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The Lazarus Effect


The story of Culion: its past, its present, and the people bringing it into the future.

Photography by
Story by
Sonny Thakur
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Location Tag

Elee Mar Bulotano is a grandson, which is a miracle in many ways. His grandmother wouldn’t have expected to survive, much less live a long and fruitful life, much less raise children and grandchildren. But somehow, she did.

She wouldn’t have been able to see her grandchildren grow up on the island, had this happened a generation earlier: As soon as people were old enough for the boat journey, they would leave the island to find lives elsewhere. In the earliest days, it wouldn’t even have been a choice; her children would’ve been forcibly taken away.

Ask Elee if there are any great-grandchildren on the island, and he cocks his head and looks up toward the sky. Great-grandchildren? He has never even considered that, and the concept seems completely alien.

Culion looks normal from afar, until you see the NHS insignia carved into the mountains.

You think you know this story, but you don’t.

You think, for example, that this is a story of isolation, and perhaps that used to be true. Culion is an island of incredible beauty, like many others in the Calamianes in Northern Palawan. Look at a map, and you’ll find that the island is a little bigger than you might expect—by comparison, Linapacan is even smaller and much further out, in a sort of limbo between Taytay and Busuanga. And yet, Culion feels much more remote than the map lets on.

The first time I went to Culion, I’d taken the public commuter boat from Coron town. The banca plies the route just once daily—a slow, grinding slog through calm waters and stunning islands, but a slog nonetheless. The boat is almost always full; crowded and hot despite the sea breeze. On the map, Culion doesn’t look too far away from the others, but it takes over two hours for the distinct terrain of the island to come into view. The sensation of being surrounded by water for so long, watching island after island slip past, gives you the feeling that you’ve gone somewhere completely foreign.

You see Culion from afar: first the port, then the fishermen’s village—all normal, until the seal of the National Health Service, carved into the hills. Some say the insignia was put there as thanks for the administration of the NHS over Culion; a more dramatic version speculates that the seal was used to warn passing sailors off the island.

The Culion Museum and Archives hosts an array of artifacts from the island’s time as a leper colony, from medical equipment to clothing.

Most people think this is a story about disease. And it’s been that way for decades: Leprosy had been the island’s entire reason for being since 1906, when the government had asked Culion’s original inhabitants to leave so they could turn the island into a leper colony.

It’s an easy part of the story to latch on to—partly because leprosy easily arouses morbid curiosity. It’s certainly the story that media has told about Culion, over and over, much to the chagrin of the island’s inhabitants and former patients. “Sometimes we entertain media, and they promise us that the story won’t be about leprosy,” says Hilarion Guia, once the honorable mayor of Culion, flicking a quick glance at me. “But then the story comes out, and it’s still like that.”

Mr. Guia is right: nearly everything written about Culion has to do with its history as a leper colony, and so he asks not to tread over all that same ground. But how do you talk about Culion, about its past? It’s still worth telling, because it’s a powerful history. All stories have to start in the past, though you have to promise not to dwell on it.

A century ago, leprosy was the most dreaded of all dread diseases. It was a death sentence… if you were lucky. If you were unlucky, you would live to feel your own body go numb, and then watch as your flesh melted away. It awoke the most basic fears in people; so feared that it was a crime to be diagnosed with leprosy and not turn yourself into police custody. Culion was not the first leper colony in the world, nor even the first in the Philippines. Because the disease incited such great fear, those afflicted have been consigned to isolation since the Middle Ages, sometimes in houses or buildings, or, as in the case of Culion, an entire island. The concept of a leper colony is unique; consider all the other dread diseases over history, and you’ll see that nowhere else have we consigned the sufferers of any other disease to exile—not tuberculosis, not cancer, not AIDS.

As the Philippines entered the American occupation, there seems to have been heightened panic about leprosy. “Estimates at the turn of the century put the number of lepers in the Philippines at 30,000, but more sober estimates later pegged it at 5,000,” writes journalist Ma. Cristina Rodriguez in Culion Island: A Leper Colony’s 100-Year Journey Toward Healing, one of the few comprehensive resources about the island. No explanation is given for the high number; for whatever reason, the Americans seemed particularly paranoid about the disease.

The grandchildren of Culion are hopeful that this new era also presents new opportunities for the people of the island.

Lepers, wrote Maj. General Joseph Wheeler, “exist everywhere, and in many places they associate with... the people as freely as the un-afflicted... Many beautiful women in this archipelago are lepers—happy, light-hearted, and vivacious; and knowing the fate that awaits them in case of discovery, they are the last who would reveal the poison that lurks in their system. A clasp of the hand, a mere touch of the garments or a kiss... may transmit the poison.”

Wheeler himself favored the complete withdrawal of American troops from the Philippines, to prevent the disease from spreading in the United States. A more moderate option was to test returning troops for leprosy (and for those found to be infected to be “secluded for the rest of his life”). The third option was to segregate the lepers completely. This put the burden on existing patients—and perhaps for that reason, became the official course of action.

Not coincidentally, the Americans had had experience in this: the secluded island of Molokai in Hawaii—also then an American annex—hosted Kalaupapa, a leper colony that had operated since the 1880s. The US colonial government moved swiftly: By 1905, the law creating the Culion Leper Colony was enacted.

It’s an easy part of the story to latch on to—partly because leprosy easily arouses morbid curiosity.

Palawan had always been thought of as the Philippines’ last frontier—a traditional place of exile since Hispanic times—and Culion was “the last frontier of the last frontier,” as people today still like to joke. Well off the lanes of regular marine traffic, sparsely populated, yet rich enough in natural resources to support a colony, Culion was a logical choice. First to arrive by March 1906 were Dr. Charles de May, the colony’s first chief, and the colony’s chaplain, Fr. Manuel Valles. Dr. de May was in office for a year (spending most of his time across the bay “surveying his domain through a telescope,” Rodriguez writes), while Fr. Manuel would serve for four years, the first of a long line of Jesuit priests in the colony.

It’s something to see the turn-of-the-century photographs now, of four nuns—one presumably Filipino, three French—posing for the camera, wearing their white habits and clutching at their rosaries: Sisters Therese de Jesus Fernandez, Sidonie Bureau, Calixte Christen, and Marie Du Bon Pasteur Lintot, all of them nurses.

The hospital is still there, and remains one of the finest in the province. This shouldn’t be a surprise, since Culion became a global center for research on Hansen’s Disease—the modern name for leprosy. The Culion Leper Colony may have been built out of fear, but the doctors assigned there wasted no time in turning it into a research center, leading the world in the search for a cure. Yes, there is a cure now for Hansen’s; the disease hasn’t been eradicated, and even Culion sees new cases and accepts new patients every year. But leprosy is no longer a death sentence, and if caught early enough, hansenites—the modern term for lepers—don’t even suffer physical deformity. But besides the hospital, Culion has an excellent museum.

Since becoming a colony in 1906, Culion has transformed into a leading center for research on Hansen’s Disease.

The Culion Museum and Archives is housed in what was the research labs of the hospital; now it’s all high ceilings and sturdy stone, accidentally well-suited to its new function. The sanitarium’s current chief, Dr. Arturo Cunanan, is also the museum’s ex officio director, and he keeps a keen eye on the museum’s displays. In 2006, in preparation for Culion’s centenary, Dr. Cunanan brought in archivist and academic Ricky Punzalan from the University of the Philippines to help design the museum experience and preserve the colony’s invaluable records.

You think, for example, that this is a story of isolation, and perhaps that used to be true.

It’s astoundingly well-designed; the floor plan is well-thought out, helping visitors understand what patients went through, from diagnosis to admission, to treatment. Antique medical equipment fill a room, from oxygen tanks and typewriters to an ancient x-ray machine the size of a small car. There are samples of Culion money—legal tender only in the colony, to prevent contaminated bills from finding their way to the rest of the Philippines. There are file cabinets of blood samples on slides; ledgers of patients’ names, written in beautifully inked script. Photos of daily life: some carefully mounted in leather albums, with annotations carefully written on paper labels (“Masipag mag-album yung mga sisters,” Elee whispers); others still kept in boxes in the storage room.

The museum sees visitors every few days, mostly day trippers on island-hopping tours from Coron who rush through the exhibits for the most part, eager to continue the tour outside or to get onto the beaches. Occasionally they get researchers from abroad, who stay on for days on end, noses buried deep in the ledgers. They get the odd request from people looking for records of family members.

We stare at one of the photos mounted on the wall, of patients gathered at the old plaza. The black-and-white photos from shortly after the war show women demurely dressed in the traditional baro’t saya lined up outside the General Kitchen—the men were in a separate line, of course. They were likely lined up, not for a meal, but for their allowances. As patients sequestered under the NHS, they were entitled to money and sacks of rice.

“Dito na rin sila nakikipag-kwentuhan,” says Lotlot Gante, Dr. Cunanan’s executive assistant, who also takes care of the museum. Like Elee, she’s a granddaughter of a patient herself. We squint at the photos, and Lotlot imagines the conversations. “Nag-tsitsismisan sila habang naghihintay. ‘Kumusta na yung gamot?’ ‘Eto, mabuti naman...’ Ganyan,” she jokes.

“Na-experience namin yung inaalagan yung mga lolo at lola namin,” says Elee. The old folks would be unaware that they had wounds, since Hansen’s kills nerves. Grandchildren were tasked to make sure their lolo or lola didn’t step on a rusty nail, for example. “’Pag nawawala si Lola, susundan ko ’yung drops of blood,” Elee deadpans, and they both laugh.

Life finds a way, even on “The Island of the Living Dead,” as Culion was once nicknamed. Though patients were segregated into different camps, the inevitable happened: People fell in love. Medical doctors ran Culion like a well-ordered research laboratory, but sociologists, political scientists, and social engineers would’ve had a heyday, too. With patients brought in from all over the country, the colony was a microcosm of the Philippines. Nobody was equipped to build a society from scratch, as they needed to do—and eventually did. Though patients eventually won the right to marry among themselves, the question of family was a bit more tricky. Within a few years, about 75 babies were being born in Culion each year.

Remember: doctors used to believe that leprosy was highly contagious; that casual contact could be enough to spread the disease. What then was the ethical course of action for infants born to “leprous parents”? Do you leave the babies with their parents, knowing that it could very well be tantamount to sentencing the child to infection? Do you forcibly take the child away from their parents and put them up for adoption?

Healthy children born on the island were sent to a welfare home in Metro Manila, or to relatives who were willing to take them in.

There is a box of photographs in the record room labeled “Balala Nursery,” and I ask to look through the handsomely bound albums. The nursery was built in the 1910s and was quickly filled with babies, cared for by nurses and the nuns. Early on, the policy was total: Healthy children were shipped out of Culion to Welfareville in Mandaluyong, to or relatives who were willing to take them in. The nuns often accompanied the children on the trip out.

If you want your heart broken, all you need to do is look for the photograph that shows mothers visiting their babies at the nursery. They are separated by a glass window, the mothers sitting excitedly on one side, the babies playing in cribs or on the floor, tended to by nurses on the other. The mothers look as if they’re dressed in their Sunday best; dressed up for children they will never hold.

This is why the museum still get visits from people who ask to look through the archives in the hope of finding their parents—we still have generations of Culion children, now grandparents themselves, who were forcibly given up for adoption. The photographs and ledgers are in excellent condition, though there are no labels for many of the boxes, let alone indices to help the search.

As soon as people were old enough for the boat journey, they would leave the island to find lives elsewhere.

“Kailangan nang i-digitize lahat na ’to,” Elee sighs. The policy regarding families evolved over the decades, partly because of a better understanding of the disease—it just wasn’t as wildly contagious as people used to believe, for one—because treatments were evolving, and because researchers were inching closer to a cure. But it was also thanks to the advocacy of patients themselves: development on Culion appears to have gone in fits and starts, helped along sometimes by energetic advocates, sometimes by the clamor of the general population.

There is, for example, the uprising known as “Manchuria,” which always merits mention in all history books regarding Culion, and merits giggles from the tour guides. It was a mutiny among patients who wanted to elope with their sweethearts, and perhaps escape the island. They invented a zipline to get into the women’s dorms, Lotlot quips. We laugh about it now, but it was cause for serious alarm: there were reports of looting and mayhem, which put the fate of the colony into question.

It eventually died down, with many of the mutineers eventually coming back to the colony. But even as the event was a stain on the history of Culion, it also meant that the issue—of allowing marriage between patients—would never be swept under the rug again.

All stories have to start in the past, but you have to promise not to dwell on it.  

As the administrative domain of the Department of Health, Culion existed in a strange political limbo. People on Culion could vote in national elections, but not in provincial and local ones—it didn’t belong under Palawan’s jurisdiction. Interestingly, the women of the colony were among the first in the world to have the right to vote: In 1906, when only seven nations had granted any kind of voting rights to women—and when Filipino women in general couldn’t vote—the “leper women” could. A 1937 magazine also notes: “Some [countries] allowed only high taxpayers to vote. Some gave women a voice only in municipal affairs. Iceland and Sweden extended the privilege only to widows and spinsters. What compensation! Leper women were not so hampered. From the first they had full privileges. No opinion was excluded.”

For decades, it scarcely mattered to Culion citizens that they couldn’t vote in the local elections. But then 1986 rolled around, and with it came the EDSA Revolution and the “Yellow Fever” that swept the nation.

Hilarion Guia came to Culion as a patient and became a respected teacher at the school, teaching English, History, and Social Studies. This allowed him to understand Culion’s disadvantage at not being part of the electorate: In local matters, a representative of Culion would sit in meetings, but, without a vote, only helplessly watch. The islands belonging to Culion were carved away little by little; the bigger, richer islands with tourism potential and natural resources were redistricted to Coron.

Even more than that, he says, he could see the students in his classroom—children who had no manifestation or symptoms of leprosy—at the prime of our political rights, having none. “It was blatant discrimination against the people of Culion, not just [those] affected by leprosy, but against the entire population, including the second and third generations who weren’t affected by the disease.”

As the administrative domain of the Department of Health, Culion existed in a strange political limbo.

Guia campaigned tirelessly to make Culion a municipality. In 1992, President Corazon Aquino signed the law that made it so, effectively granting the right of suffrage to its citizens. It wasn’t until May 1995 that the first local elections were held on the island, though it was especially poignant: Guia was elected the first mayor of Culion.

The boat is full of grandchildren today. Elee is coming along as a guide, though his guests are also from Culion: The granddaughter of Cresencio Rosello, the president of the Association of Culion Hansenites, is home from Portland, where she had been working as an intern. Kawil Tours is taking them out to go on a snorkeling trip and a beach picnic on a nearby island.

As the only tour agency based in Culion, Kawil Tours puts co-founders and fellow Culion grandsons Elee and Renlee Cubelo in a unique position: being able to understand the worth of their hometown and its history as a tourism asset. Though Coron and Busuanga welcome planeloads of tourists to their towns everyday, Culion’s remoteness also grants it a number of advantages. The beaches are stunning, for one; empty and pristine, with white sand as fine as cream. Some of the larger WWII shipwrecks that divers love also lie closer to Culion than Coron. Private developers have taken notice, fencing off entire islands to turn into resorts.

“Nakikita namin ’yung mga nagdadala ng bisita dito galing sa Coron; minsan nagpapatulong pa sila. So inisip namin, bakit hindi na lang tayo?” says Elee.

Kawil Tours is hopeful that Culion can also draw in tourists, and breathe a new life into the island.

At just a few years old, Kawil is sort of a rockstar among local social enterprises. It is the brainchild of Elee, who acts as the main tour guide; Renlee, also the general manager; and Manila-based entrepreneurs Jun Tibi and Guido Sarreal, who came to Culion as volunteers from the Ateneo de Manila University. Inspired by Jesuit priest and social entrepreneurship advocate Fr. Xavier Alpasa who was then assigned to Culion, the group understood that tourism could be used as a transformative force in the community.

Palawan drew global attention as a tourist destination, and Coron was already booming; why not Culion, too? The team dreamt of creating a tourism ecosystem that would bring in responsible tourist money and spread the wealth around. Kawil Tours would help make Culion a viable tourist destination, provide employment to locals, bring business to establishments, and in exchange provide “meaningful journeys” to their clients: Instead of just the usual beach-hopping and rushed day trips, Kawil Tours could provide a uniquely insightful walking tour of Culion, and arrange for guests to have meals with local families. They also offered guests the chance to volunteer locally, plant mangroves, or engage in similar activities.

All stories have to start in the past, though you have to promise not to dwell on it.

Kawil Tours would also work with Hotel Maya, an extension of the Loyola College of Culion. Hotel Maya claims to be the country’s first eco-tourism social enterprise, as proceeds from the hostel help fund the college. In turn, the college offers courses in only two subjects, chosen to give students a reason to stay in Culion: English, in the hope that graduates will become school teachers; and Tourism, hoping to create more entrepreneurs who could keep the fire going.

It was a very tough first few years as Kawil struggled to find clients. “Unti-unti, nakikita ko namang pataas ng pataas ang Kawil,” Renlee says. The breakthrough came when it submitted a business plan to local crowdfunding platform The Spark Project, to raise funds to buy its own tour boat. They originally thought they’d raise Php 50,000 if they were lucky (“Fr. Xavy told us to dream bigger,” laughs Elee), but the crowdfunding drive exceeded all expectations. Boosted by social media, they raised Php 368,000.

Social media would serve them well again later that year, when Typhoon Yolanda slammed into the island. Kawil would raise more than enough money to repair the damaged boat, and used the excess to buy fishing boats for a few subsistence fishermen who had lost their means of livelihood. This is where they are now: the first grandsons of Culion are coming into their own, and they mean to stay on their island.

We’ve had the cure since 1981, when the World Health Organization officially recognized the multi-drug regimen of dapsone, rifampicin, and clofazimine as a long-term cure for leprosy. The WHO has made the treatment available for free to patients everywhere since 1995, but we also later discovered that the vast majority of humans—95 percent—are actually naturally immune.

Leprosy hasn’t been eradicated, but leper colonies have died out. There still are a few of them—mostly in India, China, and some places in Africa—but the world considers the concept ignorant and backward now, and perhaps a little sadistic. Culion’s sister colony, Kalaupapa in Hawaii, is undergoing an identity crisis, wondering if it should close its doors “when the last patient dies,” as The Atlantic recently posited, or if it should embrace its future as a tourist destination. In Culion, it’s not even a question.

Palawan drew global attention as a tourist destination; why not Culion, too?

As the grandsons of Kawil take their boat to the emerald-green waters of the Calamian to pick up guests from Coron, they know that the visitors will keep coming. The question is whether Culion will get a piece of that business; if they will ever taste the fruits brought about by tourism and its development.

The last misconception about Culion is the biggest one, physically: the symbol carved onto the hills on the island, the insignia of the Philippine National Health Service (and its successor, the DOH). But it’s not the Rod of Asclepius, which is properly the symbol for the medical arts. Adopting a common mistake, this symbol—an eagle spreading its wings on top of a staff around which two snakes are entwined—is actually a caduceus, symbol of the Greek god Hermes.

But it’s a fortunate mistake, and perhaps a prophetic one. This is, after all, not a story about disease and medicine. Instead, the ancient alchemists and storytellers say that the caduceus helped ease the dying gently into death; if applied to the dead, it returned them to life.


This story was originally published in GRID Issue 09.

This story was originally published in

Issue 09 | Amazing Grace

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