After spending 10 days in a country where leprosy runs riot, a budding Hawke's Bay doctor has been inspired to fight back against the disease.
Agrani Ratnayake has been in Nepal learning first-hand about the devastating impact of leprosy.
The former Hastings Girls' High school student, originally from Sri Lanka, moved to the Bay when she was 13.
Now a third year of Bachelor of Medicine and Surgery student at the University of Auckland, Ms Ratnayake has been on a life changing journey to Southeast Asia witnessing the effects of the indiscriminate disease.
Ms Ratnayake said she had no idea leprosy was still so prevalent around the world.
"I didn't know that this disease was still highly stigmatised and patient discriminated against in their own communities."
She said we have so many opportunities to receive medical care in this country and it felt very wrong to her that people in Nepal have such little access to it.
Since 2011, the Leprosy Mission New Zealand (LMNZ) has been taking young medical students from around New Zealand to visit Nepal.
The aim is for young doctors-in-training to experience Nepalese culture, interact with leprosy affected patients and learn about the hardships that they and the doctors at the hospital face.
She described the experience as incredible.
"Everyday I was reminded how privileged I am in New Zealand."
The group only had four hours of electricity every day at the training centre at Anandaban where they stayed.
"It was around five or six degrees in the morning when we had cold showers.
"All over Kathmandu, we would see vehicles queued for maybe a half a kilometre for petrol.
"Every day I realised how much I have taken everything for granted."
In most areas of Nepal medical care is very scarce, which means people go undiagnosed and untreated for years.
"This means patients will have severe deformities and ulcers in their feet and hands, resulting in amputation."
The patients had nodules and scars all over their skin.
When physical signs of leprosy start to show, affected people are turned away from jobs and their families.
However, despite common belief, within 24 hours of multi-drug treatment, patients become non-infectious and safe to interact with.
"They are the loveliest, most humble and strongest people I have ever met."
She said leprosy patients lose all sensations in their extremities due to nerve damage.
"What was incredible was a patient undergoing surgery walked into the theatre and jumped on the table himself," she said.
"The entire surgery was also done under no anaesthesia (since patient had no sensation anyway)."
She said this was not something you saw in New Zealand hospitals.
Ms Ratnayake said hand reconstructive surgery was the most innovative of the surgeries she went to.
Patients often get what they call a "clawed hand" where fingers are always flexed and they can't extend the fingers.
"For this, the orthopaedic surgeon finds a viable tendon, splits it into four and re-inserts it into the bones, allowing patient control of their fingers.
"It's honestly the most incredible surgery."
She said some patients could not close their eyes due to their illness and their eyes dried out, becoming infected. Eventually they could lose their sight.
Ms Ratnayake said the surgery to fix this involves taking a tendon from around the jaw and reinserting it around the eye.
This way when the patient opens their mouth, so do their eye lids.
"They don't have the state-of-the art equipment but they make do in the most innovative ways," she said.
A lot of the leprosy patients were affected by the earthquake more so than other people because of their inability to get outside.
"Some lost family members because they couldn't help them out of the collapsed houses.
She said that despite the hardships, patients didn't let the disease take their lives.
"There were women who had no fingers knitting gloves or scarves.
"There was a man who did amazing paintings and all the patients had the biggest smiles on their faces every time we visited them," Ms Ratnayake said. "They ended up teaching us what true resilience and strength is."
Ms Ratnayake now plans to specialise in surgery and return to South-east Asia to work in hospitals.
This year, the goal of LMNZ is to raise $28,000 to gift the hospital a four-wheel drive.
- If you wish to assist with the cause, please visit: https://givealittle.co.nz/cause/youthadvocates2016.