Mahatma’s Dream Fulfilled

It was on the 10^th of November, 1979 that I entered the portals of St Joseph Leprosy Hospital (SJLH), a unit of Fr Muller’s Charitable Institutions (FMCI), located in my hometown Mangalore, Karnataka, on being appointed as a junior doctor. I was astounded by the sheer size and glory of this 90 years old august 140 bedded hospital, little realizing at that point of time that I would be a witness to its closure one day. Today, I am out of this institution after serving for more than 4 decades, and it is time to reminisce.

St Joseph Leprosy Hospital had a bed strength of 140 when I joined, and Dr Jerome Pinto was managing the medical aspects with a dedicated team of nursing and paramedical staff. The hospital was catering to the needs of the poor and downtrodden section of the society.

I was a novice in the field of leprosy as I was just out of the medical college and I gradually started learning under Dr Pinto, but it lasted only for a few months as he left for pursuing Master’s degree. I was left in the lurch but stood determined being encouraged by our Director Rev Fr Peter S Noronha. He deputed me to Schieffelin Leprosy Research and Training Centre (SLR&TC), Karigiri, Tamil Nadu, for training in reconstructive surgery and other aspects of leprosy where I had the privilege of being trained under Dr E P Fritschi, a renowned hand surgeon.

I would like to place before you a brief history of my great institution.

SJLH was founded by late Fr Augustus Muller S J, a German Jesuit in the year 1890.^[1] What started as an asylum aimed at providing shelter to these ostracized people to lead a life endowed with physical, mental, and spiritual well-being slowly expanded over the years to a full-fledged leprosy hospital having an in-patient facility, physiotherapy, a shoe workshop, occupational therapy, reconstructive surgical facility, and S E T activity (Survey, Education and Treatment) under the National Leprosy Control Programme (NLCP).^[2]

All these developments did not happen overnight. Although SJLH was established in 1890, it was only in the year 1926 that it got its first qualified and trained physician. Dr A F Coelho took reins as the medical officer and went on to serve for 35 years. The modernization of the hospital took place after the advent of the doctors from Switzerland who in 1962 came with the motto of “serve those who suffer most”. Dr C. Heinz followed by Dr Wintsch belonging to a benevolent voluntary organization known as EMMAUS, Switzerland, introduced reconstructive surgery for the deformed patients, rehabilitation, and out-reach programmes to detect as well as to treat patients.^[2] A novel project of school survey to detect leprosy early was launched in the city of Mangalore. School children were examined and arrangements were made to treat such cases. This program went on for more than 3 decades.

The NLCP, which was launched in 1955–56, was re-designated as NLEP in 1983 after the advent of multi-drug therapy.^[3] The Government of India gave a clarion call to all the voluntary organizations to take up leprosy eradication activities in a big way, and SJLH in 1986 also joined hands by launching the SET (Survey, Education and Treatment) program in the neighboring area of Ullal covering a population of 1.25 Lakhs. Four para-medical workers were trained in our own institution and then deputed in the control area to conduct extensive house-to-house survey.

This program was wound up in the year 2003 after achieving the eradication wherein the prevalence rate in our area was brought to less than 1 per 10,000 population.

The year 1990 was the turning point in the history of SJLH. It was the centenary year of its existence [Figure 2]. Fr Muller’s Charitable Institutions had observed its centenary 10 years earlier, and the chief guest for the occasion was none other than the “Bharatharathna” Rev Mother Teresa. The Chief Minister of Karnataka had visited our institution in 1990, and the government was so impressed with the service rendered to these leprosy patients that they offered to sanction post-graduate courses in Dermatology which the management accepted with both hands [Figure 2].

Figure 1: SJLH in 1990

Figure 2: Inmates of SJLH in 1990

Prof J N Shetty and Prof B K Hareendran Nair were the two stalwarts who joined initially as teaching faculty, and thus, the PG course commenced in the year 1991 with an intake of four students, two each for MD and DVD. The course was affiliated to Mangalore University. The post-graduation course was further extended to eight other subjects in the following year, and thus, FMCI became Fr Muller Medical College having its roots in SJLH.

Even Fr Muller himself would not have dreamt that what he started as a small homeopathic dispensary 110 years ago would metamorphose into such a vast academic institution being known all over the country.

Now coming back to SJLH, an aggressive approach in the case detection, health education leading on to better awareness, and the treatment in the form of multiple drugs bactericidal in nature brought down the incidence of the disease considerably. The need for admission gradually decreased. The older generation of the severely deformed patients who used to get admitted frequently and had to remain as in-patients for a long duration were fading. The in-patient strength was around 100 when I joined, out of which around 40 people were permanent residents, slowly dwindled. Over the years, these elderly patients left for their heavenly abode because of natural causes. New leprosy patients requiring admission for either medical or surgical reasons were being admitted in the newly built Fr muller Medical College Hospital. The few remaining inmates were shifted to the skin ward of the general hospital. The curtains were slowly coming down on this magnanimous institution built on a strong edifice and rightly so.

I cannot help being nostalgic at this moment and go down the memory lane. There used to be a family spirit in SJLH without any feelings of hierarchy. The camaraderie was at its best with all the staff members right from the doctors down to the attenders working in unison. The rural clinics and the school survey were a group work where the senior paramedics were as adept as the medical staff in detecting leprosy patches. The staff and the patients were observing anti-leprosy day and celebrating Christmas together. I fondly remember the cricket matches and table tennis which I played with younger patients. Our post-graduates are lucky to have got exposure to this kind of environment where they could hone their skills in developing human relationship and empathy.

I superannuated 2 years ago when two of the inmates were still in the dermatology ward. A year ago, one among them died and the last surviving patient Mr Charles D’Souza breathed his last on July 22, 2022. With his passing away, the closure of St Joseph Leprosy Hospital is complete, leaving behind memories in so many workers such as me who were associated with this mighty institution.

Once Mahatma Gandhi was invited to inaugurate a leprosy hospital. He said, “opening a leprosy hospital is not great, call me when you close it”. Mahatma’s dream has come true.^[4]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.