The Russian Orthodox Church, representatives of which worked in the area with a mission, trying to convert the indigenous population into Christianity, also revealed concern about the spread of leprosy in the area. Here is a quotation from one of the reports of the Yakutsk Bishop Milety to the Church authorities. 

However, the Russian Orthodox Church had not taken any practical steps to alleviate conditions of the lepers either, for the exception of distributing copies of the Holy Bible among the local population. 

Medical authorities of the Russian Empire had been quite aware of the disease and its dangers. Russian experts on skin diseases and hygiene wrote in their reports that in order to combat leprosy in Yakutia, which spread wider and wider with every year, it was necessary not only to open hospitals, but also to set up bathhouses and separate buildings for cattle and other domestic animals. However, as professor Reshetillo admitted, all the good intentions had remained on paper without being implemented, having “demonstrated human feebleness to history.”⁶ 

Meanwhile the situation was appalling not only in the lepers' yurts in the taiga but in the Yakut settlements as well. Any person suspected in contracting leprosy ran the risk of being expelled out of the native settlement and lose all the property he had had. Sometimes the inhabitants of the Yakut villages had been deprived of their property because of the false accusations of contracting leprosy. Having noticed the slightest skin manifestations, people were hiding in their houses, trying to avoid any contacts with the neighbors for fear of being driven away from their villages. 

The diagnostic procedures practiced by the Yakuts to identify leprosy were vague and based on rather dubious symptoms. One of them, for instance, was to look at the color of fingers in the transmitted light. If the color was dark, the Yakuts interpreted it as “black blood” and regarded such a person to be diseased. Some other symptoms confirming leprosy, in their opinion, were contracted pupils of the eyes, sclera icterus (yellowish color of the white of the eye), shedding of eyelashes and eyebrows, and painless infiltrations in the skin. It is obvious that syphilis and other skin diseases had been fallaciously identified as leprosy, which can be proved by the following example. According to the report of the medical examination made among the Yakut lepers by a group of doctors in 1896, leprosy was confirmed only in 25 out of 48 examined patients, which made almost one-half of the total number of the inhabitants announced lepers and expelled from their homes into the deep forest. The rest of the so-called lepers turned out to have Syphilis and Tuberculosis, while a few patients were found absolutely healthy. 

Miss Marsden's expedition to the outcast Yakut lepers had an effect of a comet that flew above the huge territory of the Russian Empire, woke up the sleepy country, and made the society react to the appalling situation with the lepers in one of the remotest places in Siberia. Funds were raised and the colony for the lepers was set up in Vilyuisk in December 1892. All the patients were examined and treated by two doctors, while nuns of the Tomsk convent and nurses of Moscow commune “Utoli Moya Pechali” (Soothe My Sorrows) provided necessary care. By the end of the nineteenth century, the number of lepers that lived in the colony was about 40.  

The authorities and medical community highly praised Miss Marsden's endeavor and acknowledged her colossal input into development of proper care for lepers in Siberia. The above mentioned  Professor Reshetillo wrote in 1901: 

It is very important that not only nobility but also many ordinary Russian citizens responded to the call and donated to the lepers' funds. For instance, Mrs. Strekalova, chairperson of Moscow's Society for Propagation of Useful Books, suggested her assistance in raising charity funds and, very soon, she collected a considerable sum of money that covered expenses on purchasing linen and clothes for 100 people and some furniture for the colony. 

While staying in Moscow, Miss Marsden got close relations with Duchess Shakhovskaya, the Head Mistress of Moscow Commune of Nurses “Utoli Moya Pechali” (Soothe My Sorrows). Five nurses of that commune volunteered to go to Siberia to provide care for the lepers and left for Vilyuisk in May 1892. 

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