Leprosy
mailing list – April 12th, 2006
Ccn:
all.
Ref.: Prevention of disabilities (POD) in leprosy
From: Lehman L.,
Brazil.
Dear Salvatore,
In response to Wim Brandsma comments (LML Apr. 5th,
2006).
I find using the ICF (International Classification of
Functioning, Disability and Health) in Hansen’s Disease (HD) helpful
as a framework when we work on POD / Rehabilitation issues.
The Brazilian national POD technical advisory team
working with the national HD coordination (Dr. Maria Leide Wand del
Rey de Oliveira) and the ILEP national project in 1997 used it than
(known as ICIDH – 2.) It
gave us a way to develop a consensus in definitions about the terms
POD and Rehabilitation. It
helped us define specific basic activities which are important to
preventing disability as we aimed to integrate POD within the
decentralization of HD Control. I
prefer not to call them levels as it makes it sound like one comes
first always before the others. It
is not uncommon that several activities must be addressed to Prevent
Disability early. It also
demonstrates the need for the INTEGRATION of POD within HD MANGEMENT
by all health workers.
BASIC POD ACTIVITIES
Health Education and Training to:
- suspect and Identify the Disease early, treat
adequately with MDT and apply BCG to contacts;
- identify and treat reactions and nerve damage early
and adequately;
- Identify persons at risk (Grades I & 2) of
furthering disability, empowering them to do Self-care and provide
interventions as needed (wound-care, footwear modifications,
surgery);
- encourage inclusion of the person affected by HD
within their family, school, work and community (starting at the
day of diagnosis).
These Basic Activities which Prevent Disability were
defined and illustrated on a FOUR LEAF CLOVER (culturally understood
as good luck). Many
people would say we don’t do any POD because we don’t have
therapist or a special centre. They
would quickly see that they were actually doing something which was
preventing disability. The
illustration helped people understand the concept and identify the
missing areas (physical and social).
In each area specific tasks were defined. The responsibility of POD was
clarified as a team effort of the:
person affected by HD, their families & communities and the
health team.
The success was and continues to be dependent on
providing regular supervision which integrates POD with HD control.
Linda F. Lehman, OTR MPH C. Ped
Regional Prevention of Impairment and Disability Consultant (Americas
& Africa)
American Leprosy Missions WEB: www.leprosy.org
Tel/Fax Brazil 55-(0)31-3476-6842 or cell 55-(0)31 9637-5576
lehman@uai.com.br
