Bombay Leprosy Project

My internship, my contact, my job, my reason for being in this foreign land.

I have now been 'working' at the Bombay Leprosy Project(BLP) for 1.5 weeks and already have much to report! I know now that beyond learning about the technical parts of leprosy, being able to know which medicine to hand out, or even becoming more facile with the clinical jargon that a huge part of my learning comes just from opening my mind to the nonwestern way of doing things. It is hard not to judge the medical practice that I see every day based on the values and health codes that we have in the states. None of this would fly over there. That much is for sure!

The clinic itself is located in the back of a building in Sion Chunabhatti, very difficult to find, not really near any main city fun, but practical nonetheless. As you walk around to the back of the building, you enter by going up 4 steps and arriving on a little landing (no handicapped ramp) next to an open door. The door leads to a minute hallway with a bench on the side of it where patients wait. About 10 feet later, you enter the main room. Imagine a large classroom-sized room with 3 desks, a big center table (composed of 4 or 6 desks put together) a bunch of rusty folding chairs and plastic lawn chairs, 2 loud nonstop phones, and more people (patients, doctors, nurses, interns, secretary, computer technicians, driver..) than maximum capacity.

*Side note: this is something that I have discovered about India. It seems that since there are SO many people everywhere, there are usually about 6 more people to do one job than necessary. Passing a construction site? You will be guaranteed to see about 4 times as many yellow hardhats as necessary (who knows? 1/3 of them may be on a chai break at any given time)!*

Anyhow, the main room is packed and noisy and hot but everyone seems to like it that way (even me). Why? Because I suppose looking on the bright side, if you keep all the doctors in the same room, then 6 heads are better than one! If one of them cannot make a diagnosis, then someone must be able to. Another appallingly unamerican quality to the clinic is the lack of privacy. This is clear from the one-big-room setup but its amazing to me every time I see Dr. Pai checking out a patient on the back step of the clinic (outside) and asking the patient to just take his shirt off right there or show us his ulcerous foot while sitting on the steps. Women are given more privacy (I haven't seen any topless women so I guess they are) but all in all, its a fairly public affair.
This photo I took at one of our satellite referral centers. As far as I can tell, the BLP has referral centers in all the major hospitals and some in little slum areas too! In order to push forward with the eradication of leprosy, they have to reach the slums and rural areas. What a job! So this photo is at one of them in Bandra where the dresser comes on mondays and thursdays. That's the opportunity for the patients anywhere nearby to come and get their ulcers redressed. And in the conditions (tiny dirty little office, very few supplies, etc) this man is a champion! We watched as he removed bandaging and dressed 5 patients who got up [mostly foot ulcers] hugged him or praised him, grabbed their multivitamins wrapped in a newspaper pouch and bounced out of the office! He was joking and laughing and teasing (mostly in Marathi) the whole time! What a character.

The main characters who I work with there:
Nanda - one of the secretaries. I have no idea where she came from but she is loud and not very educated and skinny as a rail and generally raises mayhem all the time. she was also assigned to showing me around for my first week which was interesting because we spent a LOT of time together and her english is not very good, and my marathi is worse. We're pals now, she wants me to come to her house (1 train and one bus ride away), she tries to feed me ALL the time, her english is improving and shes determined to try to teach me marathi!
Dr. Pai - my contact at the BLP, the medical director of the joint, a very busy man. He is really sweet and includes me (even when he has to translate) in his patient interactions but is not much of a chitchatter (unlike most everyone else). An incredibly hard worker, very smart man, great english.
Dr. Ravi - today was his last day with the BLP but he is young-ish and really nice and funny. his "office" is one of the desks in the corner of the main room, so hes always talking to everyone. mediocre english but definitely enough to conversate!
Mr. Kamath - el jefe, boss man. I cant tell if he has any medical background (I think he might be a doctor too) but he mostly handles the administrative stuff. He's 76 and loves to crow over Nanda (mostly becuase shes too loud) and demand things from the interns. We get along well and spent today together going to a presentation of grant money from the India Development Foundation. He's very talkative (I think he just doesnt like silence) and his english is quite good.
The interns - medical school grads who are during their internship postings at a number of different places. The ones who are posted here for the month are awesome! The ones only posted for 10 days are quiet and look like they want nothing less than to be there. oh well.

Along with many many other staff members, computer techies, drivers, rural volunteers, etc. (many of whom are rehabilitated leprosy patients themselves)that makes up the peoples. A very interesting family workplace group.

One of the most interesting parts of working with BLP (besides diagnostic and other work at the office) is the outreach work that they do in Dharavi, Asia's biggest slum. Housing more than 1 million, it is truly a city of shanties and people and animals and mud and garbage and more people. Ive never seen anything like this kind of poverty and its really hard to go there where i stand out as a shining white person. People, especially chilluns, come over and stare at me and crowd around. We have been putting up posters there and handing out fliers and that kind of thing to let people know (in Marathi of course) that leprosy has a cure. very simple.

That is the BLP in a very small nutshell and there will be more to come as work gets more involved. For those of you who had your doubts, I am not a leper now nor do I plan on becoming one. I am not working with leprachauns. The end.