A BLOODY MIRACLE

Sally Wenley visits the leech farm where little miracle-workers are born

His fingers were chopped off by a skil-saw. The man lies in his starched white hospital bed, his digits newly sewn back on by a surgeon at Middlemore Hospital, and watches several leeches hinged on the tips of his fingers. They are sucking out his blood. These vampire-like worms that latch on to injured ears, lips, fingers and toes are being used more and more in public hospitals around the country.

A native New Zealand bloodsucking variety is found in some waterways in the North Island – and near Cambridge, Maria and Robert Lupton have spent nearly a decade learning how to breed, feed and supply them for medical use.

Her life revolves around leeches: They need to be monitored and cared for every day. ‘‘I have researched them and we are the only people who breed and supply medical-grade leeches. They are used for all sorts of medical needs such as re-attaching lips that have been bitten by dogs, skin grafts and limbs after an accident.’’

They started off selling about 100 leeches a year and now they send off about 6500.

The slimy segmented worms can be described as ‘‘artificial veins’’. The doctor can hook up arteries because they are quite thick, but veins are more fragile and in injuries such as the skil-saw accident, the chopped-off part often swells up, blood clots occur and the limb ‘‘dies’’.

But a leech can suck blood through damaged tissue and also injects natural anticoagulants that prevent clotting.

Furthermore, the leech releases an anaesthetic so the process is painless. After about 20 minutes the leech is full so it falls off the wound. But the anticoagulant allows the wound to bleed slowly for several hours. The blood continues to flow through the damaged tissue while new veins form.

Leech therapy has been practiced for at least 2500 years and was popular with Greeks, Mayans and the Aztecs. It was thought many diseases were caused by too much blood, so leeches were used for bloodletting.

Their use is currently undergoing a revival as world-wide clinical evidence shows how effective they are in helping heal certain wounds.

Thirty years ago, says Maria Lupton, her children collected leeches from a pond when they were living in Northland. They sent some to Auckland Zoo for a creepy-crawly exhibit, which attracted media attention.

‘‘There was a surgeon at Middlemore who had a patient who had expensive surgery which was about to fail because they couldn’t get the blood flowing. So he rang the Zoo which got in touch with me.’’

Their leeches did the trick and the surgeon started ordering more. ‘‘We could only get them in the spring as they hibernated in winter so we started storing them. I wrote to all the hospitals and we now supply about seven of them throughout the country.’’

Maria carefully replicates their breeding conditions so they will lay eggs. The babies are fed blood from the local freezing works.

‘‘They are so small it is tedious to feed them. You have to manually pick up each leech from the tank and feed it, then take it to its next tank. There are 13,000 of them in a season.’’

Adult leeches are not fed for three months prior to being sent to a hospital, so they are really hungry. And they have to be a certain size, which means four years of hand-raising.

The business is time-consuming and she has employed an extra person for three days a week to help clean the tanks – and pick the escapees off the walls and ceiling.

The type of native New Zealand leech Maria breeds in a former dairy shed is called Richardsonianus mauianus which she originally collected from the wild near Dargaville and has since mixed with others of the same breed from different regions. They are very flexible, have black and yellow stripes and a suction disc at their tail ends.

Maria supplies hospitals with these hungry leeches at any time of the day or night, packaging them up in gel and sending the pots off by courier.

This farming may be unusual, but it is satisfying. Maria tells of a child in Waikato hospital who had part of his finger re-attached.

‘‘They were having trouble getting leeches to attach so they rang me and asked what they were doing wrong,’’ she says.

‘‘I went in there and gave them some ideas and got the leech feeding. It was great fun and I found it quite good to talk to the parents about what was going on as well.’’

Auckland constructive and plastic surgeon Zac Moaveni regularly uses Maria’s leeches, which he says are ‘‘amazing little animals’’.

They came into their own in the 1970s when microsurgery developed and small veins could be linked. ‘‘Until then people would have lost their finger or ear.’’

Using leeches comes with risks such as on-going bleeding, he says, and sometimes patients need a transfusion if they keep trickling blood. The other major risk is infection as they have guts like every other animal and that contains bacteria.

The leeches are used on just one person, Moaveni says, and are then disposed of.

Yes, some patients are understandably horrified at the prospect. ‘‘They are a very efficient way of doing it and we do reassure the patients when it needs to be done. But there’s never a joyful response!’’

Moaveni is adamant they don’t hurt and describes them as an incredible, cheap and effective tool.

‘‘There aren’t many medicines or drugs that manage to fit those categories, and patients go home with a great story to tell!’’

He is full of admiration for the Luptons. ‘‘Recently we had a patient who was coming in with multiple finger amputations and my first thought was, ‘ring the ward to make sure we have a good supply of leeches’. I take my hat off to them.’’

Back in the Waikato, Maria has a view of the leech shed across the paddock from her kitchen table. ‘‘I am known as ‘the leech lady’. If I go to a party it is a conversation-stopper. I get everything from hysterical laughter to complete silence.’’

The work is so rewarding the Luptons take leeches even on their rare weekends away.

‘‘We dispatch them from wherever we are staying. If someone has an ear or a lip they need sewn back on I can’t say ‘tough luck I’m not sending any leeches’.

‘‘This is their future quality of life and that’s what drives me back to that shed day after day. I think they are beautiful.’’