Leprosy: Myanmar struggles with ancient scourge

High in the hills of Myanmar's war-torn borderlands, a clutch of new leprosy cases among communities virtually cut off from medical help is a sign that the country's battle with the ancient disease is far from over.
It took six days by plane, boat, motorcycle, bus - and an arduous mountain trek - for a group of medical workers to treat two leprosy patients in a remote corner of the country, where conflict and neglect are the legacy of decades of military rule and even access to basic medicines is a distant dream.
They soon found three more leprosy sufferers, including one man who had such a severe case he required hospital care.

"I promised him that I would come back for him or I would send someone to pick him up," said Doctor Saw Hsar Mu Lar, after the May expedition, as he returned to his hospital in Mawlamyaing, Mon state - one of only two specialising in leprosy in Myanmar.
Weeks later the patient was still waiting to travel as tensions between the Myanmar army and local rebels closed transportation routes.
Myanmar reached so-called 'elimination' status for leprosy in 2003 - meaning less than one person per 10,000 has the illness.

But there are still around 3,000 new cases found each year and medical workers warn that the debilitating disease could be on the rise once more as the country's creaking healthcare system fails to reach those at risk.

Decades of civil war in ethnic regions have also left vast swathes of its border areas cut off from all but the most basic medical help, meaning the disease could be passing undetected.
"There can be pocket areas, hidden areas," Saw Hsar Mu Lar told AFP. "We have to tell the world that it's not finished yet."
Leprosy is one of the world's oldest - and most feared - diseases.
State health workers are technically in charge of outreach and aid groups are banned from conducting leprosy awareness campaigns or looking for new patients - although they can treat people they find through dermatology clinics and during follow-up field trips.

The number of new cases it finds annually is dwarfed by its populous neighbour India, where there were some 127,000 new patients identified in 2011 according to World Health Organisation figures.
But while India managed an over 50 per cent reduction between 2004 and 2011, Myanmar struggled to reduce its new incidences by 18 per cent.