An Enduring Legacy in Caring for Eyes in Leprosy: Margaret Brand: 1919–2014

Dr. Margaret Elizabeth Brand passed away on 17th November 2014, eleven years after the death of her husband Dr Paul Brand, and she is survived by her children. Her journey had wound through several decades of tumultuous and enormous changes globally in the battle against leprosy and she left an indelible mark in the field of leprosy, through a saga of grit, love and endurance. Margaret Brand was probably the best ‘Ocular Leprologist’ in the world. Years before I was even born, in the year 1948, she had started working in ophthalmology at the Schell Eye hospital at the Christian Medical College, Vellore and then in leprosy at the Schieffelin Leprosy Research and Training Center (SLRTC) in South India, places where she continued her work for several decades. Her vast experience in the field of leprosy and specifically in the ophthalmic aspects of the disease made her a veritable expert in the field at a time when there was tremendous stigma and fear associated with the disease. Those were the chaotic days of promim, dapsone, maggots, ulcers, amputations and severe ocular complications such as acute iridocyclitis with florid hypopyons and corneal ulcers leading to endophthalmitis, the likes of which have not been observed in recent times. Her world of leprosy included patients who came from all parts of the sub-continent to her for eye care and her colleagues who were towering giants and pioneers in various sub-specialties of leprosy: the world renowned orthopedician and author Dr Paul Brand who was her beloved husband; Dr Charles K Job a pioneer of leprosy pathology; Dr Robert G Cochrane who introduced innovative treatments in leprosy and Dr PSS Sundar Rao who had helped publish some of the best statistics in the leprosy field in India at that time. Her expertise in providing eye care in leprosy derived from a blend of knowing the systemic disease well and using that as a background and context to treat the manifestations that appeared in the eye. She loved her patients and her patients loved her back. She took utmost care to examine the eyes and her case notes were meticulous. She taught the ophthalmologists at the SLRTC and elsewhere that it was important to record findings and maintain precise case notes. Many years and decades down the line, younger ophthalmologists would wonder at the enormous amount of detail she put into her ophthalmology notes in her elegant handwriting at a time when there were no such things as computers. These details were critical in ascertaining whether certain surgical procedures and treatments were successful on a long term basis. Lepr Rev (2015) 86, 131–133