True rehabilitation is meaningful only when an afflicted person can go back to his village, his home and resume his life from the point he had left.
Leprosy is a chronic infectious disease caused by Mycobacterium leprae. It usually affects the skin and peripheral nerves, but has a wide range of clinical manifestations. Leprosy is a leading cause of permanent physical disability. Timely diagnosis and treatment of cases, before nerve damage has occurred, is the most effective way of preventing disability due to leprosy.
Need of Rehabilitation
Leprosy is a disease, which still strikes fear in the societies as a mutilating, disfiguring, contagious and incurable disease. Because of the horrifying nature of the enigmatic physical disfigurement and since no cure was discovered until the 20th century, leprosy has, for centuries, been a highly stigmatizing disease. The stigma attached to leprosy leads to loss of employment even before manual labor becomes more difficult due to disability, which often results from late or no treatment. It also leads to exclusion from society, causing physical and emotional distress.
Leprosy Associated Stigma & Discrimination
No disease has been more closely associated with stigma than leprosy, and it has become a metaphor for stigma. When the family or community knows that a person has leprosy he/she suffers economic and social losses, as well as participation restrictions in the community. It is high time that we look beyond the integration of leprosy in the general health care, access to health care and the fundamental right to health etc. It is imperative that we focus specifically on the scourge of discrimination. Discrimination against leprosy affected people has certain distinctive features- the misunderstanding of the nature of the disease or the psychological, emotional responses towards it that are often described as stigma and which result in discrimination. Many people still think that leprosy is a disease easily transmitted through touching, that if you are affected, the treatment is not perfect and the deformities will follow. This image of leprosy has been around for centuries, and it persists even today, even among well-educated people. The most obvious instance, which has been observed, is that in some cases hotels were not willing to allow leprosy-affected people to stay. Usually they discriminate, entrepreneurship, and hotels were afraid that other patrons would be unhappy.
What Can We Do?
All of us have times when we feel depressed, anxious or angry. We might even have a series of bad days, where we think that nothing will ever go right for us and the world is against us. For a physically or mentally ill person, these feelings do not go away. So the answer lies in education and understanding. If you know someone who seems very emotional, down or upset, then lead by example; show compassion and understanding, and encourage them to seek help. And if you’re suffering silently with emotional distress then take comfort in the fact that you’re not alone and there is still hope.
Facilitating Reconstructive Surgery in Leprosy
Leprosy is known to be associated with involvement of nerves due to which deformity in hand, foot or eye occurs. Due to this leprosy affected persons become disabled. Leprosy Affected Persons (LAP) already cured but left with deformities of hand, foot or eye would require Reconstructive Surgery (RCS) for correction of their deformity, to improve their functional ability. Pre & post operative physiotherapy is essential for successful outcome of surgery and therefore an integral part of the RCS process.
Ulcer / Skin cracks:
Skin cracks are caused by allowing the skin to become too dry. Leprosy often causes the skin to become very dry, through damage to the autonomic nerves which control sweating. Cracks are most commonly found in the creases of the hand, around the heels of the foot and in the toe creases.
The 2 main causes of blisters are:
- Heat – from direct contact with hot liquids or surfaces or open fire
- Friction – repeated rubbing of the skin on hard surfaces
Treating the ulcer is a great opportunity to reduce fear & stigma through demonstrating ulcer care without any discrimination. Family members are also encouraged to learn and practice the dressing of ulcer and nursing care of patient.