New project to tackle rise in leprosy cases in Sri Lanka

The number of people being diagnosed with leprosy has risen in Sri Lanka, prompting the government to promise extra funds to control its spread.

One of the families that benefited from a new well

In 2014, there were 2,157 new cases diagnosed in the island country – a rise from the previous year’s 1,990.

Minister of Health Dr Rajitha Senaratne said during the past decade around 2,000 new Leprosy patients had been detected in the country annually.

The rise in reflected more so in the northern province of Mannar, which has a population of around just  25,000, where 17 new cases of leprosy were diagnosed in  2014  – a steep rise from the solitary case in 2011.

James Pender, programmes officer for The Leprosy Mission England and Wales said: “The 17 cases are the ones we know about, and that’s without having actively looked for them. We believe that once we start looking we will discover many more. What is worse is that quite a number of the cases are children, which indicates that the rates of transmission are high. It is vital people are treated as quickly as possible to stop transmission.”

Mannar is part of the predominantly Catholic belt that stretches from Negombo to Jaffna, which was colonised by the Portuguese, who brought the first Catholic missionaries. More than 33 per cent of the region’s population of over 200,000 are Catholic. 

A Tamil Tiger stronghold, the area was heavily involved in the 26-year civil war which ended in 2009.

James, who is co-ordinating a project to tackle leprosy in Mannar said: “The area had high levels of health-care at the start of the conflict, but since then it has declined. As a result leprosy has been overlooked in recent years.”

The rocketing number of new cases in just three years has prompted The Leprosy Mission to extend to Mannar the work it does in Jaffna, where leprosy cases have also been high, and where it works with local partner Kaveri Kala Manram (KKM).

Called the Community Mobilisation, the Mannar project, which started in December last year, will replicate the leprosy work done in Jaffna and will include:

• raising awareness within communities;
• strengthen existing government health systems;
• increase detection through leprosy-screening and a network of people trained in understanding the disease;
• provide access to appropriate health-care and rehabilitation;
• start a Clean Water Project by installing water pumps and digging wells in neighbourhoods.

The project will also aim to reduce stigma and exclusion associated with the disease which results in people hiding their symptoms for fear of being ostracised.

“In Jaffna KKM has worked with community groups to increase detection and reduce stigma,” James said. “It has included improving standards of hygiene and access to clean water. We are hoping to do the same in Mannar.”  

Also known as Hansen’s disease after Norwegian scientist Gerhard Henrik Armauer Hansen who discovered M. Leprae in 1873, leprosy is not hereditary or contagious and can only be caught by close, repeated contact with nose and mouth droplets from someone with untreated leprosy. It is prevalent usually in places of extreme poverty and poor hygiene.

The disease affects mainly the skin, peripheral nerves, upper respiratory tract and the eyes. It damages the nerves on the skin’s surface leaving it without sensation or pain. As no pain is felt burns to fingers and ulcers caused by stepping on stones or glass go unnoticed and can lead to amputation, muscle paralysis and other disabilities. Blindness is also a common consequence caused by the inability to detect grit in the eye.

It is one of the oldest diseases known to mankind and people with leprosy have been stigmatized and considered to be at the extreme margins of the society.

Changing those attitudes and increasing public awareness of the fact that leprosy can now be easily cured with multidrug therapy – a combination of rifampicin, clofazimine and dapsone - remains a challenge.

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