Paul Brand, a celebrated orthopaedic surgeon, devoted his life to the care of patients with leprosy. He was born in a remote mountain district in south east India, 150 miles from Mysore, on 17 July 1914, the son of Jesse Brand and his wife, Evelyn, both Baptist missionaries. Paul was sent away to England at the age of nine to attend the University College School, Hampstead, and for the next six years did not see his parents. After leaving school, he first decided on a career in building and construction, and in 1930 began a five-year building apprenticeship. In 1936 he began training to become a missionary at Norwood, Surrey. The following year he changed direction, and entered University College Medical School in London. There he met his future wife, Margaret Berry (they were married in 1943). During the second world war, he and his fellow students were on constant call during the Blitz. It was while treating these patients that Brand first began to develop an interest in hand surgery. The medical school was later evacuated to Watford, where he became interested in physiology and the control of pain. In 1944 he was appointed as a surgical officer at the Hospital for Sick Children in Great Ormond Street, and then became assistant in the surgical unit at University College Hospital. In 1946 Brand and his wife were invited by Robert Cochrane, the foremost authority on leprosy, to join him at the Christian Medical College Hospital at Vellore, Tamil Nadu, southern India. Cochrane challenged Brand to use his skills as an orthopaedic surgeon to research and treat the disabilities associated with leprosy. Through his subsequent research Brand changed the world’s perceptions and treatments of leprosy-affected people. Firstly, he pioneered the idea that the loss of fingers and toes in leprosy was due to the patient losing the feeling of pain, and was not due to inherent decay brought on by the disease. Secondly, as a skilled and inventive hand surgeon, he pioneered tendon transfer techniques with leprosy patients, opening up a new world of disability prevention and rehabilitation. His original tendon transplantation, using a good muscle from the patient’s forearm, became known as the ‘Brand operation’. In 1953 the Brands joined the staff of the Leprosy Mission International and continued to develop their research and training work at Vellore and the newly founded Schieffelin Leprosy Research and Training Centre, Karigiri. In 1964 Brand was appointed as the International Leprosy Mission’s director of surgery and rehabilitation. Two years later, the Brands were seconded to the US Public Health Service Hospital in Carville, Louisiana, a renowned centre for leprosy research. He became chief of rehabilitation and for more than 20 years taught surgery and orthopaedics at the Medical College at Louisiana State University. He served on the expert panel for leprosy of the World Health Organization. He was medical consultant and then international president of the Leprosy Mission, from 1992 to 1999, co-founded the All-Africa Leprosy and Rehabilitation Training Centre (ALERT) in Addis Ababa, Ethiopia, and served on the board of the American Leprosy Missions. After retiring in the mid-1980s, Brand moved to Seattle to become emeritus clinical professor of orthopaedics at the University of Washington. He authored more than 100 clinical papers, as well as the textbook *Clinical mechanics of the hand* (St Louis, Missouri, Mosby, 1985), and two books on religion and medicine (*Fearfully and wonderfully made* [Grand Rapids, Michigan, Zondervan Publishing House, c.1980] and *The forever feast: letting God satisfy your deepest hunger* [Crowborough, Monarch, 1994]). He was appointed CBE in 1961, and was awarded the Damian Dutton award in 1977. He was Hunterian Professor at the College in 1952 and received the Albert Lasker award in 1960. He died on 8 July 2003 from complications related to a subdural haematoma. He is survived by his wife, an expert on the ophthalmic effects of leprosy, his children (Estelle, Chris, Jean, Mary, Patricia and Pauline) and 12 grandchildren.