Medics and patients share what it’s likeLeprosy: Can we ever beat this gripping disease? [Archives:2004/738/Health]

May 17 2004
Dr. Abdul Rahim As-Samie, Director of the national project for redding of leprosy
Dr. Abdul Rahim As-Samie, Director of the national project for redding of leprosy
Disease Spread Average 1992-2003
Disease Spread Average 1992-2003
By Ahmed Zaid
Yemen Times Staff

Once your feet touch the ground of Madinatul-Noor (City of Light) in Taiz, your heart will tremble with anxiety, if not fear, that rages through you as you get closer to its patients.
Then, soon you'll start feel sad for them: people who live in their own world, isolated by a disease that has made of them a class of “the untouchable.”
This is what I found while learning more about leprosy, and talking to Dr. Abdul Rahim As-Samie. Dr. As-Samie tacked many angels of the subject. Talking about the disease, he said.
“Leprosy is a chronic infectious disease caused by Mycobacterium leprae, an acid-fast, rod-shaped bacillus, which were discovered on 1873 by a Norwegian scientist called Graham Hansen.
The disease mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract and also the eyes, apart from some other structures. The Percentage of People affected is estimated to be up to 1% of the population. If left undetected, a chronic course of incurable disfigurement and physical disabilities are likely to occur.
When asked about the clinical signs and symptoms of the disease, Dr. As-Samie said that there are four symptoms of Leprosy and three signs for it as following:

Symptoms of the disease
I. Tingling sensation in the body, hands and feet in particular
II. Sensory Loss in the skin or a specific area of it.
III. Weakness in the muscles of the face, hands and feet.
IV. The appearance of different-colored-spots on the, with or without infiltration and thickness of the skin.

Cardinal signs
Individual should be regarded as having leprosy if he or she shows ONE of the following cardinal signs:
1. Skin lesion consistent with leprosy and with definite sensory loss.
2. thickened nerves
3. positive skin smears (contains Leprosy Bacilli) =
On how is leprosy spread, Dr. As-Samie said, ousehold and prolonged close contact is important factor. The germs probably enter the body through the nose and possibly through broken skin. The germs get in the air through nasal discharge of untreated lepromatous patients. If the germs enter, frequently and in big numbers, a body of weak immune system, the person can be easily affected.
And when we asked Dr. As-Samie about the incubation period of the disease, he said: Incubation periods vary but are usually three to five years, The process of diagnosing Leprosy consists of four procedures that should be followed accordingly and meanwhile carefully. These procedures are:
1- Reading the patient's medical history, to see any case of interaction with affected person.
2- Checking up the patient.
3- Testing the skin sensation by touching it with cotton, a pen.
4- Testing peripheral nerves on both side of the body to recognize any thickened nerve.
Dr. As-Samie also talked to us about the discovery of first case of leprosy and attempts to burn leprosy patients alive, saying: “Leprosy is one of the oldest documented diseases in yemen. The first document of this disease goes back to the year 750 A.D. In that year Mohamed Abu-Almadan, a governor of Sana'a, tried to bun alive leprosy patients. However, he died before he could commit such crime.
“On the other hand, Sheikh Saied Al-Amoudi initiated on 620 A.H. a tradition, which is still celebrated until present time in the village of Gaidon, Hadramout. That tradition is basically a celebration during which people mix up with leprosy patients. Such tradition is the exact World Leprosy Day that was initiated in France by Raoul Floro in1954-850 years after Sheikh Al-Amoudi.
As for the human side in the interaction of the society with leprosy patients, Dr. As-Samie stated that: “in 1964 some wealthy individuals from the city of Taiz built an isolated center for leprosy patient. In those days, people were socially very sensitive towards such patients, who suffered greatly because of that. Therefore, those wealthy individuals tried to take those patients to a distant area outside the city, fearing that they'd get affected. And it was done, and the patients were moved to Al-Hasab area, presently known as city of light were little medical care was given to the.
“In 1992, the Ministry of Health, decided, as a strategy to eliminate such social sensitivity, to transform that center into a hospital for venereal and skin diseases. In addition to amalgamation the efforts of fighting other widespread diseases like Leishmania and skin T.B.”
In that span, Dr. As-Samie asserted the possibility of curing leprosy saying that: “it is , like any other disease, curable if treated in its first stages.” Pointing out to cases were complete cure was achieved, Dr. As-Samie emphasized that there were 7524 cured cases. Therefore, 35 clinics were closed as a direct result of the continuous disappearing of the disease. Yet, and in accordance with recommendations from the World Health Organization, those clinics were reopened.
In the following charts, we can see the discovered and cured cases for many years.
Letters from Patient expressing their sufferings
1. Because of Leprosy, my life was scattered and I got married away from my family
By Adel Abdullah Saleh Hatim, of Hajjah Governorate
I lived with the disease, isolation and sorrow. I was only seven year old, when the disease first appeared on me. I did not know what was going on around me. All I know is that, I lost my childhood. They rejected me and I knew very early what those spots on my fingers mean. Just then, I felt like my fingers were so numb. People told me that it was leprosy, and then they isolate me at that young age.
I felt so sad and lived the misery of thinking that I am just unwanted creature in a society that rejected me without mercy, killing all the good feelings and beautiful memories I once had. Just the way they used to look at me, killed me. I used to east and drink by myself and away from my family. Though I was very young, I spent most of my days and nights alone.
In 1962, I joined the army and I got shot and was taken to the hospital in sana'a and then to Leprosy hospital in Taiz. In 1964, I started going under treatment at the hands of a Swedish physician for a whole month. When I left the hospital, I lived as a stranger, missing my family at every moment. In 1986, I got married a way from my family..they didn't know if I was dead or alive. My wife is from a decent family and previous leprosy patient, too.
Right now, I live nearby the hospital. I have my own family and I am enjoying stability and good relationships with my family, neighbors. We exchange visits in a very normall way, we are one society. I urge the government to look upon leprosy with a merciful eye.

2.Fearing rejection, I hid my sickness.
(By an un-named female patient)
I didn't feel the disease or care about it. Simply, because I didn't know what I was affected with. I thought those strange spots that appeared from time to time on my skin were just some dry skin; therefore, I used to use creams thinking that they will disappear.
That continued until I heard of leprosy and read about its symptoms which were very identical to what I had. I thought a lot about it. Then one my neighbors guided me to the hospital of the city of Light.
I said to myself I should go there. I wanted to, but was so afraid. I just never thought I would have that disease. Finally I decided to go. And I was shocked to know that all my fears had come true.
I hid everything from everyone, and kept it to myself only considering it “my little secret.” I was so afraid that I would be rejected. Then I decided to do what is right, putting my trust on God.
I took my medicine and got alone with patients in the hospital, those whose destinies were to be far away from rest of the world. Strangely enough, the thing that separated them from their family is the something that gathered them. You know, it is so sad to patients to know that there are still some people out there who deal with them without mercy.

3.Because of Leprosy, I wanted to die.
By Saied Ahmed Mohamed, of Jiblah District
Ten years ago I was struggling with the disease. I didn't know that I had it until I had a little chat with a relative who had been to the hospital for a similar situation.
In the beginning, the bottom of my feet would be numb for long periods of times. There were things that bothered me a lot about my sickness. I went to so many physicians, they all told me the same thing “it is because you extensive traveling between cold and hot regions.”
I went to physican Yasim AlQobati and was admitted to the division of Leprosy. He gave me a medicine but, though I was using it, I noticed the spread of strange spot all over my body. I used to wake up in the morning, just to see little pieces of skin on my bed's cover.
In the hospital, the medical care was great..medicines are available and services are well-provided. Right now I am getting better, thank God.
There were times, when I thought seriously about getting ride of my life. Especially those times when people would just keep distance from me.. they were afraid from me!
Angel-hearted people in the hospital have given me new hope in life and tomorrow.
Now that I am cured, I live my life normally and .. I have a job, too.