According to the World Health Organization (WHO), isolated pockets of leprosy remain within nine countries. However, even casual conversations during the course of developing this photographic essay indicate that there may be underreporting of the illness in regions of the Indian subcontinent and elsewhere.1 The fact is, leprosy remains an enigmatic but treatable infectious disease, and multidrug therapy and early detection remain the keys to its control and elimination.
This essay includes photographs I compiled during my travels over the last 15 years. Most of the images portray more advanced disease. However, readily available guidelines can be used to help prevent the advancement of disease and the development of physical disability.2 Of particular importance is care of the feet, hands, and eyes—these problems have prevented the integration of leprosy patients into their communities for more than 2,000 years. The images portray problems with all three areas.
With an incubation period that may occur over many years, a possible reemergence related to human immunodeficiency virus infection, and a natural background reservoir of the illness, leprosy should lead us to consider the meaning of elimination. According to WHO, “Elimination of leprosy as a public health problem is defined as a prevalence rate of less than one case per 10,000 persons.”3 Now that leprosy is on the verge of being “eliminated,” it is important for us to consider another global public health success, and for the nations of the world to make one last push to eradicate the disease permanently.
However, even if leprosy is eliminated, it will remain a public health problem for many decades. The illness may be accompanied by significant disability, but it is difficult to find data on the true incidence of leprosy-related disability. It appears that in some instances, the level of nerve damage and disability may progress despite adequate treatment. Thus, disability prevention may become another marker as to how well communities are treating leprosy and its complications.
This may be particularly true as leprosy control programs are integrated into primary medical care. For example, multidrug therapy has controlled the overall prevalence of eye complications. However, age-related cataracts have become a leading cause of blindness among leprosy patients. Another cause of blindness is exposure keratitis and corneal anaesthesia.4,5
Case detection and the maintenance of data on new and old cases remain important factors in assuring that all segments of society are reached. Early drug therapy and prevention of disability are also important.6 In some areas, the isolation of leprosy patients remains problematic, and living standards may be low.7 In one instance, I witnessed treatment with homeopathic remedies for which evidence of efficacy could not be provided.
There has been considerable success toward the control of leprosy. But it will be necessary to maintain funding and programs if we are going to continue to make progress.
1. Durrheim DN, Fourie A, Balt E, Le Roux M, Harris BN, Matebula M, et al. Leprosy in Mpumalanga Province, South Africa—eliminated or hidden? Lepr Rev. 2002;73:326–33.[PubMed]
2. World Health Organization. Geneva: Leprosy Elimination Group, World Health Organization; 2002. [cited 2007 Nov 23]. Guide to eliminate leprosy as a public health problem. Also available from: URL: http://www.who.int/lep/resources/Guide_Int_E.pdf.
3. World Health Organization. Leprosy. [cited 2007 Nov 23]. Available from: URL: http://www.who.int/mediacentre/factsheets/fs101/en/index.html.
4. Hogeweg M, Keunen JE. Prevention of blindness in leprosy and the role of the Vision 2020 Programme. Eye. 2005;19:1099–105.[PubMed]
5. Courtright P, Lewallen S, Tungpakorn N, Cho BH, Lim YK, Lee HJ, et al. Cataract in leprosy patients: cataract surgical coverage, barriers to acceptance of surgery, and outcome of surgery in a population based survey in Korea. Br J Opthalmol. 2001;85:643–7.[PMC free article][PubMed]
6. Mahato ME. Disability prevention and medical rehabilitation (DPMR)—prevention of disability and timely referral in leprosy. J Indian Med Assoc. 2006;104:682–5.[PubMed]
7. Chen S, Chu T, Wang Q. Qualitative assessment of social, economic and medical needs for ex-leprosy patients living in leprosy villages in Shandong Province, The People's Republic of China. Lepr Rev. 2005;76:335–47.[PubMed]
Multidrug therapy has greatly decreased the morbidity associated with leprosy, but even with this therapy, nerve damage sometimes results in disabling loss. Injury to the feet is one of the main sites.
Bacteria (Mycobacterium leprae) attack peripheral nerves, such as those that control blinking of the eyes. The loss of this reflex renders the eye unprotected from injury and dries the surface. It can eventually result in loss of sight and even loss of...
Depigmentation, scaling, and nodules are classic dermatologic manifestations of leprosy. In fact, it is considered primarily a dermatologic disease.
Leprosy may result in considerable disability. The loss of mobility may result from lack of sensation, limb loss, or visual impairment.
It is increasingly important for leprosy patients to integrate into their communities. If treated early, leprosy does not need to result in disability.
In cases of advanced disease, surgical intervention may provide some relief. In this image, extensor motion is being given back to a person by tendon reconfiguration. Though drastic, there may be some value to tertiary prevention of more advanced sequelae...
Exhibition: June 15th – August 11th, 2017
Opening Reception: Thursday, June 15th, 6-8PM
“Many artists have felt the lure of juxtaposing photographs and text, but few have succeeded as well as Teju Cole. He approaches this problem with an understanding of the limitations and glories of each medium.”—Stephen Shore
Steven Kasher Gallery is pleased to present the first solo exhibition in New York of acclaimed photographer, essayist and novelist Teju Cole. The exhibition accompanies the publication of Cole’s fourth volume, Blind Spot (Random House, 2017) with a foreword by Siri Hustvedt.
The exhibition features over 30 color photographs from the series Blind Spot, each accompanied by Cole’s lyrical and evocative prose. Viewed together, these works form a multimedia diary of years of near-constant travel. In these photographs, we see what Cole has seen, from a park in Berlin to a mountain range in Switzerland, a church exterior in Lagos to a parking lot in Brooklyn; and we are drawn into the texts—which function as voiceovers—with which Cole complicates his already enigmatic images. At stake here is the question of vision, an exploration Cole began following a temporary spell of blindness in 2011, and which he presents here in a photographic sequence of novelistic intensity.
The exhibition also presents Black Paper, a visceral photographic response to Cole’s experiences following the election of November 2016. This continuously evolving, large-scale work explores buried feelings, haunted space, and all that can be seen through darkness.
Teju Cole (b. 1975, Nigeria) is a writer, art historian, and photographer. He is the photography critic of the New York Times Magazine and Distinguished Writer in Residence at Bard College. He is the author of three previous books. His novella, Every Day is for the Thief (2014), was named a book of the year by the New York Times, the Globe and Mail, NPR, and the Telegraph and shortlisted for the PEN/Open Book Award. His novel, Open City (2011) won the PEN/Hemingway Award, the New York City Book Award for Fiction, the Rosenthal Award of the American Academy of Arts and Letters, and the Internationaler Literaturpreis. Open City was also shortlisted for the National Book Critics Circle Award, the New York Public Library Young Lions Award, and the Ondaatje Prize of the Royal Society of Literature. His essay collection, Known and Strange Things (2016), the core of which is his photography essays, was published to rave reviews in the New York Times and the New York Review of Books, among others; named a book of the year by the Guardian, the Financial Times, Time Magazine, and many others; and is the only book to have been shortlisted for two PEN Awards in the same year: the PEN/Diamonstein-Spielvogel Award for the Art of the Essay and the PEN/Jean Stein Award for originality, merit, and impact.
Cole’s photography has been exhibited in India, Iceland, and the US, published widely, and was the subject of a solo exhibition in Italy in the spring of 2016. His photography column at the New York Times Magazine was a finalist for a 2016 National Magazine Award. He is a recipient of a US Artists award, and received the 2015 Windham Campbell Prize for Fiction.
Teju Cole: Blind Spot and Black Paper will be on view June 15 – August 11, 2017. Steven Kasher Gallery is located at 515 W. 26th St., New York, NY 10001. Gallery hours are Tuesday through Saturday, 10 AM to 6 PM. For press and all other inquiries, please contact Cassandra Johnson, 212 966 3978, firstname.lastname@example.org.