Leprosy Mailing List
– December 14th, 2006
Ref.: How valid are
any of these figures?
From: Ryan T. J., Oxford, UK
Dear Salvatore,
I find Soma Banajee's comments (LML,
Dec. 10th, 2006) interesting. I have been involved in a
number of studies of Routes into Care in this country. "Sufferers" from
acute discomfort want instant care and will follow all routes. For chronic illness the
Government services are usually supplemented by other routes. One always has to ask the
participant in any study "have you taken this route into care,
not for this disease but for any other concurrent problem?”
Leprosy is commonly not diagnosed when first
seen by any route. The
habit of Dermatologists to take a biopsy if in doubt about any disease
is a safeguard. Like
India the private sector and complimentary and alternative medicine
(CAM) (Chinese, Indian systems and homeopathy) are much used for skin
disease and praised for not making a skin diagnosis but a holistic
constitutional even cosmic one. We
have only 460 dermatologists, few do much private practice, only a
handful admit to prescribing other systems of medicine but a
guesstimate is that many will use (CAM) for discomfort in themselves. As to declaring for Government
statistics one only has to look at STIs to see that the Private Sector
and CAM are not especially compliant with the rules.
I write all this because reviewers of Al Wakeel
and My "impressions" wont publish without controls and all
the other things needed for proof.
Studies in the UK are hard enough and very expensive, but have
been done and passed peer review.
Studies in India would be exorbitantly expensive to get the
evidence one would like and in India I would prefer to spend the
money on patient care.
The other diseases I study is Lymphatic
Filariasis and all these issues are similarly expressed especially in
India. The main issue is
not to believe that elimination in India is any where near even a
Public Health requirement.
Terence Ryan
