KARACHI: At 19, Noor Islam left his family in Bangladesh after leprosy made him feel like an outcast, traveling to Karachi for treatment and beginning a new life at a hospital where, more than four decades later, he still lives and cares for others once afflicted by the disease.

Leprosy, also known as Hansen disease, is a curable disease that mainly affects the skin and peripheral nerves. It does not spread through casual contact and patients stop transmitting it once treatment begins, according to the World Health Organization.

But stigma, disability and difficulties reintegrating into society mean some former patients continue to spend their lives at Karachi’s century-old leprosy hospital long after recovering from the infection.

“Sometimes I used to see my mother crying,” Islam told Arab News, recounting the circumstances that led him to leave his family. “She would go to weddings but she would not take me along and tears would come to her eyes.”

“Seeing this, I left them,” he said. “They did not leave me. I left them.”

Islam arrived from Bangladesh in 1984 and came to the Karachi Metropolitan Corporation’s (KMC) Leprosy Hospital in Manghopir for treatment. He recovered after around two years but remained at the facility, becoming a KMC gardener, marrying and raising seven children in Pakistan.

Now 61, Islam retired from KMC six months ago but continues tending plants, checking on residents and helping arrange food and medicines for those who depend on the facility.

“Today, thank God, I have become capable enough to be a pillar of support for others,” he said.

Established in 1896 as the Hiranand Leper Hospital, the facility was initially run through philanthropic efforts before its management was transferred to Karachi’s municipal authorities in 1960.

Dr. Babar Khan, KMC’s senior director of medical and health services, did not respond to questions about current patient numbers, staffing, services, repairs or the hospital’s budget by the time of publication.

LIVES LEFT BEHIND

Islam also became involved in residents’ welfare, helping run the Leprosy Patients Welfare Committee, which seeks donations for food, medicines and other necessities.

But he is far from the only resident for whom successful treatment did not mean returning to the life he had known. Many had been treated for leprosy years ago but we’re unable to leave because of disabilities, other illnesses or difficulties reintegrating into society.

Ahwaz Ali, a 59-year-old from Quetta who arrived at the hospital in the mid-1980s, said relatives gradually distanced themselves from him at a time when public understanding of the disease was limited.

“Because of the disease, everyone went away,” he said. “People believed it was a contagious disease.”

Ali later worked at a poultry farm but said weakness in his hands prevented him from continuing physically demanding work. He now performs night guard duty at the hospital and receives a stipend from KMC.

Another resident, 65-year-old Kaleem Sheikh, also came from Bangladesh and has lived at the facility for more than four decades. He married a woman he met at the hospital who had also been treated for leprosy.

“My wife was a very noble woman,” Sheikh said. “It has been around five months since she passed away.”

Dr. Muhammad Ali Abbasi, a former medical superintendent who served at the hospital for decades before retiring from KMC in 2017, said difficulties reintegrating treated patients into society had persisted despite advances in treatment.

During his tenure, Abbasi said, children with leprosy arrived from different parts of Pakistan, some of whom were left behind at the hospital. He established a school ward and arranged education for them up to matriculation level, along with vocational training for former patients.

“But even after educating them up to matric, sending them back into society was not an easy task,” he told Arab News. “Even now, if people see such symptoms, their attitude toward them is not appropriate.”

Abbasi said the 200-bed facility had around 190 patients when he began working there. He attributed the subsequent decline in long-term admissions partly to fewer new cases and the advent of multidrug therapy, which allowed many patients to be treated while living at home.

“For those who are deformed and cannot adjust to society, this hospital will still continue to serve as a shelter,” he said. “We have to control the disease and also facilitate these patients so that their lives can become easier.”

A SHELTER IN DECLINE

But the institution that became a refuge for people unable to return to their communities is itself showing its age.

Islam said the hospital’s physical condition had deteriorated significantly since he arrived more than four decades ago:

“If you look at the wards or the hospital now, it is dilapidated and falling apart. Several of our staff members have been injured, and many patients have been injured too. Still, we are not losing courage.”

Arab News observed damaged ceilings and roofs, with plaster broken away in several parts of the facility, including areas occupied by residents and KMC staff.

The hospital was also without electricity for around four to five hours during Arab News’ visit, while residents said outages regularly lasted several hours.

Islam said community surveys that previously helped identify possible leprosy cases had stopped. He said he had recently located two people himself in Hub Chowki and Ghazi Goth and brought them to the hospital for treatment. KMC did not confirm whether its active case-finding program had ended.

Abbasi said screening patients’ families and communities was important for early detection and required personnel specifically trained in leprosy care.

Karachi Mayor Murtaza Wahab told Arab News he would look into the residents’ concerns and try to resolve the problems but did not provide details of proposed measures, funding or a timeline.

Meanwhile, more than four decades after Islam arrived from Bangladesh as a teenage patient, the hospital remains his home and he continues to care for residents whose leprosy has long been treated but whose age, disabilities or circumstances have left them dependent on the community built within its aging walls.

“Whatever happens to the patients, including death, shrouding and burial, we handle it all among ourselves,” he said.