Indonesia’s anti-leprosy fight paralyzed by COVID-19 challenges

A health worker, right administers COVID-19 vaccine in Surabaya. (AFP)
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  • The prevalence of leprosy among Indonesian children is currently 9.14 percent, well above the government target of 5 percent

JAKARTA: Indonesia’s efforts to ensure an early screening of leprosy cases among children is being hampered by school closures due to the coronavirus disease (COVID-19) and a shift in focus to combating the pandemic.

The prevalence of leprosy among Indonesian children is currently 9.14 percent, well above the government target of 5 percent.

Failure of early detection and treatment in children could result in permanent disability and a lifetime of stigma and discrimination.

Al Qadri, a 49-year-old leprosy survivor from Makassar, South Sulawesi spoke with Arab News on Jan. 31, World Leprosy Day.

“I was expelled from school after I learned I suffered leprosy when I was six. It was a very painful experience. I never had a chance to graduate from elementary school, but when I was 12 I was taught how to read and write from a local school teacher,” said Qadri, who is the deputy chairman of Perhimpunan Mandiri Kusta, a nongovernmental organization advocating for leprosy sufferers.

He added that he did not receive treatment until he was 18.

When the six-month treatment finished, he underwent 13 surgeries to reconstruct his deformed fingers.

Although they could not return to their normal condition, Qadri said he could use his fingers for basic tasks such as typing.

Leprosy is an age-old infectious disease with a slow incubation period that takes an average of five years.

It is transmitted via droplets from the nose and mouth during close contact with untreated cases and is curable with multidrug therapy, but could cause permanent nerve damage to the skin if ignored.

Maxi Rein Rondonuwu, the acting director general of disease prevention at the Health Ministry, said in a press conference on Friday that eight of Indonesia’s 34 provinces still record the disease, with an average prevalence of 1 in every 10,000 people.

“We are focusing on efforts to treat new cases found in children since they could face discrimination and pose a risk to infect other children,” Rondonuwu said.

Siti Nadia Tarmizi, the ministry’s director for communicable disease prevention, said the national prevalence of leprosy cases has continuously declined since 2010, with the other 26 provinces having eliminated it. 

In 2020, the ministry recorded more than 16,000 new cases.

“But the declining figure does not mean that it was getting better since the COVID-19 pandemic has gotten in the way of active case- finding efforts through schools. In provinces where leprosy is not yet eliminated, infections remain very high, resulting in children being infected,” she said.

According to the World Health Organization (WHO), only Brazil and India have a higher prevalence of leprosy. 

The country’s 1 million COVID-19 cases and almost 30,000 deaths are the second-highest in Asia after India.

There are still some 200,000 new cases of leprosy diagnosed worldwide each year, and millions are living with some form of disability as a result of the disease, according to WHO Goodwill Ambassador for Leprosy Elimination Yohei Sasakawa.

“Leprosy cases detected in Indonesia are actually just the tip of an iceberg, especially when the public remains misinformed about the disease and stigmatizes those who suffer,” Qadri said, adding that awareness about early symptoms and treatment could prevent nerve damage and people being ostracized.

“I decided to leave my village in Wajo district when I was 19 after I was cured because of the marginalization. I am now married to a leprosy survivor and our two children, both in their 20s, are healthy, and there is no indication that they suffer from the disease like their parents,” he said.