Activities - Care and treatment of the leprosy affected people

1. Care and treatment of the leprosy affected people and general clinic

Sewa Kendra renders treatment and care of leprosy-affected people in several locations including its own hospital at Gaushala. In addition, it also provides services to the general public, who cannot afford expensive treatments, but are still looking for quality medical services.  For more than a decade now, Sewa Kendra has served many marginalized, destitute people all over from Kathmandu and outside valley, with many of our patients coming from remote locations

• Sewa Kendra Hospital at Gaushala:

Sewa Kendra runs 15-bed hospital at Gaushala equipped with an out-patient department, a physio-therapy section, a fully equipped laboratory for all necessary tests, facilities for minor and septic surgeries, and counseling services for both patients and their relatives. The medication is generally free. This is so because the patients the hospital caters to are mostly poor people, women and children. In 2009, of the total bed capacity of 5,475 (15 beds x 365 days), the occupancy level was 3,356 or 61.3% of the total. Incidentally, the occupancy rate for the year was less than those during previous years due to much political turmoil that prevented patients from getting to the hospital. For instance, in 2007, the bed occupancy rate was 88.8%. Of the total bed occupancy of 3356 in 2009, leprosy patients accounted for 2,708 or 80.7% and the rest 19.3 % by general patients. Sewa Kendra receives most of its leprosy patients from the government leprosarium at Khokana who are referred to it for hospital care by its twice-weekly clinic in the colony. In 2009 Sewa Kendra also treated 1,832 patients in its outpatient department.

• Sewa Kendra clinics in the Government Leprosarium at Khokana:

The Khokana Leprosarium is situated about 16 kms south of Kathmandu, at the banks of the Holy Bagmati river. Established as a government owned institution, the history of this centre holds stories of times when leprosy was considered a sin, an omen that was only diagnosed by police and lay people at a very later stage of infection, when severe deformities have already set in. The place was solely used to isolate leprosy affected people from the rest of the world, with only provision of food and water by the government. Medical attention was a distant dream.

Recognizing the crucial need of having a continuous medical service for the patients in the leprosarium, Sewa Kendra, at the request of and in partnership with the Leprosy Control Division of the Ministry of Health and Population of the government, started its services in 2002. Sewa Kendra became the first ever organization to provide medical services in the Khokana Leprosarium and has been running clinics every Monday and Thursday ever-since. At present, the colony has a total of 150 leprosy-affected people living there. Given the specific needs of the leprosy patients, Sewa Kendra offers a range of services in its clinics:  ulcer and general treatment, laboratory facility, physiotherapy, and footwear section that customizes footwears to the specific requirements of the individual patient's feet. While planter ulcer affected some 90% of the leprosy patients in the colony in the past, the introduction of this customized footwear coupled with counseling of patients for prevention of deformity (POD), such ulcer cases have now drastically come down to only about 25%. Similarly, the physiotherapy section has also contributed significantly to the prevention of arms burning that otherwise regularly occurred on the patients while cooking or working in the kitchen. The physiotherapy section innovated thick and long gloves customized to the specifications of individual patients' arms to be worn during cooking. The section also innovated various appliances made of leather that the patients can self-attach to their fingerless hands and attend to such chores as sweeping, brushing teeth, combing, and writing. The Khokana clinic receives some 70 to 80 patients weekly from inside the colony and some 20 to 30 cases from the neighborhoods outside. Once-a-week eye-camp and twice-a-year dental camp are routinely organized. 

Sewa Kendra has also provided the services of a resident, supported by a paramedic to attend to the health care needs of the residents round the clock. An emergency fund has also been set up in the colony to enable the residents to hire vehicles to go to Sewa Kendra hospital or to other hospitals as and when necessary. The emergency fund started with a seed-grant of NRs. 30,000 from Sewa kendra, and has thus been growing slowly as a result of membership drive (Rs. 5/month) for leprosy affected people and their children. The Leprosarium also receives kind donations from visitors that is added again to the fund. When specialised treatments are needed for individual leprosy patients in the colony, Sewa Kendra arranges for such services from various specialized medical institutions. For instance, 70 cataract operations have been done since 2002 at the Tilganga Eye Hospital. Sewa Kendra also provides sunglasses and power-corrected glasses to the patients as necessary. Similar specialized services are also obtained from Orthopedic Hospital at Jorpati in Kathmandu, Patan Hospital in Lalitpur, and Anandaban Leprosy Hospital Tika Bhairab in Lalitpur too.