Leprosy still widespread in 111 regencies

Leprosy still widespread in 111 regencies

Debbie A. Lubis
The Jakarta Post
Jakarta

The public's belief that leprosy is incurable, their ignorance of
the medical treatment's available and their prejudices against
the sufferers are three major contributors to a rise in the
number of leprosy cases in some of the country's regencies, an
official said.

"Most of the people who suffer from leprosy do not have
adequate information about the disease and its treatment. In
fact, they can get free medicine for leprosy at their local
community health centers (Puskesmas)," Sri Hastuti Suparmanto,
acting director general of community health at the Ministry of
Health, said on Monday.

Sri was speaking during preparations for World Leprosy Day,
which will be observed on Jan. 26.

Indonesia has declared itself successful in reducing the
incidence of leprosy to one case among 10,000 people since July
2000.

Nevertheless, the incidence of leprosy is reportedly rising in
111 out of 371 regencies in 12 provinces. These regencies have
reported more than one leprosy case for every 10,000 people.

The Ministry of Health recorded that there were 17,137 people
across the country suffering from leprosy as of December 2001.
Some 72.25 percent of these sufferers lived in East Java, West
Java, South Sulawesi, Central Java, Papua and Jakarta.

The data also showed that some 8,692 newly-detected leprosy
cases emerged during the January to September period last year.

Leprosy is caused by Mycobacterium leprae, which attacks the
peripheral nerves and skin of sufferers. It can leave the
sufferer crippled or cause deformities and ulceration on their
bodies.

Sri said that leprophobia -- public fear of leprosy sufferers
-- had impeded leprosy-elimination programs around the country as
sufferers were reluctant to seek medical assistance.

"Many leprosy sufferers die not because of the disease but
because of a level of social stigma that sufferers cannot bear.
This stigma also hampers the provision of medical treatment," she
said.

People in some parts of the country still believed that
leprosy was inherited, highly contagious, incurable, or related
to black magic.

Hardyanto, chairman of the Indonesian Association of
Dermatological and Sexually Transmitted Disease Specialists
(Perdoski), said that leprosy was curable and its crippling
deformities and ulcerations could be prevented as long as the
disease was detected at an earlier stage and the sufferers took
their medicine regularly and continuously.

He said that patients at the early stages of leprosy received
Multidrug Therapy (MDT), a combination of three kinds of drugs,
which would cure the disease within between six months and 12
months.

Hardyanto, who is also the dean of the Yogyakarta-based Gadjah
Mada University's medical school, said that the disease was not
highly contagious although its transmission was through direct
contact and the air through coughing and sneezing.

The incubation period for the bacterium could be as much as 40
years in unusual cases, or as little as two.

Hardyanto cautioned doctors to be meticulous in diagnosing
leprosy as in the earlier stages leprosy often displayed similar
symptoms to other dermatological diseases.

Infected people usually have skin lesions, and white or red
discolorations on the skin of their faces, ears, arms or legs.

Hardyanto, however, admitted that there were only a few
dermatologists willing to work in the regions. He said that 200
out of 450 Perdoski members worked in Jakarta while the others
preferred working in big cities like Medan, Palembang, Surabaya,
Bandung or Makassar.

Haikin Rachmat, director of communicable disease control at
the Ministry of Health, said that to support leprosy elimination
in the country, his office would provide special training for
Puskesmas workers in those regencies that had a high incidence of
leprosy cases.

He added that his office would also cooperate with the Navy to
visit small and remote islands in a bid to ensure that the people
there were informed about leprosy and its treatment.

Regions with a high incidence of leprosy

Region Incidence Leprosy cases

(per 10,000 people)
1. Papua 5.99 1,266
2. N. Maluku 5.22 427
3. Maluku 2.43 481
4. S. Sulawesi 2.29 1,782
5. Aceh 1.76 704
6. N. Sulawesi 1.54 433
7. Jakarta 1.41 1,185
8. S. Kalimantan 1.40 417
9. C. Sulawesi 1.32 272
10. E. Java 1.26 4,344
11. S. E. Sulawesi 1.15 204
12. E. Nusa Tenggara 1.14 447