TLM Annual Impact Report - 2020
A look at how TLM supported people affected by leprosy throughout 2020 and worked towards our goal of zero leprosy transmission by 2035.
Towards Zero Transmission
How we tackled leprosy transmission in times of Covid
Our target is to stop the transmission of leprosy by 2035. This means there would be no new cases of leprosy after then.
In order to achieve this we need to detect and treat cases early. This involves health workers being able to accurately diagnose cases and starting them on MDT. It also involves tracing the close contacts of these cases and screening them for leprosy.
We know there will have been many people who would have been
diagnosed with leprosy in 2020 but were not. Covid-19 slowed our efforts to visit communities to find new cases, as well as prevented
people from visiting hospitals and clinics.
However, our teams still found opportunities to conduct this crucial work throughout 2020. When countries were not living through periods of lockdown and travel restrictions, our teams visited communities to find new cases of leprosy.
people live in areas that TLM supports
Ensuring patients received treatment
Leprosy is treated with Multi Drug Therapy (MDT). Because of supply issues and Covid-related transport issues, MDT shortages affected countries around the world. This meant people could not receive treatment and potentially remained infectious.
Our teams worked with governments to ensure that the treatment reached communities that needed it most.
Training healthcare workers to spot leprosy
Another key tool in our efforts to find and treat more cases of leprosy is training government and NGO staff so that they are able to spot the key signs and symptoms of leprosy.
Our teams delivered 29,916 days of training in 2020
How we move forward from here
We know there are many people who were not diagnosed in 2020 because Covid-19 restrictions prevented us from reaching them or prevented them from reaching us.
This is not good news, as people with leprosy who are not on treatment can transmit the disease to others. Also, they may develop disabilities that are preventable when leprosy is diagnosed and treated early.
Our plan to stop transmission
We know how to limit the damage that Covid-19 has caused to efforts to interrupt leprosy transmission.
- Active case finding: The data from our projects across the world has demonstrated that actively visiting endemic communities to search for cases of leprosy leads to an increase in diagnosis rates. Our plan is to increase this work substantially, once Covid-19 restrictions will allow.
- Contact tracing: The same is true for contact tracing.
When we diagnose a person with leprosy, we can screen their closest contacts (the people they live with or near) for signs of leprosy. Those found to have leprosy will be given MDT.
For those without signs of leprosy, we now have the option of treating them with post-exposure prophylaxis (PEP), an antibiotic that can prevent leprosy. More of our projects are introducing this option.
- New diagnostic tools: One of the obstacles to detecting leprosy early is the lack of a quick and efficient tool that will diagnose leprosy instantly. Our researchers are currently looking at exciting new diagnostic tools that could allow us to diagnose more cases of leprosy than ever before. One of these tools uses a simple finger-prick test and another works through applying new technology to smartphones.
Fasmina was diagnosed and treated quickly thanks to contact tracing efforts in Sri Lanka.
Providing disability care in 2020
Covid-19 posed serious challenges for our efforts to support people with leprosy-related disabilities. In normal times, much of this work happens face-to-face in TLM hospitals and in communities. When Covid-19 travel restrictions kept people at home, this kind of support was not possible.
Finding ways to provide care
Our teams remained determined to provide care for patients, even throughout the pandemic.
In some countries, such as India, Nigeria, and Myanmar, our teams continued to use mobile clinics that visited patients in their local communities. The services kept clients safe from Covid-19 and from worsening disabilities.
Mobile clinic in Tamil Nadu, India
Mobile clinic in Nigeria
As well as running these mobile clinics, our teams set up phone banks so they could run tele-consultations with people who needed support with leprosy complications or needed to know more about Covid-19. They even provided video conferencing with our medical teams in hospitals, so patients could receive expert advice in the communities.
Some of the disability services we provided in 2020:
While Covid-19 limited our work, our teams still provided direct support to thousands of people.
424 reconstructive surgeries
17,466 people given protective footwear
971 in-patients treated for reaction
628 people given prosthetic devices
Looking to the future
As well as returning our disability services to full capacity after the Covid-19 period, we have two areas where we are looking to improve in the coming years
Prevention and treatment of leprosy reactions
Leprosy reactions are the primary cause of leprosy-related disabilities. Reactions are the body responding to a build up of leprosy bacteria within the body, which causes an inflammation.
Our teams are looking to improve current treatments for reaction and develop ways of preventing these reactions. This is particularly true of Type 2 Reactions, which are the most severe kind.
Mental health support
In recent years we have grown more and more aware of the serious impact that leprosy can have on a person's mental health. We have listened as persons affected by leprosy have told us that they would like more support on this issue.
In response to this call we have been training our front line staff to be able to provide basic levels of counselling and support and we have been improving our referral pathways that connect people to further support, should they need it. Our teams also contributed to the stigma and mental health guides that were published in 2020.
As well as this, we are conducting more research into leprosy and mental health, which we hope will improve mental health support across the world.
Towards Zero Discrimination
Facing up to the livelihoods and Covid-19 crises
One of the ways that persons affected by leprosy often face discrimination is through being denied access to a livelihood. This is often because of stigma.
This problem was made a lot worse by the Covid-19 pandemic, when many people lost their livelihoods, including persons affected by leprosy.
In fact, persons affected by leprosy were particularly badly affected because many of them work in the 'grey economy', which requires you to be able to leave home and engage customers on a day to day basis. We have learnt how important it is to make livelihoods resilient so that persons affected by leprosy can continue to make a living even through crises.
Answering immediate needs
As lockdowns forced people to stay at home, many needed support with accessing essential items. During some of the worst days of the pandemic, our teams provided tens of thousands of households with the emergency provisions they needed to see them through lockdown.
Providing crucial Covid-19 information
As well as being isolated within the employment market, far too many persons affected by leprosy were isolated from crucial health information. Our teams worked hard to rectify this situation.
In India, our team ran the Virus pe Vijay campaign, which raised awareness of Covid-19 amongst marginalised and isolated groups. In Mozambique, our team translated the government's Covid-19 guidance into local languages so that local people could access it.
In Nigeria we heard from one woman who said, “Except for our Officer from TLM, who came to tell us what the disease was all about and how to guard against it, no one told us anything”.
Enabling access to government support
In many countries there was limited state support available to vulnerable people. Our teams connected persons affected by leprosy with governments so that they could receive financial and essential support from the state.
In Myanmar our team facilitated a call between the Myanmar Association of Persons Affected by Leprosy (MAPAL) and a Union Minister, which then led to generous financial support for 15,000 persons affected by leprosy across Myanmar.
Providing for long term futures
As well as providing a direct response to the immediate needs presented by Covid-19, we have continued to provide vocational training throughout the pandemic so that we can equip more persons affected by leprosy with the skills to develop their livelihoods.
This work has even adapted to the Covid-19 situation by moving online in some instances.
1,571 people received vocational training or apprenticeships through TLM in 2020
MAPAL meeting with a Union Minister in Myanmar in October 2020
Lifting the voices of persons affected by leprosy
The UN's CRPD Conference
In 2020 we ensured that the voices of persons affected by leprosy were heard at the highest levels of government.
At the UN's major disability rights conference (the CRPD Conference), we hosted a side event where women affected by leprosy could speak about the challenges that are specific to women affected by leprosy.
At this same conference we also organised a speech that was delivered at a conference Roundtable by U Soe Win of Myanmar, who spoke about the realities of leprosy for older persons.
Submitting reports to the United Nations
In many countries, persons affected by leprosy are denied their rights.
In 2020, we supported persons affected by leprosy in Myanmar, Mozambique, Nepal and Bangladesh to submit reports to various United Nations Human Rights platforms (the Human Rights Council, the CRPD Committee and the CEDAW committee). These reports highlight the issues that persons affected by leprosy face.
Watch our UN's side event on women and leprosy
The future for ending leprosy-related discrimination
We have been growing our connections with the UN over recent years. We have now attended the CRPD Conference four years in a row and we hope to keep that connection growing in the years to come.
We also aim to continue to participate when the UN reviews the human rights situation of the leprosy-affected countries that we work in. We will continue to submit reports to the Human Rights Council and other relevant committees to ensure that the voices of persons affected by leprosy will be heard.
The pandemic has caused a crisis for livelihoods across the world and persons affected by leprosy were hit particularly hard by this.
However, we are confident that we are well-placed to handle this crisis. Through our Vocational Training Centres, our partnerships with local businesses, our education support, and our self-help groups, we have methods for getting persons affected by leprosy into the employment market.
23,902 people took part in 2,080 self-help groups in 2020
Support for TLM
When the pandemic started, all of us were placed into stressful and difficult circumstances. This was true for our supporters, as well.
Because of this, we changed our approach and began a more relational way of engaging with our supporters. We called them, checked that they were okay, and found out if there was anything we could do for them or anything we could pray for.
We were blessed by the many conversations we had with our supporters and we hope they were, as well.
We are very grateful for all they did to continue supporting TLM throughout the pandemic. Although their own personal finances will have taken a hit because of Covid-19, so many of our supporters continued to give to The Leprosy Mission.
Because of their commitment, we far exceeded our expectations for fundraising in 2020; we received more in personal donations than we did in both 2018 and 2019.
Thank you to everyone who gave to TLM in 2020. We hope this report has demonstrated how your support enabled us to provide for some of the world's most vulnerable people throughout the pandemic.
We are thankful to all those TLM staff and volunteers who continued to serve on the front lines throughout the pandemic in 2020