International Leprosy Association -
History of Leprosy

  • International Leprosy Association -
    History of Leprosy


    Dr V K Ekambaram

    Status Physician
    Country India


    Dr V Ekambaram (1917-2003) was an eminent Indian leprologist, involved in leprosy treatment from 1950 onwards. Formerly stationed at the Leprosy Department in Stanley Medical College in Madras, he later became Secretary of the Damien Foundation India Trust. In 1979 he joined AIFO (Associazione Italiana Amici di Raoul Follereau) as Representative and greatly enhanced their involvement in Indian leprosy work.

    In 1983 he led the MDT program in Chitoor, Andhra Pradesh, and in 1992 set up the Bangalore Urban and Mandya District Programs.

    He received the International Gandhi Memorial Award and the Lifetime Acheivement Leprologist Award.

    Source: JMV, "Dr. V. Ekambaram, 1917-2003", Int J Lepr (2002): 128.

    Transcript of interview answers given by Dr V K Ekambaram, for ‘An Autobiographical Sketch’ in ‘The Indian Leprologists Look Back. Bombay, 1990, pp. 43-7.

    About my early life I have nothing much to say. I was born in Madras. I had to be educated in Andhra Pradesh due to the death of my father very young. I was brought up by my maternal grandfather in Chittoor. After finishing my secondary education in Chittoor I came to Madras for my collegiate education. I joined the Madras Medical College for my undergraduate course, after finishing this I went into the British Indian Army - Indian Medical Service. Having served there for 5 ½ years I came back home and was recruited to the Madras Medical Service, since the British were good enough to have ordered that 60% of the vacancies be kept vacant or occupied by temporary assistant surgeons [i.e.] - since these posts were reserved for Army-returned candidates.

    Then I was posted to a small dispensary in a rural area. Since I was eager to do my postgraduate course in medicine I approached one of my old professors who promised to help me. He thought about my request and told me that since I was a Junior Assistant Surgeon those days he could get me posted to the Stanley Medical College Madras from where I could appear for my M.D. Examination. But then the only post vacant those days for a Junior Doctor in the Medical College was that of leprosy. So I found myself one fine morning as A.M.O. I/c of the Leprosy Department of the Stanley Medical College.

    As a matter of fact nobody pushed me into leprosy work neither did I come there voluntarily……I was just posted to leprosy and like a true Army Man who always does what he is asked to do I took the post in leprosy in the real spirit and the discipline that the Army inculcated in me stood me in good stead.

    As regards my interest in leprosy which was stimulated later this was partly because I am always one who takes life seriously anywhere I work. When I was posted to leprosy I said it is like any other disease and I should work hard. In addition certain senior workers whom I had occasion to meet and discuss also created in me an enthusiasm for this work. Prominent among these senior workers I would like to mention Dr. K. Ramanujam who retired from the Central Leprosy Teaching and Research Institute, Tirumani in addition to Dr. R. G. Cochrane, the eminent leprologist who can be starred as the father of leprosy work in Tamil Nadu. It was the example set by these prominent leprologists that ultimately stimulated me to continue my work in leprosy with zeal and dedication. I don’t know whether I am dedicated but all that I can say about myself is that I did whatever work was given to me in an honest and sincere manner as … [a] result of my efficiency.

    As regards my contribution to the field of Leprosy, I must add here that Dr. R. G. Cochrane has been rightly called the father of leprosy work in Tamil Nadu, but Dr. Cochrane was not a field worker, and the modern ideas about the control of leprosy were then not in vogue. He was actually a clinician and pathologist. He had done his best to inculcate in the administrators the belief that leprosy is a part of General Medicine and that every General Hospital should treat leprosy.

    He did very little about laying down principles of control or outlining a methodology of leprosy control work. Fortunately for me after about 10 years of work in a field unit, I was promoted as State Leprosy Officer. I was the first State Leprosy Officer of Tamil Nadu. I had the overall responsibility of finding myself in the position where I had to start from scratch to lay down the principles of control work, the methodology of control work and the various periodicals to be submitted to the higher authorities for monitoring the progress and at a later date for evaluating the progress.

    In this way I think I can be proud to say the entire groundwork as well as the later supervision and direction of leprosy control work in Tamil Nadu was entirely my creation.

    My professional life as a Leprologist has been quite happy though my work has always been in the field. Many of you will perhaps remember what I used to say in a semi-humorous manner - “I am a humble field worker in leprosy”. I spent about 30 years working in the villages in control units, when I took up the guidance and supervision of control units. I would say that I found my work and the field work quite interesting.

    As regards my role in the changing pattern of leprosy.... I should say that I took a major part in the administrative arrangements for implementation of the Leprosy Control Programme. Also, having worked under the influence of Dr. M. F. Lechat, the Belgian epidemiologist, I took some interest in the collection of epidemiological data and had also taught the medical officers the principles of epidemiology and data to be collected for monitoring the programme and now and then evaluating the programme. In the space of 30 years if not more of my life as a leprosy worker I had many an occasion to meet prominent workers and also experienced certain incidents which have left a lasting impression on me.

    I remember when I was an Medical Officer, in-charge of the leprosy treatment and study centre at Tirukoilur, we used to get a cup of tea from a neighbouring restaurant. It so happened when I started the work I sent my staff to get some tea from the neighbouring restaurant and the restaurant owner and the customers there refused to give us food on the pretext that we will not give tea to lepers (1950) because the doctors themselves might be suffering from leprosy. The proprietor is supposed to have said that the M.O. (referring to myself) must be a leprosy patient otherwise he wouldn’t be working in this field.

    I well remember when I was posted to leprosy work, I had my friends calling on me to almost offer condolences to me for……to leprosy work. I still remember the experience, but then I was more amused. As an army man the inherent discipline of the Army was there in me to take life as it comes. This reminds me of a very peculiar incidence as when I was working in Tirukoilur there was a Leprosy Mission Hospital about 10 miles from there. There was an old lady, a nurse was in charge. She came to my place when Dr. Cochrane was visiting us….Dr. Cochrane and. I were discussing the bacteriological index 1 was telling him about the B.I. Just then this lady interrupted and asked whether I had a microscope.... I replied to her in a humorous way that I stain the slide and take it to the sunlight and read it. Of course, Dr. Cochrane burst out laughing! But let me tell you in those days the voluntary organisations thought that medical facilities aren’t available at Government Hospitals.

    In my long period of work in leprosy control I had the occasion to meet many prominent Leprologists.

    The first person that comes to my mind is none else than Dr. R. G. Cochrane who was the father of leprosy work in Tamil Nadu … a very great man. I learnt the ABC of leprosy from him, though actually the person who introduced me to leprosy work was my professor of medicine at the Madras Medical College, Dr. R. Subramaniam, at the beginning to understand leprosy. Again I must recall another prominent Leprologist who was instrumental in creating interest in me for leprosy was none other than Dr. K. Ramanujam.

    I would also like to mention Dr. M. F. Lechat the Belgian Leprologist on one of his visits to India when he also visited my centre. He saw the data that I maintained and of the control work I was involved in at Tirukoilur. He called me an epidemiologist, but I protested and said I am not an epidemiologist but only a field worker. He was good enough to say that I could become an epidemiologist. So he went home and sent me a book on epidemiology. I began studying it, and then I learnt the elements of epidemiology from the book. Then I did learn epidemiology in my practice as an epidemiologist.

    I must mention here that I had the opportunity to meet other prominent workers. I remember I met Dr. Wade the leprologist from the Philippines. He was a very unusual personality but unfortunately when he came to India to attend the Indian Leprologists Meeting in 1964 in Madras he was sick. I used to take him from the meeting hall to his place of lodging which was the State Guest House and he used to call me in a humorous manner that I was his Taxi Driver! I enjoyed his wit. But later I heard that the great leprologist died very soon after leaving India.

    I must now refer to the future of leprosy control work in this country. As it is we now have available the multiple drug therapy for leprosy. From my experience of MDT in leprosy in North Arcot district I am very optimist[ic] of the results that can be achieved, with this programme. We had nearly one lakh of cases to start with in North Arcot district in the year 1983.

    But by 1988 we have discharged nearly 80,000 patients and. there are only about 13,000 patients in the district in January 1989. We have also found that the relapse rate of paucibacillary as well as multibacillary patients is very negligible. This is very optimistic. So if we can only implement this programme in a sincere efficient and honest manner I am sure we can certainly not only control leprosy but also eradicate it in the near future.

    …. As regards talk of the vaccine for the prevention of leprosy I am afraid it is going to take a few more years - probably a decade before one can find out its usefulness in the prevention of leprosy. We just cannot wait so long.

    So if we could implement the present MDT programme in an efficient manner, we can certainly succeed in controlling and eradicating the disease.

    Another aspect I want to talk about is the role of the administrators in this goal. We do depend on the administrators to develop the budget, to make arrangements for the posting of the staff and the training of the staff. But then we find that since they lack the knowledge of implementation of the programme they are not able to discharge their duties very satisfactorily. So I would suggest that the logistics of the MDT programme, the administrators should also be given a brief orientation about the principles of leprosy control with the MDT programme and the administrative arrangements involved in this programme though I must say that whatever plans we have and however well we make them we will never succeed unless we are sincere and efficient in the implementation of the programme.

    I have found in my experience that the worst aspect of all our plans is that we are good at making plans, we never implement them sincerely and properly. This has resulted in a lot of waste of our national resources. So the same thing holds for the Leprosy Control Programme. And I do hope that our leprosy workers will realise that sincere and efficient implementation of the programme is very essential.

    I am very happy that I have had this opportunity of recording my views on leprosy and also about the role played by me in this laudable venture. I do hope that the younger generation who will take over from us will do better than us and perhaps in a few years leprosy will be eradicated like small pox.

    The tape received on August 23, 1988.

    Treatment Used/Researched:

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