Stigma, distance keep leprosy patients from early care

Deep-rooted stigma, long incubation periods and limited access to health services continue to prevent many people in Fiji from seeking early treatment for leprosy, health authorities say, despite the disease being fully curable.

Speaking during World Leprosy Day commemorations at Tamavua Twomey Hospital, specialist Dr Edwin Kumar said fear and misinformation remained major barriers, with some patients still viewing leprosy as a “death sentence”.

“Leprosy is curable, and early treatment is vital,” Dr Kumar said. “But many people delay coming forward because of stigma and misconceptions, and by the time they seek help, the disease may already be advanced.”

He said stigma often forces patients to hide symptoms, making treatment more complex and increasing the risk of long-term complications.

Dr Kumar explained that leprosy’s long incubation period — which can range from 10 to 20 years — also complicates early diagnosis.

“Symptoms develop very slowly. We are often trying to identify very subtle signs, which makes detection challenging,” he said.

Geographical barriers further limit timely care, particularly for people living in interior and maritime communities where access to health facilities, follow-up visits and consistent monitoring can be difficult.

Currently, only one leprosy patient is admitted to hospital, with most cases managed on an outpatient basis depending on severity and complications.

However, Dr Kumar said limited specialist resources remained a challenge.

“We are a small group of specialists, and we cannot reach everyone ourselves,” he said.

To address this, the Ministry of Health is strengthening frontline services by training primary health care workers, nurses and zone nurses to identify early warning signs within communities.

“This allows screening to happen at the community level,” Dr Kumar said, adding that specialists now focus more on monitoring, supervision and managing complicated cases.

Health officials say sustained public education, reduced stigma and community-based detection are key to improving early diagnosis and preventing avoidable disability linked to leprosy.