Hansen’s Disease (leprosy) victims can be cured and spared suffering.

Leprosy, or Hansen’s Disease, can be cured by modern medicine. Unfortunately, many victims in Laos don’t know that a cure is possible or can’t afford to make the journey to a clinic that offers treatment. And sometimes, people don’t seek treatment because they fear being stigmatized as a leprosy victim.

Odoumsouk Village - Nakai District, Lao Peoples Democratic Republic

I’ve made it a habit to stop and talk with amputees. I find that about half the time the cause of the amputation was an accident with a bombie, landmine, or other old ordnance.  I learn from the tales that bomb victims have to tell and often use their stories to enrich and enliven the UXO safety messages that I share with villagers.

Among the amputees I meet who have lost a limb to something other than a bomb, by far, motorbike accidents are the most common cause.  I also hear woeful stories of snakebite, diabetes, and cancer.  But what I find tragic is the frequency with which I encounter Lao people who have lost noses, fingers, toes, hands, feet or entire limbs to leprosy, or Hansen’s disease.  Tragic because, unlike other events that result in amputation, leprosy is a disease that can be curbed and cured long before a victim arrives at a physical condition requiring amputation of a limb.

Leprosy is a fearful disease, frequently cited as a scourge in the Bible and other ancient texts.  Simply uttering the word leprosy conjures images of putrid flesh and horrible disfigurement, hence the effort by aid workers and health professionals to substitute the stigmatizing words “leprosy” and “leper” with the emotionally neutral terms “Hanson’s Disease” and “”Hansen’s patient.”

Considering the fact that for thousands of years victims of leprosy have been shunned and often forcibly evicted from their communities, it surprised me to learn that it is not a rampantly contagious disease.  To put it in perspective with blunt terms: it’s a lot easier to catch tuberculosis than it is to catch leprosy, even if you are working and living among victims.

At any given time, there are several hundred active cases of leprosy in Laos.  There are still “leprosy villages” in which patients and members of their extended families live more or less isolated from others.  Recognizing the stigma of the term “leprosy clinic”, the medical center in Laos that bears chief responsibility for treating patients is euphemistically named the “Skin Hospital”.

The first observable presentation of leprosy is a discoloration of small patches of skin.  Because the disease results in nerve damage within affected tissue, these discolored areas soon loose all sensitivity.  Once the tissue is insensitive to pain, the victim may suffer cuts, burns and subsequent infection without experiencing any telltale pain.  Ultimately, victims suffer so much damage to affected digits and limbs that amputation is required.

One of the aid groups that works in Laos to bring education to the general public, as well as medical treatment to leprosy patients, has produced a simple comic book that tells the story of a common villager who contracted the disease.  I will share that fictionalized story with readers because it closely parallels the lives of actual victims that I have met.

My thanks to Tulong Yang for translating this story from written Lao.  Tulong is a student at DC Everest Senior High Schofield, Wisconsin, USA

The story begins in Som Sook Village with the impending marriage of Mr. Nai and his bride Miss Nat.  Everyone is happy and the future is bright for the young couple.  At the wedding celebration we meet Noon, the groom’s best friend.

Unfortunately, Noon is not able to fully enjoy the festivities.  He’s been feeling poorly of late.  His legs and arms are sore, and he’s constantly fatigued.  He thinks to himself, “What’s wrong with me, that I feel tired all the time?”

Many days and weeks pass:

The newly weds, Nai and Nat, are enjoying their new roles as husband and wife.  Nat is already pregnant with the couple’s first child and they are optimistic about the future.  Nai is working as hard as he can and keeps himself motivated by telling himself that he’s no longer just working on his own behalf.  As a father to be, he’s got greater responsibility to be a good provider.

One day, Nai’s good friend Noon stops by the garden to visit.  As usual, he’s willing to pitch in and help with heavy tasks.  Unfortunately, in the months since the wedding he’s grown weaker and tires more easily.  He’s even lost his taste for food.  He offers to carry a heavy rice bag home for the couple and startles himself by how quickly he tires.

Noon thinks, “I’m supposed to get married myself in just a few months.  How will I be a good husband and father if I can’t work any harder than this?”

Arriving at Nai’s house, Noon unburdens himself and confides to his friend how poorly he has been feeling.  He removes his shirt and reveals to Nai several discolored patches of skin.

Nai is entirely reassuring to Noon.  So much so that he dissuades Noon from going to a doctor for a diagnosis.  He convinces Noon that he is only suffering from a mild skin disease that can be easily and cheaply cured with local medicine.

The next day, Noon goes to a local shop and buys some over-the-counter medicine.  The shop owner advises him to take all of the medicine and, if his symptoms persist, to come back and buy more.

Over the next few weeks, Noon does as the shopkeeper directed.  He spends his money on ineffective home remedies and meanwhile, his condition only grows worse.

At last, when Noon looses faith in the local medicine, he goes to the doctor.  The doctor suspects leprosy and does a simple test in which he rubs Noon’s discolored patches of skin with a cotton ball.  Noon can’t feel a thing on those patches, confirming the doctor’s intuition.  Noon has leprosy.

The doctor gives Noon some medicine and assures him that very soon he will no longer be contagious to those around him.  He also starts him on a regimen of drugs that will cure the disease.  The doctor tells Noon that the medicine won’t reverse the damage that has already been done, but it will prevent further progression of the symptoms.  He congratulates Noon for seeking proper help.

Noon can’t decide whether to tell his friends about his illness, or not.  He is afraid they will shun him and, perhaps, drive him from the village.

One day Noon is close to sharing his secret with Nai and Nat.  As he is about to confide in them, Nai tells him an unsettling story.

Nai tells Noon that earlier that day, while he was hunting, he came upon a community of outcasts living a sad life in the forest.  They were people with leprosy who had been driven from their villages.  Nai tells Noon that he agrees with the treatment meted out toward these people.

Nai says he doesn’t think victims of leprosy should be permitted to live among healthy villagers.  Nai goes so far as to throw away some food that he happened to be carrying during the encounter, telling his wife that he can’t conceive of eating food that has been in the vicinity of people with leprosy.

Obviously, Noon changes his mind about sharing the fact that he has leprosy.

Now the story takes an ironic twist:

Nai and his wife Nat both begin to show signs of the illness.  Noon tries to persuade them to go to the doctor but Nai is insistent on just using inexpensive local medicine.  Realizing that he must share his secret in order to save his friends, Noon announces that he has leprosy but is receiving proper treatment that will cure the disease.

Nai and Nat both go to the doctor, both are diagnosed with leprosy, and both begin treatment.

Months later, the final scene is Noon’s wedding.  Everyone is happy and Nai and Nat are especially grateful to Noon for sharing his secret and convincing them to get proper treatment.  They look at their baby daughter and express thanks that they are no longer contagious and in danger of infecting her.

The End