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WHO Goodwill Ambassador's Newsletter For The Elimination Of Leprosy

AMBASSADOR’S JOURNAL: Return to Indonesia

The Goodwill Ambassador’s travels take him to North Sulawesi and North Maluku provinces to promote leprosy awareness and witness encouraging examples of cooperation between local government bodies and groups of persons affected by leprosy.

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Greeting local residents who had come for a checkup at Maelang health center in Bolaang Mongondow regency in North Sulawesi Province

INDONESIA (July 23-30)

Indonesia reports the third highest number of cases of leprosy after India and Brazil. This year and next, I am making a number of visits to observe its anti-leprosy activities and to encourage all involved in these efforts.

In July, I traveled to North Sulawesi and North Maluku provinces. They are among the 12 out of Indonesia’s 34 provinces that have yet to eliminate leprosy as a public health problem.

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Calling on Governor Olly Dondokambey

Manado, the capital of North Sulawesi, is a three-hour flight from Jakarta. There, I called on Governor Olly Dondokambey at his residence. We had a very positive discussion, during which I mentioned The New Atlas of Leprosy, a guide to assist health workers in making a diagnosis. The governor expressed interest in producing a booklet aimed at the community in general, designed to raise awareness of leprosy and help reduce discrimination.

Following my meeting with the governor, I met with around 20 members of an organization of people affected by leprosy called Toumotou. Their leader Fernandez said they visit patients to offer advice, giving them the benefit of their own experience. They also liaise with government officials on improving the living circumstances of patients and people affected. I was impressed by their initiative and told them I hoped their activities would spread throughout Indonesia.

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With members of people’s organization Toumotou in Manado

 

Early detection is crucial to successfully tackling leprosy. Next I was taken to an area about an hour’s drive from Manado to learn about a community health initiative where this is happening. About 40 people, including teachers and other influential community figures, had gathered to meet me. This is an area where people have been ostracized once it is known they have leprosy, making it difficult to come forward for treatment. Now, local influencers are promoting a correct understanding of the disease and the importance of early detection, and the initiative appears to be having an effect.

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With Regent Yasti S. Mokoagow

North Sulawesi is divided into regencies. My next appointment was with Regent Yasti S. Mokoagow of Bolaang Mongondow, regency health officials and others. The regencies actually carry out the work of administering healthcare, so this was an important opportunity to promote the need to raise awareness and ensure that the public is getting correct information about leprosy.

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Attending screening in Maelang

Afterward, accompanied by the regent, I visited Maelang health center where a skincare checkup had been organized to screen for new cases of leprosy. The event drew some 100 to 150 people from Maelang and surrounding communities.

Six new cases were detected as a result and I commended the regent on this case-finding initiative. I noted that the health center was stocked with supplies of MDT, so there would be no delay in starting treatment once the diagnosis was confirmed.

I told those present that leprosy is a curable disease, treatment is free and that detecting the disease early is very important. But a few people told me that a diagnosis of leprosy leads to severe discrimination, making it difficult to go to the hospital. Hearing this, I once again stressed to the regent the importance of working to end the stigma surrounding the disease.

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Sorofo SCG’s chairman, Asnawi Jepi

The next day I flew from Manado to Ternate, the biggest city in North Maluku Province. I had come to see the activities of Sorofo Self-Care Group. Members of the group, who are all persons affected by leprosy, live together and look after each other. They began their activities in 2010 and currently have 24 members. Self-care groups are found in many parts of the world; what is special about this group is that they farm, run businesses, and are earning some of the funds they need to support themselves.

Moreover, they appear to be doing a very good job of taking care of each other, as there was nobody who could not get around. It was testament to how well the group was running and shows what it is possible to achieve when people come together for a mutually beneficial purpose,

The final item on my agenda was a visit to Morotai Island, part of the Makulu Islands. It has a population of around 50,000. At the government building, around 100 people—village leaders, health officials and volunteers—had gathered for a study meeting on early case detection.

Separately, it had been arranged for me to meet with persons affected by leprosy; instead, I took the decision to have them accompany me to the meeting. I greeted them warmly in front of all present and made a point of taking each by the hand. I wanted to show by this gesture that leprosy is not be feared and that society must reach out to those affected by the disease. I have always believed in the maxim that a picture is worth a thousand words, and I certainly believe it is the case at such times.

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Supplies of multidrug therapy at Maelang health center

As I was reminded on this visit to Indonesia, the geography of the country—a sprawling archipelago of over 18,000 islands—poses challenges for the uniform application of the central government’s anti-leprosy strategy. In addition, decentralization gives the provinces a substantial degree of autonomy and influences how measures are applied. With that in mind, I plan further visits to provinces where many cases of leprosy still occur, in order to gauge the progress being made and what still needs to be done.