HX24 Historical journey on leprosy in Sri Lanka

Abstract

The history of leprosy in Sri Lanka, formerly known as Ceylon, dates back to ancient times, being mentioned in classical medical text books such as Sarartha Sangrahaya and Yogarnavaya, which describe various clinical manifestations of the disease. However, the stigma led to discrimination and social isolation, making a significant impact in ancient society. During the Dutch colonial period, concerns raised about health risks among both locals and Europeans led to the need for organized care. In 1703, authority was granted to build a leprosy asylum. This was open in Hendala in 1708, leading to formalized leprosy control. Under British rule, leprosy management was further strengthened. In 1862 the Royal College of Physicians formed an expert committee to study leprosy, and Sri Lanka contributed with patient data, making a committee’s report in 1864. The Lepers Ordinance was legislated in 1908, aiming for disease control, and the second leprosy asylum was established on Manthivu Island in 1921. Dr Robert Cochrane, a British medical researcher and leprologist, conducted surveys in Sri Lanka in 1932 and 1936, highlighted the burden of leprosy in children and emphasized the importance of ensuring continued education for them. The treatment methods evolved from traditional plant-based local applications and oral and injectable remedies in the 19th century, to the current use of multidrug therapy. An antileprosy campaign was established in 1954, focusing on disease prevention activities. In 1995 Sri Lanka was declared as having achieved the WHO target of elimination of leprosy, which is a highly technical point and has caused a major obstacle for leprosy awareness. At present, the Sri Lanka College of Dermatologists and the Leprosy Study Group contribute to guidelines, with Dr Indira Kahawita, consultant dermatologist, playing a major role as a member of the WHO technical advisory group on leprosy.