An internationally renowned immunolo-gist, a doctor who sees thousands of patients everyday, a daughter, mother, woman … Indira Nath, professor of immunology at the All India Institute of Medical Sciences, New Delhi, was one of five women who received the 2002 Women in Science Award presented jointly through L’Oreal and UNESCO. The recognition came for her breakthroughs in treating leprosy.
Nath explained clearly, patiently, and simply, the basics of immunology, leprosy, and her research in the field, as well as her reflections on what the award means to her. It wasn’t hard to see why she is credited with lessening the stigma associated with the disease.
Nath was smitten by immunology in the late ’60s and early ’70s, at a time when it was an exciting field in the West, but not available in India. “In fact, in Europe, Australia, and the U.S., there were people working in the field whom we would now call immunologists. But at that time, they weren’t even called that,” says Nath. “I was young at that time, and also, the cells that were making the antibodies had just been identified in the mouth.” More importantly, as a medical student, her service bandaging leprosy patients at a hospice in a New Delhi slum had shown her firsthand the suffering and isolation suffered by victims of disease. The experience was too powerful to ignore and the young pathologist decided to make immunology her calling. After a year spent in post-doctoral studies in the U.K., she returned ready to take the first step towards fighting disease.
Immunology is the way the body defends itself. It is the system in our body which consists of cells in the blood that move all over the body like policemen, trying to check if any foreign matter has entered the body … bacteria, viruses, or even if one of the cells within the body turns cancerous. Then these police cells recognize them as being foreign to the body and produce antibodies. That is why vaccines are made, so that one can mimic the foreign agents and then make the antibodies that can protect the body.
“At that time the government (of India) didn’t allow the import of chemicals or equipment unless it was unavailable in India,” Nath recalled the red tape she initially faced. However, in her early years, she confesses that she was fortunate to have grants from the World Health Organization, which recognized bureaucratic problems in developing countries like India, and directly purchased and dispatched chemicals to grant recipients in the country. Government bureaucracy, as well as long review processes while applying for funds slowed down researchers, she explained. “If someone brilliant has an idea and wants to investigate in a cutting-edge area, it can delay that person.”
But very little would come in the way of this determined researcher who had decided to work towards a treatment and cure for leprosy. Not even the stigma deterred her and Nath recounts her family’s reaction to her decision to work with the once-feared disease. “Leprosy it is not contagious skin to skin. We think it spreads just like tuberculosis, like the droplets come out and someone inhales it. But it takes many years before you can actually get it,” says Nath.
“In the beginning it was a bit funny. My mother was most depressed,” laughs Nath. “… She used to wonder why I was doing these things, … but gradually got over it, as has everybody else. The stigma is now gone,” she says. When asked about her own commended efforts in reducing stigma, she brushes aside the compliments with modesty. “(Educating people) is a part of our job … when we go to clinics we are telling people, but more than me, I would say the NGOs are doing a marvelous job,” says Nath. “In fact, India was one of the first countries that took steps towards eliminating leprosy,” she says.
Nath’s research focuses to a good extent on understanding the disease. Leprosy appears like a spectrum, where the same bug can have different manifestations. When infected, someone might react with just a small white patch with decreased sensation, whereas some others might get generalized reaction all over the body, resulting in thickened eyebrows, and so on. Some of the simpler tests done in those days had shown that it was probably related to the immune system. Nath’s research looked at the way the immune system of the person who had the localized disease, or didn’t have the disease, behaved as compared to the immune system of the person with the generalized disease.
The good news today is that leprosy is treatable. Unlike the ’70s when there was only one drug in the fight against leprosy, now there is a whole battery of drugs. Even bad forms of leprosy are curable. “But what we are not able to control in spite of the treatment is the nerve damage,” explains Nath. The number of cases in India today is down to a million from 4.5 million in the 1980s.
The L’Oreal Award also highlights Nath’s efforts towards finding a vaccine for leprosy. Nath, however, adopts a realistic stance. “I am afraid to say something like that you know, because a vaccine is a very long drawn out process in a disease like this.” However, recent major breakthroughs from scientists in the U.S. have fueled research in that direction. “We are doing things which will finally lead to something that tells us what/how the cells get turned on for protective immunity. That’s what we want for a vaccine, you know, an immunity that doesn’t cause disease, but an immunity that gives you protection before the symptoms come up. … So we are plugging on at that, but I won’t say I am close to a vaccine,” she says.
Nath admits that it was very exciting to have her work noticed. “Because I think that is what keeps scientists going—getting your work recognized by your peers.” And although she has received several national awards and recognition in scientific circles, she says that this award has taken the work to the general public. She also speaks interestedly of the L’Oreal lab. “They work on skin, because they are working to beautify skin. … some of the immunologists there, they are even culturing skin, bits of skin on which they test all these products and how they test the products, it was all very exciting. In fact, the immunologist and I talked to each other because she is also working with some of the same molecules that I am. So it also opened up a new area I had not seen.”
L’Oreal’s “For Women in Science” program developed in partnership with UNESCO is aimed at advancing the role of women in the scientific world. Speaking of India, Nath comments that biology and immunology are fields that many women choose in India, and often even acquire Ph.D.s. However, their careers get interrupted when they get married and follow to wherever their husbands get transferred, says Nath; all working women have to master a fine balancing act between family and career, she concedes. “I must say both my parents as well as my in-laws were extremely supportive when I had my daughter and was also working for an exam, or even when I am doing research or going out for travel.” “That way the family system gives you a lot of support. If it’s a nice family I mean,” she adds laughing.
Recently Nath has also been appointed chair of a committee set up by the Indian government to support women scientists by putting aside money from the budget to fund their research efforts. “I don’t think the national budget got changed because I got an award,” quips Nath. “But I mean to say that gradually the awareness has come even at government level that women scientists who are lost are a loss to the nation. Thus, there is now an avenue for women to not only compete for research grants, but also be able to take their grants with them should they get transferred from one place to another.”
Today, Nath spends most of her time in the lab at the All India Institute of Medical Sciences in New Delhi. Besides that, she also teaches at AIIMS, and once a week, goes to see leprosy patients.
Speaking of her life outside the research lab and hospital she says jokingly, “When I was younger it was better … now it is very boring.” Annual trips to the Bharatpur bird sanctuary to watch the migrating birds, and bonsai as a hobby, hold a special place in her interests. Also, “I am very fond of doing things with my hands, … handicrafts, a lot of knitting, and embroidery,” she says, adding that she finds it very relaxing. “Sometimes my big picture may take a couple of years, but I keep doing it,” she says good-humoredly.