“Beloved Mother of Outcasts”
By Leilehua Yuen
Saint Marianne is beloved in Hawai`i for spending the last 30 years of her life ministering at Kalawao and Kalaupapa, on the island of Molokai, to those with Hansen’s Disease (leprosy). She died on the island in 1918 at age 80 and was beatified in St. Peter’s Basilica in 2005.
Saint Marianne, born Barbara Koob on 23 January 1838, was baptized the following day in a Catholic church in what is now SE Hessen, West Germany. She was the daughter of farmers Barbara and Peter Koob. In 1839, the family, including Barbara’s siblings, emigrated to the Utica, New York, in the United States, where they became members of St. Joseph’s Parish. In 1848, at age 10, Barbara received her First Holy Communion and was confirmed there. In the 1850s, the Koob family became naturalized citizens of the United States.
In her writings, Mother Marianne described experiencing at an early age the call to a religious life. However, her vocation was delayed nine years because of family obligations. When her father became an invalid, she was oldest child at home, so after completing the eighth grade she went to work in a factory to support the family. It was not until her younger siblings were old enough to provide for themselves that she felt free to enter the convent.
A Calling to the Serve the Sick
At age 24, in the summer of 1862 she was able to embark on her calling. Barbara entered the Sisters of Saint Francis in Syracuse, N.Y. and, on November 19, 1862, she was invested at the Church of the Assumption. She soon became prominently known as Sister Marianne. One year later she was professed as a religious.
Sister Marianne served as a teacher and principal in several beginning schools in New York State. Intending to spend her life devoted to schoolwork, she soon received a series of administrative appointments. As a member of the governing boards of her religious community, she participated during the 1860s in the establishment of two of the first hospitals in the central New York area, St. Elizabeth’s in Utica (1866) and St. Joseph’s in Syracuse (1869).
Far in advance of their time, both of the hospitals she helped found had unique charters. They were open to the sick without distinction as to a person’s nationality, religion, color, or moral character. Unlike other hospitals of the time, even alcoholics – then considered “morally debased” – were allowed to receive treatment. These two Franciscan hospitals were among the first sixty registered hospitals in the entire United States.
In 1870, a new career called her, now Mother Marianne, when she became nurse-administrator at St. Joseph’s Hospital in Syracuse. As the first hospital opened to the public in the city of Syracuse, St. Joseph’s owed much of its creation to her, as well as its survival. She became an innovator in its management in order to provide better service to patients.
Sanitation and Patient’s Rights
Mother Marianne also was instrumental in establishing standards of sanitation long before the importance of cleanliness was recognized by the scientific community. She was insistent on advocating practices such as washing one’s hands before ministering to the patients. This insistence would be critical years later when she developed patient care protocols at the hospital for the patients of Kalaupapa and Kalawao in Hawai`i.
When the College of Medicine in Geneva, N.Y. moved to the fledgling Syracuse University to become the College of Physicians and Surgeons, one significant factor in the choice of location was that Mother Marianne had accepted the medical students for clinical instruction at St. Joseph’s. Far ahead of her time in furthering patients’ rights, in her negotiations with the Medical College she insisted that it was the right of the patient in each and every case to decide whether or not he or she wished to be brought before medical students. Mother Marianne also was frequently criticized for accepting “outcast” patients such as alcoholics. Such patients were frowned upon for hospital admittance by the medical profession at the time. Because of her insistence on such reforms, Syracuse became one of the most progressive medical colleges in the United States.
Such innovative and progressive practices were to stand Mother Marianne in good stead when she was asked by the Kingdom of Hawai`i to develop a system for the care of the leprosy patients at Kalaupapa. Her experience in hospital systems, nursing techniques, and pharmacy work would prove invaluable.
A Call to Hawai`i
By 1883, Mother Marianne was Superior General in her religious community in Syracuse. While opening her mail one day, she received a letter asking for a capable leader to begin a system of hospital nursing. When she found out that the main challenge was to minister to leprosy patients, her response was, “I am not afraid of any disease….” Her devotion to Saint Francis of Assisi who cared for the sick poor confirmed her resolve that the call to Hawai`i was God’s Will.
Six sisters were chosen from among the thirty-five volunteers of her community. Mother Marianne accompanied them to the Islands to help them get settled in their assignments.
Arriving in Honolulu on 8 November 1883 aboard the SS MARIPOSA, the bells of Our Lady of Peace Cathedral rang out in greeting and crowds gathered on the wharf to see the sisters.
Much Work to be Done
In 1884, at the request of the government, she set up Malulani Hospital. It was the first general hospital on the island of Maui.
Soon, however, she was called back to the hospital in Oahu to advocate for the leprosy patients at the Branch Hospital in Kaka`ako who were subjected to abuse by the government-appointed administrator. She demanded he be dismissed, or the sisters would return to Syracuse. He was dismissed and Mother Marianne was given full charge of the overcrowded hospital. Her return to Syracuse was delayed when her leadership was declared by government and church authority to be essential to the success of the mission.
The work continued to increase. In November 1885, after she convinced the government it was a vital need to save the homeless female children of leprosy patients, the Kapiolani Home was opened. The unusual choice of location for healthy children to live in a Home situated on leprosy hospital premises was made because only the sisters were willing to care for the children of leprosy patients.
Meeting Father Damien
In January of 1884, Mother Marianne met Father Damien for the first time. He had come to O`ahu, apparently in good health, to attend a chapel dedication at the hospital she was to head.
While leprosy patients had not been sent to Kalaupapa for some time, with the1887 “Bayonet Constitution,” officials decided to close the O`ahu hospital and leprosy patients were again exiled to the Molokai peninsula. They would need a hospital there. Once again, the government of Hawai`i called on Mother Marianne.
In 1888 she notified the Hawaiian government that, “We will cheerfully accept the work…” she courageously responded upon her reception of an official appeal from government authority asking for someone to found a new home for women and girls at the Kalaupapa settlement. “Our hearts are bleeding to see them shipped off,” she wrote to Damien at Molokai.
She would finally fulfill the calling she had heard all those years ago in Syracuse. Arriving at Kalaupapa several months before Damien’s death, she consoled the dying priest by assuring him she would provide care for the patients at the Boys’ Home at Kalawao, on the opposite end of the settlement from where she was stationed.
Two weeks after Father Damien’s death on 15 April 1889, she was officially chosen at a Board of Health meeting in Honolulu to be his successor at the Boys’ Home.
After dedicating over 30 years of her life to caring for the people of Hawai`i, Mother Marianne died of natural causes on 9 August 1918.
Her compassionate care earned her the affectionate title of “beloved mother of outcasts.”
Her Legacy Continues
The legacy of Mother Marianne continues. In Syracuse and Utica, the Franciscan Sisters continue to run medical centers.
In Hawaii, the sisters are well known for founding St. Francis Hospital in 1927, which developed into two medical centers. Following the transfer of these centers to Hawaii Medical Center, in 2007, the sisters continue to have a wide ranging Health Care System shifting its focus from acute care to meeting the growing needs of Hawaii’s senior population.
At Kalaupapa, Molokai, the sisters maintain the continuity of their comforting presence to the very few Hansen Disease patients living there today. Franciscan sisters work at several schools and minister to parishioners in the islands.
But perhaps her most important legacy is the most simple – cleanliness. Farmers know that sanitation is essential for healthy animals. Through her sharp observations, Mother Marianne deduced that similar standards of cleanliness applied to hospitals could prevent the spread of disease from patient to patient.
In the days before bacteria had been discovered, Mother Marianne insisted that all nurses and physicians wash their hands between patients. She implemented standards of strict cleanliness for clothing and surfaces throughout her hospitals. As she and her sisters worked closely with the leprosy patients day after day, year after year, neither Mother Marianne, nor a single one of her nurses contracted the disease.
Mother Marianne is not only the “Beloved Mother of Outcasts,” but the mother of modern hospital nursing and patient care.