Today Search
Medical School Nurse Interviews

In conversation: Philippine Leprosy Mission’s Dr Belen Lardizabal-Dofitas discusses the complexities of leprosy, and the need to boost a patient’s morale

Jemar Nicdao, 27 Jan 2018
Dr. Belen Lardizabal-Dofitas
President of the Board of Trustees
Philippine Leprosy Mission, Inc.
Show Bio
Twenty years ago, the Philippine Department of Health declared that leprosy was no longer a public health problem in the country—having achieved its one case per 10,000 population target. However, on a global scale, the Philippines’ epidemiological situation remains to be one of the highest.

Last July, DOH’s National Leprosy Control Program Manager, Ernesto Villalon III told The Philippine Star in an interview that there is still ‘active transmission’ of leprosy in the country, and that ‘an average of 1,500 leprosy cases’ are still being reported annually, which includes children as young as three years old.

To help us learn more about the current state of leprosy in the Philippines, MIMS spoke with Dr Belen Lardizabal-Dofitas—President of Board of Trustees of the Philippine Leprosy Mission (PLM), and Medical Specialist III at the Philippine General Hospital.

“We still have so much to do much in terms of leprosy control in the Philippines,” lamented Dr Lardizabal-Dofitas. And despite the disease’s overall low prevalence in the country, more cases of the severe form of leprosy (multibacillary) continue to be detected yearly.

“Prevention of new cases is possible through a prophylaxis combining one-dose rifampicin and bacillus Calmette–Guérin BCG vaccination,” Dr Lardizabal-Dofitas notes. “The integration of this preventive measure in the leprosy control program is currently being studied in some endemic countries. Our Department of Health may eventually decide to try integrating the prophylaxis regimen in our country.”

The many aspects of leprosy treatment


According to Dr Lardizabal-Dofitas, there are many aspects that countrywide leprosy programme and healthcare professionals alike may fail to consider in a leprosy patient’s treatment journey.

“We tend to get fixated with finding and treating patients but forget that the socioeconomic and physical rehabilitation, and reintegration of treated patients are just as important. We lack community-based rehabilitation of persons with disabilities and the spiritual support for our patients and their families during and after the treatment period.

“We need to work more on monitoring and caring for complications like lepra reactions, the inflammation of the skin and nerves that can keep on occurring even after the infection has been treated,” adds Dr Lardizabal-Dofitas.

Fallacies about leprosy


Aside from a leprosy patient’s continuous battle with the disease, they also experience social isolation and emotional distress—all because of the many misconceptions about the disease.

For example, many Filipinos still think leprosy is highly contagious: “Around 95% of the population has good resistance against the leprosy bacteria and can clear it when it enters the body.”

Another false belief about leprosy is that it causes certain body parts (fingers, toes, etc.) to fall off, for which Dr Lardizabal-Dofitas explained: “Leprosy invades and damages the nerves that supply our limbs. When the nerve damage is great, the tissues of the fingers and toes cannot grow normally anymore and sort of wither and shrink, much like a tree’s branches when the roots are damaged. The fingers and toes most certainly do not rot and fall off.

Boosting a leprosy patient’s morale


Dr Lardizabal-Dofitas emphasised what family members, the healthcare community, and the community can do to help curb the stigma that leprosy patients may experience.

The patient’s family: “First and most importantly, the patient’s family has to believe that leprosy is curable through effective drugs and that disabilities can be prevented. The simple knowledge that leprosy is curable and treatment is free in government health facilities have reduced the stigma and discrimination against leprosy as well as relieving the family of the economic burden of medication. With this firm belief, family members can provide the moral support to patients especially when there are complications (ex. lepra reactions, disabilities) that take time to heal.”

Healthcare providers: “They should be knowledgeable about leprosy care, this includes psychosocial support.  Those who are competent in leprosy care and who are also compassionate can really boost a patient’s spirits. Patients can tell whether a doctor or nurse is genuinely concerned or not.  The touch of a doctor during physical examination, a reassuring word and smile, careful explanations, plus the proper treatment reduces the mental distress of a patient.  Our leprosy patients deserve to be treated just like any other patient—with respect and dignity.”

The Community: "When the awareness of leprosy’s curability is high, community members also tend to be more understanding and supportive of leprosy patients.  Leprosy is regarded as just one of the infectious diseases that are treatable, rather than a terrible disease. Educating the public about leprosy facts and its curability are essential for the reduction of psychosocial problems due to leprosy."

Finally, Dr Lardizabal-Dofitas reminds Filipinos that a) leprosy is curable, b) treatment services for leprosy is free in government health facilities, c) disabilities and deformities can be prevented, and that d) leprosy patients can still lead a full and productive life. MIMS


About Philippine Leprosy Mission, Inc.
Philippine Leprosy Mission, Inc. (http://www.leprosy.org.ph/) is a 55-year-old non-government organization that aims to find, treat, and rehabilitate persons afflicted with leprosy. They envision a world where the worst problems due to leprosy are eliminated: disability, stigma, and poverty. PLM has been a long-time partner of the Department of Health National Leprosy Control Program.

Read more:
5 of the world’s deadliest diseases in history
Did you know leprosy lingers, even in the present?

References:
http://www.doh.gov.ph/leprosy-control-program
http://www.who.int/lep/epidemiology/en/
http://newsinfo.inquirer.net/472661/ph-urged-to-make-leprosy-history
http://www.who.int/wer/2013/wer8835.pdf?ua=1
https://www.pressreader.com/philippines/the-philippine-star/20170710/281603830501136
http://www.wpro.who.int/philippines/areas/communicable_diseases/leprosy/who_review_nlcp_philippines.pdf
Patients pursuing HCPs – what can the HCPs do?

While HCPs know that a romantic relationship with patients are not allowed, patients may not know about the law or the 'boundaries' of a professional relationship.