Dear Church family,

Warmest greetings from us (Meena and Graeme), in Lalgadh Leprosy Hospital!

We miss you all very much..it's now over a year since we left Geneva, and we miss you, and church worship and church life. Hope to be back for a break soon, but haven't booked anything yet. Maybe September?

We have not been able to write to you for quite some time due to a combination of difficulties. it's very hot and sticky, the monsoon is here which means a combination of hot weather and rain coming down in buckets most days along with dramatic thunderstorms and lightning, floods and mud (but great for rice planting, of course, if that's what life requires of you) .and we are very often without electricity for long spells .. and that means without the internet too. This is all quite challenging - and we like to take on a good challenge or two - but the oppressive continuous sticky heat and the heavy patient load all seem to make everything quite an effort (or perhaps this is really me old age creeping in?).

It's what is sometimes called "the Silly Season" because as the weather hots and humids up, people's behaviour seems to become more erratic, more easily explosive, and often unpredictable. Sensibleness - along with everything else - seems to take so much more effort.....all in a way that doesn't seem to happen when it's cooler and behaviour is more rational. Silly stuff happens - hospital staff misbehave, strikes and demos and burning tyres and stopping traffic and flare-ups of violence all seem to happen more readily. Meantime for us, getting e-mails done to anyone, including our boys and family is difficult. However, amazingly (and surely all thanks to the Good Lord) we seem to be surviving and getting through the hot season without shrivelling up too much.....(well, I'm sure I've shrivelled a bit, though Meena certainly never ever shrivels.)

Haven't really been able to keep up with the Church of Scotland's news and Ian's sermons because of the intermittent internet connections but when we last did, it all looked so wonderfully busy and active and "homelike". Good to see some of the young folks - now growing up so fast - making their Christian commitments some months ago.

All around Nepal, and especially in our flat flooded area, it's rice planting time..so everyone is out in the fields planting, or transplanting rice, the way it is done here. Lots of mud, and buffalos pulling wooden ploughs, and rows of women in red saris bending over all day as they transplant rice. I'll attach a few pictures of ploughing and rice planting and growing, in the paddy fields right next to our local church, about 1 Km walk from the hospital. Yep..that's our church building with rice paddy fields all round, just over the wall from where that chap is ploughing with his buffalos. Our walk to church is along that irrigation channel in which a buffalo is cooling off.

You may have seen some news of Nepal from time to time, the political situation in Nepal is still awfully confused and uncertain.although with the king having gone and the first ever President and Vice-President elected just two weeks ago, history is being made here. However, there is still no certainty about who is running the government, and still no decision about who will be the prime minister, though it will probably be the leader of the Maoist party as they hold most seats.. and still lots of social unrest and strikes and awful fuel shortages especially down in our region. And there is still a constant flow of leprosy patients. The disease is supposed to be declining worldwide... but it isn't in our Districts. And with this wet monsoonal season comes the typhoid, diarrhoea and cholera season as these things come with contaminated water. So do the snakes. It keeps life..interesting, exciting, busy.and very very different.

One of our doctors is off in Kathmandu at the moment having badly broken his forearm when climbing on a chair trying to reach mangoes in his back garden. (That's the Silly Season for you). So I'm doing some Emergency On-call duty at the moment and this evening had to manage a teenager with a snake-bite (a krait), and old grandpa with pneumonia and probably TB, a small child with fever and pneumonia, an unconscious diabetic lady with low blood sugar, a vomiting & diarrhoea, an unconscious.....well, the list goes on like this, so that you wouldn't think this is a leprosy hospital. But it's leprosy that takes most of our times and our 57 beds are always 100% full with others waiting down in the local village for admission.

Sadly we are still getting many children with leprosy.it's not a good sign as kids catching leprosy means there is still a lot of leprosy out there in the villages and community, and being spread round. I'll attach a few piccies to show what I mean.

There is Gopal - he's 14 years with a big happy face. You can see the pale leprosy patch on his left cheek, and he has another on the right side of his face too. Leprosy is particularly dangerous if the infected patches are on the face, because the facial nerve, and the nerves that supply the eye, and the mouth are there and if they get involved, that's what leads to an inability to close the eyelids.which leads in turn to blindness. Leprosy is a common cause of blindness here.

And sweet little Shova who is just 10 years old - leprosy has affected the nerves on both her legs so that both her feet hang down (i.e. foot-drop) and unless we can get this fixed she'll keep banging her toes on the ground. that will lead to cuts and sores and ulcers on her feet. But another consequence of the leprosy bugs damaging the nerves in her legs, is that she is losing the feeling in her feet..so she can't feel any blisters or scratches or sores or ulcers that develop on her feet.

Well, Shova is now on multidrug leprosy therapy for the next twelve months, and we've put some splints on her legs to hold her feet up. you'll see that there is a strap connecting her leg strapping to her sandal, holding up the front of her foot. This keeps her foot up and prevents her from dragging her toes on the ground. Her left foot is having a rest from its splint today. And she is getting daily physiotherapy to try to keep the leg nerves active. But I do hope we have caught it early enough so that the nerves will get better with treatment. Because if the nerve damage has progressed too far, the damage is then irreversible. This will mean that unless she is extremely careful, Shova will get blisters and ulcers on her feet that will get infected and progressively eat her toes and feet away, in the awful way that this happens in leprosy. That's why so many such patients end up needing amputations. It's hard to imagine what life-long sadness and discrimination that would mean for Shova?

But meantime look at the lunch Shova and other ladies are eating. Huge quantities of rice and dhal (lentils) and cabbage. Gets boring for us (or me, as Meena doesn't seem to get bored with it either) . but the folks here feel they haven't eaten if they don't have mountains of rice, dhal and veges for every meal, every day.

That's about it. for this one. Hope you are all having a fabulous summer in Switzerland or elsewhere. We dream about Geneva often and wonder when we ought to return for a brief holiday and see you all. We also miss the well-organized church services there, and the singing and organ and all that wonderful worship-music there that we used to participate in. Here we have a lot of singing, though it's all Nepali Christian songs and choruses sung in unison as we sit on the floor and clap. And then there is a lot of loud praying where everyone is praying their own prayers out loud, all at the same time (some folks very loud, .and some folks very very very incredibly loud), which is a bit disconcerting for normally silent pray-ers like us, at least until one gets used to it. Still, there is a passion for the Bible here, and we managed to get about 50 Nepali Bibles and hymnbooks for the local church, and that was a real thrill for them (and for us). I'll attach a couple of pics of us handing these over to 2 of the church elders.

Better stop here.

Many many thanks for your continued prayer support for the work here. We are really grateful, and most certainly need it, especially when the going is a bit tough and it is easy to get discouraged. We always like to feel that this is part of the caring Christian outreach of love-in-action and mission from the Church of Scotland family in Geneva.

Warmest wishes, hugs and love from both of us, and God bless.

meena & graeme

PS. Now what about some of you considering coming here for a visit? ...Go on!....do it!. Why not later in the year round November when the weather is nice, this place is beautiful, and the Himalayas are in full view? The accommodation is good here - we always have UK med students or others from Ireland or USA coming and staying here for a few weeks ....some getting experience, some helping out, some just coming for a visit.... even in the Silly Season we've 3 podiatrist English girls here at the moment. They can see foot ulcers here like they'll never see at home. I can promise you a mind-blowing unforgettable experience.

PPS. I'm going to start a list here of our top 20 priority needs of Lalgadh Hospital... things or funds that are urgently needed to keep doing and hopefully even extend and improve all the good leprosy and health care work here. I'll pop it on the end of this e-mail.

Some of you might find this helpful as we are often asked what things are most needed for the hospital and its community programme here.

This is actually great work for our church to support because it is work that few other people or organizations want to even look at. It's heartbreakingly horrible and ugly stuff, and doesn't attract funds from organizations that want quick or dramatic results. And if leprosy-affected people - children and adults - are not found and diagnosed and treated early enough, it renders them progressively disabled, awful and even hideous to look at. They become "untouchable" (even by health staff regrettably) twisted, ulcerated and infected... so that they are outcast, marginalised, ostracised, and banished from their families and communities.

........and Lalgadh hospital is, as far as I can tell from worldwide data, the world's busiest leprosy hospital (not the largest.we only have 57 beds, and there are older, larger, but less busy leprosy hospitals still in India). But there seems to be no other hospital in any country worldwide that sees well over 1000 new leprosy patients each year, like we do.

Well....if you know or hear of or can think of someone who just might be able to help with any of these things....or would like to set up a new ward...or fund an ambulance...or even just provide some syringes and bandages..... or support a leprosy-affected child to go to school.....or if you are scratching your heads about a new church project......well...here's our list.

(God bless again! meena & graeme)