Leprosy
Mailing List, December 10th, 2008
Ref.: Referral
or consultation facility to improve the quality of patient management
in leprosy.
From: Vijayakumaran, P.,
Chennai, India
Dear
Salvatore,
Greetings
from Damien Foundation
India
Trust. I would like to
comment on the debate about the use of steroids for management of
reactions in leprosy.
All
the experts agree that dose of steroid and duration of therapy may be
decided on individual patient basis.
This is possible in specialised institutions. What about the field situation
? Where:
-
management is mainly by non-medical personnel trained in leprosy;
-
specialised referral centres are not available.
Even
a medical person in general health care system may not be able to
assess the needs in many situations.
They need a simple straight forward steroid regimen. That is what many agencies
including WHO have done.
This
argument will never end. Experts
in this field need to help those in need. The problem in the current
scenario has been well recognised by the statement in the
communication: << "there is a threat that field staff with
good clinical knowledge of leprosy are tending to extinction; there is
in addition an on-going debate regarding the threat of not having
dedicated training facilities!"
>> (Kawuma
J, LML Dec. 8th, 2008). I would also add that it
is not possible to clone Naafs and Kar!
Let
us try to establish referral facility or consultation facility to
improve the quality of patient management in leprosy.
Dr.
P. Vijayakumaran
Director
(Prog)
Damien
Foundation
India
Trust
Chennai
600031,
India
