Best wishes to all of you

Project:Project: Empowering poor & Empowering poor & marginalized people marginalized people

affected by affected by disability disability

to improve their economic statusto improve their economic status

Schedule for Orientation on Disability

TimeSubject Facilitator Comments

10 – 10:15 am

Welcome Speech & Objectives of orientation UH&FPO

10:15 am – 11:00 am

PretestDisability (Definition, Key facts, Causes of disability, Type of disability, local burden if known, challenges faced by people with disability, services offered by Lepra Bangladesh)

UH&FPO/MODC/ disability experts

Collect data from UH&FPO, CS office or Social Welfare department

11:00 am – 11:45 am

Leprosy (Definition, Cardinal sign, diagnosis, treatment, complications and management)

MODC/TLCS/PO/HSWS

Patient demonstration

11:45 am – 12:30 pm

Physiotherapy services offered by Lepra Bangladesh HSWS/PT Demonstration of Physiotherapy materials

12:30 pm – 1:00 pm

Community Development/Rehabilitation/ Self-Help Group formation, rights of people with disability

HSWS/RO Show recent laws, policy on disability (collect hard copy)

1:00 pm - 1:30 pm

Responsibilities of health personnel Post Test & Closing remarks

UH&FPO

Participants:Participants:

Government Health Personnel

Time: 3 hours

Methodology

• Interactive discussion

• Use PB & MB blister pack

• Use other materials such as cotton or feather to test sensory function.

• Question and answers session• Display Assistive Devices• Materials/Atlas• Use Bangla Training Manual (English version is also

available)• Multi-media (depends on availability)

After Orientation: • Government health personnel will be

able to refer person with disability for special services (such as physiotherapy) available in their local community.

• Government health personnel will be able to refer more leprosy suspects in early stage to Upazila Health Complex or district hospital.

• Government health personnel will take initiatives specially on disability due to leprosy.

• Government health staff will be able to support people with disability for their rights and economic development.

Definition of disability?• The International Classification of

Functioning, Disability and Health (ICF) defines disability as an umbrella term for impairments, activity limitations and participation restrictions (WHO, 2014).

Key facts• About 15% of world population has some

forms of disability• Between 11 – 19 crore adults have significant

difficulties in functioning in the world• According to world Bank, people with disability

are about 15 – 20 % of the poor in developing countries.

• Rates of disability are increasing due to population ageing and increase chronic health condition such as osteoarthritis, stroke, mental illness etc.

• People with disability have less access to health care service and therefore experience unmet health care needs.

•

Causes of disability• Genetic (Biochemical disorder,

chromosomal abnormalities) • Pre- natal (Severe anemia, Rh factor,

Rubella infection during pregnancy etc.)• Peri – natal (Birth Injuries, Asphyxia,

Pre-maturity)• Post – Natal (Malnutrition, Accidental

physical trauma to the brain, disease & infection)

• Environmental

Type of disability

• Loco motor disability (Physical disability due to polio, amputation of limb, club foot, cleft lip or cleft palate etc.).

• Vision impairment and or blindness

• Hearing and speech Impairment• Intellectual disability• Mixed/Multiple

Challenges faced by people with disability

• Ignored by society, isolation, segregation, poverty

• Limited accessibility (in Bus, building, other public places)

• Deprived of education and employment

• Stigma• Lack of rights

Services offered by Lepra Bangladesh

• Supply protective footwear for disability prevention

• Comprehensive disability and physiotherapy services through referral centers

• Technical support• Formation of Self Help group by People With

Disability (PWD)• Support for economic development (open

Bank account, support for small business etc)

• Self care training• Different activity (Awareness, advocacy etc.)

to establish Rights for People With Disability (PWD)

• Counseling support

What is Leprosy?

• Leprosy is a chronic least infectious disease caused by Mycobacterium Leprae affecting primarily the peripheral nerves and secondarily skin, nasal mucosa and other tissues of the body.

Cardinal Sign of Leprosy• Definite loss of sensation

in a hypo-pigmented patch or reddish skin patch

• A thickened or enlarged peripheral nerve with loss of sensation and/or weakness of muscle supplied by that nerve.

• Presence of Mycobacterium Leprosy in a slit skin smear

Diagnosis/Leprosy Classification

• PB (Pauci Bacillary) – 5 or less skin patches

• MB (Multi-bacillary) – 6 or more skin patches or skin smear positive

Leprosy Treatment by MDT (Multi-Drug Therapy)

• PB patient need PB MDT (Rifampicin &Dapsone) for 6 months

• MB patient need MB MDT (three drugs: Rifampicin, Dapsone and Clofazimine) for 12 months

Leprosy related Complications

Lepra Reactions

• Type 1, Inflammation of skin patches & Nerves (Neuritis),

• Type 2: Erythema Nodosum Leprosum (ENL).

Secondary complications

• Ulcers • Claw hand, foot drop, legopthalmos• Stigma• Discrimination

Management/Intervention

• Continue Treatment with MDT• Prednisolone for reaction• For Ulcer - Rest, soaking, scraping, oiling

(SOS), clean & apply bandage• For Claw hand, Foot drop & legopthalmos –

Physiotherapy and Surgical correction• Supply footwear and other assistive devices

according to the need.• Stigma/ discrimination – counseling,

advocacy, formation of community group, Create awareness about the rights of people with disability etc.

Responsibilities of health personnel

• For Leprosy: It depends on the position and nature of work. For more details use “National Guidelines and Technical Manual on Leprosy” (Annexure 2)

For Disability • Refer person with disability in “Disability

Referral Center”• Inform community people about availability

of physiotherapy services• Refer person with disability for surgical

intervention• Take action against discrimination• Create a positive environment in the local

community on disability issues.

We are really grateful