Apologies: To all the pundits on ethics of confidentiality. This post might not be acceptable to the people that I have written about. Insistently, I write this. Consider the fact that no bad news is acceptable to the ones who make that news, be it rapists or racists. This story is real. Read it if you want to or chuck it if you don’t care. Stories that must to be told should be told.
Note: I respect confidentiality. I am a doctor, not a journalist or policeman. Therefore there is no need for me to tell the real names. The name I have used is fictitious. Also, the persons in the story are aware of my feelings towards their attitude. I hope to understand them and change their attitude for the better in my future interactions. I continue to treat this family.
Post: Being a Woman, Leper and a Brahmin
Her name is Madhusmitha Panda. She is about 50 years old. She is unmarried. Of course, who would marry her, for she had Leprosy. She had the stigmata of having had leprosy. She walked with a limp. Her toes were shrunk and her foot was deformed.
Her father retired from Government Service and receives a pension. He is about 80 years now. He is hard of hearing, but quite independent. Her mother was in her 70s and she had uncontrolled diabetes. She had no other siblings. She had few cousins, who were all married and well settled economically. The women who were married to her cousins do not take good care of them. So the three live independently in a small house. They have no other social supports.
She was an old patient of our institution. She had received MDT (multidrug therapy) and was cured of Leprosy few years ago. Our nurses have treated her of a foot ulcer a couple of months ago. She used to come on an out patient basis for dressing of the ulcer in her foot.It had healed well.
I saw her few weeks ago with a bad ulcer in her foot. Considering her situations, I felt that it would be difficult for her to come all the way from her home on a regular basis. Remember that travel costs money. I advised her to stay in Leprosy Home, a place where she could get free accommodation, food and ulcer care.Her father was not interested .He said that he would bring her regularly for dressings.
Madhusmitha came daily for dressings. Her father brought her everyday in an auto rickshaw. Over few days we realized that the ulcer is not getting better. At the same time she is developing changes in her sole indicating that there is possibility of new ulcer developing. This was because she was not giving adequate rest to her foot. Being the more able of the three, she had to do all the house hold work. Her dressings were not maintained as they had to be. We pressed them for an admission. It can be assumed that once a patient gets admitted, he/she could get some rest.
We also had asked her father to buy her MCR (Micro Cellular Rubber) footwear from the shoe maker in Leprosy Home. We told him of the costs etc.He wanted to find out, if it was available elsewhere. Even after a while, her foot did not improve. We realized he has not purchased the footwear for her. We felt irritated. He was not even willing to go to the Leprosy Home! We knew we could help her if she were admitted. When we insisted on admission, he blurted out, “How can I leave my daughter? What if someone does something?” . The nurses told me that he did not trust his own daughter. That is why he accompanied her everyday, even into the dressing room.
We had a word with her mother. We thought she could think more rationally. It made sense to admit her daughter to get treatment for free! She asked, “Do good people stay there?” I began to reason with her that most people living there are nice people. They too were suffering like her daughter. I also told her that there will be people to take care of her daughter. As I was explaining this, our nurse told me, “Sir, the meaning of her ‘good people’ is not nice people as you imagine. She refers to people of higher caste. She is a Brahmin. So, she does not want her daughter to live in a Home with lower caste people.”
I was shocked. I thought “What? Mother of a Leprosy patient was discriminating other oppressed people!!!”.Madhusmitha is not suffering with Leprosy problems alone. She was suffering for being a woman. She was suffering for being a Brahmin. Her parents think that they are being helpful and protective but they are the biggest stumbling blocks to her care. They being old cannot care for themselves. They want Madhusmitha to do all the household work. After all, she was born a woman. It is her responsibility to do the household chores. Adequate rest is therefore not possible. On the top of it, they deny her benefits of admission into a Home because of being Brahmins. Sadly again, because of associated stigma they do not want to go to the Home to buy MCR footwear.
I asked her mother, “Mousi, you said you have problems with wives of your nephews. Isn’t it?” She nodded with an expression anticipating sympathy. “Are they not Brahmins like you?” I asked. She agreed though her expression changed. I asked her, “Tell me who is better? The wives of your nephews, who being high caste Brahmins do not care for you or the tribal people and health workers in the Home, who would dress your daughter’s ulcers and take care of her, even in your absence?” There was a pause. She answered in a low tone, “Tribals”.I am glad that she could see the obvious truth.
Frankly, I felt that if that old couple die then Madhusmitha might get a better deal. Till then she would remain a Brahmin woman, who would do all the household chores, limping with ulcerated feet. She should have been born into a Tribe. She would have had a better deal.
I still cannot understand how they could discriminate against persons from tribal background when they themselves get discriminated for having leprosy. I wonder how they try to hide the identity of having had leprosy, but flaunt the identity of high caste origin.
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