Our progress towards zero disability

Photo credit: Sabrina Dangol

TLM's Disability Data Points - 2025

Zero Disability: Good Practice Example

Equipping communities to deliver disability care

We support many patients with disability care at our hospitals and clinics, but leprosy disabilities require the kind of ongoing care that must continue at home.

Our teams cannot be present in every community all of the time, so we are equipping community members to support each other.

Photo credit: Sabrina Dangol

Equipping communities to deliver disability care

Myanmar

The LIGHT project works with 56 churches to support rehabilitation of persons affected by leprosy and persons with disability. This happens through direct treatment support for ulcers and basic physiotherapy exercises, as well as referral to Disability Rehabilitation Centres for advanced complication and access to emergency relief.

The project also links churches with local branches of MAPAL, Myanmar's Organisation of Persons Affected by Leprosy. This collaboration facilitates more relevant and sustainable support for persons affected by leprosy and persons with disability.

DR Congo

The EMPOWER Project works with two self-help groups in Ngombe and Tshisele, led by peer supporters - people affected by skin NTDs. They are supported by a group of community health workers. Together they participate in activities to improve the mental and psychosocial wellbeing of people affected by skin NTDs. They also support leprosy awareness, case finding, and livelihoods through vocational training.

TLM DR Congo reported 433 church partnerships in 2025. These partnerships involve pastors and other faith leaders in leprosy awareness raising and in supporting people affected with counselling and mental health needs.

Sri Lanka

TLM's partners, KKM, work closely with Sri Lanka's Organisation of Persons Affected by Leprosy, LPA. Together they address the holistic wellbeing of persons affected by leprosy, persons with disabilities and their communities.

They have introduced pioneering community-based models that integrate physical health, mental peace, and social connection. They use drama, native drumming and dance, food forums and creation care practices to promote inclusion and address the economic and psychosocial needs of members and communities.

Zero Disability: A Challenge We Face

Up to one third of leprosy patients will experience a leprosy reaction, which is a major cause of disability. With thousands of patients at risk of this, follow up with patients can be a challenge, requiring more time from staff, extra resources, and strong systems. All of this presents a logistical challenge, but disability care is an essential service.

Systems strengthening

TLM India have been working hard to strengthen systems for detecting, reducing and managing leprosy impairments. Many of these also help non-leprosy clients.

Disability Resource Centre – Vadathorasalur Hospital: A dedicated centre was established to provide disability assessment, therapeutic interventions, assistive support, activities-of-daily-living guidance, and pain management services for persons affected by leprosy and others with musculoskeletal and chronic pain conditions.

Mobile Therapy Van: A fully equipped Mobile Therapy Van was deployed to extend rehabilitation and therapy services beyond institutional settings, ensuring continuity of care for communities with limited access.

Building Future Capacity: At TLM Miraj, a new training unit was launched to offer a Diploma in Prosthetics and Orthotics for students affected by leprosy, persons with disabilities, and youth from underprivileged backgrounds. By developing skilled Prosthetic and Orthotic Technicians TLMTI is strengthening long-term national capacity in disability care— particularly for persons affected by leprosy.

Zero Disability Breakthroughs

Perfecting treatments and care for leprosy reaction patients

Getting the guidelines right

There are lots of different types of guidelines for how to care for a patient who is experiencing a leprosy reaction, but many leprosy teams are not using comprehensive guidelines.

Our Task Force on disability has reviewed the guidelines across 12 of our countries and compared them to WHO guidance. Their goal is to ensure all of our teams and government health teams are using the most comprehensive guidelines available so all patients receive the highest quality of care.

Understanding which treatments work best

The treatment of leprosy reactions can include the use of a number of different medications and methods, depending on what is available within the country and the practices and training available within the hospital or clinic.

Some of the treatments can have serious side effects and it is not always clear which treatment is the most effective. Our Task Force on disability is seeking to establish which treatments are the most effective and should receive investment through further research and training.

Hearing from patients

Leprosy reactions can be a long-term, debilitating issue for patients. They can be treated as in-patients for many months - or even years - and as out-patients for their whole lives. Our team want to understand how patients experience the treatment they receive for reactions.

Our hope is that our efforts to improve and perfect treatment for leprosy reactions will be founded not only on science and clinical evidence, but on lived experience and practical realities, as well.