Visit To Raphael - Interaction With Children, Dehra Dun

REMOVING THE PAIN: GOD'S MISSION

I am happy to visit Raphael, the Ryder Cheshire International centre and meet the inmates of this centre. I greet the organizers, administrators, medical personnel and volunteers for their contribution in this noble societal mission. You are in an important mission of removing the pain and rehabilitation of leprosy patients, TB patients, children of leprosy patients and the mentally challenged persons.

Status of Leprosy elimination in India

I am happy to note that the total number of patients has come down from 4 million to 0.3 million during the period 1981-2003. I find 70% of the total leprosy patients are concentrated in five major states Bihar, UP, West Bengal, Orissa and Chatisgarh. Concerted efforts are needed for diagnosing the causes for this situation and developing strategies by which we can bring down to the level of less than one leprosy case per ten thousand population by the year 2005. It is essential that this should be done positively and should not be further shifted. Also, there is a need to work out methods by which we will be in a position to rehabilitate the treated patients.

Gujarat model

I was studying the efforts made by Gujarat for leprosy elimination, disability care and rehabilitation of leprosy patients. They have carried out a comprehensive programme in which the state government medical colleges, hospitals and non-government organisations have become active partners. Based on the needs of particular districts they have carried out reconstructive surgery camps and mega camps to treat large number of patients. The micro planning for achieving the elimination integrated with the disability care enable targeted elimination of leprosy in Gujarat state.

Also number of NGOs have sponsored the treated leprosy patients for training them in handicrafts and cottage industries, so that they can find productive employment in their villages or they could find self employment opportunities towards rehabilitation. This model can be followed by many other states where the prevalence of leprosy cases is quite large.

Leprosy cases in India

I was studying the map of India and the leprosy distribution in the whole country. I noted that the north western region and extreme north east is virtually free from leprosy. As we proceed to the east there is a gradual increase and the concentration is in five states located in the central north eastern region. Specialists must analyse the causes for increased occurrence in these states to facilitate appropriate environmental remedial measures.

I was studying the case of a person who had turned a new leaf in his life. He was also presented with the President's Award for the ``Best Self-Employed Person". This being a great achievement in itself, his struggle was praise worthy as he has risen above ostracisation and the stigma of being a leprosy patient. After 7 years of treatment in a Welfare and Rehabilitation Centre for Leprosy Patients, he is fully cured and runs his own telephone booth at a City Railway Station. This model should be followed by other rehabilitation centres in the country to make the treated leprosy patients feel normal to function in the society. Raphael can study such cases and provide treatment and rehabilitation with compassion. Raphael can make use of the rehabilitated patients to work on leather-craft, tailoring, printing, knitting and other units.

Permanent cure ? what is to be done?.

Early detection of the disease is essential in order to avoid permanent nerve damage and deformities. This will need survey of the population and detection. We need to educate the population about facts, the signs and cure for leprosy.

Multiple Drug Therapy (MDT) a combination of the anti-leprosy drugs such as rifampicin, clofazimine and dapsone has been found to be very effective treatment of the disease. This can be followed by government and non-government agencies working in treatment plans. Patients who have developed deformities/disabilities would need special care in providing suitable jobs which will ensure non-recurrence of the disease and also does not cause discomfort while working.

Tuberclosis

The initial euphoria of the discovery of TB drug was dashed by early occurrence of drug resistance. This was overcome, but not completely so, by the use of multi drug therapy. The issue of multi-drug resistant tuberculosis which was a growing concern, even in advanced countries, became more intense by the advent of the Human Immune Deficiency Virus (HIV) infection. However, due to growing scientific knowledge, the lessons learnt from the handling of mycobacterium tuberculosis and the disease caused by it, the war against the HIV and Acquired Immunodeficiency Sydrome (AIDS) which it causes, is being fought in all fronts.

A co-infection of both diseases or a super-infection of one upon the other presents more complex management problems that have stimulated more intense research. It is hoped that the results of these research works may unearth the solution to the problems of both diseases.

Mentally Challenged Children Research

When I was at Anna University, I was also guiding a doctoral research project. The research is to find a software/hardware integrated solution to achieve a near normal functioning of the brain of mentally challenged children. When I saw some of the mentally challenged children performing certain activities like singing, painting in Central Institute of Mental Retardation, Thiruvananthapuram, I was convinced that one day convergence of information and communication technology, medical electronics, bio-technology and mathematical simulation can find a solution for their problem. We have been studying the mentally challenged children in various research institutions, homes for mentally retarded and hospitals. We were sure that by transforming the functions of the damaged portion of the brain to the normal portion of the brain by some triggering mechanism, or by implanting a bio chip to carry-out those functions, the retardation process can be arrested and rejuvenation of the damaged cells can take place. The problem is very complex. Can it be solved? The research still continues. We target to achieve a few milestones in this research by 2005.

Conclusion: Rehabilitation of children of leprosy/HIV parentage

There is need to analyse the data of the children of leprosy/HIV parentage to bring out that they are totally unaffected by the virus of their parents. Indian Pharmaceutical industry has developed anti-HIV drugs which taken by would be mothers will prevent propagation of virus to the new born child.

The fear in the minds of the normal children and their parents must be removed through counseling by the teachers, members of NGOs such as Raphael and doctors. Media can play a very important role in removing the fear from the minds of the common man. We should emphasis that they are all God?s children and they need love, compassion and affection of the society for their balanced growth so that they can make positive contribution to the development of the society.

My best wishes. God bless you.