Leprosy in paradise

Grandmother Aloka was cured of leprosy after being diagnosed by a Leprosy Mission outreach worker in her tea garden. But sadly the cure came too late to prevent damage to her left hand. Her fingers won't straighten, and they can no longer grip the delicate tea leaves. She can now only pick tea leaves with her right hand. As she is paid by the kilogram, she earns a fraction of what she once did, impacting her entire family.(Photo: Ruth Towell)

Leprosy Mission teams are shocked to discover the tea gardens of Bangladesh are home to the highest leprosy rate they have seen.

The Leprosy Mission has worked in the slums of the Bangladeshi capital Dhaka for many years. The overcrowded living conditions and poor sanitation are not only distressing but ripe for disease.

Just a few hours' drive Northeast of Dhaka, the fresh air and the vibrant foliage of the tea gardens are the perfect antidote to the city slums.

But appearances can be deceptive. While the tea crop flourishes, leprosy is choking the life out of its workforce.

There are 600,000 people living and working on the tea estates of Sylhet with the leprosy rate 20-30 times the global average. This equates to thousands of people living with untreated leprosy. Almost no family remains unscathed and even children are showing the early signs.

Leprosy Mission doctors and health workers are staggered by the number of new cases they have found. Since going into tea estates in 2017, they have found and cured more than 1,600 new cases of leprosy. The more they look, the more they find.

The discovery has culminated in the launch of the Flourish campaign on Sunday 29 January, World Leprosy Day 2023. Flourish seeks to find and cure tea workers and their families of leprosy, protect livelihoods and create a future where the whole community can flourish.

Chief Executive, Peter Waddup, says there is a real urgency to find and cure new cases of leprosy. This is before disability sets in and the tea workers lose everything they know and love. He shares this report: 

The situation in the tea gardens is very unusual. This is not just because of the extraordinary high rate of leprosy but the lack of stigma surrounding the disease.

I've had the privilege of visiting our projects across Asia and Africa and one thing is constant. That is the terrible prejudice surrounding leprosy. People are, understandably, reluctant to come forward for treatment because of this prejudice. They live in fear of being seen as cursed and cast out of their families and communities.

But what is unusual within the tea estates of Bangladesh is there doesn't seem to be a huge amount of stigma surrounding the disease.

This is likely to be because the workforce is made up of ethnic and religious minorities who are, sadly, already marginalised from society.

Dalamar, pictured, is 50 years old and was diagnosed and treated for leprosy in September. She had heard that leprosy was spreading in the tea gardens and suspected that she might have the disease. So, although afraid, she attended a Leprosy Mission pop-up clinic in her tea garden as she wanted to protect her family.(Photo: Ruth Towell)

When the workers are fit and well, they form a tight-knit community with friendships between the tea pickers often going back decades.

The trouble comes when nerve damage caused by leprosy causes fingers to curl.

As the tea pickers are paid by the kilogram of tea picked, speed and efficiency are everything.

There is a very real worry among the tea pickers that they will lose their home and community. This is because employees are provided with a basic family home which they must leave should they become too sick or disabled to work.

My colleagues in Bangladesh are already running pop-up clinics in a third of the tea gardens in Sylhet, finding and curing new leprosy cases.

Knowing the full extent of the problem, we desperately need the resources to scale up this work.

There is a real urgency to find and cure people before leprosy leaves them too disabled to work and they lose everything.

The aim is always to cure people of leprosy at the earliest opportunity.

As well as preventing transmission, prompt treatment stops leprosy from causing life long disabilities.

The fact that there doesn't appear to be too much stigma surrounding taking the cure for leprosy in the tea gardens is a good thing. It means people are open to treatment.

Tragically it is when they are forced to leave the tea gardens because of leprosy that they are exposed to extreme prejudice.