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Xun Nuo stares into space as he ponders a question that has been put to him. The air is difficult to breathe and, at an altitude of 3,000 metres, it's a bitterly cold November day. His audience shuffles to keep warm while awaiting his reply.
Xun is just 34, though you would never believe it. The harsh winters and primitive living conditions in the village of Ma Chan, at the eastern end of the Himalaya mountains, have taken their toll. Weather-beaten and leathery-skinned, the village chief looks at least 10 years older, although he is in better condition than many of his less-fortunate comrades. For this is a leper settlement and its inhabitants not only bear the disfigurements of the disease but are outcasts, shunned and feared by society at large.
Even assuming you can find a driver prepared to bring you here, Ma Chan (place of the horses) is difficult to get to. The remote outpost is off-road between Qiaotou and Zhongdian, in Yunnan province, western China. Besides the painkillers occasionally provided by the government and charities, Ma Chan has few of the medical aids you'd expect to find in a village of its size, and no doctor. The villagers can't hide their injuries, most of which are the result of a disease that eats away at nerve-endings and skin; others are caused by the harsh living conditions. Eye disease, crippled joints, loss of limbs and distorted and disfigured faces, hands and feet are just some of the more obvious afflictions. Less visible is the damage done to villagers' lungs by wood-burning fires lit in tiny rooms
that have no flues, chimneys or other ventilation. In winter, it is so cold, the villagers say, they rarely venture outside.
Xun was 17 when his family, who live 90 minutes away, in Zhongdian, sent him to Ma Chan, in keeping with the policy at the time of quarantining leprosy patients in isolated communities.
'I was bitter and felt betrayed when I was first sent here,' Xun says, recalling how friends and family noticed his appearance changing as the disease took hold. 'My eyebrows fell out,' he says, adding that he also suffered from joint pains. It took two to three years of treatment with antibiotics before he was cured, but many more years before he was given an 'exit certificate', declaring him fit to return to the community.