Leprosy
mailing list – September 23rd, 2005
Ccn: all.
From: H
Srinivasan, Chennai, India.
Dear concerned,
I am afraid I cannot resist commenting
on this issue (C R Revankar, LML Sept. 22nd, 2005).
It is good to have a good opinion
about oneself and it is also true that when a vertical service is
horizontalized there will be some apparent loss of efficiency. I say
apparent because the extent of such a loss depends on the
excellence of the vertical service.
I am not at all sure that the leprosy
patients got the best deal under the National Leprosy Programme (NLEP)
and were pampered by the programme with super service, where all
there leprosy-related health needs and concerns were anticipated
and taken care of. In most places, apart from MDT capsules and
tablets, they got some bandages and little else by way of extra care.
In the rush to cover all the drug
distribution points on time, the leprosy staff had hardly any time to
talk to the patients or examine them and find out what problems
they had. Since the same staff are working in the health centres, they can
always cater to the needs of the patients if they care to do so. The
concern expressed seems to me somewhat exaggerated.
Secondly, the proportion of patients
who deteriorate while under treatment appears to be very small,
probably because a lot of patients are identified at such an early
stage (and some may not even be cases of leprosy) that the disease is
aborted long before complications set in.
This of course does not mean
everything is OK in the horizontal set up, nor does it mean that we
should be slack in our supervision.
H.
Srinivasan
