This may be unintentional but the fact remains that many meaningful efforts will have to be made to change and restructure the image of leprosy in the print and electronic media. The first step will be to evolve a media strategy. It was suggested that WHO may play a leading role along with country governments so that country-specific media strategy is developed. This strategy will answer what product we want to market, how we want to market, what is our audience, and what is our focus. The Workshop felt that the next step will be to develop orientation programs for print and electronic communicators at the district level, rather than the national level so that feature writers, editors of Sunday editions, and producers of TV and radio documentaries can create the correct image. The third step would be to develop a data bank on leprosy and a collection of stories with human warmth and photographs that may be attractive to the press. Religious, socio-economic leaders and cult figures may be encouraged to undertake an advocacy role on behalf of leprosy. For this campaign, use of folk lore, folk arts, and theatre may be very useful to suit the cultural context. It was discussed whether the negative image was created because of disability and disfigurement resulting in the stigma.
The workshop, however, thought that the positive aspects expressed in the declining numbers of disability and lowering of percentages of active cases and disfigurement may be highlighted to create a positive image.
e) There was an extensive discussion on stigma. Stigma was defined as a social response on a continuum beginning from total rejection to total acceptance expressed in the form of social distance. Measurement of social distance and quantification of stigma are new researchable areas in the social sciences. It was felt by the participants that when stigma is overcome, it can serve as positive element in the battle against leprosy.
2. Community Involvement
The members felt that the majority of the PALs in developing countries belong to agricultural rural communities. In these communities family, either nuclear or extended, and the self-contained society provide a safety net and security. If one is able to utilise this safety net, it can be effective instrument in prevention, identification, treatment and rehabilitation, ultimately leading to community based rehabilitation. The bonds in rural society are strong and if appropriately used, the entire community could be involved in preventing dehabilitation of PAL. It was also pointed out that while the leprosy problem looks very large globally, if it is seen as a community problem at the village level, it is likely to be manageable. The additional advantage is of using the traditional institutions, such as a church, Sunday school, or village panchayat. Discussing this issue further, it was felt that the level of the village there is a definite change in the role of the health worker. This change from a provider to a facilitator, or from provider to health educator and counselor is an important change in our battle against leprosy, but to achieve this we will have to provide technical support to the community leaders who have their roots in the village itself. With the electronic revolution, the supply of information may not be the problem. The problem may be of selecting the right package for the right worker.
