| Focus Areas |
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| Leprosy |
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Case detection and treatment
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| Prior to functional integration (integrating Leprosy services with General health care), Lepra India played a ‘hands on’ approach where Leprosy control activities were carried out by Survey Education and Treatment (SET) strategy by which, identifying all patients living in an area and bringing them under MDT (Multi Drug Therapy) was the prime objective. Various methods of case finding like Mass survey, Contact survey School surveys were in use in Leprosy control programmes.
Now the leprosy control activities of Lepra India are designed in a way to support in streamlining systems for integration of leprosy services in general health services.The NGOs |
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| supported projects of Lepra India are supporting the PHCs in diagnosis and treatment services while the direct projects are implementing their activities by involving general health care system in this programme. |
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Modified Leprosy Elimination Campaign (MLEC) involving every health functionary for detecting cases that are hidden and Special Action Programme for Elimination of Leprosy (SAPEL)- a special programme for inaccessible areas where leprosy case detection and treatment are not carried out satisfactorily enhances case detection and treatment of leprosy. |
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Information Education Communication |
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As per the National Leprosy Eradication Programme (NLEP), after integration, the patients will be treated at their respective Primary Health Centres (PHCs) under the guidance of vertical programme staff. In such a situation, the health workers will promote voluntary reporting of cases. This necessitates bringing about attitudinal changes in the people, so that they respond on appearance of early signs and symptoms of leprosy. |
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Many programmes like group talks, public meetings, exhibitions, school education programmes, Audio/video (A/V) programmes and other methods such as street plays, rallies etc have been introduced with different strategies to achieve these results. Initiatives adapted by introducing multi- purpose Information Education and Communication (IEC) mobile unit has been useful in improving the awareness level of the people. |
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Preventing disabilities.. |
Leprosy control is about detecting and curing people affected by leprosy, and aiming to find people at an early stage of the disease, before nerve damage and wear-and-tear have led to permanent disability. |
With care, the majority of people who have grade one disability, that is a loss of sensation, can lead full lives. Prevention of disability programmes are designed to help people with problems of numbness and find ways to adapt their normal routines and to establish life long ‘self care’ skills to enable them to avoid damage that could lead to limbs eventually becoming unusable. |
Prevention of Deformity/ Prevention of Worsening Deformities (POD/POWD) activities |
Lepra India has been implementing well-planned POD/POWD in its projects to enable the clients to adopt self-care practices to protect their hands and feet from injuries and damage. This activity involves screening of all persons affected by leprosy, assigning risk grades (scale 1-6) based on the impairment status, provision of foot wear, proper exercises to prevent stiffness of thumb and fingers and referral of special cases towards and to surgical unit for surgery. |
Counselling for self care |
Prevention of disabilities is a joint venture in which the patient has to participate fully as an equal partner. The patient and the health care personnel must learn to recognise disability prone situations and look for practices to avoid or prevent disability. In order to develop this kind of behaviour the patients need to be trained and supported in practices appropriate to meet their requirements.
All Lepra India supported projects have a special component of counselling and training that helps the patients in self-care. |
Enhancing through knowledge |
Health education is carried out as a regular activity in all the projects. Group talks in villages are conducted by Para Medical Workers (PMWs) with the help of flash cards. Public meetings, video programmes, exhibitions and school education programmes are conducted by Non-Medical Supervisors (NMSs) assisted by PMWs. |
Ophthalmic care |
Leprosy mainly affects skin and nerves. However eye complications are quite common in Multi Bacillary (MB) type of cases, cases with repeated reactions and those with active lesions in the vicinity of the eyes. |
Eye care has been an important activity since inception of the projects. Lepra India’s project (located in Sonepur, Koraput and Malkanjgiri districts of Orissa) has been functioning over 10 years where more than 35000 cases were recorded and treated. These projects have in-patient wards to treat. Besides, other complications of leprosy and cases having eye complications have been taken care of. Over 700 cases were treated for eye complications till now. |
Special eye care programme has been started in these projects from July 1998, with a grant component from NLCB (National Lottery Charity Board, UK). The aim is to treat eye complications with medical and surgical interventions |
Living a dignified life |
Rehabilitation programme was introduced with the aim of reducing the impact of disabilities on the social and economic life of the leprosy affected persons, and enabling them to choose and undertake income-generating schemes to earn and support themselves and their families. Various rehabilitation services as detailed below are provided by the projects depending on the needs of the clients, their age, sex, work potential, attitudes, aptitudes, skills and educational status, societal acceptance and stigma. |
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Old age pension |
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Maintenance allowance |
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Arranging loans from Government, Philanthropists, LEPRA India |
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Arranging tools for self-employment |
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Students Scholarships |
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Psycho Social Counselling |
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Community based rehabilitation with the active involvement of the community |
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Capacity building |
Regular reorientation training programmes in Leprosy, IEC, POD/POWD and Communication Skills are conducted in the projects for development of essential skills in the staff. Training programmes are also organised for the PHC staff for their participation during special case detection programmes. |
Sharing our expertise |
Lepra India has placed Technical Support Teams in 4 states to supplement the efforts of the leprosy programme in 29 endemic districts. The teams are aimed at improving the capacity of the district to implement effective leprosy services through PHC and liase with other partners in leprosy elimination campaigns. They support the District Leprosy Officer (DLO) in implementing programmes; capacity building in PHC staff, functional integration, participation in MLEC (Modified Leprosy Elimination Campaign) and supply of IEC materials for implementation of MLEC. |
Specialists care for special needs: |
Reconstructive surgery |
Lepra India has established close linkages with Sivananda Rehabilitation centre in A.P and Hoina Research Trust in Muniguda Orissa to refer cases, which require reconstructive surgery. Reconstructive surgery procedures include surgeries of the hand, feet, nerves, eyes etc. Surgical correction of deformity brings the clients more acceptability in the community, increases functional capabilities and helps in rehabilitation. |
Special footwear |
About 3% of the patients have loss of sensation in feet and need special footwear to protect their feet from developing ulcers. Footwear centres have been established in Lepra India projects and in few NGOs to produce and supply special footwear to the needy patients with Grade 1 and 2 disabilities. A centralised footwear programme has been established after research in acceptability and durability in footwear for grade 1 & 2. Pairs are being manufactured and supplied. |
Quality control of diagnosis |
The Histopathological centre of Lepra India established in 1988 at Sewagram, Maharastra carries out histopathological investigations for diagnosis of cases where clinical diagnosis is difficult and also to monitor the quality of smears and bacteriological examination by cross checking 10% of examined slides of Lepra India. The centre also conducts one-day workshops in pathology of Leprosy for postgraduate students in different colleges. |
In patient facilities |
About 10% of leprosy patients develop complications like reactions, neuritis and ulcers needing hospitalisation. Lepra India established 20-bed in-patient ward at BOLEP, JUNLEP and KORALEP. Patients with complications and other complications (eye, inter-current infections) are admitted to these wards for treatment. Physiotherapy is also provided to patients needing pre and post-operative physiotherapy. |
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