Sister Roberta Pignone of the Missionary Sisters of Mary Immaculate (PIME) treats a leprosy patient at Damian House in Khulna district of Bangladesh's Khulna Division in this August 2017 file photo. (Photo by Stephan Uttom/ucanews.com)
Muslim villager Monjur Sheikh began developing infections from small rashes on his skin in 1975, coupled with aches and fever.
This prompted him to visit a series of doctors but each treatment they prescribed only made his condition worse, causing him to panic and ultimately give up hope as he watched his appearance deteriorate radically.
"Every time, I had a negative reaction," recalls the 81-year-old from southern Bagerhat district. "Soon I realized I had leprosy but I didn't know what to do or where to go."
After years of suffering the former entrepreneur, who used to earn a living selling dried and sweetened tobacco, heard about a hospital being run by nuns in Daspara, a village in neighboring Khulna district.
In 1986, after enduring a decade of agony and humiliation, he wound up at Damian House, the newly opened medical center set up by the Missionary Sisters of Mary Immaculate (PIME) to cater to poor patients in southern Bangladesh.
"I remember the day I first met Sister Rosa [Sozzi] and she began treating me," he told ucanews.com.
"I began to stay there often and kept taking the medicine they gave me. Without the help of those wonderful nuns, I don't think I would have survived much longer."
Not only did they assist with his skin condition, he said, they also taught him to fight against prejudice and the negative social stigmas attached to leprosy.
"Even my relatives shunned me as they feared they might get infected," he said.
"People used to insult me and say a lot of bad things. But the nuns were different. They not only treated me but spread awareness among others and persuaded younger people not to feel threatened and not to ostracize us [leprosy patients]," he added.
Maria Begum, a 25-year-old mother of one, also visits Damian House regularly to receive treatment for tuberculosis (TB).
"About a year ago I had a serious coughing problem. I came here to see the nuns and found I had TB. I've been taking the medication ever since and now I feel much better," said the Muslim housewife, who migrated from Barisal district to Khulna nine years.
Muslim Monjur Sheikh, 81, says he could have died years ago if he had not reached Damian House. (Photo by Stephan Uttom/ucanews.com)
In addition to offering free check-ups and medicine, the nuns support her by supplying baby food, rice, lentils and sugar every month.
"Before I came here I would visit local doctors and had to fork out a lot of money, but nothing worked. Here, I never spend a penny. Yet now I enjoy good health and my family is taken care of — thanks to the nuns," she said.
Leprosy is also known as Hansen's disease after Norwegian scientist Dr. G.H.A. Hansen who first discovered mycobacterium leprae, the causative bacterial agent of the disease, in 1873.
It has long been considered a "curse" in many parts of the world due to its contagious nature, the extreme level of physical disability it bestows on patients and its relatively high fatality rate.
However, leprosy today is a curable disease if detected at an early stage courtesy of multi-drug therapy (MDT).
There were 216,108 new cases registered globally in 2016, according to the World Health Organization.
The agency said the prevalence rate was 0.29 per 10,000 people on average based on 173,358 cases recorded at the end of 2016.
In overpopulated and impoverished Bangladesh, leprosy was considered a plague-like disease for decades. However, initiatives from the government and international health organizations helped the country to become "leprosy free" in 1998, two years before the WHO's target year of 2020.
The world health body officially declares a country free of the disease when the prevalence rate of new cases drops below 1 percent per 10,000 people.
In the case of Bangladesh the prevalence rate for new cases was still as high as 0.62 percent of the total population as of 2002. Of those who contracted the disease, 6.5 percent developed significant physical disabilities, statistics show.
However, tuberculosis is considered more of a threat to public health in the country. The WHO now ranks it sixth among 22 high-risk nations for TB outbreaks.
Currently, about 225 out of every 100,000 people get infected with the disease and 45 die from it each year.
A tuberculosis patient seen at Damian House in Khulna district of Bangladesh in August 2017. (Photo by Stephan Uttom/ucanews.com)
The WHO introduced Directly Observed Treatment (DOTS) therapy to cure TB in 1993 and it has proven a lifeline for many in Bangladesh.
Italian PIME Sister Roberta Pignone, 46, a medical doctor and director of Damian House, says the facility was the brainchild of Sister Rosa Sozzi.
"Sister Rosa worked on a leprosy project in northern Bangladesh and then decided to move to the south. In 1998 she fell sick and went back to Italy, where she died that October," recalled Sister Roberta, who has been in charge of the facility since 2012.
By 2001 the nuns found the number of leprosy patients in the area was dropping. Sadly, however, they were being replaced by a rising number of TB patients.
The hospital quickly opened a new section offering TB treatments. In 2012 they opened another ward to treat HIV/AIDS patients.
Each year they offer in-house treatment for up to 375 patients while the total number of beneficiaries of their services and those of its subsidiaries stands at 11,000.
"Poor people usually try to ignore the symptoms when they develop bad coughs. They only go to see a doctor when they realize their condition is more serious than they thought," said Sister Roberta, who is supported by two colleagues.
"Sometimes the DOTS therapy doesn't work, especially if they also have diabetes, so they can face a huge burden," she added.
Although Bangladesh is now officially leprosy-free a booklet published by the nuns shows that people in at least 12 of the country's 64 districts still remain vulnerable to the disease. These districts are usually remote and backward and located in the north and south of the country.
"We believe severe forms of leprosy that can cause death will never return here, but we still see patients trickling in, in small numbers," she said.
"Many people still suffer in silence," she added.
"We are working hard to reach them but the real challenge is helping Bangladesh to maintain what it has achieved in terms of almost rubbing the disease out."
For decades the facility relied on generous global donations including those from Italy, the base of the PIME congregation.
The 2008-2009 financial crisis in the U.S. that affected Europe and especially Italy made the nuns worried as they watched their sources of funding dry up, meaning the poor would suffer.
While the situation has since improved, funding remains tight.
"The most underprivileged members of Bangladeshi society depend on our free treatment," Sister Roberta said.
"So it worries us to see the level of global funding that we receive shrink as this threatens to impact the work we do," she added.
"But we are doing God's work. Somehow, we will find a way to continue helping for as long as we are needed."