Managing disability in Leprosy is the most difficult aspect of treatment. Usually the surface nerves of the face and limbs are involved. It is thought that these nerves on the surface are conducive for the bacilli to invade. It could be because of the surface temperature, mobility and vulnerability at the joints.
A skin smear is done close to the affected nerve to see if the bacilli is present to confirm the disease. Bacillary index indicates the strength of bacilli in the system. A smear is done at various sites where the bacteria usually resides. This is an out-patient procedure.
Disability is loss of sensation of touch, that means temperature differences also can not be appreciated. Loss of function of muscles and wasting due to nerve damage. Progressive disability will result in contracture of muscles and bone deformity due to loss of nourishment and mobility.Loss of sweat and dryness.
In order to prevent such damage, Orthopaedic management is instituted immediately. Regular Physiotherapy of hands and feet are done at the Centre. Patients are also taught to exercise at home. Early disability is an out-patient procedure.
A claw-hand deformity. This is quite an advanced type of disability that can be corrected surgically. Preparation before surgery is required. Patient is given physiotherapy for four to six weeks before the surgery.
Once the correction is done the patient is required to have their hand or fingers in cast for further period of four to six weeks. In all, a corrective surgery involves hospital admission for a period of ten to eighteen weeks.
Prevention of deformity clinics are regularly conducted to educate patients in care of hands and feet. An assessment is made of their disability and ulcers are dressed in some patients.
Disabled patients are provided with MCR foot wear. They are advised to wear them at all times so as to prevent trauma of feet and ulceration. Patient is given a card for such a foot wear.
Evening school for house-wives and working women. Education is important to understand health care as well. These women took part in awareness campaign in early signs of leprosy.
Evening school for underprivileged children. Some of them were sponsored to regular schools. They took part in awareness campaigns too.
All pictures shown here were taken at our Mettur Centre between 1999 to 2004. The pictures that shows patients with surgical correction is at a Leprosy Institution in Omalur.