The gift of pain: This is what leprosy steals from people, depriving them of the pain that could warn them that they have injured themselves. Without it, they may keep on damaging their fingers or toes, and eventually lose them.
This is the tragedy of leprosy, said Stephen Griffiths, Cambodia’s medical coordinator for the International Committee of the Order of Malta for Lepers’ Assistance. The disease affects nerves and takes away physical pain that reminds people to care for their bodies. Otherwise, leprosy would just be another skin disease, said Griffiths.
Limbs do not need to be lost; this only happens in advanced cases left untreated. Leprosy is curable, and easily so, with antibiotics. Skin lesions can disappear and nerve damage can be avoided if patients get treatment early enough. This is why the Order of Malta Committee and Cambodian authorities put such emphasis on detection and immediate care, said Lai Ky, officer in charge of the Ministry of Health’s National Leprosy Elimination Program.
Treatment also prevents possible contagion, Lai Ky said. A person may spread the disease by sneezing, but within 36 hours of taking a first dose of medicine, that person stops being contagious, Griffiths said. Most people have a natural immunity to leprosy; only five out of 100 people are susceptible, Griffiths said.
For hundreds of years, leprosy has inspired fear. Afflicted people have been shunned and excluded from communities. Cultures resorted to superstition to explain its causes.
Even today, the mention of leprosy still makes people uneasy. One young Cambodian in Battambang province refused to leave his room for nine years or get treatment because he was ashamed of his disease and afraid of neighbors’ reaction, said Griffiths.
Seng Taing Sorn, a 29-year-old farmer from Kompong Cham province, contracted leprosy when he was four years old. He said that before he started treatment in 1997, “I had almost lost hope in life.”
Now he wants people not to be scared of leprosy. “It does not get passed on from one person to the next that easily,” Seng Taing Sorn said.
Seng Taing Sorn last month joined medical authorities at Wat Sokong in Kang Meas district, Kompong Cham province, for a campaign organized by the Leprosy Program and the Order of Malta Committee, which assists Cambodia with its efforts on behalf of the International Federation of Anti-Leprosy and in cooperation with the World Health Organization.
During the campaign, which included television and radio advertising, events were held in five of the seven provinces with the most leprosy cases—Kompong Cham, Kompong Thom, Battambang, Kompong Speu and Kandal.
At Wat Sokong, provincial and local authorities arrived with posters, flyers, hats and T-shirts to distribute, plus a television set to show people sketches on leprosy. After the show, the medical officers examined dozens of people who were concerned about skin anomalies.
“It’s not difficult to check,” said Say Vongsar, director of Sokong Health Center. “We check the marks they have, and use a feather or pen to gently poke the skin to see if they feel it or feel numb.” The lack of feeling indicates leprosy, he explained.
There were no new leprosy cases among the 350 or so people who came to the event. “Most people we have checked had ringworm or a minor skin disease that leaves white spots,” said Say Vongsar. But in the eastern region of Kompong Cham province, five new cases were identified in the first two days of the campaign, said Lai Ky.
Approximately 10,000 people attended the events in the five provinces. Among the 1,804 who asked for an examination, 1,405 were suffering from skin diseases and 19 from leprosy.
The more people hear about symptoms of leprosy such as patches of skin discoloration on the body, the more people may show up at health clinics and get treatment early enough to avoid permanent damage, said Lai Ky.
It takes three to five years, and can be as much three decades, for symptoms of leprosy to appear, said Griffiths. The disease may cause skin and nerve damage fairly early in some people, and progress slowly in others.
Progress has certainly been made against leprosy. The treatment, which took up to 20 years in the 1960s, now takes just a couple of years, Griffiths said.
Leprosy has appeared on all continents and in all climates. Most cases today can be found in six countries. Statistics published
in January by the World Health Organization show that in 2000, India accounted for more than three-quarters of the world’s