Sayid Ahmed, 24, sat on his hospital bed while two French nurses wrapped white bandages around the stubs where his hands and feet used to be. His face wore no expression; years of ignored leprosy have paralyzed the nerves.
"Sayid's case is one that should not exist," said one of the nurses, Laurence Le Sommer. "We now have all the necessary medicines here to prevent this. . . . Perhaps a case like this could have happened 30 years ago, but now it is not acceptable."
The 30-year-old French woman is among the people committed to curing Egypt's lepers despite the difficulties imposed by deep-rooted fear of the disease.
The staff at Abu Zaabal leprosy hospital say Egyptians' fear--stemming from leprosy's awful deformities, the belief that it is incurable and the exaggerated fear of contagion--must be overcome to eradicate the disease.
Horror at the affliction is shared in other countries, but Dr. Mohsen Labib, head of Egypt's leprosy-control program, believes the disease can be defeated here because it's not as prevalent as in other Third World nations. Egypt's rate, for example, is 0.61 per 10,000 people, compared with India's 13.13.
The doctors at Abu Zaabal, the largest leprosy hospital in the Middle East and Africa, saw a glimmer of hope in a recent visit--his first--by Health Minister Ali el-Makhzingi. The occasion was Leprosy Day, held each year to highlight the disease as a way to combat it.
Labib says Egypt has 13,000 recorded cases of leprosy but the actual number could be much higher; many victims and their families fail to seek treatment for fear of being shunned by other Egyptians. Estimates reach as high as 50,000 cases.
One result of the fear: Some families hide relatives who have leprosy, Labib explained. The disease then reaches advanced stages where the nervous system deteriorates, leading to deformities.
"Sayid was found last year in a goat stable," said the young man's hospital roommate, former leper Ali Ahmed Hagag, 57. Sayid's stepmother had kept him locked up for 10 years to avoid mocking looks from fellow villagers.
Doctors at Abu Zaabal told of another victim whose mother, fearing a scandal in her small village, kept her daughter hidden for 34 years.
"We have to explain that it is a curable disease," said Labib.
Leprosy, he said, can be cured with drugs that eliminate the contagion and prevent leprosy from attacking the body's nervous system.
Le Sommer is helping Labib train nurses for leprosy outpatient clinics whose staffs perform "sweeps" of mainly rural areas to uncover victims, who doctors hope will be in the initial--and curable--stages.
Labib says the Ministry of Health began to promote the regional clinics in 1983.
"Before, doctors with specialties in other fields would just happen upon cases of leprosy," Labib said. "Now we go into the villages and find the victims."
Despite the clinics' success--recorded leprosy cases have dropped by nearly half since they were established--Labib said inadequate medical education and ingrained contempt are the major obstacles to wiping out leprosy in Egypt.
He noted even some doctors working in the clinics are still afraid of contagion. Le Sommer said "relieving the clinic nurses of their fears of leprosy" is her hardest job.
A well-known Arabic saying, reputedly from Islam's prophet Mohammed, calls for fleeing "the leper as you would the lion." The stigma attached to leprosy extends even to those who have been cured, Labib said.
"Most of (the patients) now at Abu Zaabal have remained there because of the disease's stigma. . . . Their families have refused them," he said.
Sabah, 24 and recently married to Hanafy, another cured leper, sees no life outside the hospital. "We are no longer contagious, but people are afraid of our crippled hands," she said.
Mitkhait Abdullah, 65, holds up her hands whose fingers were lost to leprosy before she was cured more than two decades ago and says she expects to be buried in the hospital's cemetery.
"I can never go back," she said, "not like this."