Nepal
SOCIO ECONOMIC AND LEGAL
ASPECTS OF LEPROSY/PEOPLE
AFFECTED BY LEPROSY IN NEPAL
Raj Kumar Shah
READ Nepal
Email: read.leprosy333@ gmail.com
Mountain Fishtail
G.Pokhrel & I. Tamang
Leprosy Mission Nepal
Email: training@tlmnepal.org
R. Shah, G. Pokhrel and I. Tamang
Nepal
Introduction
0.94
• Landlocked country with 147,181
sq.km
• Altitude ranging 300 ft to 29,028 ft
(Mountain Everest)
• Total population of Nepal 26,494,504
• No of Government Hospital 91
• No of Primary Health Care Centre
(DR. Service) 210
• No. of Health post & Sub Health Post
(Service from Paramedics) 3,785
Introduction
Trend of PR and NCDR
2.5
2
1.99
1.67
Rates
1.5
1
NCDR
PR
1.15
1.12
0.77
0.79
1.22
1.41
1.09
0.5
0.85
0
2007/08 2008/09 2009/10 2010/11 2011/12
Year
Cont..
• Leprosy was officially integrated to general
health services in 1987
• No of Endemic districts in Nepal (more than
1 PR) 17 District
• No of Major Leprosy Hospital 3
• Leprosy is a still Socially stigmatized problem
• No of Leprosy Cases under MDT 2,430
• No of Leprosy affected person cure from
MDT More than 170,000 till now
• Having Disability grade II Approximately
40,000 existing
Objective
Examining the existing misconceptions, legal
aspect, disfigurement and stigma is the major
causes in deteriorating the socio economic
conditions of leprosy affected people in society
of Nepal
Method and Materials
• Literature review published in different journals
• Discussion with Nursing staff and paramedical worker working in
Anandaban Hospital with key questions
• Discussion with admitted leprosy affected people in Anandaban
Hospital with key questions
• Consultation with book VASTU SHASTRA
• Legal books of Nepal
• Review the history of KHOKANA Leprosarium
• Discussion about the religious, cultural and social codes with all
groups of people
6
Common causes of stigma still in leprosy are..
•
•
•
•
•
•
•
Physical outward appearances
Progressive characteristics over time
Communicability and Disabling
Religious links
Discriminative legal aspects
Poverty related and food habit
Tradition of Isolation and Segregation
7
Cont…
•
•
•
•
•
Tradition (Unknown)
Priority level of leprosy programme in health
Frequency of coverage in media
Advocacy strategy and peoples involved
Corporate/social obligation being a service
provider, activist…
8
Common
Problems in
Nepal
• Individual effects (physical
problems)
• Intra-family relations
• Within family and relatives
• Within organization
• Within community
• Emotional effects
• Physiological effects
• Social relationship and support
Vulnerable
People to Social
Difficulties
•
•
•
•
Economically marginalized (poor)
Female and old age people
People with disability due to leprosy
Difficult to access in health facilities due
to geographical conditions
• People from marginalize and ethnic
groups
Results:
Emerging the
Misconceptions
• Misguide for conception:
(Misconceptions)
• Believe in traditional causes &
methods of treatment
• Prejudice opinion
• Social/religious/Traditional
Dictum & Codes
• Construction house site
• Regular food habit
Results Con…
Emerging the
Misconceptions
• Legal aspects:
• Bankruptcy (KANGAL)
• Marriage and divorce
• Social Aspects:
• Exclusion and discrimination in
different organization
• Isolation and segregation
• Physical aspects:
• Physical outward appearance
Key Questions:
• Fact about leprosy
Area of questions
–
–
–
–
Cause of leprosy
Transmission methods
Causes of Disability and Deformity
Consequences of deformity
• Traditional believes and treatment of
leprosy
• Religious concepts about leprosy
• Concepts about Leprosy Hospital
• Legal concepts about leprosy and rights
Discussions:
Leprosy Related
Circumstances
• Awareness about leprosy facts
• Strategy for the advocacy and
prejudices
• Amendment of laws, bylaws and acts
• Priority in health programme and
media
• Human rights and social obligation
• Community Based Rehabilitation and
socio economic development
Mount Everest