Leprosy Throughout the World

        
           My name is Emily Svehlek.  I am currently a nursing student at Alverno College.  When deciding on a topic to discuss I decided to look into leprosy.  While many people throughout America might not think that this disease is a problem in today's world, it is still quite common, even in the U.S.  Therefore, I wanted to delve into why this curable disease is still occurring.

                                                    (The Leprosy Foundation Canada, 2012)

          Leprosy has a repugnant stigma associated with it.  Throughout history, those affected by this disease have been looked at as unclean and poor.  People who suffer from this epidemic become social outcasts who are seen as unfit to be around.  This reputation dates back to early civilizations, even being made prevalent in the bible.  In Leviticus 13:46, it is stated, “He shall remain unclean as long as he has the disease. He is unclean. He shall live alone. His dwelling shall be outside the camp.” (Levitcus 13:46, King James Bible)  Originally, it was thought as a punishment or curse from god for bad people who committed sins.  It is a devastating diagnosis to live with, not only due to the horrifying symptoms that occur but also due to the stigma associated with it.  While the occurrence of leprosy has decreased immensely over the centuries, it is not yet eradicated completely worldwide.

          Leprosy is caused by the acid- fast bacteria mycobacterium leprae.  About 95% of the world's population is immune to the bacteria that causes leprosy.  It is considered a chronic disease often characterized by skin lesions, neurological issues, and complications that develop from the nerve damage.  In advanced cases, gangrene can set in.  Leprosy is often spread through bacilli bacteria discharged through the nose and spread by contact to skin.  It eventually spreads to the nerves.  Due to the fact that this disease is transmitted through contact, the most common form of “treatment” in early centuries was exiling those infected away from the community.  Later, asylums were set up for people with leprosy to go.  However, without a cure for the disease, the result was usually death. 

(Demotix.com)

Due to the nerve damage that occurs, many people have 

sensation difficulties in their hands and feet.  This often results

in injury, which increases the likelihood of the loss of fingers 

or toes. In some cases, the hand or foot may be lost altogether. 

          In 1873, Dr. Gerhard Henrik Armauer Hansen discovered that leprosy was caused by a bacteria, mycobacterium leprae, thus disproving the belief that it is caused by a curse or punishment from a higher power.  The process for finding a cure began.  Most treatments in the early 1900’s were painful and did not always result in a successful outcome. In some cases, m. leprae became resistant to treatments. In the 1970’s, after a study completed in Malta, the first multi-drug therapy was introduced.  Finally, in 1980, the World Health Organization (WHO) began supporting the idea of multi-drug therapy.  The three drugs that are combined in the preferred treatment are dapsone, rifampicin, and clofazimine.  Depending on the intensity of the leprosy and the length of time the person has had the infection, the length of time someone has to take the therapy drugs varies.  The average time is six months to one year.  This is still the preferred treatment of leprosy to this day.  It is available for free throughout the world.  

          According to the World Health Organization, in 2008, the prevalence of leprosy worldwide was estimated to be at 212,802. This number is a decrease from the years before. According to research “pockets of endemic leprosy however still remain in some areas of Angola, Brazil, Central African Republic, Democratic Republic of Congo, India, Madagascar, Mozambique, Nepal, and the United Republic of Tanzania.” (Ainsworth, 2010)  These locations have many isolated areas which can contribute to the presence of such large amounts of leprosy.

          You may be wondering how leprosy is not eradicated completely when the cure is present and so readily available both logistically and financially.  The stigma still associated to this day about the diagnosis of leprosy is repulsive.  Even after all the discoveries made about the transmission and acquisition of this disease, the common thought is that of unsanitary and unworthy individuals.  These thoughts lead to people feeling shame, so they would rather live in isolation and pain, than receive the necessary and easy treatment. 

          Below is a story of a man dealing with leprosy for the majority of his life and how it affected him physically, mentally, and emotionally.

Mr. Pete's Story


          World Leprosy Day is the last Sunday in January, every year.  It is a day set to increase awareness of all aspects of leprosy.  Hopefully education will help alter the horrible stigma associated with this disease and allow hope for those who are suffering from it.

REFERENCES

Ainsworth, S. (2010). Eradication leprosy. Practice Nurse, 39(2), 34-35. 
     http://0-search.proquest.com.topcat.switchinc.org/docview/230466626 

Buschschluter, V. (2010, April 28). Living with leprosy [Newsgroup post]. 
     Retrieved from BBC website: http://news.bbc.co.uk/2/hi/8648725.stm

Demotix. (n.d.). [Leprosy feet]. Retrieved from http://www.demotix.com

The leprosy foundation canada. (n.d.). [Leprosy facts]. Retrieved from 
     http://www.leprosy.ca/leprosy 

Levticus: Vol. 13:46. The official king james bible online. (n.d.). Retrieved 
     from http://www.kingjamesbibleonline.org/Leviticus-13-46/ 

Lockwood, D. N. J. (2005). Leprosy. Medicine, 33(7), 26-29. 
     http://0-dx.doi.org.topcat.switchinc.org/10.1383/medc.2005.33.7.26

Stanford University. (n.d.). History of leprosy. Retrieved March 11, 2014, from 
     http://www.stanford.edu/group/parasites/ParaSites2005/Leprosy/history.htm