Divorce among Saudi female leprotic patients: an experience at Ibn Sina Hospital.

DIVORCE AMONG SAUDI FEMALE LEPROTIC PATIENTS: AN EXPERIENCE AT IBN SIN A HOSPITAL Sir, As divorce is becoming a social and family threat to leprotic women elsewhere, we would like to share our experience on this important subject here at the Ibn Sina Hospital, Hadda, Makkah, Kingdom of Saudi Arabia. Social problems in leprosy are common and complex in character. Poverty plays an important role in the development of these problems . Unfortunately, leprosy is common among poor countries in general . In such places drugs are inadequately available, lack of health education and a stigma is attached to the disease leading to social rejection of the patients. Moreover, the life span of the leprotic patients is nearly normal enabling them to live longer within the community as they develop severe complications throughout life . This phenomenon adheres to the people's mind, and a malconcept about leprosy becomes the rule. It is a fact that in the management of leprosy the difficulty lies not only in eradicating the mycobacteria but also the backlog of terminal complications such as irreversible deformities and disabilities. In Saudi Arabia leprosy is not an alarming national health problem. During the last 8 years 1 276 cases were diagnosed and treated at Ibn Sina Hospital, comprising Saudis, Yemenis and other nationals, especially from the expatriate communities (Table I ) . The previous treatment we used was Dapsone alone. However, from 1 982 this hospital adopted Multi-Drug Therapy (MDT) as recommended by the WHO. Generally all cases responded satisfactorily and some had excel lent results. The role of the social workers is to help to educate the patients about their illness, participate in solving their social problems and problems in their job, help them acquire financial assistance from the Social Welfare Office, convince the patients to undergo regular hospital-OPD follow-up, education of the patients and their families about the use, importance and efficacy of MDT and help the leprologist to keep the patient admitted for as long as necessary or help discharge the patient to join normal life . Divorce is a serious social and family problem affecting leprosy patients, especially women. Presence of deformities, lack of adequate information about the disease and family hesitation to receive back the patient are all contributing factors. However, our experience showed that a long period of hospitalization is the single, most important factor leading to divorce, notably among female patients. Furthermore, as per Islamic rules of the country, the hospital discharges female patients only to their immediate relatives or guardians. In Ibn Sina Hospital leprotic women divorced by their husbands comparatively constituted a very low percentage . Our study concentrated on admitted married Saudi women aged between 1 7 and 5 0 years old with leprosy mainly as the cause for divorce . Non-Saudi women were not included as they were difficult to follow-up because most of them returned to their respective country. Likewise, Saudi women over 50 years old were not included as there was no single case of divorce in their group (Tables 2-5) . Our study showed that during the last 8 years total divorce was 1 4 -4% . The age group of 40-45