Many of the images conjured by the word leprosy (bệnh phong) can be unsettling to some. Yet, the misunderstood disease exposes the capacity for human care and empathy. Quy Nhơn’s Quy Hoà leprosy village exhibits how communities can come together to lovingly help the less fortunate.
In director Việt Linh’s film Dấu Ấn Của Quỷ (The Devil’s Mark), a character afflicted with leprosy is forced to live on the outskirts of a village with a dog as his sole companion. He willingly wears a crude bell around his neck so his neighbors have advanced warning of his arrival and can run away. His existence serves as a metaphor for the ways in which the disease robs sufferers of human connections.
It’s with this character in mind that Saigoneer entered Quy Hoà, the bright sunshine and the soothing sound of the surf in the distance already at odds with the macabre reputation surrounding the disease. An afternoon spent strolling through the village’s welcoming architecture, meeting friendly residents, and learning about the history of the hospital and the surrounding community further changed our understanding of leprosy and the positive elements it reveals about society.
The History of Leprosy in Bình Định
Leprosy, also known as Hansen's disease (HD), is one of the world’s oldest diseases. Caused by a bacterial infection, in the long run, the disease results in skin lesions and nerve damage that leave parts of the body less sensitive to pain and temperature, and prone to deformities. While it is not especially infectious, because no effective treatment was discovered until the 1940s, it brought despair to people around the world for centuries. Exacerbated by pollution, poor sanitation and limited hygiene, it most commonly proliferated amongst the poor.
A lack of scientific understanding of the disease and the misunderstanding that it was highly contagious led to its stigmatization in Vietnam. Patients and their families would be ostracized and face cruel violence including being buried alive, drowned, or tossed into the wilderness to be ravaged by wild animals.
In the 1920s, Bình Định was officially home to 360 people afflicted with leprosy, though considering the lack of widespread diagnosis and the rural conditions, it’s possible that as many as 1,200 of the province’s 70,000 people may have had the disease. Sensing the urgent need to care for them, Paul Maheu, a French priest, founded the Laproserie de Quy Hoa Hospital in 1929 along with Dr. Lemoine of the Bình Định Hospital on a stretch of land along the coast, eight kilometers south of Quy Nhơn.
Quy Hoà village seen from the sky in 1970. Photo via Flickr user manhhai.
During its first year, the hospital welcomed 52 patients who stayed in thatched cottages. To care for growing needs, in 1932, six French nuns departed from Marseille and arrived via an arduous journey through Saigon and immediately went to work expanding the facilities while bathing and tending to up to 180 patients every day. New thatched homes were added to accommodate the increase in residents and the family members that often came to stay with them.
This original colony was sadly short-lived, as a vicious storm destroyed it in 1933. But the devastation allowed for the replacement facilities to expand on the original vision and the campus grew to include a church, convent, and more than 200 homes for patients to reside in.
Quy Hoà village looked little different in 1970 compared to today. Photo via Flickr user manhhai.
The Origin of Quy Hoà’s Unique Architecture
Vibrant, colorful, creative, and flamboyant are not words that one typically associates with medical facilities. Yet, Quy Hoà is in many ways the opposite of the brutally austere architecture found in most hospitals. The picturesque beach in the background, blooming rows of bougainvillea, lush palm trees, and sandy lawns certainly help, but what is truly enchanting is the colony’s architecture.
Following the 1933 storm, Sister Ozithe oversaw the construction of buildings that relied on her work as a French architect and took into account the unique preferences of the patients and their families, as well as Vietnam’s tropical construction styles. Each resident provided their vision for their homes, including the designing of one-of-a-kind bricks and ceramic tiles that were then specially made. Such room for individual expression resulted in a charming hodge-podge of colors, reliefs, facades and roofs.
The specific needs of medical patients also influenced Quy Hoà’s design. Tiled floors, few steps, no fences, and open entrances to houses responded to the physical restrictions of those with severe cases of leprosy. A multitude of benches, shady trees, and park areas were installed with consideration of the fact that those living in the colony were not able to often leave the area.
“The leper camp is becoming more and more like an urban residence. Each street has its own name, the villas loom under the shade of coconut trees, worthy of the name 'Peace covers the country,'” explained one nun in a letter she sent back home in the early 1940s.
Despite their physical limitations, the patients played an active role in the construction of their homes. Over the years, new styles and influences, including elements of Korean and Japanese aesthetics, entered the designs, but they remained unique, in part due to the intimate relationship between home and human. Some would even argue that the suffering of those building the homes only enhanced the structures’ beauty, like water nourishing a field.
While adherence to any specific religion was not required to receive treatment, a number of statues were also installed to reinforce the values of the mission. Jesus, the Virgin Mary, various saints and famous doctors sought to calm and inspire residents. They still stand today, along with the former home of Quy Hoà’s most famous resident: poet Hàn Mặc Tử.
Arriving in in the late 1930s afflicted with advanced leprosy, the writer who famously suggested selling the moon died in 1940, at the age of 28. His simple dwelling stands as a tribute to his austere life of suffering and creativity. Books, personal possessions, letters, photos of distinguished visitors and portraits painted by his brother line the walls beside the wooden bed where he passed away.
Daily Struggles
Despite the cooperative efforts to foster comfortable, healthy conditions, life at Quy Hoà was at times arduous. At one point, only 10 nuns were tasked with taking care of more than 1,000 patients. By 1974, one year before the Vietnamese government took over its operations, there were more than 5,422 patients and the community became crowded with the additional family members that came to stay. Homes were made smaller and resources scarce as it continued to take in patients from beyond Bình Định with no discrimination based on wealth.
While Quy Hoà is now easily accessible via road from Quy Nhơn, it was once much more remote, necessitating vital supplies be brought in by boat, sometimes as infrequently as once every five months. The dire economic conditions led residents to grow coconuts to eat as well as make oil, soap, medicine and brooms. They supplemented the craft industry by asking for food and money from the surrounding communities. Until 1994, no child in the village was able to go to school beyond the elementary level.
An interesting element of the challenges and resilience of the community involves footwear. Leprosy often results in deformed limbs that require shoes of different shapes or sizes and ones that can make walking easier. Thus, in 1997 a special shoe-making operation was founded in the village. Now numerous generations of shoe-makers have participated in the craft and some, such as one man Saigoneer met, decided to continue living in the village after retiring.
And while today Quy Hoà remains well taken care of for the most part, when walking around, we did notice a few untended areas where old medical equipment, furniture and signs had been discarded. The numerous languages observed on the dilapidated signs reveal the village’s international origins and the many global organizations involved in its operations. Were in not such a sunny day with birds chirping in the background, the sight of a rusting surgery chair and old devices would have certainly made us feel as if we had entered a survival horror video game.
Life at the End of a Disease
The use of vaccines, rising living standards and isolation communities like Quy Hoà have all been credited with drastically reducing the rates of leprosy in East and Southeast Asia. Yet the disease remains a concern, and several hundred people are afflicted with it in Vietnam. And many more that have been cured remain in need of long-term care due to physical disabilities brought on by the disease. As of 2019, Quy Hoà was therefore home to 421 inpatients and approximately 40–50 outpatients.
Funding remains a significant problem for the village, even before the added economic strains of the COVID-19 pandemic. Much of the modest food rations and subsides totaling less than VND300,000 a month per person are provided via the state and other charitable contributions. Similarly, nuns continue to play an important role in offering care and securing financial support for those at Quy Hoà and the two dozen or so similar leprosy communities and hospitals in the country.
And while the stigma surrounding the disease has been reduced thanks to increased medical knowledge and falling numbers, those suffering from deformities still experience ostracism. This leads many to chose to remain sequestered amongst people that share or can at least understand their conditions. This isolation and general economic challenges mean life can be slow or lonely at Quy Hoà. When walking around, we observed many people napping, watching television and one friendly group gathered to play cards. A few groups of kids were eager to greet us, while one man had a very impressive flock of fighting roosters he was tending to. One gets the sense that like in many small villages, little changes day-to-day there.
The future of Quy Hoà is unclear. Its time as a medical facility specializing in the care of leprosy patients and survivors is probably nearing an end considering the country’s dwindling infection rates. It may transition into a more conventional small village inhabited by the families of former patients. And as nearby Quy Nhơn continues to grow, it is hardly the isolated outpost it once was. It can now be reached via a pleasant stroll that includes a side-trek up a mountain and several years ago, a few kilometers away, a state-of-the-art science and space facility opened that welcomes esteemed experts in a variety of fields from around the world.
Given the beautiful locale, unique architecture, and history, it’s impossible to imagine it won’t attract increasing numbers of visitors. It sounds morbid to consider a leprosy hospital to be a tourist attraction, but it has become a popular destination for youths to come take photos. The idea that the site of much former misery and suffering could become a desirable day trip locale is an inspiring idea.
