[Quality of life of leprosy patients' group in Vietnam].

Vietnam has achieved WHO's leprosy elimination goal at a national level, but there are a lot ofex-leprosy patients who have severe physical disabilities in the leprosy treatment centers and resettlement villages. The purpose of this study is to analyze the quality of life (QOL) of ex-leprosy patients in Vietnam. The study was conducted in two leprosy treatment centers in Vietnam. The SF-36v2 QOL survey was used to evaluate the leprosy patients' health related conditions, and as a comparison group, SF-36v2 QOL survey was provided to a random group from the general population to measure the general groups' health related conditions. For those participants aged from 10 to 29 years old, the patients' group scored lower than the general group in each of the following categories; Role physical, Bodily pain, General health perceptions, Vitality, Social functioning, Role emotional. On the other hand, middle aged and elderly participants were found to show no significant difference between the patients' group and the general group. In comparing the two leprosy treatment centers, the score of Role physical and Role emotional were significantly higher in the leprosy treatment center where vocational training programs for leprosy patients are offered. From these results, the use of vocational training program is one of the effective methods for improving the QOL of the patients' group.

Dehabilitation of leprosy-affected people--a study on leprosy-affected beggars.

Leprosy is one of the most socially stigmatized diseases known today. Social stigma is associated mainly due to the prevalent myths like its hereditary and contagious nature, divine curse along with the physical deformities caused. The affected people not only face physical impairments but also suffer psychosocial repercussions due to the community's attitude. The long-term physical and psychosocial restrictions slowly push the leprosy-affected person out of the society. With lack of social support and self-confidence, some dehabilitated leprosy-affected persons end up as beggars. The present study focuses on the long-term consequences of leprosy. It is based on case studies of leprosy-affected beggars in Delhi. The process of dehabilitation in each case has been studied. It has been found that dehabilitation is a continuous process. The combination of leprosy, physical impairments and social stigma causing further participation restriction, lead to dehabilitation of people affected by leprosy, and ending in a state of beggary for some. There is a need to develop a holistic approach including both prevention of dehabilitation and rehabilitation of those dehabilitated to overcome both the disease and its consequences. Measures to prevent such dehabilitation in future along with the rehabilitation of leprosy-affected beggars have been suggested. Both these measures should take place simultaneously.

Some observations on patients from two leprosy colonies in north India attending a city clinic.

Fifty-eight patients (26 males - mean age 52.5 years, 32 females - mean age 58.5 years) from two different leprosy colonies (Ambala and Jagadhari) were studied. Maximum number of the patients (48.4%) belonged to Uttar Pradesh. The clinical diagnosis was LLp:41(70.7%), LLs:14(24.2%), LL-burnt-out, BB-BL and BT: one each (1.7%). Mean duration of disabilities/deformities in these patients was 21.5 years. A peculiar myokymic movement of periorbital muscles was observed in 20 patients (34.5%). While dapsone monotherapy was continued in 55 patients, MDT (WHO-multibacillary regimen) was started in three patients. Vocational advice was given to 23 patients; and 35 (60.4%) patients were declared as "destitutes".

Rehabilitation in Hansen's disease.

Hansen's disease leads to deformities of the lower and upper extremities. Eventually, these deformities become a serious handicap and limit the functional capabilities of the afflicted. This paper defines the characteristics of individuals suffering from Hansen's disease and demonstrates that disabilities caused by Hansen's disease can be overcome by: (i) use of splints, (ii) reconstructive surgery, (iii) modification of the articles and tools of daily use, and (iv) proper job--worker matching.

Common vocational training project for the handicapped (CVTPH).

CVTPH is a special project imparting vocational training to leprosy patients as well as other categories of the handicapped under the same roof, in order to combat the leprosy stigma which is the major obstacle in all leprosy work and to aid rehabilitation by making the trainees economically self-sufficient. The project, which offers training in the industrial sector to leprosy patients, orthopaedically handicapped individuals and able-bodied but socio-economically disadvantaged individuals, began in a small way in 1977, but has grown considerably since then, thus demonstrating the effectiveness of the concept. There have been several problems--chief among which are the leprosy stigma and the reluctance of the trainees themselves to move out from a sheltered environment into the world outside--but these are slowly being overcome by the formation of co-operative societies controlled by the handicapped. This project is hoped to serve as a model for similar vocational training programs.

A study of medico-social problems of the inmates of a leprosy colony in Mysore.

A study of the inmates of a leprosy colony in Mysore revealed that there were more male cases and that the deformities were also more common among the male patients. There was no cases among inmates below 20 years of age group 31-50 years. 93.2% of the inmates were illiterate and 96.6% of the patients were ignorant of the cause, spread, prognosis of the disease and prevention of disabilities. This indicated an urgent need of health education among the leprosy patients and their families. All the inmates, including the apparently healthy relatives reported loss of income due to disease and disabilities. Rehabilitation of the inmates by raising poultry, breeding sheep and sericulture activities must be encouraged.

Employer acceptance of the Hansen's disease patient and other handicapped persons.

One hundred and four employers were interviewed in Bauru, São Paulo, Brazil, in order to compare their attitudes toward hirings the leprosy patient and persons with five other handicapping conditions (deep facial scars, the loss of two limbs, blindness, tuberculosis, and past psychiatric disorders). It was discovered that the noncontagious, nondeformed leprosy patient was the third best accepted of the six handicapped persons, slightly behind the job candidates with facial scars and tuberculosis. It was also found that 74% of the employers who were interviewed stated that they would either "probably" or "definitely" keep one of their workers if it were discovered that he had leprosy but was under treatment and represented no risk for other employees. A total of 82% said the same thing regarding a worker discovered to have tuberculosis. The single most cited reason by employers for having a negative attitude toward hiring handicapped candidates as a group was functional--the candidate would be "unable to do the job." The most cited justification for not hiring the leprosy patient was that "customers and other employees wouldn't like it." The author concludes that while there certainly exists employer prejudice towards the leprosy patient in the Bauru area, the study shows that this prejudice is neither unique nor insurmountable by any means. Later practical experience in rehabilitating and placing the leprosy patient in integrated jobs confirms this impression of the study. He urges that attention be given to creating many more integrated vocational rehabilitation opportunities for the Hansen's disease patient.

Occupational therapy in leprosy.

This paper presents a broad discursive assessment of the philosophy and practices of occupational therapy as related to leprosy. It stresses the role of society, self-care by the patient, integration, vocational training, rehabilitation and the amotivational syndrome, and presents some illustrative original inovations. In conclusion some new approaches are suggested.