Comprehensive Zero Leprosy Project (Co-ZLP)
Karawang district in West Java, is a diverse mix of both rural and urban areas. Data from the past several years reveals that leprosy case numbers in Karawang has been increasing year on year.
Being a major industrial hub in their urban centres, many people migrate here in search of work. With high cost of living in cities, many people end up living in informal settlements where there is inadequate housing, crowded living conditions, poor sanitation and hygiene. In addition, being new to the area, migrants are often unfamiliar with the health system and where to seek treatment. Many urban dwellers will attend private clinics over public health services. Leprosy knowledge is low in these areas amongst private practitioners, many of whom are unaware of the free treatment for leprosy in the public health service. Additional there is minimal communication and cross referrals between the public and private health sectors.
In the rural villages, stigma and discrimination against leprosy remains high. This leads to fear amongst community members in coming forward for a leprosy diagnosis and treatment. As a result, there are often many hidden cases or cases diagnosed too late to prevent permanent disability.
Recognising the need for differing approaches between the urban and rural areas, the project implements a Leprosy Friendly Village approach in rural areas and an Urban Leprosy approach in urban areas, with the goal of implementing an effective leprosy control program across Karawang District.
More information about the two approaches are explained below:
Leprosy Friendly Villages: In this approach, the project works closely with local health departments, village leaders and influential community members to increase leprosy awareness and dispel fear and misinformation. Support systems within villages will be created to assist newly diagnosed patients and those undergoing treatment. Additionally, the project will work with villages on budget allocations to support the continued running of a leprosy program.
Urban Leprosy approach: Recognising the large private health sector located in urban areas, the project will work with private doctors to increase awareness and skills in leprosy detection, treatment and management. Additionally, this approach encourages establishing of cross sector referrals and reporting on leprosy between the public and private health sectors to increase holistic leprosy service provision.
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