Disability and Leprosy
About 15% of the world’s population has some form of disability. Disability is a difficulty in functioning at the body, person, or societal levels, in one or more life domains, as experienced by an individual with a health condition in interaction with contextual factors. Several dimensions of disability are recognized in the International Classification of Functioning, Disability and Health (ICF): body structure and function (and impairment thereof), activity (and activity restrictions) and participation (and participation restrictions). The classification also recognizes the role of physical and social environmental factors in affecting disability outcomes. The ICF shifts the focus from the cause of disability to its effect, thereby emphasizing the role of the environment (physical, cultural, social, political) rather than focusing on disability as a ‘medical’ or ‘biological’ dysfunction .
AIFO Liberia uses the CBR approach to deal with disability using a bottom to top approach thereby promoting social cohesion and integration of persons with disabilities in Liberia.
Leprosy is an important cause of preventable disability. Physical impairment associated with leprosy is usually secondary to nerve damage resulting from the chronic granulomatous inflammation due to Mycobacterium leprae. Impairments may give rise to disabilities, such as limitations of activities involving the use of hands, feet and eyes, and restrictions in social participation. The World Health
Organization (WHO) classifies leprosy-related impairment into three grades: Grade 0 – no impairment, Grade 1 – loss of sensation in the hand or foot, and Grade 2 – visible impairment.
Multi-drug treatment (MDT) can cure leprosy, and, if instituted early, can prevent disability. However, leprosy is still often diagnosed too late, when permanent impairment has already occurred. Even after completion of treatment, a significant proportion of patients sustain disability from nerve damage, requiring global leprosy burden show that 5 million new cases would arise between continued (self-) care to limit further secondary damage.
Future projections of the 2000 and 2020, and that in 2020 there would be an estimated 1 million people with WHO grade 2 disability.
In Liberia, Leprosy continues to be a public health problem in Liberia. WHO set an elimination target prevalence rate of less than 1 case in 10 000. Liberia had a prevalence rate of 3.61 cases per 10 000 and an incidence rate of 11.8 cases per 100 000 in 2009.
The trend of cases is steadily increasing with 410, 414 and 415 cases in 2007, 2008 and 2009 (National Leprosy and Tuberculosis Control Programme, 2009).
AIFO-Liberia is supported the Leprosy Division Unit at the Ministry of Health in addressing the increased trend of leprosy in the country through its national strategic leprosy plan. The plan seeks to eliminate leprosy in the whole of Liberia by 2020. Activities focused on Training of Health Care Workers, Referral of Patients and reintegration of former leprosy patients in the social and economic life of the community.