wires... bottles... yep enemies :) But in this case for me acceptable... here it is not litter lying around, but something that belongs to the man here. So... part of the situation.
Illness... I guess a lot of people do not want to picture the realities of life. For me... I just have a lot of respect for these people. I am awed by their willingness and struggle to survive. For that reason I think this kind of shots need to be shown. We could do a lot for them, if we really cared...

Have a good evening my friend

Saad, I do not think power wires or plastics or other things should be seen as enemy for a photographer. It depends on the subject you are shooting. If you are shooting a breath taking landscape or pose someone for portrait, then may be you want to avoid electric lines or plastics or any number of such things that can ruin your composition.

However in the picture above, the plastic bottle tells me that it is her only source of water as she stays there for quiet some time, may be in the mid-day sun. Not only that, had there been other litters lying around, which you might consider number one enemy, it will add further towards the environment the leper is living. And further, such people who should be well cared for or provided services to overcome their disabilities (wheelchair, easy jobs etc) is forced to beg on the street not just in Nepal, but in many countries around the world.

So my main point here is sometimes even empty space can be our enemy while at other times, the most disgusting thing can add to the image, or might as well be the subject of the image. Take Care