Why leprosy has not been eradicated yet

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It is the oldest and ugliest disease in the world, and it has been proven that it could have existed in India in 4000 BC, more than 6000 years ago.

It has been mentioned in ancient texts, such as the sacred Sanskrit work Arthavaveda in 2000 BC.

And a form of leprosy called "tzara" in Hebrew is mentioned in the Book of Leviticus of the Old Testament, written around 500 BC.

Leprosy is a dreaded affliction that mutilates and causes horrible disfigurement and was considered extremely contagious.

The names of those who suffer from the disease – the lepers – are badociated with social marginalized, "impure" and those who must be rejected from society and disowned by their shameful parents.

He is so stigmatized that he was called a "living death", that his victims were offered funeral services to declare them "dead" to society and that their loved ones were allowed to claim their inheritance.

Leprosy is a disease with a long history of misery, as said Gilbert Lewis, a social anthropologist at the University of Cambridge.

In the Middle Ages, the victims were banned from leper colonies, condemned to roam the roads with a sign or a bell to warn people in good health of their approach.

In the modern era, colonies of lepers were set up on islands that became known as the "islands of death" and on which lepers often never returned.

Many people think that leprosy is an old disease, long eradicated from the face of the earth.

Nothing could be further from the truth.

Every two minutes another person is diagnosed with leprosy, says lepra.org.uk, an international charity for leprosy awareness.

"Millions of other people are not diagnosed every year and about four million are permanently disabled by the disease," says this charity sponsored by Queen Elizabeth.

Every day, 600 new lepers, including 50 children, are diagnosed.

But "because of fear and lack of knowledge," more than three million people in the world live with undiagnosed leprosy.

Memories of the world's tiniest colonies of lepers, dating back to the recent past, inspire disgust and the desire to keep leprosy behind closed doors.

WHAT IS LEPERS?

People think that leprosy is a disease of the tropics.

This is not true.

In the second half of the nineteenth century, a large-scale epidemic of leprosy and its epicenter fell on Europe. 3000 cases have been reported in Norway.

In 1873 Dr. Gerhard Armauer Hansen, a doctor, fought leprosy in Bergen, southern Norway, and identified the disease.

Under the microscope, Hansen examined a nasal biopsy sample from a patient and saw the rod-shaped bacilli of Mycobacterium leprae.

The bacterium, which is very similar to its family, Mycobacterium tuberculosis, has waxy cell walls that make them difficult to destroy.

The disease has been renamed Hansen's disease, which, except in humans, occurs naturally only in chimpanzees and mangabey monkeys, as well as in the nine-band armadillos that carry it to the lungs, liver and spleen. .

Nevertheless, many things about leprosy remain mysterious and, despite its terrible antecedents, the infection is difficult to contract.

Most people, even if repeatedly exposed, will never develop the disease.

Leprosy can grow slowly and requires nine months to 20 years to manifest.

It has two forms.

• Tuberculosis, the most common in 80% of the world's cases, produces dry, firm patches with pale, hairless centers that are insensitive to heat, cold, touch, and pain.

Nerve damage occurs in muscles and bones, causing claws and gross deformity of the feet.

Paralysis of the muscles of the face, eyes and neck may also occur and, following anesthetized skin patches, patients may accidentally mutilate their own limbs.

Large eroded ulcers may form, resulting in loss of fingers and toes; sometimes, the member's condition is so bad that it takes amputation

• Less common leprosy occurs as skin lesions on the body, with thickening of the skin of the face and "decomposition" of bones, fingers and toes.

It causes a skin ripple and a "lion's face".

Soft nodules appear on the ears, nose and cheeks and sometimes erode into painful plaques. The nose is often teeming with bacilli, which sometimes leads to the destruction of the septum of the nose and palate.

HISTORY OF LEPERS

Leprosy comes from the ancient Greek word "lepra", which means flaked.

A 4,000-year-old skeleton discovered in India in 2009 exhibited erosion patterns similar to those found in medieval leprosy skeletons in Europe.

A disease that corresponds to the description of leprosy appears in Sushruta-samhita, an Indian medical work done in India dating back to about 600 BC.

A 400-year-old Chinese medical text BC describes a similar illness and 300-year-old Greek texts BC describe a similar illness.

The armies of Alexander the Great would have contracted the disease when they invaded India in the 4th century BC and brought it back to the Middle East and the Mediterranean.

The "leprosy" mentioned in the Bible, the "tzara" of Leviticus and the "lepra" of the Greek New Testament, can represent a number of serious chronic diseases of the skin.

But according to Leviticus, anyone declared unclean because of tzara'at should be put outside the Israelite camp, marked and exiled as a polluter.

This person must wear torn clothes, leave his hair badly coiffed, cover the bottom of his face and shout: "Impure! Unclean! ".

The rabbinical tradition has attributed the cause of leprosy to various transgressions, ranging from murder to slander and arrogance to cohabitation with a woman who has her period.

Roman soldiers of the Pompey army reportedly took leprosy from Egypt to Italy in the 1st century BC. BC, and the Roman legionaries attacked it in the British Isles.

In many traditional cultures, lepers were confined to a remote location on the outskirts of the colony to prevent the spread of the disease.

In 1200 AD, an estimated 19,000 leprosy hospitals spread throughout Europe.

Colonies of lepers, also called leprosaria and Lazaret, were created to accommodate the sick.

Outside these hospices, they were feared and ostracized.

Stigma persists in countries like India, for example, where the parliament only pbaded in February a bill to eliminate leprosy as a ground for divorce.

In various Indian states, lepers are not allowed to participate in elections.

India said in 2004 that leprosy had been eliminated as a public health problem, but in 2017, 135,485 new cases were detected.

LOWER COLONIES OF LEPROS

One of the most famous settlements was in Kalaupapa, on the island of Molokai, Hawaii, where the Belgian priest, Father Damien, treated leprosy patients who had been forcibly resettled by law.

Another home of the famous leper was at Carville on the Mississippi River near New Orleans in southern Louisiana.

One hundred years ago, American law required all citizens with leprosy to quarantine them,

Thousands of people with leprosy have lived their lives in this national leprosarium.

In its early days, Carville was more of a prison than a hospital.

Horrified by the stigma of leprosy, families often leave their infected parents in this place and never come back.

The island of Culion in the Philippines with 500 lepers, a doctor, four nuns and a priest called "the island of sadness".

Lepers cultivated their own food, formed their own leprosy police and lived in poverty with a shortage of supplies or medicines.

Australia had several colonies of lepers, notably the Peel Island Lazar, in Moreton Bay between Brisbane and Stradbroke Island.

Primitive and remote, its establishment allowed the health authorities to arbitrarily dismiss without warning those suspected even vaguely to have leprosy.

It was previously used as a quarantine station and haven for vagrants and drunks, before becoming a leper colony between 1907 and 1959.

The 1892 leprosy law in Queensland legislated to isolate leprosy patients from the mainland.

Transported to the Island of Peel, mothers, fathers and children have not seen their families for years, if ever before.

Like Carville, Peel Island looked like a jail, with dirt floors, bark huts and stranded or chained patients.

Three compounds separated patients by bad and ethnicity.

People of white European descent have been separated from those of Aboriginal descent, Torres Strait Island, South Sea Island or China.

An escape was unlikely by the 2.5m fences or the 5km of shark infested water to the mainland.

Other Australian leper colonies were on Channel Island near Darwin and on Fantome in the Palm Island group in northern Queensland.

Treat leprosy

Although dreaded throughout history, leprosy is not a very contagious disease, it is curable.

The transmission of infection requires prolonged and close contact.

The bacterium seems to spread from the skin and nasal mucosa of people with leprosy, but the exact entry point is not known.

In the 1940s, doctors successfully treated leprosy with an antibiotic called dapsone, but the microbacteria developed resistance to it.

A multi-drug regimen has been developed, combining dapsone with rifampicin, an antibiotic used to treat tuberculosis and legionnaire's disease, and clofazimine, which would act by interfering with DNA.

But there is no vaccine and killing the bacillus has no effect on body tissues already damaged or destroyed.

The World Health Assembly, which leads WHO, adopted a resolution in 1991 to eliminate the disease by the year 2000.

This has not been successful, although the prevalence of leprosy has decreased by 90% since the early 1990s.

The disease has disappeared from most temperate countries, but is still present in Brazil, parts of Africa and South Asia.

But more than seven million people are currently affected by leprosy worldwide.

To donate money to reduce the number of leprosy cases, contact lepra.org.uk.