Case Studies
Ram Maya
A Mother's determination.....
When Ram Maya gave birth to a daughter rather than the hoped for son, her husband told her to leave - with their new baby. She had no means of supporting herself and her child and at one time thought she would have to hand her daughter over for adoption.
Desperately looking for work she came to NLT who offered her a job in the paper production unit. She finds the work very satisfying and is proud to be earning enough to support herself and her daughter!
Pulo Devi
Pulo Devi is a lively out-going lady of about 55 years of age. She lives in a village about one hour's walk from Loharpatti, Mahotari. She is of the Mushar caste.
She became aware that she had leprosy when she came to Lalgadh Leprosy Services Centre complaining of swelling and tingling in both her hands. At that time she had also lost her eyebrows. These symptoms first began nine years ago. At the Centre she was diagnosed as having leprosy and commenced her multi-drug therapy. She was referred for follow up to Loharpatti Health Post. Sadly she did not complete her treatment and is now severely deformed in her hands and feet. The bridge of her nose has also collapsed.
Life has not been easy for Pulo Devi. Even though she was blessed with a son, her husband died leaving her with the difficult task of raising a son on her own. She has found it very difficult to talk about her husband's death, and the many problems she had raising a son on her own. As her deformities became more obvious, she was ostracised by her family and neighbours. She was forced to live outside the village in a stick shelter by the river. The village animals appear to have been treated far better than she was. In order to survive she soon turned to begging.
One day, the facilitator of the Loharpatti Self Help Group, Mr. Muslim Ansari, noticed her dressed in rags and begging in the bazaar. He also is affected by Leprosy. By her appearance he could see that she was very poor and, from her distinctive deformities, that she had leprosy. He spoke to her and listened as she told of her illness and current living conditions. The first thing that Muslim did was to encourage her to attend the self help group. He explained that the purpose of the group was to support people affected by leprosy and to educate the community about the disease. She agreed to attend the group and has subsequently become a regular member.
Through the support of the group, Pulo Devi has recommenced treatment. The group visited her village last year and was very moved by the conditions she was living in. They decided to talk to her son and the village leaders to explain about leprosy and its treatment. After they did this, she was then allowed to move back into the village.
Pulo Devi's son's house was too small to accommodate his family of wife and two children plus Pulo Devi. After some discussion with self-help group members, a decision was made to build her a house. The facilitator placed this request through the STigma Elimination Programme and the programme then was able to help with the construction of a small house. A further request for income generation was granted, and a loan was given to Pulo Devi to purchase two goats to enable her to be self-sufficient. With the group's support she is learning to care for herself and prevent further ulcers and deformities.
At one group meeting she met Dr. Bimala Ojiha, Director of HMG's Leprosy Control Division. Pulo Devi was encouraged when Dr. Bimala expressed her support of the group. Dr. Bimala said to the group and to Pulo Devi how very pleased she was to see how people had been greatly helped by the self-help group and she could see a time when Stigma would be reduced.
Pulo Devi is very happy to have met Muslim Ansari in the bazaar and she can now look forward to a somewhat brighter future as an active participant of the self-help group in tackling stigma and an accepted member of her community.
Shyam Mahato
Shyam Mahato (Nuniya), is a cheeky 14 year old boy from Rupaitha in the Dhanusha District, South Nepal. He was admitted to Lalgadh Hospital for a large wound on his right foot. He does not sit still for one moment, so trying to get him to rest his foot was impossible. He came wearing unsuitable shoes (plastic) and despite Out Patients care of dressing, the wound got bigger and almost to the bone under the forefoot.
Despite the fact that he is alone in the hospital his smile is always bright and cheerful. He always jumps up when I enter the ward and shouts for me to check his feet. He has dry skin on the other foot too, a common effect of the nerve damage in Leprosy. His eyes are also inspected here as he has dryness there too. His first visit to Lalgadh was two years previously, at that time he already had a foot wound and loss of sensation.
Every time I saw him walking around the hospital, I would tell him to rest his foot, but he just smiled. Our answer was to put his leg in a cast for six weeks. This sounds cruel, but is the best way to heal a wound, by reducing the pressure of walking. The cast was a nice green colour and he was still able to roam around, and play kayran board game (popular in Nepal).
This story has a good ending, his cast is now removed and the wound is healed. Our footwear department made a new pair of shoes for him. He would not wear the usual nylon sandals. A new sandal design was produced by Birendra Mahara from the Footwear Department, Shyam was very happy with the new sandals.
I saw him sit still today for the first time, he was watching the Jesus film in Hindi. The film got here from a car boot sale in Cardiff, a Christmas present from my mother, to bring for the patients. They all seemed to enjoy the film anyhow!!
This week Friday 19th August Shyam will return home. He had previously attended one of the many training weeks about self -care, so we are hoping he will not return with more wounds.
Lalgadh has served him, not only as a hospital but as part of his family, in the absence of his own.
Chalitra Pasman
Victoria Elliot, Podiatrist at Lalgadh writes .............
Many patients in Lalgadh have had to return again and again to receive our care. Her at the hospital we see patients with what we term 'recurrent ulceration'. This refers to wounds that develop in the same places especially on the feet. At first the wounds seem so large it is hard to believe they can heal. One such case I saw recently amazed me, to see the effect of a clean bed, regular food and careful nursing can have.
Chalitra Pasman, a fifty year old man from Bishanpur in India, arrived one morning in Out Patients with a very unhealthy looking wound. He arrived looking thin, worried and weak. In his records his weight could not be assessed as he was too weak to stand.
He had most likely travelled a long way to reach us in Nepal. The buses are often overcrowded , and a poor ill man may not be offered a sea. I saw this happen to another leprosy-affected person on my trip to Birgunj one day in early July.
His feet had been without sensation now for at least six years, a common impairment in MB leprosy patients. The left foot wound 6cm by 7cm and filled with maggots. In the hot climate of Southern Nepal it is hard to keep away the flies, also if you are poor you cannot afford dressings that cover the early blisters and cuts.
Unfortunately, this was not his first visit to Lalgadh, he had had many wounds at different times, but each time he has received help and advice. Our wards beds are always in demand.
On one of the first dressing times he cried as he thought he would lose his foot. So ugly looking was the wound, he cried as he has to work to support his children. a major set back for these poor patients is that the farming work they so often do is in rough, muddy wet fields. The employers may expect them to complete a full day without rest, like any other person. The leprosy affected person is different in that short work breaks are essential for their damaged feet.
Now
almost
four later amazingly the wound has been cleaned and is healing nicely with
simple dressings. He is having
regular food and good bed rest. Resting the damaged feet is one
of the most important things to do
in these cases.This man's story is
one of many in this area, it highlights
the continued need for Leprosy Centres like Lalgadh.
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