DATELINE: KEUR MASSAR

Easing leprosy’s pain

MICHAEL ROSE March 30 1987
DATELINE: KEUR MASSAR

Easing leprosy’s pain

MICHAEL ROSE March 30 1987

Easing leprosy’s pain

DATELINE: KEUR MASSAR

The ragtag collection of dusty thatched huts and one-storey concrete-block buildings sits in the Senegalese desert a 45-minute drive from the country’s capital, Dakar. Children run in a rudimentary playground, kicking up small clouds of sand. Small groups of men and women in traditional tribal robes and headgear stand in the blinding sun. But despite the air of normalcy, Keur Massar is unlike the other small desert villages in the area. A colony for lepers, it is also a hospital where victims of the disease are treated with traditional African remedies.

Those remedies are subjected to laboratory analysis. The objective of that unique and controversial experiment: a simple, effective cure and preventative vaccine for the degenerative, communicable disease that still afflicts 12 to 15 million people, primarily in the Third World.

Leprosy is caused by the bacterium Mycobacterium leprae, which causes degeneration within the nervous system that can result in the loss of sensation— and even decay —in parts of the body. Although the disease can be controlled by complex and expensive drug therapy, that treatment has not proven effective among all patients. Keur Massar, established in 1980 by French microbiologist and physician Dr. Yvette Parés, exists as an attempt to fill that gap. Parés, 58, a researcher at the University of Dakar, works with master Senegalese herbalist Yoro Ba to examine and administer treatments based on local medicine. Her bold initiative and questionable claims of success have in many cases earned her the outright scorn of Western colleagues. But, said Parés, “modern medicine, despite all of its efforts, has not been able to check the spread of leprosy.”

Indeed, 200,000 new cases of leprosy are diagnosed around the world each year. Until the 1940s the only treat-

ment that even minimally arrested the disease involved doses of chaulmoogra oil—pressed from leaves and seeds of a tree native to Asia. Then scientists discovered a group of more effective drugs known as sulfones, which stopped the bacteria from multiplying. But by the 1970s the bacteria in some patients had become resistant to those drugs. Now, sulfones used in conjunction with two other drugs—clofazi-

mine, which keeps new bacteria from forming, and Rifadin, which kills them—can in many cases cure the disease. But the therapy is expensive, and many Third World patients are unwilling to undergo the lengthy and involved treatment.

Of Senegal’s 52,000 lepers, about 15,000 have been treated by the staff at Keur Massar. At the heart of the clinic’s operations is the collecting and processing of 180 kinds of plants, roots and seeds that Ba claims to have successfully used on patients for decades. The substances are then stored in old liquor and wine bottles on racks. Outpatients wait their turn for doses of the medication—taken in a variety of ways—which Parés and her colleagues

say may be the foundation of an eventual cure.

While undergoing treatment, the patients are able to continue leading normal lives. Parés is clearly cautious when asked about the success rate of her work. She said that her methods had given “good results.” Still, she has published no studies, offers no statistics and acknowledges that her patients might have to be treated and followed for years. Said Parés: “A patient treated by us improves quickly, sees his symptoms disappear, and I think we may have already

cured a certain number of people.”

The western medical establishment has received such claims with evident skepticism. Last February Dr. Jacques Millan, director of the Institute of Applied Leprology in Dakar, told CBC Radio’s Quirks & Quarks that Parés “has never presented one case that was indisputably cured.” And Dr. Laszlo Kato of Montreal, a Canadian expert on leprosy who has advised the World Health Organization (WHO) since 1966 on its leprosy projects in numerous countries, added that he was shocked to learn of Parès’s methods. “What she is doing is

antiscientific and ridiculous,” Kato declared. “Why would she want to take us back to the 13th century?”

Through the Canadian International Development Agency (CIDA), the Canadian government has provided funds for the fight against leprosy. CIDA money supported construction of one of the main buildings at the Institute of Applied Leprology, a modern and highly respected research and treatment centre. And despite the controversy surrounding Parès’s research, CIDA also provided $48,000 in funding to Keur Massar between 1982 and 1984. During Prime Minister Brian Mulroney’s visit to Senegal in late January, his wife, Mila, toured Parès’s establishment. Said Dr. Jay Keystone of the Tropical Disease Unit of Toronto General Hospital: “It is very disturbing that our government supports treatment that does not have at least a scientific ground for being effective.”

Mainly as a result of her unorthodox views and activities, Parés, who holds a PhD in biology, has become an outcast in the western medical community. A former scientific researcher in France who arrived in Senegal in 1960 and obtained her medical degree in Dakar in 1968, she was not invited to a recent international conference of medical researchers in Dakar, even though it was held in the university where she holds a research post.

But in the battle against leprosy, Parés is not alone in her departure from western medical traditions. Therapists in other countries, including China, have been experimenting for years with a combination of traditional methods and western drugs to treat leprosy. At the Hainan Island leper colony off China’s south coast, acupuncture is sometimes used as part of the overall treatment program. Even such respected organizations as the WHO—now testing a new leprosy vaccine made from the tissue of infected armadillosare experimenting with more unusual approaches.

For her part, Parés says that because modern science has not yet provided an adequate cure, she is convinced that natural remedies are “the only way.” She told Maclean's, “Plants are useful to stimulate defences, to eliminate toxins, to repair nervous disorders, bone disorders, ulcerations.” Still, much of her research takes place away from the primitive surroundings of Keur Massar. In the modern setting of her university laboratory, she attempts to isolate the medicinal elements of the plants used at the centre. In the fight against leprosy, her mixture of western research methods and traditional African treatments may yet yield some significant results.

MICHAEL ROSE in Keur Massar