United4Dignity for leprosy sufferers

dr. Hendra Gunawan, Sp.KK(K), Ph.D
dr. Hendra Gunawan, Sp.KK(K), Ph.D. Photo: Priv. Doc.

IO – The theme for the World Leprosy Day commemoration is “United4Dignity”. This theme is meant to remind everyone that leprosy still exists among us, meant to improve awareness of the disease, and to end stigmatization and discrimination against its sufferers. Former leprosy victims are also encouraged with empowering stories about their lives, in order to sustain their mental health. 

“WHO is aware of just how much stigmatization and discrimination causes patients to become reluctant to get treatment in health centers, thus increasing the rate of treatment dropouts. Globally, there is a downward trend for new leprosy cases, but it is not significant. The possibility of a leprosy-free world is still quite far away. WHO 2020 data shows that 127,000 new cases occurred during the year, 8,000 of them among children younger than 15. In terms of the largest number of new cases, Indonesia is third in the world after Brazil and India, with nearly 11,000 cases,” said dr. Hendra Gunawan, Sp.KK(K), Ph.D,, Hasan Sadikin Hospital Bandung’s resident dermatologist and venereologist, in a talk show held on Monday (31/01/2022). 

Ministry of Health 2021 records show that six of our provinces have yet to achieve leprosy elimination status: Papua, West Papua, Maluku, North Maluku, North Sulawesi, and North Sulawesi. Average leprosy prevalence in the six areas is 1 per 10,000 residents. In 2021, there were 7,201 new cases, with a subsequent disability rate because of the disease at 84.6%. Such disability, whether in the arms, legs, or eyes, is a clear sign that the leprosy was treated late. Accelerating the prevention and treatment of leprosy is essential, because we need to make sure that all of Indonesia’s provinces be free of leprosy by 2024. 

Challenges in eliminating leprosy include geographical condition, uneven availability of health service facilities, and a starkly insufficient number of doctors – as well as the strength of the stigma against lepers. “There are still many people who wrongly believe that leprosy is caused by a curse of black magic. This only causes them to shun patients instead of helping them, which in the end cause patients to suffer from disabilities or even die because of it, even though leprosy infection is slower than most other infectious diseases, such as Covid-19. Theoretically, infection takes place within two to five years, through sufferer droplets or prolonged and constant close physical contact,” dr. Hendra said. 

The fear of catching leprosy remains high even now. “Let us not allow ourselves to be consumed by leprophobia, because nearly 99% of patients who regularly take their duramycin do not infect others. Only people with genetic vulnerability will get caught. The bodies of normal people without this vulnerability can easily destroy the bacteria that causes leprosy. For example, out of 100 average people exposed to leprosy bacteria, 95 of them can destroy the bacteria in them using their own natural immune system, and out of the 5 who might be infected, only one will actually catch leprosy. There is no need to fear, because there are plenty of factors that participate in the development of exposure to sickness. In fact, the many doctors and nurses who are on duty in leprosy hospitals and maintain close physical contact with patients for years, do not get infected.” 

Two Types of Leprosy 

Early detection is essential to ensure that leprosy gets cured properly. “Raise your suspicions when there are red splotches that do not get itchy on your skin, the skin gets thick, and you feel numb. This bacteria rarely multiplies in warm parts of the body, such as the folds of the thighs or in the armpits, but it can be found in nearly all parts of the body, usually on the face, arms, or legs. Leprosy is divided into the wet and dry types. Wet leprosy contains more bacteria, necessitating a treatment using three different kinds of drug, regularly for 12 months. On the contrary, dry leprosy contains many fewer bacteria, meaning that patients need only undergo treatment for 6 months. If dry-type sufferers skip their medicine for 6 consecutive months, they are considered to have dropped out of medication and have to restart treatment from the beginning. Meanwhile, wet leprosy has a drug-free tolerance of 18 months.” 

He admits that patients often get tired of drinking their medicine, because the treatment duration is so long. Another issue is when patients stop medicating because of embarrassment that their skin turns darker as the drug fights the bacteria. “Please be careful. The Mycobacterium leprae bacteria loves to reproduce in parts of the human skin and organs, especially in the nerve ends. If they reproduce in sensing nerve ends, they will damage the touch and feel function. If in the muscular nerve ends, they will damage the muscle’s moving function. However, regular treatment will cure it. The most important thing for everyone to do is to maintain their immune system and personal hygiene to prevent leprosy infection,” he said. (est)