Visits to Delhi and Kolkata launch a Global Appeal; travels to Addis Ababa and Shashamane gauge progress in the fight against the disease

　

INDIA (JANUARY 28-FEBRUARY 3)

　

　

 On January 29 I was in Delhi to launch the Global Appeal to Eliminate Stigma and

Discrimination against Persons Affected by Leprosy (full text on page 3).

 Nearly a dozen world leaders and Nobel Laureates had joined me in putting their names to the appeal, which is designed to draw the world's attention to the ongoing problems faced by those affected by the disease.

 Among the dignitaries in attendance was the former chief justice of India's Supreme Court, Y.V. Chandrachud, who was one of several distinguished speakers at a symposium on “Law and Leprosy” later in the day.

 I also used the occasion to announce that I was establishing a new fund to help empower persons affected by leprosy in India and increase their chances of social and economic integration.

 The fund has three goals: to provide persons affected by leprosy with vocational training and job opportunities; to establish micro-credit schemes; and to provide educational opportunities for children living in colonies, using education to break the cycle of stigma and poverty.

 On January 30, I moved to Kolkata to announce the Global Appeal to media representatives in West Bengal. Among those joining me on the platform was the state minister for law and justice, who said that there are a number of laws that could help the leprosy-affected but which are not working properly because there is no social awareness of the issues they address. “The law is a cart,” he said, “and awareness is the horse. The cart cannot move without the horse.”

 The state of Jharkhand, which has a prevalence rate of 1.4, was the last stop on my journey. In the capital, Ranchi, I participated in a media workshop and a state/district level consultation. I also traveled to Jamshedpur, the home of Tata Steel, India's largest privatesector steel company, to attend a human rights seminar and visit a couple of colonies. One of these is supported by Bharat Sevashram Sangha, a Hindu charitable organization that has worked tirelessly to promote leprosy elimination in India. I saw new houses being built and the site was being attractively landscaped.

　

 On my travels I was accompanied by persons affected by leprosy from Nepal, Indonesia and the Philippines. I want to thank them for speaking at the different venues we visited together and for sharing their insights. As Adi Yosep of Indonesia reminded us in Kolkata, we must listen and learn from persons affected by leprosy, respect their voices and not make assumptions on their behalf.

　

　

ETHIOPIA (FEBRUARY 24-MARCH 2)

 At the end of February I paid my first visit to Ethiopia in about 10 years. Although only a short stay, it was extremely rewarding.

 Ethiopia achieved elimination in 1999 and registers only about 5,000 new cases annually. Unfortunately, over 40% of these involve disabilities. To tackle this problem, efforts to ensure early detection need to be stepped up.

 Fighting against discrimination and working to restore the dignity of those affected by the disease is the Ethiopian National Association of Ex-Leprosy Patients (ENAELP). Established in 1996, it now has 54 branches around the country.

　

　

 Birke Nigatu, ENAELP's charismatic chairperson, joined me in paying a courtesy call on Prime Minister Meles Zenawi. I limited my remarks to allow her to speak at length with the prime minister. She also joined me at a press conference, where she described her experiences as a person affected by leprosy. The resulting media coverage was excellent.

 On February 28, I drove to Shashamane, about 250 kilometers south of Addis Ababa. Shashamane is composed of about 15 villages totaling 60,000 people. About 12 kilometers from the center is a general hospital. Established as a leprosy hospital in 1951, but today treating TB, AIDS and other illnesses, it accounts for the large number of leprosyaffected persons living nearby.

 One of the villages I stopped at was Kuyera, which is home to about 7,000 recovered persons and their families. In a joint initiative of ENAELP and the GLRA, self-help groups of 10-15 people meet once a week. With practiced eyes, recovered persons inspect each other's old injuries. Those whose hands and feet are well looked after are rewarded with a round of applause, while those found to have ulcers are told to be careful, and some are even fined for not taking better care of themselves.

 Some 60% of leprosy-affected persons living in Shashamane are said to have serious disability, and 99% live below the poverty line. According to locals, it is hard for such people to find work because of the social stigma. For those who want to go into business, the lack of startup capital is an insurmountable obstacle, so many resort to begging to make a living. Quite a few are involved in agriculture, but yield is poor and they are hard-pressed to grow enough for their own needs.

 On the way back to Addis Ababa, I stopped to inspect an initiative of The Sasakawa Global 2000 Agricultural Program. Here a farm was trying out a new type of irrigation system.

 Ethiopians are normally only able to work the land for a couple of months of the year during the rainy season. However, by installing this simple system, the farm I visited has extended the cultivation period by two months, enabling it to grow better quality vegetables and raise dairy cows. The farmer's wife told me the results were marvelous.

 It occurred to me that this irrigation system should be taught to persons affected by leprosy living in rural settlements. Giving them access to the latest agricultural techniques will not only greatly improve their lives, but will, I hope, encourage neighboring farmers to come and learn from them and so break down the barriers of discrimination.

 There is no reason why this can't be tried in other countries, too. My trip to Ethiopia provided me with a very important insight, and I am excited about the possibilities.

　

　

Leprosy LEXICON

 Continued intervention is required to keep leprosy under control and reduce the incidence and prevalence of the disease. As defined by the WHO Global Strategy for 2006-2010, leprosy control activities delivered by the health system include diagnosis, MDT, patient and family counseling, community education, prevention of disabilities/impairments, rehabilitation and referral for complications.