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Early signs - First sign of break through

Written by Dr Sunder Rao Bethapudy

firstsignsI have worked for The Leprosy Mission back in 1975-1976 at Vizianagaram, Andhra Pradesh. Ever since I joined the post I was struggling with the attendance of the Leprosy patients in the out-patient Department. Very few people would come for the medication. At that time Leprosy was highly prevalent in that region of Andhra Pradesh. For every 10,000 population taken at random there would be about 129 people with Leprosy.


The medication was a single drug of Dapsone given daily for a long duration. So after taking for few months people would lose interest either because the disease was not improving visibly or the duration was long. A small section of the population was hesitant to come for fear of being discovered that they have Leprosy. Whatever may the region, I had poor attendance at the OP department and I was determined to improve the situation.


I decided to visit the leprosy patient homes and find out the reasons for not taking the medication.


I saw that all the persons afflicted with Leprosy were living outside their village in small huts. Some of them were having dressing to their feet. When asked how they are managing to live there in such an isolation, they told me that they would go to their homes at the meals time and have their meals served on plates at the entrance of their homes and they would take their food back to their huts to eat later. They take bath near the well which is outside the village.

The usual answer was that they have given up the hope of getting better and even if they do, they are still not allowed to enter into the village as normal leave alone enter into their homes. Because the children will not get married as there is Leprosy in the home and no relative would visit either.


After my retirement in 2007 from Norwich as a Community Paediatrician, I went back to Salur about 40 miles from Vizianagaram where I worked before.The reason I did that is the hospital in Vizianagaram is closed for clinical work.


From the treatment point of view, things have changed too, multi drug therapy was introduced in 1983 with three drugs, and the duration of the treatment is either 6 months or 12 months depending upon the stage of the disease. Dapsone is a bacteriostatic, that is this drug does not kill the bacteria but keep their number in check. In other words, it does not cure the patient but at the same time the disease does not get worst in the individual and does not spread. The disadvantage of single drug therapy is the bacteria can develope resistance to the drug, it does not really cure the patient and it need to be given for years.


However the recently introduced drugs like Rifamcin is a bateriocidal, that means the drug actually kills the bacteria and therefore the disease is cured and there is no spread of the disease. If we catch the disease early in its stage, Leprosy can be cured with no deformity and with no signs of Leprosy, therefore there will not be any social stigma whatsoever. The second drug that is used is Clofazamine is a repository drug , that is, it is stored in the body and slowly excreted. The third drug is Dapsone.


In spite of vast improvements with diagnosis and treatment of Leprosy including surgical treatment, physio and occupation therapy, the wide spread stigma and deep routed prejudice remains the same. The fear of getting Leprosy is still enormous.


I was told that a gentleman with advanced Leprosy is living with his wife and daughter in Salur for some time. So I was very much interested in seeing the family but wanted to know what made this family different from others.


I went in with a hospital helper who introduced me to the family. A bright young girl came up to meet me and introduced herself , saying that she has finished her schooling at Salur and in the second year of her Degree at a University, in Vishakapatnam about 110KM from Salur. Then her mother came and joined our conversation. While we were talking the father limped into the room slowly and joined us. The wife said her husband is managing the corner shop which they own and is a part of the veranda in front of the house. Mostly he sells cigarettes, beedies, beetle nut powder, sweets and so on. I asked the father whether he is still taking the treatment and he said he has finished the treatment long time ago. I asked the daughter what her plans are once she has finished her degree. She said she will try for a job preferably in a big city, and she would like her mother and father live with her then. I wondered why this family is unique that the family is able to accept the father's affliction and accept him into their lives.


Perhaps the mother's and the young daughter's love for the husband/father made all the difference and broke through the barriers of social stigma of Leprosy. Love conquers everything on the path.


If you read in the New Testament of the Bible 1 Corinthians 13:4-8


It tells all about Love and what love can do.


Love is patient, love is kind. It does not envy, it does not boast, it is not proud.


It is not rude, it is not self- seeking, it is not easily angered, it keeps no record of wrongs.


Love does not delight in evil but rejoices with the truth.


It always protects, always trusts, always hopes, always perseveres.


Love never fails. But where there prophecies, they will cease; Where there are tongues, they will be stilled; where there

is knowledge, it will Pass away.


A passage from the Bible

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