International Leprosy Association -
History of Leprosy

  • International Leprosy Association -
    History of Leprosy


    McKean Leprosy Hospital


    Category Leprosarium
    Country Siam
    Address Chiang Mai
    Current Address Thailand


    Dr James McKean founded the “Chiangmai Leper Asylum” in 1908, assisted by Pauliang Chantah Indravude. It was the first leprosy center in Thailand, at a time when leprosy sufferers were usually rejected from home and community. Many had wandered until they came to beg in Chiangmai town in order to live, and found shelter and some community together living under the bridge. They went regularly to the mission clinic where they received compassion, food and wound care. Although there was no effective treatment for the disease, Dr. McKean asked the local ruler for land downriver to set up a leprosy centre where those rejected by society were given somewhere to live, and die, with dignity and love. Hostels, small cottages in village groupings, a clinic, a water tower and a church were built. Orderliness and benevolence were keynotes of the centre and the example and teaching of the missionaries led many patients into a vital Christian life of faith. Patients started as recipients but gradually became participants in activities of the center. In keeping with the strict moral views of those days, the women were housed in a separate “village” at the northern end of the property, and the men were at the other end of the property in the men’s village. Both “villages” were in a community with provisions for basic necessities, plus spiritual and medical help. Hospital wards, a school and more cottages were built gradually over the next 20 years to house the stream of patients making their way to McKean from all parts of Thailand, and even from neighbouring countries. Responsible patients were put into teams (maintenance, guards, nurses) to help run the center.

    A history of the changes that have taken place at Chiang Mai has been provided by Dr Trevor Smith (McKean Rehab Center, Chiangmai, Nth Thailand)

    An account of the events surrounding the leprosarium, and especially the involvement of the McKeans, can be found in the chapter by TR Brown in Contagious Compassion: Celebrating 100 Years of American Leprosy Missions. Providence House: Franklin, 2006, pp. 25-42. The following account has been gleaned from Ted Brown's chapter.

    In 1903, between 50-150 leprosy victims were encamped on an island in the Ping River one mile south of Chiang Mai. Under unknown circumstances, they were driven from the island and left homeless in 1905. Late in 1905, Dr JW McKean, who had previously provided medical care for these islanders, gained permission from the Minister of the Interior of Siam, the High Commissioner of Chiang Mai, and the Prince of Chiang Mai, to establish a leprosy home on another nearby island. The Mission was granted 164 acres on the southern half of Koh Klang (“ Middle Island”). This was the first time that the government had ever set aside land for a persons with leprosy.

    A clearing was made on the island and bamboo huts were built. In 1908, seven leprosy victims and two children moved to the island. At the beginning of 1909 there were eight persons and, by the end of the year, 15, despite two deaths. By 1910, their number had grown to twenty. By the time the leprosarium was officially opened on June 11, 1913, it held 100 resident patients. The ceremony attended by a number of high ranking governmental and royal dignitaries.

    By 1914 four more buildings had been added, with 16 beds in each. The growth of the settlement (in terms of the absolute number of patients) peaked in 1914 and 1915 when an average of 30 residents were added each year. This was followed by a deceleration of growth which lasted for about six years. High attrition rates seem to have been the reason for the slowdown. Chaulmoogra oil treatment was introduced at this time and the Misson gave “restored health” due to the chaulmoogra as the reason for those who left. It reported, "Their improved physical condition begets the desire to get out and begin life again is what accounts for the large number of runaways." However, cures were rare. Only a small fraction (2 of 30 in 1917) were cured when they left. The others probably left from discontent. The discomfort caused by painful chaulmoogra injections was unlikely to be a factor, since this was entirely voluntary. Dr McKean attributed the number of runaways to the monotony of life in the asylum; the issue of overcrowding is also be a plausible explanation. For example, in January 1916, 178 patients were housed in rooms sufficient to cater for only 130 patients. Two years later many were being housed in bamboo huts since the permanent structures were full.

    The new women's dormitory was built in around 1917 and officially opened in 1919 at a cost of 2,000 US Dollars. The structure could accommodate 30 women in five rooms. The dormitory was accompanied by 15 small cottages, each housing a few women. Wooden or brick and mortar cottages built in the 1910’s and early 1920’s were offered to the more robust residents as alternatives to the dormitories. At some stage, a temporary school was built at the north end of the athletic field for children patients. This had 32 pupils in 1922. A second school was opened for the healthy offspring of leprosy patients, local children and the offspring of non-leprous asylum staff.

    From 1909 to 1917 the main overseas financial contributor had been The Mission to the Lepers in India and the East which later changed its name to The (British) Mission to Lepers. From 1917 until World War II the main supporting agency was the American Auxiliary of the Mission to Lepers. These two organizations provided a major part of the funding for buildings and maintenance. In 1919, the Thai Government also gave generous support of 10,000 baht, which became an annual gift in the 1920’s and 1930’s.

    On March 11, 1927, the Hays Memorial Clinic/ Infirmary was added to the other buildings on the island. It had no more than a dozen beds, but allowed the sick men and women to be gathered together for treatment. This became the headquarters for the medical staff, pharmacy and chaulmoogra injections. The missionary doctors (Cort and McKean) began to hold three regular clinics there a week. Improved medical care and better housing probably combined to bring down the death rate. In 1927, it was reported as 6% and in 1930, 4-5%. These were significant improvements over the first year of operation with a death rate of 14%.

    This entry was updated 28 September 2006.

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