Tele-Consultation as a method of reaching leprosy colonies
Despite its high GDP, India has one of the world’s largest numbers of impoverished people, with over 300 million people living in poverty. Aside from pervasive poverty and stark inequality, India has the world’s largest number of leprosy cases, with over 120,000 cases reported in 2019.
India was officially proclaimed leprosy-free in 2005 when the new cases dropped to less than 1 per 10,000 (as per WHO standards), the country still has the highest number of leprosy patients in the world. In 2020, India accounted for 51% of all new cases of leprosy diagnosed.
INDIAN SCENARIO OF LEPROSY
Despite its high GDP, India has one of the world’s largest numbers of impoverished people, with over 300 million people living in poverty. Aside from pervasive poverty and stark inequality, India has the world’s largest number of leprosy cases, with over 120,000 cases reported in 2019.
India was officially proclaimed leprosy-free in 2005 when the new cases dropped to less than 1 per 10,000 (as per WHO standards), the country still has the highest number of leprosy patients in the world. In 2020, India accounted for 51% of all new cases of leprosy diagnosed.
DISCRIMINATION:
In Indian society, poor people with leprosy has suffered discrimination and ostracism from their families, friends, societies and healthcare professionals. There are many misconceptions, socio-cultural beliefs, and stigmas associated with leprosy. Because of worries of spreading the disease, most leprosy centres are isolated from society. Their basic survival is frequently dependent on others’ goodwill. Many Indian states forbid leprosy sufferers from competing in local elections and deny them employment opportunities and benefits. Even if they do not have the disease, simply living near a leper colony disqualifies them from seeking for jobs or being admitted to schools.
UNAVAILABILITY OF HEALTHCARE FACILITIES:
The majority of healthcare facilities and other resources are only available in metropolitan areas, leaving the rural people with little access. Leprosy communities resides in rural areas of Maharashtra, Madhya Pradesh, Bihar, Jharkhand, West Bengal & Odisha where these communities lacks the access of diagnostic facilities leaving many leprosy cases undiagnosed and uncured.
COMPLICATIONS ASSOCIATED WITH LEPROSY
It is unlikely that leprosy will cause lasting damage if treated early. However, if left untreated, the condition worsens and the nerve damage spreads. People with leprosy might harm themselves because they lack feeling in their hands and feet. Ulcers, infection, and chronic disability can all result from these injuries. There were cases in leprosy colonies where patients were having untreated ulcers and infections from last 8-10 years which worsens the patient’s condition and sometimes resulting in amputation.
INNITIATIVE TOWARDS LEPROSY ERADICATION
S-ILF (SASAKAWA – INDIA LEPROSY FOUNDATION) is a Non-Governmental Organizations (NGO) with a mission, “To end stigma against the disease and ensure equal social, economic and cultural opportunities to those affected by leprosy and their families”.
S-ILF collaborates with eNext ICU (a telemedicine service provider) for TELE-OPD CONSULTATIONS where Critical care specialists from eNext ICU are remotely available for consults every day.
Language is the most significant impediment to a seamless Tele-OPD consult, where an S-ILF coordinator serves as a translator for both critical care professionals and the leprosy community.
Fig 1.1: Tele-consultation with a leprosy sufferer is assisted by a coordinator. Patients suffering from any condition in these communities met at a predetermined time and location, from where Tele-OPD consultations were conducted via a two-way audio-visual platform.
IMPACT
In co-ordination with S-ILF team, the Tele-OPD consults were conducted by eNext ICU team in various leprosy colonies: In Maharashtra such as Swadhar Nagar Leprosy Colony, Kolhapur; Pandurangwadi Leprosy Colony, Amravati; Lokmata Indira Nagar Leprosy Colony, Amravati. In Jharkhand, Nai Dunia Leprosy colony Jhariya, Dhanbad and In Odisha, Indira Leprosy Colony, Jharsuguda; Nadikhani Colony, Bargarh. Following are the few data points:
PATIENT’S DEMOGRAPHICS
Fig 1.2: It has been reported that the female patients are more prone to morbidity.
AGE GROUP OF THE PATIENTS
Fig 1.3: It has been reported that patients with the age between 50 to 70 years are more vulnerable to disease..
MAJOR COMORBIDITIES
Fig 1.4: Major 5 morbidities identified i.e. Hypertension, Diabetes, Limb Ulcers, Joint pains and Giddiness
A RAY OF HOPE
This effort offers a glimpse of hope to the leprosy community, which has been stigmatised for not receiving treatment and has been described as an isolated society.
An article by Simranjeet kaur
