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Leprosy on the rise, silently

RlZANUZZAMAN LASKAR
When rash first appeared on his belly, a 38-year-old factory worker dismissed it as an allergic reaction to something he might have eaten recently. His wife also going with the instinct handed him an ointment.
But when the red bumps did not go away even after weeks, and instead began to spread in the legs, arms and on the face, the man began to worry. He saw a doctor, who had no explanation for the condition, and then another, who made the startling yet correct diagnosis of leprosy.
In Bangladesh, most people consider leprosy as a plague buried in the past, a disease relegated to biblical times or, perhaps, to the poorer section and the remotest parts of the country.
While the incidence of infection has
been declining in some parts of the country, it has actually been on the rise in many otherparts, includingthe capital.
Leprosy or Hansen's disease (HD) is a chronic mild infectious disease caused by a germ similar to that which causes tuberculosis. It attacks the nerves of the hands, legs and face and, if left untreated, can take away the ability to move the fingers, toes and eyelids ultimately leading to loss of limbs and sight.
The longer the disease is left unaddressed, the more likely it is that the deformities, so often associated with leprosy, will occur.
Redefining leprosy as a curable disease is crucial for helping doctors identify undetected cases. But drawing attention to a disease that has become synonymous with stigma has proved to be challenging. An infected still has the chance to be treated as pariah by the society.
Against this backdrops, the country is observing the World Leprosy Day today with the theme “Together we work for a Bangladesh without leprosy”.
Some 3,800 fresh cases of infection were detected in the country in 2011 while it was around 5,000 in 2009, according to The Leprosy Mission International (TLMI), a non-government organisation working to create awareness about the diagnosis and treatment of the disease.
TLMI statistics show some 732 Dhaka city dwellers have leprosy, or locally known as “Kushtho Rog".
“Those are the ones that we know of, but the actual number of infected is much higher,” said Jewel Baudya, project manager ofTLMI.
Usually leprosy patients suffer discrimination and humiliation in Bangladesh society. They have been denied job opportunities and many other facilities available for commoners.
For instance, the 38-year-old factory worker mentioned earlier received treatment in a Dhaka hospital before it could harm him permanently. But he refused to disclose his name
to avoid the "society's eyes”.
This is not just one case. A man from Keraniganj tells his friends that the bumpy patches on his arms are allergic reactions. A middle-aged officer who received treatment for leprosy years ago still has not told his son about it.
"He did not tell anyone at the beginning,” said Thomas Singha, manager at TLMI, adding, "He [the patient] thought it was a curse and the news could bring disgrace to his family.”
Although the other close family members were informed, the man refused to share the news with his son even after he had been cured, said the TLMI manager.
Most of the worries surrounding leprosy stem from the fact that it is an airborne infection that spreads through coughing and sneezing, said Singha.
However, it is now believed that 95 percent people are naturally immune to the infection and once a patient starts the treatment, s/he is no longer infectious.
Scientists are still struggling to find an effective vaccine. If promptly identified, leprosy can be relatively easy to treat. Depending on the clinical stage, the treatment can take six to 12 months.
Leprosy treatment is free
of cost in the country, thanks to the support from the government and the World Health Organisation.
However, detecting fresh infections remains a challenge due to the lack of public awareness and the stigma believed to be attached to the disease.
The Leprosy Mission International has 500 people working in 14 districts of the country. They hold discussions, distribute leaflets and flyers to spread knowledge about the disease. Through their relentless effort, around 4,000 to 5,000 fresh cases of infection are detected every year.
Identifying the patients unaware of their infections and treating them are crucial for preventing the disease from spreading further, said Jewel Baudya of TLMI.
The government by 2015 seeks to reduce the spread of leprosy to such level where it would not be a threat to public health, said Asheque Hossain, director of Microbactarial Disease Control division of the health ministry.
“The situation is much better in Bangladesh now," he told The Daily Star, adding that according to the government statistics, only one person out of a thousand contract leprosy in the country, except for Gaibandha district where the rate is a tad high.