My experience with Leprosy patients, writes Dr. Arup Paul

Jan. 30: Leprosy is one of the oldest diseases among mankind. Leprosy is caused by bacteria called mycobacterium leprae. The presentation of patients is varied and it can mimic various other diseases. As a Post graduate trainee, I first saw cases of leprosy in Gauhati Medical College in 2010. And now in 2022, here at Silchar Medical College & Hospital (SMCH) also, I do see cases of leprosy in our outdoor department of dermatology. As a Dermatologist, I come across patients suffering from various skin diseases, sexually transmitted infections, but leprosy patients stands out from others.

As I have been examining cases of Leprosy for years, I believe its not only a bacterial disease but its impact is manifold affecting other aspect of patient as well as their family members. Societal perception of the disease is a hindrance in eliminating the disease. From children to adult, all age group can be affected. As it’s a chronic disease, the frequent visit of the patients make their faces familiar to me. I remember a young girl of 14 years who used to visit in Gauhati Medical College. She used to come with a smiling face despite of Ulcer over her foot. It has been almost 10 to 12 years, but at present, I don’t know how she is doing.

My first case of leprosy was a patient who died in our ward when I was in 1st year PGT . He expired due to electrolyte imbalance of the body. (Leprosy is not a direct cause of death). Generally, we don’t admit case of leprosy until they come with severe disease. In most of the cases, treatment is given on OPD basis. It’s not possible to remember each and every patient. But irony is that a patient who suffers a lot is remembered most of the times than a successfully and uneventfully treated case. Sometimes part of their agony and suffering affects me also.

All the patients are different in many ways but few similarities which I have noticed in them are: most patients are ignorant, belong to lower socio-economic strata, fearful, hesitate to come out to seek medical help etc. Stigma associated with leprosy is high and this is one of the reasons why patients suffering from leprosy come late for treatment. When patients come late, they generally develop deformity of various structures like hand, foot, ulcer and even blindness. These complications can be avoided with early detection and proper treatment with multi-drug therapy (MDT). MDT is supplied free of cost in government hospitals. Along with medical treatment, physiotherapy and in few cases reconstructive surgery is also required to rehabilitate the patient. But key for successful outcome is early detection and referral to proper centre.

When to suspect leprosy:

We should remember that leprosy is a disease which mainly affects nerve and skin. So, any person having lack of sensation over hand feet, ulcer over hands feet, whitish patch of skin with altered sensation, we should rule out leprosy by proper examination. They should be asked to attend skin department of medical college or any leprosy centre of Civil hospital. Along with treatment, they need compassion and support of family and society, they need dignity not discrimination.

Govt. of India under NLEP (National Leprosy Eradication Programme) is serving leprosy patients since 1955. There are different schemes for beneficiaries under NLEP. Apart from this, IADVL, Association of Dermatologist is also carrying out different activities for leprosy patients. Different NGO’s are also there. SAKSHAM, a national NGO is doing different activity for treatment of patients with deformity due to leprosy.

The experience of treating a leprosy patient can be frustrating, when with all available treatment, their agony cannot be mitigated, but at the same time its very gratifying, when I see my leprosy patients getting cured and leading a life with self-esteem and dignity. In India, anti-Leprosy Day is observed on 30 January every year, i.e., the day of martyrdom of Mahatma Gandhiji. He was deeply committed to the cause of leprosy. To quote Gandhi, “Leprosy work is not merely medical relief, it is transforming frustration of life into joy of dedication, personal ambition into selfless service…”

Dr. Arup Paul is a Resident Physician, Department of Dermatology, SMCH.