In February 2007, Colin and I had the privilege of visiting St Luke’s Leprosarium. All the staff we met were endlessly kind and patient. They treated us as ‘honoured guests’ – educating us about leprosy, explaining, and answering all our questions. Dr Jeyabalan, the Medical Superintendent, had arranged a very interesting three day programme for us and graciously gave up hours of his time to escort us.
St Luke’s has two ‘faces’ – a calm, peaceful, supportive side you would expect of any hospital, and a lively, vibrant atmosphere which comes from the 250 ‘healthy children’ who also live on the campus.
On our first morning Dr Jeyabalan explained the history of both the disease of leprosy and of St Luke’s Leprosarium, and gave us a tour of the hospital. As non-medical people we found this very moving to see at first hand the dreadful red nodules on skin, the loss of fingers and toes, and the acute weeping ulcers on the feet of some of the patients. The three hospital wards are very simple and basic – the cure of leprosy and managing its associated disabilities does not require hi-tech equipment. The nurses and other staff went efficiently about their duties and the patients sat on their beds in grateful awe of Dr Jeyabalan. Every one of them greeted us with a quiet and respectful namaste (the traditional Indian clasped hand greeting). Above each bed was a painted board indicating the name of the bed sponsor. These were mostly Indian individuals or organisations but there were some UK sponsors including the Neem Tree Trust.
The philosophy of care at St Luke’s is to take a holistic approach. When someone presents and is diagnosed as having leprosy a whole series of actions is initiated – the Multi Drug Therapy to cure the leprosy; treatment of other illnesses (eg vitamin deficiencies, ulcers and open wounds); minimisation of leprosy disabilities (eg tendon surgery to release clawed hands); aids provided (eg crutches, appropriate shoes, and special spoons); social issues addressed (eg training/retraining for work, family support if unemployed, children admitted to the Home for Healthy Children, support through the stigma of being a ‘leper’, including education about leprosy for the patient’s home village).
A large proportion of the inpatients are elderly. These older people are called Mercy Patients. They are often ex leprosy patients readmitted not because of the active disease but for the treatment of recurring ulcers. It is very easy to injure feet which are insensitive to pain whilst walking barefoot, and then these wounds can become infected and ulcerate. These patients can spend the rest of their lives at St Luke’s as mostly they have no means of supporting or caring for themselves.
If leprosy is diagnosed early enough it can be cured simply by administering Multi Drug Therapy as an outpatient. Providing the disease is caught early enough and medication compliance is good, leprosy is 100% curable. In untreated leprosy the disabilities and deformities caused by damage to the nerve endings cannot be reversed. Dr Jeyabalan told us of the outreach programme based on outpatient clinics held in rural villages and the vitally important health education programme.
We saw this latter in action when one morning we sat in with 100 students from a teacher training college. As part of their course they visit St Luke’s for lectures on both leprosy and its social issues. Dr Jeyabalan is hopeful that these future primary school teachers will be alert to spotting early signs of leprosy and de-stigmatising the illness for the pupils and their parents.
The students, all female, had prepared an entertainment for the patients and some of the children. We were delighted to be invited to this. There was dancing (to modern Indian Christian music – quite ‘Bollywood’ to our eyes!), a choir and two dramas (one in English and one in Tamil). We were honoured when the choir sang “What a Friend We Have in Jesus” for us – bringing back childhood memories of Sunday School.
We were fascinated that all meals in the hospital dining room are served on fresh banana leaves rather than plates. Although strange at first this has obvious hygiene and cost benefits, not least in that all food waste and leftovers (including the banana ‘plates’) are fed to the hospital pigs – truly eco friendly recycling!
As well as the pigs there is a farm for breeding goats at St Luke’s. Most of the patients admitted to the hospital are from rural areas and many of them are/were goat herders. Before returning home they are trained in modern husbandry methods, provided with a pair of breeding goats (stronger and more dependable than the native breed) and encouraged to grow fodder for them rather than walking long distances on their vulnerable feet to find suitable grazing – another example of St Luke’s holistic approach.
After the calm of the hospital and the discipline of the young teachers, other parts of our time at St Luke’s erupted in the joy of living exuded by the children of the Home for Healthy Children. Between the ages of 5 and 16, these youngsters are the children of, or orphans of, leprosy patients (both in- and outpatients). We had great fun being with the children – the younger ones in their playground, complete with swings and a garden; the older boys being read to from the morning newspaper before leaving for school (cricket scores were important!); being shown round both boys’ and girls’ dormitories (we were touched when the boys proudly showed us the small gifts some had received from their sponsors); the party atmosphere when the children joined in with the patients at the meal we sponsored (groups of children entertained us with dancing). Our sponsorship for the meal was channelled through the Neem Tree Trust to take advantage of the UK Gift Aid Scheme.
Probably the happiest memory of the children is when we accompanied about 50 of them (of all ages) on a picnic outing to a nearby bird sanctuary – travelling in a small bus full of little girls singing lustily on the journey there and back; everyone enjoying scalding hot coffee from tiny plastic cups; walking through a small rural village to view the painted storks nesting in the shade trees, with small girls squabbling over whose turn it was to hold our hands.
There was such hope for the future in these bright, happy children and there was also much hope for the future in some of the cured and rehabilitated patients presented to us. We visited a young man, his wife and three children in a nearby hamlet. Muragan had been a lorry driver before contracting leprosy. Although now completely cured he had sadly been unable to find a job driving because of the leprosy stigma and because of deteriorated night vision. St Luke’s provided him with a cow and a calf and by selling the milk to a milk combine Muragan earns enough to support his family. His children are being educated through the Home for Healthy Children and his wife (also cured of leprosy) is receiving free medical care during her current pregnancy. Without the intervention of St Luke’s this family would probably have disintegrated and the children possibly become beggars to support their parents and perhaps even succumbed to leprosy themselves.
Before the meal which we hosted, a number of gifts were presented to deserving cases – a sewing machine to a woman disabled by polio so that she could earn her living as a tailor, and three men each received a ‘load bicycle’ so they could work as coolie carriers. To us, used to the affluence of the UK and its welfare state, the 3,500 rupee (about £40) cost of each of these gifts seems incredibly small but to the recipients they could be life changing. We were also introduced to three young people for whom Dr Jeyabalan was trying to raise funding to pay fees for further education. One young man was halfway through a technical course for which his family had scraped together the fees. The second eighteen months of the course was in doubt because the father, a recovered although disabled leprosy patient, was struggling to earn enough.
Everything we saw and experienced at St Luke’s Leprosarium touched us greatly and we were very impressed by the thoughtful, economical and caring way everything was done by Dr Jeyabalan and his dedicated staff. When I spoke to the patients and children at our hosted meal, as well as thanking everyone for their care of us I also explained that the next morning we would be setting off on the very long journey back to the wintry cold of Edinburgh. I continued that not all of me would be travelling as ‘they had stolen my heart’. Our stay at St Luke’s Leprosarium had been humbling, inspiring, fascinating and fun.