Although treatment, expertise, and knowledge, are available at no financial burden, all these become ineffective if patients and their family do not seek for heap early, don’t provide correct needed information, and don’t follow the treatment. These types of non-cooperation is quite common in the case of leprosy44. There are many reasons that falls from stigma they face. Fear of disease, guilt, discrimination, prejudice, and lowered self-esteem force affected individuals and their family to hide the disease and delay proper treatment, which then further promotes transmission of the disease45.
As mentioned in the medical branch, the psychological and psychosocial problems arise due to stigma and this must be addressed firmly at every level, especially at the primary level46. That is when patient first suspects disease and becomes worried for following symptoms. When there are negative reactions from their surrounding (ie. Family, friends, and community), patient’s overall psychological state declines in a faster rate26. This is very serious because suicidal thoughts come after the diagnosis of leprosy for many patients, and there are lot of patients who committed suicide in hospitals and at home due to extreme psychosocial stress and depression47.
To combat these issues, proper counseling and positive health-seeking habits are critical, and psychosocial support by the family to report and start treatment will ensure complete cure and thus less transmission. Occupational therapists have a special role in reeducation and r reorientation to patients who cannot continue their earlier jobs due to anesthesia or deformities48. The best medical and surgical care still needs strong psychosocial support. Stigma is primarily strong in social participation restrictions, which interfere with the role and dignity of the affected person19. If the affected person loses their job, resulting in economic hardship, the ego suffers further49. There is still a need for special counseling, inclusive care, job opportunities, and restoration of a person’s dignity, resulting in maintaining quality of life. Competent career counselors and guidance in making the right choices for independence are essential to prevent the downward slide of the deformed patient. As far as possible, rehabilitation must be prevented through family counseling and support. Despite the best medical and psychological care, there is still a need for a proper environment to be created, and this is detailed in the third arm of the multifaceted strategy.
Although stigma towards leprosy is a complex and persistent problem, it is possible to achieve a measurable reduction using reproducible interventions. The different interventions can be used independently, but like clinical multidrug therapy, stigma should be addressed through social multi-faceted approaches that address different levels and aspects of stigma. It is also important to address both the source of stigma, which usually includes community attitudes and their lack of knowledge, cultural and religious beliefs, but also attitudes and behavior of professionals in health and social services. For most efficient outcome, it is essential to adapt interventions to local circumstances. In addition, consideration of the substantial differences between affected people in their experience of stigma and their ability to cope with the consequences. This is important because everyone varies on how much they can handle these extreme social stresses. Most importantly, stigma and discrimination do not magically disappear by themselves. They require specifically and carefully planned and targeted strategies.
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