“Mother of Outcasts” Marianne Cope Canonized for Work with Leprosy

One hundred years after her death, Mother Marianne Cope has been canonized by Pope Benedict XVI for her work with patients with leprosy now called Hansen’s Disease.

In 1883, Mother Marianne,  a member of the Sisters of the Third Order Regular of Saint Francis (based in Syracuse, New York) received a plea for help in caring for leprosy sufferers from King Kalākaua of Hawaii. More than 50 religious institutes had already declined his request for Sisters to do this. She responded to the letter enthusiastically:

I am hungry for the work and I wish with all my heart to be one of the chosen Ones, whose privilege it will be, to sacrifice themselves for the salvation of the souls of the poor Islanders… I am not afraid of any disease, hence it would be my greatest delight even to minister to the abandoned ‘lepers.’

Along with six other Sisters of St. Francis, 45-year-old Mother Marianne arrived in Honolulu in November 1883. She became the manager of the Kakaʻako Branch Hospital which served as a receiving station for patients with leprosy gathered from all over the islands.

In November 1888 she moved to Kalaupapa both to care for Belgian priest Father Damien (right) and to assume his burden. Father Damien was already known internationally for his heroic care of the leper colony there.  He had contracted the disease himself in 1884, and was now dying from it. He was canonized for his work by  Pope Benedict XVI  in 2009.

Mother Marianne and two assistants ran the Bishop Home for leprous women and girls, as well as the Home for Boys at Kalawao, founded by Father Damien for boys and young men.

Despite her close contact with the patients, Mother Marianne never came down with the disease. She lived the remainder of her life in Hawaii, and died of natural causes at the age of 80.

 What is Hansen’s Disease (Leprosy)?

Hansen’s Disease is a is a chronic disease caused by two rod-shaped bacteria: Mycobacterium leprae and Mycobacterium lepromatosis. It causes skin sores, nerve damage, and muscle weakness that gets worse over time.

Leprosy was recognized in the ancient civilizations of China, Egypt and India. References to the disease was found on Egyptian papyrus in about 1550 B.C.

Throughout history, leprosy has been feared and misunderstood, and has resulted in significant stigma and isolation of those who are afflicted. It was thought to be a hereditary disease, a curse, or punishment from the gods. During the Middle Ages, those with leprosy were forced to wear special clothing and ring bells to warn others as they walked by.

Leprosy has two common forms: tuberculoid (TL) and lepromatous (LL). Both forms produce sores on the skin. However, the lepromatous form is most severe. It causes large lumps and bumps (nodules).

M. leprae multiplies very slowly and the incubation period of the disease is about five years. Symptoms can take as long as 20 years to appear. It is transmitted via droplets, from the nose and mouth, during close and frequent contacts with untreated cases.

Symptoms include:

  • Skin lesions that are lighter than your normal skin color
    • Lesions have decreased sensation to touch, heat, or pain
    • Lesions do not heal after several weeks to months
  • Muscle weakness
  • Numbness or lack of feeling in the hands, arms, feet, and legs

People with long-term leprosy may lose the use of their hands or feet due to repeated traumatic injury resulting from lack of sensation.

If left untreated, it can cause progressive and permanent damage to the skin, nerves, eyes and limbs.

How is Hansen’s Disease Treated?

In 1941 the course of leprosy radically changed with the introduction of the first medication to treat it. Promin, a sulfone drug, seemed to work, but required many painful injections.

Dapsone pills were found to be effective in the 1950s, but in the 60’s and 70’s, M. leprae developed resistance to dapsone. At the same time, a three-drug combination of dapsone, rifampicin (Rifadin), and clofazimine (Lamprene) was determined to be very effective in killing M. leprae.

This multi-drug treatment (MDT) was recommended by the WHO in 1981 and remains, with minor changes, the therapy of choice. MDT takes from six months to a year or even more, depending on clinical manifestations of the leprosy infection.

How common is Hansen’s Disease Today?

Official figures from the World Health Organization reveal that almost 182 000 people, mainly in Asia and Africa, were affected by Hansen’s Disease at the beginning of 2012.  Approximately 219 000 new cases were reported during 2011.

Hansen’s disease is rare in the U.S. although there are currently about 6,500 cases; with 3,300 requiring active medical management. Most (97 or 65%) of these cases were reported in California, Florida, Hawaii, Louisiana, Massachusetts, New York, and Texas.

The Key Facts About Hansen’s Disease Today

Leprosy remains the most misunderstood human infectious disease. The stigma long associated with the disease still exists in most of the world and the psychological and social effects may be more difficult to deal with than the actual physical illness.

The key facts of Hansen’s Disease today include:

  • Most (95 percent) of the human population is not susceptible to infection with M. leprae, the bacteria that causes Hansen’s disease.
  • Treatment with standard antibiotic drugs is very effective.
  • Patients become noninfectious after taking only a few doses of medication and need not be isolated from family and friends.
  • Diagnosis in the U.S. is often delayed because health care providers are unaware of Hansen’s disease and its symptoms.
  • Early diagnosis and treatment prevents nerve involvement and the disability it causes.
  • Without nerve involvement, Hansen’s disease is a minor skin disease.

For more information, go to the Resounding Health Casebook on the topic.

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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