Empowerment – Self Care Training

A chief aim of NLT is to empower those affected by leprosy to become independent again, and to re-enter society and function effectively within it, equipped with new skills, and regained dignity.

The Self-Care Training Centre at Lalgadh provides a two week residential training to equip individuals practically and

Learning foot care techniques
Learning self care exercises

psychologically to participate in family and community life again. It is designed to reproduce everyday living and working conditions, allowing trainees to learn together how to take care of their anaesthetic hands, feet and eyes, while tackling the practical problems of everyday life, in a non-medical environment. Since it was established in the late 1990s, nearly 9000 people, all disabled by leprosy, have received the two week training. Studies to see whether this training has helped reduce the recurrence of ulcers, and the deterioration of leprosy affected limbs, have shown that it does work!

The pictures above show various exercises, with the group on the left working to strengthen leg muscles that have been weakened by leprosy, causing drop-foot. The group on the right are soaking, scraping and oiling their anaesthetic feet to keep the tissue supple and soft to avoid cracking and subsequent ulceration. Exercises like these also give opportunity to check limbs for damage. If these people can learn to prevent ulcers, they have a much better chance of being accepted by their communities.

Self-care training teaches people how to:

  • check that their anaesthesia is not worsening and how to protect their anaesthetic hands and feet while cooking, farming, using tools, and often with the help of a range of simple assistive devices;
  • regularly check for damage and detect it quickly, and initiate healing care so that ulceration and unnecessary hospital visits are avoided and damage is minimized;
  • care for skin that has lost the capacity to sweat and thereby stay supple and strong, and replace the natural processes with a care system that achieves the same effect;
  • use special footwear designed to reduce the risk of damage to vulnerable feet;
  • have a mindset that can use these coping skills effectively in daily life, and thereby avoid progressive and worsening physical damage;
  • work in groups for mutual encouragement, the sharing of useful experience, and the improvement of their environment, and see a future that has hope for a “life worth living”.

Outcomes

Previous experience and evaluation of self-care training has shown that it has a significant impact on preventing deterioration of disabilities caused by leprosy, as trainees are able to identify and react to problems much more quickly. Communities also become more supportive as they understand that encouraging good self-care prevents unpleasant ulcers, and enables people affected by leprosy to function better as useful community and family members. It is also clear that effective self-care reduces the need for further hospital admissions and helps individuals to stay healthy and independent, despite their disabilities. Previous trainees have gone on to become self-help group leaders amongst our 100-plus self-help groups, and important initiators of change in their communities. This project is providing new potentially influential people, as well as helping people disabled by leprosy to rebuild their lives.