L

BY: CAROLINA QUICANO.

epro
sy
ISOLATION
ISSUE 0 10 APRIL 2013
Old & New
Cures!

TYPES
OF
LEPROSY
EFFECTS OF
Real SOCIAL
Testimony:
How Flor Rodriguez encountered STIGMA
LEPROSY
Hansen Disease &
How it was
Discovered ...
No more
Isolation
 In Dedication of Granny"Flor Rodriguez",
PopPop "Manuel Rodriguez" ,
Grandad"Victor Gaya" & All of those
patients that have suffered throughout the painful
journey of Hansen's Disease in the San Pablo
Village of Peru.

Love You Dearly C.Q.

 2

Table of Contents
pg. 3 What is Leprosy?
pg.4 History of Leprosy
pg.5-6 Symptoms of Leprosy
pg.7-10 Types of Leprosy
pg.11 Cures Before
pg.12 Cures Today
pg:13-14 Epidemiology
pg.15-16 Stigma & Isolation
pg:17-20 Interview: Flor Rodriguez
pg:21 Faces of Leprosy
pg.22 Resources(bibliography)
 3

WHAT IS
LEPROSY?
~Leprosy is a chronic
infectious disease that
decays and eats away
the skin, mainly hands
and feet.
~Primarily affects
the peripheral
nerves, skin, upper
Mycobacterium leprae
respiratory tract,
eyes, and nasal ^ Is a slow-growing, intracellular
pathogen that cannot live outside
mucosa.
the person.
-Multiplies slowly, and symptoms
can take as long as 20 years to
-The transmition of LEPROSY
appear
is still unclear, most likely
spread via the respiratory
system through nasal
droplets, broken skin is also a
possibility. Mycobacterium
leprae survive best at low
temperatures, it primarily
affects the superficial sites of
the skin .
 4

HISTORY OF
LEPROSY
-Leprosy arose since 1550 BC
written in an Egyptian
papyrus document.
-Throughout the years leprosy
has been misunderstoond, it
was thought to be a
hereditary disease, a curse, or
punishment from the gods.
- In the Middle Ages leper
patients had to wear special
clothing and ring bells to warn
others as they walked by.
-In 1921, the U.S. Public
Health Service established
the nation’s first leprosarium,
located in what is now known
as Carville, Louisiana.
-U.S. Public Health Service
established the Gillis W. Long
Hansen’s Disease Center in
Carville, Louisiana, which
Gerhard Armauer Hansen became known as “Carville.” It
^ was the first person to identify the became a center of research
germ that causes leprosy under a and testing to find a cure for
microscope. Hansen's discovery of leprosy and a live-in
Mycobacterium leprae proved that treatment center for leprosy
leprosy was caused by a germ, and was patients.
thus not
hereditary, from a curse,
or from a sin.
 5

Symptoms Once infected with the

mycobacteria, the
average
incubation
period is two to
three years.

Symptoms of leprosy are generally so slight that the

disease is not recognized until a cutaneous eruption is
present.

In 90% of
patients the first
sign of the disease is a
feeling of numbness,
which may precede skin
lesions by a number of
years.
 6

Temperature
is the first sensation
that is lost.

NEXT IS LOSS
OF light touch,
pain and then deep
Patients cannot pressure.
sense
extremes of

hot or cold.

SENSORY LOSS mainly

TOES
&
FINGERTIPS.
 7

TYPES OF
LEPROSY
1.TUBERCULOID:-One large red patch with well-
defined raised borders.
- Lesions become dry and hairless.
-Loss of sensation may occur at site
of some lesions.
-Tender, thickened nerves with loss
of function are common.

2.BORDERLINE -Similar to tuberculoid type except

that lesions are smaller and more
TUBERCULOID: numerous.
-Disease may stay in this stage or
convert back to tuberculoid form, or
progress
 8

3.BORDERLINE -Numerous, red,

BORDERLINE LEPROSY: irregularly
plaques.
shaped

-Moderate sensory loss.

-Disease can stay on this
stage, improve or
worsen .

4.BORDERLINE -Numerous lesions of all kinds,

plaques, macules, papules and
LEPROMATOUS: nodules.
-Punched-out-appearing
lesions that look like inverted
saucers are common.
-Hair growth and sensation are
usually not impaired over the
lesions.
 9

5.LEPROMMATOUS LEPROSY:-Early on, cutaneous

lesions are small,
diffuse and symmetric
(consisting mainly of
pale macules).
-Early symptoms
include nasal
stuffiness, discharge
and bleeding, and
swelling of the legs
and ankles.
-Later, larger and
deeper lesions form
and these contain
many bacilli.

IF LEFT UNTREATED~
-Skin thickens over forehead
(leonine facies), eyebrows
and eyelashes are lost, nose
becomes misshapen or
collapses, ear lobes thicken,
 10

-Eye involvement causing

photophobia (light
sensitivity), glaucoma and
blindness.
-Skin on legs thickens and
forms ulcers when nodules
break down

Testicles shrivel causing sterility

and enlarged breasts (males)

-Internal organ infection causing

enlarged liver and lymph nodes

-Voice becomes hoarse due to

involvement of the larynx.

- Fingers and toes become deformed

due to painless repeated trauma.
 11

C Early 20th
Century: Leprosy patients
U were treated by injecting them
with oil from the chaulmoogra
R nut. It was painful. Wans't always
effective.
E
S

B
1941: Promin, a sulfone drug,
E was introduced as a treatment for
leprosy. It was succesful but the
F injections were too painful.

O
R
E
 12

1950s: Dapsone pills, was a

succesful treatment, but M. leprae
C
became resistant to the drug.
U
R
E
1970s:The first successful
multi-drug treatment (MDT) was
developed.
1981:The World Health
T
Organization began recommending
MDT, a combination of : dapsone,
O
rifampicin, and clofazimine. Takes
from six months to a year or even D
more, depending on strength of lep
rosy infection. A
NOW:MDT with a combination
of dapsone, rifampicin, and
Y
clofazimine is still the best
treatment for preventing nerve
damage, deformity, disability and
further transmission.
 13

EPIDEMI
In 1985, 122
countries
were
identified
in which
Leprosy
was a
Major public
health
concern.

The global prevalence of leprosy has decreased

considerably from an estimated 600,000 cases in
2001 to approximately 190,000 cases at the start of
2012.
 14

OLOGY

The HIGHEST numbers of new cases in 2012 were reported

from INDIA, BRAZIL & INDONESIA. India alone

accounts for 70% of the worldwide prevalence.

 15

STIGMA
&
ISOLATION
WHAT IS STIGMA?
-A mark of DISGRACE associate
d with a particular circumstance,
quality, or person.

WHAT IS ISOLATION?
-The complete separation fr
om others of a person suffering
from contagious or infectious
disease; quarantine.
 16

EFFECTS
* Individuals with leprosy
have emotional stress and
anxiety, which may lead to
psychological and psychiatric
morbidity.

*They become isolated and

lack motivation to continue
treatment (if already started).

*There is a risk that the

disease will progress with
resultant disability and
complications. Individuals
may have decreased status in
the community because of
their conditions.
 17

INTERVIEW:

Flor
Rodriguez
Around 1946 a leper village arouse and located near the
Amazon Rive, the Village was called San Pablo in Iquitos,
Peru.

When Mrs. Rodriguez was in her twenties- at the moment

having 3 children and was married to Manuel Rodriguez- was
diagnosed with leprosy most known as the Hansen's Evil
Disease in her village. She at the time was isolated from her
children and they were taken away by the nuns that came to
helo the leper patients.

She says " As they took my children away from me, it was
very hard to see my children go specially becausethe nuns
though i woudnt be a good mother". To think that an own
mother could be dangerous to be around, their own children
and take them away from their mother is just morally wrong.
 18

Mrs. Rodriguez said that being

isolated and apart from her
family made her feel as if they
were buried alive, sad,
nostalgic, and depressed. When
Mrs.Rodriguez was being
transfered to San Pablo, the
officers would place the leper
patients in raft and it was well
sedured by police man, she
said: " i felt as if i had
committed a crime". "At that
time leprosy was considered
the worst and incurable disease
of humanity".
^ To the left is flor's Husband next is
Flor Rodriguez holding her 4 year old
kid and to the right is the child gor
mother.

Even though they were

isolated, doctors and people in
charge of inspecting the place
went to see them and see if
they needed some type of
help.

< San Pablo Village in Iquitos, Peru. The

first Leper colony in Peru.
 19

Flor Rodriguez said that

at the time the cure for
them was Penicillin , but
only worked if the
disease was not
advanced. She said the
lack of research and
stability of a remedy was
really dissapointing.
Later on
1981 the three step treatment wass introduced: dapsone,rifampicin
and clofazimine.
The village where Flor Rodriguez said that as patients they had no
freedom of going elsewhere then San Pablo. They begun creating a
whole new community with eachother, and treating one another as
family. In a Lonely, desperate place they felt the need to express
themselves in a way that would enlightened their lives. Mst of them
begun writing lyrics-even if they had no hands- they write lyrics as
one. Mrs. Rodriguez sang a song called "SAN PABLO" it explain how the
patients lost youthful years being
in the leper colony , they
exokained as if they were
BURIED ALIVE. Flor says that
San Pablo was a very blessed
village but it was reigned by
anguish and a lot of suffering.
At this point of the interview
Flor could not keep going as
she begun to cry.
 20

"WELCOME TO SAN PABLO"

When you come to visit us,
do it without fear,
Do not look at us with your eyes,
but rather with your heart,
With my mutilated hands,
but with a complete heart,
I can give you a Rose,
a Dahlia or a Carnation Flower
Because in San Pablo, Love Lives!
 21

~FACES
OF
LEPROSY~

“The biggest diease today is not leprosy, but rather the

feeling of being unwanted, uncared for, and deserted by
everybody.”
Mother Teresa
 22

RESOURCES
1."DermNet NZ." Leprosy (Hansen Disease). N.p., n.d. Web. 09 Mar.
2014.

2."The Leprosy Mission World." The Leprosy Mission World. N.p.,

n.d. Web. 01 Apr. 2014.

3."Leprosy Today." WHO. N.p., n.d. Web. 22 Mar. 2014.

4."Leprosy." WHO. N.p., n.d. Web. 28 Feb. 2014.

DON'T Look At My Disability!
LOOK At My Ability!

Never Mind WHAT I AM

Find Out WHO I AM