The German doctor Ruth Pfau, born in Leipzig on Sept 9, 1929, first arrived in Karachi in 1960. She established 157 leprosy clinics across Pakistan, combed its inaccessible regions to treat patients and developed the National Leprosy Control Programme, as a result of which the World Health Organisation declared leprosy a controlled disease in Pakistan in 1996. Pfau passed away in Karachi on Aug 10, 2017.

In revisiting her autobiography, what strikes one most is this: that the story of Pfau in Pakistan is a story of love, and that 20 years later this love might well not have lived.

Pfau was certain that she belonged in Pakistan, wanted to be in Pakistan. No, she was not at home in Pakistan. Rather, it grew to be a part of her, it was her country: “I am a foreigner and will remain one. And still; returning is a kind of homecoming for me, because this country, after so many long years, has become my home.” [sic]

Dr Ruth Pfau’s raison d’être is of greater relevance to Pakistan’s existential questions now than when she articulated it in 1987

This experience of being both insider and outsider does not preclude a certain intimacy. Pakistan evoked in her emotions — pride, compassion, fear and frustration — that every inhabitant attached to a place experiences. “Yes, I love Pakistan. I love it with every beat of my heart — with helpless pain and surging anger when I see the social injustice and lack of concern.”

She was four when the Nazis came to power in Germany, 10 when the Second World War broke out. Among her memories of everyday life, two in particular point to an early consciousness about the theme of suffering.

One was of a lesson in class in which she heard a sentence that shook her: “The greatest bravery is to look on unconcerned when someone is suffering.” Pfau was inconsolable at this and ran home.

The other memory was of reading a story about a prison camp: one of the warders is unable to bear witness to the suffering of the inmates and disappears. Several months later his friend, who is tasked with carrying out a dying prisoner, recognises him in the heap of skin and bones he picks up. The warder’s last words always stayed with her: “It is much more difficult to stand by and look on than being there and suffering together.”

Pfau appeared to mirror the warder’s decision when she first accompanied Berenice, a Mexican nun and qualified pharmacist, to Karachi’s Leprosy Colony on what was then McLeod Road. Whereas middle-class retrospectives of the 1950s and ’60s nostalgically portray Karachi as a clean, lively and beautiful city, a symbol of the religiously inspired ideals of social equality and solidarity upon which Pakistan was founded, Pfau described the wretched conditions of this illegal settlement situated right next to Karachi’s commercial and banking centre: “Here, the poorest of the poor, beggars suffering from leprosy, simply vegetated — in huts made of cardboard boxes, bamboo sticks covered with rotting gunny bags, some just a pair of ragged straw mats joined together — none of them water-proof. And, in the midst of everything, this misery: this lamentable and hopeless misery: deformed anaesthetic hands and feet, a prey for rats at night; filth and vermin; drugs and brawls. About 150 leprosy patients lived here in indescribable filth. Unimaginable, yet real, even by Karachi standards at the time. A colony in the middle of the city, in a kind of hollow which during the rainy season became actually knee-deep in filthy drainage water; a stinking lake of horror and misery.” [sic]

The Marie Adelaide Leprosy Dispensary at the time was a hot, smelly, noisy shack of eight by eight metres with two small windows and no access to water or electricity. A man who was roughly the same age, who possessed the same right to dignity as she did, crawled in on his hands and feet: “Like a dog, on all fours.” And no one seemed the least bit perturbed.

“In the post-war years in Germany people at least used to say, ‘It can’t go on like this any more.’ Here, nobody thought of saying anything like that. … I have rarely, very rarely, attacks of sudden rage, moments in which I am no longer in control of myself. Suddenly I knew — something had to happen here. But how? Something had to be done on the spot. ‘Berenice,’ I said with suppressed emotion, ‘Berenice, it can’t go on any more like this. We will have to do something to change things!’ My heart was pounding. It was like when one meets one’s greatest love. Once and for all times I had now decided. And it was to be forever. And everything else was only the outcome of that moment in the beggar colony in McLeod Road.” [sic]

Pfau began to search for the meaning of life and death when she was a student of medicine. Her parents had fostered in their children an inclination to disobey authority. They were not raised with a specific ideology or system of values. The belief systems and patterns of thought that were emerging in post-war Germany were partly shaped by the cultural and political values of the United States. It was utilitarian, superficial and materialistic and Pfau did not want to be a part of it.

She became interested in Catholicism especially because of its sympathy toward the ‘other’, and its emphasis on mysticism as expressed by Thomas Aquinas: “Man will never be able to grasp even the essence of a single mosquito.” She knew her search had come to an end when she read the words of John of Damascus: “The Divine is incomprehensible and infinite; and this only is comprehensible about it: the infinity and the incomprehensibility.”

She decided that she wanted to enter an order and chose the Daughters of the Heart of Mary, founded by a lady of nobility, that emerged as an underground movement during the French Revolution.

In Pakistan, Pfau felt accepted because of her spirituality and she, in turn, found it easier to live her religious vocation in a society where believing in God and the metaphysical came naturally to people. For her, the “dividing line [was] not Islam and Christianity but spirituality and superficial materialism.”

Gen Ziaul Haq’s laudatory preface to her book does not engage with these philosophical themes that are quite central to the discussion, and actually kindred to that of philosopher-poet Allama Muhammad Iqbal who inspired the movement for Pakistan. Indeed, it would not be farfetched to suggest that Pfau was the embodiment of Iqbal’s concept of insan-i-kamil (perfect human).

Pfau’s relationship with God found expression in her relationship with the world. Her decisive, consistent love for Pakistan in all its beauty and its awfulness was an everyday expression of her love for God and mankind. It was an ishq supreme.

The reviewer is an anthropologist based in the Netherlands

Published in Dawn, Books & Authors, August 27th, 2017