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Leprosy: Leprosy: Rehabilitation Through Community-Sustainable Income GenerationGeneration

Alison Hench, OMS-IIJ li H OMS IIJolie Hoppe, OMS-IIMichael Sullivan, OMS-IITouro University, California

+The Basics of Leprosyp y

What is Leprosy?an infectious granulomatous disease caused by Mycobacterium leprae

Who’s at risk?individuals with compromised immunity and prolonged exposureindividuals with compromised immunity and prolonged exposure

How’s it spread?Via direct contact on mucosal surfaces

What are the physical manifestations?Skin lesions that are lighter than an individual’s normal skin color

Lesions with decreased sensation to touch, heat, or painLesions do not heal after several weeks to months

Peripheral Neuropathy Numbness or absent sensation in the hands, arms, feet, and legs

M l kMuscle weakness

+Touro University’s Global Health Program g& Global Physicians Corps

The mission of the Global Health Program at Touro University is to promote the interest of our medical and health care students on global health through education, research and g gcommunity service. Each year Touro students travel to countries like Tanzania to serve those in need.

Th Gl b l Ph i i C i l b l t k f t d t The Global Physicians Corps is a global network of students, health care and other professionals, who came together to establish a partnership aiming to understand and address all factors attributing to global health issues while providing factors attributing to global health issues while providing sustainable solutions to the delivery of health care in underserved areas of the global community.

+The Burden of Leprosyp y

Hi to icall le o ha bee a di ea e ith both h ical Historically leprosy has been a disease with both physical and social manifestations

Lepers have been ostracized by their communitiesThey have formed their own coloniesThey have formed their own colonies

Leprosy in TanzaniaIncidencePoverty increases the chances of contracting leprosy, and leprosy perpetuates poverty

In Tanzania family is a central force but the burden of the In Tanzania, family is a central force, but the burden of the disease can strain these relationships

Existing stigmaPoor educationPoor education

Financial/support difficultiesEmotional/physical needs of the lepers

+Shirati, Tanzania,

Since 2004, Touro University in conjunction with Global Physicians Corps has worked in the Shirati KMT Hospital

Within the hospital there is a leprosy wardWithin the hospital, there is a leprosy wardCurrently has 17 inpatientsRehabilitationTreatmentTreatment

Just outside of the hospital, there is a leprosy camp

Currently has 9 residentsSource of emotional supportGoal of self-sufficiency

+Leprosy Project, Phase Ip y j ,

Began in 2009 with the purpose of evaluating the needs and facilities for the long-term care of leprosy patients

Clean water and food resources were improvedWater collection tanks installed

Chickens were purchased and a chicken coop was builtp p

Farming supplies were purchased and crops were planted

+Leprosy Project, Phase I Resultsp y j ,

Questionnaire resultsProvision of food as a charity is ineffective

the lack of income generationthe lack of income generation

the lack of psychosocial support

the lack of assistance with mobility (i.e. canes, wheel chairs, and prosthetics)prosthetics)

the patients needed protective items in order to address the physical effects of the disease

+Leprosy Project, Phase II (2010)p y j , ( )

Addressed physical needs evaluated in Phase I

Promote self-sufficiencyFocus group with leprosy camp to identify obstacles:

Individual prostheses

Crop maintenance/harvestp

Recommendations were accordingly provided by stakeholders which included purchasing a water pump

Farm near Lake Victoria

Yearly income generated without water pump: 100,000 TSh (~100 USD)

+Leprosy Project, Phase IIp y j ,

Distribution of supplies

+Leprosy Project, Phase IIp y j ,

Water Pump Purchase

+Leprosy Project, Phase IIp y j ,

Water Pump Assembly and Usage

+Leprosy Project, Phase II Resultsp y j ,

Evaluated findings of Phase I and addressed the physical needs of the lepers

Purchased a water pump hoping to increase income generated and allow year-round harvest of the camp’s millet and maize crops

+Leprosy Project, Phase III (2011)p y j , ( )

Evaluate the outcome of the water pump on economic status

Sustainability of intervention programIssues regarding maintenance

Mobility improvement

Evaluate prosthetic facility

+Leprosy Project, Phase II p y j ,Conclusion

While it is well-known that leprosy is a disease of poverty, little has been documented to show how this disease furthers hardships.

In our evaluation, we found that the disease furthers hardships due to the physical manifestations (primarily

i h l th ) l di t d ti l peripheral neuropathy) leading to secondary emotional, social and financial disadvantages for those affected.

With the development of camps and rehabilitation centers, With the development of camps and rehabilitation centers, these individuals learn how to manage with their disabilities.

Our project established a method of income generation for a leprosy camp in Shirati, Tanzania with the goal of stopping this cycle of leprosy perpetuating poverty.

Thank you Touro University and Global Physicians Corps