Visiting the Lepers (contains sugical pic/vid)

The white ambassador (the yellow crown vic of india) barrelled down the road, horn blaring, and swerving every ten seconds to avoid the two wheelers and oncoming buses. My body rocked back and forth with the movement but not much else mattered. At this point I have am accustomed to the driving in India. Plus it is 0700, and Will and I are making our way to The Leprosy Mission Hospital in Manmadurai, a one and half hour drive (if we don't die first.)

We arrive at 0930 to the sounds of synthetic church bells and christian prayers in Tamil. We are shown to the dining house where a sweet Tamil lady has already made us breakfast and has 4 cups of chai waiting for us. A few minutes later Connor and Fillip arrived and we are shown to the guest house. The house is a nice (Indian nice) three bedroom with 2 beds in each room, and best of all it has a TV. (Unfortunate to us, and not so to William, the only channel we get in English is the cricket only Chanel.)

The first person we were introduced to was the director of the clinic who told us about the clinic and a little bit about leprosy. We were then introduced to our coordinator for the two day trip. She promptly took us to the ward where the head nurse showed us around.

The Ward:

The ward consists of separate male and female sections. The male section have 20 beds and the women's 10 beds. Their was also an intensive ward with about 10 beds. There were around 30 patients who had been checked in with Leprosy. We were shown by the nurse some of the primary and secondary deformities and disabilities cause by Leprosy. Most of the patients had large ulcers (sores) on their feet due to anesthesia of the extremities. The simple ulcers ranged from through just the top layers of skin to through all of the skin. The complex ulcers were much worse. In a complex ulcer you could see bone, tendon, muscle, the whole bit (in vivo foot anatomy.) After the ward we were introduced to a Russian OB/GYN doctor name Natalia who is spending a year at the Leprosy clinic.

Natalia:

Natalia is a young doctor in her early thirties who is trained in OB/GYN. However at TLM she does general practice as well as amputation surgery. We spent about thirty minutes observing her in her office and we were then invited to see minor operations.

The Operations:
*if squeamish please stop reading

Since Lepers have no sensation in their feet anesthesia is not used. The observations we observed were the removal of metatarsal bones due to infection that had entered through ulcers. The first surgery was plain gruesome. Natalia (no scrubs, mask, cap, scrubs *see pics) began by cutting the man's foot completely open with surgical scissors. Then she removed the septic bone and any surrounding infected tissue. she then packed the wound with spirit drenched gauze and it was dressed with clean gauze. The wound would be dressed days later. We witnessed five or so more surgeries similar to this at which point we were introduced to the physio doctor who taught us all we could handle about Leprosy.

If you are interested in learning more about the disease please wikki it. I don't feel like typing it all our so here's an abridged version

Leprosy is cause by the micro bacteria Lepre (sp?) it attack and destroys you PNS (peripheral nervous system. Patients if not treated will develop clawed hands, foot drop, loss of hand/foot movement feeling and gland secretions.

More time was then spent with other doctors and more lepers were seen. That night after diner Connor, Fillip, Will, and I decided to make our way 3km to Manmadurai in search of some Kingfisher to bring back to the house. We took the Rs3 bus ride and got to the small town. It was around 2100 and the town was a buzz. The town had an unwelcoming air to it, even the children did not look happy to see us. We asked around and we found a 'wine' shop where we bought 6 Royal Challenge (local beer) Will and Connor picked up some scissors (local smokes) and we were soon 4 crammed into an auto and on our way back. We spent the night living like real (American) men. We drank they smoked and we played cards. The morning we awoke at 0700 for lunch and were back to the clinic for more observing.

The next day we said our goodbyes and it was back to Karaikudi and the Chella Nursing Home.
*Please don't look at the pics if you're squeemish, or the video.

The wards

Using a flashlight because the power went out mid operation.

Lepre

Simple ulcer

Natalia removing some metatarsal.