Leprosy Mailing List – August 24th, 2007
Ref.:
Care of the feet in leprosy and diabetes
From:
Ryan, T., Oxford, U.K.
Dear Salvatore,
Dr Narasimha Rao's comments are valid (LML
August 22nd, 2007).
I am making a different point.
The Global and emerging epidemic of diabetes is
accelerating and the size of the problem far exceeds leprosy. Neuropathy far too quickly
progresses to ulceration and then to amputation. This can be prevented before
the stage of ulceration by following the washing, oiling, manipulation
and offloading procedures that we encourage in leprosy. These are two disciplines that
can each work together to spread essential messages in the general
health services with benefit.
Visiting the Procter and Gamble UK base (800
people working on skin care with one product alone bringing in £ 3
billion) I came away believing that adding a teaspoonful of salt to
water, adding a little vinegar, using tepid water as near to body
temperature as possible adding a little yeast to natural moisturizing
agents, soaking for10 minutes twice a day to facilitate the
effects of moisturizers--all have a reasonable evidence base. Vaseline is excellent but be
aware that it is also a retail name and is often sold as such.
No one has ever spoken to Procter and Gamble
before about leprosy. They
have not heard of lymphatic filariasis. Their vice President is
an Indian wishing to help solve some of India's health problems.
I continue to express the view that a disease
like leprosy needs to be managed through an Alliance at the level of
the general health service in the village, it is an alliance that sees
the common denominators of diseases such as leprosy and diabetes and
not the differences and all those researching healthy skin products
must be brought into the alliance. Leprosy
organisations need to make sure they preserve the identity of this
disease at the top with full time spokes persons for leprosy. At the bottom, especially where
it is a minority disease, while the patient when identified should be
special, the clinic attendant should not be overloaded with special
case information. In
Oxford where in the Dermatology clinic we have someone trained to look
after feet and diabetes is an epidemic, he cares adequately for
the occasional person affected by leprosy.
Terence
