Interview by Dr Jeanette Hyland with Miss Val Dunstan 2004, South Australia
Brief Biography .
Val Dunstan, an Australian nurse, worked briefly in India and then in Nepal, in Tansen, the United Mission to Nepal Hospital between 1958 and 1969. During her time there, she worked with Dr Cecil Pedley.Transcription
I am talking to Val Dunstan at Port Elliot, near Victor Harbour in South Australia. Val has very kindly agreed to talk to me about her experience working with leprosy a long time ago now.
First of all Val I would like to know how you got involved in leprosy work in the first place?
Val When I had just started my nursing training. I saw a Leprosy Mission film. It was a very old one, it would have been about 1950 – 51. It was of a Tibetan woman and her daughter with bleeding feet. They were trekking days and days from Tibet down towards India because they had heard that there was someone in India who could treat this disease. It really did affect me very much, and I longed to be able to help people who were in such a predicament.
It was very evocative, looking down a rocky road with feet bleeding. So that was when you were doing your nursing training – here in Adelaide?
Val Mmm, yes.
So you determined from then on …
Val I was always then interested in leprosy work because I felt they were the rejected people and my heart just went out to them – for the Lord, as well for their healing.
Then you went about preparing yourself?
Val Yes, I did three years general nursing, midwifery and third certificate (Maternal and Child Health), Bible College and all that…
It doesn’t take long to talk about it … but how many years did that take you?
Val Five and a half, I suppose, and I did a Wycliffe (Linguistics) course as well.
What did that help you do?
Val Well, it certainly helped me learn the language – pronunciation, how you make these sounds we don’t have in our own language.
So when did you go and where did you go first?
Val November 1958 I set off by ship, with Gwen Coventry, and we went to North Bihar (India) – Motihari – we sent four months there and I did some leprosy work there with a senior colleague and part time language and we had to go up to Landau to do full-time language study for four months and it was while we were there (we had been waiting to go the Nepal) that we got this telegram that they were desperate for nurses and would we go immediately to Nepal. So we went in to Tansen.
Tell me about your first impression of leprosy when you first saw it.
Val I don’t think I was very shocked because I had seen photos and films and had been to missionary meetings where they showed slides and that sort of thing. It did not repulse me at all. My heart just went out to these people really.
So who did you work with in Tansen and what were your duties?
Val Well first of all I was just in the general hospital for the first term (3-4 years) and then when I came home on furlough, about that time, Dr Cecil Pedley the leprologist came to work at Tansen with the Leprosy Mission, and while I was at home, he wrote and invited me to come and work with him on my return.
So what year was that?
Val I was home in 1963 so in 1964. In January 1965. I went to Purulia in West Bengal (India) for two months to study all about leprosy and to learn about pre- and post-operative physiotherapy to assist Dr Pedley with his surgery.
So, do you remember who the teachers were there in Purulia?
Val Dr Das was the superintendent. I worked with Dr Pedley for about 12 months in Tansen. We had wards for male and female patients but mostly they were male patients. He only admitted people who needed ulcer treatment or surgery. He didn’t believe in putting people in an institution and taking them away from their home village because once you take them out it is very hard to get them back again. but those who needed to have treatment had to be admitted.
So what was stigma like in those days?
Val Very bad, very bad. That was the trouble. People were terribly ostracized and persecuted – they couldn’t draw water from the local water source, they couldn’t work together with people in their fields - the community thing – you work in my field today and I’ll work in your field tomorrow – that kind of thing was denied them. Even their own families – children were just put out of the village, if they had leprosy.
Were they fed?
Val In some cases they were put somewhere and food was taken to them, but often they were sent off and they would just beg. … in the nearest town.
Tell me what else you did while you were there. … You were mentioning Malunga.
Val When the mission hospital was opened in Tansen in 1954, it wasn’t long before the people at Malunga, which was – I don’t know whether you would call it a Leprosarium – a big brick building and all the people got there was a rice ration and a clothing ration each year and no medication whatsoever – and when they heard that the Americans had come to open a hospital in Tansen, they started coming down to the hospital for treatment and we were treating them. But the people in the town became very upset and distressed because these with this terrible ‘great disease’, the Maha Rog, cursed by god, were coming to Tansen, so they asked the hospital staff would they go out to Malunga instead so that the people wouldn’t come.
So you used to go out …
Val Every month we made a trip out to Malunga – different ones – we walked four hours …
So it wasn’t all that far …
Val No … no … we had two main mountains to go over. I remember one occasion there was a terrible landslide and we had the horse with us. We had to lead the horse over this landslide. That was very hairy.
I’ll bet …
Val The path had been obliterated. It was a two day trip really because you had to walk there and you either did the clinic that afternoon and stayed somewhere in the village and went back the next day or you went in the afternoon and did the clinic the next day.
And there were a lot of people there?
Val Yes, I think there were probably a couple of hundred. I’m not sure – and there were families and the sad thing was that there were people there who didn’t even have leprosy. There were a lot of healthy children and spouses probably who did not have leprosy, but they were all there as families. They had no privacy in this building – they used to make themselves little mud partitions – waist high – to divide the place off – you know each family.
And they had been sent there?
Val Yes, they had to stay there – well they got these free rations of clothing and rice when they turned up. Later on we gave nursing training to some of the daughters of leprosy patients.
So that was good … and … when I was talking to Jean Raddon who trekked into Nepal in 1952 they went via that area so they saw people at Malunga and found out about it. She was saying how that was very evocative for them to start the leprosy work in Pokhra. The sight of the leprosarium and what was going on …
Val They suffered from more than leprosy – there was tuberculosis, hookworm, and dysentery - so we treated for everything that we could find. We did smears and …
So you were looking after their general health?
So you went out – two of you …
Val Different people – it was only one missionary and a Nepali nurse or … different ones, we would take it in turns – until Dr Pedley came and then he took over.
He went each time, he had a horse and Mrs Pedley used to go and Atan.
Tell me about Atan.
Val Atan Chering was a Lepcha from Sikkim originally. He had done nursing training at Duncan Hospital in Raxaul (India) on the border of India and Nepal. Very good nurse, he had a lot of theatre experience and then he came to work in Tansen hospital and he also became the pastor of the church. He had no fear of leprosy and he had a wonderful compassionate attitude towards these people. He was invaluable going with Dr Pedley and sometimes on his own … returning patients to their villages after they had treatment or surgery to try and educate families and communities that is was not curse of the gods but – we used to call it an insect the eye cannot see – germ. ‘Acha deckna nasakne’. The fact that they stayed with the family in the house with the leprosy patient … spoke volumes … was a wonderful witness really that we shouldn’t be frightened of the disease – it is treatable.
Fantastic. So you worked with various people over the years in leprosy – any others you would like to mention?
Val The other doctors before Dr Pedley came all knew something about leprosy. We always treated leprosy patients but [only] after he came that we set up a special out- patient’s clinic for leprosy, and it was during that time that Dr Pedley discovered that there were active bacteria in the breast milk of a woman with lepromatous leprosy [who] was nursing a babe.
His research is famous isn’t it; he did a lot or groundbreaking research. Did Doctors Warwick and Annette Britton come to Tansen while you were there?
Val No. They were there later.
One of our biggest tasks was to try to break down the stigma, the ostracism that people were subject to because of the disease and many of them came late and there were children … one little boy Man Bahadur had lepromatous leprosy – he was only about 10 and his face was such a mess. His mother brought him. She was free of the disease. So we employed her as a sweeper so that the child could be admitted for treatment. Sometimes there were[those] – who reacted to the Dapsone. The practice was then that you put them on TB medication for, I think it was, three months, Streptomycin injections and Isoniazid tablets, until things settled down and they were gradually put back on DDS. A lot of our patients were treated for ulcers and when they had cleared up a bit we put Mag. Sulph and Tuille Gras dressings for a week and a wooden rocker to keep them off it so that they could still walk about and after four weeks the plaster was removed and most times the ulcer would be healed. I used to do wax baths too for patients who were preparing for surgery – to make the skin softer - more supple.
Did Dr Pedley operate on hands as well as feet?
Val Yes, hands feet and eye lids and eye brows – taking a graft from the scalp to re-form eye brows but of course the patients had to remember that they had to keep trimming their eye brows because they would keep growing. It was very important to remove the stigma.
People used to recognize people without eyebrows and sunken nose and things like that …as leprosy?
Val Because the problem was that that the lepromatous cases were not as conspicuous as the tuberculoid ones with their claw hands and drop feet, but unfortunately it was the leprometous ones that were infectious – spread the disease. If they were not an acute reactive case with inflamed nodules they may not have been noticed and they were passing on their disease. But of course we know now that 94 – 98% of people have a natural immunity to leprosy anyway. It is only a few who are the ones that actually get it.
Was that ever a fear of yours …?
Val No! We could have had treatment.
Tell me about the time you were dressing a ulcer in India – a leprosy ulcer ..
Val Yes, my first experience with leprosy was in Motihari in north Bihar in India. We had a leprosy clinic and a general clinic – no doctor there just a senior nurse and myself. I was dressing a patient’s ulcer and putting the bandage on and the senior nurse called out to me just to be very careful that I didn’t touch his skin. Obviously the feeling was there was still a danger, you could contract leprosy through skin contact.
That staff member was An Australian and she was giving you advice about not touching the patients?
Val Mmm. And that was in 1958 – 1959.
So did you obey?
Val Not necessarily. I had no fear of the disease at all really – I just felt these people they needed love, you know and I’m a tactile sort of person anyway – so …
Patients got touched?
Val Patients got touched!
You were telling me earlier on about something that was very upsetting to you…?
Val One of the last patients I had in Tansen before I moved to another area was – I suppose she was an old lady, a middle aged lady with very advanced leprosy and she was admitted because she had maggots in her nose. It must have been at the time Dr Pedley was at home on furlough because I was there on my own. It was distressing for me and it was distressing for her. The Medical Superintendent of the general side of the hospital advised me to spray some either Ether of Chlorophorm – I can’t remember which - onto cotton swabs and insert them into the nasal cavity to stun these maggots and then to draw them out with forceps. I used to have I can’t remember how many sessions a day doing this. It was only a few days and that lady died. She had an overwhelming infection. It was very sad.
What were some of the good things?
Val Wonderful – to see people respond to treatment, to appreciate the loving care and compassion that they received, to see them – in most cases, it was not the common thing – welcomed home again into their family or into their village after Dr Pedley and Atan especially had made a lot of effort to educate people. That was a wonderful thing, and when I returned – went for a visit in 1993 – I went to Anandaban just outside the Kathmandu Valley for a few days and looking round the hospital – went down to the Out Patients clinic and discovered that people from the local villages around were coming to Anandaban, a leprosy hospital for ordinary general medical treatment and that women from the area were actually coming to have their babies in the hospital – they had a special place for a labour ward. And these people had no leprosy in their family. This was a leprosy hospital and they were coming to it. So obviously in those 25 years since I had left the country, there had been an enormous improvement in understanding of the disease and not so much fear.
That’s fantastic, that must have been very exciting for you?
Val I remember too going up to the ward, and I’ve got a photo of an elderly man, an old leprosy patient who was blind, terrible – no fingers, can’t remember if he had toes, it was lunch time and another patient was sitting there feeding him because he couldn’t feed himself and both of them were so full of joy – these two you know – and it touched me tremendously to see the acceptance and the love shared between them in that hospital.
So you went home – came back to Australia in 1969 and you didn’t revisit until you went back in 1993? That must have been very special. You went back to Tansen?
Val Yes, didn’t see Malunga, just a few days in Tansen and Pokhra.
And the leprosy clinic still works there…?
Val It would be part of the general outpatients now, I’m not sure whether they had a skin clinic – it might have been on a skin clinic day I’m not sure.
And you went to Pokhra?
Val I worked in Okhaldhunga, we did have a few patients there, and we put them onto treatment.
So your work in leprosy only covered three or four years, but it is very memorable…?
Val It is very close to my heart.
I’m sure you made a great difference. How do you feel about it now as you look back?
Val I feel it was a great privilege to show some Christian love and compassion to these people who were rejected by their own society and I know that many were very appreciative and grateful.
And your participation at Malunga was towards the beginning of their contact with western medicine? It was 1954 Tansen (Hospital) was established and you were there in 1958? It was early days and Dr Pedley’s vision must have been enormous for that whole situation.
The history of Malunga itself is fascinating, when I was working with the leprosy programme in Pokhra Jennie Collins, who is now Director of UMN, was part of a team involved in rehabilitating people who were in Malunga, settling them on land and helping them establish another life in another place. That is a story that must be told as well. So long years of the history of a leprosarium came to an end eventually - as it should be with modern medicine and help that can be given.
Any other stories, can you think of people you would like to talk about?
Val That little boy, Man Bahadur who was so badly affected by lepromatous leprosy – the problem was we used to give them medication – treatment for up to six months at a time ‘cause many of them – you know they walked for days and if they already had anaesthetic feet as may of them did, you didn’t want them walking too often on the rough roads so you would give them as much medicine as you could. But of course not everybody came back. It was new, unfortunately, they thought if this medicine is good it should work in a short time and that should be it. At that time people with lepromatous leprosy were persuaded that they really needed to take medicine for the rest of their lives – the people with tuberculoid leprosy I think it was three years they were encouraged to take their medicine. So – that was another thing that Dr Pedley and Atan did was to check up on people who had not come back for their treatment – to go out. All our Doctors there in Tansen, when they went on any village trips they would check people for leprosy as well as for other things.
So it was really pioneering work, beginning to think about how to do it.
Well thanks Val – I’m very grateful to you for talking to me.