Sri Lanka is an island 23 ,332 square miles in extent with a p opulation of about 15 million. It has several different races, the majority being Sinhalese (73%) ; others are Tamils (19%), Moors (7%), Burghers and Eurasians (0.3%), Malays (0.3%) and unspecified (0.1 %). The total number of registered cases of leprosy at the end of 1981 was 11,389, 29.6% being lepromatous; prevalence rate is 0.77%; child rate is 6.2%. 617 new cases were registered during 1981. Primary Health Care (PHC) in Sri Lanka is dependent on Public Health Midwives (PHM-I per 3,000 population), Public Health Inspectors (PHI-1 per 30,000 population), and Public Health Nurses (PHN-1 per lOO,OOO population), supervised by Medical Officers of Health (MOH-1 per 200,000 population). Each MOH has several PHIs under him-each PHI serves in an area called his Range which is part of the large area under the MOH. The PHIs are specially involved in leprosy control in that they are expected to (a) maintain chartings and data regarding all leprosy patients in their areas, (b) visit defaulters and persuade them to resume treatment, (c) screen contacts of known patients, (d) assist in school and other leprosy surveys, (e) assist at leprosy clinics in their areas, and (f) notify any new cases to the Superintendent, Antileprosy Campaign (S/ALC). Each PHIl ALC has patients in several MOH areas under his surveillancethat is patients living in an area of between 1,000 and 2,000 square miles. He conducts the clinics in his area, and carries out leprosy surveys, defaulter retrieval and health education as best as he can manage. He is, however, unable to carry out leprosy control activities satisfactorily due to (a) the large area he has to cover, and (b) a reluctance on the part of general health staff to enter positively into leprosy control activities. This has resulted in nearly 50% of the known cases defaulting from regular treatment, which is available at 81 leprosy clinics held monthly, twice a month or weekly (depending on the numbers of