Written by: Haroon Shuaib
Posted on: April 20, 2023 | 
| 中文
Dr. Chris Schmotzer with a young patient
The unassuming exterior of the Rawalpindi Leprosy Hospital in the densely populated Amar Pura area of the garrison town is pretty deceptive. One is only left humbled after discovering its history and the noble services the hospital has been offering for the patients for well over a century. Today, operating as a referral hospital for leprosy, the hospital also serves as a center for tuberculosis, eye and skin diseases for patients from Punjab, Khyber Pakhtunkhwa, Gilgit-Baltistan, Kashmir and the adjoining areas.
Dr. Chris Schmotzer
The hospital compound is spread over an area of 70 kanals and consists of many old and new blocks, including an out patients’ department, wards, administration offices and residential quarters. The earliest records of Rawalpindi Leprosy Hospital date back to 1867. Some of the older construction with exposed bricks and wooden beams are remnants of the colonial period. A white marble plaque on the periphery wall, tucked behind a thick bush, is dated 1939. The compound’s old name displayed on the plaque is ‘Shanti Niwas’, a Hindi term meaning ‘Harmony Residence’.
The plaque on the boundary wall from 1939 shows that the compound was called Shanti Niwas before Pakistan’s independence
Dr. Chris Schmotzer, the Medical Director of the hospital hails from Germany. She arrived in Pakistan 35 years ago, after spending a couple of months in Ethiopia, training to treat leprosy patients. A team of medical volunteers from Germany were in Pakistan treating leprosy patients, and she wanted to work in a region where people didn’t have the same healthcare facilities that are enjoyed by those in the developed world.
According to Dr. Chris Schmotzer, “We always should see the living conditions of the people when trying to understand the prevalence of a particular infectious disease. There are many people in the world who live in overcrowded ad poor conditions. These conditions are a breeding ground for a lot of diseases. Obviously, many people living in one room will have a higher risk of infection. It is important to plan how living conditions for the people can be improved, if we want to tackle the spread of any infectious disease.”
Dr. Chris inquiring about her health from a patient
Unfortunately, there have been many stigmas and myths attached to leprosy since the olden days. In the more developed societies, these misconceptions have been removed over time through education. In many others, including Pakistan, it took much longer and a lot more effort by dedicated health professionals such as Dr. Chris Schmotzer and Dr. Ruth Pfau, another German–Pakistani physician who immigrated from Germany in 1961 and devoted more than 55 years of her life to fighting leprosy in Pakistan. Dr. Pfau passed away in 2017 in Karachi, and was given state honours at her funeral. “I always tell people to use the more accurate medical Urdu term ‘Jizam’ for leprosy, instead of the pejorative term ‘Kohr’, which was used previously. In fact, the term Kohr is a reminiscent of the time when leprosy didn’t have a known cure and people with leprosy were shunned by society,” said Dr. Schmotzer.
The hospital in Rawalpindi receives a small funding from the Government of Pakistan, but the bulk of funding comes from The German Leprosy and Tuberculosis Relief Association. This organization has been supporting the leprosy control work in Pakistan for over 60 years.
Dr. Chris has been recently awarded 'Order of the Merit', Germany’s highest civil award
Leprosy, also known as Hansen's disease, is a long-term infection by the bacteria Mycobacterium leprae. Infection can lead to damage of the nerves, respiratory tract, skin and eyes. This nerve damage may result in a lack of ability to feel pain, which can lead to the loss of parts of a person's extremities from repeated injuries or infection through wounds that the patient cannot feel. ‘The good news is that with the discovery of antibiotics around 1950, leprosy has become completely curable. Its timely and accurate diagnosis is important, but once it has been detected in a patient, it can be cured through a very simple treatment since it is just a skin disease. Of course, if the treatment is delayed, it can lead to complications and sometimes a loss of limbs. Its bacteria is very similar to that of tuberculosis. While tuberculosis mainly effects the lungs, leprosy is diseases of the skin and nerves. Medical research has shown that tuberculosis is much more infectious and dangerous than leprosy. Tuberculosis is much more widespread in Pakistan than leprosy,” said Dr. Schmotzer. “Leprosy is not as contagious as is widely believed. Ninety percent of the people who may be exposed to leprosy, never actually develop the disease. I will take my own example. I have been working in this hospital for 35 years, and although there is no vaccination for leprosy and no significant precautionary measures, but I have continued to be healthy. This is the good news about leprosy that it is a simple skin disease. This is the reason why we are now stressing that medical professionals be made aware about the symptoms of leprosy for early detection. World Health Organization (WHO) describes it as a neglected tropical skin disease. It is important to raise the awareness of people for its early detection and diagnosis, for in that case it is fully curable,’ Dr. Schmotzer said.
‘Historically, people’s fear of leprosy stemmed from the fact that it did not kill people but led to their disability. We are now teaching doctors, nurses, and other healthcare providers that leprosy never starts with the disability. It always starts as a simple skin disease. Right now, we have a little boy admitted at the hospital. He was just detected last week by a skin specialist. He referred him to us. We did all the tests and started his treatment. If you see the boy, you will ask as to why he is here, because he is fine, except for a little skin spot and that too will disappear after the treatment is complete. For the rest of his life, he will remain healthy’ she adds.
Patients of leprosy in one of the wards
‘This hospital was on the outskirts of Rawalpindi and in the middle of fields when it was established, and made an asylum for leprosy patients. The colonial government’s law was that any person diagnosed with leprosy had to leave home and go to live in an asylum, because there was no known cure for this infectious disease at the time. There was also a law that the children born to the patients with leprosy had to be separated from their parents, and had to live in a children’s home. We still have those buildings, but they are now used for a totally different purpose. Fortunately, things changed when treatment became available,” Dr. Chris Schmotzer narrates.
In recent years, the figures of leprosy patients have come down significantly in Pakistan, thanks to the efforts of Dr. Schmotzer and many other dedicated health practitioners like her. ‘This is a real success story in Pakistan. When I came to Pakistan 35 years ago, there were always 1500 to 2000 new leprosy patients annually. Now we have around 300 cases per year, and even less patients with disabilities,” Dr. Schmotzer ends on a positive note.
Exterior view of the hospital
While the spread of leprosy may have come down, it is important to continue raising awareness about early diagnosis, correct treatment and removing stigmas.
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