Small loan schemes: the experience of Ethiopia.

Leprosy is a medico-social problem and more than a disease . Statistics indicate that the disease, as a medical problem, has been decreasing steadily world wide since the advent of multi-drug therapy (MDT) in the early 1980s. However, the social dimensions of the disease in terms of stigma, poverty, disabilities and deformities, loss of self-respect and dignity have continued to constitute a major social problem in many developing countries. Until the 1 970s, rehabilitation in Ethiopia was merely considered as an act of charity . It was undertaken by religious persons and institutions. Throughout the 1 940s and 1 950s patients were kept within the leprosy hospitals compounds where they were provided with shelter, food, and sometimes clothing in addition to medical treatment. In Addis Ababa, a volunteer (also a missionary) established a sheltered workshop in 1 950 for 250 persons. The German Leprosy Relief Association (GLRA) established the Relief Center Bisidimo for treatment and rehabilitation of patients in 1 958 . A group of volunteers from Haile Sellassie I University ( now named Addis Ababa University) initiated a resettlement and rehabilitation project for 80 displaced leprosy-afflicted families. In the north (Boru Meda) the Society of International Missionaries (SIM) used to provide rehabilitation services for patients; a sheltered workshop that has accommodated 62 households was erected at the end of the 1 960s. The American Missionaries had been undertaking rehabilitation activities in Kuyera, near Shashemene, 240 km south of Addis Ababa; a total of about 570 families were resettled around the hospital to carry out farming on individual bases in 1 950 and 1 966. Generally however, the preI 970 rehabilitation efforts were all institutional . In the early and mid1 970s, approaches had incorporated some of the features of institutional and community based rehabilitation (CBR) . In a country where there is no clear social policy, rehabilitation takes many forms and up to 1 990, rehabilitation in Ethiopia had been sporadic . Neither the National Leprosy Control Programme ( NLCP) nor the donor agency (GLRA) had a clear policy on rehabilitation; they were concerned with the medical aspects of the problem. In 1 988, GLRA in collaboration with NLCP set up a Social Rehabilitation Department with in the NLCP, to coordinate and promote rehabilitation activities. Since 1 999 the government of Ethiopia has adopted a social policy (preventive, developmental and rehabilitative).