Australian Jean (Davis) Porteous worked as a registered nurse at the Leprosy Mission Leprosy Hospital at Muzaffarpur , India between 1968 and 1976. Her expatriate colleagues, both English, were Dr Margaret Owen and nursing Sister Jill Tipping, with whom she is still in touch. Her work was conducted in Hindi, which on a recent visit to Muzaffarpur ‘came back’ to her. She left India to be with her mother. She is still involved with The Leprosy Mission in Australia through the New South Wales State Advisory Committee as well as the National Council. She lives in retirement with her husband in Sydney, Australia and is sometimes invited to speak about leprosy.
Jean (Davis) Porteous - interview conducted by Dr Jeanette Hyland
Transcription of interview conducted with Jean (Davis) Porteous in her home, in Sydney, in August 2004.
Good afternoon Jean. Thank you very much for agreeing to talk to me today. Perhaps I could begin by asking you where you worked with leprosy and what was your name at that time?
Jean I was working in Muzaffarpur, north Bihar, India and my maiden name was Jean Davis.
When did you go to Muzaffarpur?
Jean I went there in 1968. I came home in 1976 although I did have a furlough in between too.
We were chatting a while ago and I asked you about training. Where did you learn about leprosy and how did you learn about it?
Jean I learned on the Job. When I went to India first I west to language school first to learn the Hindi language and then I went to Muzaffarpur, to the Leprosy Mission Hospital. There I worked with Dr Margaret Owen who was an English Doctor and Jill Tipping who was a registered nurse also from England. Anything I learned about leprosy I learned from them. They were very good teachers; Margaret especially because she had worked with leprosy for many years and she was very keen to teach and to pass on her knowledge.
What was your role in the institution?
Jean I was the registered nurse although we did have a young staff nurse, an Indian man, and we had Nurse Aids – as we called them in those days – they are now Enrolled Nurses who helped. It was an 84 bed hospital and we had four enrolled nurses and two registered nurses. They were all Indian staff. There were just the three of us expatriate staff.
The Leprosy Mission ran the hospital. We had an administrator – there were two or three different administrators while I was there.
And you had 84 beds, and what other facilities were there?
Jean We had an operating theatre. The theatre wasn’t going when I first went, but after a couple of years, we were able to find a surgeon who was able to do reconstructive surgery, and we had the theatre going once or twice a month. There were a lot of minor operations done. Margaret did that, she had to debride ulcers – that sort of thing.
We had a physiotherapy department and a young Indian man who had done the nine month physiotherapy aid course and was able to look after the needs of patients for physiotherapy.
We had a large out-patient department. There were several out patient clinics held in the outlying villages where Margaret and paramedical workers and Jill and quite often the man called the’ Compounder’ – pharmacist – went to conduct the clinics.
How did they travel?
Jean They had a jeep, and of course to go 40 Km there was quite a journey on dusty or muddy roads. A couple of the clinics; there was one up at the Duncan Hospital at Raxaul which is on the border of India and Nepal, and that was an all day clinic and they needed to stay over night, it was at least 100 miles; and the other was at Motihari, that was conducted each month and that was probably 50-60 miles.
So anyone in those clinics who had a problem, were they sent to the hospital or brought in?
Jean Yes, they were either brought in or usually they were requested to come in. They either had to get the bus or the train and a rickshaw 5 miles from Muzaffarpur station to the hospital.
And what was stigma like in those days?
Jean People were – a lot of people - were put out of their homes because of leprosy, people didn’t understand that it was an ordinary disease. We had lots of posters for our clinics and the hospital produced by a leprosy organization and they said things like – “Leprosy is a disease.” “Leprosy is curable.” “Leprosy is not a disease of the Gods.”
This was the thing that we had to get through to the ordinary person; that they could be cured, they could be cured without deformity if they got treatment early and that it wasn’t anything terrible they had done to get the disease, but it was a disease that was treatable.
So those were very common and strong beliefs?
Jean Yes, amongst almost everybody as far as I can remember now. It is going back a lot of years and it is hard to remember the details, but I think it was and it was difficult getting through. But once you got through they did understand.
Our leprosy patients were our best workers really – they would say to other people “Oh, you’ve got leprosy, if you go to the hospital in Muzaffarpur, or if you go to the clinic in such and such you will obtain treatment and you will be made better.” We had a lot of patients coming to us simply because someone who had been receiving treatment told them to.
That’s wonderful. I was going to ask you, did you have trouble getting staff, were local people willing to work in the hospital? Was it a stigmatized occupation for people?
Jean No, I think – certainly with the paramedical workers, and of course in those days, back in the 60s, early 70s, the paramedical work was a new work really with the Leprosy Mission and the Mission as far as I know and remember had to recruit the staff. They had a special program – courses - for the paramedical workers to undertake. The majority of our paramedical workers certainly had not had leprosy. Our registered nurse had not had leprosy, a lot of the people who worked in the office had never had leprosy; they were very happy to come and work in the leprosy hospital. Our nurse aids had had leprosy and had done a special course to become a nurse aide. Our physiotherapist had not had leprosy.
That is quite something because leprosy hospitals in those days employed a lot of ex-patients.
Jean Yes, they did and it was good for the patients too because a lot of the patients couldn’t go back to the work they had done before. It was very good because we were able to see these people who had not had leprosy coming in to work and not being afraid of the disease.
Did you have patients come from outside your area at all, from Nepal at all or from other parts of India?
Jean Yes, especially when the clinic was held in Raxaul, patients came from Nepal to that and that also meant that some of those patients would have to come to us if they needed hospital admission. We had quite a wide circle from which patients were drawn, not necessarily from our choice but because there really was not anywhere else for them to go.
Would the next place be Purulia in West Bengal?
Jean As far as the Leprosy Mission work went, it was. They could have gone to a public hospital, but they weren’t happy to do that. The public hospital quite often sent them to our hospital because they felt they did not understand the disease.
Right. Did your institution undertake training too?
Because some Leprosy Mission Hospitals were centres for courses for various paramedics or physio techs or various other …
Jean Yes, well Purulia did a lot of that but we didn’t have training.
So you worked with Jill Tipping and Margaret Owen. Any others over the years?
Jean No, we were they only expatriates there.
Were there other Indian Doctors…?
Jean Yes, we did have when Margaret went on furlough or home leave, we had an Indian doctor. A couple of different Indian doctors. But - on the whole, while I was there certainly, it was Margaret.
When you look back on your experience of working with leprosy how do you feel about it?
Jean Well, I’m very glad that I had that time …
What recollections do you have of leprosy at that time, how did you come to be interested, how did that all eventuate?
Jean Yes, of course, this is now 2004, and people’s attitudes to leprosy are very different from what they were some years ago. I remember going to a meeting in a Methodist Church when I was a small child. My parents were very interested in Mission and there was a man from what is now The Leprosy Mission, but in those days it was the Mission to Lepers, speaking and he was showing slides of the leprosy sufferers. I remember seeing a particular slide of a man who had a sunken nose and really looked quite deformed. As a small child I closed my eyes and I didn’t want to see any more of the slides. That attitude stayed with me for many years.
When I applied to go to India to work with the mission that I went with, called the "Regions Beyond Missionary Union", my application was to go and work in midwifery and do domiciliary midwifery because that was really my first love. In those days, the Government of India had changed its policy concerning admitting missionaries to the country, and you could only go if there was a vacancy in a certain position and so there was not a vacancy for me in a midwifery role at the Duncan Hospital, but there was a need for a registered nurse in Muzaffarpur Leprosy Hospital.
One day I was sitting on the platform of the station waiting for the train to go back to the hospital where I was working and I read a book about a lady who worked in Africa with leprosy sufferers and she had actually commenced the work with leprosy sufferers in Africa and she found that it was a tremendous work, a very big work and as I read this story I remember thinking to myself ‘Dear God, please don’t call me to work with leprosy sufferers.” Straight away I realised that if I had truly given my life over to God for him to do what he wanted then I shouldn’t be telling him what I was to do. And so I apologised and went on my way. Then some months later I received a letter from the mission saying that they couldn’t get me a visa to do midwifery but they could get a visa for me to go to the leprosy hospital. And I just wrote back straight away and said ‘All right, that’s fine with me. So there was no real struggle in my heart because the work on my attitude towards leprosy had been done by God that night on the railway platform. So then I decided to read all I could about the disease and I started doing that so that when I went to work in the leprosy hospital the pre-conceived ideas had really gone and I was able to recognise that it was a disease, it was curable and that these people needed care and attention and treatment for their disease the same as anyone else would need it.
I look back on those days with enjoyment and I enjoyed my time there. There was a rapport there between the leprosy patients and the staff and I found that the staff and the patients looked on me, even though I was a foreigner amongst them, as a sister. They would say to me ‘Oh, we forget that you are a foreigner’. It was really a nice atmosphere to work in …
And very accepting?
Jean Yes, and very pleasant and it was wonderful when you saw some of the people going home happy, specially when some of them had come in very depressed, and in fact as you got to know them they would tell you that they had been contemplating suicide. We had four wards in the hospital, their names were ‘Faith’, ‘Hope’, ‘Love’ and ‘Peace’. The reason why we named them those names was because we believe that we were – that the Lord Jesus Christ was showing to the leprosy sufferer through us that there was faith for them , there was hope for the future, and that there was a place of love and peace. The patients would say to us, ‘When we come here we find that there is a peaceful atmosphere here and we are very happy to be here’. They would want to know why there was the peaceful atmosphere.
And so have you got any special memories when you first went there the kind of thing that sticks in the mind - what you saw of heard when you first got there?
Jean I can tell you a lot of stories – well there were two little boys who had come a long way for their treatment. They had actually been put out of their home, what had happened with them was, we heard later, these little boys were the sons of a washerman. The washerman died. Why he died we don’t know, whether or not he had leprosy we don’t know, but they were living with their mother and the people in the village noticed that these little boys had lepromatous leprosy and they said to the mother that you will need to take your little boys away. She apparently said to them that they would have to go and find someone to look after them. They travelled a long way on the train. Somebody saw them in the town and said to them ‘You had better go to the leprosy hospital. It was a very cold winter’s day when they arrived and they had advanced lepromatous leprosy. We took them in – first of all we got somebody to give them a good bath.
How big were the little boys?
Jean One I suppose was about six and the other about nine. They had a good bath, were given warm clothes, and started on their treatment. Both those little boys needed to be in hospital for some time to make sure they got their medicine – then they were able to go to the Faizabad Hospital where there was a school for children and they went to school. When they returned from that school, we asked one of the paramedical workers if he could go and find their home, which he did, and they were able to return home. So that was a very good outcome and a nice ending and for the mother.
Oh, Wow, wonderful! It shows the breadth of the kind of interventions that you were able to do. You didn’t just dish out the tablets.
Jean No, mmm.
You cared for the people; you cared for their future and for the whole being.
Jean Yes, that’s right. The interesting thing is and I think the important thing is that back in the 60s and 70s we had Dapsone, we were able to assist the patients with their physiotherapy and show them what to do, we were able to tell them how to care for their hands and feet, we were able to ensure they got the right shoes to wear, to do all those things to enable them to live as normal a life as possible. But we were never, as far as I remember, we were never able to say that the patient was completely cured. They were called ‘Disease Arrested’. The person who had Lepromatous leprosy often took about 10 years before he was ‘Disease Arrested’. The person who had the negative type of leprosy perhaps took 4 or 5 years before he was classed as ‘Disease Arrested’. But now days, because we have multi-drug therapy, anyone who works in leprosy knows that within three years we can call the patient with lepromatous leprosy cured. But it is still as important for the person to have the good care and attention, be told how to manage their disease, look after their hands and feet and all those things so that they won’t get deformity.
In 1968 the Muzaffarpur Hospital had 82 beds. My husband and I visited Muzaffarpur in 1996 and if I remember rightly there were 44 beds. That shows the advance over those years of the treatment of leprosy. The other interesting thing to me was that when I visited in 1996 there was one patient in the hospital with leprosy reaction. When I was there in the 60s and early 70s we would often have 6, 7, 8 or even more patients in at any time with leprosy reaction. That is good proof of how the advances in treatment have helped the leprosy sufferer not to have so much suffering.
So that is a good outcome for leprosy patients.
Jean Yes, it’s a wonderful outcome, and it is also wonderful to know that patients can live at home, they don’t have to go into a treatment centre and also that people are not isolated from their communities like they were. They don’t have to feel that they need to stay away from their community because within a very short time they are no longer infectious. Others may know but if I remember rightly it is now 48 hours they are now no longer infectious.
And when you left Muzaffarpur, was that your decision or did you come home …?
Jean Yes, well unfortunately, my father died and my mother wasn’t well and so I needed to come back to be with her to care for her here. Otherwise I’d probably still be there!
Do you still have contact with the people you were with there?
Jean From time to time I’m in touch with the staff there and also I write to Jill Tipping, who has now retired. I write to her at Christmas. She lives in England. Margaret died a few years ago.
And do you communicate with the people in Muzaffarpur in Hindi or in English?
Jean In English, yes, I used to communicate in Hindi but time has gone by and …
Faded a little !?
How did you get on when you went back?
Jean Well it was really amazing, I was a bit worried because I was asked by the superintendent if I would take the morning devotions and I though ‘Oh Dear.’ And he said, you know - in Hindi. It was really wonderful, as soon as I got back into the atmosphere, the Hindi came back and I was able to take the devotions in Hindi.
End of interview
Interviewed 26 August 2004 by Jeanette Hyland.