Visionaries

A busy day at work today, our 'Vision Day' when we had a great group of staff from The Leprosy Mission around the world with us to talk to some of our volunteers and other stakeholders about their work. Loved the fact they were all asking questions and taking notes on aspects of each other's work - while much of the basic medical stuff is the same, there are a variety of differences due to cultural and political factors, geography, never mind how on earth you communicate in a country with nearing 900 languages (Papua New Guinea)! We also talked a bit yesterday about cultural differences, with Dr Jean-Pierre Brechet of TLM Angola admitting that his Swiss wife struggles with his African timekeeping (he is of Swiss extraction, but was born in Angola, is an Angolan citizen and has lived there for most of his life). Also fascinating to hear that Tweedy's name was chosen by his parents after watching a war film with a Scottish character whose surname was Tweed, and they liked the name so much they gave it to their son! Some of our visitors were in Scotland for the first time, others had been several times before, so it was great to see them again.

One of the discussions about leprosy care around the world is that in most countries which have hit the WHO elimination target of less than 1 case per 10,000 population, the government stops actively looking for new cases. Looking for new cases is important for early treatment to avoid permanent disability and to limit the spread of the disease, as starting treatment stops transmission. Counting only the cases which come to the health service's attention when people go to the doctor themselves usually means they haven't come to the doctor until the disease has progressed significantly and a large proportion of these patients present with visible disability. At the most basic level, it means the statistics are wrong, there are more cases than the government knows about. For example a small sample survey in India in 2010 showed that the official figures were probably far below the actual number of cases. Dr Sunday Udo of TLM Nigeria gave us a variety of statistics on the leprosy situation there. TLM works in 8 states out of 37 in Nigeria (well technically 7 states and FCT), with under 20% of the population. The statistic that stayed with me is that 30% of the total leprosy cases detected in Nigeria in 2012 were in TLM supported states, where TLM does go out and look for cases. How many more cases are out there not being treated?

L-R This is Dr Yousif Deng (Country Leader for TLM Sudan/South Sudan), Dr Sunday Udo (National Director TLM Nigeria), Mr Shovakhar Kandel (Country Leader for TLM Nepal), Mrs Wubitu Abere (Country Leader for TLM Ethiopia), Miss Linda Todd (CEO TLM Scotland), Dr Eliane Mbounga (Deputy Country Leader for TLM Angola), Rev Matthew Halder (Country Leader for TLM Bangladesh), Dr Jean-Pierre Brechet (Country Leader TLM Angola) and Mr Tweedy Malagian (Country Leader for TLM Papua New Guinea). Very inspiring time had by all, such a privilege to work with these amazing people.