On 10 September 2006, I paid a return visit to Singapore Leprosy Relief Association (Silra) Home, exactly one year after it was relocated to new premises in Buangkok Green Medical Park.^* Walking through the multi-storied building, I saw many familiar faces, and we nodded and smiled at each other in acknowledgement.

 Explaining the reasons behind the move, the authorities said at the time that the old home was run down and the site was needed for a new school. Consequently, the relocation to a brand-new building with modern toilets and elevators in an accessible area was billed as progress. But for the aging residents, whose interests were yet again sacrificed in the name of moving forward, it represented one more act of dislocation in their lives.

 In the past, many had lived in Trafalgar Home − formerly the Singapore Leper Asylum − where they had jobs as cooks and cleaners, nursing aides and clerks. When Trafalgar closed in 1993, they were moved to Silra Home, minus their jobs in most cases. Then, last year, came the move to the new Silra Home in Buangkok Green.

 The shift to Buangkok Green is probably the final journey for the 60-odd residents, who are in their 60s to 90s, and about half of whom are wheelchair-bound.

　

　

 Some welcomed the move. A TV program from 2005 shows them applauding the new premises for being cleaner and free of mosquitoes. The dilapidated buildings at the old Silra Home (constructed in 1971) were a fire hazard. One resident remarked happily that they no longer risked being struck by falling ceiling beams that had been eaten through by termites.

 But for others, despite the better, modern living conditions, relocation has brought a fresh set of problems. In building the new facilities, the planners overlooked the basic needs of leprosy-affected persons. There is only one cubicle per toilet with wheelchair access and only three toilets in all for more than 20 male residents on the second level. The cubicle door handles, which conform to building standards, are too short to be gripped by those with hand disabilities. Residents must negotiate a ramp to access the wheelchair toilet. Wheeling up the ramp, residents have slipped and fallen on their heads.

 In the old Silra Home, they lived three or four to a room. Now they sleep on hospital beds, more than 20 to a ward. They have had to exchange their own clothes for hospital uniforms, even though, as some protested, they are not ill. Meanwhile, they have been joined by other, non-leprosy affected persons, admitted with skin diseases.

 The sleeping arrangements apply to married couples, too: Mr. Chan Mun Tuck and his wife are allocated two beds in one corner of the ward − the nearest thing they have to privacy. Mr. Chan and his wife have repeatedly asked for a partition but so far have received nothing but assurances.

 Many residents feel disillusioned and apprehensive and long for the old Silra Home. Mr. Song Kok Huar recognizes the cleanliness and lack of mosquitoes. But he reminds me that the old premises had trees, grass and better ventilation, and says the new home “can't beat that place.” Another couple, Mr. Kuang Wee Kee and Mdm Ow Ah Mui, decided against moving to the new premises and rented a one-room flat nearby. They disliked the communal living quarters and view the new home as “a camp.”

 Those who suffer most are individuals with serious disabilities, such as Mr. Joseph Tan, who is 84, blind, wheelchair-bound, and has hand disabilities. Once, he slipped on the toilet ramp and hurt the back of his head. “I'm accustomed to the old place,” he laments. Even after a year, he still can't find his way to the toilet by himself.

　

　

 Mr. Lim Kah Lee, a renowned painter and the de facto “voice” of Silra Home, says plainly that nothing has been done to address residents' complaints. “There is still no privacy and the ward is too open. It is too difficult to go to the bathroom to change our clothes every time, too inconvenient and troublesome.”

 Something did change, but only at a high cost. Mr. Lim and Mr. Tan Ah Boon related to me that Mr. Lim Ah Liat, a wheelchair-ridden resident in his 70s, went to the toilet on the second floor at night about two months ago. He fell off his wheelchair on the ramp when leaving the toilet, and died. Staff discovered his body at about 3.30 a.m.

 Mr. Lim had been unwell and taking medication, so it is difficult to say how much the fall had to do with his death. Soon after, volunteers staged a skit on how to use the toilet safely. More importantly, the management placed a large aluminium sheet with a patterned surface about four feet long over the ramp in two toilets on the second floor, reducing the angle of the incline and providing a better grip for the wheels.

 Mr. Lim Kah Lee tells me the sheets are being tested for a trial period and there have been no incidents since. The wheels of progress generally turn fast in Singapore but, despite many appeals by residents from the beginning over the toilet ramps, not quickly enough for when it comes to catering to the needs of former leprosy sufferers.

 Between those who look back nostalgically to the old home, and the few who reject the present Silra Home premises outright, the majority of residents have come to terms with their new environment, just as they have done repeatedly throughout their lives. The result is a perspective on life that straddles resilience and resignation.

 Mr. Lim Ah Hin, a charming man with a small, wiry frame and thick spectacles who plays the harmonica, says he is “simply waiting to die.” Mr. Tan Teow Meng, one of the most vigorous persons in the home, tells me, “I am now so old. The future? I will have no more road to walk. Now, what I wish for most is to simply pass my days, live my life, that's all.”

 At the very least, they deserve to live out their remaining years with all due consideration given to their needs and dignity.

　

 The article is based on interviews with the following residents of Silra Home, Singapore, in September-November 2005, and February and September 2006: Chan Mun Tuck, Kuang Wee Kee, Lim Ah Hin, Lim Kah Lee, Ow Ah Mui, Tan Ah Boon, Joseph Tan, and Tan Teow Meng.

　

　

　

 HANDA, which celebrated its 10th anniversary in August, is an organization of people affected by leprosy that was registered as an NGO in Guandong Province, China, in 1996. It works as a branch of IDEA − the International Association for Integration, Dignity and Economic Advancement − with a mission to promote dignity and respect among all human beings, particularly those affected by leprosy.

 Since its founding, HANDA has worked to eliminate social discrimination against affected persons and improve their quality of life through social, psychological, physical and economic rehabilitation. Activities include organizing skills training workshops; providing small loans to help start income-generating projects that lead to economic independence; I running a mobile eye unit and comprehensive foot-care project; helping children of affected persons go to school; and mobilizing social resources to improve the basic living conditions of those with leprosy. It also operates HANDA Quilt, a micro enterprise begun in 1997 that exports handicrafts to several countries.

 HANDA is now based in Guangzhou and is active in seven provinces in China. It has made rapid progress in its first decade, and will continue to help persons affected by leprosy as it works toward its goal of a world free of discrimination and full of equality.