[Background of development and effectiveness of myanmar sandals (the activity of Leprosy Control and Basic Health Services Project in Myanmar)].

"Leprosy control and Basic health service Project" was terminated at March 2005 within the scope of the period. I was assigned to develop the Plantar protect footwear for neuropathic feet, which called "Myanmar Sandals" in common. These sandals are not made by new technologies but made by basic knowledge. I would like to report about this activity as which is a part of distinguished strategy of ODA (Official Development Assistance) for developing country, but not as the technical report of these sandals. There is only one National Leprosy Hospital in Myanmar. At the time this project started, there were only two footwear technicians for the people who had disabilities by after effect of Hansen's disease in this country. And, it would appear that the number of the people is over 50,000. Furthermore, the budget of national hospital is not enough to refill necessary consumable supplies and materials. Although, I should instruct new technique which like making in Japan in ordinary circumstances, I could not think that such technical transfer by using costly imported materials woud bring beneficial effect and be continued. We were bound to be anxious about such situations when we made the plan. As a result of examining a plan based on these situations, we reached the conclusion that development of the simplified ready-made footwear was pressing need.

[Results obtained by a mobile handicap-prevention unit at the Institut de Léprologie de Dakar]. / Résultats obtenus par une équipe mobile de prévention des invalidités à l'Institut de Léprologie de Dakar.

Of 584 leprosy patients known at the Institut de Léprologie Appliquée de Dakar because they suffered a nerve lesion with or without chronic plantar ulcer (CPU), 242 (41%) could be followed-up during a mean period of time of 8.2 years (range: 5 and 10 years) by the means of the mobile disability prevention team (health education, medical care and shoe workshop). Every two months a visit of the patients, at their home town, was organized, with the purpose to assess whether they could actually put into practice the foot and hand as having been trained for. At the same time, further advice and encouragement were given to the patients. Adapted footwear was brought to the patient, at reduced fee, the foot prints and special moulds having been taken during the previous visit. The local health worker were responsible for light surgical cares. Among the 242 followed-up patients: of 107 without CPU at beginning, 90 (84%) remained so, of 135 with CPU at beginning, 57 (42%) were cured, of 135 with CPU at beginning, 74 (55%) remained stable (no worsening), the last 21, of whom 17 showed severe foot deformities but without CPU, worsened (all presented one or more CPU at the last control). Of the 242 patients, 221 (91%) remained stable or showed substantial improvement. Therefore, it must be emphasized that careful follow-up of patients is essential to insure the improvement or care of CPU as well as to prevent the onset, worsening or reappearance of CPU. Such follow-up must consist of cares, health education and special shoe wearing.