COMMUNITY-BASED REHABILITATION - AN EVALUATION STUDY

Leprosy gives rise to two types of stigmatization, one from the disease and its neuropathic manifestations, with their resultant disability and handicaps, and the other due to social ostracism. The process of rehabilitation should begin from the moment the disease is diagnosed, and the earlier its detection the better the prognosis for patients. The family unit to which the patient belongs plays a vital role in his social life. ensuring and enhancing his self-respect and dignity in society, and this fact must be recognized when evolving a strategy for rehabilitation. In no circumstances should a patient be removed from his natural home environment. It is important that the community is made leprosy conscious and gets more involved in hastening the social assimilation of patients. Communication plays an important role throughout the rehabilitation process. One of the major functions is the removal of the social stigma in the family and in the community and this involves communication skills to ensure interaction between the staff and patients' families and the education of the community. A highlight of community-based rehabilitation is the excellent rate of repayment of loans by the patients to whom they were made. Also of note is the extent to which former defaulters make repayments due to the continous rapport and good interpersonal relationship between the staff and patients. Most of the subjects of this study were drawn from the lower economic strata of society and for them the most essential consideration is to make a living, however meagre. This problem is augmented in the case of leprosy sufferers, not only because of the fear and hostility which their disease excites in others, but because of their deformity and handicap. No rehabilitation programme can afford to ignore these factors which so seriously disturb the normal life of patients.