One of the painful sights which specially attracts the notice of the European in Burma is the large number of lepers to be seen in all the public places. As you walk along the streets you see them, sitting in the dust, holding out their mutilated limbs, from which sometimes all traces of hands and feet have ulcerated away. If you go into the great bazaar, they are seen mingling with the crowds of buyers and sellers. If you go to the great pagodas, where hundreds of people congregate daily, there are lepers sitting on the steps, and appealing to the generosity of the worshippers. At the gates of the royal city, and in the public zayats or resting places, they are to be found; and when the leper has dragged about his poor diseased body as long as he is able, he lies down to die, a friendless, homeless outcast. In Burma, until we took the matter up, there was no organised relief for them beyond chance coppers, no place of refuge where they could be housed and provided for.
Seeing the lepers were so numerous, I began to investigate the matter, and as a preliminary measure looked up the statistics of the leper population of Burma. There had then been no census in Upper Burma, but according to the census of 1881, there were upwards of 2,500 returned as lepers in Lower Burma. Large as that number is, it is to be feared that it does not fully represent the evil, for the people naturally object to being called lepers even if they are, as though by avoiding the name they could hope to avoid the awful thing. I have known a leper, so far advanced as to have lost the whole of both his hands, and quite emaciated in body, declare in answer to my question, that it was not leprosy, only “Koh-ma-koung-bu,” a bad state of body. To form a fair estimate of the actual number of lepers in Burma, we should have to make a considerable addition to the 2,500 returned for Lower Burma, and multiply that by two, to take in both Upper and Lower Burma. It is probably not too much to say that there will be about one leper to every thousand of the population.
I have often been asked what is the cause of leprosy. That is not a question that can be answered in a word. The native of India makes short work of it. He scarcely recognises any laws in nature but the one law of his fate.
“I saw a leper,” writes Mr. Bailey,[3] “in a shop, sitting in the midst of his goods. He sells betel nut, tobacco, oil, cakes, etc. He has a leprous brother living with him, also a brother not leprous, and a niece who already shows signs of the disease. We asked the healthy brother if he were not afraid to live in the house, and he said that if it were not God’s will he could not take the disease.” So far as science has yet ascertained, three causes may be specified: (1) Insanitary conditions of life generally, as predisposing to it. (2) Heredity, to some extent. (3) Contagion resulting from lengthened residence in close company with leprous and insanitary surroundings. It is not yet determined to what extent these causes respectively operate. It is the business of the Leprosy Commissioners, sent out at the expense of the National Leprosy Fund, of which the Prince of Wales is the President, to try and ascertain more on these points, by the careful and exhaustive inquiries they have been pursuing; and their report is now awaited.
In India there are medical men who have studied this disease for many years, for there are hundreds of thousands of lepers scattered over India. Dr. Munro, an acknowledged authority, and a man of deep research, says: “Summing up, therefore, leprosy is not always, but only very rarely, transmitted from generation to generation, has never been proved to be transmitted without contact, is not constantly transmitted even when both parents are diseased, seldom affects more than one child in a family, and those only successively, independently of age, sometimes the youngest first, after contact, and goes back from child to parent when in contact. From all I have learned of the disease, I can find no proof of even the hereditary predisposition allowed to exist by Virchow, but feel much inclined to believe with Landré, that contagion is the only cause of its propagation.”
On the contrary, another expert, Dr. MacLaren, who has been in charge of a leper asylum at Dehra for many years, and has very carefully studied the question, has come to the conclusion, after an exhaustive inquiry into the antecedents of all the inmates of his asylum, that 36·4 per cent. of the cases were distinctly traceable to heredity. A curious light has been thrown on these mutually contradictory conclusions, by the contrast in the experience of two different homes for lepers shown in the following quotation from Mr. Bailey’s book. At Tarn Táran there is a large Government Institution, supported by the different municipalities that send lepers to it. Here no restriction is placed on marriage, and there is no attempt at the separation of the sexes, consequently many children are born in the asylum. The missionary of the Church Missionary Society stationed there says:—
“Of all the persons born at that asylum during the last thirty years, I know of only two men who up to the present have not become confirmed lepers. But even these, when last I saw them, began to show signs of the disease upon them. How different is the history of the asylum at Almora, which is largely maintained by the Mission to Lepers in India! There, for many years past, this plan of separating the children from their parents has been adopted with most gratifying results. Of all those who have been thus separated, only one child has shown any signs of the disease. Many more are now out in the world, and gaining their own livelihood. Surely we have here a most striking proof, that in one direction at least a great deal can be done towards stopping the spread of leprosy. What a wide field for the exercise of Christian love is thrown open to us in this branch of work! The followers of Jesus no longer possess the power of curing ‘diseases and all manner of sicknesses’ by a touch or a word; but in these who may soon be lepers, the ‘least’ of Christ’s little ones, there is given to all an opportunity of stretching forth the hand of loving compassion, and of saying, ‘Be clean.’”
At the time the public mind was greatly exercised on this leprosy question, and the Leper Bill for India was being considered, the Bombay Medical and Physical Society met to discuss the subject. There was a general consensus of opinion amongst these medical men that heredity is a mode of propagation, though some were of the contrary opinion. As regards contagion as a means of propagation, the majority of the medical men considered it was. It seems, however, to be not easily communicable by contagion, but due to continuous and lengthened contact, together with predisposing general causes. So far no cure for leprosy has been discovered.
Some authorities have expressed the opinion that in some way fish-food, especially when either salted or decomposed, is largely to blame for its origin. The Burmese ngapee, which consists of partly decomposed fish made into a paste, can hardly be a healthy article of diet, and may have something to do with predisposing to this and other diseases in Burma.
As the disease advances, mutilation and wasting of the fingers and toes set in, extending in time to the whole hand and foot. The sight is often dimmed or lost, and a kind of horny substance grows over the eyeballs. The skin of the face becomes thickened, giving the countenance a peculiarly heavy, morose expression. Thus the disease progresses, and the constitution becomes enfeebled, until the leper falls a victim to some other malady; for leprosy is not often the immediate cause of death. In the anæsthetic form of leprosy all feeling leaves the part specially affected. Mr. Bailey tells of a case of this kind. “One poor fellow was pointed out to me who had burnt himself fearfully, in burning the dead body of a comrade. He knew nothing of it at the time—the dead burning the dead!”
In the institution at Madras, out of 233 inmates, no less than 34 were Europeans or Eurasians, chiefly the latter.
The leper’s lot in India and Burma is a terribly sad one. The following picture of his condition is drawn by Colonel E. H. Paske, late Deputy Commissioner of Kangra, Punjab:—
“Leprosy is a slow, creeping disease, seldom or never immediately fatal, though shortening life. It is accompanied by a great deal of physical pain and suffering, and an amount of mental torture varying with the natural sensibilities of the victim. The leper’s life is burdensome to himself, and his presence loathsome to those around him; no object can be more pitiable, more repulsive, or more terrible.
“While the living body is undergoing a process of perceptible waste and decay in a manner the most loathsome, the mind is subjected to the most depressing influences, aggravated by the life of separation and isolation which the sufferer is forced to lead. As soon as the leprous taint becomes apparent, the victim is shunned by those around him, even members of his household avoiding his touch. For a time he leads a life of separation in his own home; but as the disease progresses, and his appearance is rendered more repulsive, he becomes an outcast, wandering through the country, subsisting by beggary, or else located in a small hut at a distance from all other habitations. A truly piteous sight it is to see the leper crouching outside his hovel, holding out wasted stumps that once were hands, and crying for alms from the passing traveller. When the leper resides near his home, his relatives, or fellow-villagers, make provision for his wants, but for a time only; they soon tire of the burden of his support. Too frequently, when police reports announce that a leper has been found dead, has committed suicide, or has been burnt to death in his hut, there is reason to believe that those who have been responsible for the maintenance of the sufferer had adopted sure means of freeing themselves from the burden. In one instance where a leper had been murdered by his own sons and brothers, the prisoners on their trial pleaded that they had put an end to the man’s existence at his own request, to spare him from further suffering. In another instance, where a leper had been buried alive by his next-of-kin, it was urged that this mode of death would prevent the disease from becoming hereditary. Such are briefly a few particulars of the life of the poor crippled leper in India. An outcast, he still clings to life in a condition the most helpless—an object so repulsive that charity almost loathes to approach it.”
From the foregoing information it is abundantly evident that there is great need for the establishment of Homes for Lepers. Mr. Bailey, in his recent tour through India, visited twenty-six homes, where he saw in all 1,425 lepers, and he thinks that not more than 5,000 poor sufferers are being provided for throughout the whole of the empire, out of several hundreds of thousands who need such provision.
It was about the beginning of 1890, when our general mission work was getting upon its feet, and the pressure of the early difficulties was relieved a little, that I became concerned to do something for the lepers in Upper Burma, for whom nothing was being done. I waited upon Sir Charles Crosthwaite, then Chief Commissioner, to broach the subject to him, and was very cordially received. Sir Charles welcomed the idea. There was nothing of the kind, he said, in all Burma. Government could not well do anything directly in the matter, and even if they could, he remarked that we, the missionaries, could do it much better, that is, more kindly and mercifully than they could. He would gladly do all he could to help the scheme. Government would give the land, and he himself started the subscription list with one hundred rupees.
Encouraged by this, I issued a printed circular, setting forth the object of the undertaking, and appealing to all classes for subscriptions. There was a very liberal response to this appeal from all classes and sections of the population. I wrote to the Prince of Wales, as President of the National Leprosy Fund. My application was handed to the Secretary of the Fund, and in due time there came, in response to this application, through the Viceroy of India, a draft in rupees which was the equivalent of £80. I also put myself in communication with the Mission to Lepers, and received from that Society immediate help in the form of a contribution, and eventually we placed ourselves amongst the number of Homes for Lepers supported by the Society.
In all 6,500 rupees were collected for a commencement. The land assigned to us by Government was fenced in, and the first ward of the Home was erected in January 1891, in the usual Burmese style—teak posts, board floor raised a few feet from the ground, bamboo matting for the walls, and thatched roof, with accommodation for fifteen inmates. The time had then arrived for us to go home to England on furlough, and it fell to the lot of my colleague, Mr. Bestall, to gather in the sufferers, if he could induce them to trust themselves to our care.
THE HOME FOR LEPERS, MANDALAY.
Many had been the predictions that the whole thing would prove a failure. The lepers would never be induced to come; if they came they would never stay. But these fears have not been realised. As regards the first experiences in the Home for Lepers I could not do better than let Mr. Bestall tell the story for himself. Towards the end of 1891 he writes:—
“It is eight months to-day since I set out in the early morning to persuade a few lepers, who lay dying beneath the shadow of Mandalay’s pagodas, to enter the refuge we had prepared for them. I anticipated reluctance on the part of these lone creatures to commit themselves to the care of an Englishman. Only five years before, the Burmese king reigned in the palace. Suddenly all Mandalay was in a ferment of dread. English war boats had touched the strand, and British soldiers were marching through the streets, to take the city and capture King Theebaw. Only last year the crack of our rifles was heard in many parts of the country, and even as I write British troops are marching out of the city to take part in fresh expeditions on the frontiers. Burma is not the settled country it will be ten years hence, nor has there yet been time for the people of the conquered land to trust us implicitly. I quite expected, therefore, suspicion and fear on the part of these, the poorest and most desolate of our Burmese fellow-subjects. Persuasion was my only means of gathering them in. To many I was an executioner. What could I want with them except to put them to death? ‘We pray thee let us remain here,’ some said. ‘For mercy’s sake do not take me,’ others replied. All were in great terror. I could not but be touched by the timid, fearful attitude of many, and I was very thankful when I saw the first leper on his way in a bullock cart to our Home for Lepers. It was sad to see how they hugged their wretched dwellings, and clung to their filthy haunts. Christian philanthropy they could not understand. I promised them permission to return if they did not like the Home.
“The first day’s work of rescue was a long one, and the breakfast ran into the tea hour before I returned with seven inmates for the Home for Lepers. Bazaars, where the people congregate to buy and sell all sorts of food, are always centres of attraction to paupers, lepers and pariah dogs. It is not uncommon to see a poor old leprous native handle the orange or banana on the stall, and ply the world-wide query ‘How much?’ It is a sad and even disgusting state of things, and it is a dangerous one too. For ages it has gone on; and as far as I know, that morning’s work eight months ago was the first attempt ever made in Burma to stay the evil and rescue the lepers.
“We started with a small bungalow capable of housing fifteen inmates. In a little while the number was completed, and I thought of extending the work. I made use of the sufferers already gathered in, sending them out in bullock carts, in charge of a faithful Tamil helper, to advertise the comforts of the Home to their leprous countrymen. Narayanaswamy took a great interest in this work, and was invaluable as an assistant. He met a dreadful fate whilst living at the Home, as I shall afterwards describe, but for six months his fidelity and zeal in leper rescue work were admirable. You should have seen his face light up when he met me at the gate on my daily visit. ‘The leopards are all safe, sir,’ he would say. And though he knew no more of hunting than his own infant, he would often come across to the mission-house with joy to say, ‘Brought two more leopards to the Home to-day, sir.’ With his help I extended the work, and built four new houses for the reception of further cases. So that now we have three large bungalows and two hospital buildings, a caretaker’s house, and—for the purpose of preparing food for the settlement—a substantial brick cook-house. To-day we have fifty inmates in all stages of the disease, of all ages, varying from a little girl of twelve years, to an old man with hair as white as snow.
“The site of the Leper Settlement is over five acres in extent. This area is divided into two sections by a bamboo fence. The western section is given up to female lepers, the eastern to males. The bungalows for men will accommodate sixty, and we have room for twenty-five women. The hospitals are used for separating cases of extreme disease from the other inmates. A mortuary has recently been added. Daily worship is conducted, generally by our few young men whom we are training for preachers and teachers. The singing is not good—how can it be with such a congregation? But the poor souls make a noise, and that is enough in these early days! If they can’t sing, they can and do listen. In preaching we have to begin at the beginning and finish there. The idea of a Saviour is to them very surprising. They always thought they had to save themselves. The cleansing Jesus is a new hope to them, for they have been taught to cleanse themselves.
“Service over, the food is brought to the different houses. The boiled rice is carried in a large basket; the curry of meat, fish, or vegetables in earthenware bowls. The lepers eat like ravenous schoolboys, and I believe they have greater appetites than the hale and hearty inhabitants of Mandalay. After breakfast they sit and chat, and read, and—the inevitable—sleep. The few who are able keep the place clean; but no work can be done by the majority. Many of them are without fingers, some without hands. The evening meal is always welcomed, and we get evening worship when it is possible. At present we have no converted leper.[4] When we have a few Christian inmates, much of the religious work may be conducted by the lepers themselves. This institution, in addition to being a boon to the public, and to the diseased ones, will in time become to the latter the gate of heaven.
“In the eight months of our work among them death has been very busy. Naturally the bodies of these sufferers are little able to cope with sickness. When a leper sinks he sinks like lead. The pale face, the sunken cheeks, the loss of appetite, the unnatural smile, all tell of a speedy end. We have had nine deaths. Some of them have been very touching. The worst case we have received was a woman named Mah So. She was revolting to look at. She had no hands, and her wrists were raw; she was stone blind, and her sightless eyes were covered with a horny skin; she had no feet, and her legs were eaten away to above the ankles; she could only crawl about upon her elbows and knees. I felt more pity for her than for any other fellow-creature I ever saw. I preached to her in a little hut made on purpose for her. She was in dense ignorance. It was very difficult work indeed. She became ill, and was quite helpless. She lingered for a week. Often she would say, ‘I want to die; it is no good living; I can’t eat, can’t sleep; I want to die.’ I asked her, ‘Where are you going?’ ‘I don’t know.’ ‘Would you like to go to Jesus?’ ‘Yes, but I don’t know Him.’ I told her to repeat after me, ‘Lord Jesus, I am Mah So, a dying leper; take me in my weakness and save me now. Amen.’ She repeated the short prayer, and died during the night. I never saw a case of more utter misery, and never did a soul pray to Christ from a lower depth of emaciation and disease. Was not that prayer answered?
“One night a young man came of his own accord to the Home. ‘Let me in; I am very ill,’ he said. He had only five days to live. Dysentery, fever and leprosy, a hideous trio, were all ‘dragging’ him, as the Burmans say. We had the opportunity of directing him to Christ in the last hours of his life. And other instances of dying lepers listening to the news of the lepers’ Saviour come to me as I write. But these cases are sufficient to show the nature of our spiritual work among this class of the population.
“Our greatest trial has been the loss of the caretaker. On my return from Rangoon recently,[5] we rode over to visit the Home. Narayanaswamy met us at the gates, but his face wore so unnatural an expression that I at once asked him, ‘Down with fever again?’ ‘No, sir,’ he replied, ‘but I have a bad pain here,’ pointing to the back of his head. He looked so strange that I told him to go to the doctor. A bullock gharry stood at the gate. The poor fellow walked to it, but had to cross a bridge over a little ditch, in which lay some water. Immediately he saw the water he uttered a great cry, pressed his sides violently with his hands, and rushed, a very madman, back to the house. In a moment every nerve in his body seemed to spring to life. Nothing could cross his vision without causing him to start violently; water gave him a terrible fright, and I beheld before me the first case of hydrophobia I have ever seen. For the next twenty-four hours I had no rest. He was removed to our own premises, to keep him from terrifying the lepers. He rapidly grew worse, and he who, but a few days previously, had been the best, quietest and most willing helper I had, became a raving maniac. A whole night of paroxysms preceded his death. ‘I want to bite you,’ was his frequent cry. All the native people fled, and I had to face him alone. The doctor did what could be done. Strange to say, though it is not strange to the disease, in the last hour of his life he was as quiet and reasonable as when in health. ‘A little dog scratched my ear,’ he said to me. On looking I saw the smallest of marks behind his right ear. He died quite suddenly whilst in the act of taking medicine.”
Our aim in establishing and carrying on the Home for Lepers in Mandalay is somewhat wide and far-reaching as a philanthropic enterprise:—
1. To succour and provide for the wretched, helpless, outcast lepers. We call this institution not a jail, nor an asylum, but a home; and it is our constant endeavour to make it as much of a home to them as the sad circumstances will permit. That the lepers have taken to it is clear from the fact that there has only been one case, since we commenced the work, in which there was a desire to live again the old mendicant life, and that was the case of a young leper gifted with a fair voice and able to make a good living outside. This speaks volumes, for there is no law either to compel them to come or to remain. It is clear that such a law is not needed.
2. To offer the lepers the Gospel. Worship is held daily. No one is compelled to listen to it, or in any way pressed to accept the Gospel. It is believed they will gladly do so of themselves when they learn how merciful it is, and see illustrations of it in the Home.
3. To segregate the lepers from the healthy population, and thus do what we can to stamp out the disease. Formerly it was impossible to prevent them from going about in the markets and other public places of resort, but there is no reason for allowing that, now there is a comfortable home provided for them.
4. To rescue the children of leprous parents, removing them from the parents, with their consent, before they contract the disease; and to provide for them. What a blessed preventive work is this!
5. Lastly, to follow the example of our Master, who never came in contact with suffering but He relieved it; and thus to give a worthy and consistent view of the true genius and spirit of the Christian religion to the tens of thousands of the heathen who throng around us. To them this Home for Lepers is an argument which they know how to appreciate, and it will not be lost upon them.
Richard Baxter quaintly says: “As long as men have eyes as well as ears, they will think they see your meaning as well as hear it; and of the two senses they are more likely to trust their eyes as being the more reliable sense of the two.” So if we can let them see Christianity as well as hear it, we may hope that they will embrace it the sooner. No one knows philanthropy when he sees it better than a native of the East. Here, then, we trust there will always be Christianity writ large before their eyes.
“Is not this the fast that I have chosen? to loose the bands of wickedness, to undo the heavy burdens, and to let the oppressed go free, and that ye break every yoke?
“Is it not to deal thy bread to the hungry, and that thou bring the poor that are cast out to thy house? when thou seest the naked, that thou cover him; and that thou hide not thyself from thine own flesh?
“Then shall thy light break forth as the morning, and thine health shall spring forth speedily: and thy righteousness shall go before thee; the glory of the Lord shall be thy reward.
“Then shalt thou call, and the Lord shall answer; thou shalt cry, and He shall say, Here I am ....
“And if thou draw out thy soul to the hungry, and satisfy the afflicted soul; then shall thy light rise in obscurity, and thy darkness be as the noonday:
“And the Lord shall guide thee continually, and satisfy thy soul in drought, and make fat thy bones: and thou shalt be like a watered garden, and like a spring of water, whose waters fail not.
“And they that shall be of thee shall build the old waste places: thou shalt raise up the foundations of many generations; and thou shalt be called, The repairer of the breach, The restorer of paths to dwell in.”—Isa. lviii. 6-12.
With this divinely inspired encomium upon practical godliness,—the godliness that does something to make the world brighter and better around it, as distinguished from the bare and empty profession,—I close this humble effort.
The putting together of these chapters has been a labour of love, on behalf of the country and people I wish to serve, accomplished with some difficulty, during the brief breathing spaces afforded in the intervals of a busy life, almost filled up with missionary advocacy, whilst on furlough in England, and in the hope of returning very shortly to Mandalay. I have here sought to give some information about a country mostly new to English people, rich in interest as regards its different races, their religions and customs, and the circumstances attending the first few years of British rule. Of British rule in the East I entertain a very high opinion as to its substantial justice, and its direct issue in the general well-being of the people. It ought to be the aim of every Christian amongst us to purge it of everything detrimental, and to make it all it should be. The responsibilities laid upon us as a people in this respect are very great.
That Burma is destined to play an important part in the development and civilisation of the far East, there can be little doubt, now that our frontier is brought up to the confines of China, and that a railway is to be constructed from Mandalay through the northern Shan States, that will bring us within measurable distance of the great “Celestial Empire.” It is of great importance that this development be not confined to material things, but that Britain employ her great power and influence in the direction of everything that will uplift the nations, which Providence has so manifestly placed under her charge. Mission work amongst the Burman race may be slow; humanly speaking, and judging by all former experience, it looks likely to be so. That, however, is not the fault of what is being done; we may safely assert that much more might be done if the work were taken up in a more liberal and enterprising spirit. Are you, dear reader, doing your share?
FOOTNOTES
[1] Mr. Smeaton says in his book, The Loyal Karens of Burma, that Judson had lived seven years in Rangoon, preaching the eternal God, before a single Burman would admit His existence, while the poor unnoticed Karens were continually passing his door singing by the way:—
[2] Lest the reader should get the impression, from the accompanying illustration, that the tattooing appears white on the person, it may be well to explain that the real colour is a very dark blue. The photographer, fully alive to the resources of science, in order to oblige us with a better view of the subject, induced the youth to smear the tattooing plentifully with oil, with the result that the bright shining of the sun on the glistening, dark-blue pattern brought it out white!
[3] “The Lepers of our Indian Empire,” by W. C. Bailey, Secretary of the Mission to Lepers. (J. F. Shaw & Co., London) A book well worthy of perusal by all who would like to know more on this subject.
[4] In a letter received four months later than this, Mr. Bestall writes: “I am very glad to tell you of one poor old leper, one of the first who came into the Home, finding Christ. He is a sad sight, but after fourteen months’ instruction and thought, he has come out from among his fellow-lepers and publicly professed Christ. I don’t expect him to live long.”
[5] It is an interesting illustration of the lights and shadows mingling in missionary life, that this journey to Rangoon Mr. Bestall speaks of, was to meet and bring home to Mandalay his bride, and it was this young lady’s first introduction to the Home for Lepers, in company with her husband, that was marked by this tragic scene! It is worthy of mention in this connection, that Mrs. Bestall, before going out to Burma, underwent a two-years’ course of training in nursing and elementary medicine, in order to be more useful among the women and girls of Burma.