Driven by compassion, Leah Pattison, from County Durham, is helping destitute Indian women affected by leprosy. In her final article from Nagpur, Sarah Foster reports on Leah's latest charitable campaign for those with HIV and mental illness.

WITH her long limbs and perfect smile, Durga is strikingly beautiful. Sitting on an old blanket, surrounded by her few possessions, she looks poised and serene; out of place in such squalor. Only the gauntness of her frame provides a hint that she's close to death.

For most of her life, Durga's home has been the streets. She once had a job - albeit only doing domestic work - but then she contracted HIV. After that, her fate was sealed. Her family rejected her and in the eyes of the community, she ceased to exist. Weak from a prolapse (fallen womb) and with low immunity, she succumbed to TB. When she was found by Leah Pattison and her friend Usha Patil, she was void of hope.

"She was quite convinced that she was going to die and we were quite convinced that we didn't want her to die," says Leah, from Frosterley, in Weardale. "We've started her on TB treatment and then we're going to start her on anti retroviral treatment. After that, she can go for her operation for her prolapse."

After meeting at a leper colony, where Leah was a volunteer and Usha a patient, the pair devoted themselves to helping women victims of the disease, cast out from their families and shunned by society. They set up a charity - Start - and opened a clinic in Usha's home city of Nagpur. Yet while they already had their hands full caring for those with leprosy, they felt they couldn't let Durga down.

As they gradually got to know her, calling on her every day, they learned that her son had been taken from her - thrown from a window to his death by her now vanished husband. Her sisters, although wealthy, would not so much as spare her a few rupees, and her mother was content to let her die.

Full of anger, Leah and Usha went in search of Durga's mother and found a means of forcing her hand. "Basically, we threatened her that if she didn't bring her daughter food, we would bring Durga to her home," says 34-year-old Leah. "That was our greatest weapon."

Now Durga's health is fragile, but improving. When I ask to take her picture, she shows a poignant spark of dignity by insisting that she change her sari. She may not have much, but under Leah and Usha's care, her chance of living is the best that it could be.

I've come to visit Durga to see a new charity's work. Knowing many women who face problems other than leprosy, but being constrained by Start's remit, Leah and Usha have set up the second charity WIN, or Women In Need. While still in its infancy, it aims to cater for a broad spectrum of cases, offering health and social care to any woman in distress. As Leah puts it: "We feel that whatever we can do, we want to do it."

One of the key issues WIN hopes to tackle is the spiralling incidence of HIV. While on the surface, Indian society is strictly moral, in reality rape is common and prostitution rife. In the city slums, Aids awareness is often scant and in a male-led society, the real victims of the disease are women.

According to Leah, the situation may be even worse than in Africa. "Eighty per cent of the healthcare system in India is private and there have been no statistics from the private sector," she says. "The government is getting its statistics from people who are actually developing Aids, so who knows how many people are HIV positive? The estimate has been that there are 15 million who are living with HIV.

"At a local level, we've been given statistics by a general surgeon who's doing his own testing. His statistics are that one in four are HIV positive."

The human cost of this is felt by women like Durga, or Mina, another of WIN's cases. At just 22, she's watched her husband die of Aids and now she too is HIV positive. Although, as yet, it's unconfirmed, the child she cradles in her arms is likely also to be infected. Like many men, Mina's husband probably caught the virus in Nagpur's red light district, bringing it home without her knowledge. WIN is paying for her to learn embroidery, so that at least she can support herself.

Like others with HIV, what she's been told has been selective. "We choose what we say to these ladies," says Leah. "We've just said to her, 'you don't have to worry about the medical side'."

Another major problem faced by lower class women is mental illness. The pressure of poverty, especially when coupled with rejection, can understandably cause conditions like schizophrenia. Many of those living on the streets have deep psychoses and are thought to be possessed, yet for Leah and Usha, they're just women in need of help.

The first case they ever took on as part of WIN was that of a street woman, also called Mina, whose mental illness had left her destitute. When they found her, a wound to her head was teeming with maggots, and despite her protests, they tried to treat it. In the end they took her to hospital, only to find that doctors wouldn't touch her. It took sheer determination - and Leah's own money - to pay for a skin graft to save her life.

Now reunited with her mother, and with food and shelter provided by WIN, Mina is a different person. Her mental health has been restored through drugs and when she's ready, it's planned to settle her in a flat. Being raped while on the streets has left her with HIV, but she's responding well to treatment. While her future remains unclear, her shining eyes and broad smile are symbols of hope.

Without a base for the new charity, Leah and Usha must care for its women in a makeshift way, keeping up exhausting rounds of visits. In the long term, they aim to buy land, where they hope to build a permanent home.

"After some years, we may bring Start under the umbrella of WIN," says Leah. "We want to build a hospice and an out-patients' department - people shouldn't have to die on the streets. We also want to build workshops where the women can make cards. We would sell them in England as well as here and there would be a stamp for the words, so even women with deformities could use it. On the back of the card would be information about the woman who made it. The profits from this business would provide monthly salaries."

To sidestep the problem of finding doctors, Leah and Usha would target those with HIV. "We know that there are a lot of doctors in Nagpur who are HIV positive," says Leah.

Achieving her goal of changing many women's lives will be an uphill struggle, but she's confident of success. "We can't take on too much - we are realistic - but we're convinced that we can do it," says Leah. "The thing about Start is that it's consisted of a lot of luck. When things have got rough, we've lived in hope. We do need funds for WIN but if there's a genuine need, and people know there's a genuine need, they will give money. Maybe it's blind faith, but I believe in it."