Book reviews
Leprosy, A Glimpse at the Changing Scenario. Ganapati, R. Mumbai: Acworth Leprosy Hospital Society for Research, Rehabilitation and Education in Leprosy and Bombay Leprosy Project. 68 pp., paper cover, English.
This booklet is a transcription of six guest lectures to six different organizations by Dr. R. Ganapati, Director, Bombay Leprosy Project and Vice-President of the Acworth Leprosy Hospital Society for Research, Rehabilitation and Education in Leprosy (ALH RRE). It has been published to commemorate the Silver Jubilee of the ALH RRE Society and the 20th anniversary of the Bombay Leprosy Project. The topics covered are: 1. NLEP: Performance, Problems and Solutions; 2. Urban Leprosy Control; 3. Fixed Duration Therapy; 4. Recent Concepts in Chemotherapy and Newer Drugs in Leprosy; 5. Prevention of Nerve Damage and Disability Care; and 6. Community Participation in Leprosy Rehabilitation.
Dr. Ganapati is a pioneer in urban leprosy control and shares his enormous insights into the disease in this setting, a setting which seems destined to become more and more the norm in leprosy work. His understanding of the disease as a whole is evident in his discussion of the public health approach using WHO/MDT. As part of a wealth of useful clinical information, detailed practical guidelines are provided for the use of steroids in reactions, for example.
The booklet is well done and makes for interesting reading.-RCH
Provoking Thoughts on Leprosy. Shetty, K. V, Secretary and Executive Director, Belhangady Rehabilitation, Industries, Gardening, Horticulture Training, Maddadka, Post Kuvettu 574 224, Dakshina Kannada District, Karnataka, India. 184 pp., hard cover.
The author, Sri K. V. Shetty, is 62 years old and has had leprosy for 49 years. This book is about his experiences, encounters, and mistakes, and is said to be in the hope that they may be of some use - both to leprosy patients and to their physicians.
The author shows long-standing frustration with his experiences as a leprosy patient, and the book contains many accounts of injustices to both the author and his fellow patients. Specific institutions and specific physicians and staff are mentioned by name and time. Much of the book is devoted to these confrontations and disagreements, particularly the autobiographical Chapter VII (pp. 92-123). On the other hand, one chapter (VI) is devoted to brief biographies of selected eminent Indian leprosy workers.
The author's grasp of the medical aspects of the disease is interesting. As examples: on page 4, "If stigma is removed from the mind of every doctor, leprosy will disappear from this world within just a few years." He believes that drug resistance is the "main reason for the spread of the disease" (p. 14). Statements are made that leprosy leads to stammering and that dapsone can reverse male gynecomastia, among other points. He believes that nasal discharge of leprosy bacilli has nothing to do with transmission of the disease (p. 40) and that ". . . only prolonged bodily contact with patients who have developed drug resistance due to irregular treatment can spread the disease" (p. 41).
It is of some interest that he advocates removing the words "leprosy" and "leper" from all dictionaries and replacing them with "Hansens" while the jacket of the book uses LEPROSY in letters nearly an inch high. In a chapter devoted to the eradication of leprosy (Chapter IV) the author gives nine suggestions, all but one of which (outlawing begging) deal with increasing benefits to leprosy patients.
A series of social case reports is presented in Chapter V. Interestingly, several of the patients were given 3 chalumogru [sic] oil capsules daily in addition to conventional therapy. A patient is described who is "addicted" to tea, consuming at least 10 cups per day. In a later chapter more details are given of the author's institution, BRIGHT INDIA, which deals with the economic rehabilitation of leprosy patients. In the first 8 years of operation, some 60 patients have been admitted and 40 have been "cured" and discharged. The inmates all work (mainly in horticulture and agriculture on the 17-acre site), are all handicapped, are not charged for their food or lodging and are given a stipend of 100 rupees per month.
While the reader is compelled to admire the story the author tells, one wonders if patient militancy of this type will further the abandonment of leprosy patients by those who currently labor around the world in laboratories, offices, bedsides and in the field on their behalf.-RCH
Studies on Leprosy in Bombay. Bombay: Acworth Leprosy Hospital Society for Research, Rehabilitation and Education in Leprosy, 1996. Softbound, 100 pp. Rs. 50/-. Available from: Acworth Leprosy Hospital Society, Wadala, Mumbai 400 031, India.
This 100-page booklet has been published as part of the Silver Jubilee of the Acworth Leprosy Hospital Society for Research, Rehabilitation and Education in Leprosy. It consists of abstracts of scientific contributions which have appeared in journals over the last 25 years.
The abstracts are arranged under headings of Historical Aspects (1 paper), Epidemiology/Control/Treatment (38 papers), Clinical Aspects/Diagnosis (6 papers), Laboratory Aspects (23 papers), Social Aspects/Rehabilitation (13 papers), and Health Education/Training (8 papers).
This is an impressive display of the extraordinary productivity of the Bombay group and the members of their Society are to be congratulated. - RCH
In order not to delay publication of this issue, the Board of Directors of the JOURNAL has given its permission for the Index to Volume 64 to be published in the March 1997 issue of the JOURNAL. We hope this will not duly inconvenience readers who wish to bind their volumes promptly. - RCH