K.V. Desikan. An extraordinary life in the service of leprosy patients

K.V. Desikan. An extraordinary life in the service of leprosy patients. Prabha Desikan, Bhopal, 2022. 116 pp.

This tribute by his daughter is welcome as her father, Dr Kothapalle Vedantha Desikan (1926–2022) was an unobtrusive person, preferring to work silently in the background. His tale is inspiring, and we are grateful to Dr Prabha’s mother, Kamala (who pre-deceased Dr Desikan), for asking Dr Prabha to chronicle her father’s extraordinary journey through life. The daughter has kept her promise to her mother in a comprehensive manner and this book is the result.

We are fortunate that Dr Desikan kept a diary, intended for his granddaughter, which provided many of the details included here. Also presented to us are the gleanings from the many conversations Dr Prabha held with her father to elicit facts and his feelings on the major events of his life. She was able to do this as her father moved from Wardha to her home in Bhopal after the demise of his wife.

‘His work on leprosy spans more than six decades. That is more than a lifetime for many. While his achievements were tremendous, I have never known him to take credit for any of them. He…took great pride in the accomplishments of his juniors and delighted in their enthusiasm. He…faced, and overcame, challenges without losing sight of his purpose, or his faith in humanity…’ (Preface)

Dr Desikan was the eleventh of twelve siblings born in a poor Brahmin family and had to struggle to reach medical school.

Dr Prabha is a gifted narrator. The first paragraph sets the tone for the rest of the book as she describes how on 15 August 1947, after hearing Nehru’s stirring address on the radio at midnight, the 20-year-old medical student in Mysore noted inability to move his right little and ring fingers. (He had consulted physicians when he developed an anaesthetic patch on his left forearm but had been sent home without a diagnosis, advised vitamins.) Dr Robert Cochrane in Vellore made the diagnosis of leprosy and started treatment. Dr Paul Brand, who had just joined the Christian Medical College, decompressed his ulnar nerve. This may have been the first operation on a leprosy patient by Dr Brand.

The terror of being ostracised and, worse, expelled from the medical college was horrifying. Fear of being shunned and rejected persisted even after graduation. The empathy shown by Dr Cochrane, Dr Jayaraman (Dr Desikan’s professor of dermatology) and the kind family physician who gave him the daily intradermal injections of hydnocarpus oil sustained him.

His visits to Vellore and interactions with Dr Cochrane, his assistant Dr Russel and Dr Brand inspired him to pursue a career caring for leprosy patients. He trained under Dr Ramanujam, a renowned leprologist in Madras. Dr Ramanujam introduced him to Professor Jagadishan, secretary of the Hind Kushth Nivaran Sangh. He was advised to join Dr Sushila Nayar in her work for leprosy patients at Wardha.

Since Dr Desikan had not worked at a dedicated leprosy centre, Dr Nayar contacted Dr V.R. Khanolkar in Bombay (now Mumbai) and, at his suggestion, Dr Desikan joined the Acworth Leprosy Hospital in Wadala in 1952. It is disheartening to note that in this hospital the clinicians ostracised him and made him sit on benches with other patients, fearful of being infected by him even after he showed them Dr Cochrane’s certificate that he was non-infectious.

He moved to Wardha the same year and was pleasantly surprised by Prabhakarji, Chief of Kasturba Hospital in Sewagram. The section entitled ‘The work in Wardha’ describes his setting up the house-to-house survey in selected villages around Sewagram—the world’s first Survey, Education and Treatment programme. One of the photographs shows him in a group along with Mr C.D. Deshmukh and his wife Durgabai. It was also in Wardha that he was introduced by Prabhakarji to Kamala, a Sarvodaya worker, whom he married in 1957. He was later asked to take over the Leprosy Control Unit at Chilakalapalle, in what is now the Vijayanagaram district. This unit catered to nine villages.

He also helped organize a series of conferences of leprosy workers and we see Dr Jivraj Mehta in the group photograph taken at the second conference.

He returned to Christian Medical College, Vellore in 1962, this time to join the course for MD in pathology. Dr C.K. Job was his mentor. This section of the book describes his autopsies on leprosy patients and descriptions of lepromatous granulomas in the larynx, liver, bone marrow, testes and adrenals even in patients who were bacteriologically negative and in quiescent states. His findings emphasized the need for prolonged treatment even after the patient showed no skin lesions. He also found an increased incidence of interstitial nephritis and pyelonephritis in these patients. He obtained his MD (Pathology) in 1966, Dr V. Ramalingaswami being his external examiner.

He was then appointed senior research officer at the Central Leprosy Teaching and Research Centre at Chingleput. Dr C.G.S. Iyer was the director. He faced difficulties in setting up an upgraded pathology department with facilities for autopsies. It was here that Prabha was born. A WHO fellowship enabled him to visit centres in Britain, USA and Japan. He studied the technique of inoculation of the footpads of mice with the leprosy bacillus from Dr R.J.W. Rees (Britain) and Dr Charles C. Shepard (USA). The photograph on the right on page 58 shows him paying homage at Father Damien’s grave in Molokai, Hawaii during his stay in America.

Pages 62–72 describe how in 1976 he was directed by Dr Karan Singh, Union Health Minister, to take charge of the Japanese Leprosy Mission for Asia (now Central JALMA Institute) in Agra. This is where he was able to set up electron microscopic studies in leprosy. Dr M. Nishiura was his partner in these studies. (Dr Nishiura passed away in JALMA in 1985 and his remains are buried in its premises with a memorial raised unto him.)

Dr Desikan was invited by WHO to serve on its committee on the immunology of leprosy.

He retired from JALMA in1987 and, with his wife, settled in Sewagram, Wardha. He set up the leprosy histopathology laboratory at the Mahatma Gandhi Institute of Medical Sciences there with the help of the British Empire Leprosy Relief Association (LEPRA). He was appointed the first Chairman of LEPRA in India and helped set up centres in Hyderabad and Odisha and helped strengthen the St Joseph’s Leprosy Centre in Sanawad, near Indore. He stepped down from this position in 2003 but continued helping as a consultant. After moving residence to Bhopal, he visited the centre in Sanawad every alternate month.

The section entitled ‘Awards and recognition’ highlights the high respect in which this humble leprologist was held in India and abroad. On receiving the Damien–Dutton Award, he said, ‘I am no greater than several others who have worked, struggled, sacrificed and remained unknown.’ JALMA honoured him in 2021 by naming its new laboratory building complex ‘Desikan Bhavan’. The photograph on page 82, showing him in a wheelchair near the foundation stone, also shows us Dr Prabha for the second time in this volume. (The first photograph of her as a toddler is on page 56.)

Pages 83–113 feature tributes paid to him by those privileged to work and interact with him. Fittingly, the first tribute is by his assistant in Wardha—Mr Vishweshwar Hiwase. The anecdote narrated in the third paragraph shows the deep vulnerability of Dr Desikan—physically and emotionally. Each tribute highlights aspects of his efforts and achievements in unforgettable anecdotes and with feeling. While Mr Hiwase called him Anni, Mr Mani used the term Guruji. Others had their own, personal relationships with him.

Each of these sincere and heartfelt tributes deserves study.

Dr Desikan passed away just before this volume went to the press.

Dr Chinoy Chacko (with whom Dr Desikan worked while studying towards the MD) sums up the feelings of many. ‘It is people like Dr Desikan and Kamala, who are the true builders of modern India, working quietly, without publicity and contributing their best in the various areas of responsibility over a lifetime…May this volume be an inspiration to the next generation…’ Amen!

[The book is available from Dr Prabha Desikan. Her email is prabhadesikan@yahoo.com.]