The People at the Doorstep

14 August 2018

The People at the Doorstep
If you didn’t address the people at the doorstep, who is going to address them?
An interview with Geeske Zijp, The Leprosy Mission Chad.

Geeske Zijp has served with The Leprosy Mission for over 25 years. We talk with her about her work in Chad, the challenges she faces and the incredible transformations she has witnessed.

You’ve been with the Mission for over 25 years?

I started in October ‘92. I’d been working in other countries and when I came back, I didn’t have anything to do, so I came to a mission refresher course in London, and mainly there were all these older ladies, and there I was in my dungarees… but there were two young ladies, one was from Finland and one from France, and they worked with The Leprosy Mission in Indonesia, so they told me about the work and what they were doing and I found it so interesting that I thought, this is what I want to do too. And I’ve always been intrigued by St Francis. He was very scared of leprosy but then he was converted because of a leprosy-affected person, he touched him, so that made it all the easier for me to go into this work. 

What was it that made you stay so long working for the Mission in Chad?

The staff. We all became sort of brothers and sisters, everyone is helping one another out. 

You also work with a blind school?

The Blind School, well there was this issue, I wasn’t allowed to travel around (due to restrictions from another organisation), so the Director of TLM Africa said "do whatever is good for the Guéra people". So my colleague said we could do a little bit more with the school … I had received a financial gift so I used that and prepared a programme for the teaching of these blind youngsters, then we realised it was only the Bible and Christian books but it was not a proper school, so we said why not make it into a school? So we set up a blind school, and the children came here from the surrounding area, primary school kids, and it became a real school. And you can see these children grow up and become people who participate in daily life and activities, it is just so rewarding. 

I understand you live with some kids too?

Geeske and one of the boysThese kids in my house, I have got three of them living with me, sort of ‘my kids’, their parents are very far away. Two of them are completely blind except for a little bit of light they can see, and the other one wears thick glasses. But all of them are very capable. One of the blind boys makes us breakfast, he makes the coffee, he prepares the meal, he calls us, “come, let’s have breakfast”. Which is really nice. Yesterday I was thinking ‘what is disability?’ Because of course, their eyes, they cannot see, but … Last year at a community-based rehabilitation training, the staff came to the conclusion that it is the environment that makes a person disabled, it’s not necessarily the physical impairment itself. So if you create an atmosphere in which a person with disabilities can do whatever he can do… take away the barriers. Like in my garden, if there’s something sitting in the middle, we can put it to the side so they don’t trip on it – that sort of thing you can do. But otherwise? If I ask one of them, “can you put credit in my telephone,” or “please go to the market and buy something”, then they can, no problem, and they like it because it brings dignity – we are equals. I find it very rewarding. So I am used to these kids, though of course it is not always easy … and they are important for me too, I couldn’t live without them. 

That sounds like just allowing for different strengths and weaknesses, which we do with everybody. Everyone has some things that they’re stronger at, things that they’re weaker at, and you help them out with the things that are not their strengths. 

Yes, because in our area, people think that a blind person can’t do anything. These kids can’t do anything, some cannot even walk, because people just leave them sitting there. We’ve got a student at the moment who is doing teacher training school. He is over thirty years old now, but when he first came he could hardly walk, couldn’t even go to the toilet alone, and I was so shocked and I said “but you have to learn this” so I gave him a guide cane, because people were taking him in and bringing him back and it was total dependence. But then you see people getting on with their own thing without any help and it’s very rewarding. If you see positive change, that is what is encouraging … of course there are moments of frustration but if you see a change that is so helpful for someone, you forget all these frustrations. 

One day I was called by the eye nurse and he said “Do you know so-and-so?” and I said “No I do not”, and he said, “Well, he came with his son and can you come and have a look at him?” because our leprosy supervisor was away… So I went and I saw the father, and we’d had him on leprosy supervision treatment a long time ago, and then his son, he had brought his only son, and he was so sick, he had a terrible leprosy reaction, he had paralysed hands, a paralysed foot, he looked very thin, he had oedema (swelling), he was so sick. He had been this way for five months and three days, and unfortunately the nurse hadn’t treated him properly, and the father was so worried, and since we’d met in the past he said he wanted his son to see me, so he’d put him on the back of a motorcycle for three days in the water in the rainy season, terribly dangerous, and then he’d taken the bus one day to N’Djamena and then onto Mongo another day, and there he was.

So I was very shocked because it had already been five months, and after six months the nerve impairment becomes irreversible. We wanted to get to work straight away, so I informed the old doctor who specialised in leprosy and the doctor took him to do some lab tests straight away. He had malaria and typhoid fever, as well as oedema from leprosy reaction. He was so sick, when I saw him walking up to the laboratory room I thought this was worse than I had ever seen, like a drunkard walking in the street, he could hardly walk, he couldn’t lift his feet. So we did all these exams, treated him for leprosy and typhoid and malaria and put him on prednisolone for reaction treatment, and I visited him every day since the supervisor was absent. After a while he started using his fingers, could actually lift up his thumb, and slowly, slowly the movement in his fingers came back, not completely, but he started to use them to hold a cup and to shake hands, and the oedema disappeared, and of course he’d got better from his typhoid and malaria so he started to eat, then he started to lift his feet, and that was just amazing because then he started to walk and he was walking normally, and that was just so unbelievable. And then after about two months he wanted to go back to his village, and we do supervision in that area so we took him home. His mother was so happy – for her, the son that was lost was found. And his father was overjoyed. It was very rewarding, I was happy seeing them so happy together. And last year when we were in the same area, we found him in the market selling some things, and he took off his hat and said “It’s me, yeah, me”. We couldn’t believe it. We were staying at a house there and he said “I will come and visit you” and I think he brought a meal. That was just such an incredible event, it was so sweet, we couldn’t believe it ourselves, that it’s possible, and yet it was. But if he hadn’t come he would have been in for it lifelong, terribly disabled, a beggar. And we know that these kinds of things still happen, because there are nurses that are just not interested in leprosy patients and aren’t bothered, and there are others that don’t have the skills to recognise that this is very serious and know what to do. 

So that is of course very rewarding. Of course when we saw the nurse we trained him on what to do next time. We often tell people, if there’s a problem you can always phone and ask “What should I do?” instead of saying “Oh, no, this is harmless”. The nurse knew it was leprosy and put him on leprosy treatment but apparently he hadn’t been trained to know that this is something that is not normal in a leprosy patient and something needs to be done urgently. So that is a challenge. 

In conversation

You talked earlier about ‘removing barriers’ in a very ongoing, day-to-day way, just being aware.. 

Yes, it just needs a tiny little bit of thinking, you try to imagine yourself being in that situation, what would be of value. The kids at home, I just have them do exactly the same thing as anyone, like I was saying one of them makes our coffee, he gets the breakfast for us, he doesn’t see but he does our coffee, which is very nice to watch. If they accept their own disability, they even joke about it. He picks up a torch and switches it on and says ‘Oh it’s so dark tonight’. Actually they once did a play for Christmas at the church, two sitting at a table and one says “What are you doing there?” “Oh, I’m in school” and he starts to laugh, “how stupid, a blind person in school,” and they’re all blind. It’s very moving. And all that in front of the public. They invented this themselves, nobody ever told them to do it. They also recently did a sketch in front of the authorities, a play about disability. 

They’re advocating for themselves? 

Very much so. And another example, the members of one of our partner DPOs (disabled people’s organisations) – they have a store, they take millet during the rainy season, but they actually provide for the villages around each site, the non-disabled, so they include them within their own structure, they don’t think about ability. Normally it’s the village that will think about them, but they’re thinking about the village, it’s the other way around. They’re contributing to society as a whole, and that was their own idea. 

What’s your work with this DPO and how are people affected by leprosy involved?

This DPO, they heard about other DPOs and they wanted to do the same, they had persons affected by leprosy among them. One of the first things we do is make sure that they have proper procedural manuals for their projects and of course business codes, these official documents of authorisation, criteria, rules and regulations, it’s properly done so if they can follow that, the management will be much better. So that is one of the first things – what do they want, what are their real wants, what do they do if somebody doesn’t align with the association rules, so that makes them strong, because of good governance and rules and regulations. And then slowly most of them go into grain stores, for something to eat during the rainy season, some of them sell water, we have some microcredit arrangements.

And did these groups always include people affected by leprosy? 

In the very past no, in Mongo they refused, they were angry with us, but now it’s no problem, it’s normal and they mix together. 

What brought about that change? 

I think The Leprosy Mission, because we clearly worked with persons affected by leprosy and reached out to them, and people see it, they say “why do these people reach out to them”, and see that we didn’t develop leprosy ourselves, that there’s nothing wrong, there’s good treatment, and they start to understand that there’s no need to exclude them. I think it’s an example sort of thing, they see what you’re doing and say "well, it’s possible … We can do that also". But we didn’t tell them to include. Recently we had a new DPO asking us to help, and you go for the meeting and there are persons affected by leprosy you know: that’s nice. Looking back over 25 years in this country, it’s difficult to see a 2, 3 or 5 year programme and then stop. Changes go very slowly, it’s a continuous procedure, but we do see changes. When we first started there was no way you could integrate persons affected by leprosy, especially those with disability, into normal life. Nowadays patients who have had amputations are in the same room as other patients and it’s fine, no problem, so stigma is a lot lower than it used to be. 

So do things just spread through word of mouth? 

Making sandalsIf a person affected by leprosy gets better, then people see this and they want to go to the same place where that person got healed. Because there is still a lot of fear amongst the medical staff, doctors and nurses, they’re not always treated very nicely, so if you then go to a place where you are treated nicely and you are welcomed, then you go there. So we even have patients that have come from hundreds of kilometres, just for treatment. And we have an older person affected by leprosy working at the hospital as a nurse’s aid – he’s always there, even if he has nothing to do he will be there, the door is open, so he’s welcoming other people affected by leprosy, it gives them confidence that they can go there and get proper treatment. 

What impact does God have in your work and everyday life? 

Well of course I couldn’t do it without Him. In Africa, everybody believes in God anyway, so it’s strange for them to know or to hear that there are people in Europe who don’t believe or who can’t believe it, it’s very strange for them. Even our staff, they know very well that we are Christians, we read from the Bible, sometimes we pray together. 

What’s one vivid memory that has stayed with you, that’s really meant something to you? 

When we went into the war, in 2008, Henno Couprie (Country Leader of TLM Netherlands) visited and I remember that I had to take him to the airport so we had to leave the town and we went right into the war, and I had to see our Field Director lying on the floor there in front of me, because of gunfire. He’d come for a visit and instead he had to lie down on the floor for two days. I found that’s something I will never forget . 

What are some of the other practical challenges where you’re working? 

Electricity, and water is of course very important. Most times we have water. Mosquitoes, snakes. There’s a lot of malaria, sometimes every month. You can buy drugs in the market but people are not taking the right treatment, they do it completely wrong so the mosquitoes get resistance, this is one of the major problems. Because then even if you yourself take proper treatment, it doesn’t have the full effect.

My colleague Mark often says to me, if you didn’t address the people at the doorstep, who is going to address them? The bigger organisations, often they don’t get to the grassroots level. The very poor, they are not really included. It’s very sad. At least they know they can come to The Leprosy Mission and we will try to find a solution, if there is one, and if there is not, well then we can do something. It is difficult to say no we can’t do anything. I think as a Christian, I couldn’t do that.

Photos by Jaco Klamer

Geeske with Maïmouna and Abdelkerim