The story of Kate Marsden's epic journey to the outcast Yakut lepers still stirs imagination with the outstanding courage, selflessness and willpower demonstrated by this young woman, who ventured into the Siberian taiga, despite harsh conditions of the journey, endeavoring to find the cure for leprosy and deliver it to thousands of lepers in other countries. Her efforts to improve conditions for the leprosy sufferers launched the process of gradual elimination of this terrible disease in Siberia, which was acknowledged by Russian society a few years after her unforgettable journey. Here is the opinion of Professor Reshetillo, a well-known Russian expert in leprosy and other skin diseases whose authority was recognized not only in Russia but also throughout Europe:
Miss Marsden definitely deserves that her name would be marked out in the history of leprosy in Siberia. We must pay homage to her extraordinary energy and distinguished self-sacrifice that helped this young woman, who could not speak or understand Russian, to overcome unbelievable hardships of the journey throughout Siberia in order to reach the, so called, “dead places” in Yakutia, where the natives expel their lepers. Moreover, not only did she thoroughly describe what she had seen there, but she also came back and roused Russian society, raised necessary funds in a foreign country, and in fact determined the Yakut lepers' destiny. 1
Professor Reshetillo personally knew Miss Marsden and met her in St Petersburg in 1890. That year Miss Marsden arrived to Russian capital city with an intention to find patronage and support for her future mission to lepers' settlements in British colonies from the Russian Empress Maria Fedorovna (Danish Princess Dagmar before marriage). Together with Dr. Duncan, a British physician who accompanied her in St. Petersburg, Miss Marsden visited Reshetillo, who had just returned from Jerusalem, to inquire about lepers in Palestine, where she planned to go with a research mission, aiming to study more about the living conditions of lepers and available means for treatment.
However, in order to find the reasons why Miss Marsden got so interested in studying leprosy and how she appeared in St. Petersburg it is necessary to go a few years back to the times of the Russian Turkish War of 1877-1878. Working as a nurse of the Red Cross Mission in Russian field hospitals in Bulgaria, she met a couple of lepers in a small shack near Sistov and the sight of their mutilated bodies made her think about finding possible means to mitigate the effects of leprosy. It is most probable that the decisive incentive that inspired Miss Marsden to dedicate her future life to alleviating sufferings of lepers was the news about the death of the Blessed Damien Joseph de Veuster, also known as Damian the Leper, a Belgian Catholic priest who had spent 16 years among the lepers at the Molokai islands in Hawaii as a missionary, contracted leprosy, and died in 1889. The story of his deeds and death made many people throughout the world reconsider their attitude towards lepers and other people suffering from incurable illnesses. Today Damian the Leper is regarded as a patron saint for those people who have AIDS.
Having made a decision on dedicating herself to helping the lepers, Miss Marsden started raising funds to implement her plans of organizing a charitable mission to India, where hundreds of thousand of lepers had been languishing in terrible conditions, and applied to the British Queen Victoria and Princess Alexandra for patronage and support. Obviously, both the Queen and the Princess approved the idea in general but did not provide enough funds, so that Miss Marsden made up her mind to go to Russia and appeal to the Russian Empress Maria Fedorovna, Princess Alexandra's sister, for support. Although the problems of lepers in British colonies had not been close to the Russian Empress, she met Miss Marsden with sympathy and provided sponsorship for the expedition to the lepers' settlements in the Middle East. At this point, there had not been any plans of going to Siberia at all. Miss Marsden intended to study the problems related to leprosy treatment and lepers' living conditions in order to organize a well-prepared and fully equipped mission to India later. However, the news, which she had heard in Constantinople from a doctor who had worked with lepers, about a miraculous herb existing in Siberia that reputedly had a curative effect on lepers made her change her previous plans. Miss Marsden decided to find the herb in Siberia and to bring the cure to thousands of lepers around the world.
The herb she was looking for turned out to be one of the species of wormwood - Artemisia gmelinii Weber ex Stechm, which may be found in Eastern Siberia and in the Far East. The sap of this herb, called “kutchukta,” was used by the Siberian indigenous population for healing wounds in lepers. The local inhabitants also used wormwood in diarrhea, menorrhea, fever, and a range of other inflammatory diseases. According to modern experts in herbal medicine, Artemisia gmelinii Weber ex Stechm does have anti-inflammatory, haemostatic and antipyretic effects, though it can be used only as a symptomatic medicine.2 However, 110 years ago no cure for leprosy was known, so that any rumors about healing properties of one or another medicine instilled hopes in doctors, nurses, and the poor sufferers. It is no wonder that Miss Marsden was also inspired with such a hope and rushed to St. Petersburg, where she shared her new ideas with the Russian Empress and made a plan for the expedition to the Yakut area in Eastern Siberia.
Obviously, the Russian Empress was very impressed by Miss Marsden's proposed venture and provided her extraordinary support, which predetermined success of the expedition. Not only did the Empress provide the necessary funds for purchasing supplies, but she also granted Miss Marsden the writ of Her Majesty's Protection and the, so-called, open list - a document prescribing authorities in Russian provinces to provide every possible support for the mission and to cover any additional expenses. This conferred Miss Marsden enormous power in the eyes of all the officials that she met on her way, because from that moment on she was regarded as the Empress' envoy. It might seem unbelievable today, but in the country of almost absolute monarchy, as the Russian Empire was those days, such subordination was typical. As a result, every official tried to do his best to provide housing, transport, and supplies for Miss Marsden's mission and to fulfill her claims. It does not mean, though, that everyone did it with willingness and sincerity. They just did not have any chance to behave differently.
It is rather peculiar that Miss Marsden was sure that everyone shared her approach towards the goals of the mission and believed that all the native people in Siberia were eager to meet her charitable mission and to provide all possible assistance. For example, she sincerely believed that the Yakut men voluntarily laid a road through the thick forest, leaving all their usual summer activities behind, working hard day and night in the taiga, as soon as they heard about the expedition's intention to provide help for the lepers. Such willingness would have contradicted the typical behavior of the aboriginal community in regard of their own lepers. Taking into account the fact that, typically, any person suspected in having contracted leprosy was to be expelled from the community and to be treated as an outcast, it is rather unlikely that hundreds of the Yakut peasants overcame their fears and changed their age-old habits in treating lepers with ultimate cruelty after a single appearance of a foreign visitor who could communicate only through an interpreter. The following extract from the report on leprosy in the Yakut area made by a group of Moscow doctors in 1934 confirms that the local people were forced to work on laying the road for Miss Marsden's mission.
The days when English Nurse Marsden came to help the lepers are not forgotten. The local people remember very well how all the able-bodied men were forced to cut the trees, lay a road, make campsites, and prepare supplies for the expedition. It was owing to their hard toil that many adversities that Miss Marsden mentioned in her book [On Sledge and Horseback to Outcast Siberian Lepers] had been eased.3
In the end of the nineteenth century, Russian society cherished much more sympathy towards American Indians and liberated black slaves rather than to the ethnic minorities scattered over the vast territory of the Russian Empire. Neither authorities nor the public demonstrated much concern in the problems of ethnic minorities. The aboriginal communities of the Siberian taiga were regarded as strangers, while their culture was considered primitive. Very little had been done to improve their living conditions or to provide medical help, although leprosy among the Yakut people had been reported yet in the 1820s. By the time of Miss Marsden's expedition the futile correspondence between the Interior Ministry of the Russian Empire and Irkutsk General Governor on the necessity to provide some funds for setting up a hospital for the Yakut lepers lasted for 64 (!) years. Since 1827 the governmental officials who inspected the area had been pointing out unanimously to the lack of any measures taken against the spread of the disease and every report had described the state of the lepers as “unbearably appalling.” Nevertheless, no measures had been taken to improve the situation, despite the long lasting exchange of the reports between the local administration officers and the Empire's authorities. The ministry's responses were invariably indifferent - “the state's finance cannot afford to perform such expenditures.”4
The Russian Orthodox Church, representatives of which worked in the area with a mission, trying to convert the indigenous population into Christianity, also revealed concern about the spread of leprosy in the area. Here is a quotation from one of the reports of the Yakutsk Bishop Milety to the Church authorities.
The terrible disease of leprosy has existed in Sredne-Vilyuisk area since ancient times. The native population regard this disease contagious and the lepers are expelled from the society into the depth of taiga where they live near lakes in small yurts in the most dreadful conditions.5
However, the Russian Orthodox Church had not taken any practical steps to alleviate conditions of the lepers either, for the exception of distributing copies of the Holy Bible among the local population.
Medical authorities of the Russian Empire had been quite aware of the disease and its dangers. Russian experts on skin diseases and hygiene wrote in their reports that in order to combat leprosy in Yakutia, which spread wider and wider with every year, it was necessary not only to open hospitals, but also to set up bathhouses and separate buildings for cattle and other domestic animals. However, as professor Reshetillo admitted, all the good intentions had remained on paper without being implemented, having “demonstrated human feebleness to history.”6
Meanwhile the situation was appalling not only in the lepers' yurts in the taiga but in the Yakut settlements as well. Any person suspected in contracting leprosy ran the risk of being expelled out of the native settlement and lose all the property he had had. Sometimes the inhabitants of the Yakut villages had been deprived of their property because of the false accusations of contracting leprosy. Having noticed the slightest skin manifestations, people were hiding in their houses, trying to avoid any contacts with the neighbors for fear of being driven away from their villages.
The diagnostic procedures practiced by the Yakuts to identify leprosy were vague and based on rather dubious symptoms. One of them, for instance, was to look at the color of fingers in the transmitted light. If the color was dark, the Yakuts interpreted it as “black blood” and regarded such a person to be diseased. Some other symptoms confirming leprosy, in their opinion, were contracted pupils of the eyes, sclera icterus (yellowish color of the white of the eye), shedding of eyelashes and eyebrows, and painless infiltrations in the skin. It is obvious that syphilis and other skin diseases had been fallaciously identified as leprosy, which can be proved by the following example. According to the report of the medical examination made among the Yakut lepers by a group of doctors in 1896, leprosy was confirmed only in 25 out of 48 examined patients, which made almost one-half of the total number of the inhabitants announced lepers and expelled from their homes into the deep forest. The rest of the so-called lepers turned out to have Syphilis and Tuberculosis, while a few patients were found absolutely healthy.
Miss Marsden's expedition to the outcast Yakut lepers had an effect of a comet that flew above the huge territory of the Russian Empire, woke up the sleepy country, and made the society react to the appalling situation with the lepers in one of the remotest places in Siberia. Funds were raised and the colony for the lepers was set up in Vilyuisk in December 1892. All the patients were examined and treated by two doctors, while nuns of the Tomsk convent and nurses of Moscow commune “Utoli Moya Pechali” (Soothe My Sorrows) provided necessary care. By the end of the nineteenth century, the number of lepers that lived in the colony was about 40.
The authorities and medical community highly praised Miss Marsden's endeavor and acknowledged her colossal input into development of proper care for lepers in Siberia. The above mentioned Professor Reshetillo wrote in 1901:
At last, an excellent hospital for lepers was set in Vilyuisk owing to energy and diligence of a foreigner - Miss Marsden, who managed to awaken the Russian society, which found plenty of kindhearted people who contributed their labor and resources to the good deeds.
It is very important that not only nobility but also many ordinary Russian citizens responded to the call and donated to the lepers' funds. For instance, Mrs. Strekalova, chairperson of Moscow's Society for Propagation of Useful Books, suggested her assistance in raising charity funds and, very soon, she collected a considerable sum of money that covered expenses on purchasing linen and clothes for 100 people and some furniture for the colony.
While staying in Moscow, Miss Marsden got close relations with Duchess Shakhovskaya, the Head Mistress of Moscow Commune of Nurses “Utoli Moya Pechali” (Soothe My Sorrows). Five nurses of that commune volunteered to go to Siberia to provide care for the lepers and left for Vilyuisk in May 1892.
At the same time, it would be wrong to conclude that Miss Marsden fully succeeded in melting the ice and convincing the authorities and the public throughout Russia about the necessity of reconsidering their approach to the problem of leprosy. On the contrary, her activity aroused suspicions and smoldering resentment among certain groups of people in provinces, which resulted in the accusation of spying. It is quite probable that such a far-fetched charge was a result of culture difference or misunderstanding caused by Miss Marsden's persistent claims to change the living conditions of lepers not only in Siberia but in every place she visited. She tried to use every opportunity to tell about what she had seen in the Yakut area, appealing for mercy and help for the lepers. However, many people in Russia were afraid of contacting lepers and would have preferred to see them somewhere in remote places rather than in the neighborhoods. The situation might have been exacerbated by the fact that, having been granted enormous powers by the Russian Empress, Miss Marsden spent huge sums on charity at the expense of the local Governors and communities. None of the provincial officials dared to object openly to any suggestions or claims expressed by the Czarina's envoy. At the same time, it is difficult to imagine that the provincial authorities were happy to see the stout woman who openly criticized the current situation with the lepers and persistently called for charity and a new approach towards the problem of leprosy. Moreover, in Samara, where she stayed for a while on the way back from Siberia, she stopped the attempt of the local authorities to expel a dozen of lepers to remote parts of the area and made the local Governor arrange a house for lepers in the city. It is not excluded that the accusation of spying was just a kind of a revenge taken by some people who regarded Miss Marsden as a foreign intruder who shattered the piece and quiet of Russian provinces with obscure claims and requests.
Although some newspapers published a number of wrathful articles that cast a shadow on sincerity of Miss Marsden's activity, accusing her of sabotage and espionage, the central Russian authorities in St. Petersburg refuted all the accusations as groundless. As it was said in the governmental report on Miss Marsden's research on lepers in Siberia submitted and approved by the Synod,
Great enterprises have always been wrongly interpreted in part and therefore, it was inevitable that some misunderstandings had occurred in regard of such a huge remote area as Siberia. After thorough investigation, we announce with confidence that Miss Marsden fully vindicated all the credibility and respect granted her in Russia.
The situation with Siberian lepers changed radically after the revolution 1917. The Soviet government applied drastic measures to improve social conditions of the ethnic minorities throughout the former Empire. Thorough medical examination and care became available even in the remotest places of Siberia. In 1934 an expedition of the Soviet doctors spent about 10 months in Yakutia, studying health problems of the local inhabitants. According to their report, they found only three cases of leprosy after thorough medical examination of 6 000 people. Although their report was written with certain political bias, they admit that the leprosy colony and hospital set up after Miss Marsden's expedition had been the biggest in the area and it had provided treatment for at least 450 lepers between the years 1897 and 1933, according to the archives found in the colony. In spite of the fact that the expedition did not find any case histories referring to the earlier period (1892-1897), it seems quite realistic that the colony might have provided care to no less than one hundred lepers during the first five years of its existence, in consistence with the descriptions and blueprints of the original plan7, because the amount of the funds raised for that purpose was quite sufficient.
Today Miss Marsden's expedition is still remembered in Russia. Some information and short descriptions may be found in a book on the history of Yakutia8 and on the official WEB site of the Sakha-Yakutia republic.9 According to the report of the republican information agency YSIA [www.ysia.ru as of 18.10.2002], the Yakut artist Alexander Romanov started a sculpture composition devoted to Miss Marsden's visit to the lepers in the tundra, while the local poet and playwright Aisen Doidu planned to make a movie about Miss Marsden's trip to Siberia.
The Russian Orthodox Church also acknowledges Miss Marsedn's expedition to the Siberian lepers as an outstanding example of a Christian charity mission. The Sunday Church School of Kaliningrad's Christ the Savior Cathedral included the story of Miss Marsden's journey into the curriculum, together with the biographies of such famous women as Florence Nightingale, Elisabeth Blackwell, and Mother Theresa [www.kcxc.org/school].
Other References and links
Ed. Note: Yuri Bessonov is a Russian physician who works as a translator, independent researcher and a freelance journalist in the fields of nursing history and history of hospital care. He has carried out extensive research in the history of nursing in Russia and in some European countries.