- we are not allowing enough time to patients to understand and incorporate the message The most recent approach is that of "self care". It is an important item since the participation of the patient in POD is essential. Some new material has been devised for this purpose in many countries and results are still to be analyzed. However, it seems that "self care" is the future for POD.
What should we do in the future?
1. To really face leprosy as a disability-and-deformity producing infectious disease.
That means, not only as a infectious disease alone. In this regard the essence of the present situation of POD was declared in an article published in the International Journal of Leprosy - MDT for all - target oriented leprosy control program in the 1990s. Those that did not read this article are urged to read it. In doing so, it will be possible to understand the present situation of POD (YUASA, 1990). As stated in the article, we should strongly stress and deeply believe that now it is the time for the second stage for leprosy control： in this second stage leprosy should be regarded as a disability-and-deformity producing infectious disease.
2. To induce leprosy control managers to understand and accept that POD is an essential part of the control of leprosy as an infectious disease.
3. To define who should be responsible to implement prevention actions.
- in vertical programs - all health workers should be in charge of
- in integrated programs - all health workers should be trained to be in charge of
- in some special situations, should a specialized cadre of workers be created to cope with disability prevention/rehabilitation needs?
4. To improve early detection of leprosy
5. To stimulate studies solve the following equation：
- why results of POD activities are not really effective in the global sense?
5.1 - to stimulate studies in the social/educational area in order to better understand why the messages of health education in leprosy are not adequately incorporated by patients.
Is it a problem of the patient?
Is it a problem of the health worker?
Is it a problem of the message?
6. To agree that no further technical material is needed. The list of available teaching and training material for leprosy includes a sufficient number of high quality publications on disability prevention and management. If any extra material is to be prepared, it should be focused in self-care. In preparing such material some important concepts should be kept in mind such as：
- POD requires active collaboration between health personnel, patients and their families.
- Ultimately, it is the patient who becomes disabled and deformed - not the health worker or the one who is preparing the teaching/training material.
- Remember that leprosy, presently, is a problem of undeveloped or developing countries.
