The Foreign Service Journal, March 2009

and as the patients came up and called out their names, I would look up their card. He would drop one tablet on the tongue of the patient, and I would note the date on the record. There were more than 30 patients. Some walked for many miles to reach the clinic. They stood in line quietly. Most of the patients were men, but there were a few women and a few young children. Desikan said they had a hard time getting people to come to the clinic because no one wanted to admit to having the disease. But the older people recognized the importance of the medication, proba- bly because Desikan could point to himself as a “cured” patient. Indeed, he had not lost any fingers or toes or his nose, and neither had any of his patients. The Importance of Pain I read as much as I could find in Madras about leprosy. I learned that the disease was not easy to catch; sim- ple health precautions were all that was needed. The servants at our home were shocked by my work, however, and would keep the kids away from me when I returned from the clinic. I would walk right up to my bathroom and climb into the tub, scrub thoroughly and then toss in all my clothes, including my sandals, and wash everything, hanging it all out on the rooftop clothesline. This seemed to satisfy everyone. One book I read was by Dr. Paul Brand, an Englishman and missionary doctor based at that time in Vellore. (He became an international author- ity in the field and subsequently won many awards for his work.) He had developed many useful tools and practices to allow lepers to maintain functionality in their limbs, including a way of rearranging the muscles and nerves of damaged hands to make them work. When I eventually met him, Dr. Brand explained the basis for many of his inventions: leprosy strikes first at the extremities, killing the nerve end- ings, leaving the patient without the feeling of touch. So, for instance, he developed a coffee cup that fit inside a wooden rim, with a wooden handle on the rim. A patient who has no sen- sation of hot or cold in his nerve-im- paired hands will pick up a scalding hot tin cup of coffee, badly burning his hands. That is the reason so many leprosy patients lose fingers and toes — not because of the disease, per se, but be- cause they have no perception of pain and therefore unwittingly damage their fingers and toes. “Pain is a very important sensation,” Dr. Brand had said. A Providential Development Meanwhile, news of my extracur- ricular activities was spreading among the wives at the consulate, and now and then one of them would join me for the junket to Pammal. Then, at a meeting of the American Women’s Club, a providential development oc- curred. Madam “Clubwallah” Djadhav, a portly woman from New Delhi who was a well-known organizer and work- er in women’s groups (hence “club- wallah,” one who is involved with clubs), had come to address the group on the problems of India’s poor. She talked of how they were kept out of any type of work that would improve their station in life by the fact that they were on the very lowest rung of the caste structure. They were out- casts or, as Gandhi had renamed them, “Children of God.” They were doomed to a life of drudgery, a hand- to-mouth existence that could only be improved when they died and were reborn, hopefully, into a higher caste. Missionary efforts had made some progress, she admitted, but the mis- sion groups tended to quarrel among themselves and this undermined their efforts. She gave an example: Tons of powdered milk, in five-gallon cans, were sitting on the docks right now waiting to be collected by one or an- other of the missionary groups in South India. No one would claim the milk, and Mrs. Clubwallah worried that it would go bad. “Too bad we can’t get it for the clinic,” I muttered to my neighbor. There was no further discussion of the milk powder, but the next day a huge army truck pulled into our drive- way. I ran downstairs just as Ra- gavelu, the head bearer, opened the gate. The driver asked us where he should unload the milk. I asked him carefully if he was sure it should be delivered to our house, and he showed me his “chit,” signed by Mrs. Clubwallah, with our name and ad- dress. Milk for the Clinic “Ragavelu, what’ll we do?” I asked helplessly. But he was way ahead of me. (The servants in my house al- ways knew what was happening be- fore I did.) Opening the door on a small unused shed at the end of the garden, he told the soldiers to stack the tins inside. Ragavelu picked out a couple of tins that had been punc- tured and gave one to the truck driv- ers to share. Another one he said he would take to his family. All the oth- ers were placed in the little store- room, and then he locked the door. He would drop one tablet on the tongue of the patient, and I would note the date on the file card. 44 F O R E I G N S E R V I C E J O U R N A L / M A R C H 2 0 0 9