Working with The Leprosy Mission in Nigeria

Natalie Smith, Nigeria

Warming water with a boiling ring to soften moulded thermoplastic hand splinting material is among Natalie Smiths daily experiences of improvisation while working as an occupational therapist in Nigeria.

Natalie, a fieldworker with The Leprosy Mission, has been working in northern Nigeria for the past five years as a Prevention of Disability officer and has learnt how to work with limited resources. Her role is to help leprosy patients re-establish themselves in their community as well as advising hospitals, field clinics and leprosy control officers in three large, connecting States on how to prevent disabilities among leprosy patients.

Isolated conditions in Nigeria have also forced Natalie to become incredibly versatile, often having to perform jobs normally carried out by nurses, physiotherapists and other medical staff.

Natalie is called on to debride and dress wounds caused by leprosy while still teaching patients how to protect their anaesthetic limbs from further injury and how to manage their disabilities within everyday life.

Her varied role at Sokoto extends to planning, budgeting and project funds management, training health workers and even coordinating a hospital building extension to the Physiotherapy/Occupational Therapy department.

"I love the variety of the work, although it is really challenging," Natalie said. "No day is the same and you can't predict what problem you might have to solve next." She said another great challenge in working as an Occupational Therapist in Nigeria was working within a Muslim culture where she felt women were often not respected as individuals in their own right.

"I really try to encourage the women affected by leprosy to take more control over their lives but the Muslim culture is very dominating," she said. "It is also difficult to do my work when electricity and water supplies are not reliable. The power can go on or off during the day so sometimes I cannot complete all the work that was planned. Water might also only run for a few hours a day so water storage facilities in big drums are also needed in the department so that work can go on."

Leprosy affects the sensory and motor nerves controlling the hands, feet and eyes, consequently patients lack feeling and injure themselves. In the same way, unfelt injuries become infected which can gradually cause the bones to deteriorate. Many of Natalie's leprosy patients have no fingers or toes to perform daily living activities, so a large part of her work is spent in designing and creating practical aides for their rehabilitation. “One patient I recently assisted had lost all of his fingers and also suffered a stroke which paralysed his right side,” she said. “I was able to make him a spoon-holding wrist strap allowing him to become independent and feed himself.’’

Natalie, who was raised by missionary parents in Papua New Guinea, completed a degree in Occupational Therapy at Latrobe University in 1992. After completing her studies, she moved from Melbourne to Tasmania to begin a career as an Occupational Therapist, working at both Devonport and Burnie hospitals and majoring in paediatrics.

But it was the major event of surviving the Port Arthur massacre as an onlooker in the car park in 1996 that caused Natalie’s dramatic change of direction - encouraging her to reassess her personal goals and priorities.

"That knowledge of being so close to possible death really shook me up and I guess it made me subconsciously evaluate where I was going," she said.

Three months later, Natalie joined World Vision leaving her enjoyable social life and satisfying career in Tasmania behind her. She was employed to help rehabilitate amputee war victims in Sierra Leone, Africa. Unfortunately, her experience of working in Sierra Leone, West Africa, only lasted 12 months when she was evacuated from the country due to another coup in their 10-year civil war.

“The experience of being in fear for my life at Port Arthur gave me a small glimpse of what these people in Sierra Leone had gone through," Natalie said. "Many had fled from their villages as rebels attacked, raped, killed and burned all they could find. I and most other expatriates were evacuated from the country within two days of the coup carrying only an overnight bag. Everything else I had was left behind. I came to realise that I didn't really need all the things that I accumulated every day. To just escape with my life was enough."

With her newfound love for Africa, Natalie returned to the continent six months later with The Leprosy Mission (TLM). "I loved working in Africa so much, I had to go back," she said. "People there are so grateful for the smallest thing you can do for them. It is quite a change from patients in Australia who demand healthcare as their "right".

“It is a real experience working overseas and with another culture. I really recommend others to try it - you'll see Occupational Therapy through different eyes when you get back."

For more information about TLM, contact: 9890 0577. Natalie can be contacted at P.O. Box 1851, Sokoto, Sokoto State, Nigeria or email tlmsokot@skannet.com

The Leprosy Mission, Australian Office: P.O. Box 293,
37 Ellingworth Parade, Box Hill, Victoria 3128, Australia
Telephone: +61 3 9890 0577, Fax: +61 3 9890 0550
Email:tlmaust@leprosymission.org.au