International Leprosy Association -
History of Leprosy

International Leprosy Association -
History of Leprosy

Uzuakoli (Nigeria)

Uzuakoli Leprosy Settlement was founded by the Methodist Missionary Society and the Local Authorities of Owerri Province. It was opened as the Provincial Leprosy Settlement in August, 1932, with Dr J A Kinnear Brown as its first Superintendent. Under his leadership, between 1932 and 1936, the Settlement grew into an institution catering for 800 patients. In 1936, Dr T F Davey arrived as the senior specialist. By 1938 up to a thousand people were living in the colony and five times that number had been turned away. Dr Ross arrived in 1940.

Experts were of the opinion that the incidence of leprosy in the Owerri Province of Nigeria was probably the highest in the world. (Report 1939) From a survey of a Division in the province, the incidence of the disease was 33 per 1000 (approximately 7,000 people in one Division). Up until 1938, Uzuakoli was isolated from other leprosy control efforts that may have been taking place, but in that year, a new plan of leprosy control was adopted for the province that placed Uzuakoli at the centre, as if it were, in Ernest Muir’s words, the hub of a wheel radiating in all directions.” (Report 1939) The scheme began the following year and doubled the number of patients coming for treatment. Outstation clinics treated others.

In 1939, the numbers of patients treated at outstation clinics were as follows:

  • Alayi (opened in Dec 1939): 95;
  • Nkpore (opened Feb 1939): 319;
  • Igbere (Feb 1939): 73;
  • Uturu (May 1939): 328;
  • Uzuakoli (Oct 1938): 186;
  • Ibeku (June 1939): 40;
  • Ozuitem (June 1939): 125;
  • Isieke (Dec 1939): 77.

Every week over 3,000 treatments were administered from Uzuakoli and the adjoining clinics. In a year, more than 200,000 were administered.

As part of the scheme, the assistance of nineteen clans in the Bende and Okigwi Divisions was enlisted, and seventeen responded positively, requesting anti-leprosy work to begin at once in their areas. The clinics were built by leprosy-affected people on lands given by the chiefs.

By the 1940s the medical workers were beginning to think that 50,000 was too low an estimate of the numbers of people infected with the disease. In response, in 1942, the work at Uzuakoli again expanded to include 44 centres or clinics so that more than 11,000 people were being treated every week with hydnocarpus oil.

People voluntarily segregated themselves in model leprosy villages. Fifty percent of the people in Bende Division were being treated. In the other Divisions hardly anything had been done. Workers hoped to progressively bring down the numbers of infected people by isolating all infectious cases, treating all the patients, repeatedly surveying the population, and trying to prevent the spread of the disease through education and early diagnosis. They were optimistic that this was being achieved in a small number of clans: the Bende clan, the Ozuilem clan, Abam, Ndi Oji section, the Abiriba clan, amongst the Nkporo villages, and the Oborodan. (Report 1944)

BELRA helped establish a Research Unit at Uzuakoli, and for six years, Dr John Lowe worked there, and transformed leprosy treatment through his studies of using dapsone (DDS) orally.

In 1945 the Uzuakoli Leprosy Settlement and Research Centre became part of the Nigerian Medical Service, and the Government assumed responsibility for the medical aspects of the work. With the introduction of DDS, the numbers of people requiring treatment fell from 16 000 patients to 4 000, with many being discharged as symptom free.

In 1955, the Leprosy Research Unit at Uzuakoli was undertaking preliminary trials of new drug, some serological studies, studies in biochemistry and also some aspects of epidemiology. DDS was being used in the settlements and outstations without any sign of resistance to it.

Stanley Browne was invited by the Nigerian government to succeed Frank Davey as senior leprologist of the Leprosy Research Unit at Uzuakoli in Eastern Nigeria. At the Unit he continue to trial new drugs, including B663 (later known as clofazimine).

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Sources

“The First Report on Control Work Undertaken by the Staff of the Provincial Leper Settlement, Uzuakoli for 1939”.

“The Owerri Province Leper Settlement Uzuakoli Annual Report for 1939”.

“Leprosy Control in Owerri Province 1944: A Report on the Sixth Year of Control Work in the Provinces”.