Leprosy sanatorium, Nooranad

“Unnunni?” I call out. “P C Unnunni,” the handsome 102 year old corrects me, sitting up in bed. Handsome, because a centenarian cannot possibly be this good looking or optimistic even in the best of circumstances. And this is the Kerala Government Leprosy Sanatorium at Nooranad, Alappuzha District, Kerala, where Unnunni, the oldest inmate, was brought by his father, when he was a strapping young man. He has been here ever since. He cannot walk as well as he did a year ago, but his memory is enviably sharp. He rattles off, with a toothless smile, a long list of the superintendants of the sanatorium, most of whom he remembers with affection. Unnunni came here not long after the sanatorium was set up in 1934 when it was Travancore, before the State of Kerala came into being. Today, thanks to the National Leprosy Eradication programme, there are no leprosy patients as such in the sanatorium, but the 236 inmates have nowhere to go, so they live here, often healthy, sometimes with other ailments and mainly with the damage done by leprosy before their nomenclature changed to ‘cured leprosy patients’. Unnunni is the best representative of this tribe of children of a lesser God. He loves to lie in bed, amidst his wardmates. By his bedside is a Boost bottle. He was the ‘injector’ (sic) at the sanatorium for decades. “He was taught to give injections to the patients at a time when it was difficult to get employees. Now there are many patient-employees,” says Dr J Shirley, Superintendant of the sanatorium. “The disease must have been in its early stages, for he has no physical handicap,” says Ismail Kunju, convenor of the Patients Welfare Committee, (Number A350, he elaborates) who came here as an eight year old, when he was sent out of class for being afflicted with leprosy. His fingers are clawed and he has a leg amputated, but he walks fast, with his Jaipur foot, a certain fire raging in his 60-year old frame, almost strident, in his quest for a better life for the cured leprosy patients. “There was a time when we were 1,500 and the place was brimming with life. They used to say it was Kochu Keralam’ (Small Kerala),” reminisces Ismail, with a sense of déjà vu that seemed eerie. Ismail, along with Gowri Antharjanam, 74, in the female ward, have been conferred the tag of actors too. In Aswamedham, (a 1967 Malayalam movie on the social problems of leprosy patients), Ismail and Gowri played bit roles, as the movie was shot in the sanatorium. This gated community also had its high moments when Jawaharlal Nehru and Indira Gandhi visited it, the inmates say with pride. Of the 96 women in the sanatorium, Panchali Amma is the oldest. “92, yes, 92,” reiterates the fair aristocratic lady, as she ate rice gruel and pappad. In her spotlessly clean white blouse and dhoti, Panchali Amma seemed almost out of place. Her husband brought her here ‘years and years ago’ and he too stayed on, ‘unable to get out of the sanatorium for fear of the stigma’, till he died, she says. “With the wonder multi-drug therapy that began showing results in the late eighties, there was no need to admit patients in the sanatorium. New cases became out patients and within six months, they can be cured, if they take their medicines regularly,” Dr Shirley says. Even so, cases that test positive are few and far between, usually relapses. The 138-acre facility has 236 inmates only. So, most of the 45 male wards and 15 female wards are shut down today. The Patients Cooperative Society, which farmed on the campus, is less active now, for there are fewer able-bodied inmates. There are small patches of tapioca and banana plants, but much of the sanatorium area lies wild. But the place bustles with khadi clad men when elections are announced with promises galore, says Ismail with a snigger. After all, 236 votes can make a difference to a politician’s future. But every year, the number of inmates comes down. Reason: Deaths. The downward trend threatens to snowball into a zero soon. The focus has shifted fully to rehabilitation from cure and that needs no hospitalisation or isolation. No one harbours the leprosy bacilli per se in the sanatorium, yet living with the damage done by the disease is heart breaking, with sores that refuse to heal and stumps for limbs. Hope is dawning, though, in the latest developments in clinical trials at the Department of Virology, Kings Institute of Preventive Medicine, Chennai. Called amnion therapy, amnion tissue, from placenta, rich in stem cells, was preserved and bound on old wounds of leprosy patients. The results have been encouraging. But it will be too late for Unnunni, Ismail, Panchali Amma, Gowri Antharjanam and friends to reboot and get on with life. This was written nearly a year ago. I wonder if Unnunni is alive, and Panchali amma..... Prema Manmadhan