Dear Salvatore,
The question was, if it is desirable to start
preparing a new clinical, multi-authored text about leprosy, because of
an existing lack of material about leprosy.
I don’t think we need that. On the contrary, I think there is an
abundance and great variety of good material about leprosy, especially
clinical leprosy. Anybody with
access to Internet and medical bookshops can confirm this.
However, there is an other problem
on leprosy teaching which deserves attention.
I have only experience with teaching of leprosy in some countries in
Africa, so I don’t know if my reasoning below is applicable to Asia
and South America as well. Given
my experience in Africa, I can say that most of the case-finding and
case-holding activities is performed by local nurses, local technician,
physiotherapists (and sometimes volunteers).
A very limited number of doctors and specialists are involved in
these tasks.
Nurses and technicians working in
the periphery have little or no access to learning material because they
lack adequate access to Internet and/or libraries. Usually the only book they have
is a copy of the National Leprosy Manual. This usually is in pristine
condition and rarely consulted. Also
during leprosy training sessions the availability and use of the National
Leprosy Manual is limited. I
think there is a need to focus on that.
It would be good for ILEP to help improve the quality and the use of
National Manuals in such a way that they are helpful for district health
workers. I think ILEP could be
helpful to produce a Standard Leprosy Manual which can be adapted to local
conditions.
Together with a Standard Leprosy
Manual and strongly linked to it, we need a Leprosy Teaching Guide, full of
tests, exercises etc., which can be used in all Leprosy Training Courses.
This could positively standardize leprosy training courses and simultaneously promote
and stimulate the use of the National Leprosy Manual.
In
Mozambique we are at the moment in the process of producing both a Leprosy
Manual and a Leprosy Teaching Guide. When
they have been implemented we can see if application by ILEP in other
countries is feasible.
Best Regards.
Charles Phaff
NLR representative Mozambique
