Got questions about Flourish, our Leprosy Sunday campaign for 2023? World Leprosy Day is on 29 January and this year, we're bringing people together to help end leprosy in the tea gardens of Sylhet, northern Bangladesh. But why are we focusing on this area? And how can you help? Find out more.

Why are leprosy rates so high in the tea gardens of Bangladesh?

Bangladesh achieved the World Health Organization’s target to eliminate leprosy as a public health problem in 1998. At that time, leprosy elimination was defined as less than one person per 10,000 of the population having leprosy. It was, however, a target considered arbitrary by leprosy organisations. This is because people often don't come forward for leprosy diagnosis and treatment. Prejudice surrounding the disease instead sees them hide the early symptoms. Also, in places where there is limited healthcare, it can take a long time for someone to be diagnosed with leprosy, if at all.

Many cases of leprosy remained undetected in Bangladesh and a falsely optimistic picture covered the real situation. When it was believed that the elimination target had been reached, leprosy was no longer seen as a public health priority and resource was focused on combating other medical conditions.

As a result, there was little leprosy detection work in the tea gardens until 2017. This is when Leprosy Mission staff began working in the tea estates of Sylhet. They were astonished by the number of people they were finding with leprosy. The team has made huge strides, but there is an urgent need to increase our work to stop leprosy spreading to more families in the tea gardens and throughout Bangladesh.

What is causing leprosy to thrive in the tea gardens?

Leprosy is a disease of poverty. It thrives in areas where there is overcrowding, malnutrition and poor sanitation. These are the conditions in which most tea workers and their families live. Bangladesh is a flood-prone country, and their living conditions are also affected by climate change. Most rural areas don’t have drainage systems, so stagnant flood water often surrounds housing on tea estates during and after the monsoon. This creates a breeding ground for bacteria.

What are the living conditions like?

Tea worker housing is provided by the tea estate and is typically a basic mud hut with a corrugated iron roof. There is usually just one room for a family of up to ten people, often spanning three generations. Most families cook and wash outside their home.

How many people in the tea gardens are affected by leprosy?

Leprosy rates in the tea gardens of Bangladesh are 20 to 30 times higher than the global average. There are 600,000 people living and working in the tea gardens of Sylhet. As many as one in seven people are thought to have leprosy.

How can we stop leprosy transmission in the tea gardens?

Leprosy Mission teams set up pop-up clinics in the tea gardens to find and cure new leprosy cases. People with skin complaints are encouraged to attend the clinics. This is because the first sign of leprosy is often a light-coloured skin patch which is numb to the touch.

When a person is diagnosed with leprosy, our team follow up with door-to-door check-ups in their community. This helps us to find and treat new leprosy cases as early as possible.

A person newly diagnosed with leprosy is cared for by a Leprosy Mission outreach worker throughout their treatment journey. They may need specialist leprosy services to help heal ulcers or even surgery and hospital care. Family members are always checked for symptoms of leprosy.

The aim is always to cure people of leprosy at the earliest opportunity. As well as preventing transmission, prompt treatment stops leprosy from causing permanent disabilities.

Approximately how many people are seen at a pop-up clinic?

A pop-up clinic typically runs for around half a day and 100 people are seen.

How many tea gardens are there?

There are 150 tea gardens in Sylhet, the Northeastern division of Bangladesh famed for its tea production. The Leprosy Mission is currently working in a third of these and is looking to expand its work to many more tea gardens.

How many people on average in a tea garden?

There are an average of 2,000 workers in each tea garden, with women making up more than 75 per cent of the workforce.

How many people would benefit when I give a gift to adopt a whole tea garden for £7,055 and what help would they receive?

More than 10,000 people would benefit. This will include tea garden workers, their families, and their community.

This package will include training for 270 health workers to diagnose and treat leprosy. Each health worker will provide regular support for up to 300 affected people a year. It will also cover the cost of leprosy screening in a school, a pop-up clinic, and door-to-door leprosy checks for all of the communities in a tea garden.

Transport to hospital and specialist treatment will also be provided for people with more severe leprosy complications. In addition, this funding will enable our team to set up a self-help group for people affected by leprosy and disabilities. Members of the group will be supported with counselling, training, and help to save money to start their own business or pay for family emergencies.

Will Aloka have reconstructive surgery to help her hand?

Nerve damage from leprosy has caused the fingers of Aloka's left hand to claw. Although Aloka has been cured of leprosy, she can no longer pick tea leaves with her left hand without medical intervention.

Aloka is currently undergoing physiotherapy to improve the movement in her fingers. This is often the first step our doctors recommend as it helps to achieve the best surgical outcome. If physiotherapy alone is not sufficient to restore the movement in Aloka’s hand, she will be referred for specialist surgery at our hospital.