The under-utilised secret weapon in the fight to defeat leprosy: how we can engage faith communities
Leprosy is a complex disease with distinctive, often deceptive, and slow-moving symptoms. It is a disease that requires ongoing care and a disease that suffers from consistently negative public perceptions.
In an ideal world, we would defeat leprosy through comprehensive engagement within communities. Well-informed community members would spot signs and symptoms early, disability care would be well signposted, peer-support would be available for self-care and inner wellbeing, and there would be no stigma or discrimination.
Needless to say, that kind of community engagement is easier said than done. However, the key to achieving anything close to comprehensive community engagement may already be embedded within the communities we serve.
Around 85 percent of the world’s population is religious and that number will often be much higher in leprosy endemic countries. Within leprosy endemic communities, the role of faith communities and faith leaders is significant. The deepest-held beliefs, behaviours, and attitudes of community members are heavily influenced by their engagement with their faith.
In low-resource settings, where government health teams are overstretched with competing demands and limited time, faith communities have a valuable role to play. If we are to defeat leprosy, they may be our secret weapon.
Across the world, The Leprosy Mission has worked with faith communities on a variety of game-changing interventions.
In Myanmar, where rural health resources are limited, churches have become Disability Resource Centres. The TLM Myanmar team trained church members to provide basic disability services – like ulcer care – and gave them the tools to make referrals for further care.
In Mumbai, one of the churches was prompted to make a difference by a person affected by leprosy who was a member of their own congregation. They started the Karuna project, which reaches out to some of the poorest communities in Mumbai through a mobile clinic that they fund. Members of the congregation have been trained in basic disability care and they join the clinic on its tours of Mumbai.
In DR Congo, Bangladesh, and Sri Lanka, faith communities have been mobilised as case finders. This can mean going door to door within communities alongside a regional government health worker. If a suspected case is found by faith community members, they bring it to the attention of the government health worker who can start the process of providing treatment.
© Ruth Towell
Case finding through faith communities can also mean teaching faith leaders to spot the signs and symptoms of leprosy within their congregations.
James Pender is one of TLM’s experts on engaging with faith communities and he speaks to the readiness of faith leaders to make a difference,
“At heart, most faith leaders you speak to want to serve their communities. Obviously they do this through spiritual and religious care and guidance, but in a small community we know they do a lot more than that. They provide advice and counselling, they influence their communities through their teaching. They want the best for their communities.
“When they hear leprosy is an issue and the people in their communities are being affected, they want to help.”
It is this attitude that also prompts faith leaders to challenge stigma and discrimination. Research from TLM Nigeria shows that faith communities can play both a positive and negative role; if they allow stigma to persist within the world of the local faith group, this can have a devastating impact on persons affected by leprosy. Equally, if church and mosque leaders in Nigeria promoted a positive message, this was seen to transform a community’s attitude towards leprosy.
In Sri Lanka, this happens through inter-faith networks that work together in communities to change attitudes towards leprosy and support persons affected by leprosy.
As James puts it, “If you want to challenge stigma and influence how people treat other people, doing it through looking at a faith angle has much more influence than an NGO or government-based community awareness campaign. You use faith teaching to show how their faith encourages them to love and serve persons affected by leprosy. This approach is much better than telling people this is something they ought to be doing.”
One final contribution faith communities can make is through counselling and care for the inner wellbeing of persons affected by leprosy, something they are often already experienced in. We know all too well that inner wellbeing is a major challenge for many people throughout their experience of leprosy.
By standing alongside persons affected by leprosy from the news of their diagnosis, to facing stigma within the community, and the chronic challenges of long-term disability and ill-health, faith leaders can make a difference.
The answer to this question will vary from context to context. Churches are often structured through denominations, so approaching the regional or national leaders within a particular denomination will give you access to a whole network of churches. Through this, you can access church leaders, teach them about leprosy, and engage their congregations too.
Different approaches will work for other faiths, however. For example, in Chittagong, Bangladesh, there is a training school for imams. TLM Bangladesh attend this school each year to deliver training on leprosy so that the imams can spot the signs and symptoms of leprosy within their communities.
Similarly, there is an imam in Sri Lanka who visits Madrasas (religious schools) across his district to spread awareness of leprosy. This one imam has opened up a huge network of people through this; government or NGO staff are unlikely to be welcomed into the Madrasas to deliver this message, but this imam has no trouble visiting them.
Sri Lanka is a country that has required a careful approach to engaging faith communities. Following years of violence that was linked closely to faith communities, tensions can often run high. At first, TLM started engaging with churches, but there was high distrust of churches and it was challenging to gain traction. At the same time, they found that there was interest in leprosy coming from other faith communities.
TLM’s Christian partners, Alliance Development Trust (ADT), started a partnership with The Inter-Religious Peace Foundation. The evangelical pastors who were mobilising the community across each district of Sri Lanka began working with other faith communities and developing inter-faith networks in each district working against leprosy.
In a country marred by religious violence, where religious buildings have been burnt down, we now have a network of Christians, Muslims, Buddhists, and Hindus who are working together to defeat leprosy in Sri Lanka. The lesson is that some countries require a multi-faith approach.
One of the most significant challenges will always be keeping leprosy on the agenda of faith communities – or getting it on the agenda in the first place. Communities that are leprosy endemic are often communities with a variety of other significant challenges and faith communities can be called to work on any number of the issues their community is facing.
You can see this most dramatically in Myanmar, where the churches had been running their Disability Resource Centres but the civil war has increased the needs of their communities. These churches are now overwhelmed with the needs related to the conflict and have begun providing support for internally displaced people. In times of acute crisis, it may be right for churches to shift their focus to emergency needs.
However, away from extreme contexts like this, TLM teams have found success in keeping leprosy on the agenda through regular meetings, providing resources, and celebrating World Leprosy Day.
To get leprosy on the agenda in the first place, it is important to take the same approach you would with any other major stakeholder, such as governments or major funders. In countries such as DR Congo, the church acts as a kind of para-state, providing services to communities on a massive scale. Our team has had success with engaging them by treating them as the massive player that they are.
With this in mind, show faith leaders and their communities what need there is within their local area and show them how they can meet that need. This context-specific approach is vital.
In Mumbai, the churches are responding to the lack of government health services in many of the surrounding communities. In Myanmar, local church people provide services because government and NGO workers cannot safely access communities that are caught up in the violence of war.
Look at the community, its needs, and the capacity of faith communities. Through this, you can present a path for faith groups to make a difference.
Another challenge with engaging faith communities is ensuring there is not a skills gap. Our projects have invested heavily in equipping congregations to play a role, particularly in case finding and disability care. Alongside this, safeguarding training has been essential, to ensure we are not creating risks.
Western governments and NGOs are starting to reawaken to the role of faith communities within development work. As the West has become secularised, we have quickly forgotten how pervasive faith is throughout the rest of the world.
In communities where faith is ubiquitous, faith communities can be part of the problem or part of the solution. If they are a part of the solution, they could be transformative; their resource base is massive and their networks cover most of the world.
If we want to end leprosy, we have few stronger partners than these faith communities.
3,500 church people sensitised to leprosy
850 suspected cases referred
83 leprosy cases confirmed
2,075 churches, 844 Mosques, 1,096 Hindu temples and 1,890 Buddhist temples were engaged in leprosy-awareness raising activities
65 faith leaders were involved in 33 mobile screening clinics
In 2023, 159 new cases of leprosy were identified, mostly through people coming forward following awareness. This is a huge increase on the 34 cases identified in 2022
