General Diagnosis and Treatment
As well as looking after thousands of people affected by leprosy each year, Lalgadh Leprosy Services Centre also helps many thousands of people with general medical conditions. Around 8,000 people from the local community come each year for help with all kinds of difficulty, from the usual coughs and colds, fractures and burns, to cholera and snakebite, childbirth and malaria, road traffic accidents and much more.
Space in the wards is very limited with only about 50 beds which are over 95% occupied throughout the year by people with leprosy complications. We try and keep 2 beds available for general problems but this can be hard to do. However, with support from the BUILD Organization, TLM England and Wales, and wonderful Swiss friends of Dr Graeme and Meena Clugston (based at LLSC) more ward space is being built to allow for more people with leprosy and more general cases to be accommodated. It is hoped that by the end of 2011 there will be at least 25 more beds available, along with improved maternity facilities. It is interesting that the new buildings have been designed by the same Swiss architect – Ueli Zuerrer – who designed the original buildings at LLSC.
For some patients we are only able to be the first point of contact and after carrying out initial care we have to refer people to a more appropriate centre.
Each year we have 35,000 or so people who visit with various skin diseases, often concerned that they may have leprosy. LLSC has earned a good reputation as a centre where people can get real help, and where staff are not just interested in taking patient’s money, but aim to deliver a good service. The phrase in the region is “Go and get some Lalgadh medicine” and people even come up from India for help. In many ways we welcome the skin cases because a significant number of these can prove to be cases of leprosy. We have had 20 new cases of leprosy in one day!
On a busy day, these large numbers mean that the OPD staff may have to examine over 400 patients in one day! This
does put a considerable strain on services and can be very tough in the hot season where patient tempers can get a little frayed, but by and large people wait their turn patiently and staff do their best to get through the load without turning people away.
A challenge to NLT is to know how to handle so many general cases without impacting negatively on the leprosy services which are our primary concern. Our resources are very limited and are provided for Leprosy work and so the general work has to be self-funding. This means that we have to charge for general services, but these charges are kept as low as possible. It is planned by NLT Nepal to provide some specialist orthopedic sevices in time, using some of the increased space, and thereby to generate some additional revenue.