In a hostile environment, Leah Pattison, from County Durham, is on a mission to care for Indian women blighted by problems such as leprosy. In the first of a series of articles from Nagpur, Sarah Foster gains an insight into her remarkable life.

IN the midst of an Indian slum, thronged by barefoot children, stands a lone white woman. All eyes are on her, watching with quiet reverence as she speaks in their native tongue. I don't know what she's saying, but her voice is calm and measured, with the hint of a North-East twang. At her side, glowing with admiration, is a woman marked by leprosy; a woman with stumps instead of hands.

This is where Leah Pattison feels she belongs - in the grime and squalor of the city she has made her home - for it is here that she is needed, and needed desperately, by women who would otherwise have no hope.

Leah first came to India as a tourist, taking time out, as many do, between university and a job. Fatefully, she chose to work in a leper colony, where, amid the ranks of deformed patients, she came to understand the crippling force of the disease. Among the pitiful mass of women, cast out from their homes as rejects, was a bright young girl named Usha Patil.

Unlike most at the colony, Usha's family still cared for her and with their support, she was slowly recovering. Leah and Usha became friends and the notion of helping women victims blighted by leprosy was born.

Armed with just a simple First Aid box, the pair began trawling the slums of Nagpur, Usha's home city in central India, looking for desperate cases. They found women on the streets, begging to survive, women shunned by husbands and loved ones and left for dead, and women whose leprosy, left untreated, had led to gross disfigurements.

In the year 2000, shortly after beginning their work, they set up a charity - Start - and fought for acceptance by the authorities. It is a battle they are still fighting, in a society where women are second-class citizens and those with any kind of abnormality become non- entities.

Sitting in the office of Start's clinic, which after a nightmare of red tape, finally opened last year, Leah recalls the early days. "Initially, getting into the work was quite difficult for Usha and me because we were just two girls and in India, women are not taken as seriously as men," she says. "We were given permission to do a leprosy survey of some of the slum areas of Nagpur. We used to travel by bus and auto rickshaw, doing about 70 to 100 households a day. Through that, we got to know the slums intimately. We were regarded with suspicion to begin with but by perseverance, we managed to break down the barriers. When we detected women with leprosy, we would dress their ulcers and bathe them. We were also the link between them and the hospitals."

All this was worlds apart from Leah's upbringing, in the scenic village of Frosterley, in Weardale. Nothing in her background, as the middle child of affluent parents, could have ever prepared her for such a life. And yet from that first visit to the colony, she could contemplate no other.

Still only 34, Leah has followed her vocation for the past ten years. When she first came to Nagpur, she didn't even have a home, and had to live with Usha's parents, sleeping on the roof in hot weather. Her single-mindedness has baffled many, with even doctors asking why she and Usha bother helping broken outcasts, but for them, every life is precious.

"There have been people who have said we should be helping useful people, but we help the women who don't have anything, who have no support from anyone," says Leah.

The clinic, with its atmosphere of warmth and laughter, is a shining tribute to her work. Women come here with their ulcers - a common problem for leprosy patients - for general care and conversation. As well as meeting their medical needs, Start provides them with food, clothing and somewhere clean and safe to live. They come for massages and yoga, for help in starting their own business, and such is the thoroughness of care, are even offered dentures.

Latterly, Leah and Usha have broadened their scope to cater for women with HIV, a burgeoning problem of modern India. Through a new charity, WIN, or Women In Need, they aim to prolong life and offer hope to these ostracised victims. They also plan to expand, taking their work to other areas, and would like ultimately to buy land to build a hospice.

Whatever a woman's problems, once she agrees to take them on, Leah is there for them for life. While this is no small responsibility, she bears it with good grace, taking modest pleasure in being useful. She has been compared with Mother Theresa and dubbed 'The Angel of Nagpur', but such epithets only embarrass her.

"I often think I'm not the right person to be in this environment," says Leah. "I'm a hypochondriac and not charitably minded at all. I've always got to have my make-up on. I'm the intrepid explorer that can't do without her make-up."

On a more serious note, she says: "I think a lot of things that have happened to me have changed me and I think that somebody else in my position could quite easily have been changed in the same way.

"I could give this all up tomorrow and go back and have a cosy life. I'm fortunate, whereas these women are stuck. A lot of our women used to talk about wanting to die. I can't imagine being in that situation, and that's a motivation to me to do something."

Leah admits that it's difficult being a foreigner, especially as a woman in India, and that she'll never feel fully accepted. As well as rudeness and constant stares, she's coped with several bouts of illness in her time there, including leprosy - which was quickly cured with antibiotics - and pneumonia.

The daily sights of suffering take their toll, but she tries to remain positive. "I do get depressed about the things I see - Usha and I both do," says Leah. "There are animals on the streets in awful conditions and most Indians won't notice, but I see them every day. I'll never be immune to these things. But I thrive on my work. I get a buzz out of it and that's the reason why I'm here.

"Life is so short - I'm reminded of that every day. I would like to think that I reach old age and think, 'didn't I do some mad things and didn't I do something positive with my life?' I do miss my friends in England but I've gained so many benefits from being here."

Not least of the things she counts as blessings is her friendship with Usha. "Usha and I are exceptionally close friends," says Leah. "Usha is strange in that I've never found another Indian who has the same level of compassion that she has. We often joke that in a different life, she may have been an English girl and I might have been an Indian."

When it comes to the future, Leah is philosophical. While, as it stands, her work leaves scope for little else, she feels there will be time for other things. "I think I'm going to have everything eventually," she says. "I think I will settle down and have my kids. I think everything has got to come at its right stage.

"At the moment, I just feel I have to do what I'm doing. It's an instinctive thing. I'm learning about myself."

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Touching the untouchable: inside Leah's amazing clini