The use of MDT in the three western regions of Nepal.

The Leprosy Control Programme (LCP) covers 2 1 districts in the three western regions of Nepal, and provides treatment for more than 1 0,000 leprosy patients in about 200 treatment units of the Basic Health Service, and several hospitals/ referral centres . PMWs work at various levels, visiting health posts and running clinics on a pre-fixed date . The number of clinic days per month varies according to the number of patients per unit, but in most of the treatment places there are less than 25 registered patients, and those places are attended bi-monthly . The majority of treatment units are not easily accessible, and most of the travelling has to be done on foot, which considerably limits the supervisory assistance given to the paramedical staff and consequently the PWM must be able to deal with the entire care of leprosy patients , including diagnosis, dealing with complications, and release from control .