Stigma attached to leprosy has been a major hindrance in wiping out the disease as many new cases found recently were completely disabled and deformed, meaning that the patients have been hiding the disease for long.

As the country celebrated the World Leprosy Day on Sunday, such entrenched social beliefs where leprosy is thought to be a disease of sinner and those who had committed mistakes in their previous lives have also put into question the programme run by the government and failure to raise public awareness.

Despite advances in medicine and possible cure for the disease, people are reluctant to see health professionals and start medication in many districts in the Tarai including Bara, Parsa, Rautahat, Sarlahi, Mahottari, Dhanusa, Siraha, Sunsari.

Leprosy was believed to have been eliminated globally in the year 2000 with the disease prevalence rate dropping to below 1 per 10,000 population. Though all countries have achieved this rate at the national level, at the sub-national level, it remains an unfinished agenda. Leprosy continues to afflict the vulnerable, causing life-long disabilities in many patients, subjecting them to discrimination, stigma and a life marred with social and economic hardships.

A total of 175,000 leprosy patients are receiving treatment across the world, while 2,500 such patients are undergoing treatment in Nepal. While there has been a gradual decrease in the overall number of leprosy patients in the world, there has not been much progress in Nepal since 2010.

The cases of leprosy have been reported high in Banke and Bardiya districts.

Health workers said that the leprosy cases were found high in Rajhena, Bankatuwa, Naubasta, Samshergunj, Katkuiya and Kalaphala among other bordering areas in Banke.

In recent mobile health camps conducted by the District Public Health Office (DPHO), 106 cases were recorded in Banke district and 120 in Bardiya.

According to the Mid-western Health Directorate, Banke is the most vulnerable district to leprosy infection. Of the 420 cases of leprosy detected in the region last year, 332 were found to be complex, suggests the health directorate’s data.

Padam KC, an official at the directorate, said the number of leprosy patients has been increasing as most of the patients are unaware about the disease. “Usually, leprosy spreads in crowd and densely populated areas,” said KC. 

Khim Bahadur Khadka, chief of the DPHO in Banke, said the cases of leprosy were reported high in Banke and Bardiya due to the open border areas with India. “India is the country having highest number of leprosy patients in the world. So, the people living in bordering areas of Nepal could have been affect. Besides, most of the people suffering from leprosy hide their disease which creates complexity in the future,” said Khadka.

A major risk for hiding the disease that is caused by Mycobacterium leprae is that it could transmit to people who come in frequent contact with those carrying the bacteria. If left untreated for long, it could permanently damage nerves, eyes and limbs of the host body.

“Our approach in finding new cases has been flawed. We have been waiting for patients to come to the health facilities,” said Dr Basu Dev Pandey, director of Leprosy Control Division at the Department of Health Services. “Now we are more focused on reaching out to the patients. And this has been a good start so far.” The World Health Organisation (WHO) has considered Bangladesh, India, Indonesia, Myanmar, Nepal and Sri Lanka as the high-endemic countries, contributing 99.8 percent of new cases from the South-East Asia Region in 2014.

Dr Pandey said they have been running special programmes in the affected districts to track more patients and provide them medical treatment.