Asia-Pacific, Development & Aid, Headlines, Health, Human Rights

HEALTH-SRI LANKA: In Forgotten Isle, Lepers Live with Stigma

Marwaan Macan-Markar

BATTICALOA, Sri Lanka, Jun 7 1999 (IPS) - Herath Punchi Banda’s eyes turn watery when he talks about his family. It has been 39 years since he last saw them — his mother, his wife, his son.

“No one visits me,” he laments outside his small, two-roomed cottage, that has pink walls and grey shutters. He does not expect a change in the offing, being resigned his fate until he dies.

Banda, 62, is one among 34 men and women who have been leading similar lives on the island of Manthivu, which rises out of the lagoon bordering the east-coast town of Batticaloa.

It is an island with thick shrubs and spacious trees, with hibiscus bushes growing wild and with pools of water where egrets, kites and peacocks come to sip.

Neither Banda nor his fellow islanders chose to spend their days as forgotten people on Manthivu. They ended up on it due to an illness they contracted years ago: leprosy.

Banda bears testimony to this. He has lost all his fingers and his feet have no toes.

According to Banda’s neighbour, Krishnapillai Eliyathamby, the number of leprosy patients living in Manthivu was much higher 50 years ago, reaching more than 500. Eliyathamby himself was quarantined in this leper colony in 1943.

At that time, those like Eliyanthamby had no escape from being forced into such a colony. The Lepers Ordinance of 1901 was still a powerful tool, giving health authorities the power to segregate those inflicted with leprosy from the rest of the population.

The ordinance stated that no on could harbour a leper in their homes, and that public health inspectors had the power to “forcibly” take patients to Manthivu. This ordinance was repealed as late as 1990.

Today, however, no new patients are being shuttled off to this island colony. The last to arrive was sent in the late 1970s, and that is due to Sri Lanka’s success rate at combating the spread of leprosy.

According to the last World Health Organisation expert committee report on leprosy, countries that have eliminated leprosy have fewer than one case for every 10,000 people, a target Sri Lanka has already met. This compares favourably with its neighbour, India, where there are between 5 to 15 cases for every 10,000.

“(The year) 1982 was are turning point,” says Dr Sunil Settinayake, the senior medical officer of the country’s anti- leprosy campaign, in his office at Colombo’s Medical Research Centre.

“We started getting new drugs to treat patients with early symptoms of leprosy, and due to our distribution network, and our hospital system, we managed to get it across to all registered patients,” he added.

This explains why Sri Lanka achieved another badge of recognition: the first country in South Asia to have a hundred percent coverage with the new multiple drug therapy.

Today, there are 1,800 known lepers in the country, with children accounting for seven percent of that number. All of them are treated at one of the 70 clinics that dot the country.

The one most visit is a small room hidden away in Colombo’s sprawling national hospital, which sees a patient a day. They are cared for in the same way other patients are when visiting the outpatients’ department at the hospital.

“We are glad it is no more a public health issue,” Settinayake goes on. “Leprosy is treated like a normal disease. No sooner patients are diagnosed with early signs, we recommend a course of drugs for a period ranging from six months to a year,” he added.

Despite such achievements, the stigma associated with leprosy still lingers.

It was precisely to counter such prejudice that Settinayake and a small band of doctors and public health inspectors rallied to launch an awareness campaign in 1990.

After four years, this media campaign succeeded in breaking down some of the fears that prevailed in the public mind about leprosy. Foremost was the notion that this disease had no cure; also the belief that a leper had to be quarantined.

According to Settinayake: “School children and young adults were easy to convince. The older generation was difficult. Some of them still hold on to the old tales.”

Nevertheless, nine years later, those like Banda and Eliyathamby have little to take comfort in. Although they have been cured, the stigma about leprosy continues to keep their families away.

So, too, in the case of a female islander, Dotty, who admits she will not be accepted back into the home she once lived.

It is to ease such loss and loneliness that the nuns from Batticaloa’s Franciscan order take the boat across the lagoon to Manthivu every Friday. “We feel for them and they are happy we come and spend time. They want company,” says Sister Thiru.

“It is a pity, that they have been ignored by their people,” she adds. “If only they come here they will realise that those on the island have been healed. The medicines have worked. You cannot get leprosy mingling with them. Look at us. Look at the staff working here. There has hardly been a case.”

The Franciscan sisters have been coming to Manthivu since the beginning of the leper colony. They care for those forced intothe asylum, bathing, cleaning, feeding and providing company for the lepers until the state took control of the colony in 1962.

In addition to regular visits by the nuns, contact with the world beyond comes to the islanders in the form of radio and television. One of the small cottages has been converted to a common room where residents gather to watch a Tamil film, or listen to the news in Sinhala.

Scenes like this will not be around for long in Sri Lanka: a sad symbol of an era that the country has moved beyond.

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