UTO Grant Aids Ethiopian Leprosy Victims
Diocesan Press Service. January 27, 1969 [73-14]
ADDIS ABABA, Ethiopia -- A one-year United Thank Offering grant of $11,500 is helping an American doctor serving here at the Princess Zenebework Hospital to play a key role in combating leprosy in Ethiopia, a country which has the highest incidence of the disease in the world.
Dr. Luther C. Fisher III of Jackson, Miss., is an orthopedist and Episcopalian who has been in Ethiopia since last June on a three-year contract with the All-Africa Leprosy and Rehabilitation Training Center in Addis Ababa under the sponsorship of the American Leprosy Mission.
Serving as a missionary of the Episcopal Church in Africa, he describes the work of ALERT as being one of treatment and training.
More than 3,000 lepers living in the Addis Ababa area are being treated at the center on an out-patient basis. At the same time field workers, leprosy control officers, doctors and nurses are being trained in a method of treatment for leprosy which does not isolate the patient from his family or the community. It is an attempt, Dr. Fisher said, to treat the "whole man" as a useful member of the whole community.
Dr. Fisher said also that although leprosy is a contagious disease, it is not difficult to control its spread under proper management.
The leprosy training center at Addis Ababa is one of the few places in the world where lepers continue to live in their home communities while undergoing treatment. In many areas where leprosy is endemic lepers are legally required to live in settlements apart from families and the community.
As an orthopedist much of Dr. Fisher's work involves surgery to correct deformities of hands and feet so that recovered patients can take care of themselves and lead productive lives, although he minimizes the place of surgery as a major function in the leprosy program.
A primary emphasis, he says, is preventative, seeking to convince lepers that the disease is curable and that they can lead useful lives without crippling if treatment is started early enough. A common result of leprosy in its later stages is deformity and the crippling of hands and feet. Eye injuries also often result because the disease attacks the optic nerves.
Even when corrective surgery has been performed, Dr. Fisher says, it is very difficult to overcome the feelings of despair and hopelessness that years of suffering with the disease have created, and a major thrust of the program seeks to reach children and young people who are the most vulnerable to contagion and to check the disease before deformities develop.
The Princess Zenebework Hospital, center of ALERT's leprosy work, was founded by American missionaries and named for a daughter of Emperor Haile Salassie I. It is the main leprosarium under the control of the Ethiopian government's Ministry of Health.
" It has functioned continuously since the 1930's, " Dr. Fisher said, "but with an intermittent type of service usually under the direction of a nurse, very frequently without a doctor. With three to ten thousand patients to be cared for, leprosy control and advancement in treatment has been impossible because of the tremendous load and the lack of physicians."
"About fifteen years ago the Ministry of Health hired Dr. Ernest Price, who worked in Nigeria and the Congo for a number of years, as leprosy control officer. Two years ago ALERT was forged by several African nations and people. ALERT was started and designed as an organization to teach treatment of leprosy to all types of leprosy workers -- leprosy field workers, leprosy control officers, physicians, surgeons and anybody in the leprosy business. This is roughly the principle of the Leprosy Training Center in India started 30 years ago not far from the Christian Medical College at Vellore, South India, and this is the basic plan the hospital ran on, teaching other leprosy workers.
"ALERT was built to extend this service to Africa. It started with the idea of a small staff associated with ALERT being grafted upon the Princess Zenebework Hospital so that teaching would utilize the facilities of the hospital and the Ministry of Health, utilizing the patients at the hospital for teaching purposes.
"The problems that have arisen are associated with the tremendous number of patients who are in the area. It's impossible to achieve an effective leprosy control when you have so many patients.
"Most of the basis of ALERT and the people who have come there has been to try to control leprosy there first, and in the midst of this hopefully to teach other people how to go about the same problem. In a sense, if we can control leprosy and do anything about it there, then we can show effectively that it can be done anywhere.
"The basic approach in Addis Ababa is treatment of leprosy as any other disease as an out-patient type of illness where the patient is not to be segregated from the remainder of the population. This is the dream, the ideal.
"Problems are overcoming centuries of social problems and misunderstanding about the disease. The idea is to treat the man, and as a part of society. We try to teach the patient that it is not a hopeless disease, and to teach the public it is not a hopeless disease.
"The facts that need to be brought out about leprosy are that it is not highly contagious and that it is definitely treatable and controllable, not only in the population but in each individual patient if proper treatment is given. We can almost guarantee to prevent all of the deformities and disfigurement that goes with leprosy just by persistent treatment. The treatment, of course, is slow, and like every other disease has to start early.
"The patients don't know that there is any treatment, so they go for years knowing they have leprosy, knowing that they insensitivity and paralysis of their hands and feet, but still not seeking treatment because treatment means leprosaria, leprosy means isolation, and it means all sorts of bad things. It means you've resigned yourself; your disease has gotten the best of you; you're no longer able to take care of yourself, and you're no longer able to contribute to your family's support, so you go to exist, more or less, until you die. "
Dr. Fisher said the cost of curing leprosy in its advanced stages is enormously expensive, but on the other hand "the younger people, if we are able to treat them early it would take $20 for a 20-year supply of DDS to completely cure their leprosy and prevent all disabilities."
"This is the big problem of education, to educate the people to the fact that if they come for treatment when they first realize they have something wrong, when they have insensitivity, then all these deformities are totally preventable and, this is basically what the job of ALERT is."
Dr. Fisher attended high school at Sewanee before taking undergraduate studies at Emory University. He received his medical training at Tulane University, and did his residency in orthopedics in Jackson, Miss., where he was a member of St. James Episcopal Church.
He is married, and he and Mrs. Fisher reside with their five children in Addis Ababa.
Home, he says, is "where the garbage is" and where there is work to do.