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”.

 

Nippon Foundation Announces US$ 2m Support for the Education of Rohingya Children in Bangladesh

Asia-Pacific, Conferences, Development & Aid, Education, Featured, Headlines, Health, Human Rights, Migration & Refugees, Poverty & SDGs, TerraViva United Nations

Chairman of The Nippon Foundation Yohei Sasakawa and BRAC Executive Director Asif Saleh announcing $2 million partnership. Credit: Rafiqul Islam / IPS

DHAKA, Bangladesh, Dec 11 2019 (IPS) – In the light of limited access to education for displaced Rohingya children, the Nippon Foundation has announced US$ 2 million support to BRAC to launch a project to ensure educational facilities to both Rohingya and local community children.


The Nippon Foundation made the announcement at a press conference at the BRAC Centre in Dhaka, which was attended by Nippon Foundation chairman Yohei Sasakawa and BRAC Executive Director Asif Saleh.

Under the US$ two million project, BRAC will build 50 steel-structured two-storey learning centres at Rohingya camps in Cox’s Bazar to provide an educational facility for Rohingya children. This project aims to provide educational access to 8,000 Rohingya children aged between 4 and 14 years. The Nippon Foundation is also supporting BRAC to open and operationalize 100 pre-primary centres for 3,000 host community children aged between 5 and 6 years through this funding.

Learning centres will educate Rohingya children

The project will ensure education access of Rohingya children to incoming children and existing children at the newly constructed learning centres.

As the host community in Ukhya, Teknaf and Ramuupazila of Cox’s Bazar are under significant stress. The project targets 3,000 host community children aged 5-6 years to get pre-primary education from BRAC-operated learning centres to prepare them for primary education. Engagement with parents, as well as the broader community, will be prioritised to select the location of centres, which will be established on the community premises.

Providing humanitarian support

The chairman of The Nippon Foundation Yohei Sasakawa said he visited the Rohingya camps in Cox’s Bazar to personally witness the reality there. “When I was there, I found the situation is much more serious.

“I have seen the refugee camps from the Myanmar side and Bangladesh side as well. And as a result of that, I actually saw, on my own eyes, how difficult the situation is. And under such a different situation, the Bangladesh government is trying to provide humanitarian aid (to the displaced Rohingyas),” he said.

Chairman of The Nippon Foundation Yohei Sasakawa and BRAC Executive Director Asif Saleh. Credit: Rafiqul Islam / IPS

Sasakawa, who is also a World Health Organization (WHO) Goodwill Ambassador, said given the circumstances, women and children are the most vulnerable in conflict-prone areas across the world and “that is why we need to provide support to women and children”. “With the partnership with BRAC, we will be able to provide more humanitarian support,” he added.

Regarding the long-standing Rohingya crisis, he said: “I hope the Rohingya problem will be resolved soon and the refugee camps (set up in Bangladesh) will not be permanent”. Bangladesh is hosting more than one million Rohingya refugees.

In August of 2017, a small group of Rohingya militants launched an attack against local police forces in Myanmar. This led to clashes between the Rohingya and the non-Rohingya population, Buddhist monks and police. This led to mass killings, abuses and abductions and s ost of the Rohingya fled to Bangladesh where the refugees now live in camps where they receive essential assistance and basic medical care

(http://www.ipsnews.net/2019/01/the-rohingya-the-forgotten-genocide-of-our-time/.

Promoting education to local and Rohingya children

BRAC Executive Director Asif Saleh said about 55 percent of the displaced Rohingya people staying in Cox’s Bazar are children and they have very limited access to education.

Apart from facilitating education to the Rohingya children, he said this project will provide support to 3,000 children of the host community as they are also very vulnerable and have limited access to education. “Our vision is to promote the facility to the poor and those who are still lagging behind,” he added.

Saleh said the support of the Nippon Foundation and the Japanese government are very important for Bangladesh, stating: “We always welcome such support”.

The Nippon Foundation has been working in Bangladesh since 1971. Its activities were focused on supporting health, education, human resource development and support for people with disabilities. These include, for example, supporting flood or cyclone victims, providing anti-leprosy drugs, scholarship programs, prevention of the cholera epidemic and supporting projects for relief and the rehabilitation of refugees in Bangladesh.

The Nippon Foundation, a Japanese private, non-profit grant-making organisation established in 1962, has decided to further support those projects in Bangladesh for basic human needs, including education and learning opportunities.

BRAC is a leading development organisation in Bangladesh dedicated to alleviating poverty by empowering the poor to bring about change in their own lives in Bangladesh.

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”.

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Bangladesh Can Be Leprosy-Free by 2030 Says Leprosy Activist

Aid, Asia-Pacific, Conferences, Headlines, Health, Multimedia, Podcast, TerraViva United Nations

Health

DHAKA, Bangladesh, Dec 11 2019 (IPS) – Despite its efforts to eliminate leprosy as a public health threat, 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.


Leprosy issues have taken centre stage at the National Conference 2019 on Zero Leprosy Initiatives by 2030 in Dhaka Bangladesh. The country’s National Leprosy Programme, in collaboration with the Nippon Foundation and Sasakawa Health Foundation in Japan believes its key that every person with leprosy has access to the right medicines, diagnosed and treated in a timely fashion.

Akthar Ali is the Project Co-ordinator of the Missionary Sisters of Mary Immaculate (with the Pontifical Institute for Foreign Missions (PIME) Sisters) in Khulna in the south of Bangladesh and believes the country can be leprosy-free by 2030.

Crystal Orderson spoke Ali on the sidelines of the National Conference in Dhaka, Bangladesh.

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Bangladesh Can Be Leprosy-Free Before 2030 Prime Minister Tells National Zero Leprosy Conference

Asia-Pacific, Conferences, Development & Aid, Featured, Headlines, Health, Human Rights, Poverty & SDGs, TerraViva United Nations, Women’s Health

Mr Yohei Sasakawa, chairman of the Nippon Foundation and Sasakawa Health Foundation and WHO Goodwill ambassador. Credit : Crystal Orderson / IPS

DHAKA, Bangladesh, Dec 11 2019 (IPS) – Leprosy is not a curse but should be detected and treated early, Bangladeshi Prime Minister, Sheikh Hasina, has told delegates at a gathering in her country’s capital to discuss the elimination of the disease.


“In the past, it was thought that leprosy was a curse. But it was not a curse at all. The disease is caused by bacteria (Mycobacterium Leprae). We should fight it through research,” Hasina said, adding that the discrimination against leprosy sufferers should end. She called upon all concerned to work together so that Bangladesh could be leprosy-free before 2030.

Prime Minister Hasina, who spoke in Bengali at the National Conference 2019 on Zero Leprosy Initiatives by 2030, also committed her government to proper treatment for leprosy sufferers.

To achieve these targets, the country’s National Leprosy Programme, in collaboration with the Nippon Foundation and Sasakawa Health Foundation in Japan, has worked tirelessly to convene the conference, bringing together hundreds of health workers, medical professionals and district officers to discuss the issue under the theme “Zero Leprosy Initiatives”.

Certain areas in Bangladesh are particularly leprosy-prone, including its northern region and the Chittagong Hill Tracts, Prime Minister Hasina said.

Sheikh Hasina, Prime Minister of Bangladesh.

“If we can give special focus to these areas, I do believe it would be quite possible to declare Bangladesh a leprosy-free country before 2030,” she added.

“Leprosy patients must be considered on humanitarian grounds. If we all take a little responsibility in this regard, they will get recovery from this disease … I think we can do so,” Prime Minister Hasina said.

Distribute drugs free of cost

The prime minister said many Bangladeshi pharmaceutical companies export medicines, and she called upon these companies to produce drugs for leprosy locally and distribute those among leprosy patients free of charge.

The prime minister also warned that no-one could fire leprosy patients from their jobs but rather should arrange treatment for them.

End stigma and discrimination

The Chairman of the Nippon Foundation and World Health Organization (WHO) Goodwill Ambassador for Leprosy Elimination, Yohei Sasakawa, says leprosy is not only a medical issue but also a social issue “because of the stigma and discrimination that the disease attracts”.

He said: “We have an effective cure for leprosy, and it is essential that every person with the disease has access to the cure and is diagnosed and treated in a timely fashion. With timely diagnosis and treatment, a patient can be cured without disability.

“This conference presents us with an opportunity to re-focus efforts on leprosy and aim at an ambitious target: zero leprosy by 2030,” Mr Sasakawa added.

The WHO Representative to Bangladesh, Dr Bardan Jung Rana, told delegates that leprosy has caused immense human suffering when those affected remained untreated.

“With the aim of a leprosy-free world, WHO is committed to providing technical and strategic guidance, strengthening country-level capacity and delivering interventions through appropriate technology at affordable costs,” said Dr Jung Rana.

Leprosy a treatable disease

Leprosy is a chronic infectious disease affecting mainly the skin, the peripheral nerves, the mucosa of the upper respiratory tract, and the eyes. Leprosy is curable and treatment has been available through the WHO free of charge to all patients worldwide since 1995.

The history of leprosy dates back centuries in Bangladesh. Different Christian missionary organizations used to provide leprosy services in various high endemic areas in the country. In 1965 the government sector implemented leprosy services through three public hospitals.

Eliminating leprosy in Bangladesh

Despite its efforts to eliminate leprosy as a public health threat, 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. The human suffering resulting from the physical deformities and related social problems are immense.

Activists and community workers in Bangladesh welcomed the government’s commitment to ensure proper treatment for leprosy sufferers.

Delegates at National Conference 2019 Zero Leprosy Initiative by 2030, Dr Sr Roberta Pignone, PIME sisters (middle). Credit : Crystal Orderson / IPS

Stop pushing Leprosy in a corner

Dr Sr Roberta Pignone, Project Director of the Missionary Sisters of Mary Immaculate (with the Pontifical Institute for Foreign Missions (PIME) Sisters) in Khulna in the south of Bangladesh, told IPS: “It is good to listen to the prime minister and health officials and hear what they say they will do in the future to eliminate leprosy.” She added: “Leprosy is always pushed in a corner. It is good to hear that the government is aware of the disease. If the prime minister speaks to the nation, they will listen.”

The PIME Sisters have been working with leprosy since the mission opened its doors in 1986. “Sometimes leprosy is neglected and this conference shows that the government is committed to deal with leprosy,” says Dr Sr Pignone. “It is time to accept that leprosy is in the country and to deal with the situation.”

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”.

 

Human Rights and the Global Protests: Addressing Systems as Well as Symptoms

Civil Society, Global, Headlines, Human Rights, TerraViva United Nations

Opinion

Ignacio Saiz is Executive Director, The Center for Economic and Social Rights

In Ecuador, indigenous-led protests compelled the government to reconsider an austerity package agreed with the International Monetary Fund (IMF) that included public sector wage cuts and fuel price hikes. Credit: Conaie.

In Ecuador, indigenous-led protests compelled the government to reconsider an austerity package agreed with the International Monetary Fund (IMF) that included public sector wage cuts and fuel price hikes. Credit: Conaie.

NEW YORK, Dec 10 2019 (IPS) – Human rights advocates should be as concerned with the economic injustices giving rise to recent worldwide demonstrations as with the repressive responses to them. 


In recent weeks, an extraordinary wave of mass protests has swept the globe. While their specific causes and contexts vary, many can be seen as part of a worldwide revolt against extreme inequality and the unjust economic and political systems driving it.

A common weave running through many of the protests is widespread indignation against austerity – the package of debt-reduction policies that scores of governments are now implementing.

In Ecuador, indigenous-led protests compelled the government to reconsider an austerity package agreed with the International Monetary Fund (IMF) that included public sector wage cuts and fuel price hikes.

Chile has seen million-strong protests against low wages, costly social services and the most extreme levels of economic inequality of any OECD country.

In Lebanon, a third of the population is estimated to have taken to the streets since the latest round of austerity; while Iraq has been rocked by mass protests against high unemployment, ailing public services and economic mismanagement.

These events follow large-scale demonstrations earlier this year against austerity in countries including Argentina, Honduras, Egypt, Sudan and Zimbabwe.

What has often begun as a spontaneous stand against fiscal injustice has burgeoned into a mass mobilization against the structural inequities underpinning it: political systems seen as corrupt, captured and unaccountable, and economic systems seen as generating inequality by privileging private profit over the public good

Many of the protests have been triggered by a specific fiscal measure–a tax on messaging apps in Lebanon or an increase in Santiago metro fares–perceived as emblematic of attempts by governing elites to foist the burden of national belt-tightening on ordinary working people and the already disadvantaged.

But what has often begun as a spontaneous stand against fiscal injustice has burgeoned into a mass mobilization against the structural inequities underpinning it: political systems seen as corrupt, captured and unaccountable, and economic systems seen as generating inequality by privileging private profit over the public good.

Demonstrations in Chile and Lebanon, for example, have continued far beyond the repeal of the offending measures or even the resignation of senior government figures, insisting on a more fundamental economic and political overhaul.

Another alarmingly common feature has been the repressive response of the authorities, who in most cases have addressed the protests as a threat to public security rather than a clamor for social justice.

From Quito to Cairo and from Santiago to Baghdad, security forces stand accused of excessive use of force, killings, ill-treatment and arbitrary arrest of demonstrators.

It is somewhat understandable, then, that where prominent international human rights actors have spoken up about these protests, it has largely been with respect to these abuses. The Office of the High Commissioner for Human Rights, for example, has sent a team to Chile to investigate breaches of international standards related to the use of force by security personnel.

A recently-concluded Inter-American Commission on Human Rights mission has gathered numerous testimonies of similar alleged abuses in Ecuador. Amnesty International and Human Rights Watch have done important work documenting excessive force against protestors in Baghdad, Beirut and elsewhere.

Abuses by the security forces have also been the primary if not sole focus of investigations by national human rights institutions such as the Instituto Nacional de Derechos Humanos in Chile or the Ecuadorian Defensoría del Pueblo.

Each of these organizations has, to different degrees, acknowledged that the protestors’ socio-economic grievances are also human rights concerns. But the economic and social rights dimensions of these crises have generally been relegated to the background and are yet to meaningfully inform their analysis and recommendations.

While the acute repression of civil and political rights in the wake of these protests clearly merits urgent scrutiny, the chronic denial of social and economic rights motivating them must also be addressed as a central human rights concern.

International human rights standards apply equally to governments’ use of fiscal policy as to their use of force.  Where austerity policies result in widening gender or racial disparities, push people into poverty or lead to avoidable backsliding in access to health or housing, they also breach international legal obligations on economic, social and cultural rights.

To relegate these violations to the margins of human rights concerns serves only to perpetuate the lack of accountability that has brought millions out on the streets.

The mass mobilizations against extreme inequality, like those against the closely-related crisis of climate change, beg a holistic approach to the human rights claims underpinning them. They should also prompt human rights actors to rethink their traditional agnosticism with regard to economic systems, and adopt a more frontal critique of neoliberal economic orthodoxy.

The protests demand that we call out the ravages of neoliberalism as human rights deprivations, challenge the fallacies sustaining this ideology and envision rights-centered alternatives.

Recent developments have consolidated the normative and methodological foundations for such a critique. For example, earlier this year the UN Human Rights Council adopted Guiding Principles for Human Rights Impact Assessments for Economic Reform Policies, which set out the human rights standards that should anchor economic policymaking, including fiscal adjustment.

These are informed by the practical experience of civil society organizations such as CESR in assessing austerity and its human rights impacts in numerous countries, as well the work of progressive economists bringing a human rights lens to challenge dominant economic paradigms.

Such efforts have focused on fiscal policy as a critical entry point for addressing structural injustice, as reducing inequality and fulfilling human rights are simply not possible without a radical redistribution of resources, wealth and power.

Systemic approaches to economic and social rights accountability are also targeting the responsibilities of international financial institutions and corporate actors in maintaining the unjust economic status quo. CESR’s efforts have been aimed at the IMF, whose complicity in prescribing austerity has fanned the flames of crises in many of the countries where protests have erupted.

For example, just last month the IMF pressed Lebanon to apply even more regressive adjustment measures, minimizing concerns about the potential for social tensions. Ongoing initiatives to codify the binding human rights obligations of business actors and overhaul the rules of international corporate taxation are equally critical fronts for systemically hard-wiring corporate accountability.

Of course, a truly “eco-systemic” human rights practice needs to go beyond normative elaboration and international policy reform. A challenge for those working internationally is to build stronger links between norm development, policy critique, context-specific advocacy and movement building, supporting the efforts of national human rights activists who are drawing attention to the structural and social rights dimensions of the crises.

We can likely expect more protests of this kind in 2020, as fiscal contraction spikes, the global economy slackens, and traditional spaces for civic engagement shrink.

There is a clear message emerging from the streets that human rights actors should get behind: there can be no democracy without economic and social justice. For this reason, any durable resolution to the current unrest must have economic and social rights accountability at its core.

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Building a Leprosy Free Bangladesh

Asia-Pacific, Conferences, Development & Aid, Featured, Headlines, Health, Human Rights, Poverty & SDGs, TerraViva United Nations, Women’s Health

People living with Leprosy receiving care from the Institute of Leprosy Control and Hospital in Dhaka, Bangladesh. Credit: Rafiqul Islam / IPS

DHAKA, Bangladesh, Dec 9 2019 (IPS) – Despite having remarkable success in leprosy control in the last decades, the Bangladesh government is now moving forward with a vision to build a leprosy- free country.


“In 2017, the Bangladesh government revised the Bangladesh Leprosy Control Strategy for 2016-2020 – ‘Accelerating towards a leprosy-free Bangladesh’ – in line with the Global Leprosy Strategy 2016-2020,” programme manager of National Leprosy Programme Dr Md Shafiqul Islam told IPS.

Leprosy continues to be a stigmatized condition deeply embedded in society. Socially marginalized groups such as women and the urban poor are less likely to seek medical attention..

The Global Leprosy Strategy ensured increased commitment towards a further reduction of the burden of Hansen’s disease and prevention of lifelong disability for children affected by leprosy. This strategy focuses on universal health coverage bringing women, children and vulnerable people under the programme so that the sustainable development goal-3, which ensures a healthy life for all, can be achieved by 2030.

Shafiqul said the National Leprosy Programme of the government aims to reduce the leprosy burden further by leprosy elimination at the district level by 2020 as per the global strategy, with targets of zero grade 2 disability (G2D) among paediatric patients and reduction of new leprosy cases with G2D to less than one case per one million people.

To achieve the targets the National Leprosy Programme, in collaboration with partner NGOs, is arranging a national conference on leprosy in Dhaka on December 11 under the theme “ZeRo leprosy initiative”.

Bangladesh Prime Minister Sheikh Hasina is expected to speak at the inaugural session of the conference as the chief guest.

Leprosy in Bangladesh

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.

People living with Leprosy receiving care from the Institute of Leprosy Control and Hospital in Dhaka, Bangladesh. Credit: Rafiqul Islam / IPS

The grade 2 disability rate among the newly detected cases was 7.15 percent, 11.52 percent and 9.7 percent in 2000, 2010 and 2016 respectively, which reduced to 7.9 percent in 2018.

The rate of child patients among the newly detected cases was 15.3 percent in 2000, while it reduced to 5.9 percent in 2018.

The data reveals 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. Among the newly detected cases about 41 percent are MB patients.

Major challenges remain

Leprosy is a chronic infectious disease caused by bacteria (Mycobacterium Leprae). It mostly affects the skin, peripheral nerves and mucous membranes of the body. Delayed diagnosis of the disease leads to deformity mainly in the hands, feet and eyes. The bacteria not only destroys the peripheral nerve but also destroys social norms by leading to stigma, discrimination, divorce and isolation. It also affects the person physically, socially, mentally and economically.

The Leprosy programme is now facing several critical challenges after achieving its elimination target due to a gradual decrease in funding allocation for the programme, which has resulted in fewer activities, less training and losing experienced personnel. Ultimately, leprosy is losing its importance as an infectious disease.

Experts say the next major challenge is to sustain knowledge, skills and expertise in leprosy management, especially in less prevalent areas.

“Community education and awareness do not immediately dispel stigma. More evidence is needed for better understanding the causes of stigma and access to the effective intervention to decrease it,” Shafiqul said.

Finally, he said, additional challenges remained for prevention of visible disability and deformity in those who are already taking MDT, as well as community-based rehabilitation for the affected people.

“One of the challenges is to ensure quality care for the people affected by leprosy. There is no room to show our sympathy but it is their right to get quality health care. They also deserve our love, respect, dignity and support so that they can overcome life-struggling situations,” Dr David Pahan, Country Director of Lepra Bangladesh, said.

“We should continue our fight against leprosy bacteria. M. Leprae is a very clever bacteria with a long incubation period (remaining inactive especially in the nerves) before showing any symptoms. Our goal is to unite all our efforts to eradicate this disease and to see leprosy–free Bangladesh as soonest possible,” he added.

History of Leprosy in Bangladesh

The history of leprosy dates back centuries in Bangladesh. Different Christian missionary organizations used to provide leprosy services in various high endemic areas of the country. In 1965 leprosy services were implemented in the government sector through three public hospitals. Dapsone monotherapy was used to treat leprosy patients at that time. Multi-Drug Therapy (MDT) was recommended by the World Health Organization (WHO) for treating leprosy in 1982. The Bangladesh government expanded leprosy services to 120 high endemic upazilas by using MDT in 1985.

After the adaption of the WHO resolution to eliminate leprosy by 2000, the Bangladesh government revised the National Leprosy Elimination programme and expanded MDT services to all upazilas in a phase manner, covering the whole country by 1996. To achieve the time-bound target, the Bangladesh government had involved NGOs working in different endemic areas.

Fighting the stigma

Bangladesh achieved a national target of leprosy elimination as a public health problem (less than one case per 10,000 population) in 1998, two years ahead of the WHO target for leprosy elimination by 2000. At present eight NGOs, including Lepra Bangladesh and Damien Foundation Bangladesh, are working with the National Leprosy Programme with shared responsibilities to completely eradicate the Hansen disease in the country.

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