History of Leprosy in India

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For the next 5 days, we were completely immersed in learning about the history of leprosy in India. Its symptoms, clinical signs, target population, social stigma, misconceptions, and existing health assistance programs. Leprosy currently affects approximately a quarter of a million people throughout the world, with 70% of these cases occurring in India. Cases of leprosy in India have decreased dramatically from 5,000,000 cases in 1985 to 213,000 cases in 2009. This significant decrease is largely due to the effectiveness of multi-drug therapy (MDT) that was developed in 1981. The prevalence of leprosy in India is now less than 1 case in 10,000 individuals. However, the elimination is not met in all areas of the country; rural areas and urban slums continue to experience up to five times the number of leprosy cases as the national average.

India is considered the point of origin of leprosy with skeletal evidence of the disease dating to 2000 B.C.The disease is thought to have spread through trade and war to other parts of Asia, the Middle East, North Africa, and later Europe and the Americas. In ancient Indian society, individuals suffering from leprosy were alienated because the disease was chronic, contagious, resulted in disfigurement, had no cure at the time, and was associated with sin.In colonial India, the government enacted the Leprosy Act of 1898, which institutionalized leprosy victims and separated them based on gender to prevent reproduction. These laws mainly affected the poor because those who were self-sufficient were not obligated to be isolated or seek medical treatment. In the 20th century, even when drugs to treat leprosy became available and more knowledge was gained about the disease, the scourge of leprosy remains a persistent and widespread health problem throughout all regions of the country.

Leprosy Misconceptions:

Consider incurable

Deformity causing disease

Mostly present in beggars

Considered highly infectious, in spite of very close contact back in Roman Times, there was never contagious.

Considered as a hereditary transmitted disease

There is still legal discrimination against leprosy patients that prohibits them from participating in local elections, getting a driver’s license and from traveling by train. Another fact is that almost all of the marriage and divorce laws of India consider leprosy as grounds for divorce with the Special Marriage Act of 1954 declaring leprosy “incurable.” These laws do not reflect the current understanding of leprosy and they need to be updated. A leprosy patient looks like a normal and healthy person, they are able to have a regular job, are independent and have a family (leprosy is not a sexually transmitted disease), but the social stigma still exists and they are forcefully segregated in India’s society.

We visited the Leprosy Referral Community Center in Golibar, Santacruz (East). This center not only treats leprosy patients but also other skin infectious diseases as fungal infectious. Here, leprosy patients receive medical care free of charge.

Leprosy is a chronic disease caused by the bacteria Mycobacterium leprae and Mycobacterium lepromatosis. Contrary to folklore, leprosy does not cause body parts to fall off, although they can become numb or diseased as a result of secondary infections; these occur as a result of the body’s defenses being compromised by the primary disease. The mode of transmission of Hansen’s disease remains uncertain, most investigators think that M. leprae is usually spread from person to person in respiratory droplets.Studies have shown that leprosy can be transmitted to humans by armadillos.

Damage to peripheral nerves is a key component of leprosy. The sensory and motor loss that follows is the basis for many of the classical features of this disease, such as skin wound, cracks, plantar ulcer, clawed hands, foot drop and incomplete closure of the eye. Electrical stimulation therapy (in the arms) and paraffin wax therapy are part of the treatment to improve fissures and callosities in plantar ulcers in leprosy patients. Due to the stigma of leprosy and how is transmitted, medical workers in public hospitals are reluctant to provide leprosy patients with the adequate medical care; here patients are able to have their wounds clean and dressed properly to prevent further infections.

This center has contributed enormously to the early detection and treatment of leprosy patients. Many of them have been completely cured with no residual effects, allowing them to have a normal life and breaking the chain of transmission.

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