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#4214: Haiti's lepers bear ancient stigma (fwd)



From: Greg Chamberlain <GregChamberlain@compuserve.com>

     By Jane Sutton

     LEOGANE, Haiti, June 14 (Reuters) - Tropical sunlight streams through
the hibiscus trees, shining on the gnarled black hand that Jugelhomme
Fanfan rests on the arm of his wheelchair, a hand clawed and twisted by an
ancient scourge.
     By the time Fanfan, 47, reached the Cardinal Leger Leper Hospital near
Leogane, some 40 miles (60 km) west of Haiti's capital Port-au-Prince, his
numbed feet were toeless clubs and leprosy had attacked the nerves of his
hands, squeezing them into permanent knots.
     "They wait as long as they can before they come in. When it's too
late, it attacks the nervous system," the hospital's administrator, Sister
Edwina Dube, said.
     Leprosy has plagued mankind for thousands of years. The World Health
Organisation launched an all-out assault in May to wipe it off the planet
by 2005, aiming to track down and cure the estimated 2.8 million remaining
cases with drugs donated by pharmaceutical companies.
     Recognised since the 19th century as a bacterial disease, leprosy can
be cured today, usually in a matter of months, with a trio of antibiotics:
rifampicin, clofazimine and dapsone. If caught in time, it leaves no
permanent disability.
     But the Missionary Sisters of Christ the King, Canadian nuns who run
the Cardinal Leger hospital, must battle ignorance, miserable poverty and
leprosy's awful stigma before they can tackle the bacteria.
     "The stigma of being a leper is a social stigma, more so than AIDS. If
you are a leper you cannot hide it unless it's treated right away," said
Sister Dube, a New Brunswick native.
     The hospital is named for the late Cardinal Paul-Emile Leger, the
Archbishop of Montreal who worked with lepers in Africa. Members of the
Canadian order that runs it worked in Japan's leper colonies after the
Second World War.
     Through the ages, lepers have been shunned and considered cursed or
spiritually unclean. In biblical accounts, leprosy was sent to punish King
Uzziah for his pride and to punish Miriam for badmouthing her brother
Moses' devotion to God.
     In Leogane, neighbours and local officials fought to keep the modest
28-bed hospital from opening in 1986. "They didn't want it because they
(the patients) are the rejects of society. They called it a dump, a human
dump," Sister Dube said.
     Leprosy is also called Hansen's disease after Norwegian Dr. Gerhart
Armauer Hansen who discovered the Mycobacterium leprae bacterium in 1873.
No one really knows how it spreads but scientists at the U.S. Centres for
Disease Control and Prevention (CDC) think "respiratory droplets," such as
from sneezes, are the most likely transmitter.
     Clusters of the disease are rare, even among families, suggesting it
is far less contagious than its fearsome reputation leads people to
believe. The bacteria multiply slowly and the first signs of infection are
usually nodules or dark splotches on the skin. Untreated, leprosy attacks
the peripheral nerves, causing numbness of the hands and feet that is often
mistaken for arthritis or rheumatism.
     "Doctors don't know the disease. They treat them for other things,"
said Sister Therese Lamoureux, an Ontario native and director of Cardinal
Leger hospital.
     In its worst form, leprosy slowly destroys the fingers, toes and nose,
which gradually become absorbed into the body, leaving the sufferer
permanently and horribly disfigured.
     India, Indonesia and Myanmar account for 70 percent of the world's
sufferers. But in Haiti, a mostly rural Caribbean nation with an average
yearly income under $400, many people lack access to medical care and
leprosy often is undiagnosed.
     On the tidy row of white beds in the women's wing of Cardinal Leger
hospital sits a woman in her 30s who recently gave birth to a baby she
cannot hold or cuddle with hands that end in brutal stumps.
     Nearby stands Jocelyn, one of the lucky ones treated in time. The
pretty young student fell into deep depression, crying constantly when
diagnosed with leprosy, then had a bad reaction to the medicine.
     After five months of treatment at the hospital, the only sign of the
disease is dark spots on her tawny face. Sister Dube assures her they are
fading and that she will soon return to school with no tell-tale sign she
had leprosy.
     Jocelyn hopes her "dip into hell" will soon be only a bad memory and
does not plan to tell anyone she had leprosy because "they look afraid"
when she does, she said.
     Fanfan hopes to support his seven children by selling rice in front of
his house once he leaves the hospital.
     "They can lead normal lives if they take their medicine for one year."
Sister Dube said. "Most of the patients return because they stop the
treatment."
     Food for the Poor, a Florida-chartered charity that has provided $95
million worth of aid to Haiti in the last two decades, provides beds,
medical supplies and other equipment for the hospital. It also helps
patients like Fanfan set up small businesses to support themselves after
they leave.
     But Sister Dube suspects people may be reluctant to buy rice from him.
When others with leprosy-ravaged hands try to shop in the marketplace, they
must lay down their money without touching the merchant, who then wraps
paper around the money to avoid touching anything a leper has touched.
     Food for the Poor has built a few dozen small houses in the village of
Titanyen near the hospital for those who are cured but can never go home.
"They have a tendency of being rejected by the family and the
neighbourhood," Food for the Poor's Haiti director Ramonde Pun said.
     For the three dozen people who live there, life would improve if they
could have a well of their own rather than face terrified neighbours who
turn them away from the communal well.
     "They're afraid they're going to contaminate the water," Sister
Lamoureux said.
     "Everybody says it's a mistake to put them together," Sister Dube
said, sighing. If we're together there is solidarity. They've all been
rejected. I find it's pitiful."