Starting point
Approximately four million people all over the world have to live with the long-term consequences of leprosy - chronic inflammations or paralysis of muscles and joints, partial amputations or blindness. Older people in particular, whose disease dates back many years, are affected. They have been healed completely of leprosy itself, but nerves have often been destroyed because the disease was not detected early on.
Due to their disability or their age, it is almost impossible for these people to support themselves. Furthermore, people who are suffering from the visible effects of leprosy - such as missing fingers - have often been outcast by their families and village communities. Most of them thus continue to live in hospitals, also because they cannot return to their villages due to the stigma attached to the disease.
This situation was not satisfactory for two reasons: Firstly, the leprosy hospitals supported by DAHW have by now developed and have become general hospitals which take over important functions in the health system of poor countries. Entire health stations with long-term patients restrict the provision of medical care for patients with acute illnesses.
Also, these patients need social support rather than medical care. They can lead a more humane life in a residential care home than spending the rest of their lives in hospital.
Aims of the project
DAHW has discussed in detail with its partners how older people with disabilities can be looked after adequately. It was important from the start that the facility be tailored to these people's special needs. This means: suitability for disabled users, access to medical care and social contacts. A larger legate has now laid the foundations to build residential care homes for older people who live with disabilities after their leprosy disease and who do not have any family members who can look after them.
Activities
DAHW only supports construction measures if later maintenance can be guaranteed. A total of eleven homes for approximately 500 people are planned in India, Yemen, and Nigeria. The project partners do not only have to present construction plans, but also convincing concepts on how to pay running costs after construction has been completed.
In the first construction phase until the end of 2011 alone, the costs for construction are estimated to be more than 450,000 Euro. Annual operation costs for seven homes in India alone will be approximately 50,000 Euro, however, no significant additional costs will arise as many of these people already live in these projects and are looked after there. Furthermore, caring for patients in an old people's home is much cheaper than providing medical care in a hospital, i.e. more patients could be looked after at the same cost.
The largest share of operation costs is for providing food for the residents or - depending on the degree of disability - for providing prepared meals. These tasks are already carried out within DAHW projects anyway; for years these projects in particular have been taking care of leprosy patients and former patients suffering from long-term consequences of leprosy.
Specialists in these countries commissioned by DAHW have compiled the construction plans. Local partner organisations or the DAHW representative on site take care of the construction permit. Suitability for disabled users was especially important as many future inhabitants live with aids such as wheelchairs.
What was achieved in 2010?
In 2010, DAHW invested approximately 175,000 Euro in six of a total of seven projects in India. The foundations have been laid and construction work is making progress. Once these buildings have been completed, they will offer room for 285 people who live with disabilities because they previously suffered from leprosy or who are disabled for other reasons.
Plans for 2011
With another 192,000 Euro, construction work in the six Indian projects will be completed in 2011; there has been a delay with the construction permit in the seventh project. Two homes will be built in Nigeria and the costs have been estimated at 70,000 Euro to begin with. No precise calculation is possible so far in Yemen, as the call for tenders has not yet been completed.
Due to cultural differences, the plans look different as well: While a residential home in India is made up of one big house, it will be several smaller houses close to each other in Nigeria. Instead of building new houses, existing leprosy colonies which have hardly been in use for years are renovated and adjusted to the requirements of future use.
Risks of the project
In countries like Yemen or Nigeria there is always the risk of political instability. A change of government - especially if enforced violently - could lead to civil war, or, at the very least, however, to great insecurities among the population and to long delays in the proceedings at authorities.
Increasing costs for the maintenance of buildings or the care for residents are possible, as well as fluctuations in currencies and such things always carry a small risk for our project work.
