In 1949, almost 20 years before Julie Andrew immortalised the image of a carefree nun in The Sound of Music as she sang and danced her way across the hills of Central Europe, another young woman made a similar trek across Germany. She wasn’t a nun, not as yet. But Dr Ruth Katharina Martha Pfau, born in Leipzig , Germany in 1929, would go on to become the founder of the Mary Adelaide Leprosy Centre (MALC) in Karachi and arguably Pakistan’s most famous social worker. Here, she talks to Dawn about her early years: the strange, gutsy path she took to study medicine and the even stranger twist of fate that brought her to Pakistan.

“I couldn’t get admission in an East German institution,” she recalls. “There were a number of factors — for instance, your parents had to be members of the [Communist] Party. In West Germany, you simply had to pass an entrance test.”

So young Ruth crossed over (illegally) to the western side, traversing perilously for two days straight through an endless stretch of woods. She made the journey alone and, at one point, was apprehended by a soldier from the Eastern side. Instead of sending her back, however, he showed her the way. “And thank God for that,” she says ruefully, “I was completely lost otherwise.”

Was she scared at the time? Her wrinkled face furrows further. “I can’t remember,” she says with a laugh. “Now I think of it as one big adventure.”

She studied medicine at the universities of Mainz and Marburg in West Germany and after graduation, joined the Catholic Order of the ‘Daughters of the Heart of Mary’. Her Congregation decided to send her to a mission station in India but due to visa problems, she was forced to stopover in Karachi. “They said, at the time, it would be easier to get an Indian visa from Pakistan.”

Her early recollections of Karachi are mostly cobwebbed and dusty, but one image lingers: rows and rows of Indian refugees lining the streets of the city, camping on pavements, huddling morosely under makeshift tents.

“Pakistan had nothing to welcome them with,” Dr Pfau recalls grimly. “A huge number of diseases spread through the camps: malaria, cholera, typhoid. Mass vaccinations were required. I was amazed that this didn’t lead to conflict and crime…I guess they were too hungry, too exhausted, too focussed on meeting their daily needs.

“Pakistan was a bit like East Germany. We too had no qualified medical personnel (in Germany), we too were just trying to get our feet on the ground. (We) didn’t have enough to eat, everything was damaged. War is a horrid, horrid thing. But it meant that, to a certain extent, I knew what was coming (when I came to Pakistan).

“In the years I’ve been in this country, this population has always been on the move, for one reason or another,” she says thoughtfully. “Up until the 1960s, it was the refugees from 1947. Then, in the 1970s, there was a new wave — an influx of Bihari refugees (from East Pakistan, later Bangladesh). We had no place for them; we had to put them up in tents. There were no educational facilities, no medical care was available. One thing that I distinctly remember, and what moved me, was that these Biharis would be starving, they wouldn’t have had a meal in days, but when we asked them what they needed, what they wanted, they would always reply: ‘A school for our children’.

“In the 1980s, it was the Afghans, of course. Then, our own people from the North, (following the militancy and the military operations in the late 2000s). And most recently, the people affected by the floods.

“As a nation, we’ve always been caring for someone or the other, for refugees,” she adds.

“One of the reasons that I decided to stay in Karachi — and this is a story I tell frequently — was my encounter with a young Pathan in the leper colony. He was as old as I was at the time, about 29 years of age. He came towards me, crawling on his hands and feet, wading his way on all fours through a slush of mud and dirt (we first began frequenting the leper colony during the monsoon season, which meant that everything on McLeod Road was drowned in dirty water). And what struck me, what shocked me so, was how this young man seemed no longer to hope, to desire change. He had obviously, in his young age, decided that this — this dismal, disease-ridden neighbourhood — was going to be his life henceforth.

“A problem that I immediately encountered (as a new arrival in Pakistan) was the hurdle of communication — I didn’t speak Urdu or any of the other regional languages. In those early days, I had a priest who came along, who spoke the language and translated for me as we made our rounds through the colony. The complaints from the residents were more or less the same — nevertheless, I set about learning the language immediately.”

Natives, however, did not immediately assume that a fair-faced, ostensibly foreign-looking young woman would be well-versed in the local vernacular. In the early sixties, Dr Pfau attempted to revive the by-then defunct Municipal Leprosy Control Programme in Karachi; when she approached the in-charge of the programme, a betel leaf-chewing man with a visible paunch, he offered to show her the clinics under his command. As they inspected the decrepit, unused buildings, the area’s guards and watchmen would ask the man, with characteristic Pakistani curiosity, who the ‘foreigner’ was. Assuming that Dr Pfau couldn’t understand a word, the man would reply sleazily ‘Yeh humari gurriya hai’ (she is my doll). The doll knew enough Urdu to understand what was going on, but chose to remain silent.

Another story that haunts Dr Pfau — her face visibly darkens as she relates the tale — is of a leprosy patient, a young unmarried woman in her mid-30s, who belonged to an educated family. “She was admitted to MALC (Mary Adelaide Leprosy Centre) for treatment; when she became visibly better, she asked to go meet her family. I was very happy to hear this — I said, yes, sure. But she didn’t return.

“The next day the police came knocking. The girl, they said, had jumped off the bridge at the harbour. Her handbag, which she’d left at the bridge’s edge, contained my business card, so the police came to MALC to investigate.

“The story was, she’d gone to her brother’s home, wanting to meet the family, see the children of the house. The brother refused her entrance. Devastated, she took her life.”

“It’s been a long 50 years,” Dr Pfau says sombrely, as an afterword. “And though things are better now, though much has changed — still today, the stigma lingers. One of our patients, in interior Sindh, is financially very well-off — he belongs to the landed elite — and he refuses to come down and get admitted to the centre for treatment. I’d be mad to do that, he says. You see, the stigma is still there.”