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Chad Bouchard | Dili 30 January 2010
East Timor is one of the few remaining countries where leprosy is endemic, and one of only two in Asia where it has yet to be eliminated. The government has declared war on leprosy, and vows1 to eliminate it this year.
Florindo di Silva started feeling pain in his eyes four years ago. The 60-year-old father of six says he went to a doctor in the East Timor capital, Dili, but no treatment was available. The disease that caused di Silva to lose vision, and his hands and toes to go numb2 - turned out to be leprosy.
He says he can walk a little bit, he can chop wood, but it hurts. Right now, his hands cannot do anything. Di Silva says his eyes and head hurt every day, and he is not strong enough to cut coconuts3 with a knife.
According to the World Health Organization, di Silva is one of about 1,300 new cases of leprosy that have been detected in East Timor since 2004.
Health officials say the number of undocumented people living with disabilities caused by leprosy is likely three times higher.
Some progress has been made. In 2004, the overall ratio of infection was 4.7 per 10,000 people. In 2009, that fell to 1.3 per 10,000.
The decline is due in large part to a program that blanketed the country with hundreds of health ministry4 staff members able to diagnose and manage the disease.
One of those health workers, Jose Pereira, works at a clinic where he monitors di Silva and about 12 other patients with leprosy.
Pereira says if his patients do not come to the clinic to get medicine, he goes to their houses in the villages to give them medicine. But, he says, they often ask for food, and he does not have any to give, and it is very difficult.
Leprosy is relatively5 easy to treat with a cocktail6 of antibacterial drugs known as multidrug therapy. After taking the medicine for one month, patients are no longer contagious7, and damage from the disease stops for good after a few months.
Poverty - a key challenge
But poverty is a key barrier to eliminating the disease. Natalie Smith, the country leader for the Leprosy Mission in East Timor, says the bacteria that causes the disease is endemic here, and flourishes in a population that is largely isolated8, malnourished and living in unsanitary conditions.
"It really thrives where there's poverty, poor sanitation9, poor diet and poor hygiene10 and those sort of contribute to affect the people living in that environment's immune system, so when their immune system is compromised, they're more susceptible11 to catching12 leprosy," said Smith.
In rural East Timor, where about three quarters of the country's 1.1 million residents live, diagnosing patients and ensuring treatment remains13 a challenge. Smith says failing to identify the disease and treat it perpetuates14 a crushing cycle of poverty.
"I think it needs to be a priority because of the disability that it produces. And there's been a lot of studies on the burden of disability now and the fact that if people with disabilities are assisted and helped they can actually add to a country's economic viability15 rather than economic demise16. But the longer we delay in treating someone, the more likely they're going to get nerve damage and that's going to lead to long-term disability," she said.
Leprosy campaign
The government has vowed17 to eliminate the disease this year. The head of East Timor's Leprosy Program at the Ministry of Health, Jose Liu Fernandes, says to do that, the government has begun a radio and television campaign about the disease and how to prevent it.
He says East Timorese do not yet know enough about the disease, so they are surprised when they contract it. Fernandes says they need to teach people that if they start feeling numbness18 in their hands, it could be leprosy.
In many countries, people with leprosy are shunned19 and face a lifetime of isolation20.
But Salvador Amaral, with the World Health Organization, says there is no such stigma21 in East Timor. Salvador says traditionally here, leprosy is not considered to be a disease, but a result of eating certain foods, like fish, or a curse from God.
Back in the outskirts22 of Dili, 22-year-old Joao Godinho Sarmento recounts how he started noticing light patches on his arms six years ago. It turned out to be early signs of leprosy. Doctors caught the disease before it caused serious disability.
Sarmento says his life is pretty normal. He does not have problems at school, and no one considers him to be different or disabled. He hopes other people who have this disease can realize they are not different from anyone else.
Sarmento studies mathematics at the national university, and hopes to become a teacher or an engineer.
1 vows | |
誓言( vow的名词复数 ); 郑重宣布,许愿 | |
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2 numb | |
adj.麻木的,失去感觉的;v.使麻木 | |
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3 coconuts | |
n.椰子( coconut的名词复数 );椰肉,椰果 | |
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4 ministry | |
n.(政府的)部;牧师 | |
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5 relatively | |
adv.比较...地,相对地 | |
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6 cocktail | |
n.鸡尾酒;餐前开胃小吃;混合物 | |
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7 contagious | |
adj.传染性的,有感染力的 | |
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8 isolated | |
adj.与世隔绝的 | |
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9 sanitation | |
n.公共卫生,环境卫生,卫生设备 | |
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10 hygiene | |
n.健康法,卫生学 (a.hygienic) | |
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11 susceptible | |
adj.过敏的,敏感的;易动感情的,易受感动的 | |
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12 catching | |
adj.易传染的,有魅力的,迷人的,接住 | |
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13 remains | |
n.剩余物,残留物;遗体,遗迹 | |
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14 perpetuates | |
n.使永存,使人记住不忘( perpetuate的名词复数 );使永久化,使持久化,使持续 | |
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15 viability | |
n.存活(能力) | |
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16 demise | |
n.死亡;v.让渡,遗赠,转让 | |
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17 vowed | |
起誓,发誓(vow的过去式与过去分词形式) | |
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18 numbness | |
n.无感觉,麻木,惊呆 | |
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19 shunned | |
v.避开,回避,避免( shun的过去式和过去分词 ) | |
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20 isolation | |
n.隔离,孤立,分解,分离 | |
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21 stigma | |
n.耻辱,污名;(花的)柱头 | |
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22 outskirts | |
n.郊外,郊区 | |
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