Leprosy attacks nerves under the skin - in severe cases sufferers can lose limbs
By Yolande Knell
BBC News, Cairo
Modern drug treatment and medical checks have brought leprosy under control in Egypt. Yet a colony near Cairo remains the biggest in the Middle East, home to several thousand people.
If you set off early, it now takes under an hour to drive from downtown Cairo to Abu Zaabal, Egypt's last such colony.
However, when the site was set up in the 1930s it was a very isolated place in the desert.
At one time, any Egyptian found to have leprosy could have been forcibly brought here by the police.
Sitting in the well-tended gardens, I meet many long-time residents who still recall the anguish that caused.
"Before they found medical treatment to cure the disease people ran away from us and they were very scared of it," said Mahmoud Ali Mohammed, who arrived in 1970 from Assiut, south of Cairo.
As he shakes my hand, Mr Mohammed stresses that there is no longer any need to be afraid.
"Leprosy is a normal sickness and you can recover from it. They have a cure. I'm negative now although I still live here," he said.
The disease is treatable, but sufferers say there is a lingering stigma
In the hospital wards, many former sufferers are receiving ongoing medical treatment.
Leprosy attacks nerves just under the skin. In advanced cases it leaves sufferers with no sense of pain and many have lost fingers and limbs. Some are blind.
Yet it is the lingering stigma of leprosy that most complain about.
A middle-aged man, Abdul Khalek al-Sayid, tried life outside the colony after he was cured but soon returned.
"Anyone who leaves here and goes back to his home village or town gets strange looks from people. They wonder how he became like this. Of course this makes one a little sensitive," he said, holding up damaged hands.
For many the hospital has become a refuge, a place of acceptance and understanding.
Osama Ali Sawi says he cannot envisage life anywhere else.
"It's almost 20 years since I came here - if I went away, who would know me and who would I know?" he asked.
At Abu Zaabal there is a large bakery, a mosque, even a prison. It has become a thriving community.
The charity Caritas runs a primary school at the Abu Zaabal colony
Former leprosy patients who have married often choose to live close by in the village of Abdul Moneim Riyadh.
At a primary school run by the charity Caritas, the children dressed in blue-check uniforms enthusiastically recite the alphabet. All are free of leprosy.
"We have an important medical control service so the children are healthy. Since our work began here there have been no leprosy cases," explained Caritas director Magdy Garas.
Recently Egyptians have begun to move to the village, attracted by the services and new jobs. There are now about 5,000 inhabitants.
"In our kindergarten we have about 75% from leprosy families and 25% from other families. Our aim is to support the integration of the children in society," Mr Garas noted.
At the hospital pharmacy there are a few patients still receiving multi-drug treatment to combat leprosy. Yet the number of new cases has dropped dramatically.
The Abu Zaabal colony has a mosque and prison on its grounds
Saleh Abdul Naby is head of the health ministry's leprosy programme. He says doctors can usually identify the disease before complications develop and it can be treated at regular hospitals.
"In the past, isolation was the main treatment for leprosy but now we have medical treatment and there is increased awareness about the disease," Dr Naby explained.
"Most patients now are outpatients. They come to any clinic to take treatment and go back home."
Officials have suggested that the colony is no longer needed and could be cleared out. But the idea has met with strong resistance from former sufferers.
Although many have bad memories of arriving at the site, they insist it is at the heart of their new community.