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WHO Goodwill Ambassador's Newsletter For The Elimination Of Leprosy

AMBASSADOR’S JOURNAL: In the Footsteps of Dr. Hansen

A visit to Bergen, which holds a special place in leprosy history, is a highlight of the Goodwill Ambassador's recent travels to Indonesia and Norway.

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Greeting a patient at Dr. Rivai Abdullah Hospital

INDONESIA (August 30-31)

The Dr. Rivai Abdullah Hospital in Palembang, South Sumatra, is one of three rehabilitation hospitals in Indonesia for people affected by leprosy. At the end of August, I combined a visit to Jakarta to attend the opening of the annual meeting of the National Alliance for Leprosy Elimination and Yaws Eradication (see page 3) with a trip to South Sumatra to visit the hospital and a nearby leprosy settlement.

The hospital was established in 1918 as the Sungai Kundur Leprosy Hospital to serve the adjacent leprosy settlement of the same name. The settlement had come into being four years earlier after a sailor stricken with leprosy was put ashore by his ship. Locals objected to his presence in their midst, leading to the creation of a settlement for those with the disease.

The government took over the running of the hospital in 1960. In 1985, it became a leprosy referral hospital for western Indonesia while at the same time opening its doors to the general population.

With its main focus on rehabilitation, the hospital helps people with disabilities to improve their quality of life through medical and social rehabilitation and empowerment. It makes artificial limbs and protective footwear, offers occupational therapy including farming and carpentry, and promotes patient independence and the optimization of potential. When I visited, there were about 60 in-patients undergoing rehabilitation.

The average hospital stay is six months. This is followed by two weeks in a transit community called Rumah Singgah to prepare for life beyond the hospital walls. Rumah Singgah is a self-care community that instills the self-care habits so important to preventing injury in those with leprosy-related disabilities.

Next to the transit community is the Sungai Kundur settlement. It is home to about 2,000 people, of whom some 100 are people affected by leprosy. Here I addressed a gathering of about 50 affected persons. Two middle-aged men, speaking on behalf of the group, brought up problems with their living conditions. For now, they are relying on government support, but they told me that one day they wanted to live on their own land and be economically self-sufficient.

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The Goodwill Ambassador with residents of Sungai Kundur settlement in Palembang, South Sumatra

With the decentralization of power in Indonesia, provincial governors can set their health priorities. Leprosy has not been a high priority for South Sumatra, but the occasion of my visit had focused attention on the disease. When I met with South Sumatra Governor H. Alex Noerdin, he told me of his surprise at learning that leprosy remains a significant problem on the island of Sumatra as a whole. He said he felt guilty about this and promised to do something about it.

Given the problems caused by disability in leprosy, particularly in terms of social rehabilitation, he said he would focus on its prevention by promoting early diagnosis and treatment. I suggested getting elementary children to check whether they or their families have patches on their bodies - a tell-tale sign of leprosy - as this would aid early detection. The governor said he thought this was a good idea, commenting that cooperation between the education and health sectors was important. "I'd like to be the first volunteer to be tested," he said.