February 8, 2010

Chitpur leprosy clinic

Arriving at the Chitpur leprosy clinic this morning, I witnessed the staff assembling its structure for the day, tying tarps to bamboo poles drilled in the ground, lugging metal cabinets full of medications, dressings, and patient files, and assembling chairs and tables to create the waiting, examination, physiotherapy, pharmacy, and wound care stations. Due to absurd regulations about the land ownership and certainly also the stigma against leprosy, CR is not allowed to maintain a permanent structure here despite fighting for the past 18 years. This makeshift street-side health care center is therefore rebuilt daily and deconstructed nightly, an inconvenience that is nevertheless worth the nuisance for the incredible services CR is able to offer.

All of the patients here are infected with Hansen's Disease (leprosy), a chronic yet curable disease caused by Microbacterium leprae whose incidence in West Bengal is one of the highest in the world. Chitpur clinic offers wound care six days a week, along with comprehensive medical care three days a week (M, W, and F) when a doctor is also present in addition to the wound care nurse. A health educator begins by teaching the patients about the disease's signs and symptoms, as well as wound care so that they may maintain, clean, and bandage their wounds at home. Staff commented that over time, they have returned to the clinic cleaner and cleaner due to this invaluable hygiene education, despite the reality that most of them are living on the streets and cleanliness is an uphill battle. After their lesson, the patients are instructed through physiotherapy exercises that slowly strengthen their numb and debilitated limbs. Though they have difficulty following a regular regimen given their living situations, they at least can complete the movements in supportive company. Next, the patients soak their feet as they wait in line to have their wounds dressed, a process that is quite efficient and satisfying to watch. Scales are removed, nails trimmed, skin shaved, and bandages applied as the healing process progresses for each one. Finally, if necessary, the patients see the doctor for any medical issues. Patients receive free anti-leprosy medications from the government hospitals, and any other medications, extra dressings, as well as crutches and reconstructive therapies from CR. The clinic sees about 35 patients on a busy day, people who come from far and wide to be seen anywhere from every fortnight to once per month. They recieve a meal when they arrive, since coming to the clinic is a big deal for many, the travel and time forcing them to lose an entire day of work if they have a job at all. Altogether 270 patients are seen at this clinic.

The magical and tragic thing about leprosy is that it is entirely treatable, and after months of visiting the clinic for medications, physiotherapy, wound care, and health education, they often return to a relatively healthy lifestyle. However, it is certainly true that the stigma associated with their clubbed feet and hands, loss of digits, and handicapped limbs will stick with them forever. Indeed, they have often been alienated by family and friends, unable to get jobs, and forced to beg on the streets.

Nonetheless, "Someday, leprosy could be cured!" Asis, the clinic manager, told me hopefully. After spending the day sketching the leprosy patients, seeing their optimism, gratitude, and camaraderie, and observing the efficient quality of care they received, I have no doubt that this ideal will one day come true.

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