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