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WHO Goodwill Ambassador's Newsletter For The Elimination Of Leprosy

INTERVIEW: 'STILL PLENTY TO DO'

What were you doing before you took up your post at the Anti-Leprosy Campaign (ALC)?

Dr. Tilaka Liyanage, Director, Anti-Leprosy Campaign, Ministry of Healthcare and Nutrition
Dr. Tilaka Liyanage, Director, Anti-Leprosy Campaign, Ministry of Healthcare and Nutrition

Between 1989 and 2008 I worked for the filariasis elimination program. Sri Lanka was the first country in the WHO's Southeast Asia Region to eliminate filariasis and now is at the certifying stage. I was a member of the Global Alliance on Filariasis Elimination expert committee.

How did you feel about being assigned to ALC?

In the beginning I was a bit upset because I thought leprosy had already been eliminated and there would be nothing for me to do. Then I spent two days looking at the statistics and found there was plenty for me to do. There are still problems. I did not expect to find as many 'pockets' of leprosy and as many patients as there are. So I personally went to get a wall map and mapped out the situation. Then I saw how much there was to do and that gave me energy.

What did you do during your first year?

The whole of last year, I did my homework. I upgraded the software so as to have all the statistics in order at least since 2001. The leprosy control office has an outpatient clinic and I saw patients coming for ulcer care. I felt that disability care was a neglected area, and as a Buddhist I thought I should do something for all the patients. From this year we have started disability care sessions.

Did the civil war impact leprosy services in any way?

No it did not. Throughout those difficult years, health services continued and multidrug therapy (MDT) treatment was never disrupted.

Is stigma against leprosy prevalent in Sri Lanka?

No. The level of stigma is very low here. Most patients, including those with deformities, are accepted by their families and society. The general public knows that this disease is 100% curable. This is true in all parts of the country. There is no such thing as colonies of people with leprosy.

What challenges does the program face?

Leprosy still exists, but awareness of symptoms and the need for prompt presentation is lacking among the general public and even among health workers. More should be done to make early diagnosis possible and to reduce the leprosy burden, including leprosy-related disabilities, especially at the district level where there are hot spots. Another challenge is to reorganize and improve information systems for better defaulter tracing and follow-up reaction cases to ensure quality leprosy services.