COVID-19 in the Time of Insecurity

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Opinion

HRH Prince El Hassan bin Talal

AMMAN, Jordan, Mar 26 2020 (IPS) – Humankind has outlived multiple pandemics in the course of world history. The kingdoms and states of Central and Western Europe abolished the institution of serfdom once it had become clear that medieval rule in the aftermath of devastating pestilence would founder without ending the dependency and servitude that characterized the Dark Ages. The vulnerability of entire nations to the risk of total collapse in the absence of widespread access to the most basic healthcare in the Spanish Flu spurred governments to build the public health systems that have made the progress and development of the last hundred years possible. If the past is prologue, then continuity and survival command that we change.

We have more often than not banded together in the face of all kinds of threats. In all its ramifications, COVID-19 threatens to push our social, political and economic structures to the brink. Disease, recession and fright can rapidly overwhelm states and societies. Each coming day will bring increasing challenges that can only be met by caring for the sick, minimizing the impact of shutdowns on lives and livelihoods, securing the delivery of adequate water, food and energy supplies, and racing for a cure. Success – as in an asymmetric conflict – rests on resilience. To contain the socio-political and socio-economic fallout from the crisis, policymaking efforts should center on human dignity and welfare as the bedrock of national and international security.

The most vulnerable members of society in some parts of our world are those on the front lines of the crisis: the doctors, nurses, care-givers, pharmacists, sanitation workers, farmers, supermarket cashiers and truck drivers whose courage, sacrifice and dedication will see us through the next 12 to 18 months of expected lockdowns. In the absence of state support, what will happen to the hundreds of thousands of people who have already been laid off, while millions more face looming hardship as the numbers of layoffs grow? Some will continue to ignore the vulnerable and marginalized, those who have least access to humanitarian assistance, while others will continue to exploit them. The calls for social distancing have grown louder and more frequent over the last couple of days, and as we begin to separate from one other we must remember our humanitarian duty to each another.

Security, far from being individual, is collective and global. The current crisis calls for transcendent thinking between politicians on both sides of the aisle. Grey areas in politics in which zero-sum games and the perverse logic of mutually assured destruction proliferate will not protect and promote human dignity and welfare. Conservatives and reformers must now move beyond the tournaments and arm-twisting of politics. The logic of mutually assured survival cannot accept grey areas. If conflict resolution transcends political beliefs, nationality, ethnicity, gender, and religion, then human dignity and welfare is the benchmark of the humanitarian commitment to life.

Reliable brokers in the management of this crisis and other crises do exist as in the International Committee of the Red Cross and Médecins Sans Frontières. Corporate social responsibility requires developing a public platform of health facts so that people-to-people conversations and consultations can be promoted through civil society, the media and educational institutions. We cannot cherry-pick energy and climate change without talking about health or education and human dignity. Migrants and refugees must be an integral part of the national response for halting the spread of the novel coronavirus. The United Nations Economic and Social Commission for West Asia reports that 55 million people, in West Asia region, require some sort of humanitarian assistance and that the vulnerability of displaced women and girls is especially heightened in a pandemic. Post-conflict insecurity – whether in countries ravaged by war or across the urban centers and countrysides of advanced economies overwhelmed by disease – can only be addressed in the careful terrain mapping of humanitarian access. Yemen, Syria, Gaza and Libya are frighteningly vulnerable to the onslaught of epidemics – what will peace uncover there when the wars end?

Regional insecurity is heightened in the absence of cooperation, but the multilateral system is not at a loss in facing an existential crisis. European solidarity has been sharply damaged by the onset of widespread disease although China is performing through the swift and effective action that has come to the aid of the people and government of Italy. Multilateralism today can only be revisited with a focus on the interdisciplinary priorities of the twenty-first century that include addressing the need for a Law of Peace. We draw humanitarian concessions from the law of war in times of conflict, but have no recourse to legal instruments that can secure the dignity and welfare of all in times of peace.

The current crisis is as much a global health crisis as it is a crisis of the globalization that has come to undermine the foundations of modern society with its rampant inequality and rising injustice and which threatens the very survival of our species with climate change. The planet that we share with other organisms is fragile and prone to crises. A resolution to our predicament will take nothing short of extending the ethic of human solidarity beyond the contours of our immediate response to the outbreak of COVID-19. Real success lies not in the taming of a pathogen or in re-discovering the value of compassion, respect and generosity, but in institutionalizing these values in the days, weeks and months ahead.

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What’s Needed for Real Changes for Women in Lebanese Politics?

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International Women’s Day, March 8 2020
 
The year 2020 began with a shock report, Mind the 100 Year Gap, from the World Economic Forum which projected that gender equity would take at least 100 years to realise. Women and girls play a crucial role in society. However, they bear the brunt of patriarchy, their needs often unmet by traditional humanitarian responses and their health and education needs not prioritised. In the run-up to International Women’s Day with its theme, “I am Generation Equality: Realising Women’s Rights” IPS is publishing a series of features, opinion and editorials from experts and affiliated journalists around the world on women.

Lebanese women in politics. Credit: Eliane Eid

KESERWAN, Lebanon, Mar 2 2020 (IPS) – Women were at the forefront of Lebanon’s 2019 ‘October Revolution’. Beyond the iconic images of their participation, it seems that by women linking equity in politics to the broader issues of mismanagement of corruption paid off – although activists say there is a long road ahead.

In May 2018 saw the election of six Lebanese women to parliament from 86 female candidates. Following the October 2019 uprising, that started to change the equation within the political system and under the continued pressure of the civil society, a new cabinet was formed. It included six female ministers out of 20.

From a general perspective, this seems like a win for achieving gender equality, considering that 30% of the actual cabinet is female. Lebanon, a democratic republic in the Middle East, is deemed to have acknowledged the role of women and started to include them in the political field.

However, from a Lebanese perspective, questions arise whether this achievement is a veneer to please the streets and Western donors in a crumbling country?

Rouba El Helou-Sensenig, coordinator of the gender, communications and global mobility studies at the Faculty of Law and Political Science at Notre Dame University in Lebanon, is not convinced this change is enough.

“Even though the Lebanese government signed international agreements related to advancing women’s rights and their participation in political life, I believe that the Lebanese government is not serious about reaching gender equality,” she says.

“What has been achieved so far is the result of a combination of pressure from civil society and international bodies,” she added, citing a list of reasons why women’s rights within the country are flawed.
“Today, the Lebanese people, whether they are with or against gender equality, are aware that Lebanese women do not have the right to give their citizenship to their children; that the religious courts do not rule in favour of a mother most of the time.”

She says the Kafala system promotes more injustices in Lebanese society and “family friendly-policies should be drafted and implemented” as a matter of urgency.

El Helou-Sensenig explained to IPS that Lebanon still has a labour code with a long list of articles which prohibit women from working in certain fields. Gender-based violence and sexual harassment are still not appropriately criminalised.

Two young women rest in the morning of a new day during the October 2019 Revolution, Lebanon. Credit: Blanche Eid

Historically, Lebanese women waited until 1953 to vote and run for elections – and their fundamental rights undermined until Lebanon signed the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) in 1997.

Most of the women in parliament have been elected based on their political affiliations or even traditional ones. Lebanese society has rarely seen any organic approach to promote female candidates in any election.

This year the World Economic Forum (WEF), in its 2020 report Mind the 100 Year Gap, noted that gender parity would not be attained for 99.5 years – meaning that none of the current generations will witness it. WEF’s even more sobering analysis puts the gap in the Middle East, and North Africa is 140 years. This is a challenge to NGOs and institutions fighting gender discrimination.

Once such a global advocate for gender equality and health and rights of girls and women, Women Deliver is working with five civil society organisations (CSOs) to breach the gender inequity gap in Lebanon. Its Humanitarian Advocates Program, along with the CSOs, is working toward meeting the needs of the women and children who make up 80% of the country’s more than 1 million registered refugees.

In the broader society equality will take time, but many countries still lack fundamental human rights, including Lebanon.

In February Notre Dame University held a seminar on women pursuing peace and justice and being politically active. During the seminar, Cedar Mansour, dean of the faculty of law and political science, explained that for Lebanon to make changes, women need to be more involved in policymaking and participation.

“In order to make a real difference, the change should start in the institutions. Equality should be paramount, inherited discrimination that is infesting our laws should be revolted against,” Mansour said.

By making laws and creating opportunities for women to become more involved, only then, Lebanon will have a chance to stay in the race.

Many factors stand in the way of achieving these goals, the seminar heard.

Lea Baroudi, the founding member and director of March, Lebanon, told IPS has personal experience of many of these challenges and what it takes to be successful.

“What made me continue is what I saw I was capable of doing. I had this belief that I can change. There are two struggles that affect us as women: the patriarchal attitude and the older generation mentality. The attitude of ‘you cannot do it’,” she said.

“But, to succeed, you have to fail many times, and that’s what kept me going”.

Baroudi explained that no matter what a woman will do, she will always be questioned and evaluated every step of the way. She always has to be number one in every field; otherwise, she is considered weak and powerless.

“As long as we cannot change the laws, we have a problem” she adds. Lebanon needs a shift in the understanding of gender equality and its implementation. Many factors play an essential role in shaping this culture, especially patriarchal power rooted in the Lebanese mindset.

In 2016, Lebanon created the first ministry of women’s affairs; this initiative was supposed to be a step forward to achieve political empowerment and gender equality. In the case of Lebanon, the minister of women’s affairs was a man. The idea of creating this ministry was to promote political empowerment, but a female figure in Lebanese politics is known to be more of a mediator than an action taker.

Four months have passed since the revolution started – women have taken a critical role in keeping this uprising safe and its agenda in the spotlight.

One of the current demands is to have an early election with more women involved.

Lebanon might witness a new era of female leaders, but the key issue is whether create a safe environment for Lebanese women by changing policies or they would fall in the trap of being the winning ticket for political parties.

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Our Message at Davos: Water & Sanitation Are a Critical Line of Defence Against Climate Change

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Opinion

Tim Wainwright is Chief Executive of WaterAid UK.

Credit: WaterAid/ DRIK/ Habibul Haque

LONDON, Jan 31 2020 (IPS) – There was only one topic on everyone’s lips at Davos this year – climate change. The headlines focused on the cold war between Greta Thunberg and Donald Trump, but there was much greater consensus among those gathered for the annual meeting of the World Economic Forum (WEF).

The Forum itself updated its manifesto for responsible business – with climate right at its core.

Among those calling for urgent action was WaterAid’s own president, His Royal Highness the Prince of Wales. It’s more than 30 years since he last attended Davos and, as he reminded the audience, 50 years since he made his first speech on the environment.

His message was stark, and his call to action challenging: the climate emergency requires nothing less than an overhaul of the current economy, with a new deal for people and planet.

The mood is slowly shifting towards the scale of action needed, given that climate change will affect every part of the economy. This cannot be truer than for water – the WEF has ranked water crises in its top five global risks in terms of likelihood or impact every year since 2012.

Infographic showing the top 10 risks over the next 10 years, according to the World Economic Forum’s 2020 report. Credit: World Economic Forum

The climate crisis is a water crisis, and a threat multiplier

Throughout the forum I had one consistent message: for the world’s poorest, the climate crisis is a water crisis. Yes, it has long-term implications for your businesses and economies. But, first and foremost, it is a question of survival, dignity and justice, with climate change already having devastating impacts on the lives of the people who did least to cause it.

Flooding, storms and droughts, which all impact on how and if people can get clean water, are becoming more frequent and extreme, and these trends are predicted to rise as the climate continues to change. This will undermine the already precarious access to water for billions around the world.

Climate change acts as a huge threat multiplier, worsening existing barriers to these services and rolling back progress already made.

As people living in climate-vulnerable areas experience changing weather patterns, less predictable rainfall, salt water intrusion and increased exposure to disease, water and sanitation become a critical line of defence.

If your water supply comes from a shallow aquifer that fills with sea water, then you can no longer drink it. But if the person designing your water supply has thought of this threat and factored it in, perhaps by drawing on deeper aquifers, then you can carry on living in your neighbourhood.

If your toilets and sanitation systems are constructed to withstand flooding, then your community does not suffer the same level of contamination after flooding as if human waste had been spread by the high waters.

The water and sanitation sector could become a leader in climate adaptation

But we currently lack the level of public and private sector investment and innovation required to deliver the sustainable water services that would benefit poverty reduction, industry and economic development.

This is a huge blind spot for business leaders and politicians, and a missed opportunity for creating a more sustainable future.

Rather than lagging behind, the water and sanitation sector could become a leader in delivering the kind of green infrastructure, services and jobs urgently required to enable adaptation to the worst impacts of climate change.

Tim Wainwright, Chief Executive of WaterAid UK, speaking with Hassan Nasir Jamy, Secretary Ministry of Climate Change, at Pakistan’s Ministry of Climate Change in Islamabad, Pakistan. Credit: WaterAid/ Sibtain Haider

Water, sanitation and hygiene are core to a sustainable future

Leaving Davos last year, I was frustrated. I felt that too few understood or discussed the impact climate change would have on the already grave state of the world’s water and sanitation, and the devastating consequences for education, health, productivity and development.

This year, I sensed a greater understanding of the interlinked challenges we face, and with that an air of urgency and proactivity. Businesses are looking for solutions – not just raising concerns.

That is why WaterAid will be one of the organisations working closely with HRH the Prince of Wales as part of his 2020 year of action.

In March, in London, we will bring together the public, private and philanthropic sectors for a high-level summit that will position water, sanitation and hygiene at the forefront of the fight against climate, and work on the solutions that will ensure a sustainable future for all.

And we will continue that work across the WaterAid federation throughout the year, including at the Commonwealth Heads of Government Meeting in Kigali in June, and at the UN Climate Change Conference, COP 26, in Glasgow in November, to help build momentum for decisive action.

In this way we hope WaterAid can play its part in shifting the global trajectory in the coming decade, resulting in a fairer world for the poorest and most marginalised people.

Read our guide Water and resilient business: the critical role of water, sanitation and hygiene in a changing climate to learn more about how businesses can take action.

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Mainstreaming Leprosy-affected People a Big Challenge in Bangladesh

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Feroza Begum, Leprosy activist. Credit: Rafiqul Islam / IPS

DHAKA, Bangladesh, Dec 12 2019 (IPS) – When Feroza Begum was first diagnosed with leprosy in 2006, it felt as though she had been struck by a thunderbolt due to the deep-seated prejudice in her society that the disease is a curse from Allah (God).

“ I was affected with leprosy disease, nobody accepted me (in the past). They had made me isolated. I cannot forget the plight I suffered at that time. Even my family was broken as I was left by my husband,” she told IPS. The 35-year old says she was ostracized and made to feel like a lesser person.

Feroza travelled about 200 kilometres from Bogura district to Dhaka, the capital city to attend the first-ever Conference of organizations of persons affected by leprosy. Feroza came to listen and talk to other people who had similar stories and also to engage with organizations that are fighting for an end to discrimination of people with leprosy.

“I got married in 2006 and a few days later, I was diagnosed as a leprosy patient’. She says after the diagnosis, members of her husband’s family started ignoring her. ‘They ignored me and did not talk to me and one day sometime in 2007 my husband divorced me and sent me back to my father’s home.”

After returning home, she started treatment with support from a local NGO and she eventually recovered from the Hansen disease. But as a result of the disease, she could not avoid disability.

Leprosy stigma in Communities

Although there is a stigma around leprosy in her society, Feroza is living with a disability and is leading a normal life. “Fighting stigma for a leprosy patient is a hard task in our society and leading a normal life is a challenging task too,” she added.

“Now my mother and I prepare mats and sell them in a local market. This is our only livelihood option but I never bow down to the stigma,” Feroza said.

Dr David Pahan, Country Director of Lepra Bangladesh, said Prime Minister Sheikh Hasina’s announcement of the ‘Zero Leprosy Initiative’ to eliminate the Hansen disease from the country by 2030 is commendable.

“Bringing leprosy patients into the mainstream of society is big for us as there is a negative perception about leprosy in our society,” he told IPS on the sidelines of the conference.

Now it is time for an Action Plan

Although the Zero Leprosy Initiative was announced, formulation of policies and action plans to eliminate leprosy is also a challenging task which lies ahead, he added.

Dr Pahan, who has been working on leprosy elimination since 1996, said leprosy patients must raise their voice together so that the authorities concerned take proper steps to bring them into the mainstream of society.

Dr David Pahan, Country Director of Lepra Bangladesh. Credit: Rafiqul Islam / IPS

Close to 100 leprosy patients and representatives from several organizations working in the field of leprosy attended the landmark leprosy conference in Dhaka which was organized by members of the Leprosy and TB Coordinating Committee (LTCC) and People Organizations, with support from The Nippon Foundation and Sasakawa Health Foundation.

The conference allowed people from across the country to share their experiences about the long plight in the recovering period of the disease.

Bangladesh is still a high burden leprosy country. The registered prevalence of leprosy was 0.7 percent, 0.27 percent and 0.2 percent in 2000, 2010 and 2016 respectively, and stood at 0.19 per 10,000 population in 2018, according to official data. The data also shows that about 4,000 patients were detected per year in the country over the last few years, with this figure standing at 3,729 in 2018.

Access to resources limited

Sonia Prajapoti of HEED Bangladesh, a local NGO working on leprosy control, said the case of leprosy is highly prevalent among tea workers in Sylhet, Habiganj and Moulvibazar districts as they are not aware of the leprosy disease and have limited access to civic amenities.

She said a social awareness must be created among the tea workers to keep them free from leprosy, while the leprosy patients could be brought into the mainstream of society by increasing their social status, providing proper healthcare and creating working opportunities for them.

“Prime Minister Sheikh Hasina’s announcement of the ‘Zero Leprosy Initiative, will increase the voice of the people who have been working on leprosy elimination, and this will help them fight leprosy together,” said participant Shandha Mondal, district coordinator of local NGO Shalom (leprosy) in Meherpur.

Speaking as the chief guest at the conference, Chairman of The Nippon Foundation and WHO Goodwill Ambassador for Leprosy Elimination, Yohei Sasakawa, assured Bangladesh of continuing support of the implementation of ‘the Zero Leprosy Initiative’ which was announced by Prime Minister Sheikh Hasina and which aims to eliminate leprosy by 2030.

“The government has already announced the Zero Leprosy Initiative that will help eliminate the discrimination the leprosy patients have been facing,” he said.

“You, the leprosy patients, know better about the disease than doctors…your government is working to eliminate leprosy by 2030. And we are here to know how we can help your government fight leprosy,” Sasakawa said.

The Nippon Foundation and the Sasakawa Health Foundation of Japan organized a national conference on leprosy in Dhaka on December 11 under the theme “ZeRo leprosy initiative”.

 

Sasakawa Vows to Continue Support for Fighting Leprosy in Bangladesh

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Chairman of the Nippon Foundation and Sasakawa Health Foundation in Japan Yohey Sasakawa speaking at the Conference of Organizations of Persons Affected by Leprosy in Dhaka, Bangladesh. Credit: Rafiqul Islam / IPS

DHAKA, Bangladesh, Dec 12 2019 (IPS) – Chairman of The Nippon Foundation and Sasakawa Health Foundation, Yohei Sasakawa, has assured Bangladesh of continuing support for the Zero Leprosy Initiative announced by the country’s Prime Minister, Sheikh Hasina, aimed at eliminating leprosy by 2030.

Sasakawa was speaking at the opening of the first ever meeting of organizations working on leprosy in Bangladesh.

“The government has already announced the Zero Leprosy Initiative that will help eliminate the discrimination the leprosy patients have been facing,” he told a conference in the country’s capital. Prime Minister Hasina on Wednesday (December 11) also addressed the conference and Sasakawa reminded activists that the country’s leader expressed her commitment to make Bangladesh free from leprosy in the next decade.

Several organizations working in the field of leprosy, like members from the Leprosy and TB Coordinating Committee (LTCC) and People Organizations with support from The Nippon Foundation and Sasakawa Health Foundation, are attending the gathering.

Bangladesh’s leprosy burden ranks fourth-highest in the world. Four thousand new cases are detected annually – an average of 11 to 12 cases per day over the last 10 years. Every year an estimated 3000 leprosy sufferers are affected by complications that require specialized treatment in hospital.

Although the the number of leprosy cases are declining, more than one-third of leprosy patients are facing the threat of permanent and progressive physical and social disability.

Govenment needs help

Calling upon the leprosy patents to extend their support to the government in this regard, Sasakawa said Bangladesh’s Ministry of Health could not fight leprosy alone.

Sasakawa, also a World Health Organisation (WHO) Goodwill Ambassador, said: “You, the leprosy patents, know better about the disease than doctors. Your government is working to eliminate leprosy by 2030. And we are here to learn how we can help your government fight leprosy.”

He asked the participants to play a strong role in eliminating leprosy in Bangladesh. “I hope you will convey the lessons you learnt from the conference today to your community.

“If you all raise voice together, it would be stronger. So, you have to be stronger to fight leprosy (in Bangladesh). Your support is important to reach the goal,” he said.

About his journey as WHO goodwill ambassador, Sasakawa said he has been working on fighting leprosy around the world for the last 40 years.

“I have been providing assistance to about 120 countries, while I have traveled to different parts of the world 700 times to help (leprosy patients),” he said. “No matter which country I visited, the plight of the leprosy patients is the same.”

Sasakawa said he came here to share his opinion and experiences on leprosy from his journey. “I am very happy seeing the faces of leprosy patients who are participating in the conference, as this is the first time … we have met together,” he added.

Highlighting the nature of leprosy patients, the Nippon Foundation chief said the people who get disabilities suffering from leprosy and those become disabled due to road accidents are not the same, because leprosy is an infectious disease.

“That’s why leprosy patients fear to meet and their communities also do not accept it,” he said.

Role of NGO’s in the fight against Leprosy-free world

Sasakawa also praised the role of the NGOs, including Lepra Bangladesh and the Damien Foundation, in fighting leprosy in the country.

Shandha Mondal, district coordinator of SHALOM (leprosy), a local NGO working in Meherpur, said Prime Minister Hasina’s announcement on the Zero Leprosy Initiative will increase the voice of the people who have been working on leprosy elimination, and this will help them fight leprosy together.

Motiur Rahman, a leprosy patient of Gazipur, said the prime minister always gives priority to leprosy patients. For example, he said he had sought accommodation from the Bangladesh premier and he received a house from the Government.

The participants attending the national conference said that the prime minister’s call to local pharmaceuticals to produce medicines and distribute among leprosy patients free of cost is really commendable.

Speaking at the National conference on Zero Leprosy Initiative 2030, Prime Minister Hasina said many Bangladeshi pharmaceutical companies export medicines, and she called on these companies to produce drugs for leprosy locally and distribute those among leprosy patients free of charge.

But, they said, the PM should also instruct the authorities concerned to launch a new programme and announce a special budget for leprosy. This would be more helpful in fighting leprosy in Bangladesh, they said.

The Nippon Foundation and the Sasakawa Health Foundation of Japan organized a national conference on leprosy in Dhaka on December 11 under the theme “ZeRo leprosy initiative”.

 

Taking Bangladesh to Zero-Leprosy, One New Case at a Time

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Sandhya Mandal – a community health worker working on leprosy in Meherpur district of Bangladesh. Credit: Stella Paul / IPS

DHAKA, Bangladesh, Dec 11 2019 (IPS) – Sandhya Mandal has never felt so vindicated. For the past four years, the 36-year-old community health worker from Meherpur – a rural district bordering India – has been traveling 50 km every day along dusty roads on an old motorbike, searching for leprosy patients who needed urgent treatment. But in her community, instead of compliments, neighbours and relatives raised questions about her work and her character. “They ask why I come home so late and what is this ‘work’ that I really do. Some even imply that I might be doing something like prostitution,” Mandal tells IPS.

However, Mandal – project manager at an NGO called Shalom, which works with the government to end leprosy, sat in an audience of diplomats, ministers and health experts from all over the country, listening to Sheikh Hasina – the prime minister of Bangladesh – at a national conference on leprosy. “Nobody can doubt me or my work now,” she says, proudly clutching the yellow invitation card she received from the organizers of the conference – her first to a national-level event.

Mandal has every reason to be in the conference: since 2015 she has searched and found over 300 new leprosy cases. In fact, in November this year, she found 10 new cases on a single day – the result of an intense door-to-door search in Gangni, a small town with a high rate of leprosy. “We opened our database of old patients and contacted each one of them individually. We asked them if they knew anyone around them who had leprosy. Nobody could give us any concrete information, so I went from one house to other and from morning to evening I covered 40 families,” she recalls the drill. It was hard and Mandal did not have any time to eat or drink. But by day-end, she had found eight adults and two children who had visible signs of leprosy. She arranged for all of them to visit the TB and Leprosy Clinic (TLC) in Meherpur, a facility run by the government.

Early detection in leprosy key

Early detection and early treatment are the key to complete cure for anyone affected by leprosy, tells Mujibur Rahaman – a doctor at the TLC Meherpur. “The treatment is free. We have enough medicines. But bringing the affected ones to the treatment facility remains the biggest challenge,” Rahman tells IPS. Bangladesh eliminated leprosy in 1998, but new cases continued to be detected. In 2018, 3 729 new leprosy cases were detected.

Earlier this week, in her opening speech at the national conference, Prime Minister Hasina asserted that Bangladesh was committed to become leprosy-free by 2030. According to Rahman, dedicated community workers like Sandhya Mandal are the key to realizing the zero-leprosy status.

“Identifying a new patient is one thing; convincing them to see a doctor is entirely different. It takes very different level of skills,” he adds.

Providing counseling services

Mandal throws a little light on that skill: every time she finds a villager with a suspicious white patch with numbness, she tells him that it is a skin disease that needs urgent medical attention. “I never tell him it’s leprosy because, only a doctor can declare that after a test and also, if I spoke of leprosy, it would shock the person as everyone is still afraid of the disease,” Mandal reveals.

Mandal also counsels and provides emotional support to the person after a doctor has confirmed his or her leprosy. “Women are more scared than men because they feel their husbands will abandon them if they find out about their sickness. They are also scared of how their community would react. I tell them that they must tell their husbands but explain that its curable. To the neighbours, they can say it is a skin disease. I hold their hands, spend time with them. It calms them and it also makes them feel confident,” she tells IPS.

Listening to the prime minister has been an inspiring experience, Mandal says. At present there are not enough community health workers on leprosy. For example, in her own NGO, there are just two health workers. So, to achieve zero-leprosy in the next 10 years, Bangladesh would need many more community health workers, she says. Equipping the field workers at the rural NGOs with a motorbike would also help, as transportation remains a huge challenge in the villages. If these gaps are plugged, there is no reason why Bangladesh could not be leprosy-free, she says.
For those doubting her work, Mandal now has an answer: “Even the prime minister has shown an interest in leprosy, in our collective work. If anyone still doesn’t know why I work on leprosy for such long hours, they can ask the prime minister!”

The Nippon Foundation and the Sasakawa Health Foundation of Japan organized a national conference on leprosy in Dhaka on December 11 under the theme “ZeRo leprosy initiative”.