German missionaries winning battle against leprosy in Pakistan

The moment Dr Ruth Pfau steps into the invalids home the half blind and handless Khamim Ahmed, from the Neelum Valley in the Himalayas, jumps up to greet her with a passionate hug.

Used to such welcomes, Dr Pfau, a German doctor heading the campaign against leprosy in Pakistan since 1962, responds with an affectionate smile. Where have you been for so long mother, asks Khamim who has lost his right eye and both hands to the disease.

He is one of the inmates of the Marie Adelaide Leprosy Centre's home for invalids at Manghopir, a suburb 23 kilometres west of Karachi.

Pfau explains her absence by pointing to the two crutches she is leaning on after breaking a leg in an accident last September.

The German doctor receives the same welcome from Zakia, a handless and footless Afghan woman whose face has been disfigured by leprosy. "I love you, I love you, Dr Pfau," exclaims Zakia while trying to throw her arms around the doctor.

Zakia's tragedy started after her illness became public when she was barely six years old and the clan elders in the Bamiyan province of Afghanistan declared her dead.

"They had condemned her to isolation in hills until I got wind of her agony during my secret visit to Afghanistan in 1984 and retrieved her from a cave," Dr Pfau says.

By then Zakia had lost her feet and hands, and she had to be carried to Pakistan. Dr Pfau, who was born on September 9, 1929, in Leipzig, Germany, joined the Paris based order of the Daughter of the Heart of Mary to serve humanity.

Assigned to India, she landed in Pakistan in 1962 to explore possibilities of a getting an Indian visa. At that time, she says, Indians were reluctant to grant one.

What was intended as a brief stay became one of 35 years and Pfau was given an honorary citizenship of Pakistan in 1988 for her services.

"The helplessness of patients at the Marie Adelaide Leprosy Centre, being run by our congregation in a beggars' colony in Karachi, and the misery of the people there compelled me to ask for a posting here," Pfau said in an interview at the small third floor quarters in the MALC.

When Pfau arrived in Karachi there were hardly any facilities for leprosy patients in the country except for those at the MALC.

Treatment of the disease was time consuming and not as effective as the latest combination of three medicines that kill the leprosy bacilli with the first dose.

Today, the 140 leprosy treatment centres and hospitals spread from Skardu in the north to the shores of Gwadar on the Arabian Sea, and can claim to having registered some 43,000 patients.

More than half of the patients are fully cured and about 18,000 remain under surveillance. By the end of 1996 the prevalence of leprosy had declined to 0.23 per cent of a population of 130 million, an achievement Pfau and her colleagues are proud of.

"We have just managed to kill the bacteria, and reached out to people carrying it. The real victory, the elimination of this disease may take another 10 to 20 years," Pfau says.

She estimates that there are still some 15,000 to 30,000 people in the incubation stage of the disease, who will have to be diagnosed and treated.

The leprosy control programme of Pakistan is at a crucial stage and the public needs to be made aware of the consequences of late reporting of cases to hospitals, Pfau points out.

The doctors, in particular, carry greater responsibility, and need to equip themselves with adequate knowledge of leprosy so as to diagnose it in time, Pfau adds.

Not many doctors are, however, willing to give up some of their time to finding out more about the disease and helping the voluntary services.

Pfau insists that despite the success against leprosy her mission is far from over. The elimination of tuberculosis and the rehabilitation of leprosy patients as well as drug addicts remain on her agenda.

"I wish to live on to see the world free of these menaces, though this may sound wishful," she said.

UNI