Timor Leste: leprosy's last frontier?
The Democratic Republic of Timor-Leste (formerly East Timor) lies to the east of the Indonesian archipelago. It became the first new sovereign state of the century in 2002, and is formed from the eastern half of the island of Timor, the nearby islands of Atauro and Jaco, and Oecusse - a lush secluded area cut off from the rest of Timor Leste by the Savu Sea on the north western side of the island, and thought to have been a site for a leprosy colony during early colonial rule. Timor-Leste is placed 162nd. in the Human Development Index (HDI) of the United Nations development programme (UNDP).
Although Timor-Leste has had an active and successful leprosy elimination campaign in place since 2003, with multi-drug therapy (MDT) supplied free of charge by WHO, the disease remains a significant public health problem in some areas, and one such area of high endemicity is Oecusse. Because of the often long incubation period of leprosy, there remains a significant backlog of hidden cases in the community that have still to be diagnosed, because they are not yet showing any clinical signs of the disease. The programme primarily focuses on early case detection (via active case finding) and treatment, and on ensuring all patients have uninterrupted access to MDT.
Multimedia (video & interactive graphics)
Associated Press (AP) have produced a multimedia presentation filmed in the high endemic Oecusse area of Timor-Leste, which highlights the contrast between the fate of those who contracted leprosy before MDT became available, and the younger generation who no longer fear the disease as they know it can now be easily treated within the community.
Also shown in this presentation is an interactive graphic showing the decline in the burden of the disease due to widely available MDT. A further graphic show how the causative agent m.leprae attacks nerve cells, the common ways in which leprosy is thought to be transmitted, how it can be diagnosed and what treatment is now available for curing the disease.