Current situation of leprosy colonies/leprosaria and their future in P.R. China.

OBJECTIVE: To identify the current situation of leprosy colonies/leprosaria and make some recommendations for improving the quality of life of people affected by leprosy in China. METHODS: A national survey using designed forms was carried out in 2004. The forms were filled in by local heads responsible for the management of leprosy colonies/leprosaria and sent to Provincial and National Centres for analysis. RESULTS: China had 605 leprosy colonies/leprosaria with 555 active leprosy patients (on treatment) and 18,175 ex-patients (people affected by leprosy) living in them at the end of 2004. Among 18,730 patients and people affected by leprosy, 13,430 (71.7%) had grade 2 disabilities. Among those with visible disability, 6392 (47.6%) lost the ability to take care of themselves due to serious deformity. Because of a decrease in health workers working at leprosy colonies and a shortage of medical materials, the health care quality of these people was neglected. Most colonies/leprosaria were located at remote and isolateS places with difficult transportation, and most buildings/houses were in danger of collapse because the colonies/leprosaria were built in the 1950's. Those affected by leprosy were in great need of help. CONCLUSION: The authors recommend that small, remote and isolated leprosy colonies should be closed. New leprosaria at District, Provincial or National levels should be established or some old leprosaria with good transportation should be reconstructed to house those affected by leprosy from closed leprosy colonies/leprosaria. The newly established or reconstructed leprosaria could act as centres for reference, training, rehabilitation and research on leprosy.

O dispensário nos programas de lepra. Dispensários pilotos

O autor lembra que, apesar do dispensário especializado ser considerado peça superada nos modernos programas de lepra, pode ainda prestar grandes serviços nas regiões onde a endemia é grave. Um dispensário, pelo menos, deveria ser aparelhado convenientemente para servir de centro de treinamento de pessoal, e de centro de estudos e pesquisas. Êsse dispensário, considerado "pilôto", servirá  como modêlo de funcionamento dos outros dispensários, nas áreas onde houvesse tais unidades sanitárias. O dispensário pilôto deverá estar bem aparelhado com pessoal e material e ser dirigido por leprólogo com conhecimento de saúde pública, ou sanitarista com conhecimentos de leprologia. O autor menciona os requisitos indispensáveis para o funcionamento de um dispensário dessa natureza, e lembra as funções de coleta de dados, supervisão, coordenação de atividades e avaliação, educação sanitária e outras, que a¡ devem ser desenvolvidas. Acha o A. que os grandes centros não se prestam muito para a localização de um dispensário pilôto, lembrando em São Paulo alguns munic¡pios onde êles poderiam ser localizados. Recomenda, finalmente, a instalação de dispensários pilotos em  áreas especiais do Pa¡s (Norte, Nordeste, Centro e Sul) a fim de servirem de centros de estudos e investigações epidemiológicas da lepra.

Report of the Philippine Leprosy Commission

Thepresent method of cotrolling leprosy by segregation of the bacteriologically positive leper is the one best adapted to the conditions prevailing in the Philippine Islands. The basic principle of segregation is that the positive leper is isolated for the public good and not as a matter of charity for the individuals concerned. This measure unavoidably involves the sacrifice of certain personal rights. In view of this, the restrictions upon the individuals affected should be made as lenient as is consistent with the purpose of control. The government should use all reasonable means to insure that the rights of segregated lepers are properly safeguarded. The methods of segregation employed should be such as to allow them to live in as nearly normal an environment as possible. The government should appropriate sufficient funds to provide segregated lepers with the ordinary necessities of life or the meands for obtaining a livelihood. The foregoing discussion has brought out the following points: (a) Leprosy is an infectiondisease which is transmitted through more or less intimate contact. (b) The source of the infection is the bacteriologically positive leper. (c) Children are especially susceptible to infection. For practical purposes in control work adults may be regarded as immune, although cases in which adults have acquired the disease have been reported. (d) Under conditions as they exist in the Philippine Islands the segregation of bacteriologically positive lepers is and must continue to be the basic measure for the control of leprosy. The form of segregation employed should be that which will afford the necessary protection for the public and interfere as little as possible with the rights of the leper.