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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!