1. Leprosy Hospital - Leprosy Colonies-Background www.dryaminleprosy.blogspot.com

It was reported that Leprosy Control had been introduced since the era of Dutch occupation in Indonesia. There was no specific drugs for treatment at that time. The endeavours were started with collecting the leprosy patients, put them in the temporary settlements for isolation and general treatment. The purpose of isolation was also to protect the transmission of the disease and for the social economic aids. It was a fact that many leprosy patients were found through out the country. The authorithy then established many permanent settlements and leprosaria (leprosy colonies).

After the independence of Indonesia, the government established the institution for leprosy control programme and started with mono DDS for its treatment. Encouraging the management of leprosy patients by upgrading the settlements (leprosy colony), establish special clinics and also erected some leprosy hospitals.

After years many patients has been hospitalized then the government found difficulties to send them back to their homes. It was happened due to the high stigma and leprophobia amongst the community. The hospital became overcrouded due to social problems

The government is aware of the complexity of leprosy problems, which is not only in medical part but include socio-economic problems. The Ministry of Health alone cannot solve these problems. Therefore the government established Intersectoral Board to handle leprosy problems compherehensively in 1979. The government through the Intersectoral Board, instructs that the leprosy problems should be handled comprehensively. The members of this board consist of Ministry of Home Affairs, Social Affairs, Ministry of Health, Ministry of Information, Ministry of Transmigration, Ministry of Education and Culture and Ministry of Religion. The member roles of the Intersectoral Board were formulated and evaluated periodically. In reality, the Intetrsectoral Board was not function well as expected.

Since the introduction of MDT programme in Indonesia many leprosy patients has been cured. The registered prevalence rate has been fallen down from year to year and on July 2000, Indonesia has achieved elimination of leprosy national wide (registered prevalence rate less tahn 1/10,000 pop).  

After decades of the leprosy control programme, it is important to know, how is the situation of leprosy colonies/settlement/leprosy hospital today?  To describe the situation, the inventory of Leprosy colonies /Settlements, Leprosy Hospitals has been conducted in 2003.

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10. Leprosy Control Dr. Andy A. Louhenapessy 1974 – 1985 www.dryaminleprosy.blogspot.com

Dr. Andy A. Louhenapessy 1974 – 1985

The Leprosy Control Office changed its name into Sub-directorate for Leprosy Control under the organisational structure of the Directorate of P4M.
The control method for leprosy became more clear. Treatment with mono DDS therapy continued. In the early treatment period, the effect of DDS was quite good. DDS mono therapy proved excellent in Bali under the guidance of Dr Ichsan and many people were found cured. Its weakness was the danger of people getting bored taking this lifelong medicine. As a result, when the medicine was not taken regularly and at a small dosage, resistance to DDS would occur.

In 1981 the WHO Expert Committee recommended the treatment of leprosy
Using a combination of Rifampicin, Lamprene and DDS (Multidrug Therapy – MDT).
Indonesia adopted the use of this combined medicine in 1982 first on a small scale since not all the HCs had doctors - which was required for supervision when Rifampicin was used. In Indonesia MDT treatment always complied with WHO recommendation. Rifampicin and DDS were given for PB leprosy for 6
months and for MB types a combination of Rifampicin, Lamprene and DDS for two years.
Since the independence of Indonesia, Indonesia actively participated in International Leprosy Congresses such as Havana (1948), Madrid (1953), Roma (1953), Tokyo (1963), London (1938), Bergen (1973), Kuala Lumpur (1982), and New Delhi (1984).The recommendations of the congresses influenced the method of leprosy control in Indonesia.

The main activities for the control of leprosy were now case finding, treatment and case holding, rehabilitation, health education, training of leprosy workers, recording and reporting.
The organization of the control of leprosy by central level, provinces, districts and Health Centers (HCs) now became clearer. Doctors trained in the provinces were called Provincial Leprosy Doctors. Paramedics trained in leprosy and involved inactivities for leprosy control at province level were called Provincial Leprosy Supervisor (Wasor Kusta Propinsi) while at the district level they were called District Leprosy Supervisor (Wasor Kusta Kabupaten). Health workers conducting leprosy control activities at HCs were called Junior Leprosy Worker (Juru Kusta).
Training for leprosy workers was upgraded. With assistance from the Danish Save the Children Organization (DSCO) the National Training Centre for Leprosy was established in Ujung Pandang in 1975.

Indonesia now defined the policy for leprosy control as follows:
·   Leprosy control activities are integrated in the general health services
·   Chemotherapy is provided free of charge
·   Therapy regiments follow the WHO recommendations
·   People affected by leprosy should not be isolated
In 1975 the total reported number of people with leprosy was 99,450, with a Prevalence Rate (PR) of 7.5 per 10,000 population. At the end of the term of Dr. Andy in 1985 the total number of cases was 125,300 with a PR of 8,2 per 10,000 population.

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