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so you have Hansen's disease. Even though you may
have been ill for some time, we know that
being definitely diagnosed with this disease has probably been a
shock to you by now. In addition to shock
you may be experiencing other emotions as well.
Fear and uncertainty, dread and dismay. Or maybe
you're just plain scared and angry. While such feelings
are quite normal under the circumstances, we'd like to
relieve your mind as much as we can. The
best way to do that, we think, is
by giving you accurate facts and information about Hansen's disease
and through television, we'd like to introduce you to
five of Carville's staff members who can give you accurate
facts and information. We've asked these staff members representing
the clinical and rehabilitation branches to speak to you briefly
on their area of specialty and how it may relate
to you. First, we would like for you
to meet Dr Robert Jacobsen as chief of the clinical
branch. Dr. Jacobson directs our medical staff of
doctors and nurses. I am pleased to have this
opportunity to welcome you to Carville and to talk to
you today on videotape about your illness. I believe
that what I tell you will answer most of your
questions. But if not, please don't hesitate to
ask your doctor about anything that concerns you. I
am convinced that the more you know about your disease
the more smoothly treatment will go now. Hansen's
disease is an infection, which can involve the skin
the nerves, the eyes and the nose and
throat. Mild cases referred to as tubercular oId will
involve only a small area of the skin and one
or two nerves, while more severe types called I'm
Orpheus and the prominence may involve most of the skin
and many nerves, as well as the eyes,
nose and throat. It is caused by a bacteria
which is known as mycobacterium leprae, which in
many ways is like the one that causes tuberculosis.
Because the disease involves nerves, it can lead to
loss of feeling or numbness in some areas or weakness
in the hands, feet or face. Some of
you will already have these. When your disease is
diagnosed, we can help you adjust to it and
often at least partly correct any weakness with surgery.
Those of you who have no significant weakness or numbness
have an excellent chance of avoiding these problems. If
you faithfully follow your doctor's directions regarding treatment while you
are here at Kerrville, you will, of course
see many patients who have severe deformities or blindness
in most of these. This occurred many years ago
before we had so many effective medicines to manage
this disease and therefore probably would not have occurred today
In a few of these things are the results
of not taking treatment as it was prescribed and could
have been avoided had they followed their doctor's advice.
It is very unlikely that any of you will end
up with severe problems. Treatment will usually be with
a drug we call DAP sonar DDS, although some
of you, for various reasons, may be advised
to take other medicines or more than one medicine.
Your doctor will always carefully explain the reason for this
to you and ask that you sign a consent giving
your permission for him to prescribe these for your case
Those of you with mild disease may need to
take treatment only a few years, but those of
you with severe disease will need to stay on it
for life. This is necessary because we know that
a few living bacteria may still remain hidden away in
nerves or elsewhere. Taking medicine for life will then
protect you from the disease ever becoming active again.
Periodically, we will check the effectiveness of your medicines
and treatment by routine tests such as skin smears or
skin biopsies. All of the drugs we prescribe are
very safe, and you can take any of them
at home. Those of you taking an investigational drug
may have to return every 2 to 6 months for
follow up. However, even if this is not
the necessary, any of you with more extensive disease
may benefit from returning here every year or two for
a brief visit to let us evaluate how treatment is
progressing. How long this your first visit here will
last depends very much on how many problems you have
but usually 1 to 2 weeks is sufficient.
I'm sure many of you worry about where you got
your disease. For most of you, it will
never be known. It probably, however, resulted
from unknown contact with another patient several years ago.
The reason for this long time between exposure and appearance
of the disease is that the bacteria that cause it
grow very slowly. The numbers of your family have
less than one chance in 10 of also developing the
disease, and even if they do, they may
not have gotten it from you, but from the
same contact that gave you your disease. If you
take your treatment regularly, your disease will become non
contagious very quickly and will stay that way as long
as you continue the treatment as prescribed by your doctor
Because your family has been exposed. However,
they should be checked by your local doctor or the
doctor here at Kerrville once or twice a year for
at least five years and sooner. If any unusual
skin changes, numbness or muscle weakness occurs when you
leave here, you should be able to lead a
completely normal life, except for any limitations that numbness
or weakness you already have may impose on you.
You can live with your family, work at your
usual job and associate with your friends just as you
always have. You can in fact, expect to
have a normal lifespan, since this disease has no
significant effect on how long you will live. Finally
there are a few things that you should keep
in mind when you leave. First of all,
if you have any areas of numbness that might be
injured in the course of your normal daily activities,
learn the various ways you can protect them while you
are here and put into practice what you have learned
When you get home. Your doctor, occupational therapy
and others will be glad to help you with this
If you do develop any injury, see that
it is promptly cared for. Secondly, some of
you will later get what we call reactions. Your
doctor will talk to you in more detail about this
and advise you what to do. But briefly,
this usually appears with fever and tender red bumps on
the skin or swelling of your old skin spots.
Pains in some of your nerves, aches in your
joints and so on may also occur. It is
very important that you see your doctor at once.
If this should happen, since it can be treated
and in this way, damage to your nerves and
skin can be reduced or avoided entirely. In some
cases where reactions last a long time, we may
advise you to take one of our investigational medicines to
control it. Problem, by the way, is
not caused by any of your medicines, but instead
it is the result of either a kind of allergy
to the products of the bacteria being killed by the
medicine or to an improvement in your immunity with treatment
Thirdly, although there are no major limitations on
your activity, you should avoid excessive exertion or emotional
stress as far as possible, since these may sometimes
lead to the reactive episodes I have just described.
Get plenty of rest and eat properly. Lastly,
always take your medicines as prescribed. You can only
hurt yourself by missing doses of the medicine again.
Don't be afraid to ask questions. We're all here
to help you in any way we can. Thank
you. Next. We would like for you to
meet Sister Merida, chief of the pharmacy department.
This is your pharmacy, and I would like to
familiarize you with the pharmacy service you'll receive well.
Carville, The most important medication used in this hospital
are the anti leprosy drugs. There are several types
of medicine available for the treatment of hands and disease
You may be put on one or a combination
of some of these medications as your place on this
medicine. The effect of each will be explained to
you. It is very important, and I cannot
stress enough the word important that you follow your doctor's
order regarding your treatment. This includes your compliance with
drug therapy. The pharmacy is talking in such a
way as to meet any kind of therapy you might
need. Like in the course of your stay at
Carville, the doctors treat the whole person so you
could be placed on additional medication if needed. An
example of that will be if you're a cardiac,
you'll be placed on medication for your heart. And
if you're a diabetic, you'll be placed on medication
for your diabetes. The role and the responsibility of
the pharmacy personnel is to cancel the patient. As
to the safe and effective use of medication, communication
is a tool that we will use. We have
by the pharmacy window a poster which reads before you
leave. Please be sure you understand all directions on
how to take your medication to better understand your doctor
prescription, read and follow the instructions on the label
of your medication containers. They will tell you exactly
when and how to take them, and they are
properly labeled. Should you have any question whatsoever regarding
your drug therapy Peace? Uh, feel free to
contact your pharmacy or your pharmacy technician will be very
glad to help you. Thank you. Now meet
Mr Harry Berg called chief of the physical therapy department
The physical therapy department is concerned with hands and
feet. Hansen disease often involves the nerves which affect
your feeling in your hands and your feet, and
also sometimes affects how your muscles work and your hands
and your feet. So physical therapy primarily works and
is interested and how the hands and feet work.
Now we mainly work in three general areas. The
first. If you just have been admitted to the
hospital, you would come for an evaluation in which
we would check for the nerve damage by several different
methods, which we'll talk about it a little bit
The second thing is we often teach exercises,
uh, for your hands, feet and lower legs
which can sometimes strengthen muscles and prevent some deformity
The third thing, and probably the most important
thing we have to offer, is to try to
help you the patient. Understand the problems that you
may have with your hands and feet so that you
can do better at your home and prevent more problems
that may arise. Let's look at some of the
tests that we may use when you first come to
the physical therapy department. One. We take a
footprint test. I'll show you one. This is
an example we have. You walk on a mat
and when you finish, it shows where the
high pressure points are on your feet. As you
can see in this footprint, the largest pressures in
the center of the 4 ft. This may be
an area that may take a special sort of in
Seoul in your shoe. If you had some problem
with sensation or the feeling in your foot, another
thing we would probably do is check your sensation,
how well your hands and feet feel. We often
use a little nylon, and we would check different
areas and see how well you feel. We may
do this on your feet as well. Another test
We would test your muscle function. We would
see how well your foot works. Can you pull
your foot up Can you put your foot down properly
We may check your hands, See if you
can make this sort of position. If you can't
make this position well, you may have a little
nerve damage and your hand may get in this sort
of position. We would also test your nerves and
see if they are working properly or not. And
we use an expensive type of machine to do this
sort of test called a nerve conduction test. We
also sometimes check temperature. We have another expensive machine
that finds if you have areas that are hot and
these point out to areas which are inflamed and may
lead to an injury if they're not treated properly.
And this is really important when you have a hand
or foot that lacks proper feeling. Okay, now
that we have evaluated your problems and have an idea
of what is going on with you, we try
to do something about the ones that we can.
One thing we mentioned before we teach you some special
exercises to prevent any increase in your weakness or in
your deformity. These are exercises that you can do
on your own at your home when you were discharged
If you have a lot of weakness, we
may make a special splint for your hand or for
your foot to maintain the proper positions. If you
have a wound on your foot, we may make
a plaster cast, such as somebody would have when
they had a fractured leg in which you could then
get up and walk around while the wound healed.
Mhm. And most important, we try to help
out you to understand how to take care of your
own problems. If you have dry skin, which
is often a problem enhancing disease, we can instruct
you, or the occupational therapy department may help you
learn how to soak in water and then put a
lotion or Vaseline on your hands and feet to keep
them moist and to prevent cracks. If you have
calluses on your feet, we can show you how
to care for those heavy calluses become problems and can
create wounds. We can show you how to use
sandpaper to remove those and keep those down to a
minimum level. One can go over what areas on
your hands and feet that you need to inspect for
injuries. If you have a sensory loss and don't
have proper feeling. There's certain things that you should
look for and probably most important for your feet.
If you don't have feelings that you have the proper
footwear, there's a shoe shop which is nearby.
The physical therapy department, which orders shoes, modifies
them, makes any sort of changes that they need
for you to do well. Some other things that
you may see going on in physical therapy when you
were here is that we help people before their surgeries
If they have some sort of major hand or
foot problem, they perform surgery, and physical therapy
would help them with their exercises. And they're splitting
around the surgery surgery time. Also, physical therapy
usually and other hospitals takes care of the aches
and pains that you get in your shoulder or your
sprained ankles. And so we give exercises and have
various heat treatments to help the needs. But our
main purpose at this hospital, I think, is
to try to help you understand the problems that may
arise or that you presently have and be able to
deal with them yourself. And if you ever have
any questions while you're here we are always open to
try to help you and answer them any way we
can or send you to somebody else who could answer
your questions. Helen Rahm. Sammy is chief of
the occupational therapy Department. I'm going to talk to
you about the care of your hands. Basically,
there are three problems that could arise. You may
have one of these problems. You may have all
of them or you may never have any of these
problems they will have to do with you're feeling.
They also will have to do with the texture of
your hands, whether they're dry, rough and scaly
And it will do also have to do with
the motion in your fingers. The problem of you're
feeling okay may come about when you notice that you're
cooking and you had part that was boiling and you
put your hand over it and found that you burned
your arm and you really did not feel that you
could get yourself cut and not feel the pain.
You may have some Kleenex in your pocket and you're
reaching for that. And you can't feel that Kleenex
any longer because you've lost the light touch in your
fingers. These problems can be solved by wearing protective
mittens when you're cooking or gloves. When you're doing
your gardening, perhaps you have a key to open
your door, and it is giving you traumas on
your fingers, your breaking your skin Every time that
you turn your key, you can pad all of
these things. These are daily living items that you
must watch and see that you take care of them
so they're not hazardous. The the problem of your
dryness in your hands can be remedied by soaking for
20 minutes every day, at least once daily.
It's best to try to soak before you go to
bed because you're going to put Vaseline on your hands
to hold the moisture in. And at the same
time you're going to do some massaging exercises, and
you will also be doing some exercises. Two.
Remedy the contractors that you might get in your middle
joints of your fingers. The nerves that that govern
your motion can become involved, and you may notice
that your middle joints on your fingers are starting to
bend downward. It may start with your little finger
and your ring finger first But if you notice this
then these exercises will be very good for that
You put your palm of your right hand on
the palm of your left hand and stroke out to
the ends of your fingers. If you already have
some slight contractors, this will help to give motion
in your joints and also stretch your skin. You
do that with the opposite hand the same way do
these exercises, perhaps about 20 times and maybe two
or three times a day on your admission to this
hospital, you will have, um, the opportunity
to come to occupational therapy. And we can explain
more of these exercises and why we do them give
you any literature that can help you, uh,
refresh your memory on them. And be glad to
answer any questions that you will have about these things
that we're speaking of. And now meet Dr Margaret
Brand of the Ophthalmology Department. I want to welcome
you today to the eye clinic where I am right
now, and in this place with Sister elaborate as
my assistant, we see every patient who comes to
the hospital. Perhaps you already have been here by
the time you see this video tape now, you
might say, Why do I have to come to
the eye clinic? I had my glasses checked,
and I'm under a doctor at home. Well,
that's fine. Uh, if you don't have glasses
that suit you, let me just say that we'll
be pleased to try and help you while you're here
But coming back to the question, why should
people come to the eye clinic? Is there some
reason in this disease that we want to know what's
going on in the eye? The answer is yes
There are definite problems, and some individuals may
escape without any of them, and some people might
have quite a lot of trouble. And we want
to know if they're likely to what's going on and
then be able to take the necessary steps and precautions
so that we can control those problems. Yeah.
Now you might want to know what kind of things
we're looking for. First of all, like any
other parts of the body, this disease affects the
surface, the surface nerves. You've probably been told
about the nerves, your hands and your feet.
Perhaps you already have trouble there. Perhaps you haven't
realized that you've got a nerve that comes up in
the face and that makes the muscles of your eyelids
work so that you can blink so that you can
close your eyes when you go to sleep. Now
if something happens to that nerve, you may
not be able to do these things. You may
just find that you don't sleep with your eyes closed
or that you might have a blink that doesn't always
work. Doesn't go the whole closing every time you
try to close your eyes to shut, and you
should be blinking about every 20 seconds to keep your
eyes nice and moist and seeing well and feeling good
So that's one thing that can happen. Another
thing is that you might just lose a little bit
of the feeling in your eyes so that even if
they got dry, you perhaps wouldn't know it.
And this can be serious. We want to find
out whether you have a good feeling in your eyes
good enough to protect them. And then in certain
individuals, the bacteria actually can take up residents in
the eyes. You might say they get into the
front part of the eyes. Now, perhaps you
know something about your I Maybe you know what I'm
saying when I say the cornea that's like the crystal
on your watch. The front clear part of the
eye through which you're seeing is the window of your
eye. Well, we can find out if you've
got the organisms in there and they can get their
quite early in the disease. And we want to
know because it's important that we know exactly what is
happening. What is the status of your eyes?
You won't feel them. They won't hurt. You
won't have any redness. You won't see any differently
but we can find them. We can see
them. I'll show you in a minute. The
instrument that will sit you at and chick and then
some individuals can also get inflammation in the eyes,
and this can lead to problems if it's not controlled
We want to find out if you have that
inflammation, if you're likely to get it and or
even to be able to tell you that you're not
likely to get it, and that will be good
news, too, I'm sure. Then there are
some individuals who have a problem with glaucoma. It
may be related to the Hansen's disease. It may
be quite independent, but we want to find out
about it. We want to know we want to
be able to control it so that your eyes will
stay good the rest of your life. And so
while you're here at Kerrville, you will come to
the eye clinic and we'll take your vision. Sister
will do a tear test. By the way,
you will meet sister elaborate When you come to,
she's my clinic nurse. She will do some tests
and I will do something. And then I will
look at you with this instrument. It's a microscope
a rather nice microscope, and I can see
a lot of detail that wouldn't ordinarily show up.
And you will come here for the first examination,
and then you will come subsequently every three months if
you were going to be here. But perhaps if
you're going home, then we'll just say, Whenever
you come in, come back and see us and
get another check up. We want to keep monitoring
new carefully. Well, you might say, Is
there a chance I could actually go blind? And
the answer to that is not very much chance providing
providing you one take your medicine like we tell
you. And two that you would know what to
look for if I problems occur and that you would
go to see a doctor or come back here.
And if we give you instructions and give you drops
like I was showing a minute ago and and you
use those, then the chances are very good that
whatever your problem, it can be controlled. But
you might say even since I've been in this hospital
I have seen people who have gone blind.
Couldn't you help them? Well, the answer is
for most of those people. They came here too
late for us to do very much for them or
they had not had treatment or they started on treatment
and they didn't keep it up. Perhaps they thought
they didn't need it, and their disease became worse
again. And sometimes it is harder if the second
time, if the disease gets worse, it's harder
to take care of the eye problems. They can
often be very severe, But don't let that happen
to you. You just take your medicine like you're
told and be faithful. And the chances are that
even if we find the disease right now, the
first time you come, we can say to you
probably within months or within a year or two
the disease will have cleared from your eyes.
This doesn't mean to say you could never have another
eye problem. Supposing you can't close your eyes.
You'll always have a little bit of a problem.
You'll always have to do something like using tear drops
or shielding your eye at night. But we'll give
you instructions about that, or you might have a
little problem with inflammation, and we'll have to tell
you what to do about that. The main thing
is that you don't have to go blind. We've
got you here in time and there's a good chance
that you won't lose any site at all. And
as I said before, we will watch for changes
of your glasses prescription. If you have to have
surgery, we can offer that we can do a
lot of special investigations and if we can't do them
here, we will send you over to New Orleans
where they've got a very well equipped by department
and they'll take care of you there and so we
can look forward to some very hopeful and very happy
years together. I hope that you'll always come back
and see us and that you will come any time
You have a question? We're here every day
throughout the week. If I can't immediately see you
just elaborate, perhaps can answer your question.
Or she will set you up with an appointment to
talk to me and to share with me any problem
that you have. Don't worry. We do care
We have equipment, we have the experience and
we know that we can say fairly confidently, You're
going to do fine. So that's just get on
and work together and make sure that your eyes keep
seeing just as they do today. We hope that
you now have a clearer understanding of Hansen's disease,
an understanding based on accuracy and not hearsay. We
have a few more things we would like to show
you. But first we would like for you to
meet the director of our hospital. Dr John Trautman
Hello. Speaking for all of us at Carville
I want to welcome you. We're going to
try to give you the best care possible at this
hospital and help you to the extent possible. Otherwise
I hope you stay here, however, will
be a short one. Now, I know that
hospital life is oftentimes not pleasant, but we are
going to try to make it as comfortable as we
can for you. And we want you to feel
at home, no matter how long you stay here
Now Carville is a much better place to be
than it was some years ago. We don't call
it a leprosy. Very um anymore. For instance
the official name is the United States Public Health
Service Hospital. And soon it will be called the
National Hansen's Disease Center, which I think is another
step in the right direction. We have rules,
but we try to keep things a little bit relaxed
and still give you the care you need. Carville
is an excellent hospital, believe me. But we
also know there is always room for improvement. Now
if there's anything you feel we can do to
make your stay here a better one, please let
us know. Now the best way to do this
is to contact a representative of the patient Federation,
but the hospital staff and I are also available.
If you feel you need to contact us personally still
we know we won't be able to please everybody
All of the time. We're going to do
the very best we can. The staff that is
going to care for you is the best in the
world. Each of each of them is here to
help you. So again, please accept my sincere
welcome to Kerrville. Now, at this time,
we would like to tell you a bit about Carville's
history and then show you some of the unique aspects
and activities of our hospital. Thanks. Yeah,
yeah. When the first eight patients arrived in 18
94 from New Orleans, they found this crumbling plantation
site known as Indian camp, the old Woodlawn Plantation
the deserted home of a Confederate army general.
The patients remained basically alone until four Catholic nuns,
Sisters of Charity of ST Vincent de Paul, came
to minister to them in 18 96. After being
run by the state of Louisiana for 27 years,
the hospital became a federal institution in 1921 today,
the United States Public Health Service Hospital still stands near
the banks of the Mississippi River with a proud international
reputation for treatment, research and training related to Hansen's
disease. The hospital is staffed by uniformed commissioned officers
of the United States Public Health Service, the Sisters
of Charity and federal Civil Service employees You may see
either in uniform are in civilian clothes today. Carville
like any other hospital, has departments such as
X ray admissions, the laboratory surgery and others routine
areas, which you have probably already seen our Macy
during your stay. Right now, though, we
would like to give you an inside glimpse of some
of the other activities and services around Carville, which
are available and might be of interest to you.
A great deal of the activity at Kerrville centers around
the recreation building on the first floor of the recreation
building, you will find the patient's canteen as a
focal point of activity. The canteen sells a number
of items drinks, sandwiches, canned goods, fruit
and toiletries. You'll also find the canteen is a
lively spot for socializing and exchanging bits of news between
friends are new acquaintances. Next door to the canteen
is Carville's many post office offering. All of the
regular postal services. The post office gives mail service
five days a week and an important note. While
you're here at Kerrville, your mailing address will be
Pointe Claire Branch, Carville, Louisiana, 707 to
1. Find to television lounges, each furnished comfortably
and with color televisions. You'll also find the movie
theater, where late run movies are shown several nights
each week, some of them with Spanish language soundtracks
You can check the bulletin board by the canteen
for movie titles and times and other special events.
There's a patient library on the first floor to which
offers an excellent selection of current newspapers, popular magazines
and lots of best selling books. Library also has
a wide selection of talking books available both on record
and audio cassette. Claim the stairs. And on
the second floor of the recreation building, you'll discover
a grand ballroom often used for bingos, musical programs
dances and fairs throughout the year. On a
daily basis in the ballroom, you'll probably be able
to find someone to challenge in a game of ping
pong, maybe a hand of dominoes, our a
game of poo and you'll also find to recreation specialist
to assist you if needed. Looking out from the
balcony of the ballroom, you can see a nine
hole golf course used by patients, staff members and
their invited guests. Golf carts, equipment and a
few initial lessons are available for you. Invitational golf
tournaments are held twice yearly at Carville and include golfers
from surrounding areas who compete with the local golfers.
If you enjoy the outdoors and water, you will
find fishing, picnicking and paddle boating available at Lake
Johansson, located on the back corner of the hospital
grounds, several fishing rodeos are held on the lake
in the spring and summer. Back indoors now and
actually in house 24. Near the Recreation building is
a unique feature at Carville, the shopping mall run
mainly by patients. Why inside you'll find a barbershop
to novelty shops. Washington area, a beauty shop
bicycle repair shop and a bank office offering most
banking services. Now, if you should have to
stay at the hospital for a longer period of time
you'll be assigned a room in one of the
dormitories and you'll be able to take your meals in
the patient's cafeteria and again if you have to stay
for a longer period of time. You may be
interested in the services of the vocational rehabilitation department.
A counselor is available who can, after an interview
suggest an activity for you, such as testing,
training, employment are attending the local school. Various
test can be conducted by the department and are usually
done before a patient is sent for. Vocational training
which is available either at a local trade school
or college, are which may be arranged at a
school in your home state. Also within the vocational
rehabilitation department is an area known as manual arts.
If you enjoy constructive activities, you'll be able to
work with wood Are plexiglass projects. Patient employment may
be a possibility for you if you're at the hospital
for several weeks. Jobs may vary from hospital tour
guide research Animal care attendant housekeeping aide Printing classman are
maybe work in the sheltered workshop, making popular fishing
lures. Mhm. No mhm Carvilles. Local school
fully accredited with two full time teachers, conducts
classes eight hours a day. You may check with
the teachers if you're interested in educational opportunities. Aside
from the various occupational and educational activities, a social
work department is available at Carville and interested in talking
with you and your family about aspects of your life
which may be affected by a Hansen's disease diagnosis
and hospitalization. Whether in your room or in their
office, you may ask to see a male or
female social worker and discuss any personal or family matter
financial concern, housing or transportation problem you may encounter
We might also mention that to full time chaplains
Protestant and Catholic are available at Carville for matters
of spiritual concern. Our counseling. You'll probably see
the chaplains as they make their rounds, either in
your room or possibly out in the hospital corridors.
Uh huh. Located near the front of the hospital
grounds, the Union Protestant Chapel and the Catholic Sacred
Heart Chapel are open at all times and offer regular
services. Church service times and many other announcements of
events and activities are published in the hospitals Weekly paper
called The Question Mark our QM. For short,
this is a free publication distributed at various points around
the hospital by the school's students. Another very unique
activity at Kerrville we'd like to tell you about is
the patient owned and printed International magazine called The Star
The star disperses educational information on Hansen's disease to
more than 100 foreign countries and the United States,
with the circulation of about 100,000. Its purpose is
to provide vocational rehabilitation to patients while promoting an educated
public opinion on Hansen's disease. We'll mention also that
reprints and educational materials about Hansen's disease are available at
the hospitals training branch for your family and friends.
The training branch will mail the materials for you at
your request. Finally, during your stay at Kerrville
feel free to ask questions when something is not
clear to you. All of our staff members are
here to serve you and make your stay as pleasant
and profitable as possible. Mhm wow!