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World Africa Day
Lepra has over ninety years of experience supporting those affected by leprosy and other neglected tropical diseases (NTDs) in India and Bangladesh. World Africa Day is an opportunity to focus on Lepra’s more recent collaboration with Netherlands Leprosy Relief (NLR) in Mozambique, which began in 2015.
Despite the commonly held belief that leprosy is no longer a problem, 214 000 new cases of leprosy were reported globally in 2014 [1]. Leprosy is a mildly infectious bacterial disease which leads to nerve damage, blindness and deformity if left untreated; however, it is completely curable using multi-drug therapy.
NTDs in Mozambique
In terms of annual growth in GDP, Mozambique is among the top ten countries in the world, but at the same time their inequality rating and life expectancy are among the worst [2]. Out of a population of 28.4m, 60.2% are at risk from at least one NTD. The most common NTDs in Mozambique are trachoma, lymphatic filariasis (LF), onchocerciasis, schistosomiasis and soil-transmitted helminths [1].
Leprosy in Mozambique
Around one in every 20,000 people in Mozambique has leprosy [3]. As is the case in many parts of the world, people with leprosy are often shunned from their communities due to a lack of understanding about the cause of the disease. In the language of the Nampula province people with leprosy are known as ‘a moribund person’, meaning someone on the verge of death. Many believe the disease to be incurable and surveys have shown that people are often ashamed of having leprosy [4].
Lepra has started work in the Zambezia province, which has one of the highest rates of leprosy in the country. Getting treatment for NTDs in Zambezia can be difficult as only 60% of the population has access to health services and people often have to travel far to reach them [5]. While there are national efforts to distribute drugs to treat leprosy [6], the new project run by Lepra and NLR is helping to fill the gap in follow-up care and treatment for leprosy-related disability.
An integrated approach to NTDs in Zambezia province
Self-care groups
The new project brings together NLR’s experience in other provinces of Mozambique and Lepra’s experience from India and Bangladesh to improve the lives of people living with various NTDs, particularly leprosy and LF. Self-care groups are an important part of this as they bring together people affected by leprosy and other NTDs to:
Learn how to take care of their own injuries which could otherwise lead to disability
Support each other and combat the isolation and depression associated with leprosy
Access proper footwear, economic opportunity, eye care and surgery to reduce disability
Self-care groups have a positive impact on the lives of people involved according to group members themselves. In a survey carried out in Nampula province, at least five out of six self-care groups believed that they had experienced benefits ranging from better wound care and footwear to economic benefits and the ability to fight for rights [4].
Leprosy and LF can be tackled together
In India and Bangladesh, Lepra has already shown that targeting leprosy and LF at the same time can be very successful. The self-care practices used to reduce leprosy-associated wounds and disability are similar to those required to reduce secondary bacterial infections linked to LF.
Volunteers play a key role in tackling a range of diseases
The project also has huge potential to benefit people living with other diseases. Lepra has 240 champions in Mozambique and 1,400 volunteers across all of their projects teaching them to recognise the symptoms of leprosy, as well as TB, HIV and malaria, the ‘big three killers’, and refer people to health services [5]. This approach increases the range of diseases that can be tackled at the same time, and makes efficient use of time and resources. Lepra’s work engaging local volunteers, some of whom have themselves been affected by NTDs, also helps to tackle deep-rooted cultural prejudices and lack of education to reduce the stigma associated with leprosy.
This World Africa Day, you can donate to help Lepra and NLR carry out its life-changing work.
Laura is currently in the third year of her PhD at the University of Oxford, following her undergraduate degree in Natural Sciences at the University of Cambridge. During her bachelors she specialised in infectious disease and is continuing that theme during her PhD, studying host-parasite interactions in leishmaniasis. Laura is looking forward to embarking on a career in global health, with a particular interest in neglected tropical diseases.
References:
1. http://www.who.int/.
2. De Kruijff, A. (2015) Mozambique country profile. Leprosy review 86, 89-95
3. http://leprosyrelief.org.
4. Deepak, S., et al. (2013) Self-care groups of leprosy-affected people in Mozambique. Leprosy review 84, 283-291
5. http://www.slideshare.net/Fiocook/fionas-presentation-on-mozambique1.
6. https://www.lepra.org.uk.
7. Waite, C.G.R. (2015) The importance of water, sanitation and hygiene for lymphatic filariasis and leprosy care and inclusion. WaterAid