Nobel Prize 2021: the link between touch, mental health, and physical wellbeing
Written by Jannine Ebenso, who has been working with people affected by leprosy since 1991
I am both intrigued and pleased that the The Nobel Assembly at Karolinska Institutet has awarded the 2021 Nobel Prize in Physiology or Medicine jointly to David Julius and Ardem Patapoutian for their discoveries of receptors for temperature and touch (see press release)
Our relationship with touch keeps us safe
Why has this capture my attention? Because it has again brought to the public domain something that we in the leprosy world have been saying for a long time, “Our ability to sense heat, cold and touch is essential for survival and underpins our interaction with the world around us.”
Leprosy can cause damage to the nerves that help us to sense heat, cold and touch. This means that things that most people take for granted – like walking barefoot, one of the things that Julius and Patapoutian mention “Imagine walking barefoot across a lawn on a hot summer’s day” – become things that are high risk.
Remember when you bought your last pair of new shoes? How long could you wear them for on the first day? If they had any kind of heel, probably not too long – you kicked them off and searched for your comfy ‘flatties’. The pressure receptors in your feet were telling you that these new shoes are a little tight in places and need ‘wearing in’ for short periods before you wear them all day.
Persons affected by leprosy often lose a vital layer of protection
Unfortunately for many people affected by leprosy with nerve damage in their feet, their bodies do not have this protective feedback mechanism, so they continue to wear shoes that are too tight, hold drinking glasses that are too hot, using tools that have long since damaged their hands.
“…impressions of temperature, touch and movement are essential for our adaptation to the constantly changing surrounding” say Julius and Patapoutian.
If you cannot feel pressure, movement, temperature etc. then you are at great risk of hurting yourself.
Touch, and the ability to sense pressure, temperature and pain are really important. Sadly, I have seen so many people come into the hospitals and clinics I have worked in who have severe damage to their eyes, hands and feet because they have lost the ability to sense pressure, pain, temperature. Men, women, boys and girls who have been going about their normal life and work, suddenly find injuries - cannot understand why they are there, and as for this wound, “it doesn’t hurt, so it can’t be serious can it?”
That is why The Leprosy Mission works in communities affected by leprosy in various ways:
- We seek to prevent the impairments that leprosy can cause, by diagnosing the disease as early as possible – before nerves are damaged
- We ensure that people complete their leprosy treatment and we monitor them closely while they are on treatment for signs of reaction and neuritis – the major cause of nerve damage and disability.
- When we find the signs and symptoms of reaction and neuritis, we provide the treatment necessary to treat it and to protect the nerves in the body.
- We train those who have nerve damage and have lost sensation in their eyes, hand and feet how to protect those parts of the body
- We provide assistive devices such as protective footwear, gloves, sunglasses
- We provide physical and occupational therapy for those who need it.
- Where needed, we provide surgery to correct parts of the body that have been damaged – our surgeons have the skills to
- Our researchers continue to look for new ways to identify nerve damage earlier, and new, improved drugs to treat reaction (many of the current drugs have sever side effects)
Leprosy and mourning lost touch
Julius and Patapoutian have focused on the physiology of touch. However, there is another perspective on the word ‘touch’.
How have you felt during the past 20 months of the pandemic? Keeping 2 metres away from those you love, not touching anyone, sanitising your hands before and after you touch anyone? Psychologists tell us that mental illness is at an all-time high. Human beings are made to be in community, and part of being in community is about being in physical contact with one another.
Sadly, being kept apart and away from others is something that some people experience every day and over many years. In communities across the world, leprosy continues to be misunderstood and people affected by leprosy miss out on the touch of those they love. Children and young people diagnosed with leprosy are often kept apart from the rest of the family. This is not at all necessary, but it is very damaging to these children and young people.
In the world of leprosy, a simple act can become a revolutionary one
Touch is more than a physical thing, it has significant mental and emotional impact, too. Lack of touch is detrimental to our mental and emotional health.
When I started work as a physiotherapist at a leprosy hospital in South East Nigeria, my mentor Dr Esther Davies told me,
“the best thing you can do for the people in this hospital, is to touch them, shake their hands, hold their hand while you talk with them, pat their backs, hug them …That has been denied them by their families and other loved ones for so long.”
Living and working alongside people affected by leprosy has had a profound affect on me – showing me the impact of a simple act, like shaking someone’s hand. It is more than a greeting – it is acceptance, it is respect, it is valuing another person. It is reassuring, it is encouraging, it is strengthening.