Although it may appear surprising to many yet it is a fact that leprosy is now a curable disease, and its dreaded complica-tions can be prevented provided that treat-ment is begun early. There are, however, two major difficulties; first, leprosy con-tinues to evoke an irrational fear; and second, recent statistics reveal that the number of leprosy sufferers in the world reached 11 millions.
Leprosy is dreaded not because it kills like malaria or tuberculosis or because it is highly contagious like small pox, or because it attacks whole populations like schistosomiasis, or because it is responsible for epidemics like cholera or measles or for pandemics like influenza. Leprosy is dread-ed because it cripples. It vies with polio-myelitis as the world’s greatest crippler. If crippling included impairment of sensa-tion, then about a quarter of those suffer-ing from leprosy are crippled. Leprosy is thus the cause of grave economic loss in many developing countries; instead of pro-ducing, or contributing to the community, the crippled victim of leprosy makes de-mands on his healthy fellows for food, shel-ter and medical care. All this is quite apart from the human tragedies that result from a disease that has serious social consequ-ences for the patient and his family.
There is always more leprosy in. a country than early guesses indicate, sometimes much more. There are several rea-sons for this; despite the fact that a good drug has been available for over twenty years and that during this time many have been cured of leprosy but in very few countries leprosy control schemes have been successfully organised. In countries that have a big leprosy problem, medical facilities in general are inadequate (especially for people living away from the large towns), the population is increasing (that is, there are more people to catch leprosy), and clothed leprosy patients in the growing towns not only conceal the signs of leprosy more easily, but often they are not sur-rounded by good neighbours from their own tribal group.
The disease which is unfortunately prevalent in countries that are economi-cally poor and technically under-equipped presents an extremely serious problem. Des-pite the tremendous efforts of the health services of the countries affected, helped by international organisations and by volun-tary agencies only a quarter of those afflict-ed by leprosy receive adequate treatment which means that more than 8 million are still denied the benefits of modern treat-ment. It is realised that in some areas 10-45% of the patients have the contagious form of leprosy (called lepromatous) and that children and young people in contact with these patients are in danger of con-tracting the disease. For the diagnosis of pastor present leprosy infection no skin test (like the Heaf or Mantoux test for tuberculosis) is known, nor is there a specific serological test. Sample surveys of typical populations indicate approximate prevalence rates. When treatment is provid-ed, and later is seen to be effective, and when facilities for re-constructive surgery and social rehabilitation are made avail-able, more people suffering from active leprosy and from the results of past leprosy come forward for treatment.
Pakistan too has not been spared this scourge but the Government became aware of this problem and took counter measures against the alarming spread of disease in certain parts of N.W.F.P., Azad Kashmir and Baluchistan. Leprosy control schemes have been initiated in these areas with the help of private organisations and leprosy treatment centres have been established in the leprosy affected areas and in Punjab and Karachi as well. About 13000 patients are under treatment in the 36 centres functioning in the country.
From the rocky mountains of Gilgit to the sandy sea shore of Makran; in the scattered hamlets of far-flung rural areas and the congested slum-quarters of the large industrial cities; by foot, on camel, on motor-cycle or by jeep, the leprosy survey and treatment teams have reached nearly every corner of the country where this disease is found. However, much remains to be done to screen exposed popula-tion groups, impart the basic knowledge of the disease on literate and illiterate alike to gain the cooperation of medical profes-sion and population at large, and bring regular treatment, into easy reach of each patient. The first spade work however has been done; the infrastructure established; and the way has been opened up to success-fully tackle the problem to control this disease in our generation; and hopefully to eradicate it in the next, so that our child-ren may be spared the fate which spoiled the life of so many of their parents.
On the occasion of centenary celebra-tions of Dr. Hansen’s discovery it is hoped that on a world-wide scale, the interests of governments and the public should be aroused so that the unfortunate sufferers who are still unable to avail themselves of the remedies that science has placed in our hands, may be provided necessary help. Efforts are also being made to develop a potent drug that may be rapidly effective. For evolving an effective procedure for protecting the children and young people exposed to the risk of contracting leprosy medical experts are busy day and night.