Ulcers are very common amongst leprosy patients, with up to 20 percent of people affected by leprosy being at risk of developing an ulcer. These ulcers are wounds that occur because people lose feeling a part of their body. This means, for example, they may not feel if there is a stone in their shoe that is damaging their skin.

After a patient has their first ulcer, it is likely that ulcers will recur for the rest of the person’s life, causing devastating disruption. In places where walking is central to transport and work, leprosy ulcers (which most often affect feet) can lead to a downward spiral of losses over time, including income, job, community, home, family, and even limbs.

When placed in hospital wards alongside these patients, first-time ulcer patients can develop suicidal thoughts, because they see the other patients’ sad stories as their own unavoidable future.