India has the highest number of people affected by leprosy. Reported new cases exceed 125,000 per year (60% of the world total) and millions live with disability and health issues stemming from leprosy. TLM was founded in India in 1874 and, now with around 850 staff there, has continued to make the leading contribution to overcoming leprosy. TLM operates programmes in nine states of India, through 14 hospitals, 6 Vocational Training Centres, 5 residential facilities for care of elderly people severely disabled by leprosy, a molecular biology research laboratory, advocacy and communication, leprosy training, and multiple community empowerment projects.
With 14 hospitals across 9 states, TLM aims to model a functioning referral system. The hospitals provide specialised leprosy referral services, primary-level preventive healthcare through community outreach, and institution-based and community-based disability management both hospital-based and in the community. They also provide secondary-level healthcare in dermatology, ophthalmology, general medicine, general surgery, obstetrics and gynaecology. TLM hospitals also support the Government in active case detection and build its expertise in early detection of leprosy and its complications, and disability management.
Sustainable livelihoods and empowerment
The deep-rooted stigma attached to leprosy often leads to people being unable to participate fully in the day-today life of the society in which they live. TLM works to restore marginalised people to full participation, through local action along with broader strategies to reform policies that have negative impacts on vulnerable people. Self-help groups enable disadvantaged households to receive a better income through improved livelihood opportunities. Educational scholarships to children from leprosy backgrounds and an adult literacy programme provide a brighter future. Through self-care groups, people affected by leprosy encourage each other to keep up the necessary practices to prevent damage to insensitive hands and feet.
Awareness and advocacy
Through means such as formation of collectives of people affected by leprosy, TLM supports people to speak out on issues that are important to them, defend and safeguard their rights, and have their opinions considered when policymakers make decisions that affect their lives. In parallel with this support, TLM staff work at state and national levels to highlight the issues leprosy-affected people face, target negative practices and change mindsets. TLM seeks to create a favourable policy environment so that the Government makes legislation and policies favourable to people affected by leprosy, and ensures those responsible for carrying out those policies understand issues of leprosy so that they take positive action in matters concerning people affected by leprosy.
Through its six Vocational Training Centres, TLM prepares young people affected by leprosy and other disabilities for gainful employment. The job-oriented trades include diesel mechanics, printing, computers, two/three wheeler mechanics and electrics. The training, accompanied by individual tailor-made rehabilitation plans, enable young people to opt for careers which were formerly only dreams. TLM also provides placement assistance and advocates for fair labour conditions and safe and appropriate working conditions for students when they are placed. In addition to the six centres, TLM reaches more people (such as married women) through community-based vocational training in mushroom cultivation, silk thread weaving, computing, mobile phone repair and tailoring. This sort of training is unique as it promotes community-based solutions in linking skills training and sustainable livelihoods for the most vulnerable communities.
Care for the elderly
In its five Snehalayas (‘houses of love’) TLM takes care of around 100 elderly people who were rejected and abandoned by their families due to leprosy. Many have crippling deformity in their hands and feet, and TLM provides them with loving care that enables them to live healthy lives with dignity.
With its wealth of expertise in leprosy and a state of the art laboratory, field hospitals and programmes, TLM India conducts research into diverse issues which continue to pose problems in the control and eradication of leprosy. These areas include transmission, diagnosis, treatment, drug resistance, societal and community-based research and advocacy.
TLM India’s country leader is Dr Mary Verghese. The annual budget in India is around £8 million, of which more than half is raised in India through fees, grants and donations.