ETimor leprosy experts train Australian health workers

Updated Thu Nov 13, 2008 10:36am AEDT

The disfiguring disease leprosy may have been almost eradicated worldwide, but it's still endemic in a handful of countries, including East Timor. There very few cases of leprosy in Australia, even though a small number still occur in remote regions each year. Australian doctors see the disease so rarely, diagnosing leprosy is often a struggle, and recently, a team of medical workers from northern Australia visited East Timor, to learn from their colleagues there on how to spot the disease.

Presenter: Stephanie March

Speakers: Public health nurse Lesley Scott; Salvador Amaral, leprosy officer, World Health Organisation East Timor

STEPHANIE MARCH: Brazil, Nepal and East Timor are the only countries yet to eliminate leprosy. The World Health Organisation considers the disease eliminated once case numbers in a country drop to less than one instance per 10,000 people. The average prevalence rate for East Timor is 1.7. Ocuesse is the worst affected district in the country. It was a home to a leper colony during both Portuguese and Indonesian periods of occupation. Salvador Amaral is from the World Health Organisation in East Timor.

SALVADOR AMARAL: The prevalence in Oecusse is 16 of 10,000 population. It is not acceptable in the country.

STEPHANIE MARCH: 650 kilometres south of East Timor in Australia's Northern Territory, between one and four cases of leprosy are diagnosed each year. Those cases predominantly occur in indigenous Australians and immigrants from leprosy-endemic areas. Lesley Scott is a public health nurse with the Territory's Centre for Disease Control. She and seven other health professionals recently spent a week in East Timor.

LESLEY SCOTT: Most of us over the last few years, of course, have seen very few cases of leprosy because there's not so many there anymore and some of the staff had not seen the disease at all.

STEPHANIE MARCH: The eight Australians went to Oecusse, for a series of leprosy screenings. In six remote areas, the Ministry of Health organised a concert and a film about leprosy, to encourage people to come and get tested.

LESLEY SCOTT: That was during the evening and then the next morning they said, "OK, come back and we'll be here to screen your skin, have a look at you and see if we can diagnose any new cases." And people walked a long way to come in and see those people.

STEPHANIE MARCH: The screenings gave the Australians a chance to observe their Timorese colleagues, and learn how to accurately diagnose the disease.

LESLEY SCOTT: What we were really looking for was to be able to diagnose the skin lesions of leprosy and, because it's a disease of skin and nerves, you're mainly looking at skin, trying to differentiate between what might be a lesion that could be leprosy and many other skin diseases that we see in tropical Australia. So, there's many fungal infections, other infections that could look a little bit like leprosy.

STEPHANIE MARCH: Nerve damage caused by leprosy can lead to a loss of sensation in extremities and possible loss of body parts. Early detection and proper treatment can prevent life long disability for a person with the disease. Lesley Scott says the experience in East Timor was extremely useful.

LESLEY SCOTT: Having someone working with you during a survey to tell you that this is something that looks like leprosy or is not something that looks like leprosy is an invaluable experience.

STEPHANIE MARCH: Salvador Amaral says the district health director in Oecusse was very proud his staff could show off their skills.

SALVADOR AMARAL: He was very surprised that Timorese can also share their experience to other countries like Australian people. They were here to learn from us how to diagnose leprosy cases.

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