Leprosy in Nepal

Diplomarbeit von Andreas Jenny

Abstract:

Leprosy, a communicable disease, is one of the most feared and stigmatised diseases in the world. This disease is an important cause of permanent and progressive disability when it is not treated in an early stage. Leprosy control is an instrument to find and treat all existing leprosy cases in a certain area, to bring them under treatment in order to prevent the disabling consequences of the disease.

It is essential to consider the cultural, the social, the political, and the economical aspects in the context of leprosy in Nepal to meet the real need of each individual patient. Due to the agricultural background of almost 93 % of Nepal's population, this field needs special attention as a tool for adequate rehabilitation.

This paper aims to provide a solution providing a concept for agricultural leprosy rehabilitation. In chapter five rehabilitation strategies for clients with agricultural background are lined out regarding the specific situation in Nepal. Possibilities for the integration of agricultural topics in occupational therapy are discussed, as well as agricultural business creation suitable for disabled clients. Chapter six contains two curricula. The first curriculum deals with a kitchen garden training in occupational therapy and the second curriculum with a curriculum for a beekeeping training as a business creation measure.

Table of Contents:

	List of Figures	iv
	List of Pictures	iv
	List of Maps	iv
	Table	iv
	List of Abbreviations	v
	Acknowledgements and Preface	vi
1.	INTRODUCTION	1
2.	HISTORICAL BACKGROUND	2
3.	MEDICAL ASPECTS OF LEPROSY	4
3.1	Prevalence	4
3.2	Epidemiology	5
3.3	Treatment	6
3.4	Leprosy Control	6
4.	LEPROSY IN NEPAL	8
4.1	The Country	8
4.1.1	Geography	8
4.1.2	People	9
4.1.3	Government and Administration	10
4.1.4	Economy	11
4.2	The Context of Leprosy in Nepal	12
4.2.1	Cultural Aspects	12
4.2.2	Social Aspects	14
4.2.3	Political Aspects	16
4.2.4	Economical Aspects	17
4.3	The INF Leprosy Control Project (INF LCP)	18
5.	REHABILITATION STRATEGIES FOR CLIENTS WITH AGRICULTURAL BACKGROUND	21
5.1	Agricultural Work and Rehabilitation Problems	21
5.2	Rehabilitation	22
5.3	Socio-Economic Rehabilitation	26
5.3.1	Community Based Education	27
5.3.2	Community Based Vocational Training and Job Placement	28
5.3.3	Community Based Business Creation and Income Generation	29
5.3.4	Community Based Resettlements and other Capital Assistance	29
5.3.5	Institutional Sheltered Work, Home Care and Pension	29
5.4	Agriculture as a Tool for Rehabilitation	31
5.4.1	Occupational Therapy and Agriculture	32
5.4.2	Rehabilitation and Business Creation in Agriculture	32
5.4.2.1	Horticulture	32
5.4.2.2	Poultry	34
5.4.2.3	Rabbit Rearing	35
5.4.2.4	Goat Keeping	36
5.4.2.5	Sheep Keeping	38
5.4.2.6	Sericulture (Silk Worm Rearing)	38
5.4.2.7	Beekeeping	39
5.4.2.8	Fish Farming	41
5.4.2.9	Cottage Industries	42
6.	CURRICULUM FOR OCCUPATIONAL THERAPY AND BUSINESS CREATION IN AGRICULTURE	43
6.1	Kitchen Garden Training in Occupational Therapy	43
6.1.1	Anthropological Assumption	44
6.1.2	Goals	47
6.1.3	Contents	49
6.1.4	Methods	57
6.1.5	Media	60
6.1.6	Time Schedule	62
6.1.7	Evaluation	65
6.2	Business Creation Beekeeping	66
6.2.1	Anthropological Assumption	67
6.2.2	Goals	68
6.2.3	Contents	69
6.2.4	Methods	78
6.2.5	Media	79
6.2.6	Time Schedule	80
6.2.7	Evaluation	84
7.	DISCUSSION	86
8.	SUMMARY	88
	Literature	I
	Appendix A	VII
	Appendix B	XIII
	Appendix C	XV
	Appendix D	XX
	Appendix E	XXIX