Look behind the lens of leprosy with photographer, Tom Bradley

We asked photographer, Tom Bradley, to share his experiences from Bangladesh and how your support really can transform the lives of these forgotten communities.

“As I watch Shopna examine patches on the faces of brothers Chaina and Joy, aged six and nine, she takes down their details, marking them both as suspect leprosy cases, Masuma spots another boy in the crowd with facial patches, noticing that he looks just like Joy. She soon discovers that the boy was his twin brother, Bijoy. He too has the telltale patches on his skin – three children from one family potentially affected by leprosy.

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6-year-old twins, Joy and Bijoy, may have leprosy. Photo: Tom Bradley

Shopna is a Field Organiser for The Leprosy Mission’s partner Mukti, and she’s assigned specifically to diagnosing new cases of leprosy, along with her co-worker Ripon. My name’s Tom Bradley; I’ve been photographing people affected by leprosy for almost a decade now, and I’ve been following both Shopna and Ripon for the day, as they have been called out to examine two suspect cases of leprosy in a village in western Bangladesh. Accompanying me are Leprosy Mission staff Masuma and Jiptha, both of whom are also trained to recognise leprosy cases.

But Bijoy isn’t the only extra case that day. As Shopna begins to examine him, another boy, 10-year-old Durantha, is pushed to the front of the onlooking crowd of children. He also has patches on his face. And he is not the last unexpected case that day either.

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10-year-old Durantha has patches on his face. Photo: Tom Bradley

We walk through the village on this very hot and humid morning, followed by a number of children and a few adults. Most of the men are out working in the fields, and a few of the women steal away from their work preparing food, looking after the house and children and tending to any livestock left at home.

As we leave the village, we walk along narrow paths, slightly raised up with earth to divide the square rice paddies.

It seems it’s difficult to even leave the village without spotting yet another child with patches of leprosy.

Meanwhile Shopna and Masuma, walking a little behind us, are called off to someone’s house, having just been informed of another child who has patches on their face. Two more suspect cases are discovered. Having caught up with us, Shopna takes over from Jiptha to take down the boys’ details.

As we move onto the next village, just across the road, Shopna comes across a young man with patches on his arm. The patches show signs of clear anaesthesia, and then Shopna realises his mother is affected by leprosy, although she was cured some time ago. The young man, Dukhiram, is confirmed as a new case and Shopna notes down his contact details so he can be supplied with the vital MDT tablets as soon as possible.

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Shopna checking the patch on Dukhiram’s arm. Photo: Tom Bradley

The next village is much the same as the first, and though we’re going primarily for my benefit, to interview an old patient I have met before, Shopna is busy wading through the crowd picking out people with patches on their face.

The work seems neverending – so many suspected new cases found.

Shopna hasn’t yet been doing this work for a month, but already enjoys it greatly.

“When I visited the field last month, I felt very encouraged. If I visit more areas I can identify more people affected.” Shopna tells me. “I feel it’s such a great opportunity to work with them and help them get treatment in time. I feel really proud doing this work.”

I can see Shopna enjoys her new job and is so good at interacting with the people she meets, smiling and reassuring them, but also listening with genuine concern if they talk about their problems.

“Now so many women come to meet with me and talk about different issues,” she says.

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Shopna works tirelessly to ensure people with leprosy are diagnosed and treated. Photo: Tom Bradley

Shopna’s job, which takes her out into the community most days in the week is absolutely vital in effort to combat leprosy in the area, where people living in remote villages may not get the treatment they need otherwise, their leprosy left undiagnosed.

On this day alone she registers ten new suspect cases and one new confirmed case. The suspect cases will all be followed-up regularly, so that if their patch does indeed turn out to be leprosy they can be put on treatment and cured, hopefully, without complication. The longer leprosy is left untreated, the more potential it has to cause severe disability and have an even greater impact on someone’s life.

People like Shopna work tirelessly to prevent this from happening, a real lifeline to the people they meet.”

You can see more of Tom’s work on his website or on Twitter/Instagram @tombradleyphoto

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Anik, who is affected by leprosy, in hospital receiving ulcer treatment.

Affected by leprosy at just five years old

Anik, who is affected by leprosy, in hospital receiving ulcer treatment.
Anik, who is affected by leprosy, in hospital receiving ulcer treatment.

Worldwide, around ten per cent of new cases of leprosy diagnosed every year are in children. Sometimes, their leprosy is caught early, they’re given multidrug therapy (MDT) and cured before the disease takes its toll on their bodies. Sadly for 17-year-old Anik, from Bangladesh, this wasn’t the case. He developed leprosy when he was just five.

“I can remember a thorn piercing my right foot,” he said. “My parents took me to the village doctors who gave me medicine, but I reacted to it and my arms and legs swelled up.”

By the time he was eight, he had clawed hands, ulcers and extensive loss of feeling. “I didn’t understand what was happening. When I looked around and saw that no one else was going through this I began to despair,” he said.

It became difficult for him to hold a pen and he dropped out of school, ending his education. Anik’s story here is so familiar – many of the children we meet have dropped out of school due to the effects of leprosy on their hands. Often, they’re excluded by the prejudice of teachers and classmates.

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Anik’s hands.

Anik was diagnosed with leprosy around this time and given MDT, but the drugs could do nothing for his disabilities, which began to get steadily worse. He developed a deep, infected ulcer on his leg. Not knowing how to treat the ulcer, Anik’s grandmother poured hot water on it, hoping it might help. But the scalding hot water combined with Anik’s loss of feeling in his legs caused terrible burns, making the infection worse.

“I couldn’t sleep because of the pain,” he said.

It was not until a month later that Anik eventually made it to a Leprosy Mission hospital. And by then, it was too late. The infection in his leg was so bad that aged just 12, he was told it must be amputated.

“I felt horrible when they told me, but they explained very well and I knew I must accept it. After it was gone I couldn’t sit, or move from my bed,” he said, adding that he didn’t want his family to visit him because he felt so upset about what had happened.

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When he returned home after six weeks as an inpatient, Anik learned to get around on crutches, but could no longer play cricket and football with his friends. He misses being able to do the things any other teenager can do and he knows his parents are worried about his future – who will look after him when they grow old?

With extensive disabilities and little education, Anik is facing overwhelming difficulties. He still requires frequent treatment for his ulcers and needs a lot  of support.

And he’s not alone. Many young people just like him are facing an uncertain future because of the devastating effects of leprosy on their lives. Thanks to you, we’re working to get MDT to as many people as early as possible, before they suffer irreversible disabilities.

But people like Anik need more than the cure. A gift of £10 could pay for someone to attend a counselling session. £40 could pay for a course of physiotherapy. So many people affected by leprosy feel like they have no hope for the future, but with your help, we can change this. You could make a difference to someone like Anik today.

Photos: Tom Bradley

Keeping leprosy-affected people and those with disabilities at the heart of development programmes

Momina from Bangladesh
Momina from Bangladesh

It is important to not to view leprosy as an isolated problem in terms of development. It is our desire to see leprosy-affected and disabled people included in mainstream and Neglected Tropical Disease-specific development programmes so that they can reap the same benefits from government aid programmes as their able-bodied counterparts. Yet many NGOs and programmes do not include disability, with claims that it is too expensive, does not offer value for money or due to a lack of expertise.

Recent research carried out by The Leprosy Mission England and Wales with more than 5,000 leprosy-affected people from nine countries across Africa and Asia revealed that although they had seen changes around them, they did not feel they had benefited from the Millennium Development Goals.

The UN Convention on the rights of persons with disabilities states that disabled people have equal rights and must be included in development processes. 2015 brings the global challenge to develop Sustainable Development Goals that will not just halve poverty and reduce associated with it as the Millennium Development Goals attempt but to create goals which will include all to ensure that no one is left behind (United Nations General Assembly 2014).

One billion people globally are disabled, 80 per cent of which live in developing countries (DfID 2014).  We know that permanent disability is a reality for many of the 1.5 billion people living with the consequences of NTDs.

The EC-funded Food Security for the Ultra Poor in Bangladesh was run by a consortium of NGOs is a good example of disability-inclusive development. The Leprosy Mission provided technical expertise and spearheaded the leprosy and disability components of this life-changing project which has seen more than 900 leprosy-affected families (out of a total of 40,000 beneficiaries) benefit from a new source of income. The majority are women-headed families, some as a result of their husbands being unable to work because of leprosy-caused disabilities. Others are leprosy-affected women like Momina desperately needing an income. Disabled women are doubly disadvantaged and subject to high levels of abuse (DfID, 2014).

Coming from the Gaibandha district of Northern Bangladesh, 50-year-old Momina’s husband divorced her on hearing she had leprosy, taking with him their son and three daughters.

Despite being shunned by villagers, her brother gave her a place to stay. Her feet are numb as a result of leprosy-caused nerve damage and she cannot walk far without developing ulcers that, if they become infected, could result in her lower legs being amputated. This greatly limits her earning capacity. But Momina wants to work, not least to repay the debt she feels she owes her brother.

As part of the Food Security for the Ultra-Poor project, Momina was given 10 chickens, a goat and a cow. The chickens have produced 12 chicks and the goat two kids. She is able to sell eggs and milk and says she is “able to hold her head high” in the community. She is also benefiting from the camaraderie of being part of a 26-member women’s support group. She even has 600 Taka (around £5) worth of personal savings as part of a self-help group cooperative, enough to support her when she next hits tough times.

As well as livelihood activities, the project provided rehabilitation services including physiotherapy, Occupational Therapy and the provision of assistive devices including protective footwear, wheelchair and crutches. A total of 70 per cent of people who received these services noticed positive changes in their ability to perform livelihood activities. Crucially many women stopped begging as a result and disabled women stated that working was empowering and meant they were more respected by their family as they were able to contribute to the family income. Many disabled women took on leadership roles within their group and 251 disabled women were included as members of federation committees.