Community Based Comprehensive Leprosy Work in Rural Maharashtra

“And miles to go before I sleep, And miles to go before I sleep” - Robert Frost

Reaching the ideal of

  1. Totally community based leprosy work in a comprehensive manner and
  2. Integration of leprosy work with other diseases as a part of community development including disability care and rehabilitation is too farfetched to think of at this stage.

However, one can progress towards the utopian goal of Community Based Rehabilitation (CBR) step by step by taking relentless efforts.

In this context it may be worthwhile referring to the work of Bombay Leprosy Project (BLP) in offering disability care to persons affected by leprosy in rural Maharashtra as a preliminary step towards implementing CBR at a later stage.  All the field work in the adopted villages is managed by volunteers including some persons who were affected by leprosy in the past and are  living in the same community as the disabled patients whom they serve. By offering employment these youths are also rehabilitated.

It is interesting to know how effectively these volunteers derived from the same rural community serve, if properly trained and supervised. In an massive field operation, more than 1,250 disabled leprosy patients (with grade 2 deformities) have been identified in an  adopted rural population of 476,970, covering 11 Primary Health Centers (PHC) in three “talukas” of Thane district. In some PHC areas the prevalence rate of visible deformities is about 25 to 27 per 10,000.

Door-step services using simple inexpensive aids and appliances are offered by 8 rural volunteers. They work in close coordination with the PHC staff. The overall supervision is done by visits of trained and experienced staff from BLP

 If any other agencies specializing in other conditions causing handicaps are available in the same villages, we may be able to collaborate and  implement CBR.  Unfortunately services to the physically challenged due to causes other than leprosy are not planned in a community based manner.

The photographs show how the volunteers derived from rural communities operate: -

Group of rural volunteers working in 11 PHC areas in coordination with govt staff.
 
Gutter splints being provided by a volunteer who is himself cured of leprosy.
 
A volunteer taking measurement of the foot for preparing MCR footwear.
 
A volunteer who is a cured of leprosy advising a patient on how to use an ulcer dressing kit.
 
Home-self care being practiced by a patient with plantar ulcer.
 
A patient being provided MCR footwear.
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