Leprosy. Nurse cleaning wounds due to leprosy (Hansen's disease) on a woman's foot during a daily house visit. Leprosy is a chronic disease caused by the bacterium Mycobacterium leprae. The woman is undergoing multi-drug therapy with antibacterial drugs, but must still have her wounds regularly dressed. Leprosy affects the skin and mucous membranes, and irreversibly damages nerves. In serious cases, swelling of the nerves, numbness of the skin, muscle weakness and paralysis follow. The loss of feeling means that injuries may not be noticed, leading to scarring or even the loss of fingers and toes. Photographed in Samoa in 1999.