The people of India do not take good health for granted. In their country, diseases that are under control elsewhere in the world still strike with epidemic force. Cholera, malaria, hepatitis and encephalitis can spread wildly if left unchecked, and they are dreaded as much as flood or famine. Often it takes more than serum to fight them; people must be helped to overcome fears and misunderstanding about cause and cure.

One disease that could be conquered still rages, partly because it is feared and misunderstood more than any other. It is Hansen’s disease, commonly known as leprosy.

Leprosy is caused by a micro-organism which mainly attacks the skin and nerves. It is rarely fatal, and with treatment it can be cured. The widespread belief that leprosy is contagious is true only for one rare strain of the disease. For the most part it is not contagious.

To fight leprosy in India is to do battle not only against the disease itself, but against a fortress of cultural and religious beliefs. According to the Hindu religion, which three-fourths of India’s 650 million people profess, all beings are continuously reincarnated after death. To the devout Hindu, a person’s situation in life is a direct result of his deeds in a past life. Thus the Hindu believes that leprosy is not just a disease, but a judgment of the gods. He sees it as evidence that the victim was guilty of selfish behavior – perhaps even crime – in his previous existence. Persons afflicted with the disease are either pitied or despised.

The victim of leprosy therefore loses more than the sense of feeling in a hand or foot; he loses his sense of self-respect. In its place there comes a demoralizing feeling of uselessness. Many of the afflicted hide themselves away, refusing to seek medical advice or treatment. The psychological anguish they suffer far outweighs their physical pain.

Often it is not just the victim himself who loses esteem in the community. The members of his family may be shunned as well, even if all of them are completely healthy. They may be prevented from socializing, marrying, or finding steady work. For this reason alone, the victim of leprosy may choose to remain hidden, enduring the pain and disfigurement of the disease so that his family will not be ostracized.

The afflicted person who lives in isolation is dependent upon his family for support. If he has no family, there is only one line of work open to him: begging. The more disfigured and destitute a beggar appears, the greater are his chances for earning a small income in the crowded markets and train stations.

Today, the victims of leprosy need no longer resign themselves to the grim choice of either hiding or begging while disease ravages their bodies. Prospects for treatment and recovery are improving rapidly. Although no preventive serum has been found, the drug known as Dapsone has proven very effective in curing leprosy. Reconstructive surgery and follow-up therapy are helping to reverse its crippling effects.

The first step in healing those afflicted with leprosy is to locate them, especially the children, and to begin treatment at the earliest possible stage of the disease. The next step is to convince the older patients that the disease is controllable and curable, and that it has no relation to a past life or to one’s religious belief.

In the crowded province of Bihar in northeast India, where the incidence of leprosy is particularly high, the Damien Social Welfare Centre is using the most modern methods of treatment and education to lead the fight against the disease.

Founded by Jesuit priests during the 1960’s, the Centre began its work by treating victims of leprosy in and around the town of Dhanbad. Today it has extended its services to provide hospital care for resident patients, therapy programs for outpatients, and treatment and instruction at roadside clinics. It also runs youth hostels where the children of leprosy patients attend school.

Father Larry Hunt, S.J., the American priest who directs the work of the Centre, reports that it receives funds from sources all over the world. Contributions from the Catholic Near East Welfare Association during 1979 amounted to $25,000.

One of the Centre’s most important projects is the Nirmala Leprosy Hospital, where victims with advanced cases of the disease are housed and cared for. Having the patients reside at the hospital enables the nursing staff to give them their medicine regularly and to keep their sores clean and well-bandaged. These are two essential steps in bringing difficult cases of leprosy under control.

Even after leprosy has been cured, however, damaged muscles may leave the patient with a useless hand or foot, or partially blind. Dr. Joe Lobo, the Centre’s chief physician and surgeon and a specialist in reconstructive surgery, can often repair the muscles and restore sight or movement in the affected part. Before Dr. Lobo joined the staff last year, only 10 to 20 operations could be performed annually, depending on the availability of visiting volunteer physicians. Now, thanks to Dr. Lobo, the hospital can offer diagnosis, surgery, and post-operative therapy to patients who would otherwise have to learn to live with a reversible deformity.

After surgery is performed, long hours of simple muscle exercises are required to render the repaired muscle fully usable. Dr. Lobo supervises each patient’s therapy program, assisted by a staff of 25 Sisters and lay medical workers.

Every morning, Father Hunt offers Mass at the hospital for the Sisters and other members of the staff. After Mass, he visits each patient. All of them have a special affection and respect for Father Hunt, and they greet him joyfully as he moves among the cots that line the ward.

Many of the hospital patients have children, and the Damien Centre provides for their education. Girls attend classes at the hospital, where they are taught by the Sisters. If the Centre did not make it possible for these children to go to school, many of them would be wage earners for their families. They would have to work in the rice fields, or scour the streets as beggars. At the hospital they learn English, math, weaving, sewing, and batik. They often sing at Mass in the morning, and Father Hunt stops in to see them after he visits their parents.

About 15 miles from the hospital, in the town of Gomoh, 300 boys are housed and educated at the Damien Centre’s DeBritto Youth Hostel. Some of them are the sons of leprosy patients, some are not, but all are needy.

The boys at the hostel range in age from eight to 18. They study the usual academic subjects, including English, as well as many manual trades: carpentry, masonry, tailoring, blacksmithing, weaving, and pottery-making. Their training will enable them to find good jobs when they leave the hostel.

Father Joe Lacey, S.J., lives at the hostel and takes care of administrative duties, but the boys virtually run it themselves. They raise their own vegetables, keep livestock, and draw water from wells they constructed. When a building is in need of repair, the boys do the work. The Damien Centre is very proud of them, and Father Hunt is a frequent visitor.

Once or twice a week, Father Hunt also rides out into the country to visit the many leprosy colonies he has organized. These remote villages usually consist of about 50 families each; most of the older members are badly disfigured by leprosy. Children in the villages are often allowed to remain with their families, but paramedics from the Centre give them regular examinations to check for signs of disease.

In order to provide employment and a source of income for the colonies, the Centre has set up craft groups. They make baskets which are sold at markets in the towns.

When Father Hunt’s jeep is not heading for the outlying districts, it can often be seen in the villages near his church in Dhanbad. He and his staff regularly check the progress of former patients. In this way, they can continue to care for persons who are well enough to return to their own communities to live and work.

The Damien Social Welfare Centre provides patients and their children with exceptional care, treatment, and education. But most important, Father Hunt and his colleagues give their people a sense of self-respect and usefulness. They prepare both young and old for the future, as they heal and teach them day by day. In their work, they are living the prayer of St. Francis: where there is despair, they bring hope.

Mark Guidera and his brother Tom, a photographer, have worked with the Jesuits who care for leprosy patients in Bihar, India.