The experience of self-care groups with people affected by leprosy: ALERT, Ethiopia

This paper describes the development of self-care groups in Ethiopia by ALERT, and the successes and failures experienced in the processo The groups were started in 1995 in response to two main problems, the increasing number of people dependent on ALERT to heal their wounds despite years of health education, and the lirnited financiaI resources of ALERT for wound healing supplies.By December 1999, there were a total of 72 established groups.Group membership was voluntary.There have been a number of positive outcomes.Group members have taken up responsibility for managing and monitoring their own wounds and supplying their own wound healing materiaIs.More attention is paid to their personal hygiene and personal appearance.They also report increased confidence to participate in society, retored dignity and self-respect, and a sense of belonging within the community.In addition, some members have started to pay more attention to their local environ mental hygiene by building pit latrines and waste disposal sites.The ALERT staff involved in this initiative had to change their role from that of a leprosy service provider to a self-care group facilitator, but not all were successful in making this transition.The remaining challenge for the programme is sustainability and further development through the National TubercuIosis and Leprosy ControI Programme, The Ethiopian National Association for Ex-Leprosy Patients and possibly other organizations too.This paper outlines the reasons that prompted the establishment of self-care groups, their deve10pment and the outcomes.In 1995, ALERT staff expressed cone em about the increasing number of people affected by leprosy who continued to use the ALERT hospital and field clinics for their wound management.In short, the traditional approach for the prevention and management of u1cers, the didactic, health education talk or lecture which rnight or rnight not inc1ude a practical demonstration of soaking, oiling, scraping, wound trimming and dressing, l had disappointing results.The dressing of wounds was time consurning for the leprosy workers, who also expressed concem about the dependency of the people upon this service.There were lirnited