LEPRAnews

In this issue:Visceral leishmaniasis - the devastatingparasitic killer

Restoring sight at LEPRA’s eye hospital

January 2013www.leprahealthinaction.org

Bangladesh:a country insilent crisis

LEPRAnews January 2013

Dear FriendWelcome to the first LEPRA News edition of 2013. Within this issue you will find details of our continuing work, and news of a deadly disease that is gripping the adjoining parts of India, Bangladesh and Nepal. As always in disease prevalent areas, it is those living in poverty who are hardest struck.

Our job is to overcome the deadly mixture of poverty, disease and prejudice and to implement measures that tackle diseases such as leprosy, TB, LF and visceral leishmaniasis effectively, and ultimately save lives. Amongst many things, LEPRA fights prejudice and ostracism, bridges gaps in health care provision, and opens friendships, community relations and employment opportunites. LEPRA also restores sight.

I hope you find this issue of the newsletter interesting, and that you’ll let us know what you think. We always like to hear from you.

Joanna BelfieldLEPRA News Editor

Message from the Deputy CE 3

Cover Story 4

Spotlight On 6

Programme News 8

Programme News 10

Fundraising News 12

Fundraising News 14

Case Study 16

Bangladesh: a country in silent crisis

Visceral leishmaniasis

Restoring sight at LEPRA’s eye hospital

A ray of hope for Samida Khatoon

2 | healthinaction

In thisissue

Reg Charity no. 213251Charity registered inScotland no. SC039715

LEPRA Health in Action28 MiddleboroughColchester, CO1 1TG01206 216700www.leprahealthinaction.org

EditorJoanna Belfield

Guest EditorBernard Farmer

ContributorsBernard Farmer – Deputy Chief ExecutiveCatherine Cherry – Programmes OfficerJayne Parsons – Business DevelopmentKaren Page – Development OfficerIrene Allen – Asst Editor Leprosy ReviewNicolette Dawson – Communications Madhavi Sakuru – Programmes OfficerAnita Pal – Project VolunteerLizzie Dearling – Events FundraiserRos Kerry – Community Fundraising

PhotographyPeter CatonColin Summers

Design and PrintThe Print Connection, 01473 810230

Adidas Half Marathon3rd March

Paris Marathon 7th April

Virgin London Marathon21st April

Edinburgh Marathon26th May

BUPA London 10k 27th May

Virgin Active London Triathlon27th - 28th July

Ride London 4th August

Great North Run15th September

Berlin Marathon29th September

Dublin Marathon28th October

For more information about these fundraising events, email events@leprahealthinaction.org or telephone 01206 216799. More details are also available at www.leprahealthinaction.org

Dates for your Diary 2013

Haldhar received care and compassion

messagefromtheDEPUTY CE

The more things change, the more they stay the same. This phrase is often used to express a frustration about the pace of change but I want to use it in a positive way to illustrate LEPRA’s core strengths and values.

As my retirement looms ever closer, our editor, Jo, has asked me for some reflections on my 20 happy years with LEPRA. I won’t spend too long looking back as there is so much opportunity and positivity looking forward. I will reflect, however, that despite the massive changes that I have experienced in LEPRA, some things will never change. I can still remember the first patient I met on my initial trip to India: Haldhar Gauda was having his ulcers dressed at the site of a drug delivery point that LEPRA had established to provide multi-drug therapy to leprosy patients. Before LEPRA, Haldhar approached a private clinic where for a one month supply of drugs, he had been charged the equivalent of a year’s

earnings. Luckily, a LEPRA voluntary village health worker heard his story and pointed him in LEPRA’s direction. I met him during this first contact with our team.

What made such a deep impression on me then was the loving care that Haldhar was receiving. There were people around him treating him as a person and not as a receptacle of disease.

Over the last 20 years we have seen changes in the way that we work; we have expanded into new countries, and withdrawn from others. We have added to the portfolio of diseases that we treat. We have written strategies, started and completed major programmes and battled against every difficulty that has been thrown at us.

Through it all, one constant remains. We always have been and always will be a people focused organisation. Haldhar’s story proved that to me two decades ago and this will never change. Thank you for your support, both past and present, which allows us to both change and stay the same.

healthinaction | 3

Plus ça change,plus c’est la même chose by Bernard Farmer

LEPRA operates in four districts in the north west of Bangladesh: Bogra, Sirajgonj, Pabna and Natore. We support TB and leprosy activities in district hospitals and health centres, and run a community livelihoods programme for those affected by leprosy. In 2011, 68,000 people received diagnosis and treatment, and 390,000 others benefitted from health education.

Through LEPRA’s work, gaps in leprosy services are filled and weak government health systems in districts with the highest leprosy burden are strengthened. Our work is crucial in districts without local disability services or referral systems for leprosy cases.

Behind the success, Bangladesh remainsin crisis

There are many reasons why LEPRA chooses to work in Bangladesh. There is a need for improved health services and for a reduction in advanced leprosy and TB cases. At 56,000 sq miles, Bangladesh is just smaller than England and Wales. It has 155 million inhabitants, making it the most densely populated country in the world. As a low income country, 80 per cent of people in Bangladesh live on less than £1.25 per day.

Its geographic setting makes Bangladesh highly prone to natural disasters. Each year, two-thirds of the country suffers from flooding, causing loss of life and damage to infrastructure and crops. Floods also cut large sections of the population off from essential health services, increasing ill health and mortality through a lack of access.

Eighty thousand people die in Bangladesh from TB every year. It is the country’s largest public health problem. Poverty, poor living conditions and a lack of TB awareness contribute to the high number of new infections each year. Geographical barriers and distance between patients and health facilities contribute to the low rate of TB case detection, especially in isolated rural areas.

These are not the only set-backs faced by the people of Bangladesh. The country also experiences a health worker crisis. With just three doctors and three nurses for every 10,000 people, large numbers are missing out on vital access to health services. The World Health Organisation advises a minimum of 23 health workers for every 10,000 of the population; anything less is a crisis. This means that Bangladesh’s patient to health worker ratio is nearly 75 per cent below that deemed acceptable for any country. Low even compared to other parts of south east Asia, where this figure is around 18 medical staff for every 10,000 people.

Playing our part in improving access to health care, LEPRA reaches people in Bangladesh with diagnosis, treatment and health education.

Bangladesh: a country in silent crisis

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COVERstory

Waiting for treatment

COVERstory

healthinaction | 5

Around 90 per cent of new leprosy cases each year are reported by LEPRA and other non-governmental organisations. Collectively, we provide leprosy services across 40 per cent of the country. There is serious under-reporting of new leprosy cases in the rest of Bangladesh where LEPRA does not work, and there is need for more investment. With 12 per cent of new cases showing visible disability on diagnosis, there is clearly a delayed response in seeking treatment and limited expertise among health workers to diagnose leprosy. Five per cent of new cases are children, indicating that leprosy is still spreading.

Limited in-country resources mean that the Bangladesh government relies on organisations like LEPRA to help control diseases such as leprosy and TB. It also looks to LEPRA to undertake reconstructive surgeries: LEPRA’s Country Director Dr Aprue Mong is one of just two surgeons in the country who perform corrective surgery on leprosy patients.

There is limited funding available for leprosy and other neglected tropical diseases, so we are not able to do as much work as we would like. With your help however, we will continue to make a difference in Bangladesh.

Local flooding destroys

homes and crops, and

creates favourable

conditions for disease

A snapshot of Bangladesh

of households lack access to adequate sanitation facilities

of households are deprived of electricity

of children are unable to access their full schooling

of children are malnourished

of pregnant women do not receive appropriate antenatal care

50%

40%

25%

43%

77%

Jahangir holding

leprosy drugs

spotlightON

An estimated 500,000 people in parts of Asia, Africa and South America become infected with VL each year and more than 50,000 people die; a death toll that is surpassed among the parasitic diseases only by malaria. Children and women are the most vulnerable, contributing to two-thirds of cases.

Sixty-seven per cent of global cases are concentrated in a small area of Asia where north east India, Bangladesh and Nepal meet. Fifty per cent of these cases are concentrated in just one highly endemic state in India, Bihar, where LEPRA works.

VL affects the poorest people with the lowest living standards. The sand fly finds its ideal habitat in cracked walls of mud houses or in straw roofs. Poor sanitation and open water storage, along with frequent flooding, contribute to an environment in which sand flies thrive.

The economic impact of VL is huge. It is estimated that the cost of treatment plus a loss of income due to illness can cost around £120; in the poorest communities this can represent three quarters of the average income needed to support a family member in a year, a huge sum for a family to find.

Visceral leishmaniasis- the devastating parasitic killer

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Visceral leishmaniasis (VL) is a deadly parasitic disease. Spread by bites from infected sand flies, the disease infects a person’s internal organs, causing fever, weight loss and anaemia. Enlargement of the liver and spleen result in a characteristic swelling of the stomach and greyish discolouration of the skin, giving the disease its local name ‘kala-azar’ or black fever. Left untreated, VL is almost always fatal.

healthinaction | 7

spotlightON

Early detection of cases, completion of full treatment, and disease control strategies within the community, are all vital for reducing VL death rates. However, the effective implementation of these measures poses many challenges in India and Bangladesh. Knowledge on VL is low - a recent study revealed that only 30 per cent of people in affected districts of Bangladesh identified fever as the leading symptom, and only 21 per cent knew that sand fly bites spread the disease. This may mean that they do not know the importance of protecting themselves from the insects.

Poor provision of government services means that 80 per cent of those surveyed in India use unqualified and unregulated private health practitioners as their first stop for seeking health care, putting them at risk of incorrect diagnosis and delayed treatment.

There is still a need for more effective drug treatments - both old and newer drugs have developed widespread drug-resistance.They are often expensive and ineffective, with some toxic side-effects. High numbers of patients do not complete their treatment mainly because they cannot afford to. Also,the drugs are frequently unavailable to the most remote communities. Public health centres offer free treatment, yet are often located far from the most affected communities. There is no vaccine.

In India, the programme to control sand flies through indoor insecticide spraying has a low geographical coverage and insecticide resistance is growing. In Bangladesh there is no community programme to control sand flies.

LEPRA’s founder, Sir Leonard Rogers, was a pioneer in the field of VL as well as leprosy. He introduced the use of the mineral antimony as one of the earliest treatments for VL in 1915. As we approach our 90th birthday we want to continue the pioneering work of our founder. We would like to work with communities in the most endemic districts to improve prevention and control measures, and we would like to strengthen local health systems to improve diagnosis and treatment for those most at risk.

LEPRA could help communities to implement VL control strategies by destroying breeding grounds of the sand fly, improving water and sanitation facilities, supporting household indoor insecticide spraying and promoting the use of bed nets treated with insecticides. Through community education activities we could raise awareness of the symptoms of VL and treatments available. We have already started this work in a small area of Bihar, however, we need your help to expand it. Given the high number of global cases concentrated in a small area of India and Bangladesh, this work in Asia could make a significant impact on reducing VL rates at a global level.

At LEPRA we’re proud of our long history as pioneers. We are not neglecting our commitment to those affected by leprosy, yet by providing care and services for leprosy along with other prominent local health issues, we can make better use of our skilled staff, take advantage of our close relationships with communities and make our work more cost effective. Your donations can then have an even greater impact on the health of poor and marginalised people.

The female sand fly lays its eggs in the walls of homes

8 | healthinaction

programmeNEWS

Many of us take our sight for granted, yet loss of sight can lead to loss of livelihood. Nearly 12 per cent of people with leprosy have eye problems. Leprosy robs people of sensation and the ability to blink, so eyes can easily become infected, and this in turn can lead to blindness. The blind person then becomes a burden on their family and community. For nearly a decade, LEPRA has been meeting the eye-care needs of the people of Western Odisha, India, thereby preventing such a scenario through its first class eye care programme in Sonepur.

With the support of Sight Savers International and the Government of India, the LEPRA Mahanadi Eye Hospital (LMEH) was established

at Biramaharajpur in 2005. Since then, over 24,000 people have had their sight restored through cataract or glaucoma surgeries. State of the art ophthalmic equipment has ensured that over 88,000 people have benefitted through its outpatient services, including 15,000 who have received glasses to correct refractive errors. LEPRA provides free eye care and surgery to 80 per cent of people who come for treatment, and 20 per cent – those who are able – pay for their operations. This, plus several philanthropic donation schemes, helps to pay for the work, and local and governmental organisations are fully behind it. This excellent local co-operation ensures that the work is not only successful, but sustainable.

Surgery enables people to remain financially self-sufficient, and is an excellent example of LEPRA’s ethos of philanthropic treatment and after-care. But there is more to eye care than surgery, and as part of its programme, LMEH also provides outreach camps in villages. This is an extension to its outpatient services at community level, where to date over 57,000 people have been screened for curable eye problems. This screening is undertaken by LMEH’s mobile team led by an experienced ophthalmologist and an assistant. Those with minor problems are treated at the camp site, and others needing inpatient treatment are referred to LMEH or to other clinics if they are nearer. Community eye screening events also include eye health education programmes. Over 37,000 children have also been screened in school surveys where potential eye problems can be discovered at an early stage, and further complications prevented.

Restoring sight at LEPRA’s eye hospital

Patient consultation

LEPRA provides a wide variety of services

LEPRAteam

healthinaction | 9

Anita Pal, Project VolunteerAnita Pal is a project volunteer at our Buniyad programme. She lives and works in the tribal district of Jhabua, Madhya Pradesh in India. She is a mother of two and an active health promoter. Here, Anita shares her experiences with us.

Can you describe the district in which you live and work?I live and work with an indigenous group called ‘Bhils’. Our community has its own culture, customs and ritual celebrations. The district we live in is far from the main cities and the population in the area is scattered. Many houses are largely made with mud slabs and dung, with roofs made from palm leaves and plastic sheets. There are some village schools, but educational provision and vocational training in the district is poor. Most villages have a traditional health worker, but it is a 5-20 km bumpy rickshaw ride to reach a qualified medical practitioner.

Can you describe the work that you do with these communities?I am an accredited social health activist (ASHA). Some of the main issues I face are leprosy, TB, malaria, malnutrition and HIV/AIDS. After LEPRA’s training on these diseases, I can identify symptoms and know where to refer people. Knowing how HIV and TB are spread, I help conduct health awareness meetings in the villages. There are good government health care initiatives for the detection, referral and treatment of diseases, but it is often difficult to persuade or attract local people to come and engage with them. Even after lengthy intervention programmes, people often remain wary and sometimes revert to local ‘magic remedies’. I have a challenging and ongoing task of persuasion.

How has LEPRA supported you as a volunteer?The training that LEPRA gave us improved my knowledge, developed my speaking skills,

and strengthened my ability to arrange group meetings. The community health workers of LEPRA are always there to guide us. They help us to meet doctors and tell us about the lab results.

What is the most rewarding aspect of being a community health volunteer?Seeing someone fully cured from TB. Seeing someone being counselled and directed to a health centre, and then starting to live a dignified life. Things such as this are the reward and they bring a respect that has changed my attitude. It is great to see those who were once reluctant, now turn up for group meetings. I feel a sense of personal respect when people ask me for advice. Working with the team of other LEPRA staff makes me happy.

What future would you like to see for the people living in the communities you serve?I would like to see an empowered community which no longer needs people like me to tell them where they should go to get a particular health service!

Anita and her colleague provide health training

10 | healthinaction

programmeNEWS

A rayof hopeSamida Khatoon is 40 years old and a mother of four. She lives in the family’s two-room brick and mud house with her husband and their children. Her husband is the sole income provider, working in a bicycle shop for 150 rupees (£1.75) per day.

From left: Makari, Menaka, Putul and Fulo are determined to reduce stigma for others

Samida endured fortnightly fevers for eight years. They disrupted her life with pain and kept her housebound – for many days she was unable to get out of bed. Her first fever started when she was pregnant with her youngest child Haji Subhan, lasting a week. Medicines prescribed at the local primary health care centre helped reduce the fevers, but the underlying cause remained undiagnosed. Two weeks after one fever would pass, another returned, and she was given more medication. This cycle continued for years, the drugs treated her fevers, but did not reduce the swelling in her left leg or the ulcers and wounds on her foot.

For five-and-a-half years, Samida spent up to £7 per month on medication; £5.60 of this paid for the six injections she needed to reduce her fever and pain. The financial burden was a huge strain for this low income family. Samida said that had it not been for the kindness of others, their home would have been in tatters.

‘What was the root of her condition?’ No information was given. A neighbour suggested she was showing all the symptoms of lymphatic filariasis.

Samida and her husband heard from a village neighbour that LEPRA Munger Referral Centre offered free medical services. After her initial

consultation with the doctor, and confirmation of her condition, LEPRA provided immediate medical attention.

What our referral centre provides

Now, with the right treatment, Samida’s fevers and acute attacks have disappeared. Physiotherapy sessions at the Centre, coupled with exercise techniques and massage have significantly reduced her swelling. Specialised footwear made on site is tailored to Samida’s requirements, and provide her with the support and comfort to walk distances that she once could not manage.

Before experiencing the protective nature of our microcellular rubber footwear, Samida described the burning sensation and ongoing soreness she experienced in her left foot. The pain of open ulcers around it was unbearable. Going to the market for food was a pain filled experience. She was reliant on the help of others for simple tasks that most people take for granted. With an expression of joy, Samida boasts that she is now able to walk up to five kilometres at a time. She feels that she is once again able to live a fulfilled and dignified life whilst enjoying her family commitments.

“I now have a ray of hope that I can live a healthy life.”

Samida once felt isolated and alone

To poverty and disease, add prejudice. Physical pain is compounded by the stigma commonly associated with these health conditions. Poverty is exacerbated by loss of community links and the closing of employment opportunities. Families can be torn apart by the loss of loved ones.

Poverty, disease and prejudice are a deadly mixture. Literally so, in far too many cases. All three aspects must be addressed as a package so that diseases such as leprosy and TB are tackled effectively. We can think of this as a three-pronged strategy - a concept that accurately describes LEPRA’s approach. It enables us to work in a holistic way. With this synergy, the sum of LEPRA’s work becomes greater than could ever be achieved through discrete treatment of the various parts.

LEPRA’s approach is illustrated in the diagram on the right, which provides details of interventions and their impacts on communities and individuals. It works because it is fuelled by the generosity of supporters like you. With your help, we are able to deliver programmes with an average cost of £7 per beneficiary per annum. I am sure that you will agree that this is good value for your money.

healthinaction | 11

programmeNEWS

LEPRA’s holisticapproach

LEPRA’s interventions Impact on communities and individuals

Disease n Early diagnosis and treatment of diseases

n Bridging the gap in public health services

n Training government health workers and unskilled rural practitioners

n Decreased illness and mortality

n Quality health care for free

n Saves time and cost of travelling long distances

n Enhanced utilisation of health services

n Savings on medical expenses

Poverty n Socio-economic rehabilitation programmes e.g. micro loans to buy cattle and poultry

n Livelihood training

n Increase in household income

n Improved skills and finances for new livelihood options

Prejudice n Educational and behavioural change campaigns to raise disease awareness

n Advocacy at local and global levels for expanded investments in disease elimination

n Improved community referrals at public health services

n People affected are accepted in their communities

n Repealed discriminatory laws

n Patient charters promote global consideration of health and human rights

The social& economicimpact ofdiseaseStriving to live on £1 a day is a stark reality for many rural households in developing countries. When this level of poverty is combined with disease, the results are severe. For people living with diseases such as leprosy, TB, malaria, lymphatic filariasis or visceral leishmaniasis, it can result in loss of half of their annual earnings. Treatment costs, loss of income, increased indebtedness and a depletion of assets place an intolerable strain on limited resources.

Scraping together an existence

12 | healthinaction

fundraisingNEWS

LEPRA steps into its ninetieth year next January. We are proud to be an organisation with much to look back on, and excited at how much lies ahead.

With its anniversary approaching, LEPRA needs to have a clear, consistent and memorable identity in the UK for the purposes of fundraising with new groups and corporate donors.

We want to stand out from other charities and create a compelling reason for new donors to support LEPRA, so it is imperative that we create opportunities for greater recognition and recollection in how and where we present ourselves. We also know that we need to present LEPRA in a way that is attractive and easy to understand.

Free professional support has made it possible

Charities often rely on the kindness of lawyers, public relations and IT experts to do pro bono work on behalf of their cause. LEPRA has been lucky enough to have enlisted the help of a London-based branding and creative agency called Industry. They have worked long and hard on framing a new and exciting ‘face’ for LEPRA to help us reach new audiences. And what is more they have done it all for free!

Sholto Lindsay-Smith, Partner at Industry said: “When we set up Industry we committed to undertaking a pro bono project with a different charity every year where we think there is an opportunity to apply our branding skills and make a difference. We identified LEPRA and saw an opportunity to shine a light on the amazing work it is doing. The new brand is designed to challenge prejudice

and preconceptions through education about the cause and attract new fundingfor LEPRA’s work”

Using interviews with people involved with LEPRA, Industry mapped out and identified the charity’s unique position: working where others do not, where disease, poverty and prejudice meet. In so doing, they have distilled the essence of LEPRA’s enabling and pioneering spirit into a new logo, colour palette and stronger requests for help from others.

Going forward with a new face, but the same heart

What this means is that when you next see us and our newsletter, we will look different. We remain, of course, the same organisation: a carer, a pioneer, a leprosy expert, with the voices of those we help at our heart.

We do hope that you will like our new look and feel. We have already had some very positive feedback from people at our annual supporters’ meeting which was held in October. With our new identity we are looking forward to stepping into the future with you and corporate donors like Industry, and being able to attract more supporters to carry LEPRA to age 100 and beyond.

A fresh fundraising face for LEPRA at 90 years

Sholto and the team at Industry get creative

healthinaction | 13

Third marathon in a year for fundraiser MaxRetired teacher and grandfather of nine, Max Scott–Cook, has stormed through three marathons in a year. Max completed the Dublin and Paris Marathons in October 2011 and April 2012, and went on to run the prestigious Berlin Marathon on September 30.

He was part of a trio of Celtic runners – along with Hamish from Aberdeen, and Lana from Londonderry, who took on the Berlin Marathon for LEPRA. Together they have raised £4,258.50 and we are very thankful and proud of them all.

When reflecting upon his most recent challenge, Max said: “I remember resting at the Titanic Comfort Hotel Berlin after the event. Running the Berlin Marathon was a titanic challenge but the comfort and reward it has given me is incredible.”

If, like Max, you are interested in incorporating a fundraising challenge with travel and sightseeing, LEPRA has a number of guaranteed places in various events throughout the year, including the Paris, London, Dublin and Berlin Marathons, and the London Triathlon.

Alternatively, if you or someone you know is taking part in another sporting or fundraising event and are looking for a charity to support, please consider LEPRA. We can provide you with the materials you need to get started to help maximise your fundraising.

fundraisingNEWS

New biking event in LondonWe are delighted to be involved in a brand new event, which will be part of the Olympic Legacy organised jointly by the London Marathon and the Tour of Britain. Hot on the heels of the incredible success of Team GB’s cycling superstars, and accompanied by double gold medal winning cyclist Laura Trott, the Mayor of London has confirmed plans for the capital to host a two-day world class festival of cycling. The weekend festival will be known as RideLondon and will feature a series of events for amateur, club and world elite cyclists.

LEPRA has guaranteed places in the 100 mile ride taking place on 4th August 2013. RideLondon hopes to be the UK’s largest cycle event with an estimated 20,000 participants in year one, growing to 35,000 participants in 2018.

Starting at The Queen Elizabeth Olympic Park and finishing in central London, the race organisers aim to make this the largest charity cycle race in the world. Riders will cycle 100 miles and should finish the event in under nine hours. This is the cycling equivalent to the London Marathon.

If you would like to be a part of this exciting new event, we would love to hear from you.

A good time was had by allTwelve bike riders have returned from taking part in our legendary bike ride in Madhya Pradesh in India. The group cycled 500km whilst visiting LEPRA projects, as well as towns and villages and forts and temples along the way. They also enjoyed celebrating the Diwali festival with our colleagues and their families which was a delight and unforgettable.

To date the cycling challenge has raised £23,000 and we are very grateful and proud of them all.

Max shows

off his Berlin

Marathon Medal

14 | healthinaction

fundraisingNEWS obituary

Alexandra Mary EversoleAlexandra Eversole passed away on 1st October having held the role of Chair of the LEPRA Westminster Committee for many years.

Alexandra was deeply committed to the work of LEPRA and was a passionate advocate, involving her wide circle of friends in fundraising. She continued to work tirelessly for the cause throughout her long illness.

Alexandra was particularly proud of the recent effort of her godson Oliver Alcock who, with two good friends, undertook the Three Peaks Challenge for LEPRA in 2011, raising in excess of £3,000.

The Requiem Mass held at the Brompton Oratory on 12th October was a fitting tribute to a remarkable woman and a remarkable contribution. The Oratory was packed to the door with family, friends and many former pupils from the Gatehouse School, Bethnal Green, where Alexandra was Headmistress for many years. All were pleased and proud to acknowledge, with respect, a life lived well for others.

Easter cardsare available on our website. Both designs are £2.25 per pack of five plus P&P. If you would like to receive a leaflet or place an order, please call 01206 216700.

Prestonfield Primary comes through for LEPRAPupils at Prestonfield Primary School in Edinburgh raised the superb sum of £1,356 last summer. Pupil Councillors Marianne and Ellie were pleased to receive a plaque commemorating this achievement on behalf of all the children in the school.

Head Teacher Ms Fiona Murray thanked LEPRA for making such a happy and valuable contribution to the school through strengthening the children’s understanding of global issues. LEPRA’s educational input was greatly appreciated by staff, children and their families. LEPRA would like to thank the school for their superb donation and particularly warm and enthusiastic welcome.

Make LEPRA your businessLEPRA would like to talk to people in the workplace, to have the opportunity to introduce our charity. We want to raise our profile and inform more people about our life-changing work to gain support and interest.

Do you know anyone who would be interested in hearing more about LEPRA?Could you introduce an individual or an organisation to LEPRA’s wonderful work? Whatever you can do with us to raise awareness, raise funds or raise support, we would welcome an introduction.

Companies or organisations may like to hold a fundraising event, nominate LEPRA as their charity of the year, or hear more about LEPRA’s work and projects. Help us make a real difference to those who do not have a voice. Help LEPRA continue to fight disease, poverty and prejudice.

For more information please contact Jayne Parsons, Donor and Business Development, on 01206 216734or email: jaynep@leprahealthinaction.org. Thank you.

Proud pupils Marianne and Ellie

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Forty-eight year old Sahbuddin lives in a dusty village in Madhya Pradesh. He is a quiet and dignified man. We sit in his small yard on plastic chairs to talk. A few scrawny chickens peck the ground around our feet.

Sahbuddin explains that he grows and harvests soya and wheat for the wholesale market. He gestures to his small farmstead where his wheat crop sways in the afternoon sun. He looks well now but spoke about the illness that had plagued him for a year. He is so thankful that it’s over: “I didn’t know what was wrong with me. I was taking treatment, but I wasn’t getting any better.”

By the time Sahbuddin’s brother heard a LEPRA TB talk at a local meeting, Sahbuddin had been coughing for more than six months. Medicines

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The power of a health talk

prescribed by a local doctor were costing him a small fortune yet were doing little to help.

LEPRA’s Outreach Worker, Srikant, was called to the house to see Sahbuddin. “He took my sputum in a small pot and disappeared on his motorcycle.” Srikant took it to the government hospital in the nearest town, several miles away.

Srikant returned with the diagnosis two days later. Sahbuddin said: “I was confused to hear I had TB. I have heard of it but thought it was genetic.” Sahbuddin says he still doesn’t fully understand the disease but knows that when someone has a cough for more than two weeks they need to get tested.

“I am totally fine now,” he says, demonstrating how to cut the wheat in his fields. “I don’t feel tired or unable to walk. I can work, I feel free.” Last year, LEPRA tested and referred more than 90,000 people like Sahbuddin for TB testing. This is made possible through your support.