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Hope on the horizon

As president of the Indian Leprosy Foundation (ILEF), Dr. A.R.K.Pillai has been working towards cure and eradication of the disease for three decades. A profile.

SOMETIME IN 1945, Prof. T. N. Jagadisan invited Mahatma Gandhi to inaugurate the Kasturba Kushta Nilayam building. Gandhiji wrote back, "Get someone to open it; opening a hospital is not a big matter. But I shall come to close it.''

The Mahatma will be sorely missed at leprosy centres in Tamil Nadu after four years if the promise of Dr. A.R.K. Pillai, president, Indian Leprosy Foundation (ILEF) is fulfilled. From 7.33 lakh patients in 1982, detected leprosy cases have drastically decreased to just about 24,000 cases this year. And the doctor believes that leprosy will be `eliminated' in the State by 2005.

Equally gratifying for him is the change in the social attitude towards the patients proved by the fact that from zero voluntary reporting, the scenario has shifted to 70 per cent seeking a doctor's help for a patchy skin.

How did this transformation come about? Mainly due to the multi-drug therapy (MDT), whose efficacy in treating the disease has been dramatic.

According to Dr. Pillai, MDT is a fixed duration treatment that ensures definite cure within a year even in acute cases. This speedy cure has helped treat many leprosy patients successfully.

But the miracle milestone had to be accompanied by a mass awareness campaign, which was kicked off in 1981, when Mrs. Indira Gandhi, the then Prime Minister, declared at the World Health Assembly, India's determination to eradicate leprosy by 2000. Political will was soon translated into efforts by government agencies and voluntary organisations to disseminate information about the disease — its causes and medication. Doordarshan did its bit by telecasting a movingly dramatised story of a middle class woman returning home from a leprosy centre only to find the family unwilling to accept her in spite of being cured. Deeply agonised, the woman returns to work for the patients at the centre.

Dr. Pillai is proud to be a part of this movement, which has brought down the leprosy cases to five from 57/10,000. He and his trusted team at ILEF roped in experts in mass communication to educate people about the disease: it is least communicable, caused by colonising bacterium infecting loose flesh in the body, affects one due to reduced levels of immunity; not hereditary; one does not get it by looking at someone who has it, early detection can prevent deformities, just one dose of ROM will clear the initial no-sense patch and most importantly, it is curable.

``The ILEF is funded entirely by individuals and the corporate sector,'' says Mumbai-based Dr. Pillai, who was in Chennai to address the XVI International Conference on Health Power, convened by the Pontifical Council of the Holy See. ``School children have been the bulwark of our programme to attack prejudices about the disease. The silent social revolution would not have been possible without the school teams. Along with their teachers, they have participated in voluntary resource mobilisation schemes that help finance ILEF's medical camps. Women volunteers join teachers and community workers in villages to convince people of the need to get treated early." Awareness is also created through media, skin camps, reach-out events, observing anti-leprosy week and conducting orientation courses. ILEF volunteers spread out to collect old and new clothes for poor patients, distribute orthopaedic shoes and conduct briefings.

Chennai can look back with gratitude to the Gremaltes Referral Hospital (Shenoy Nagar), which had first mooted the urban leprosy programme in 1971. The city was brought under MDT in 1990 and leprosy work was integrated with general health service by the State Government in 1997. The State Government, Municipal Corporation and the Referral Hospital steer the anti-leprosy drive in the city whose affected population now stands at 1.7/10,000.

Dr. Pillai, who was recently honoured with the Albert Schweitzer Award for his work in this field for three decades, recalls his meeting with the Pope. Pillai's prescription of dharma, yoga, vegetarianism and pranayama for health and peaceful living was well received in the West.

Despite the encouraging news of a total cure, a nagging question remains — in the absence of immunotherapy, how do we make sure it won't return? To prevent its recurrence after eradication, cities have to ensure regular disposal of garbage, dirt-free roads, education on hygiene and enhanced immunity levels among its population. If we don't make efforts to clean up our environment, we will continue to depend on organisations like ILEF to cure while prevention should be a better option.


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