy^ 200 1

So 200HEALTH EDUCATION FOR LEPROSY INRURAL AREA

M.D.Shaik, Dudhiya, Dahod District, Gujarat

I am M.D. Shaikh, Leprosy Assistant work ing inNLEP in Gujarat State. I want to explain some experi-ences about 1-kali') Education in Leprosy. Health Edu-cation plays an important role in the control of leprosy.ft should be directed towards the general public, espe-cially receptive sections such as students, school chil-dren, school teachers, also medicai students and physi-cians, paramedical workers and the leprosy patient andhis family.

Most of the public live in villages. They have notenough education about leprosy Those people haveblind beliefs about leprosy disease. As per my tield ex-periences, people believe that leprosy means Man wholias lost his hand, feet and tingers, depresed nose, lionface or a claw hand . People do not know early signsand symptoms of leprosy - even educated people areignorant about leprosy. Due to social stigma, peopleare not taking interest to work itt this field.

Health education is the most important to detect earlyleprosy cases. In rural arcas people have some blindsbeliefs such as:

I) Leprosy is an incurable disease; 2) Leprosy is aheriditary disease.

First of. all. we should remove these beliefs by healtheducation - tlip book in local languages, charts andposters are very useful for wide spread health educa-tion about leprosy During house to house survey, flipbook is very useful. like AN ATLAS OF LEPROSYpatches on different parts of body where loss of hair.different colour from original skin colours. nodularthikening of earlobes, loss of eyebrow -this kind ofphoto pictures are very effective with rural people. Byseeing this book, hidden cases themselves come outfor treatment.

Those people who have no knowledge about leprosybecause they live itt tribal intenal arcas, sometimesthey cannot take early treatment and become victimsof deformities.

Now-a-days our government has started M.L.E.C. andin this programme, we are giving broad health educa-titio in rural arcas. We have tinished two M.L.E.C. pro-gramines in Gujarat State by general health staff.

At. & Pos. Dudhiya - 389 146, Litukheda Taluk, Da-hod District, Gujarat Phone : 0091-2677-22455

So 212MAKING HEALTH EDUCATION EFFORTSRELEVANT : THE KARIGIRI APPROACH TOCOMMUNITY TRAINING

Sivasankaran S. Ready N.B.B. & Samuel SolonumSchieffelin Leprosy Research And Training Centre.Karigiri. Vellore District, Tamil Nado

With integration oU leprosy services with generalhealth care. there was a need for senior field personnelfrom the original leprosy programme to be retrztined inkey arcas of general health, so as to make thent equiv-alent to their counter-parts in the publie health sector.This paper presents our experiences and ellicaey in nu-dertaking a training course in Health Education for Se-nior Non-Medical Supervisors in the Government of'Farol] Nado.

A total of 35 participants were trained in two balches,each for 2 murutis duration from April 1999 to July

1999 at SLR &:TC, Karigiri. It was decided to use thestrategy of employing only active learning methods sothat they would be involved in Learning by Doing .The curricull1111was designed partly as community-ori-ented and partly community-based. Modem methocl-ologies tailor-made to suit the needs of the groupswere used. Dynamic innovat tons based ou the currentsituation in specitic groups are incorporated. Finally.the programme drew from the experiences of indi-vidual members, utilizing peer to peer teaching andlearning strategies to the fullest. After carefully con-sidering individual differences of the participants, theywere divided into 4 groups. Two nearby villages weregeographically di vided loto four arcas for implementa-tion of Health Education activity. Participants weremotivated to establish good rapport with the commu-nity. and were required to condoei ao initial survey, toestablish lacunae in the health situation as well as es-tablish the level of knowledge among the villagers bya pre-test. Four key arcas were identitied by the partic-ipants such as Maternal and Child Health, Poliu. Envi-ronmental Pollution, etc. The topic was then toilizedboth to learn about, share their newly-learned knowl-edge with the other three groups as a trial teachingprocess, impar' this information to the community, andfinally monitor the effectiveness of (heir health educa-tion effort by a post-test among the villagers.

The levei of knowledge of the villagers for all groupstaken together was 27% in the pre-test and 72% in thepost-test. Improvement in specific topics was a 1)111)muni of 32% anel maximum of 71W .

Further details and experiences will be discussect andpresente(' in the paper.

Schieffelin Leprosy Research And Training Centre.Karigiri -632 106, Vellore District. Tamil Nadu

Phone : 0091-416-274229

Fax : 0091-416-274274

69, 2 (Suppl.)^

Ab.suacts of. Congress^ S195

So 215IMPACT OF IEC IN URBAN LEPROSY CON-TROL IN CHENNAI

V.Sreenivasulu, DrS.Thirunarakarasu & DrM.Math-ews Gremaltes Referral Hospital, Chennai

I.E.C. continues to be the strongest instrument in casedetection at Gremaltes Hospital in Chennai. Gremaltescaters to a population of twenty four lakhs for the pe-riod of three decades. Out of the 56,932 detected casesso lar. 32.13% is by voluntary reporting.

This has been achieved by intensive systematic I.E.C.covering the project arca of seventy nine corporationdivisions. Mass group and individual approach wereused by trained health educators and other healthworkers.

Comparison of various modes of surveys in case de-tection versus voluntary reporting is discussed in (letaliin this presentation.

Gremaltes Referral Hospital, 5 Gajapathy Street,Shenoy Nagar, Chennai - 600 030 Phone : 0091-44-6441840. 6443411

Fax : 0091-44-6446479

Ema i I : grema 1 tesel km ron 1 i ne.com

So 266ME'l'HOD AND EFFECT OF HEALTH EDUCA-TION ON LEPROSY IN THE NATIONAL AREAOF SICHUAN PROVINCE IN CHINA

Wang Rang Mong, Hu Lulang, Wu Xingshen, LingYong & He Lu, Sichuan Institute OU Dermatology &Venereology, Sichuan, China

Health education on leprosy are carried out in theLiangshan national arca of Sichuan Province, theknowledge of leprosy are popularized, good effect isgol in discovering more patients and increasing theknowledge leprosy grasped by the civil servants.

Method: The government attend the workshop to traio-ing the clirectors of the town and the sanitation house aswell as epidemie doctors. News media and public healthorganization carry out health education on leprosy by alikinds of methods. Special organizations collect the cluesreported by the barefoot doctors and the mass, assign ex-perts to detenninate the dinnosis. Health education cov-eis 17 comines, 601 townships, more Man 3709 villa2es.59 short training classes are held, 4707 cadres of coun-ties, townships and villages and health workers attendthe training, 225 chies are reported right now, and 47 aredeterminated as leprosy patients by bacterial and histo-los;ical examination. 134 cases are discovered o thepreecture that year which is 47 cases more than the yearbefore (54% more). The knowledge of leprosy twaspedby health workers and the mass is increased. It ("emoli-strates that it is necessary for the government to attend

the health education on leprosy in the national area,which can discover the hielden patients in the commu-nity, and teach a good lesson on leprosy to the whole so-ciety, push forward the work of elimination of leprosy.

Institute Of Dermatology & Venereology of Sichuan.12 Sidao Street, Chengdu - 610031, Sichuan, China

Phone : 0086-28-6240384

Fax : 0086-28-6641301

Entali : [email protected] .chinfomet

So 298AWARENESS ABOUT LEPROSY IN SUNSAR IDISTRICT OF NEPAL

Agarwal S, Gare V.K.„lha N & Agarwalla, B.P.Koirala Institute Of Health Sciences, Dharan, Nepal

Nepal is one of the countries with high prevalence ofleprosy and in general the prevalence of the disease isrelatively higher in the Terai compared to the Hills. Inline with the objective set by WHO for eliminationleprosy, a Nationwide Leprosy Elimination Campaign(NLEC) was unclertaken during Auszust 1998 to Febril-ary 1999 under the co-ordination of the Leprosy ControlDivision, Department of Health Services, HMG. Nepal.One of the objectives of this campaign was to increasecommunity awareness. In the present study. we ana-lyzed the knowledge of leprosy, leprosy eliminationprogram and the impact of the mecha on sttch awarenessin the population of Sunsari District, Nepal on nationalimmunization day program (2Ist November 1999). Atotal of 1647 respondents were interviewed. Out ofwhich 60% were female and 74% were in the age groupof 20-40 years. Agricultural workers constituted 58%.31.6% were illiterates. Approximately 60% of the re-spondents knew the cause and symptoms of leprosy.Leprosy is curable was felt by 81.8% and 95% thoughtthat in suspicion of disease it is necessary to go to hos-pital for treatment. Although, 75% of the respondentsknew that CillIQS for leprosy are available free of cost butthe goal of elimination by 2000 AD was tmderstood byonly 47% of respondents.Radio was the single most ef-fective means of providing information, education andcommunication about leprosy. The good response aboutleprosy knowledge in illiterates was comparable to oth-ers. A good knowledge may increase the altitude to-wards leprosy, case reporting, and motivation to becured and decreases lhe deffirmity. So, intensilication ()I'health education is a must for achieving the gottl.

Department ()I Dermatology & Com mim ^Medicine,

B.RKoirala Instante OU Health Sciences, DitaramNepal Phone : 00977-25-23877

Fax :00977-25-20251


S196^ Intermilional foro-mil of. Leprosv^ 2001

So 394MASS AWARENESS THROUGH VILLAGEMEETING

S.N.Venna, Shira Nair(' Verna & D.PVerma New Delhi

A simple formula for mass-awareness without any ex-pense. In my strategy, every NMA will conduct onevillage meeting in every week. Hence. there will be 4meetings in a month and 48 meetings in a year. If thereare 50 NMAs in the district. the total village meetingswill be 2,400 in a year. The total village under mie dis-trict is less than 2000 itt maxiinum cases.

Ii it is good. it can be tried in N.L.E.P.

S.N.Verma, C/o.Dr.M.A.Arif, Country Representative,Netherlands Leprosy Relief - Ilidia. U-9 Green ParkExtension. New Delhi - 110 009 Phone : 0091-11 -6107959

Fax :0091-11-611)7963


Me 03AWARENESS ABOUT LEPROSY IN SUNSARIDISTRICT OF NEPAL

Agarwal S, Garg VK„lha N & Agarwalla A, Depart-ment aí Dermatology and Community Medicine. I3PKoirala Instante of Health Sciences. Dharan, Nepal

Nepal is one of the countries with high prevalence ofleprosy and in general the prevalence of the disease isrelatively higher in the Terai compared to the Hills. Inline with the objective set by WHO for elimination ofleprosy, a Nationwide Leprosy Elimination Campaign(NLEC) was undertaken during August 1998 to Febru-ary 1999 under the co-ordination of the L,eprosy ControlDivision, Department of Health Services, HMG. Nepal.One of the objectives of this campaign was to increasecommunity awareness. In the present study, we ana-lyzed the knowledge of-leprosy, leprosy eliminationprogram and the impact aí the media on such awarenessin the population of Sunsari district. Nepal ao nationalimmunization day program (21 st November 1999). Atotal of 1647 respondents were interviewed. Out ofwhich 60% were female and 74% were in the age groupof 20-40 years. Agricultural workers constituted 58%.31.6% were illiterates. Approximately 60% of the re-spondents knew the cause and symptoms of leprosy.Leprosy is curable was felt by 81.8% and 95% thoughtthat in suspicion of disease it is necessary to go to hos-pital for treatment. Although. 75% of the respondentsknew clrug for leprosy available free of cost hut the goalof elimination by 2000 AD was understood by only47% of respondents. Radio was the single most effec-tive means of providing information, education andcommunication about leprosy. The good response aboutleprosy knowledge in illiterates was comparable to oth-ers. A good knowledge may increase the attitude to-

wards leprosy, case reporting, and motivation to hecured and decreases the deformity. So. intensificado!) ofhealth education is a must for achieving the goal.

Department of Dermatology and Community Medicine.BP Koirala Instante of Health Sciences, Dharan, Nepal

Phone : 00977-25-23877

Fax : 00977-25-20251

Entali : sudlia92@ liai mai I.com

Me 15DISABILITY AND REHABILITATION - MASSAWARENESS THROUGH MEDIA

Sudhakar Bandyopadhyay , Grecaltes Trai ni ng Cen-tre. Calcuna

The persons lacking normal functional ability doe tothe disease Leprosy are within the social jurisdictionbut except a few, they are not in tune with the main-si reuni. They also equally become the victim ai self -stigmatisation and the loss of psycho - social equi ib-rium stimulates these persons even to be hostile to thesociety and to curse their own fale.

Social participation (tf the clisabled is a multi functionaland inulti-sectoral approach. It incl odes social. psy-chalogical, educatianal, occupational, econamic andmedicai nneasures ai ming at social assimi I ation of theLeprosy disabled.

The power - lobby needs equally to be.aware regardingthe dimension aí the rehabilitation - problem and stepsof solution. All these faciais call for a planned changeto intluence the social altitude and media can contributepotentially to create a desired mass awareness levet.

The coverage of rehabilitation services could broadlybe incorporated hy prim. electronic and folk media.While print and electronic media have much intluenceon the literate and urban people, folk and non conven-danai methods have greater approach to the ruralpeople.

In arder to maintain the correct, integrated. tiniKomand comprehensive quality of communication. the me-dia - persons should be oriented ao the subject througha series of workshops organised ali over the country. Asyl tabus could be worked out accordingly.

The respective programmes. persuations. contacts andorgzmisational activities will be undertaken hy the re-habilitation service agencies bui in arder to maintainthe harmany. pace and parity, it is suggested that a co-ordinati iig agency should be there ou national levei.

23 Market Street, Calcutta - 700 087 Phone : 0091-33-2441297

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Re 349 Re 412 So 24

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