Retooling Green Gardens

Having nearly wiped out leprosy, a hospital now tackles cancer

text by Paul Wachter
photographs by Cody Christopulos

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Pappachan’s scar stretched from ear to ear and he could barely open his mouth, but he managed a smile as Dr. Thomas Cherian, his surgeon, recounted the operation 10 days prior. “I operated on him for 12 hours and removed the cancer from the jaw and cheek,” Dr. Cherian said. “And I reconstructed his face with skin from his leg. We must not only remove the cancer but also restore the patients so they can live their lives as humans.”

Dr. Cherian was making the rounds of the cancer ward at Green Gardens General Hospital, a no-frills three-story concrete structure in Cherthala, about 30 miles from Cochin, the largest city in the southern Indian state of Kerala. The hospital is just one of several buildings – including a school, convent and outpatient clinic – in the 16-acre compound. The compound was founded as a leprosarium in 1942 by Father Joseph W.K. Kavadathil. Father Joseph, who died in 1991, also founded the Assisi Sisters of Mary Immaculate, who staff the compound. Dr. Cherian joined the hospital in 2003.

The facility used to treat as many as 200 leprosy patients at a time, said Sister Michael Francis, who heads Green Gardens. But in recent years, leprosy, also called Hansen’s disease, has waned in India. Though it still accounts for 70 percent of the world’s new cases, the rate of infection in India has plummeted. Currently, the prevalence rate stands at about 2.5 per 10,000 people, with most new cases in northeast India – not in Kerala. In 1981, the prevalence rate was 57.6 per 10,000. The World Health Organization is committed to eliminating the disease – by which it means achieving a prevalence rate of less than 1 per 10,000 – by the end of this year. In Kerala, where the rate stands at 0.06 per 10,000, that goal has already been achieved.

“Now that leprosy is no longer much of a problem, especially here in Kerala, we decided to change our focus,” said Sister Michael Francis. “We decided to focus on cancer, because there’s a need here.”

A unique confluence of history, culture and enlightened government has allowed Kerala to stand apart from the rest of the country when it comes to health and other social indicators. Despite having a per capita income of $473 – only slightly more than India’s national average – life expectancy is 74 years, 10 years higher than the rest of the country and on a par with Western Europe. Infant mortality rates are much lower in Kerala. Literacy is nearly 100 percent. Experts credit a series of Marxist and progressive governments that have ruled the state since 1956 for enacting aggressive social policies – agrarian reform, health outreach, literacy campaigns, women’s education and empowerment – that have allowed Keralites to achieve a quality of life not to be found in any other Indian state. They also point to Kerala’s isolation – the state is bounded on the west by ocean, on the east by mountains – and a history of trade with the West. Another significant factor has been Christian social outreach, which introduced a network of schools and hospitals.

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