Report on the Visit to RCHKS - HANDA Liangshan Leprosy Project

May 8th –13th 2006

Shaken and Stirred

When Will asked, back in October 2005, if anyone in the congregation would be interested in visiting a leprosy project in Sichuan, little did I realise it was an invitation to step back into the Middle Ages. I’m not quite sure what I was expecting but the reality-desperately poor, deformed, sick and dying people living in remote and primitive mountain villages almost totally cut off from the outside world was not part of my expectations. Note, however, the ‘almost’.  The Liangshan Leprosy Project, along with other organisations, helps to provide a vital link to these forgotten people, giving them a  measure of hope and a modicum of health care.

Our first day started in Xichan at the new headquarters of the project. I looked around rather confused and bewildered: there was a series of modernised but mostly empty one- story buildings, some ramshackle dilapidated brick shacks, a  large but uncultivated plot of land. Nick (Pirie- the Rotary Club project director) and Sally (Chun- the wonderful project co-ordinator) were walking around excitedly talking about clinics, workshops for prostheses, beekeeping, education centres. But where were the patients?

I was soon to realise that the PALS (people afflicted by leprosy)  were no where near Xichan. They were all confined to leprosy villages well away from the modern world of developing China. After a quick cup of Chinese tea we were asked to repack our bags, prepare for an overnight stay (where?) – and off we went in the jeeps.

After a couple of hours on a reasonable road, with the terrain getting more and more rural (and more and more beautiful) we turned onto a track that had seen better days as a river bed. Half an hour later we arrived at the end, took a short walk up a hill and entered another world. We were met by about 30 villagers, mainly elderly , dressed in traditional (but filthy) costume. They were hunkered down on the ground and , as we approached, they started to clap. As we drew nearer the old ladies reached out to us and we saw, for the first time, the gnarled and misshapen stumps that had once been hands. Within minutes we were in a tiny, rather dirty little room where a small Chinese man in a white coat was attending to a young lady . She was sitting on a bench, staring out from her one good eye. A crutch was propped against the wall; her feet were grossly deformed by leprosy. This was Eisha, our first real contact with a PAL in desperate need of medical attention. As the time wore on, more and more people came to the clinic. Word had spread that the doctors had arrived. A young man appeared in the doorway. He was a new patient. Soon he removed his shoe to reveal a deep, suppurating ulcer on the sole of his foot.

In this remote region of China, health care in the rural areas is mainly in the hands of the Barefoot Doctor, a villager who is capable of  delivering basic medical care. Leprosy, however, is deeply feared in these communities and anyone found to have developed the disease has to move, with their family, to a designated leprosy village. Once there it is virtually impossible to leave. The leprosy village at Xide, the first one we visited, is comparatively lucky. It has Dr Lu, the barefoot doctor, who is able to deliver some health care with the support of the project. It also has a school. We were treated to a dancing show by the children. They were clearly pleased to have us amongst them.

After several hours it was time to leave. Nick, David (Anderson- the Medical director of the project) and Sally were due to meet local health officials. It was strange to walk back down the hill, into the jeeps and gradually re-enter modern day Western China.

The following 3 days continued much as the first. We were shaken around, travelling for hours on narrow, stony, deeply rutted mountain paths.  We walked up mountains and were deeply moved to find small, isolated villages populated by PALS and their families. We saw patients horrendously disfigured by leprosy, living in conditions that must have changed little in hundreds of years.

So what is the Lianshang Prefecture Leprosy Project doing to help these people? We saw the effect of their work more clearly in our last village, Puge. By the time we arrived the local barefoot doctor had the villagers soaking their feet in plastic bowls provided by theproject. They were being instructed in basic, but vital foot care. Kelly (the team’s Chinese doctor) A Je (a Yi speaking nurse employed by the project) and Xiao Liu (the team’s young foot doctor) were soon busy dealing with the worst cases of ulcers and infections. Patients with virtually no hands started to file away at the dead tissue on their feet with bits of sandpaper mounted on lollypop sticks, a cheap, disposable alternative to metal foot files. Most importantly, the local village head, a young man, had come to visit and observe the team at work. There are plans for a new health centre. He was soon in deep discussion with Sally and Nick over the viability of sites.  Word is gradually beginning to spread in this remote region that leprosy is curable, it is not highly contagious and there is much that can be done to alleviate the symptoms of people with an advanced form of the disease.

The aims of the Lianshang project are ambitious. In the new headquarters there will be a clinic, a health centre, an education centre and a workshop for making suitable shoes and prostheses. Opportunities will be there for PALS to learn new skills such as  beekeeping. There will be a recreation area and a generally welcoming environment to persuade people to seek treatment.  In the villages there will be local health centres from which the barefoot doctors will operate. They will be supported by regular visits from the  medical staff of the central clinic. Supplies of  equipment, drugs and dressings will be adequate. The general hygiene problems such as sewage and running water will  be addressed. All this will be done with the co-operation and in partnership with the local health officials and village chiefs.

It is a far reaching vision but it can be achieved. Progress is already being made. Whilst we were visiting, Dr Anderson gave a talk to over 100 local health workers. Efforts are being made to overcome simple but vital obstacles (The drug treatment supplied by WHO comes in a blister pack. How can you open that with no hands?)

Slowly, slowly the stigma is lifting and little by little the suffering is being eased.

Money, expertise, enthusiasm and commitment can all combine to overcome this terrible disease.

Liz Kemp

May 2006

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