Strictly speaking, the detection of leprosy does not exist since the way in which the disease is transmitted and acquired is still not very well known, due to its very long incubation period. One way to combat the disease is through the rapid detection of new cases and their timely access to treatment in order to stop contagion to other people and prevent the severe disabilities associated with the disease.
Prevention therefore requires raising public awareness in rural and urban areas – by disseminating knowledge about the disease as widely as possible – as well as training healthcare workers.
Due to damages to their nerves, people affected by leprosy may injure themselves while carrying out their daily activities. They may then suffer aggravated ulcers. This risk can be reduced with appropriate self-care. People affected by leprosy receive training on basic care during their stay at Kien Khleang center or during the field visits of the healthcare staff.
Self-care training involves physical exercises, learning the simple steps to treat a wound, carrying out daily activities such as cooking or gardening in a safe manner.
These trainings include:
a physical evaluation by a physiotherapist;
self-care instructions and practical exercises focusing on the eyes, feet and hands;
practicing the use of tools and utensils necessary in everyday life to avoid getting injured;
distributing adapted footwear and kit (gloves, glasses);
each participant receives an illustrated booklet summarizing all the information provided during the training.
These training activities are carried out by the medical staff at the rehabilitation center of Kien Khleang.
Leprosy becomes an incapacitating disease when neurological damages appear in the eyes, hands or feet. At its initial stage, most often a painless spot on the skin, the disease does not cause any particular problem, which means that people usually dismiss the lesions as banal and delay seeking a consultation. Yet, it is at this stage that antibiotic treatment is most efficient and may avert the onset of complications, hence the importance of raising awareness as widely as possible about the early signs of the disease.
In Cambodia, behaviors and practices relating to leprosy are still faced with many challenges and taboos:
for many people, leprosy is still a hereditary and incurable disease
discrimination and stigmatization are still too frequent
ignorance and weaknesses remain high in the services in charge of fighting leprosy
To overcome these challenges, the following strategy has been implemented:
dissemination of a message explaining clearly that it is possible to treat leprosy and that treatment must be started as soon as possible to avoid any disability
visual campaigns (theater, television, posters) showing leprosy signs on the skin to facilitate early detection
regular information campaigns in garment factories to draw the attention of garment workers to any symptoms of concern.
Awareness campaigns in garment factories
Since 2005, CIOMAL has developed awareness campaigns in garment factories. Twice a year, CIOMAL teams, together with employees of the Ministry of Social Affairs and the National Leprosy Elimination Programme, distribute documents and provide trainings in 12 garment factories, different ones each time. Thereafter, every year, nearly 30,000 garment workers then distribute them in their villages and communes.
In 2016, campaigns were carried out in 12 garment factories, 25,000 flyers and 360 posters were distributed. 384 trade unionists and 20 health workers received information about the disease. These campaigns are conducted prior to the holidays of Khmer New Year in April and the Festival of the Dead in October, when garment workers go back to their families and villages.
To ascertain the impact of these campaigns, our team has interviewed 240 garment workers: over 95% understand that leprosy is contagious, know how to recognize the first signs, know that treatment is free and all know where to go to receive treatment. In the communities, 50 people have also been interviewed: 76% have received documents from their relatives working in the factories, 84% understand that leprosy is contagious, 86% know how to recognize the first signs, 78% have learned that treatment is free, and 100% know where to go to receive treatment.
CIOMAL has partnered with Cambodian independent theater groups defending and promoting Khmer culture. The concept behind these partnerships is to create a theater scenario on the subject of leprosy and hold performances throughout the country, especially in the most remote areas. Performances include traditional Khmer theater, dances and music. A CIOMAL team travels with the theater group to identify new cases and provide them with the right information.
In 2016, 3 performances were organized, featuring popular Cambodian TV slapstick comedians from famous Peakmi troupe. In Phnom Penh, 2,000 people attended the show, in Kompong Speu, 2,500 villagers attended the show, in Kompong Chnang, 3,000 villagers attended the show. The performances were broadcast on the country’s main national TV channel.
Media and social media
CIOMAL carries out public awareness campaigns on the radio, the television and the Internet – an information website is underway. CIOMAL also puts up posters in public places, notably on the back of tuktuks (the most commonly used mode of transportation), so people know how to contact its team if they have any doubts. CIOMAL is actively involved in the organization of events for World Leprosy Day and the International Day of Persons with Disabilities.
In 2016, 164 tuktuks benefited from information boards, 539 houses received sun/rain coverings, and 12 provinces benefited from radio daily transmissions during two months. The provinces that have benefited from the awareness campaigns include Kandal (1,500,000ha), Battambang (991,800ha), Pursat (453,500ha), Bantey Meanchey (822,800ha), Kampot (629,400ha), Kompong Chnang Kompong Thom (688’300ha), Kompong Speu (804’800ha), Svay nothing (504’900ha), Prey Veng (985’000ha), Kompong Som (181,000ha), Siem Reap (892’000ha), Preah Vihear (165’600ha), Koh Kong (166’000ha), Odor Meanchey (142’000ha), Mondolkiri (55’500ha).