In Photos: Inside One of the World’s Loneliest Hospitals

The frail man took my notebook and pen scribbled what resembled letters 'n' and 'h'. “I don't remember how to write. Can you see it?” Sena Jenejasoriah, 53, smiled, not knowing what else to say. When asked how old he was, Jenejasoriah said, “five three”, unable to recall numbers correctly. 

Hospitalised for leprosy — an illness that was incurable a long time ago — Jenejasoriah has not seen his family in 40 years. He has not been home since the day he was hospitalised at the Mantheevu Island Leprosy Hospital – one of the two leprosy hospitals in Sri Lanka that continue to accommodate disabled and disfigured inmates, despite being cured of the disease. 

Jenejasoriah is one of the two patients receiving care in the island hospital in Batticaloa, some 300 kilometres away from the country's capital. Sequestered to the island, this is the loneliest hospital in the country with two patients and a handful of caretakers.

“When the wounds showed up on my legs first, my family took me to a hospital, close to where I lived,” Jenejasoriah told VICE World News. He recalled that his home was in Beliatta — a small town in the southern part of the country. 

“I was hospitalised there first. That was the last time I saw them [the family]. I didn't bring anything with me when I came here. I can't remember exactly where my house is and I don't remember how to go there.”

From that hospital, he was transferred to the Mantheevu island hospital in 1975. At that time, the island was commonly known as a leprosy colony. Patients with deformities and signs of having contracted the disease were segregated from society, to prevent its spread.

The first leper colony in Sri Lanka colony was built in 1708 by the Dutch colonists, and the second was built by the British on Mantheevu Island in 1921.

Archival documents dating to the 1930s report that the hospital and the colony accommodated over 10,000 patients. It had 24 individual cottages, male and female wards, an administration block, an isolation ward, a dressing station, a laundry, a government school, quarters for the staff, and dormitories for the Religious Sisters of the Franciscan Order who nursed the patients. The hospital staff included one medical officer, two apothecaries, one overseer, 16 labourers, and 16 attendants.

Over the past 80 years, however, the situation at the hospital has changed for the worse. The 99-acre land is thick with shrubs and towering trees. Tallgrass has invaded what used to be the paved road. That road has now, reduced to a sandy walking path from the small boat jetty to the dilapidated hospital premises. The cottages that once housed patients have been abandoned and are falling apart.

The wards are in a state of decay; the walls have turned yellow-brown with bird faeces and the cement on corridor walkways has chipped off, exposing the brickwork underneath.

Not much has been written or been documented about the hospital's history in the recent past.

In September 2009, months after the three-decade-long civil war concluded, a fire broke out at the hospital. Sri Lankan Air Force operators deployed to douse the fire, reportedly evacuated 13 personnel (patients and staff members) from the island, but many of its buildings were destroyed by the fire, remnants of which are still present.

Recently, the island was brought to national attention once again when President Gotabaya Rajapaksa proposed in July the idea of establishing a state-of-the-art prison on the island. 

Similarly, the Government Medical Officers' Association — a local trade union — put forward a proposal to develop the island as a quarantine centre for COVID -19 patients and other communicable diseases.

At present, the government-run Batticaloa Teaching Hospital oversees the Mantheevu hospital. 

Dr Kalaranjani Ganesalingam, director of Batticaloa Teaching Hospital told VICE World News the island patients have not been relocated elsewhere due to the instructions received by the ministry of health. According to her, the instructions came during her predecessor's period and since then have not changed. Dr Ganesalingam said, “Whenever and whatever they [the patients] need, we [Batticaloa Teaching Hospital] provide.”

Chandrakumara (45) has worked as the island’s administrator for the last 15 years. He is unmarried and spends all of his days on the island, working in his dimly lit office. “It will be good if the patients were transferred from the island,” he said. “They will have better facilities at a different facility and more people to interact with. It’ll be better for their mental health. Who knows what is going on in their heads when they are here?” he added, reluctantly. 

Ponniah Punnuthuraih, 63, is the oldest surviving patient at the hospital. Like Jenejasoriah, has a scattered mind, full of partial memories. “I was brought here when I was five. There used to be many others. I remember there were as many as 50 other [patients] here. But not anymore,” he said.

Both patients share similar looking rooms. Jenejasoriah sleeps in the corner most room, away from Punnuthuraih. Both rooms have one bed each, a tiny cupboard in which they keep their sarongs and shirts folded, alongside their plates and cups. 

Jenejasoriah has befriended the stray animals – three cats and two dogs abandoned like their caretaker. He would occasionally pick a fight with Punnuthuraih because the strays would defecate near the beds. So Jenejasoriah sleeps further away from the others.  

Punnuthuraih is the only person to own a working radio and a television set at the hospital. The caretakers routinely flock to him to listen to the radio or watch the television. “That’s how I spend my time; watching TV and listening to the radio,” he said. “I bathe. [And] I eat when the food is brought in.”

Punnuthuraih said he would love to see his family one more time, but he has no memory of how to get home, let alone where his home is. “I have no land to my name, no money, and no skills. I can’t find employment. I don’t know anyone outside of the people here [on the island]. I’ve lived here my whole life. So how can I go back?” he asked.

For these two patients, life outside the island is impossible to imagine. Having lived almost all of their lives confined to this island, life outside of this situation brings nothing but confusion to them. Jenejasoriah smiled awkwardly when asked if he wanted to leave the island. Punnuthuraih ruffled his eyebrows and dismissed me.

“Even if I go home, even if I find them [family] I’m afraid they will not take me back. They will hate me.”

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