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In response to Theodore Dalrymple well written piece that draws
Graham
Greene’s pessimistic comparisons between leprosy and life I would like to
offer a more positive analogy. A disease is progressively destigmatised by
society when an individual who suffers from the affliction is openly
welcomed
by another family through the bonds of marriage or a commitment of equal
standing. I came to this realization after observing the way Nepalese
society, where leprosy is endemic and afflicts mainly subsistence farmers,
is
progressively moving towards the destigmatisation of the disease when I
attended a wedding where the groom suffered from leprosy.
In part this may be due to the tireless efforts of the doctors,
scientists and
Christian missionaries in conjunction with the Nepalese government for the
last 50 years in eroding the stigmatisation of a disease that is destined
for
some time to be persistent. I don’t believe that their motivation is
necessarily
“leprophilia.” Despite the decline in the prevalence of leprosy over the
last
twenty years from 12 to 1 per 10 000, the incidence remains unchanged with
approximately 600 000 cases per year globally (1). Although this reflects
improved leprosy control and case detection (2), the global use of
multiple
drug therapy has had limited impact on the transmission of M. leprae in
high
endemic regions, the reasons for which are unclear (3). As leprosy
afflicts
individuals in their most productive stage of life, the economic burden
posed
by the deformities and disabilities from chronic nerve damage is
significant to
the community. The acceptance of individuals with leprosy by the wider
population will at least ease the burden felt by sufferers of the disease.
1. World Health Organization. Global leprosy situation, 2005. Wkly
Epidemiol
Rec 2005;80(34):289-95.
The Destigmatisation of Disease
In response to Theodore Dalrymple well written piece that draws
Graham
Greene’s pessimistic comparisons between leprosy and life I would like to
offer a more positive analogy. A disease is progressively destigmatised by
society when an individual who suffers from the affliction is openly
welcomed
by another family through the bonds of marriage or a commitment of equal
standing. I came to this realization after observing the way Nepalese
society, where leprosy is endemic and afflicts mainly subsistence farmers,
is
progressively moving towards the destigmatisation of the disease when I
attended a wedding where the groom suffered from leprosy.
In part this may be due to the tireless efforts of the doctors,
scientists and
Christian missionaries in conjunction with the Nepalese government for the
last 50 years in eroding the stigmatisation of a disease that is destined
for
some time to be persistent. I don’t believe that their motivation is
necessarily
“leprophilia.” Despite the decline in the prevalence of leprosy over the
last
twenty years from 12 to 1 per 10 000, the incidence remains unchanged with
approximately 600 000 cases per year globally (1). Although this reflects
improved leprosy control and case detection (2), the global use of
multiple
drug therapy has had limited impact on the transmission of M. leprae in
high
endemic regions, the reasons for which are unclear (3). As leprosy
afflicts
individuals in their most productive stage of life, the economic burden
posed
by the deformities and disabilities from chronic nerve damage is
significant to
the community. The acceptance of individuals with leprosy by the wider
population will at least ease the burden felt by sufferers of the disease.
1. World Health Organization. Global leprosy situation, 2005. Wkly
Epidemiol
Rec 2005;80(34):289-95.
2. Britton WJ, Lockwood DN. Leprosy. Lancet 2004;363(9416):1209-19.
3. Alcais A, Mira M, Casanova JL, Schurr E, Abel L. Genetic dissection of
immunity in leprosy. Curr Opin Immunol 2005;17(1):44-8.
Competing interests:
None declared
Competing interests: No competing interests