With the birth of two wonderful little girls in my extended family this week in Ireland I am reminded of the mother and baby ward in Lalgadh Leprosy Hospital in southern Nepal.
This last week in February there have been 3 births in Lalgadh, two girls and a boy. All going well the mothers will return home with their newborn baby about 5 or 6 hours after birth. The normal birth figures in the hospital are an average of two a month.
This low figure is due to three things:
1. the specialised ward is a new facility within the hospital compound
2. most mothers have their babies at home and continue with normal daily life
3. the hospital is situated in rural Nepal and travelling long distance, at short notice, usually on foot is not ideal during labour.
This trend is slowly changing as a result of the Village Alive Program which includes training of Rural Health Champions (RHC).
The RHC’s are women working on a voluntary basis and have been selected by their respective villages. These women take part in efforts to control diarrhea, vomiting, malnutrition, malaria, and tuberculosis and referral advice when required. Most of them were illiterate, but now function as health volunteers, measuring blood pressure and performing examinations, including examination of pregnant women. They are also able to recognise danger signs and advise to move pregnant women to hospital if necessary.
Dr Anne Dee will be returning to Lalgadh, Nepal in March after a break of twenty years. She has obtained funding under the ESTHER* alliance which is a European organisation which encourages partnership between developed and developing world healthcare facilities.
Under this scheme, the Department of Public Health in Limerick has been funded to set up a partnership with LLSC (NLT’s leprosy centre in south-eastern Nepal) . She will travel with the Director of Public Health in Limerick, Dr Mai Mannix, and will spend time in LLSC meeting the workers there, viewing the projects and agreeing the scope of this proposed partnership.
Dr Krishna Lama and Dambar Aley from LLSC will make a return visit to Ireland in May in order to finalise the partnership agreement.
Dr Anne Dee, Specialist in Public Health Medicine, Department of Public Health in Limerick.
When I visited Lalgadh Leprosy Hospital for Easter 2014 I was blessed to meet some beautiful people. I know I have made friends for life as a result of my time spend there. One of the ladies I met was Sarita, she was part of the outreach team who travelled with us to the remote villages. On these trips she preformed many tasks, one of which was introducing us to the villagers, helping to translate and share their stories.
I also spent time with her in the small jewellery making workshop which she manages. She provides training and support for people in a similar situation to her own. Sarita, seen here on the left, is a very warm, confident and outgoing person but this was not always the case.
The Nepal Leprosy Trust hospital in Lalgadh, south eastern Nepal reached its highest recorded number of patients with 601 outpatients on Sunday 12th October – 58 leprosy and 543 general. This is very good news as there still remains a reluctance to present with leprosy related symptoms due to the associated stigma.
These continuously increasing numbers suggest a wonderful increasing visibility and drawing power of LLSC’s hospital services under the Good Lord’s hand and with its reputation for low cost (or free) high quality caring clinical diagnostics and patient treatment – things that characterise compassionate Christian care. Perhaps you could spare a thought or a prayer for the stretched Out Patient Dept (and In Patient Dept) staff, especially the doctors, nurses and paramedics who battle through the pressures of these huge numbers each day, willingly and caringly despite the present uncomfortable heat.
Thanks to everyone who attended the Nepalese Cultural day in Farmleigh last Sunday. We really appreciated the interest and support for both our craft sale and in hearing about our mission in Nepal. Sales of Christmas stock was surprisingly high although not altogether unusual as the felt Santa Cones are really loveable. It was such a glorious warm sunny Sunday!
There was a lot of interest in how the felt santa cones are made. They start out as pieces of dyed wool fibres, which are kneaded and matted together, by hand, using warm water and soap. As the wool shrinks and tightens the pieces are formed into specific shapes to give an end result. To form the santa, pieces of cone shaped wood are used as a structure to support the felt as it dries which in turn absorbs the shape of the cone.
The natural lanolin in the wool, the warm soapy water and the hand movements are extremely beneficial to hands that have suffered as a result of leprosy infection. The finished products provide income generation opportunities for the artisans, who are supported by NLT Kathmandu.
Nepal Day Craft Fair in Farmleigh, Phoenix Park. Sunday 21st September 2014 from 12pm – 5pm.
Join us for a family fun day in the beautiful setting of Farmleigh estate. Nepalese crafts, cultural performances, food, photographic exhibition plus much, much more. Come and say hello to us at the NLT stall. We will be selling Nepalese jewellery, batik cards, felt beaded hearts, and stars in a fantastic range of colours.
This photo was taken in April as Durga, Sunita and Sarmila hand sew on beads and put the finishing touches to the felt hearts, angels and star shapes for our order for Ireland. This is one section of the NLT craft workroom in Kathmandu, it is outdoors under a light canvas roof. I watched as the artisans sat cross legged sewing, they can remain working in this position for hours.
These happy felt faces are looking for a home for Christ… it is a little early in the year, and with summer still here, to finish typing the above word!
Stigma – A mark of disgrace associated with a particular circumstance, quality, or person.
“It all began with a small patch on my skin that didn’t feel anything, but now I feel tingling in my toes and feet.”
Leprosy is caused by bacteria, mycobacterium leprae, affecting the nerves in the skin, face, hands and feet.
“As time went by my hands and feet would get injured. I feel no hurt.”
Leprosy can permanently damage the nerves so that they feel no pain, hot or cold, just like an anaesthetic.
“Cuts get infected, and ulcers develop. I feel no discomfort.”
The patient feels no pain, injuries are not rested and may get infected badly.
“My family don’t like the disease, they hide me, and make me live alone. I feel loss.”
Stigma can begin between husband and wife, parents and children.
“My children are discouraged from going to school. I feel shame.”
The wider community can affect the families of leprosy sufferers.
“We cannot go to the well with everyone else, our neighbours shout at us. I feel anger.”
Fear and misunderstanding in the community can lead to separation.
“I’ve lost my job, as my boss does not want me around. I feel hunger.”
Economic loss can cause the family great hardship.
“I went to the hospital at Lal Gadh Leprosy Services Centre (LLSC), the doctor tells me I have leprosy. I feel despair.”
The actual diagnosis can be the most painful part, for patient, family and community.
“The nurses take care of my wounds and ulcers and give me medicine. I feel compassion.”
The secondary effect of having damaged nerves is infections, this is what most people see as leprosy, the leprosy bacteria is treated by antibiotics.
“I sleep in a hospital bed and have a full meal. I feel safe.”
Often patients may be malnourished and need to be admitted as in-patients.
“The hospital staff hold my dry hands in theirs and make me laugh. I don’t feel untouchable.”
Stigma begins in the heart, and we overcome it by the way we live, by the example we show.
“I am much better now, so I can go home, I meet other leprosy patients in my area. I feel a new community beginning.”
Leprosy patients form self-help groups (SHG), to look out for each other. Men and women, young and old, Muslims, Christians and Hindus of different castes all sit together and share their struggles, offer advice, laugh and cry, touch and comfort each other, building self-esteem and confidence.
“In the SHG we can start to learn again, to read and write, to understand health issues. I feel I am growing.”
Self-help groups receive support from LLSC with adult and health education.
“The SHG begins a monthly savings scheme. I feel hope.”
Self-help groups receive seed capital from LLSC and encourage leprosy patients to budget and save.
“I start a small business and earn money to support my family. I feel pride.”
The savings scheme can lend money to its members to start an enterprise to break the downward cycle of poverty.
“My children respect me again, and my spouse welcomes me in the home. I feel love.”
The family often adapts and heals remarkably easily.
“My children can return to school. I feel they have a future.”
Public health education, through street drama or discussion provided by LLSC can help bring down barriers in the community.
Drinking clean water, washing your hands, seeking treatment for infections: such things may be second nature in Ireland. But for many villagers in rural Nepal, a lack of education hinders their knowledge and ability to live healthy and ward off preventable diseases.
Thanks to a 3-year grant from Irish Aid and effect:hope The Leprosy Mission Canada, Nepal Leprosy Trust Ireland is now supporting some of the very poorest in Nepal to live more productive lives in a project called Village Alive Programme or VAP.
NLT has organised groups in two Dalit villages (a group of people traditionally regarded as untouchable) to effect and promote health improvements. After training and support from NLT staff, a volunteer in each village qualifies as a Rural Health Facilitator, who helps the groups to identify major health problems and tackle them through health education: the use of clean water, and improved sanitation.
The project also includes a micro-finance element, which encourages men and women to develop their own small businesses.
Measurements will be taken to gauge the success of the project, and it is hoped that the long term incidence of Leprosy will reduce as a result of improvements in the standard of living.