January 29, 2017 was the World Leprosy Day and awareness of Leprosy is indeed vital in Papua New Guinea.
The disease is caused by a bacillus (rod-shaped) bacterium known as, Mycobacterium leprae that multiplies very slowly. Its incubation period can last up to 20 years, and it mainly affects the skin, and peripheral nerves.
It primarily affects and spread through the peripheral nerves, skin, upper respiratory tract, eyes, and nasal mucosa. Warm tropical countries like PNG are conducive habitats for the bacteria, also known as Hansen’s bacillus spirally.
The disease causes severe, disfiguring skin sores, and nerve damage in the arms and legs and has been around in PNG for along time, often surrounded by terrifying, negative stigma and tales of leprosy patients being shunned as outcasts.
Contraction
As a multicultural society with various forms of belief systems, Papua New Guineans should understand that Leprosy is caused by a germ and not from a curse, from a sin or hereditary. Researchers suggest that Leprosy spreads through contact with the mucus of an infected person. This usually occurs when the infected person sneezes or coughs. However, the disease is not highly contagious like the flu. Close, repeated contact with an untreated person can lead to contracting leprosy. They speculate that infected droplets reach other peoples’ nasal passages and begin the infection there.
- muscle weakness.
- numbness in the hands, arms, feet, and legs.
- skin lesions.
The skin lesions have decreased sensation to touch, temperature, or pain. They don’t heal after several weeks and are lighter than your normal skin tone.
Treatment
Most people have a natural immunity to the leprosy bacteria; factors such as hygiene and diet contribute to a person’s natural immunity, which is why the occurrence of leprosy is usually associated with extreme poverty. For those without a natural immunity to the disease, modern medical interventions are now available to kill the bacteria – the earlier this treatment is started, the better the hope for a complete cure without the lasting consequences of disability.
Leprosy is completely curable, using a combination drug treatment for Mycobacterium leprae infection known as Multi-drug Treatment (MDT) which consists of corticosteroids and antimicrobials. For paucibacillary leprosy, rifampicin and dapsone are used, while rifampicin, clofazimine, and dapsone are used in multibacillary leprosy.
And while there is still no vaccination to protect against the disease, reconstructive and rehabilitative techniques and processes have come a long way in the treatment of leprosy.
Prevention
The prevention of leprosy ultimately lies in the early diagnosis and treatment of those individuals suspected, or diagnosed as having leprosy, thereby preventing further transmission of the disease to others;
- Public education, and community awareness are crucial to encourage individuals with leprosy, and their families to undergo evaluation and treatment with MDT.
- Household contacts of patients with leprosy should be monitored closely for the development of leprosy signs and symptoms.
- A study demonstrated that prophylaxis with a single dose of rifampicin was 57% effective in preventing leprosy for the first two years in individuals who have close contact with newly diagnosed patients with leprosy.
- There is currently no widely used standard for using medications for the prevention of leprosy.
- Currently, there is no single commercial vaccine that confers complete immunity against leprosy in all individuals.
- Several vaccines, including the BCG vaccine, provide variable levels of protection against leprosy in certain populations.
Patient’s Safety Measures
Leprosy causes those affected to lose the sensation of pain in affected parts of their body, therefore it is easy for them to damage their skin and not even be aware of it. Thus prevention of these incidents is very important.
Walking over jagged rocks, blowing the embers of a fire, and wielding farm tools are all common ways that people with leprosy can damage the skin on their feet, face, or hands.
The Leprosy Mission (TLM) which works alongside the PNG Ministry of Health, and other agencies in Papua New Guinea teaches patients how to best care for themselves and prevent further injury and disability.
Patients are taught how to care for their hands and feet by soaking them in water, scraping away dead skin, and moisturising thoroughly.
They are given practical assistance and are shown how to wrap the material around the handles of tools to protect their hands or to use a pipe to blow on embers so they don’t get too close to the fire. They are also advised to examine themselves regularly for the beginning of sores or ulcers.
Wearing shoes and gloves can protect their hands and feet from damage, and sunglasses are important in protecting their eyes. Items like these are supplied by TLM and can be purchased by you as a Gift of Love.
Self-care also involves learning how to bath and protect leprosy-affected hands and feet.
Cases in PNG
Meet Augustine, Philomena, and Ronnie of Bougainville Island
Photo Credit: The Leprosy Mission
The above photo is of Augustine (aged 70) with two of his granddaughters: Ronnie (aged 10) on the left and Philomena (aged 8) on the right. Augustine has ten children and 30 other grandchildren. But Philomena and Ronnie pictured here were diagnosed with leprosy. They have an aunt, and uncle with leprosy too. They all live on Bougainville Island, an autonomous region of Papua New Guinea.
Augustine was first diagnosed with leprosy by a village health volunteer. Because Augustine was placed on treatment relatively early, he will have no permanent damage to his hands and feet. Early treatment has spared Augustine the injustice of living with a preventable disability.
A couple of weeks later, health volunteers noticed patches on his two granddaughters. They were diagnosed with leprosy and immediately started a six-month treatment programme. They weren’t heavily infected. They had between two and five patches which suggested they had “Paucibacillary Leprosy”. This is a category of symptoms that indicates some natural resistance to the disease.
With so few symptoms, Philomena and Ronnie hadn’t really noticed their leprosy. With early treatment, they too will have no permanent damage — which Augustine is most happy about!
Fortunately, social stigma isn’t as severe where they live. But Augustine, Philomena, and Ronnie do experience some self-stigma — where they accept the negative attitudes surrounding leprosy, resulting in a withdrawal from their community. That’s why it’s so important to provide counselling, and early detection.
(Source: The Leprosy Mission)
