Monday, July 28, 2014

The Role of Primary Care Centers and NGO's

“Since 1955 till 2004, our country had a vertical leprosy program, which has been merged with the GHC system”

One of the debates that my GPP 105 Literature Review tried to address was the role of Leprosy NGOs, along with the role of the government clinics.  Many of the articles I read stated that integrating Leprosy treatment into Public health centers was effective, and there was no need for NGOs to treat Leprosy patients.  As a result, I concluded that the role of the public health centers was to detect and treat Leprosy, while the NGO’s role was to diagnose and treat complicated cases of Leprosy and have disability prevention programs.

However, everything I have witnessed so far has shown me otherwise.  My experience in the Bombay Leprosy Project has shown me that Leprosy is an extremely complicated disease, and is very difficult to diagnose.  There were several cases that I have witnessed in which the patient went to see a general practitioner and the general practitioner was unable to correctly diagnose the patient.  For one case, the patient was undiagnosed for several years, resulting in him infecting many of the people close with him.  Instead of referring him to BLP or a dermatologist, the general practitioner tried to treat the patient by giving him injections.  As a result of the patient being left untreated, not only was his bacteriological index extremely high, but his sister displayed hypopigmented patches, one of the signs of Leprosy.
This is one of many cases in which the patient was left untreated because of misdiagnosis.  Another patient visited not only a general practitioner, but many other physicians before he was lucky enough to have an orthopedic test him for Leprosy to rule it out.  There is no proper way as to how Leprosy should be treated.  By integrating Leprosy into the General Health System, there has been less of a stigma towards the disease.  However, general practitioners need to be aware of the signs of Leprosy and when they should send the patient to a Leprosy NGO.  In order to aid in Leprosy eradication efforts, Leprosy must be caught early in order to reduce the chance of disability and infection to others.  People diagnosed with Leprosy should be sent to Leprosy NGOs in order to be treated, manage reactions, and start disability prevention programs.   


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