An article published in PLoS Medicine has shown that, in certain circumstances, even free treatment is not enough to help the poorest of the poor. The disease, caused by Mycobacterium ulcerans is prevalent in over 30 countries, with the worst affected situated in West Africa.
Despite free treatment people often abandon treatment or are abandoned by their families during treatment. This study showed that the added costs of transportation to the hospital, earnings lost while caring for the patients and other hidden living expenses often put families in a position of needing to abandon hospitalized family members. At the time of the study, more than half of all patients (62%) had been abandoned at the hospital due to the extra costs, which ultimately accounted for up to one-quarter of the household's yearly earnings.
As a result, many Buruli ulcer victims stop treatment before it is complete or avoid it altogether. This has serious repercussions because there are devastating future consequences including deformity, disability, and loss of livelihood, which result in further impoverishment, according to the authors.
The authors suggest that future programmes look at bringing the treatment to the affected person, rather than expecting the person to go to hospital.
