Leprosy has been a scourge since ancient times. Lepers were historically shunned and isolated from their communities owing to fear of infection. Also known as Hansen’s Disease, leprosy remained a major global public health problem well into the 20th century.
Sufferers lived in leprosariums, which became known – in various languages – as Lazarus houses, from the Biblical myth of the leper Lazarus, who was miraculously cured by Jesus. The last major leprosarium in the United States, in Louisiana, closed in 1998.
As the disease was largely incurable until the 1970s, removal of sufferers to dedicated, isolated leprosariums meant – in effect – lifelong banishment from the rest of society. In its terminal stages, the illness was fearsome; faces collapsed and noses, fingers and toes – and sometimes, entire hands and feet – dropped off as nerve endings were gradually destroyed.
The first effective curative treatments were developed in the 1940s, and research advances over the following three decades rendered leprosy completely treatable, with a combination of drugs. Nevertheless, numerous cases are still reported worldwide.
Macau had dedicated leper colonies from the 17th century. The last one, at Ka Ho in the isolated southeastern corner of Coloane, opened in 1930; now closed, the buildings, chapel and surroundings are due to be extensively renovated as a heritage site. A combination of government aid and religious subsidy provided care and treatment, and the colony was partially self-supporting, with vegetable gardens and livestock pens. Leprosy sufferers – and those suspected of infection but who had not yet displayed any of the more horrifying symptoms – were compulsorily removed from their families and kept within the confines of the leprosarium.
With the massive influx of refugees into Hong Kong when the Chinese civil war ended in 1949, the number of confirmed leprosy cases in the territory steadily increased, with 12 reported new instances for every 100,000 people. Hei Ling Chau, a small, rocky island between Hong Kong and Lantau, was selected in 1950 to house a leprosarium. Aided by the Leprosy Mission in London, the Hong Kong government brought in specialist Dr Neil D. Fraser in 1951 to run the new facility. It closed in 1974.
When curative treatment eventually became possible, some healed leprosy sufferers decided to remain on Hei Ling Chau. In many cases, family links were long severed and former intimates had become complete strangers.
Fellow inmates eventually became surrogate friends and family, many lepers married each other, and in the confines of these remote and beautiful places they could live out their days in peace and serenity, without having to endure humiliating stares and crude comments from callous strangers about their disfigurement.
Dr Mark Yoi Sun Soo, a Hong Kong University medical student who worked there briefly in the late 1950s as part of his training, movingly described the scene on Hei Ling Chau in My Days in the Sun, his recent, fascinating memoir of an upbringing divided between Hong Kong and Malaya.
“What moved me most,” he writes, “was the choice made by some to remain on the little island, cleaning the premises, and tending the vegetables and flowers. Roaming the unspoiled woodlands, they seemed content with life. As I was about to depart for Hong Kong, one of the men cut me a bunch of budding yellow roses. That man’s smile was touching, but what I cannot erase from my memory is his calm acceptance of his self-imposed isolation.”