Leprosy mailing list – February
28th, 2006
Ccn: all.
Ref.:
Epidemiology of leprosy disabilities.
From: A
Salafia, Mumbai, India.
Dear Salvatore,
I just want to add a word to the statistics of
deformities in leprosy (J Kawuma LML Feb. 22nd and R
Ganapati, LML Feb. 17th, 2006).
A few years ago GRLA called a meeting of surgeons
involved in the surgical rehabilitation of leprosy patients. A report showed that there
were in India about 3000 patients (in the units financed by GLRA) who
needed surgery. I made a
point which is still valid: every report on the number of patients who
require surgical correction is unreliable because whoever writes the
statistics looks at deformities which, as per general understanding,
are correctable.
This is a fallacy; many deformities which are labeled
‘beyond repair’ in reality can be repaired; our surgical unit at
Vimala Dermatological Centre (a leprosy hospital in Mumbai) has showed
and proved that ‘mitten hands’ can be transformed in useful tools,
hands without a thumb can be provided with one, by a surgical
procedure called ‘pollicization’, very stiff fingers can be opened
up thanks to the JESS (Joshi external stabilizing system) etc.
Now if we add all such patients, so far labeled
‘hopeless’, to the statistics available, than the number increases
ten folds. Unfortunately,
doctors without any surgical training are the ones who assess the
patients, and when they see a ‘mitten hand’, they tell the patient
that nothing can be done. The
same surgically-untrained doctor at times, make to the patients
promises that we, the surgeons, cannot fulfill; the reasonable thing
to do is: looks for deformities, any, even hopeless one and refer them
to the surgeons.
Unfortunately the number of surgeons is not increasing
and some centres have even stopped performing that little surgery that
they were doing instead of moving ahead and care for those hopeless
hands.
I am aware that a good treating is required to correct
difficult hands; and that is what we (my unit) are doing for the last
16 years, free of charge. Yet
you will be surprised to know that every year we get 6-8 surgeons
(drawn from all India) interested in this type of surgery (whether
later on they really practice what we teach is beyond my control).
In short the statistics presented by Dr Ganapati, and any
government statistics, for that matter, are not comprehensive.
Best regards,
Antonio
