Chapter Ten, Section I.
Although our medical work embraced most public health problems and just about every disease known in India, we gradually found ourselves becoming more involved in caring for leprosy sufferers. This is evidenced by the name under which we came to operate - "The NAVJIWAN (New Life) LEPROSY CLINIC".
Keith doing repairs on vehicles. The Mobile Leprosy Clinic Vehicle is in the background. We had to do all our own repairs and taught nationals to do repairs. Those we taught, now operate their own motor and electrical businesses.
When we first went to Palamghat, Bihar and later to Surgapam, M.P., we thought there was no leprosy problem in the area, but later, we were to learn otherwise. Because the victims of the disease had no hope of recovery, they thought it futile to come to the clinic. Many of the more seriously neglected cases who suffered from gross deformity and ulceration, never were seen. Society had rejected them, sentencing them to an isolated and most wretched existence outside the village, often to live in extremely primitive conditions.
It was Jethu who triggered off .our special concern for these desperately needy people with what some of us would prefer to call Hansen's Disease or "HD". It is known by this name in honour of Dr. G. Armauer Hansen, a Norwegian who, in 1873, discovered the offending organism -- Mycobacterium Leprae or M. leprae.
From time to time, a few people have asked me, "Why do you get polarized on this one disease? Aren't there also other ways of suffering?" Yes, there are other ways of suffering - more acutely. I never again want to see the shocking burns from which some persons died. Nor could I face again a writhing victim of rabies and agonize with him to the bitter end.
But these are ways of suffering acutely; when we think of leprosy, it is chronic suffering that drives the victim to despair, although it should be understood that, in the very early stages of the disease, perhaps before the victim knows he has been infected, no suffering whatsoever is experienced.
Paradoxically, in the "Guinness Book of World Records ", we are informed that of all the communicable diseases, leprosy is the least contagious. In its infectious lepromatous form, it is also the most bacilliferous.
Although leprosy can reduce one's life span, only in rare cases of exacerbated reaction, can it be called a killer disease. We dreamed - an Impossible Dream - of being more adequately equipped to diagnose the disease in its very early stages, to ease the suffering and prevent its spread in the community.
Chapter Ten, Section II
I shall never forget when our first leprosy patient, Jethu, came to the clinic. He had massive necrotic ulcers on both feet, or on what was left of his feet. The gangrenous stench that pervaded his immediate environment was most nauseating. His hands, too, were grossly deformed and suppurating, with most of the fingers gone. Frankly, I was scared, so scared, in fact, that I donned surgical gloves before touching him.
In retrospect, I feel ashamed for having so insulated myself from this one who, above all else, must have yearned for the touch of another human being. Because we knew nothing in those early days, of the treatment of leprosy, Ruth and I had to contact a doctor. Our good friends, the Kishores, had moved to East Bihar, so we sought out other Daulatapur medical practitioners, hoping to find one who would teach us about the diagnosis and treatment of the disease. We found that those doctors with smart-looking clinics and well-to-do patients, did not even wish to discuss the subject of leprosy.
However, there was one friendly old doctor in the town who had a very dilapidated looking clinic. I tried him by delicately asking the question, "Doctor, what do you know about leprosy?"
"To tell you the truth," he replied in Hindi, "I don't have a clue, but I'll see what the medical books say." Reaching into his shelves made of old packing cases, he brought down a musty, ancient book, blew out the dust and looked up the chapter on "Leprosy and its Treatment".
"It states here," said the kind old GP, "that the vegetable oil extracted from the seeds of Hydnocarpus Wightiana is of some value. Would you like me to get you some of this oil?" And so it was that Ruth and I started the treatment of our first leprosy patient. At the time, we didn't realize that, although there is only one type of leprosy bacillus, there are different ways in which the disease manifests itself.
All the six main types of leprosy are conditional upon the patient's ability or otherwise to produce the right sort of immunity - "Cell-Mediated-Immunity (C.M.I.)". In those early days, there was so much we didn't know about leprosy, that it is a miracle the work ever got off the ground at all.
We had been treating Jethu with injections of Chaulmoogra Oil (sometimes also called Hydnocarpus Oil) for about six months, when one day he said, "You know, Sahib, - do believe I'm starting to get better. I feel, deep down, that my leprosy is going." In retrospect, I think it was not so much due to the Chaulmoogra Oil that his condition was improving, as to the fact that we had cleaned up his other health problems - amoebic dysentery, worm infestation, anaemia, malaria, scabies and protein deficiency.
Also, we removed some of his dental problems by extracting two rotten molars. Into the bargain, we cut away the rotten tissue of his damaged feet and trimmed up the ulcers as best we could. There was no way we could actually tell if his leprosy was abating, for we desperately needed laboratory skills. Above all, we yearned for diagnostic guidance from experts in the field and funds were required to cover all our expenses.
Until such time as we did receive financial help, which, according to mission rules, we were not allowed to solicit, Ruth and I invested our own personal salary. How we came into contact with The Hansen Institute is nothing less than a miracle. It was now very clear that we could expect no encouragement from the British Gospel Mission in relation to our leprosy work.
One top official on the British Board wrote to us,
"Keith remember your calling. You were not sent to India to do "Social
Work" but to preach the Gospel!" Evangelical Fundamentalism has done
so much harm to the cause of Christ, that, at times, I am almost ashamed to be
associated with the
Frankly, to me, the Mission's reprimand was like red rag to a bull; I was infuriated and told the Board so.
There was just no way that we could be expected to reject any person whom society had cast out. After all, what is the Gospel? To reject people in real, desperate need, whatever that need may be, even of those suffering from Leprosy or AIDS, is to reject Christ himself. We felt constrained, therefore, to "go it alone in faith", at least to offer acceptance and compassionate care, even if we could not meet their medical needs.
What we needed was specific training in how to diagnose a case of leprosy, especially in its early stages, so that disability might be prevented. Up to this point of time, it was only possible for us to identify obvious cases with disfigurement, deformity and ulceration. But, by this time, so much damage had been done to the patient already, that it was next to impossible to rehabilitate the victim and restore him or her to their rightful place in the community.
The Lord must have known we needed training to carry out the basic diagnostic tests, for what he did next in answer to our prayers, was to bring us into contact with delightful Canadian Missionaries - the Gabriel Family. These dear folk also had children studying at the Mussoorie Boarding School and, during one vacation in the Himalayas, they said to me, "Keith, how would you like to come to our field in West Bengal to conduct a week's theological seminar for our pastors? You would be our Conference Guest Speaker."
Even the thought of that scared me. Lecturing for six hours a day, seven days a week, would be burdensome enough in English. To face the challenge of doing this in a foreign language would require courage beyond my ability to muster. "I would like to accept your kind invitation," I said with a sigh of relief, believing I had the answer to free me from what I thought would be a strain, "but I know only Hindi, not a word of Bengali." "Never mind," was their insistent reply, "Being not far from the Bihar border, means that all our people know Hindi!" I could not escape.
Although I made many excuses in a vain attempt to avoid that series of preaching and lecturing appointments, I had a strange feeling, deep down, that I was being constrained beyond my own volition to accept the frightening challenge to be a mini-Billy Graham.
Ruth and I had no idea at the time of the remarkable way the Lord was leading us right to the very place we most wanted to visit. In a vague sort of way, we had heard of some mission that looked after "lepers", as they were so cruelly called, at the time, but we did not know it was located right there in Puruliganj where the Gabriels' mission had arranged its Annual General Meeting & Conference.
The Hansen Institute, or "The Leper Mission", as it was known then, has well over one hundred hospitals and clinics in India, but it was at Puruliganj that its Headquarters for all of Southern Asia was located in those days. And to think that the Lord led us right to that very place. This was more than just a coincidence; it was an Impossible Dream come true.
Somehow, as their Guest Speaker, I struggled through that week of high-pressure lecturing and expository preaching in Hindi, at the end of which, Ruth and I received our reward. The Gabriels knew The Leper Mission staff intimately and introduced us to the person at the top - Dr. Vikram Dasram, the Mission's Director for all Southern Asia. At the hospital, we were introduced to Dr. Ivan Collett and his charming wife, Maria, with whom we stayed as guests. So began our training in leprosy diagnosis and treatment, sitting at the feet of top-ranking experts in the field.
In the hospital and village clinics, we learned how to palpate nerves, identify various skin lesions and "chart" the patients. Also, we were instructed in "Differential Diagnosis" to distinguish leprosy from, Syphilis, Berger's Disease, Bell's Palsy, Diabetic Ulcers, Leukaderma, Carpal Tunnel Syndrome, Fungal Infections and about twenty other conditions that can be confused with early and advanced HD.
After the Gabriels' Mission Conference, Dr. Collett arranged for us to receive some laboratory training, specifically in taking skin smears, staining slides and "reading" them under the microscope to differentiate between the main forms of the disease - Tuberculoid, Borderline Types and Lepromatous.
Before leaving Puruliganj, we thought we should bid farewell to the Gabriel family, who were interested in every aspect of our stay with the folk at the Leper Mission Hospital. I mentioned that we had learned to use a microscope in detecting the leprosy bacilli but that we did not have a microscope and had no hope of receiving one from our own mission, which seemed bent on stopping our work.
"Come over to the old bungalow," said our hosts. "We have a microscope you may like to buy. The lenses need cleaning, but we can arrange for that in Calcutta, where also it could be evaluated."
With no certainty that we ever could buy the instrument, I said, "Fair enough, you get it into working order, put a price on it and we shall try to raise the money."
Several months passed before we had any further word from the Gabriels, but, meantime, we received a letter from a Birmingham (England) Gospel Mission Sunday School, enclosing a Sterling check with covering letter worded, "Please feel free to use this money as the Lord leads; maybe you have some need in your medical work!"
After cashing the check, a letter from John and Esther Gabriel informed us that the cost of the microscope would be Rs.600.00, almost the exact amount of the British Sterling check when converted into Indian currency!
Dr. Collett also introduced us to the main anti-leprosy drug at the time - Diamino Diphenyl Sulphone ("Dapsone" or DDS), which his famous father helped to pioneer. Dapsone, being bacteriostatic, prevents the living M. leprae from multiplying and what a thrill it was for us, after a period of time, to have clear evidence of that through a reduction of the Bacteriological Index in the smears of some of our "positive" cases.
The brief training we had received at Puruliganj, along with our constant study and communications with Dr. Collett, now enabled us to understand the reason for the different manifestations of Jethu's and Dasrat's types of the disease. In the case of Dasrat, who had some measure of C.M.I., his large white defence cells, called macrophages, were not only ingesting but also digesting a large number of M. leprae, for which reason, his skin smears of "Tuberculoid" leprosy were localized and "negative".
This was because his macrophages were being assisted by smaller defence cells called "T - Type" lymphocytes, to produce special enzymes, or digestive juices, to actually kill the bacilli. "T - Type" lymphocytes are specially sensitised to behave in a way most beneficial to leprosy sufferers. "T" stands for thymus, the essential gland which shares with the lymphatic system to program or sensitise the lymphocytes to recognize the antigens liberated from the dead M. leprae.
In most cases, the macrophages can ingest and digest various germs but, in relation to M. leprae, by themselves and without the help of C.M.I., they cannot digest the leprosy bacilli which leprologists say are encapsulated in a wax- like, "lipid" material. Paradoxically and tragically, those non-infectious bacteriologically "negative" patients, with some measure of C.M.I., are those who may suffer serious nerve damage even in the early stage, resulting in crippling deformity and ulceration.
The "B - Type" lymphocytes, which produce "antibodies," are not really effective against leprosy. They may be very effective against other diseases but can cause much trouble for the leprosy sufferer, particularly during bouts of "reaction".
It had now become clear to us that Jethu had suffered much from this very debilitating "reaction" condition of "Erythema Nodosum Leprosum (ENL)". The suffering experienced during acute episodes of ENL can produce in a full-grown man, tears of a baby in real distress. In the case of our first patient, the absence of C.M.I. resulted in the proliferation of the disease throughout his whole body, which yielded "positive" results from wherever we took skin smears.
In Jethu's case of lepromatous or infectious leprosy, the very defence cells (macrophages), which were meant to ingest and digest the bacilli, were actually transporting them to all parts of his system.
The leprosy bacillus has a peculiar characteristic in preferring the cooler areas of the body, such as the peripheral nerves, nasal mucosa, ear lobes, male testes and other parts, which, incidentally, are not being "eaten away". The prime target of M. leprae is the Schwann Cell of the nerve and the resultant intra-neural pressure of lymphocytes on the tiny blood vessels supplying the nerves, resulting in "anoxia", causes destruction of the nerves. Virtually, the nerves are starved of oxygen.
Where the sensory nerves are destroyed, this can result in loss of feeling, particularly in the extremities - hands and feet. Anaesthetic areas are then prone to ulcer damage due to handling hot utensils and walking on unprotected feet to name only two of the many ways leprosy sufferers are at risk. Where the motor nerves are affected, various forms of paralysis develop, such as "dropped foot", "dropped wrist", "clawed hand" and "lagophthalmos" (eyes can't close, due to 7th. cranial nerve involvement).
Many leprosy patients become blind due to paralysis of the 5th. cranial nerve which may produce corneal anaesthesia. The insensitive cornea is then vulnerable to injury and may lead to loss of sight. Damage to the autonomic nervous system can result in the sweat and sebaceous glands becoming inoperative causing dryness and cracking of the skin which can lead to secondary infection and consequent ulceration.
In the male, destruction of the testes (cooler organs), may lead to hormonal imbalance and consequent Gynocomastia and Gynocotilia. Lepromatous male sufferers, who develop female type breasts and enlarged nipples, are at risk of harassment from religionists with male gods who discriminate against women. This stigma is enhanced when the victim also suffers from destruction of the larynx (a cooler organ), resulting in a squeaky, husky, female type voice. This is one of the reasons why, in practically all religions, leprosy is thought to be a "Curse of God"!.
At some time during their career, because there is still no anti-leprosy vaccine, most leprosy medical workers, have experienced fears of contracting the disease. For me, it happened in the following way:-
We had been trying to clean out the sinus passages of one of our lepromatous, "positive" patients who had forgotten to insert his nose plugs and blowflies had taken full advantage. The nasal mucosa, being one of the cooler areas of the body, is prone to bacterial infiltration with tissue destruction, resulting in hundreds of maggots that nearly drove our patient crazy. It was while endeavouring to draw out the creeping, crawling bugs, by inserting drops of mineral turpentine into the nostrils, that the patient coughed violently into my face.
In those days, we did not know that only about 25% of victims of HD, those with the Lepromatous types, have the ability to pass on the bacilli, mainly in nasal droplets. Also, we did not know that only about 5% of the human race - those with little or no C.M.I. - are at risk of catching leprosy in endemic areas.
For several months, I lived in fear of contracting the disease and then the fatal day arrived.
I was in my study, hammering away on my old Remington when shivers of terror raced up and down my spine in the realization that I was not feeling the keys of the typewriter with full sensation of touch.
"Ruth, would you please come out to the office," I cried out in panic, "I think I've got it!" "What have you got?", came the innocent inquiry.
Being in some measure of shock, I had difficulty in giving her a clear reply but eventually blurted out, "I think I've got leprosy!"
"Why, that's ridiculous," she said, "Let me look."
Taking my hands, Ruth said, "Oh, you silly thing," or words to that effect, and began to peel from my fingertips a thin layer of plastic! A few days previously, I had been repairing a neighbour’s old radio that had fallen from the table when he tripped on the wire connected to a car battery. The broken bakelite cabinet needed cementing. Earlier, we had received, in a food parcel, a tube of "Quickfix" adhesive, only a little of which remained in the tube.
It was while squeezing to get out the adhesive, that the tube burst, leaving the sticky-stuff on my fingertips. Having no solvent to remove the glue, I thought of leaving it to wear off in time. I had forgotten that resolve, which helped to make me a "man of experience" in that I have been through the trauma of knowing what it is like to have leprosy. Also, I know the elation that comes with a cure, when the plastic is peeled off and you know the utter joy of healing!
Chapter Ten, Section III
As could be expected, the leprosy work did get out of hand, bringing real trouble from the Home Board, especially after Miss Elaine Gallaway, of a British Gospel Mission home church, made a private visit to our field. Although she had spent quite a number of years as a social worker in devastated areas of Germany, immediately following World War Two, she never before had seen such human degradation until she visited our leprosy clinic. It so happened that we had a few in-patients at the time.
In modern leprosy treatment, patients are only isolated from their families if it is absolutely necessary. This could be for drug stabilization, physiotherapy, lepra-reaction, reconstructive surgery or occupational therapy. At the time of Elaine's visit, we had several in-patients with the acute form of lepra-reaction (ENL). We called them "in" patients, but to Elaine, they were very much "OUT", being camped outside the compound under trees with only a few leafy branches to protect them from the burning sun by day and the bitter frosts of the night.
It was the only place we could find for them. Although ENL is the most common type of reaction, it is accompanied. by real suffering. There may be intense fever, severe arthritic-like joint pains, erythematous nodules and tender skin which sometimes comes off like a rubber glove, exposing the patient to secondary infection. Very often there are painful, tender peripheral nerves and ocular problems, which can lead to blindness, to mention just a few of the side- effects of ENL.
In later years, we were to acquire corticosteroids and even the controversial Thalidomide -a wonder-working drug for ENL male patients and females unable to bear children, to ease the suffering, but in those early pioneering days, we had only antimonial preparations to bring some measure of relief to our patients.
All this suffering overwhelmed Elaine, reducing her to tears. On returning home, at her own expense and of her own volition, she made an extensive tour of the British Gospel Mission's home churches, soliciting interest in our leprosy work.
She even made a fervent appeal to Annual Conference, which some thought to be quite "unconstitutional"! Her audio- visual presentation also left indelible images on the minds of her audiences. It was felt that she should have made her appeal through the Missionary Committee, but she sensed that the latter had no interest in the "lepers". Some even thought that I was behind Elaine, using her and the "glamour" (their word) of leprosy to raise money, also for my personal needs, in violation of Mission rules!
The outcome of the discussion that followed in the Annual Conference in Britain, was that the Social Questions Committee was entrusted with the responsibility of sending us the rupee equivalent of [[sterling]] 400.00 to dig a small well, construct a more substantial mud clinic building and a row of simple mud huts to accommodate our many "in" patients.
The fact that all this was done over the heads of the Missionary Committee did not help to improve our relationships with the Home Board. And yet there was nothing we wanted to do less than provoke bad feelings between ourselves and those lovely people in whose gracious homes we had stayed on furlough.
The repercussions that followed were to be catastrophic. For the next ten years, we were to suffer a shattering series of blows that, ultimately, left us utterly devastated and almost totally destroyed as human beings. How we endured that ordeal and came through it with any measure of sanity, is all part of the miracle. It is hoped that our experiences may help to encourage and strengthen potential candidates for a missionary career or cross-cultural ministry abroad.
It may even guide and caution "Home Boards" who have responsibilities for their isolated representatives in Third World areas.
While we received almost no encouragement from the British Mission authorities, the Lord raised up a most faithful servant, following his graduation from Indore Theological College. Through the sufferings of his sister Meena and the many other patients he saw while visiting her at the Ranitola Mission Hospital, Suresh Kh~ma1 caught a fresh vision of Jesus and offered to help us. This devout brother had love, compassion and the courage enough to actually touch the patients without gloves.
Keith, Sarson, and Suresh working in the New Life Leprosy Clinic.
Furthermore, Suresh had a flair for medical work and became very adept also in mechanics since I taught him to help me fix the Dodge truck that took his sister to hospital. Why, I even had visions of teaching him to drive so that he might visit distant patients, perhaps even those at Joypur. Ruth and I were jubilant. The Lord further answered our prayers when The Hansen Institute accepted him for Para-Medical training at Puruliganj.
I informed the Home Board of the offer and, when they raised no objections in their Missionary Committee Minutes, it seemed that, at last, they had given tacit approval of the leprosy work. After all, it was costing the Mission nothing extra to the budget, because The Hansen Institute offered to assist us as an "Aided Institution". Could we have wished for more?
Chapter Ten, Section IV
With another round-the-world furlough coming up in a year's time, involving an extensive schedule of appointments in Australia, New Zealand, USA, Canada, Eire, Britain, Sweden and Denmark, we had to start making plans, well in advance. The outstation clinics could only be maintained with the use of a vehicle, and Ruth and I were the only ones working in the clinic who had licenses to drive.
This meant that Suresh would have to learn to take the wheel. No karmchari had previously been allowed to drive the mission motors, so we had fears about revealing the automotive secrets and thus, establishing a precedent. What we really needed was a vehicle of our own for the exclusive needs of the medical work - an ambulance-cum-mobile- clinic. I dreamed of acquiring such a vehicle but was this an Impossible Dream?
The cost seemed too prohibitive for us even to hint to the Home Board that we needed such equipment. But the Lord knew what we required and, deep down in our hearts, was a yearning for a more reliable means of transport. Unknown to us at the time, Dr. Rae W. Dunhill, who had experienced the primitive conditions under which we worked, saw the need for a four-wheel-drive mobile clinic and expressed that need to Mr. Robert McLeod, the then Secretary of The Hansen Institute's Australian Auxiliary. It so happened that Dr. Dunhill was a member of the Institute's Executive Committee.
It was agreed that, if the good doctor could raise half the cost, The Hansen Institute would pay the other half. The Cameron Edison Benevolent Trust, through its Chairperson, Mr. Ralph P. Moran, who, coincidentally, happened to be an elder of our home church at Balmoral, came up with the balance and, within a few months, we were the proud and very surprised recipients of a brand-new four-wheel drive Kaiser-Jeep FC-150 Mobile Clinic, through the All-India Christian Federation (AICF).
It was beautifully fitted out with water-tank, sink, table, cupboards, bottled gas stove for sterilizing instruments, seats for staff and a bed. How about that?
Thanks to Suresh and the more efficient way of visiting the out-clinic centres, we now felt free to make our final preparations to leave India, on our second round the world trip, this time, from west to east. Imagine our horror, on receiving the startling news, when almost ready to depart, that Suresh had been transferred to Daulatapur, as pastor of the church there. This meant that, in our absence, there would be no one to operate the clinic at Nawapara, Surgapam and no one to drive the vehicle to the sub-clinics.
It was a ludicrous, crazy and cruel decision to appoint a village tribal karmchari, with no university qualifications, to serve a sophisticated city church, with its numerous graduates, including magistrates and other government officials. Besides that, Suresh was a widower who would have to engage a housekeeper, on the same salary he had been receiving for a rural ministry.
It seemed to be a deliberate attempt by the Board to destroy our leprosy work so we requested the British Committee to cancel our furlough that the patients may not suffer. Later, we were to learn that the founder of the Hansen Institute, Wellesly Bailey, suffered a very similar fate at the hands of his Scottish Home Board.
The British Board's reply came back loud and clear "all flight reservations had been confirmed and the extensive itinerary throughout England, Scotland and Wales could not be cancelled.
Talking the matter over with Suresh, he assured me that, even if we were absent for a year, the patients' treatment would not be interrupted. I wondered how he was going to fulfil that promise until I heard that he had refused to take up his ministerial appointment to Daulatapur, thus risking Mission discipline.
As could be expected, Suresh was sacked! His love for the leprosy patients was so great that he sacrificed his job rather than let them suffer.
This won for him the patients' deep respect and they searched out many of their fellow victims, thus increasing our work even more.
Suresh now faced a serious financial crisis because his salary was stopped and we had no personal funds from which to support him and his family, in our absence abroad. Amazingly, during our year out of India, under Suresh' s care, the work actually expanded until it was becoming out of control! What we now needed was a fully trained doctor with experience in leprosy diagnosis and treatment, or, at the very least, another trained para-medic; what an Impossible Dream?
Imagine our surprise when Suresh's brother, Sarson, offered to forfeit his well-paid job in the Daulatapur Judge's Court, to take training as a para-medic, on Dr. Dunhill's request.
With no guarantee that he ever would get a salary, Sarson, following para-medic training at Puruliganj joined our Nav Jiwan Clinic staff to help his brother and us. It was just unbelievable. From then on, the leprosy work expanded so rapidly that a doctor was a "must".
Meena Khamal, Sarson Khamal, and Suresh Khamal working in the New Life Leprosy Clinic.
Asking God to provide such an expert was really requesting a miracle.
After all, what busy doctor would be prepared to travel hundred miles return trip from Puruliganj to Surgapam and back, in shockingly overcrowded "buses", over atrocious "roads", in unbearable heat, to work under such primitive conditions? "Totally impossible," I told myself time and again.
For the first time, I really doubted the efficacy of prayer. There was just no way that this prayer could be answered and yet, in our desperation, we had to pray because we could see no other way out. But the Lord worked yet another miracle and we praised him for it. Not only did he send us a doctor in the person of Ivan H. Collett; he also sent us his wife, Maria, who is a fully trained nurse, along with their children, Hazel and Murray, who made a "picnic" of the occasion.
We loved working with these dear folk and I often thought how wonderful it would be to serve under Ivan on a more permanent basis, but that was wishful thinking - an Impossible Dream. Ivan had such a gracious, humble rapport with the patients and for this reason, was ideally suited to rural clinic work. Maria was of the same nature and they made a wonderful pair. During the years that followed, Ivan's and Maria's Christian dedication and medical expertise made a profound impact on our lives.
Ivan's occasional visits from Puruliganj gave such official status to our Nav Jiwan Leprosy Clinic, under The Hansen Institute, that, in the years ahead, the Australian Government took special cognisance of this aspect of our ministry.
Along with Ivan, our good friend, Dr. Rae W. Dunhill, developed a keen interest in our leprosy work and several times visited us on his way to Europe in relation to his medical research.
One aspect of our clinic treatments that caught the good doctor's interest was the iron and vitamin supplements we provided to all those taking "Dapsone". Earlier, we had been told that such regular "extras" were not only costly but served no real purpose. However, when Dr. Dunhill went through our treatment records each time he visited from Australia, he was pleased to note that those on DDS, had a much better prognosis when their anti-leprosy drug treatment was combined with iron and vitamin supplements.
Dr. Dunhill presented these findings before one International Medical Conference in Europe. It is interesting to note that, worldwide, such supplement treatment is now a regular procedure in many leprosy centres. Unfortunately, though "Dapsone" is a very fine drug in leprosy treatment, in many patients on long-term treatment, it can lead to anaemia.
It should be remembered that one of the most tragic ways victims of leprosy suffer is to be outcast from society. Several of our patients begged me to kill them to put an end to their torment. Not a few told me that they could bear the loss of fingers, toes or even hands and feet, also eyes. What they could not tolerate is to be cut off from the human race. It was a great privilege for us to be instruments in helping restore a measure of dignity to some of the world's 12 million people afflicted by this horrible, yet curable disease.