More than 100 years of care at McKean Rehabilitation Institute

Legacy lives on in one of Thailand’s most vulnerable communities

by Kathy Melvin | Presbyterian News Service

The chapel at the McKean Rehabilitation Center and Hospital in Chiang Mai, Thailand. (Photo by Kathy Melvin)

CHIANG MAI, Thailand — In 1907 Presbyterians took steps to protect one of Thailand’s most vulnerable communities. More than a century later, the legacy of care lives on.

Dr. James McKean, a physician and missionary, began his work in Chiang Mai in 1889 and remained there his entire missionary career. His first contribution was creating a smallpox vaccination program that reached more than 200,000 Thai people. In 1905, he began to treat leprosy sufferers who were rejected from society with no homes and no means of caring for themselves. Word of the country’s first leprosy care center spread quickly, and patients began to come there by the hundreds.

The need became so great that McKean worked with the minister of the interior of Siam, the high commissioner of Chiang Mai, and the prince of Chiang Mai to create a care facility on Koh Klang, a river island where elephants were kept. White elephants are rare and are always given to the reigning monarch as a gift — which the monarch then must care for the rest of its life. That’s where the traditional “white elephant gift” tradition began —a gift that is not useful or practical. The locals refused to visit the area, fearing the spirit of an elephant that had killed someone on that island. The Thai fear the spirit of anything that dies — it is a reason they abandon houses that cannot be sold when someone dies there.

Leprosy is a chronic, progressive bacterial infection. It primarily affects the nerves of the extremities, producing skin ulcers, nerve damage and muscle weakness. Even today, in developed countries, many people don’t understand the disease. Some believe it causes fingers and toes to fall off. Actually, simple injuries lead to ulcers and infection and sometimes fingers and toes must be amputated. There can also be wasting of the muscles that can result in wrists or ankles being locked in place, making it difficult to walk or perform simple daily tasks. Leprosy is contagious, but only after regular contact during a prolonged period of time. It is estimated that more than 95 percent of people who are infected with the bacteria Mycobacterium leprae do not develop leprosy because their immune system fights off the infection. People who develop leprosy may have genes that make them susceptible to the infection once they are exposed.

At the height of the disease, more than 3,000 people lived permanently on the grounds. By the turn of the 20^th century, McKean was recognized as one of the leaders in leprosy community care, setting an example followed by many other countries around the world. Cut off from the general population, schools, shops and community centers were developed. The community had its own currency and its own police force. For many years, each family was given a tiny cottage on the island and taught skills to earn a living, while the mission doctors ministered to both their health and their souls.

As patients began to be cured, they learned they could not go back home because of the stigma of the disease. So McKean began buying land and creating new villages. There are now over 20 villages established by McKean still overseen by the institute that bears his name.

There was no cure for leprosy until the early 1980s. Now, a three-drug regimen for 6-12 months can totally alleviate the disease. After the cure was widely available, new cases of leprosy dropped significantly and McKean began to adapt, turning itself into a rehabilitation center.

Today the handicapped, those in need of surgery, rehabilitation and the very poor come to McKean looking for help. There is vocational training, education, and all other programs to help those in need. McKean has even opened a retirement home for Thais and expatriates. Traditionally, the elderly live with their oldest child until death, but with education, the rise of the middle class and two-career families, this is changing and creating a need for elder care.

At the annual mission meeting of 1948, there was a proposal to rename the Chiang Mai Leper Asylum the “McKean Leper Home.” Today, it is the McKean Rehabilitation Center and Hospital, a service branch of the Church of Christ in Thailand, a longtime PC(USA) global partner. There is also a village for the elderly at McKean for those who have been cured of leprosy but have no family left.

The grounds at the McKean Rehabilitation Center and Hospital are both peaceful and beautiful. (Photo by Kathy Melvin)

Mission co-worker the Rev. Sharon Bryant, serving with the Church of Christ in Thailand, knows the Presbyterian connection was even closer than partnership. Her father was the director of the institute.

Dick Bryant graduated from McCormick Theological Seminary in 1945 and made the decision to go into mission work in China with the United Presbyterian Church.  He and his first wife, Adeline Fox Bryant, went to Beijing in 1946.  Following the death of Adeline in childbirth, Dick married Evelyn Coovert, a Lutheran missionary nurse, in 1948. Driven out of China by the communists, the Bryants were sent to Thailand. Dick Bryant taught theology at the McGilvary Theological Seminary in Chiang Mai from 1952-1957. After launching the Christian Service Training Center for lay leaders in Chiang Mai, he spent time evangelizing in rural areas. He served as director of McKean from 1977-1982. Evelyn Bryant participated in the mobile clinics that McKean operated.

He was honored to host H.M. King Rama IX on March 5, 1978 and H.M. King Rama X, the current King when he was crown price in February 1982. King Rama X will be coronated May 4-6.

The Bryants retired in 1986, but returned at least six times — in 1992, 1993, 1996, 2001, 2002 and 2003, three times serving as interim manager of the Bangkok Christian Guest House, once in the Department of Evangelism, and twice as evangelistic leader at Pranburi Training Center in South Central Thailand.