Tuesday, February 28, 2012

Portrait of a lady in Nizamabad: Isabel Kerr. Wellcome Library Item of the Month.

Photograph by G.M. Kerr, 1926. Wellcome Library no. 726380i.
This photographic print is one of the apparently few and elusive portraits of Isabel Kerr (1875-1932), a Methodist missionary who founded the Victoria Treatment Hospital for people with leprosy at Dichpali, near Nizamabad in the state of Andhra Pradesh in India.

Born Isabel Gunn, she had graduated MB ChB at Aberdeen in 1903, and arrived in India with her husband, the Rev. George McGlashan Kerr, in 1907. They noticed the frequency of leprosy and the unsatisfactory treatment of its victims, and having resolved to do something about it, received a donation of 10,000 rupees (£590) from a citizen of Nizamabad, Narsa Gowd, towards a leprosy hospital. In 1913 a gift of 60 acres of land at Dichpali (also called Dichpalli), a village ten miles down the railway line from Nizamabad to the city of Hyderabad, was received from the Nizam of Hyderabad. With further funds from Narsa Gowd and others, the hospital opened on 18 April 1915. [1]

The hospital expanded rapidly owing to demand, and by 1921 it consisted of 120 buildings. Further buildings were added in 1923 when the Minister of Finance of Hyderabad, A. Hydari (later Sir Akbar Hydari) opened more new buildings, again paid for by the Nizam. The running costs from 1910 to 1944 were subsidised by the Mission to Lepers, from 7 Bloomsbury Square, London (since 1965 known as The Leprosy Mission).

In 1920 Isabel Kerr adopted the treatment using oil of the chaulmoogra tree, which she learnt from Ernest Muir in Calcutta. It is presumably a chaulmoogra injection (excruciating for the patient) that is shown in the photograph. An Indian variation of the treatment used the related hydnocarpus plant, which was cultivated along with cinchona in the Nilgiri hills.

At Dichpali there was no shortage of patients, but in too many cases they were the wrong kind for treatment. The Rev. G.M. Kerr described how, in the early stage, when the disease was infectious and treatment would be most effective, patients would hide their symptoms. Only much later would they go for treatment, when the hydnocarpus oil could do nothing to undo the mutilations caused by the bacillus decades previously. Kerr compared the treatment-after-the-event at Dichpali to a clifftop where people were in danger of falling off: it would be better to install a rail at the top than a casualty station at the bottom. To encourage people to be treated in the early stages of leprosy, the Kerrs therefore opened an outpatient clinic in Hyderabad in 1928, with the desired effect: "Students from the colleges, clerks from their offices, and Government officials from their posts" all flocked to the clinic. [2]

A second photograph in the Wellcome Library (below) shows yet another foundation-stone laying ceremony, this time in 1935.
The foundation stone was laid this time by Amena, Lady Hydari. By this time Isabel Kerr had died: she died in 1932, aged 57. [3] The Rev. George McGlashan Kerr continued to run the hospital after her death, until his retirement to Scotland in 1938. His archive including three photographs is in Edinburgh University. He died in 1950.

Isabel Kerr was described as "modest, shy and diffident, and reluctant to speak in public". Hence no doubt the lack of photographs of her: the opposite of the much-portrayed Albert Schweitzer, renowned for his skilful use of publicity.

As a Methodist, Isabel Kerr was doubtless familiar with, and motivated by, the words of John Wesley (1703-1791), the founder of Methodism:

"Do all the good you can. By all the means you can. In all the ways you can. In all the places you can. At all the times you can. To all the people you can. As long as ever you can."


[1] Dermott Moynahan, The story of Dichpalli, London: The Cargate Press, 1949, is the source for most of what is written here. It is a revision of his earlier book The lepers of Dichpali, London: The Cargate Press, 1938. In the earlier edition but not in the later, the present photograph of Isabel Kerr is reproduced with legend "Dr Isabel Kerr giving an injection" (facing p. 28) 

[2] Rev. G.M. Kerr, 'Tackling a great social problem: the fight with leprosy', The foreign field (of the Wesleyan Methodist Church), April 1926, pp. 155-158 

[3] Her obituary in The Lancet reads as follows (in its entirety). "Isabel Kerr, M.B. Aberd. The death is reported from Dichpali, the Leper hospital settlement outside Nizamabad, of Dr. Isabel Kerr, the Scottish medical missionary, who has made this institution the outstanding centre in South India for the treatment of leprosy, and for training in diagnosis and treatment. Born at Fochabers-on-Spey in 1875, she graduated in medicine at Aberdeen in 1903, and went to India with her husband, the Rev. George M. Kerr, who is superintendent of the Wesleyan Mission Station at Nizamabad. She had charge for 12 years of the mission hospital there until the foundation of the Dichpali Home, where husband and wife have worked devotedly ever since. In 1923 she was awarded the Kaisar-i-Hind gold medal in recognition of her services." (The Lancet, 31 December 1932, pp. 1460-1461) 

Portrait of John Wesley: mezzotint by J. Faber after J. Williams, 1743. Wellcome Library no. 9621i.