Treating lymphoedema patients in Indian villages

Dermatology (IAD) developed a low-cost integrative treatment protocol for lower limb lymphoedema. Treatment consists of a combination of compression bandaging, skin care, herbal-based procedures of traditional Indian medicine (Ayurveda), and yoga exercises (Narahari et al, 2007). Lymphoedema in India is mainly due to lymphatic filariasis (LF), a mosquitoborne disease caused by the parasite Wuchereria bancrofti (Cobbold, 1877). These parasites reside in the lymphatics and enter into lymph nodes, developing into adult worms which destroy the lymphatic system. Lymph then gradually accumulates in tissue spaces and lymphoedema occurs. India has 7.44 million lymphoedema patients caused by LF alone (Michael et al, 1996; Ramaiah et al, 2000), and there are 470 million people at risk (http://nvbdcp. gov.in/fil5.html). In addition, secondary of the estimated cost of treatment (333–555$). Although this is low cost for middle and upper class Indians, it continues to remain above the reach of the average LF patient in India.