Himalayan Snow

Katmandu -- Nepal is full of dramatic contrasts. The capital city Katmandu is situated close to the rooftop of the world, the Himalayas. To the south, the mountainous terrain drops away to the warm, flat plains and countryside that borders on India.

Nepal with all its healthy, smiling faces still confronts the challenge of eliminating leprosy. It is still one of three countries in the world (Nepal, East Timor, Brazil) that has yet to bring the country-wide leprosy prevalance rate below one case in 10,000 people, which qualifies as elimination in medical terminoloy.

But, due to recent changes and reorganization in Nepal's government, the leprosy treatment program has been given a strong, new emphasis. "There is no place for leprosy in the new Nepal," says Prime Minister Prachanda, who gave his personal support to the elimination program during a meeting in Katmandu with Mr Yohei Sasakawa, chairman of the Nippon Foundation.

The Sasakawa Memorial Health Foundation, a branch of the Nippon Foundation, has contributed nearly $4.5 million dollars to Nepal's leprosy elimination program. Among many things, this has funded the supply of leprosy treatment drugs, technical assistance, health education and teaching materials in Nepali, and the establishment of a network of leprosy affected people who communicate with each other to improve the social and health conditions of people who have been cured of leprosy.

Terai Scene

Mr Sasakawa and his team of experts travelled to distant leprosy health treatment centers which have been supported by the Foundation far from Katmandu along the distant eastern border with India. He was told there that people affected by leprosy are crossing the border from India into Nepal to receive the free leprosy drug treatments that have been made available due to the support of the Foundation, the World Health Organization (WHO), and the Ministry of Health and Population of Nepal.

The target for leprosy elimination in Nepal for 2009 is the Terai area, which reaches from the eastern to the western border lands of Nepal. Most cases of leprosy in Nepal are found in the Terai area. Here, Mr Sasakawa met key health officials and spoke at the opening ceremony of a rural Women's Empowerment Workshop, which was meant to educate and raise the awareness of the human rights of women affected by leprosy.

During Mr Sasakawa's trip from 2-7 December in Nepal, he visited a wide range of hospitals and clinics in the Terai area, met local health officials, and watched several leprosy "street theaters" -- which featured an entertaining and educational content put on in village squares and markets to inform people of leprosy symptoms and encourage them to seek treatment in local hospitals.

Another key element in the street theater presentations is to lift the social stigma against people affected by leprosy. There are scenes in the street theater in which actors playing people affected by leprosy are welcomed back by family and friends after being cured in the leprosy multi-drug treatment program.

In Nepal, the country of the pure white snows of the Himalayas, the easy part is curing leprosy. The hard part here and throughout the world is the stigma that remains long after the disease has been eliminated. This is the next tough stage of the elimination program in Nepal.