Unique partnership provides training for histology lab at Lalgadh Leprosy Hospital in Nepal
“At the intersection where your gifts, talents, and abilities meet a human need; therein you will discover your purpose.” -- Aristotle
For Dr. Krishna Bahadur Tamang and Dr. Simon Warren, their rare meeting first in Nepal, and
Dr. Warren describes his first visit to Lalgadh as “tantalizing.” There were 500-600 patients lined up each day largely with skin disease including leprosy, a range of tropical skin diseases, as well as skin diseases more familiar in the West. Warren estimates that 35% of them needed skin biopsies to confirm their diagnosis, however, the hospital does not have a lab on site to perform biopsies. Instead, samples need to be sent to Kathmandu—a 12-hour drive—for testing, often taking two months for a diagnosis and delaying critical early treatment.
Dr. Warren formed a friendship with Dr. Krishna Bahadur Tamang, Medical Coordinator of clinical practice at Lalgadh, and invited to him apply for the Department of Pathology’s Dermatopathology fellowship program at the IU School of Medicine. Dr. Tamang arrived in July 2017 to complete his one-year fellowship, and his colleague Ravi Nepali, Head of the Laboratory also joined him for short-term training in Indianapolis. With the additional training and some used equipment donations secured by Dr. Warren and his colleague Debra M. Wood, the hope is that Lalgadh Leprosy Hospital will be able to establish its own histology lab to perform biopsies and provide better care upon their return.
Lalgadh Leprosy Hospital was founded in 1996 by British missionary and nurse Eileen Lodge who had been working with leprosy for more than 40 years in Nepal. Today the hospital serves about 100,000 patients each year and sees more new and returning leprosy patients than any other hospital in the world. 70% of the patients are from Nepal with the remaining 30% from neighboring India. Many suffer from poverty and poor nutrition which compromises the immune system and increases susceptibility to leprosy and other skin diseases. Lalgadh sees 1200 new leprosy patients per year.
Early diagnosis and treatment are critical for effectively treating leprosy, a disease which attacks the nervous system with early symptoms including skin lesions and numbness in the extremities. Dr. Tamang, explains that by the time a leprosy patient is showing signs of deformity, it is often too late to reverse some of the nerve damage that has occurred. Because leprosy damages the nerves, patients also lose their tactile sensitivity and develop ulcers from trauma which later become infected. The deformity caused by the disease is stigmatized in Nepali society and people attribute its occurrence to something earlier ancestors did wrong or to a curse from the gods.
Dr. Tamang, like 25% of the hospital staff, comes himself from a leprosy-affected family. His mother had leprosy and he lived for five years in a leper colony and remembers as a 10-year old boy being stigmatized. Those memories now inspire him in his work as he seeks earlier treatment and greater cure rates with a still large patient group.
“Skin biopsy is largely affordable,” says Warren. “It’s incredible to have the opportunity to teach, give back, and have an impact through this partnership.” Expanding Lalgadh Hospital’s capacity for effectively treating a poor and vulnerable population has become a shared and motivating possibility as Warren and Tamang combine their experience and resources.
An IU Foundation account has been set up to help fund the needed equipment and training of the dermatopathology lab at Lalgadh Leprosy Hospital. To contribute, visit https://www.myiu.org/one-time-gift and search all for funds for “Nepal Dermatology Training Fund.”