February 3, 2014: The next stop on our Busuanga Island circumnavigation took us a little off the beaten track to the town of Culion, just a short hop across the water on Culion Island. Getting there meant navigating between pearl farms that seemed to stretch for miles in every direction. It’s hard to tell where one ends and the next one starts, and whether there’s a clear route between that doesn’t involve a shallow reef, so once again I was stationed on the pilothouse roof with binoculars in hand.

On arrival in Culion, we entered a harbour that looked rather wide but in fact had extensive reefs sitting just below the surface on either side, making the actual channel quite narrow. Luckily, the water was remarkably clear, so the reefs were easy to spot. A good thing too, because our chartplotter was of no use to us here either. It had us located outside the bay altogether, sitting on the other side of the peninsula to our east. Needless to say, we went really slow and relied heavily on our depth sounder.

One we were happily anchored in about 15m (45 feet) of water, we hopped into our dinghy to go ashore. On our way in we’d already spotted the big Catholic church and the hospital which dominated the scene. The hospital, which has a good reputation in the area, seemed to be lacking in one respect. Most of its roof was missing, the rafters open to the sky. Yet another casualty from Supertyphoon Yolanda.

We tied up our dinghy by the breakwater and strolled along the waterfront until we came across the road leading up to the church on the summit. La Immaculada Concepcion is an impressive building. The first Spanish missionaries (Augustinians) arrived in 1622 to “evangelize” the island. Fort Culion was built around 1740 as a defence against Moro Raiders (Muslims) with the original church located inside. Today, only one of the fort’s original bastions is still partially intact, complete with a cannon overlooking the harbor.

In 1933, the church was enlarged and rebuilt on the same site, retaining its original Spanish facade and repurposing the stone blocks from the fort. Interestingly, these blocks were actually hewn from live coral.

It was here at the church that we met up with Sister Mary Josephine, a nun posted to Culion. She had stopped by the church briefly on her way to meet up with friends when we asked her where the museum was located. Instead of simply pointing the way, she insisted on taking us there with a detour through the leprosy ward on the hospital grounds.

Culion was a leprosy colony established under the American administration in 1906. At the time, people suffering from leprosy on the islands in the Philippines were forcibly removed and relocated to the colony for treatment. In the ward were perhaps a dozen elderly patients, former residents of the colony not having anywhere else to turn who stayed on for care. Most suffered from the debilitating effects of the disease left untreated for too long, from disfigured hands and feet to blindness. It was heartbreaking to meet these people, especially knowing that today leprosy is easily treated.

From here, Sister Mary Josephine took us to the museum and then found an administrator from the hospital to open it up for us. We had the place to ourselves. In fact, it seems we were the only tourists in the entire town today, foreign or otherwise.

The collection in the museum was fascinating. Here are some of the harrowing and some of the interesting bits of information we discovered:

• One early indigenous treatment involved placing a leper in a hole in the ground and burying them from the neck down with dried leaves, soil and tree branches. They could stay like that for years. This was meant to be therapeutic.
• Another treatment involved placing a leper inside the intestines of a black cow for two days.
• In the worst case, lepers were burned or buried alive in the belief this would stop the cycle of the disease.
• In 1900, the American Military government in the Philippines identified leprosy as a national public health problem. There were an estimated 30,000 cases in the islands and another 1,200 new cases developing each year. Compulsory segregation of lepers for confinement and treatment was made into law in 1907.
• Leper “collection trips” were made around the islands, often resulting in forcible removal. Culion became known as the “island of no return”. Later, as information spread that patients were being treated, provided with food, living quarters and clothing at no cost, and weren’t being shunned, more lepers voluntarily came forward to be sent to Culion.
• The first 370 leprosy patients arrived at Culion in May 1906. At its peak in 1935, there were 6,928 patients. In 1942, when Japan occupied the Philippines during in World War Two, 1,256 patients ran away because there was a severe shortage of food. After the war, regional treatment centres began to spring up and fewer patients were admitted each year. By 2005, there were 158 remaining patients and no new admissions.
• Patients who were able to work were hired, for a nominal fee, as nursing aids and pharmacists. Between 1906 and 1914, all able-bodies patients were required to put in four hours at a stretch for two days each month on jobs like street cleaning, construction, garbage collection and the cleaning of public toilets.
• In 1910, marriage between patients was allowed to solve the “immorality issue” of extramarital affairs. Babies born at the colony were sent off the island for adoption until 1916 when the Balala Nursery was built. This allowed infected parents to visit their non-infected children weekly through a glass viewing window. More than 400 babies were admitted to the nursery until its closure in 1983.
• The colony had its own church, school, hospital, post office, police force, fire brigade, shops, marching band, orchestra, Boy Scout troop, cockfight pit, baseball diamond and cemetery. The lepers were segregated even in death.
• In 1913, a separate currency was established because of the fear that leprosy could be transmitted on items like coin and paper.
• By the 1930s, Culion had become the biggest and most well-equipped and organized leprosarium in the world. It became a centre for research about the disease and various treatments.
• Even when they died, patients were researched an examined. An average of 200 autopsies were performed each year in the 1920s and 1930s.
• Multidrug therapy began at Culion in 1986 but new patients continued to be diagnosed. It wasn’t until 1998 that leprosy was eliminated as a public health concern on the island.

Following our tour of the museum, we set off to explore more of the town itself. There are signs posted to mark sites of interest and provide a brief history. At the Grand Staircase, we found some arborists (it said so on the back of the green shirt worn by the guy on the ground) hard at work to top a damaged tree perilously close to several buildings and the people walking up the staircase. Notice the safety gear, or lack thereof.

After a late lunch of pancit bihon and a trip through the teeny tiny market to buy cucumbers and bananas, we walked back to our dinghy, which we found sitting high and dry. Oops! The tide was out.

That evening back on MOKEN, we were serenaded, quite badly I will add, by three young men in a small banca who circled us a few times, waved hello and went on their way. Another interesting end to another interesting day.

About Leprosy

Throughout history, people afflicted with leprosy have often been ostracized by their communities and families and banished to live apart from society. With no cure in sight, leprosy colonies began to spring up in many countries, under the belief that isolation and segregation would eliminate the disease from the population over time.

Leprosy (or Hansen’s Disease) is a chronic disease caused by a slow multiplying bacillus, Mycobacterium leprae. Incubation is approximately five years, but symptoms can take as many as 20 years to appear. Untreated, leprosy can cause progressive and permanent damage to the skin, nerves, limbs and eyes.

Today, the diagnosis and treatment of leprosy is easy and most endemic countries are striving to fully integrate leprosy services into existing general health services. While the World Health Organization provides the treatment for free to all endemic countries, pockets of high endemicity still remain in the Philippines, among other countries, usually afflicting the most marginalized people and poorest of the poor.

Over the past 20 years, more than 14 million leprosy patients have been cured worldwide and the prevalence rate of the disease has dropped from 21.1 cases per 10,000 people to less than 1 case per 10,000 people in 2000. That’s a 90 per cent decline.

Source: World Health Organization