Alupe, the forgotten leper camp of Kenya’s social outcasts

At Alupe, about eight kilometres from Busia town, Samson Kurgat Kiptalam and Safere Juma sit near an old brick house with rusty iron sheets. This is one of Kenya’s most horrific medical sequesters — and they are not about to leave.

The two are victims of a history that society left behind. Their aging faces, and the scars on their limbs, are sad reminders of decades-long battles with one of the world’s most feared diseases — leprosy. Kiptalam and Juma are the forgotten survivors of one of two known leper colonies in Kenya: Alupe and Kaloleni.

While the other patients were forced to leave, the two — who were treated at Alupe Sub County Hospital in Teso South Constituency — had nowhere to go. Previously, Alupe Leprosy Hospital (as it was then known) housed the Leprosy and Skin Disease Research Centre for East Africa.

The leper colonies were established during colonial times when a policy of mandatory quarantine was effected as the only way to stem the disease, which was falsely considered highly infectious.

MEDICAL PRISONS

Victims were sent to either Alupe or Kaloleni to fend for themselves. Or at worst, to die alone there. Even after Independence in 1963, doctors continued to send lepers into these medical prisons — or what are today called “leper asylums”.

And because of the social stigma, those who didn’t die in the camps were abandoned in these villages, with nowhere else to call home.

Although they have healed, Mr Kiptalam, 63, and Mr Juma, 78, are still confined to Alupe’s remaining segregation camp — almost a decade after the hospital’s management forced out hundreds of residents after demolishing seven dwellings where they used to live.

The story of Mr Kiptalam and Mr Juma is one of pain and joy. They successfully battled a scourge widely dreaded by humankind. Bravery, patience and hope were key.

Leprosy is a bacterial disease that affects the skin, eyes, nose and peripheral nerves. Its patients were quarantined for fear they would infect others.

Patients mainly suffer from patches on the skin, reduced physical sensation, numbness and general weakness.

PRONE TO ULCERS

The bacteria affects both the skin and the nerves, making the victims prone to ulcers, self-caused injuries, and limb loss. Symptoms take as long as 20 years to appear.

If untreated, the disease can lead to disability; but it can be cured with long administration of antibiotics.

Mr Kiptalam is from Nandi County He says he was referred to Alupe by a doctor in 1978 after he developed leprosy symptoms. The doctor gave him Sh150 for the journey to the Busia facility.

“My limbs were becoming numb yet I had no idea why. It is then that I went to a nearby hospital, from where I was sent here. I was received by one Dr Adalla (deceased) and was enrolled for medication immediately,” he recalls.

Mr Kiptalam says he responded well to medication until 1990 when he was discharged. But in 2000 he injured himself on the right ankle and the wound took long to heal.

“This made me return here for a second time. I have since healed but I am on post exposure medication. I can dress the wounds by myself. We have also been told to ensure our skin remains soft and moist all the time,” says Mr Kiptalam during a chilly morning interview.

DEHYDRATION

The patients are advised against working for more than two hours a day, despite their ability to handle simple menial jobs such as cleaning, gardening and shoe making.

“We were told that this is due to dehydration of the body,” says Mr Kiptalam.

Before Mr Juma came here, he used to work at Msabweni Sub-County. Then, in 1957, he started feeling unexplained pain in his legs. He was referred to Alupe in the early 80s, some 23 years after the initial attack by leprosy.

“I felt numb in my right leg, then in the left one, too. I was referred here, where Dr Adalla amputated four toes from both legs. I am okay now, save for occasional pain. We are also having problems with feeding, since we cannot fend for ourselves fully,” he says.

Mr Juma hails from Amukura in Teso South. He says he has been shunned by his family and society for almost four decades. He has two sons, he recalls, one working at the Kenya Ports Authority and the other as a police officer. Six other children died, but he was unable to attend their burial.

“I can’t go home any more. Nobody wants to see me. My land has been sold by my relatives.”

On his part, Mr Kiptalam says his wife ran away with their two sons after discovering that he had leprosy.

WORLD WAR II

Worldwide, leprosy was first recorded in the first century, and almost disappeared from Europe by the 18th century. But a handful of areas in Africa, Southeast Asia and South America were still affected.

Mr Francis Amakoye, a senior occupational therapist at the hospital, says lepers were brought to the facility after World War II.

“The war victims were drawn mainly from East and Central Africa. They were first hosted at the Kakamega-based Public Government Hospital for five years, from 1939,” he says.

“The colonial settlers did not want leper colonies in Central or Rift Valley regions, where they had settled,” said Mr Amakoye, who has been at the facility for 36 years.

In these camps, the patients were not allowed to mix with others. They were contained in one place — the Alupe segregation camp, which sat on land measuring about 800 hectares. In the 50s, survivors were housed in tents before brick houses were built.

“The doctors treating them were mostly from Netherlands. Only these doctors, and a few other people who worked with them, handled the patients,” Mr Amakoye says.

When he first joined the hospital in 1982, he found patients from Sudan, Somalia, Malawi, Tanzania and Rwanda, among other countries. Some of them died and were buried nearby, not far from today’s Alupe Primary School.

INFORMAL SCHOOLS

“They were not allowed to move out of this compound. They had their own market, informal schools and other social amenities,” he recalls.

A breakthrough in the treatment of the disease came in the early 80s, as the hospital celebrated its 30th anniversary, following introduction of a multi-drug therapy that cleared relapse cases. Previous therapies used single drugs.

“This milestone is largely due to the intervention of the National Leprosy and Tuberculosis Programme that was headed by the Dutch team. Leprosy, which spreads via nasal fluids, is not highly contagious. It can be treated with a six-month cocktail of drugs,” he says.

But if the nerves are affected and sensation is lost, or physical deformations are observed, patients are advised to take care of the remaining parts of the body. Amref surgeons are occasionally available for reconstruction surgery.

Newer cases from other regions in Kenya are today referred to their home counties, which have competent personnel to handle them. “Health officers and students come here periodically to learn about leprosy,” he says.