Dr. Edward C. Riggs plans to spend the next five months lecturing in schools and churches and catching up on conversations with colleagues. His wife, Frances, is working toward her master's degree in nursing at Catholic University. All this is in sharp contrast to their work over the last five years.
The Riggs are medical missionaries with the United Church of Christ. They are currently living in Falls Church on a year's furlough after five years in south India.
"We're here as representatives of the American Leprosy Missions to explain to those who've donated money how we're using it," said Mrs. Riggs.
Missionary work is not new to the Riggs, who are descendants of four generations of missionaries.
"We both started our careers in China [in 1946] and met and married there," Mrs. Riggs, who is a nurse and midwife, said.
"We stayed in China until one year after the Communist takeover but found the people resented us because we were Americans," said Mrs. Riggs, who was born to missionary parents in China. "The Communists placed restrictions on us. We weren't allowed to go out of the city limits any more, so we left."
"We arrived in south India in 1951," said Riggs, "5 years after their independence, and it's been rapidly changing ever since." He is 64 and his wife, 57.
"We used to work in one of those old-fashioned leper colonies," said Riggs. "These people were in the advanced stages and were there just waiting to die. That was before there was an inexpensive, easy method of treatment."
Riggs shook his head in dejection. "It was a 200-bed hospital and there was a 10-year waiting list to get in. Of course, by the time patients got in, their disease was in the advanced stages."
Doctors now know that leprosy is caused by an organism that attacks its victim's skin and nerves. Most people are born with a resistance to the disease, but there are leprosy belts in tropical areas that carry a higher rate of the disease. Doctors still do not know how the disease spreads.
"When treated in the early stages, when a patient first notices numbness in hands or a light patch on his skin, the disease is easily cured through medicine," said Riggs. "However, due to the stigma which has been attached to the disease, many of those afflicted would not seek treatment, resulting in unsightly facial disfigurement, twisted hands and feet with loss of feeling and eventual blindness. A person won't die from leprosy and it could take half a lifetime for the disease to become advanced."
"We used to go from village to village on bicycles [later in a jeep] and set up roadside leprosy and turberculosis clinics," said Mrs. Riggs. "The villagers would come to us and we'd give them enough medicine for a week or a month, depending on how far away the village was."
"This was effective," said Mrs. Riggs. "However, we soon discovered that a lot of people who had leprosy would not come to our clinics because they were afraid of being identified as a leper and becoming social outcasts. So we began to call them general health clinics and treated all medical problems. No one knew whether a patient was suffering from diarrhea or did have leprosy."
"But now we're treating leprosy just like any other health problem," said Riggs. "We're spending more time on mothers and babies and malnutrition. The infant mortality rate used to be around 50 percent. But it's rapidly dropping."
Government health agencies now are training "community health guides" who are high school graduates, to go from door to door distributing medicine and checking to see that patients are taking it, looking for diseases and teaching mothers about balanced diets for their children.
"This is a very effective program," Riggs said, "and 8,000 leprosy cases in hiding were uncovered as a result. This makes our statistics look bad, because it looks like there are more cases of leprosy than when we started and that doesn't make the government very happy.
"We won't see the results of modern health care for probably 20 years when the older, advanced cases die off.
"One area in which I've made a mistake was being so rigid in the past about patients taking medicine orally whenever possible instead of by injection," said Riggs.
"I insisted on this because of the complications that can result from an injection. But the natives prefer the injection and have more faith in it because it hurts and they believe it therefore works better."
"When we see a child's health declining," Mrs. Riggs said, "we'll bring in the mother and teach her how to find nutritious food for her children. There are certain highly nutritious greens, found growing along roads, which we teach her to prepare. We also learned that many of them were workng in fields picking types of nutritious beans which they could have fed to their children. They listen to us when they see their children getting better.
"I've also taught mothers how to grow spinach and tomatoes in 'kitchen gardens.' They've been able to upgrade their diets a great deal this way."
Riggs has seen the life expectancy increase from the mid-30s to more than 50 years, principally as a result of control over epidemic diseases, such as malaria and smallpox, and a reduction in the infant mortality rate.
The Riggs believe part of the reason the people accepted them was that they lived among the villagers in the same type of modest hut. "If they see you down at the well getting water just like them, they're more inclined to trust your work," said Mrs. Riggs.
Despite the substandard conditions that have surrounded them, neither the Riggs nor their four children ever have been seriously sick.
In addition to general health care, when the Riggs return to India this spring, they will be continuing family planning education (only for those villagers who request it, according to Mrs. Riggs), and the training of new native doctors to eventually assume their practice.
Before returning to India, the Riggs will sign another 5-year contract with the United Church of Christ. "We don't know where we'll be going yet, but wherever we're needed, that's where we'll go," Mrs. Riggs said.