The letter of Dr. Pannikar

Leprosy Mailing List – December 9^th, 2010

Ref.:   The letter of Dr. Pannikar

From: Salafia A., Mumbai, India

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Dear Salvatore,

I may be the only one ‘singing extra corum’ but let me tell you the letter of Dr. Pannikar does not come as a surprise to me.

1.

For years WHO has been telling the world that leprosy will be eliminated soon, and many doctors have being singing the same tune.  The people at large have got the message and when I go to Italy and I ask friends and benefactors for financial help, people ask me why do we need money when leprosy has been eliminated?

2.

Various Governments have been advertising that leprosy has disappeared from their country.  I understand the position of the politicians: they like the world to believe that their country is free of dreaded diseases.

3.

After all this, is it surprising that funds are dying up?  Further, there is a world economical recession, I have been told….

4.

As for shortage of specialists…. There will be more shortage in future considering what is happening now.  My experience: we run one of the few centers where all aspects of reconstructive surgery is dealt with: starting with nerve exploration and decompression (more that 2800 done so far), lagophthalmos, nose deformity, hand deformities (including mitten hands), foot etc….  In the past GLRA used to support our work, now the new management believes that our work is not important (so much so that they have sanctioned $ 25 for a major case of hand repair, when the same surgery, in private here in India, would cost about $ 600 and I am referring to the surgeon fees only).  A Spanish association, Anesvad – that supported us in the past - has been cornered by a NGO based in Mumbai (whom I introduced to Anesvad) and only if you work ‘under this NGO’ you get funds; but then the same NGO sends patients to me for surgery, yet they have never asked me whether I would like to work ‘under their umbrella’.  What do you suggest?  Shall I charge the said NGO for every surgery I do on their patients, after all they are getting the money while we have to beg around…

5.

About expertise; Anesvad had asked us to start a training programme for young surgeons: we did, we offered free training to young surgeons and Anesvad was willing to foot the bill; but then there was a change in the management, and this project was abandoned.  Still, every year (for the last 20 years) we give practical demonstrations to young orthopedic surgeons; this is done under the auspices of Bombay Orthopedic society.

6.

My younger son is studying medicine –at my costs.  He has been coming to the operation theatre for years as he is very keen in taking up my job; he has to finish his MBBS and then go for PG.  When he finishes his PG (Plastic Surgery) what shall I advice him to do? (of course by that time he will make his choices).  But, if he asks me, what shall I tell him?  Seen that GLRA values a major hand surgery only $ 25, and that some NGO have cornered all the funds that come from Spain, can I, in conscience, encourage my son to take up my job and, after years of training and great expenses, make him work for peanuts?

I have been telling for years now, that leprosy is going to increase in the next few years, and there will be greater shortage of experts.  If you really want specialists in the field of leprosy, you should start now to:

1.

Encourage younger doctors to take up this work.

2.

Pay for their studies, if they have economical difficulties.

3.

Man does not leave on bread alone”… but bread is necessary to live; so pay them a decent honorarium.  I know that ‘leprosy-work’ is a mission (that is true for me, but not necessary for anybody else) yet you cannot under-value the work, knowledge and experience of a specialist, and then complain that nobody is interested in this work.  Mind you, the people working in this field are aware of the fact that leprosy is a ‘mission’ and they do not expect a huge salary, but they too have to live and look after their families.

At the end, I am still willing to offer free in-training to young doctors, both medical and surgical, but do not ask me to bear the expenses.

Dr. Antonio Salafia

Head of Dept. Of Reconstructive Surgery

Vimala Dermatological Centre

Mumbai