Come January, the Modi Government will carry out its own “Har Ghar Dastak” of sorts, albeit for a completely apolitical reason. A decade after leprosy was declared eliminated from the country, concerns are being expressed over its likely return. The Centre has decided to embark on an intensive fortnight-long “door-to-door” campaign in 50 high-endemic districts in seven States to screen suspected patients and detect early signs of the crippling disease.
The NDA Government’s campaign will see Accredited Social Health Activist (ASHA) workers visiting each house in leprosy-endemic districts and screening families for the disease.
“Overall, though there are 137 districts in the country which are on the priority list and where we are witnessing a rise in leprosy cases, 50 districts need immediate attention. These districts have a prevalence rate of more than one case per 10,000. Also, cases of children suffering from the disease are coming up from various areas,” Health Ministry officials said.
The 50 districts are in Odisha, Maharashtra, West Bengal, Bihar, Uttar Pradesh, Jharkhand and Madhya Pradesh. Though States have been carrying out such surveys from time-to-time, it is for the first time that the Centre is involving itself in a vigorous campaign mode to detect the cases and ensure treatment accordingly.
The UPA Government had focused more on polio and non-communicable diseases like cancer as it became complacent once leprosy was declared eliminated in many areas in 2005. leprosy is considered to be eliminated if the prevalence rate is less than one case per 10,000.
The NDA Government is now out to attend to the “neglected” sector. The move follows concerns that due to the stigma and ignorance, besides the State Governments’ apathy towards the disease, patients suffering from the contagious disease are not coming forward to get treatment, thus posing a serious health threat to society.
The ignorance can also be attributed to the integration of the National leprosy Elimination Programme (NlEP) into the General Health Care system after 2005. This took the focus away from the disease due to the shortage of funds and staff.
Data shows that after 2005, when the disease was declared eliminated at the national level, the threat of leprosy continues to loom large in various districts. The fact that grade II cases (when the disease has already set in and the patient has started showing deformity) are on the rise itself shows that the disease is not being detected in the early stages, said sources in the Union Health Ministry.
“Detection of new cases at an early stage is the only way to reduce the transmission potential in the community and also to provide relief to the leprosy-affected people by preventing disabilities. Hence, the door-to-door campaign has been drawn up,” they said.
The Centre seems to have taken inspiration from Bihar Chief Minister Nitish Kumar’s door-to-door campaign billed as ‘Har Ghar Dastak’ programme. Nitish personally interacted with the voters by knocking on their doors and seeking their feedback about his Government’s performance in the last ten years. His JD (U) had targeted 1 crore voters through the programme with each party worker assigned the responsibility of ten houses.
ASHA workers will visit each house in leprosy-endemic districts and screen the family members for the disease. Each ASHA worker will be accompanied by a male worker from local NGOs to ensure that male patients are not left out.
The Government urgently wants to curb the disease before it gets aggravated. The Health Secretary has already held two meetings in the last four months with State health officials asking them to focus on the prevention and treatment of the disease.
On its part, to enable early detection, the Ministry in August extended the scheme for utilization of the services of ASHA to cover other Anganwadi workers, health workers, volunteers or any other person who brings or reports a new case to the Government.
They will be given an incentive of Rs 250 for bringing in an early case before the onset of any visible deformity and Rs 200 for a new case with visible deformity in hands, feet or eyes. On completion of full course of treatment in time, ASHA workers will be given Rs 400 in Paubacillary (PB) cases and Rs 600 in Multi-bacillary (MB) cases, the sources added.
leprosy is a chronic infectious disease caused by Mycobacterium leprae, which mainly affects the skin, peripheral nerves, upper respiratory tract and the eyes.
MB leprosy is labeled when there are six or more skin patches and/or two or more nerves affected, while PB leprosy is labeled when there are five or less than five skin lesions and/or one or more nerve affected.
Although there is no vaccine, leprosy is curable with multi-drug therapy (MDT). Within a day of starting MDT, there is no risk of the disease infecting another person.
Also, the Centre along with State officials from the leprosy division plans to hold reconstructive surgery camps in January and February 2016, with the help of local organisations to help the needy to live a meaningful life.