that Health For Life organized.’
As gentle waves washed the boat up onto the sand, children appeared from behind the trees, waving and running up and down the beach. Tom clambered out of the boat and started unloading the packs.
‘We always get a big welcome when we visit. The kids really suffer from the isolation of the island. If one member of their family has leprosy then the whole family has to move to the village. As their parents are not welcomed in the towns they are stuck here until they’re older. Even then they can experience prejudice when looking for work or trying to attend high school on the mainland.’
The fisherman handed Bec out of the boat and she and Tom walked up the beach, toward some low-roofed buildings.
Bec mulled over how such a beautiful natural setting had become a prison. ‘So this false paradise is both a home and a hospital?’
‘It’s like any other village, except the two hundred people here can’t leave to work. Those that can grow rice and fish but the poverty here is dire. When you’re missing an arm or a leg, the physical work of farming is pretty much impossible.’
Tom grimaced. ‘There isn’t a hospital here. They have a medical clinic with health aides. If they need surgery they have to go to a provincial hospital. That creates its own set of problems. We don’t run a clinic here but we provide bandages, gauze and dressing supplies, which are always needed.’
‘What about crutches and artificial limbs?’
‘We work with some charities to source those when we have patients who need them. Today we’re going to do some skin checks and help the health workers.’ He slowed his pace. ‘Bec.’
The tone of his voice made her pause. ‘Yes?’
‘It can be pretty confronting if you’ve never seen the ravages of leprosy before.’ Again his eyes shone with concern.
The feeling of being cared for welled inside her, warming her.
Scaring her.
‘Thanks for the heads up.’ With a monumental effort she dragged her eyes away from his, away from the feeling of wanting to fall into their softness and be cared for. But she cared for herself, that was how it had to be. You’re here to work.
The clinic was L-shaped. Concrete walls were painted a bright cheery yellow and blue shutters lined the windows. The low thatched roof sloped downward and was rimmed by wide gutters to cope with the monsoon rains. Bec gave a wave to Hin, their interpreter. He stood chatting to people in an attractive courtyard dotted with flowering plants, and swept to within an inch of its life. Patients waited for their turn to see the health worker.
The peace and tranquillity of the tropical paradise setting clashed dramatically with the physical disfigurement of leprosy. Some people sat in wheelchairs—empty spaces below them where their legs should have been. Others had both legs but muscle contractures had left them bent and disfigured. One man was missing a hand, another an earlobe. Scarred eyes peered out of ulcerated faces, the cloudy whiteness of the pupils obscuring all vision.
Yet their calm smiles radiated a spirit of survival.
An elderly woman greeted her warmly, her gnarled, two-fingered hand gripping Bec’s five-fingered one. ‘Xin chào.’
Bec repeated the oft-said greeting, which came out sounding like Sin jòw. She knew immediately the task she would be working on for the day, and why a pallet of bandages had been delivered to the island.
She quickly got to work, setting up dressing packs.
‘Even with the Multi-Drug Therapy, leprosy can never be totally removed from the body. But the damage can be limited to pale-coloured skin patches.’ Tom spoke quietly while they worked together, debriding wounds. ‘Many of the villages didn’t have access to the antibiotic therapy that is offered today so by the time they got help, the bacterium that causes the lesions had led to a lot of skin thickening and nerve damage.’
‘So they get peripheral neuropathy, which adds to the problems, right?’ Bec’s mind clawed back to find any memories of leprosy from nursing lectures. ‘When part of the body is numb, the patient can’t feel properly, which puts them at risk of injury and ulceration.’
She carefully snipped away the blackened skin around the edges of the wound on the old woman’s leg, biting her lip in concentration.
Her patient gave her a toothy smile and patted her hand as if to say Don’t worry, it doesn’t hurt, keep going.
Tom’s large hands belied the way his fingers could delicately debride a wound and carefully bind it with bandages. ‘The extremities of the fingers and feet are hardest hit but the eyes can be involved and blindness is common.’
Tom spoke in Vietnamese to his patient as he taped the bandage in place.
The woman put her hands over his as her words floated out into the hot, humid air.
Tom smiled at her, shaking his head, his cheeks unusually bright for a man who seemed to take the heat in his stride.
Hin added a few words and then laughed a big belly-shaking laugh. Turning to Bec, he wiped his eyes. ‘She says he has the touch of an angel but he should also use his hands to get himself a wife.’
The old woman nodded her head vigorously toward Bec.
Hin continued, ‘She says you would be wise to choose a man with hands of delight.’
Bec forced out a polite laugh against a tight chest. It didn’t seem to matter which side of the world she was on, patients always wanted to matchmake. It seemed to be an international hobby.
She caught Tom’s gaze, wanting to share the ridiculous joke with him. His eyes, the colour of dark chocolate, held laughter and mirth, which confirmed that the old woman’s idea was a preposterous notion.
His gaze flickered, a small flare of … what? She couldn’t pin it down. Amusement quickly rolled in as his trade-mark grin streaked across his face at the ridiculous idea.
She laughed again, this time a true laugh, sharing the joke with someone who truly understood.
A sudden feeling of emptiness thudded through her. Crossly, she shrugged it away. People might want to matchmake but love didn’t work for her. If she’d ever believed it could, she’d had the idea knocked out of her at twenty, proving how wrong she could be.
‘What about the children, Tom? Do you skin-check them when you visit?’ She asked the question, needing to fill the silence between them.
‘If their families are concerned, I check them out for lesions but all of them have had the preventative immunisation using the BCG vaccine.’
She wrinkled her nose. ‘BCG—I thought that was for tuberculosis?’
He nodded. ‘It is but it has a small protective effect against leprosy. As long as people don’t come into repeated direct contact with the lesions, they’re unlikely to get the disease.’
They worked consistently through to the end of the day.
Bec lost count of how many different wounds she bandaged but she had a
