Suitable for health personnel working for disaility

1. Best wishes to all of
you

2. Project:Project:
Empowering poor &Empowering poor &
marginalized peoplemarginalized people
affected byaffected by
disabilitydisability
to improve their economic statusto improve their economic status

3. Schedule for Orientation on Disability
Time
Subject Facilitator Comments
10 – 10:15
am
Welcome Speech & Objectives of orientation UH&FPO
10:15 am –
11:00 am
Pretest
Disability (Definition, Key facts, Causes of disability,
Type of disability, local burden if known, challenges
faced by people with disability, services offered by
Lepra Bangladesh)
UH&FPO/MODC/
disability experts
Collect data from
UH&FPO, CS office or
Social Welfare
department
11:00 am –
11:45 am
Leprosy (Definition, Cardinal sign, diagnosis,
treatment, complications and management)
MODC/TLCS/PO/
HSWS
Patient demonstration
11:45 am –
12:30 pm
Physiotherapy services offered by Lepra Bangladesh HSWS/PT Demonstration of
Physiotherapy materials
12:30 pm –
1:00 pm
Community Development/Rehabilitation/ Self-Help
Group formation, rights of people with disability
HSWS/RO Show recent laws, policy
on disability (collect hard
copy)
1:00 pm -
1:30 pm
Responsibilities of health personnel
Post Test
& Closing remarks
UH&FPO

4. Participants:Participants:
Government Health Personnel
Time: 3 hours

5. Methodology
• Interactive discussion
• Use PB & MB blister pack
• Use other materials such as cotton or feather to
test sensory function.
• Question and answers session
• Display Assistive Devices
• Materials/Atlas
• Use Bangla Training Manual (English version is also
available)
• Multi-media (depends on availability)

6. After Orientation:
• Government health personnel will be able
to refer person with disability for special
services (such as physiotherapy) available
in their local community.
• Government health personnel will be able
to refer more leprosy suspects in early
stage to Upazila Health Complex or
district hospital.
• Government health personnel will take
initiatives specially on disability due to
leprosy.
• Government health staff will be able to
support people with disability for their
rights and economic development.

7. Definition of disability?
• The International Classification of
Functioning, Disability and Health
(ICF) defines disability as an
umbrella term for impairments,
activity limitations and participation
restrictions (WHO, 2014).

8. Key facts
• About 15% of world population has some forms of
disability
• Between 11 – 19 crore adults have significant
difficulties in functioning in the world
• According to world Bank, people with disability
are about 15 – 20 % of the poor in developing
countries.
• Rates of disability are increasing due to
population ageing and increase chronic health
condition such as osteoarthritis, stroke, mental
illness etc.
• People with disability have less access to health
care service and therefore experience unmet
health care needs.
•

9. Causes of disability
• Genetic (Biochemical disorder,
chromosomal abnormalities)
• Pre- natal (Severe anemia, Rh factor,
Rubella infection during pregnancy etc.)
• Peri – natal (Birth Injuries, Asphyxia, Pre-
maturity)
• Post – Natal (Malnutrition, Accidental
physical trauma to the brain, disease &
infection)
• Environmental

10. Type of disability
• Loco motor disability (Physical
disability due to polio, amputation of
limb, club foot, cleft lip or cleft
palate etc.).
• Vision impairment and or blindness
• Hearing and speech Impairment
• Intellectual disability
• Mixed/Multiple

11. Challenges faced by people with disability
• Ignored by society, isolation,
segregation, poverty
• Limited accessibility (in Bus, building,
other public places)
• Deprived of education and
employment
• Stigma
• Lack of rights

12. Services offered by Lepra Bangladesh
• Supply protective footwear for disability
prevention
• Comprehensive disability and physiotherapy
services through referral centers
• Technical support
• Formation of Self Help group by People With
Disability (PWD)
• Support for economic development (open Bank
account, support for small business etc)
• Self care training
• Different activity (Awareness, advocacy etc.)
to establish Rights for People With Disability
(PWD)
• Counseling support

13. What is Leprosy?
• Leprosy is a chronic least infectious
disease caused by Mycobacterium Leprae
affecting primarily the peripheral nerves
and secondarily skin, nasal mucosa and
other tissues of the body.

14. Cardinal Sign of Leprosy
• Definite loss of sensation
in a hypo-pigmented patch
or reddish skin patch
• A thickened or enlarged
peripheral nerve with loss of
sensation and/or weakness
of muscle supplied by that
nerve.
• Presence of Mycobacterium
Leprosy in a slit skin smear

15. Diagnosis/Leprosy Classification
• PB (Pauci Bacillary) – 5 or
less skin patches
• MB (Multi-bacillary) – 6 or
more skin patches or skin
smear positive

16. Leprosy Treatment by MDT
(Multi-Drug Therapy)
• PB patient need PB MDT
(Rifampicin &Dapsone) for 6
months
• MB patient need MB MDT
(three drugs: Rifampicin,
Dapsone and Clofazimine) for
12 months

17. Leprosy related Complications
Lepra Reactions
• Type 1, Inflammation of skin
patches & Nerves (Neuritis),
• Type 2: Erythema Nodosum
Leprosum (ENL).

18. Secondary complications
• Ulcers
• Claw hand, foot drop, legopthalmos
• Stigma
• Discrimination

19. Management/Intervention
• Continue Treatment with MDT
• Prednisolone for reaction
• For Ulcer - Rest, soaking, scraping, oiling (SOS),
clean & apply bandage
• For Claw hand, Foot drop & legopthalmos –
Physiotherapy and Surgical correction
• Supply footwear and other assistive devices
according to the need.
• Stigma/ discrimination – counseling, advocacy,
formation of community group, Create awareness
about the rights of people with disability etc.

20. Responsibilities of health personnel
• For Leprosy: It depends on the position and
nature of work. For more details use “National
Guidelines and Technical Manual on Leprosy”
(Annexure 2)
For Disability
• Refer person with disability in “Disability
Referral Center”
• Inform community people about availability of
physiotherapy services
• Refer person with disability for surgical
intervention
• Take action against discrimination
• Create a positive environment in the local
community on disability issues.

26. We are really
grateful