Informing the population - Information, Education and Communication Campaign (IEC)
The report of the survey on the knowledge, attitudes and practices associated with leprosy in Cambodia, financed by CIOMAL and carried out at its initiative, was published in September 2004 by the National Institute of Public Health.
Its findings :
• many people still think that leprosy is an inherited and incurable disease
• discrimination and stigma continue to colour the attitudes of many
• there are still many among the public who do not know where to find services to treat leprosy
Actions taken :
• the message that leprosy is curable (with Multi Drug Therapy - MDT); to avoid handicap, treatment should not be delayed
• to aid early detection: use of visual campaigns (television, posters) showing the marks on the skin that characterise leprosy
• organisation of information campaigns at garment factories to draw the attention of workers to the symptoms
Screening by leprosy supervisors in the health operational districts:
There are 1,000 health centres in Cambodia's 80 operational districts. The supervisors of the health operational districts (ODS) of the Ministry of Health are therefore at the forefront in identifying new cases of leprosy. They need to be properly trained and motivated. Because the outlying health centres can only be reached with difficulty and at expense, the supervisors are regularly assisted by CIOMAL and receive a bonus - necessary to complement their very low official wages.
Self-treatment
Leprosy victims suffering from arch ulcer must care for their feet every day. They have to soak feet and ankles and vigorously scrape the injured areas with soap, then apply a fat balm on the sole of the foot, which nourishes the skin and makes it smoother and more elastic. Because the treatment can be very difficult to follow, especially for those living in poverty - lack of hygiene, difficult access to clean water - CIOMAL's local staff regularly organise group courses of self-treatment.
The CIOMAL Kien Khlang Centre
The Centre has 38 beds and an annual average of 1000 outpatient consultations, including follow up appointments, and 323 inpatient admissions with an average length of stay of 56 days.
In 2006, out-patient consultations totalled 1339, with 260 inpatient admissions. A field programme was also launched to provide for patients suffering nerve damage as a result of leprosy, with information and advice on how to protect themselves from further trauma and disability.
Surgery
Every year surgeons specialised in reconstructive surgery volunteer to operate at the KK Centre. They train the Cambodian medical staff in the Centre in surgical care.
As a follow-up to contacts initiated by CIOMAL, a request was made to the Medical School to send groups of seven medical students for training at the KK Centre. In addition the KK Centre provides specialised training in leprosy to three groups of students in physiotherapy.
Physiotherapy
Each leprosy sufferer will have a different handicap, which is why it is important to set specific objectives for patients receiving individual treatment. This approach requires imagination and creativity from the medical staff.
The attitudes of their communities are often the greatest difficulties leprosy victims face. Many CIOMAL employees are former patients of the KK Centre. They assist the leprosy patients when they leave the Centre for the first time. Their mission is to help restore their self-confidence.
Socio-economic rehabilitation
After cure and surgery, the patients can rely on the help and experience of CIOMAL personnel to initiate the process of their social re-integration and self-support. Many need to attend the occupational training courses CIOMAL offers, or to complete their education.
The social reintegration of leprosy victims has an important psychological aspect. CIOMAL ensures that the former patients will be accepted back into their families and communities. CIOMAL helps the re-establishment of independence by facilitating income-generating activities with micro-loans for small businesses such as animal raising, commercial vegetable gardens, grocery shops or recycling. On average, the micro-loans of 150-300 USD are paid back in two years.
