The story of a disheartened American doctor, a Irish nun who runs a free clinic in India, and a rickshaw driver they help, City of Joy also includes a portrayal of people with Hansen’s disease (formerly known as leprosy) in the form of little person Anouar and his blind wife. Anouar is, indirectly, the reason Dr. Max Lowe began practicing medicine again after a young patient died; he appears at the free clinic in a panic (carried by a friend of average stature) when his wife begins bleeding during childbirth. Max saves the baby, but later wonders aloud to Sr. Joan if it was right to bring another mouth to feed into a family mired in such horrific poverty. She reminds him that they, too, are entitled to the comforts of family.

Though Anouar is portrayed with bandaged lower limbs and his wife is missing a few fingers, they’re not amputees in the conventional sense. Contrary to popular belief, leprosy does not cause limbs to fall off. Secondary infections can result in tissue loss causing fingers and toes to become shortened and deformed, as cartilage is absorbed into the body.

Once Max commits to working at the free clinic, he points out to Sr. Joan that it would save them a lot of travel time if they allowed the lepers to visit the clinic instead of visiting them. Sr. Joan is reluctant, saying the Indians wouldn’t stand for it. Max argues that they would get used to it, and Sr. Joan gives her assent. But the corrupt local self-styled Godfather figure doesn’t like the thought, and his thugs incite a riot. The staff and patients of the clinic fight back, including Anouar, who is burned by a Molotov cocktail. The others rush in to pick him up bodily and extinguish the flames with a wet blanket.

Godfather continues to exert pressure on the clinic supporters by taking away Hasari’s rickshaw. When he builds another, they beat him and attempt to kill his son. Hasari exhorts a crowd of Godfather’s employees to stick together against the abuses of the only employer in town, and Anouar offers the services of the lepers as weavers to help support the clinic.

Today, several Indian organizations support people with Hansen’s disease in weaving work.

Based on the book City of Joy.