Wed, 14 Jan 2004

Indonesia still struggling with nationwide leprosy

Eva C. Komandjaja, The Jakarta Post, Jakarta

Indonesia is facing daunting challenges in its efforts to eradicate leprosy, which remains a serious health problem in 111 of its 440 regencies and mayoralties.

Director General of Communicable Diseases Umar Fahmi at the Ministry of Health said on Tuesday that the government had set a target of reducing the number of leprosy cases to under 1 in 10,000 people by 2005, but the fear of leprosy among people, geography and lack of funds were great obstacles.

"Most lepers are found in relatively poor, densely populated and remote areas, making it difficult to combat the disease. There are also many other health problems that need more attention than leprosy," Umar said at a media conference held to mark World Leprosy Day, which falls during the last week of January in Asia.

The health ministry recorded 19,805 lepers nationwide, a figure that ranks Indonesia as the second Asian country with the greatest number of leprosy cases, after India. Most cases are found in East Java, Central Java, Jakarta, Nanggroe Aceh Darussalam, South Kalimantan and South Sulawesi.

The World Health Organization (WHO) has set a prevalence rate of leprosy at one per 10,000 people.

Leprosy is a chronic disease caused by the Mycobacterium leprae bacillus, which can cause permanent physical deformities, muscular atrophies and mutilations if medical treatment is not given immediately. The disease can be transmitted through direct contact and exposure over a long period of time, and has an incubation period of two to five years.

The disease is curable with proper medication within a year after it has been contracted.

Umar said the government had established the National Alliance for Leprosy Eradication (ANEK) and had conducted the Rapid Village Survey (RVS) involving local people to record leprosy cases in isolated rural areas.

Medication for leprosy is provided free at community health centers across the country, he said.

Farid Husain, the deputy Coordinating Minister for People's Welfare in charge of health coordination and environment, said the government had appointed several hospitals in Banten, South Sulawesi, South Sumatra and East Java to provide free surgery for lepers.

Many foreign institutions and non-governmental organizations, such as the Netherlands Leprosy Relief, the Sasakawa Memorial Health Foundation, the Leprosy Mission International and Novartis, have contributed about 90 percent of the total budget for leprosy eradication.

Director of Social Services and Rehabilitation for Disabled People Irna Kurniasih at the Ministry of Social Affairs said the ministry had resettled lepers in 23 special housing facilities near hospitals that treat leprosy.

The ministry has also provided Rp 1.3 million (US$153) in housing and annual aid to families of people suffering from leprosy.

"We are discussing the possibility of providing more job opportunities for them. The Ministry of Manpower and Transmigration currently allows only a one percent quota to disabled people," said Irna.

Leprosy cases in Asia -------------------------------------------------------------- Country Cases (Dec. 2002) Rate (/10,000) -------------------------------------------------------------- Bangladesh 8,143 0.53 Bhutan 33 0.50 India 344,377 3.22 Indonesia 19,805 0.92 Maldives 19 0.70 Myanmar 4,965 0.94 Nepal 7,291 3.02 Sri Lanka 1,639 0.86 Thailand 1,905 0.31 Timor Leste 249 2.93 ------------------------------------------------------------- Source: WHO