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National Institute of Leprosy.

National Institute of Leprosy

Plan and Purpose: It was a chilly February in 1965, when two young lady doctors, one a glittery eyed German M.D., the other a slender sariclad Pakistani dermatologist, set out on a humble plan. The proposal had come from the directorate of health. Its purpose was to prepare a work force to fight on the battle front of leprosy. The disease was present in formidable proportions in many parts of the country, most of which lacked proper medical facilities. The few doctors available had an aversion to leprosy work, they were after all members of an ignorant society, highly prejudiced towards "Lepers".

The First Step Forward: The first batch comprised 9 matriculate paramedical workers chosen from the staff of the government leprosy scheme, Marie Adelaide Leprosy Centre and Manshopir leprosy hospital. A syllabus was formulated for a 6-month course. It was aimed at imparting training in the diagnosis and treatment of leprosy and its complications with some elementary knowledge of related anatomy, physiology, pharmacy and also basic English and Mathematics. Lectures were held in the premises of the Marie Adelaide Leprosy Centre, Karachi. For practical training, bedside instruction in wards, students were taken to the subcentres of Malir, Korangi and New Karachi.

Moving Ahead: Today when we are entering into the 90's, 26 springs have blossomed since those first seeds of dedicated diligence were implanted by Dr. Ruth Pfau and Dr. Zarina Fazalbhoy. The subsequent crops have been nurtured by Sr. Berenice Vargas, the Mexican pharmacist; Sr. Jeannine, the dedicated nurse from Belgium; Dr. Thomas J. Chiang, the Chief Executive; and Dr. Shaukat Ali, the present Director of Training. Today Marie Adelaide Leprosy Centre has the honour of being recognised by the government as the only National Training Institute for Leprosy in Pakistan. It is proudly affiliated with the National Institute of Health at Islamabad. Today, our Training Department has its 16th batch of junior leprosy technicians under way. Until now 308 candidates have passed the course, whose certificate since 1984 is considered equivalent to FSC in medical technology. Basic qualification required for admission is matriculation, preferably Science group. Selections are made by the provincial health department against available vacancies in their Leprosy Control Centres, whose number has now reached around 120 in the whole country. The variety of situations faced by field workers has necessitated constant revision of syllabi and increased duration of the course from an initial six months to the present two years.

Training, Objectives & Achievements: During these two years, 30-40 young boys & girls representing all the four provinces, as well as Azad Kashmir, are trained to diagnose and treat leprosy, its related reactions and consequent complications. Classroom lectures taken by Medical Officers and senior paramedical workers include instruction in relevant anatomy, physiology, pathology, and pharmacology, with the help of charts, models and projector slides. Just adjacent to the main classroom is a well equipped library. Practical skills are demonstrated by the bedside, there being 80 beds in the hospital. Students are rotated through departments of OPD, Laboratory, Pharmacy, Physiotherapy, Health Education, Social Work & Statistics. The 10 subcentres in Karachi, each covering a population of about one million provide opportunities to the students to deal with community based problems in leprosy.

In each course duration, all students are posted to their respective areas for a one-month period. There they get acquainted with leprosy control measures being carried out by their seniors, which have until now detected 34,058 patients scattered from the coastal regions of Mekran to the mountains of Chitral. Out of these 11,000 have been cured and discharged from treatment. About 13,000 are under treatment, with another 1,000 under special observation for treatment of complications and prevention of deformities.

Their slogan is |Leprosy is Curable', their aim is to control Leprosy in Pakistan by the year 2000. They have yet to go a long way to achieve this cherished goal, but they have already accomplished a part of it - Leprosy is no more the dreaded disease, shunned by laymen and medical professionals alike. Every year our department entertains undergraduate and postgraduate medical and nursing students from the Sindh Medical College, Aga Khan University, Holy Family, Karachi Adventist and several other hospitals, who are made aware of the recent advances in the diagnosis and treatment of leprosy.

Thanks to these leprosy workers, who, spearheaded by their seniors and often accompanied with Dr. Pfau herself, traverse the arid deserts of Sindh and Balochistan, travel across fertile plains of Punjab, often on foot, climb mountains of the Northern Areas and Kashmir, undaunted by floods and precarious glaciers, often risking their lives, just to deliver the required dose of tablets to their precious patients. For many such patients who are very often disowned by their families and rejected by the society, the leprosy worker's smile, or a handshake are the first humane gestures in several years to cheer them up and to give them a hope of life when they have lost all.

A Lesson in Accommodation: Back in their hostel, they provide a sight, rare in our country these days. A repartee in Karachiite Urdu is responded by smiling Sindhi contours. Traditional Pathan hospitality blends well with kashmiri gentleness. The air rings with hearty Punjabi laughter and, of course, Baloch "Leva" is a must in every get together. Their asset is not a Klashnikov, but a deep regard for humanity.
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Copyright 1991 Gale, Cengage Learning. All rights reserved.

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Title Annotation:Pakistan
Author:Zia, Mutaher
Publication:Economic Review
Date:Sep 1, 1991
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