Washing is an important self care technique to prevent and treat LF and Leprosy patients. Photo Credit: LEPRA Health in Action
According to The World Health Organization a ‘fundamental prerequisite for accelerating the elimination of lymphatic filariasis, is the integration of the programme with other disease control/eradication programmes’. Disability prevention is however an essential part of LF elimination.
Where people are already affected by the mosquito borne disease LEPRA Health in Action has found that an integrated approach using self-care techniques to treat patients with LF along with leprosy and other lower limb disabilities is reaping rewards.
In places like Bangladesh and northern India there are few specialist services to help disabled people and government health centres are often only able to offer primary health care. The result is that preventable disability can occur. In addition to the physical effects of these diseases patients’ self-esteem and economic well-being can also be affected.
As part of ensuring that resources are used efficiently and cost-effectively the technical knowledge and skills historically used to treat leprosy disabilities are also being used to treat other conditions such as lymphatic filariasis (LF) in Bangladesh and the north Indian state of Bihar.
The main elements of this approach are deceptively simple, involving foot elevation, washing, soaking and exercising. By integrating this into its programmes LEPRA is working to improve the health of 4,000 people affected by LF in four districts in Bihar and in Bangladesh provides 10,000 patients in four districts with self care and disability care services.
LEPRA has been working with leprosy patients for over 85 years. Our experience with leprosy self-care is that in order to make it sustainable it must be incorporated into a patient’s daily routine. In order to achieve this self-help groups are established and patients’ relatives are also trained in the techniques. This means that support and encouragement is available to a patient affected by leprosy or LF to help them practise the self-care techniques they have been taught. It also means that ultimately people are not alone with a disease that is disfiguring and disabling, stigmatising and often discriminative.
Health education activities are also conducted to help reduce the stigma associated with these diseases. Leprosy stigma for example can have an impact on patients’ willingness to come forward for treatment early, before Grade 2 disabilities have occurred.
As a source of specialist services to improve the quality of life for people with disabilities we find our projects incorporating disability prevention, rehabilitation and disability care are making a real difference to people’s lives. In a sample of 32 patients recently assessed in India for example, every person was found to be practising self-care on a regular basis. Swelling has reduced for half of the affected people. Over three-quarters of patients practicing regular self-care had improved their skin hygiene and had fewer skin infections. A person with LF who used to experience 50 days of acute fever (linked to infections) a year, for example, now experiences fevers for only five days.
Patient with LF recieves treatment. Photo Credit: LEPRA Health in Action
Integrating services at a local level means that patients are able to access services closer to home, particularly important when taking into account barriers to travel, costs and lost earnings that would severely affect the poorest and those already disabled. According to the parent of a disabled child able to receive self-care services in Bangladesh, ‘Many patients become cured, there is good treatment at no cost.’
LEPRA Health in Action works to treat, educate and support people in some of the world’s most deprived countries. Originally formed in 1924 with the aim “to rid the British Empire of leprosy” we have built on our extensive experience to address not only prevention and treatment of leprosy, but also other diseases of poverty including lymphatic filariasis, tuberculosis, HIV/AIDS and malaria. In order to do this we need to continue to increase the availability of health care and improve its quality.
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