Leprosy and its effects

Leprosy and its effects in Bombay are shown not only through the illness’s visible consequences but through the exclusion that shapes where affected people can live and how they obtain care. At a makeshift camp near Khar, people denied a stable place in the city build a community amid railway land; their informal medicine network makes them both vulnerable outsiders and indispensable providers. Their story also draws Lin into a role as a clinic worker whose limited training cannot overcome the larger failures of access.

Exclusion and precarious settlement

Several treatment colonies for Bombay’s lepers offered medical attention, support, and cleaner surroundings, but their strict rules did not suit everyone. Some residents left; others were forced out. At any given time, a few dozen people, including women and children, lived beyond those colonies in the wider city. Their movement reflects not a settled choice of neighborhood but the difficulty of securing a place where they would be allowed to stay.

The tolerance that slum communities extended to people of different castes, races, and circumstances often failed to include those with leprosy. Local councils and street committees did not sustain their presence for long. The group consequently formed mobile encampments, setting up shelter wherever open space was available and leaving quickly when necessary. Their camps could stand for weeks beside rubbish dumps, on swampy vacant land, or near industrial waste outfalls. When Lin first visits with Abdullah, the group is living on rusty railway stones near Khar.

The site makes their marginal position visible. Outside the railway boundary lies suburban Khar, with traffic, gardens, balconies, and bazaars; inside is an industrial landscape of tracks, warehouses, and service buildings. The camp occupies a clear space between the lines. Its low shelters, patched from cardboard and plastic and held up with branches and string, provide little security. About thirty people live there. The contrast is not merely between a slum and a suburb, but between a functioning urban system and people required to find temporary shelter within its leftover spaces.

Bodies, communication, and community

The people Lin encounters include adults with extensive impairments as well as children who appear comparatively well, though uniformly thin. Several adults have lost fingers; some have lost features of the face, while others’ feet are wrapped in bandages. The children work, their small hands performing tasks for the group. The account records these differences without reducing the camp to illness alone: its residents watch visitors, gather to listen, provide tea, and maintain relationships and responsibilities within a precarious settlement.

Ranjitbhai, whom Abdullah greets as a son might greet an elder, comes out to welcome them with the support of two children. His face has been severely affected, and he has no fingers. His speech is difficult to understand because the loss of his lips alters how he forms certain sounds; gestures with the hands are unavailable to him as well. A child stands beside him and repeats his words steadily, one beat behind. This practical act of interpretation makes the limits of communication plain without making Ranjitbhai’s own voice disappear: he speaks, while the child helps carry his words to the visitors.

Ranjitbhai’s account of the camp’s medicines shows the residents acting collectively and maintaining expertise under conditions of exclusion. A boy brings a canvas bundle containing labelled, new ampoules and bottles, including morphine hydrochloride, penicillin, and antibiotics for staph and strep infections. Ranjitbhai says the group can provide medicines every week and expresses its willingness to help Abdel Khader Khan. The camp is not simply a place where care is absent; it is also a place where people who have been denied reliable inclusion organize a supply of care for themselves and others.

The medicine network and its uses

Abdullah explains the history and practical importance of this network over tea with the camp residents. During the British Raj, he says, lepers were placed at the bottom of the order of entitlements and often missed out on limited supplies of medicine, bandages, and treatment. In famine or flood, traditional remedies could also become scarce. The residents became skilled at stealing what they could not otherwise obtain, accumulated surpluses, and began selling medicines through a black market.

The trade developed partly because official systems of distribution were also systems of surveillance. Purchases from chemists, hospital pharmacies, and wholesalers were recorded; unusually large orders could attract attention and lead to arrests or killings. Medical supplies, particularly antibiotics, could leave a trace that exposed outlaw groups. The lepers’ network, by contrast, asked no questions of customers able to pay. Abdullah describes it as extending through India’s major cities and serving terrorists, infiltrators, separatists, and other outlaws. Its function is therefore double-edged: it supplies life-saving goods to people shut out of ordinary channels, while secrecy makes the same supply useful to people pursued by the authorities. Abdullah sums up the contradiction by explaining that people near death steal life for themselves and then sell it to others who are dying.

Lin’s clinic and the limits of care

Lin’s own position links the camp’s informal medicine economy to the slum clinic. He has some first-aid training, has used CPR to revive people after overdoses, and possesses a first-aid kit given to him by friends in New Zealand. People in the slum begin calling him Doc, and his work treating wounds becomes part of how he understands his presence there. He sees a connection between his training, his past, and the clinic, even when he cannot explain why his life has brought him to that work.

That work does not make him a qualified doctor. When Abdullah introduces him to Doctor Hamid as the doctor in the Colaba hutments, Lin resists the title: he has been drawn into helping but does not consider himself properly trained or good at it. His concern is concrete. When he cannot identify an illness, he refers patients to the diagnostic clinic at St. George Hospital, but many return without having seen a doctor or nurse. Lin has visited the hospital twice and understands its pressures: it is understaffed and overcrowded, handling about six hundred patients a day and sometimes as many as a thousand. The residents cannot afford the consultation with a licensed practitioner that would provide a referral and help them move through the hospital queue. His clinic treats about fifty people daily, but its work cannot substitute for the services its patients cannot reach.

The wider story also shows the network’s medical supplies entering an emergency response. During the slum cholera outbreak, Khaderbhai’s lepers provide oral rehydration salts, and Hamid explains how to use them. When a municipal health official acknowledges that hospitals are already overwhelmed, the residents organize water purification, sanitation, safe food, and care for the sick; Lin supervises the use of the salts. The outbreak is not evidence that leprosy caused cholera. Rather, it shows the consequences of fragile access to public care and the practical value of relationships built beyond official institutions. Across these scenes, leprosy marks a condition of bodily vulnerability, but the camp’s members are not passive symbols of suffering: they communicate, organize, trade, and provide care in a city that repeatedly pushes them away.