Interview with Dr Debbie Langford, by Dr Jeanette Hyland at Sale, Gippsland Victoria August 2005

Brief Biography.

Dr Debbie Langford is a specialist General Practitioner who with her husband, also a Doctor, worked in Nepal with the United Mission to Nepal from 1985 to 1996.

Her recollections about a few people affected by leprosy in eastern Nepal during those years is from the perspective of a generalist working in a small (22 bed) and isolated rural hospital at Okhandhunga. In this hospital, people with leprosy were cared for in the context of the general hospital. Her stories illustrate the plight of those people and the realities they had to face because of stigma.

Dr Debbie Langford is now working at the Sale Hospital in Victoria, Australia.

In Sale, Victoria, 25 th August 2005, I am talking to Dr Deborah Langford who with her husband Dr Michael Langford worked together in Nepal from 1984 to 1995. Debbie has kindly agreed to talk to me about a couple of things, one of which is the arrangement, she and her husband had when they first went to Nepal and worked together in a Mission hospital and job shared. Debbie, could you tell me a bit about that?

Debbie We decided to job share because we had a young child, a daughter, who, when we went to Nepal, was nine months old. In terms of our skills and experience, we were both fairly similar and we both wanted to maintain our skills in medicine. We decided probably the best way to do it was to take it in turns to work. Given that we recognised that often if you try to work part-time in medicine, particularly in a missionary or a third-world situation, part-time very easily becomes three-quarter time or full-time, so we felt that the best way to do it was to have one person full-time at home and one person working full-time in the hospital. That worked well. For the first year – for the first eight months we were doing language study, and I was still breast-feeding our daughter so at that stage, it was easy to fit our language lessons in with feeding. Then I weaned Simone and when we went out to Okhaldhunga to work, we set up a system between ourselves, where we would work three months in the hospital and three months at home. That is not dissimilar to the way that hospital residents, doctors, work in Australia. You work three months in a unit and then you go and do something else. That system seemed to work well for us. It was interesting ‘cause as Simone grew up and started to talk she called whoever was at home ‘Mummy’ and whoever was at work ‘Daddy’. Laughter She got her gender issues caught up in all of that…

We found that both medically it was good – because we both learned how to be doctors in Nepal at a similar sort of rate and the other thing, it was good for was language ‘cause it was our experience that whoever was at home looking after the children tended to find it difficult to improve their language skills; whereas, we were both working in the hospital and working in an environment where we had to speak Nepali both with other staff and with patients, our language skills developed at a fairly even rate. Later on we had another child, Tim, and we worked a similar system with Tim when he was young.

As the children got older and started doing schooling where we were, we tended to work a bit more - like whoever was at home would have some things they would do in the hospital. Also as time went by, we started to develop skills in different areas, though by and large, we still maintained the system with one of us full-time and one of us responsible for home, but the person who was responsible for the home situation would do whatever their special interest was. So Michael was doing administration so when I was working in the hospital he would do his administrative work while the kids were at school and when I was at home, I did some extra work in ultra sound so when I was at home I was still responsible for doing the ultra sound in the hospital. Sometimes it meant that we were both at work if one had to give an anaesthetic and someone had to do some surgery and vice versa but by and large, for the time we were there, it worked out well and it worked out well as far as our family was concerned.

I think you were fairly unique. I don’t remember anyone else in UMN doing that. It was certainly very admirable and something that I remembered from that time.

Debbie I think the other thing that came into it was that a few women – it’s interesting, I’m sure there were a lot of men who didn’t think they would want to do what Mic was doing - a few women said to me that they actually didn’t think they could cope with their husband doing the home thing. For me it was a question that there were things that had to be done and he was doing them and he was doing them his way then – Yes – you just have to accept that. That was the price you paid! That was an interesting comment that did not occur to me at the time.

It didn’t worry you?

Debbie No, though I might have been a bit picky about things … Laughter.

Tell me about your recollections about one or two leprosy patients who you saw when you were at Okhaldhunga .

Debbie We didn’t see a lot of leprosy in Okhaldhunga – generally speaking the incidence of leprosy in the eastern part of Nepal is much lower that in the western part of Nepal. There was one guy that came in who had been commenced on treatment for leprosy and developed Iritis. I had quite a long conversation with him about the fact that his Iritis needed to be treated and we needed to give him medicine for it and he needed to stay for a couple of days in the hospital in order that we could be sure that the treatment was working because there was a risk that his eyesight could be damaged if it was not treated properly. He came from a village about six hours walk away from the hospital - quite a prosperous high caste village. He said to me ‘I can’t stay in the hospital because it is the time that we need to plant our corn and if I don’t go home and plant the corn then our family won’t have food to eat.’ And I said, ‘Well if your treatment is not done properly and is not satisfactory then you might loose the sight in your eye.’ And he said, ‘Better that I loose the sight in my eye than my family starve.’ So that was the choice that he had to make. So he went home, and when I saw him some time down the track – maybe months, maybe even a year down the track – and asked him how did things go, he said that in the end other people in his village had taken his land away from him because he had leprosy, and he was kicked out of the village anyway. It was a very sad ending to the story.

Very poignant…

Mic told me about the ‘apple lady’ and her fighting life, the way she tried to at least keep her son alive and fight to get his right to an inheritance – you remember her too?

Debbie Yes... she was quite a survivor. She was someone that, while she had been rejected by her husband and kicked out of her village, she was fortunate that she was – I don’t know that she was actually accepted, but she was tolerated - in a Sherpa village but she hadn’t lost her self esteem, she hadn’t lost her sense of her value as a person in the midst of all that. She could easily have done that. She was quite a character. She was the only person who could sell you rotten apples Laughter and make you feel good …

Mic said she was actually successful in getting her son accepted again in the family so that he got his inheritance?

Debbie Yes …

Any others …?

Debbie There was just a guy and he came into the hospital and he was complaining of numbness in his hands and it was interesting that you could actually see the swelling on his radial nerve. It was the only nerve that was actually affected – you could pick it from the other side of the room, it was so obvious. I actually don’t remember too many other leprosy patients.

Where did you learn about leprosy?

Debbie In Pokhra at the leprosy centre there, in a weeklong course they used to run there.

Do you remember the teachers?

Debbie One of them was Chandler, she was French – she is the only one I remember.

Were people there from other parts of Nepal?

Debbie Yes, there was a bit of a mixture – both Nepali and expatriate but I don’t – and Tim Linton (Australian Doctor) from Am Pipal (UMN Hospital in West Nepal) he was there at the same time, but I don’t remember any of the others.

Thanks Debbie. That is very good. Interview ends.