I arrived in Dhaka on Monday morning. I was collected and brought to The Leprosy Mission (TLM) guesthouse where I was made to feel very welcome. After a long flight I took the first day to catch up on some much needed sleep and to take the opportunity to settle in to my new surroundings.

Tuesday morning began by visiting a leprosy hospital in Dhaka. This hospital was roughly 1km away, and took 20 minutes to travel due to severe traffic. During the journey, the driver was telling me that Dhaka has a population of approximately 15 million people in a city 15km wide, and the traffic certainly is an indicator of this. I was shown around the hospital starting where the patients are initially assessed and ending at the inpatient ward. Within the ward I saw various clinical features of leprosy; skin lesions, clawing of the hands and plantar ulcers (picture 1,2,3). Many patients are kept in the hospital for ulcer treatment rather than being discharged with advice on self care as if the patients return home they continue work rather than resting and off-loading their feet. This is especially common in men as they are traditionally the main providers in a household, many families are struck with severe poverty therefore asking a man to rest instead of work creates a huge burden for the family.

In the afternoon I visited the slums with a TLM member. She explained that one of their developmental projects involved helping patients and their families deal with the stigma of being diagnosed with Leprosy. Leprosy still has serious social implications in Bangladesh. Many families disown family members if diagnosed. If a child has a parent with leprosy, they are frequently refused education. As clinical features are very noticeable, especially clawing of the fingers and the patches on the skin therefore suffers are easily identified. Due to this, TLM provides education to families to help them accept their family member; they also help to create leprosy support groups in areas of Dhaka. Leprosy patients then have the opportunity to come together to support one another and discuss their feelings among people who understand. Family members are also welcome to join and speak to other families to share their feelings. I attended one of these meetings with a TLM staff member; it was located in one of the poorest slums in Dhaka in a member’s home (picture 4). After the meeting, we walked around the slum visiting different member’s homes. The picture below is a leprosy patient who lives with her 7 children and husband. Due to her disabilities she receives 120 taka a day from the development project. Keeping in mind that 1kg of rice cost approximately 50 taka, this is not a lot of money (picture 5).

On Wednesday I travelled for 8 hours to the Danish Bangladesh Leprosy Mission (DBLM). The following morning I was shown around the hospital, this hospital is the largest of TLM’s leprosy missions with approximately 130 beds. I spent the day between the physiotherapy and orthotist/prosthetic department. I helped evaluate patients and manufacturing prosthesis (6).

I have been in Bangladesh a week and have already had many wonderful, sad and without a doubt life changing experiences. I am learning the culture and adjusting to the life here with the help of many caring TLM members.