Concern over India's leprosy rehabilitation

Concern over India's leprosy rehabilitation

Global lead poisoning "Lead poisoning is at one and the same time an international problem and an intensely local one", says a report from two Washi...

210KB Sizes 4 Downloads 217 Views

Global lead

poisoning

"Lead poisoning is at one and the same time an international problem and an intensely local one", says a report from two Washington, DC, research and lobby groups. The report is an analysis of over 700 published and unpublished studies on human blood and environmental lead levels and is intended to prod policy makers worldwide.’1 : The global problem of lead is worsened by the volume and geography of production and consumption. Production has increased steadily from 100000 tonnes annually during the industrial revolution to 5-5 million tonnes today. Although developed nations account for nearly 65% of world consumption, lead consumption in Latin America, Eastern Europe, and Africa is steadily increasing-in the past 20 years African consumption rose 300%. Leaded gasoline and paint continue to be insidious causes of childhood lead poi-

1

World Health Assembly 1991 resolution

Concern over India’s leprosy rehabilitation

leprosy as a public health problem by the year 2000, elimination having been defined as prevalence of lepto eliminate

The parliamentary standing committee on rosy to less than one case per 10 000 pophealth has expressed dissatisfaction over ulation, the level at which leprosy would rehabilitation of leprosy patients and has be expected to die out. Rehabilitation of leprosy patients resuggested more humane measures for its the under ceived NLEP attention only recently, when implementation leprosy control : a scheme was launched for establishment programme. For many years the department of of district rehabilitation centres. There are health has done almost nothing for the 75 rehabilitation promotion units but their work is hampered by stigma against rehabilitation of leprosy patients; this "virtually negates" the objective of the the disease. Community-based rehabilitaNational Leprosy Eradication Programme tion is still a long way off. A Union party (NLEP), the committee said. Critical of minister some time back called for legislathe department’s approach in regarding tion to make "discrimination" against leplong-term cases as being "burnt out" with rosy-affected people a punishable offence, little scope for improvement, the commitas was done with untouchability in 1955. tee said "no case is a burnt out case and The voluntary agency Hind Kusht every patient deserves the best treatment Nivaran Singh has recommended incluand rehabilitation even if he/she can not sion of leprosy-cured people in the definibe cured". The committee recommends tion of "handicapped" to benefit from the adoption of a more humane approach positive discrimination. India’s leprosy to these people by extending hospital stay control programme has the participation soning. Nearly 50 nations, mostly develfor as long as required. India, which has of over 250 non-governmental organisaoping, have allowed lead concentrations in the world’s largest number of leprosy tions, some of which have contributed to some grades of gasoline to remain at prethe evolution and development of NLEP. patients, also runs the largest multiple1970 levels of 0-78 g/L, and most of The drug-therapy (MDT) programme. They can be a major instrument for rehaEurope permits premium gasoline conNational ProControl bilitation programmes in India. Leprosy country’s centrations of 0.15 g/L (USA and Canada gramme launched in 1955 was : redesigPeople with leprosy are not wanted by standard, 0-026 g/L). Japan has banned nated National Leprosy Eradication anybody-neither relatives nor society. It leaded gasoline altogether. : Programme in 1982 with the aim of redis commonplace to find them begging on The record on paint is little better. in the infection community through streets or living in isolated places, and on ucing Despite multinational subscription to a MDT and social and economic rehabilitathe river banks of religious places. The 1921 treaty banning interior use of paints tion of leprosy patients. The success of . parliamentary committee has recomwith more than 2% lead carbonate or lead . NLEP is evident from the decline in the mended the formulation of a scheme to sulphate, old housing stock persists, espeestimated number of leprosy patients from provide them with complete care-food, cially in Europe. Lead chromate remains v 5-5 million in 1985 to 3 million in 1992 clothing, shelter, and medical care. largely unregulated and leaded exterior (although 1-8million leprosy cases were paint is still sold in most nations outside recorded in 1991). India has adopted the Zaka Imam the USA. : Lead poisoning is a local issue when its . change is long overdue, but for the past three years a legal battle has been fought origin derives from regional custom or history. In India, a lead sulphide based eye Hungary’s pharmaceutical industry has over their ownership. Most of these make-up, called surma or kohl, has been always been one of the country’s major wholesale and retail outlets were estabused for 1500 years and is easily ingested economic successes. But its by local councils. However, the law post-socialist lished on state assets that paved the way for by children after rubbing. A similar prodprivatisation is running into difficulties, uct, called tiro, is found in Nigeria, where over the issue of who owns what. : privatisation put them under the authcontamination of water supplies by small ority of the state property agency. The the Privatising big pharmaceutical promines and smelters is another source of ducers has been government would like the pharmacies For fairly straightforward. lead; up to 40% of dietary protein in instance, one company that dates back to to be privatised by the agency, arguing Nigeria is fish. Leadhills (southern Scotthe nineteenth century had managed to that this would provide standard princiland), which was mined in the early preserve, even under socialism, the outples and procedures for privatisation of 1900s, has soil lead levels as high as ward form of a limited liability company other retail units and would improve the 75 000 parts per million (UK standard on the pharmacists currently (although the employee-shareholders, who chances of domestic soil, 500 ppm). Another source in working public-sector pharmacies to each held one symbolic share apiece, had of poisoning has also become apparent: their own businesses. The pharmabuy to surrender them to the company on toxic blood lead concentrations in young cists themselves favour this option and leaving or retirement). Several others are wherever Los Angelenos with retained bullets and possible have taken advantage of undergoing privatisation. The main conbird shot.2 : cern of the government is to make sure preferential state loans to purchase their that small domestic investors can buy premises. The local authorities, however, mainDavid Frankel shares: already 91% of one company’s tain that because they financed the outlets Sanofi of has been taken by equity France, initially, they are still the legal owners. 1 The global dimensions of lead poisoning: an while the European Bank for Reconstrucinitial analysis. Alliance to End Childhood tion and Development has become one of The money received from privatisation Lead Poisoning, Environmental Defense the owners of another. : sales, they insist, should go not via the Fund (202-545-1147, or 202-387-3500). agency to the state budget but into their More difficulties arise at the distribuWashington, DC, 1994. Pp 80. $15. own local coffers. tion level. 300 pharmacies have been pri2 Lead poisoning from retained bullets: health vatised ; a further 1300 plus 20 wholesale threat to inmates? Correctional Health Care companies are still in state hands. This Vera Rich Manage 1994; 2: 27-31.

1

1

1

1

1

Hungarian drug industry

1

787