“The most important factor is that leprosy patients and their families are never discriminated against, are included in the community, and treated as human beings”

Roundtable discussions to mark the National Conference on Combating Leprosy held.

MRTV aired a live program on the “Roundtable Discussions on Myanmar National Conference on Combating Leprosy” in which Dr. Tin Shwe, Deputy Director (Retired), Department of Health of the Ministry of Health; Dr. Kyaw Nyunt Sein, Deputy Director-General, DOH of MH; Dr. Chan Tun Aung, Leprosy Elimination Project Manager and Deputy Director of Public Health of the Ministry of Health and Sports have participated in the program.

  • By Nandar Winn and

Mee Mee Phyo

Photo by Hla Moe

 

Leprocy4 copy

(Continued from Yesterday)

Moderator: Kindly explain about the strategies.
Dr. Kyaw Nyunt Sein: I would like to explain in five talking points. The first point is the commitment, the ownership, and the partnership. The second point is about MDT service, which seeks patients and treated with MDT approach for full recovery, and monitoring task. Another point is to change the poor image of the leprosy patient into decent life, and also to prevent them from becoming disabled person. A total of five points in these strategies are laid down.
With a view to achieve the commitment, the partnership and the ownership, we carried out advocacy of anti-leprosy at different levels in regions, states, districts, townships and villages. As this malady could occur at every community, we covered to all walks of life, including the armed forces. We also provide detailed information including the fact that the treatment is free of charge.
We need the assistance of the media to elevate image of the committee and raising awareness in connection with the reflection of leprosy patients.
Since 1999, we moved ahead in two stages in the whole country. We conducted seminars, made field trips, provide better MDT service to the leprosy patients, empowering health care workers especially midwifes to shoulder special activity in the Leprosy Elimination Campaign.
During the time of our predecessors, they worked on Special Action Projects for the Elimination of Leprosy (SAPEL), and that during our time, we are working on Improving Geographical Coverage (IGC), both of the approach is the same.
It is believed that the leprosy infection is widely occurred in upper Myanmar, but according to the survey the leprosy issues are occurring in the Regions and the States. We have been extending MDT service to every corner of the country, where our midwives are very much instrumental in the forefront as they are very active and agreeable in treating the patients.
The international organizations called our nurses and midwives as “Red Angel”.
We continuously monitored and analyzed the situation of leprosy at different villages, and put on records. We found the hyper endemic areas in four regions and one state involving (99) townships and we grouped the villages together and marked then as category (1) and category (2). We identified whether the village is risk prone village or it is infection eliminated village.
We introduced and looped in the celebrities namely Academy winning actress May Thinzar Oo and Academy winning actress Thet Mon Myint in the campaign through videos, in addition to pamphlets and newspapers using the media as a tool including MRTV and MWD.
Regarding the prevention and rehabilitation programs, we worked along with the American Leprosy Mission, which is termed as International Federation of Anti-Leprosy Associations (ILEP) . The JICA and the ILEP are lending hands to us, and that all the tasks are based on the strategies.
We are also working on the elimination campaign with advanced vision such as that of using the Geographical Information System (GIS) in finding the leprosy patients. The outcomes and results of the research have been integrated in the plan for better implementation.

Moderator: Kindly explain the results and the reason of success.
Dr. Kyaw Nyunt Sein: In 1999, we started the LEC as national level in the whole of the country, and that one week of program in the region and one week in the state. During the two weeks period, we could pull in (15,000) new patients. We continued the district LEC, and that the Mandalay region happened to be prone area where we expected more patients. Eventually, we could register nearly (30,000) new patients in a single year, which happened to be the hidden patients that we had uncovered.
We continued in the same pattern in the following year.
According to the old records of 1990, there was (276) leprosy patients out of (10,000) population, and that in 2003, it dropped to (0.8) per cent. We were able to pull down the percentage to the lowest level.

Moderator: In what year that you could announce the successful elimination.
Dr. Kyaw Nyunt Sein: We called it the third Global Allowance of Leprosy in our country; it involved the world partner countries namely WHO, Sasakawa Memorial Health Foundation, ALM, Novartis Foundation, and we conducted a seminar at the Sedona Hotel on 6 February 2003. On that particular day, we were able to announce the elimination.
The driving force for that success was the political commitment which was supported by the people, responsible authorities and the partners.
In our awareness raising program, the media had assisted us. When we were making research work, the Yangon Institute of Medicine, the Department of Medical Science, the Yangon Arts and Science University (Psychology Department) assisted in our tasks. The work was related with the psychology issues, and that motley assortment of ideas made us successful.
We had streamlined the task of integration in 1978 at a time when we had only (902) number of leprosy elimination staff, and that we had to cover (68,000) villages with (330) townships. Therefore, we had to integrated basic health workers in the country for the campaign.
Our success came from our strong team where we devoted heart and soul in the task and also we organized and inspired other people. The ability and strength of our leprosy elimination staff members played a major role in the campaign. Myanmar gained success earlier than our neighboring countries.

Moderator: Please tell us the current situation on leprosy.
Dr. Chan Tun Aung, Leprosy Elimination Project Manager and Deputy Director of Public Health of the Ministry of Health and Sports: On 6 February 2003, we were able to announce the elimination of leprosy during the time of Dr. U Kyaw Nyunt Sein, which means less than (1) per cent of registered patient in (10,000) population.
In other words, the issue of leprosy patient could be eliminated from the public problem. It is not necessarily mean the total elimination.
It could be interpreted that the blazing and burning fire had been extinguished into small glimmer of fire. In fact, the rate of infection remains as new patients of (2,500) to (3,000) are coming out each year. Among them, (10) to (15) per cent are the patients with visible physical defect, and (5) per cent are kids, and it is therefore, the issue could be termed as continuing infection.
Moderator: Kindly explain the current work program.
Dr. Chan Tun Aung: We would keep on searching the patients and treat them with MDT treatment free of charge. Another work program was in focusing at (60) village health units in finding out patients for (3) consecutive years in 2015, 2016 and 2017. Moreover, we could manage in preventing the patients from becoming disabled condition.
In addition, we carried out a research program by proving protective drugs to the family members of the households in NyaungU District, Myingyan District and Thayawaddy District. We also carried out Leprosy Mapping Project to understand and analyzed the distribution of patients.
We have many ongoing research programs combined with better management along with Technical Advisory Group (TAG), involving experts and retired personnel for the elimination campaign.

Coordinator: Kindly explain about the National Leprosy Conference which was held on 12 and 13 December 2018.
Dr. Chan Tun Aung: We have conducted the conference with three objectives. The first objective is to obtain the political commitment from the government departments and the organizations. The second objective is to have total non-discrimination of the leprosy patients. The third objective is to make all inclusive in the drive for leprosy elimination.
The patients, the family members, the community, the Ministry of Health and Sports, the Ministry of Information, the Ministry of Education, the Ministry of Social Welfare, Relief and Resettlement, the relevant ministries, the UN Agencies, WHO, the ILEP, the American Leprosy Mission, the Novartis Foundation, the local NGOs, and the partner organizations are being called in to participate in the campaign.
We are able to organize this conference due to the cooperation among the donor organizations such as the Nippon Foundation, the Sasakawa Memorial Health Foundation, and the mother ministry namely the Ministry of Health and Sports.

Moderator: Please tell us the expected results from the National Leprosy Conference.
Dr. Chan Tun Aung: The first expected result is to combine and unit the commitment of the authorities and our active participation. The second expected result is to go ahead with the non-discrimination attitude and not to sideline the patients.
The third expected result is to have the proper understanding among the public on the malady of this infectious disease and to call upon all people to actively participate in the elimination campaign.

Moderator: Kindly explain your additional view in this program.
Dr. Tin Shwe: I would like to share two to three points. The first point is that we now have arrived at the stage that leprosy issue is no more a problem of public health matter.
We would like to inform the correct news to the people that the leprosy disease in not entirely eradicated in our country.
The second point that I would like to submit is the fact that we are striving for a Leprosy Free World including Myanmar. However, no one could definitely say when we would achieve that status.
The most important factor is that leprosy patients and their families are never discriminated against, are included in the community, and treated as human beings.
Dr. Kyaw Nyunt Sein: We are referring the term as the family members in which the relatives are also included. People thought that the real leprosy patient may have physical deformity and defect, but in ground reality, the irregular and defective patch on the shoulder or on the buttock is the sign of leprosy.
The leprosy infection could be treated with drugs and could come out fully recovered as normal. However, some are of the wrong view that once a leprosy patient is always a leprosy patient. With this attitude among some people, the patient remains to be in the shadow, and never mingle among the community.
When we could push aside the discrimination, only then the remaining glimmer of fire spark might be totally extinguished. The problem may still remain, if the discrimination persisted.
The discrimination may bring supplementary problems such as that of social, education, economic and other matters.
The leprosy patient may have defective physical formation, but the brain function is normal, and could pursue education to become a valuable productive citizen, who could support his family members and serve the country one way or another.
When the discrimination has enveloped the situation, the good opportunity might be lost causing negative impact to the patient, the family members and the nation.
Translated by UMT (Ahlon)

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