Leprosy And Colonialism

Leprosy is a neglected topic in the burgeoning field of the history of medicine and the colonized body. Leprosy in Colonial South India is not only a history of an intriguing and dramatic endemic disease, it is a history of colonial power in nineteenth-century British India as seen through the lens of British medical and legal encounters with leprosy and its sufferers in south India. Leprosy in Colonial South India offers a detailed examination of the contribution of leprosy treatment and legislative measures to negotiated relationships between indigenous and British medicine and the colonial impact on indigenous class formation, while asserting the agency of the poor and vagrant leprous classes in their own history.

Leprosy and colonialism investigates the history of leprosy in Suriname within the context of Dutch colonial power and racial conflict, from the plantation economy and the age of slavery to the modern colonial state. It explores the relationship between the modern stigmatization and exclusion of people affected with leprosy, and the political tensions and racial fears originating in colonial slave society, exerting their influence until after the decolonization up to the present day. In the book colonial sources are read from shifting perspectives, of the colonial rulers and, ‘from below’, the ruled. Though leprosy is today a neglected tropical disease, recognizing influences of our colonial heritage in our global management of health and disease, and exploring the perspectives of other cultures are essential in a time in which migration movements make the permeability of boundaries, and transmission of diseases, more common then perhaps ever before.

An innovative, interdisciplinary study of why leprosy, a disease with a very low level of infection, has repeatedly provoked revulsion and fear. Rod Edmond explores, in particular, how these reactions were refashioned in the modern colonial period. Beginning as a medical history, the book broadens into an examination of how Britain and its colonies responded to the believed spread of leprosy. Across the empire this involved isolating victims of the disease in 'colonies', often on offshore islands. Discussion of the segregation of lepers is then extended to analogous examples of this practice, which, it is argued, has been an essential part of the repertoire of colonialism in the modern period. The book also examines literary representations of leprosy in Romantic, Victorian and twentieth-century writing, and concludes with a discussion of traveller-writers such as R. L. Stevenson and Graham Greene who described and fictionalised their experience of staying in a leper colony.

By comparing institutions in Hawai'i and Louisiana designed to incarcerate individuals with a highly stigmatized disease, Colonizing Leprosy provides an innovative study of the complex relationship between U.S. imperialism and public health policy in the late nineteenth and early twentieth centuries. Focusing on the Kalaupapa Settlement in Moloka'i and the U.S. National Leprosarium in Carville, Michelle Moran shows not only how public health policy emerged as a tool of empire in America's colonies, but also how imperial ideologies and racial attitudes shaped practices at home. Although medical personnel at both sites considered leprosy a colonial disease requiring strict isolation, Moran demonstrates that they adapted regulations developed at one site for use at the other by changing rules to conform to ideas of how "natives" and "Americans" should be treated. By analyzing administrators' decisions, physicians' treatments, and patients' protests, Moran examines the roles that gender, race, ethnicity, and sexuality played in shaping both public opinion and health policy. Colonizing Leprosy makes an important contribution to an understanding of how imperial imperatives, public health practices, and patient activism informed debates over the constitution and health of American bodies.

The story of leprosy in the Dutch East Indies from the beginning of the 19th century to the middle of the 20th reveals important themes in the colonial enterprise across the territory that is today’s Indonesia. Operating in a territory with only a few hundred Western-trained doctors and a population in the tens of millions, Dutch colonial officials approached leprosy with uncertainty and anxiety. In the early 19th century, the Dutch administration simply removed sufferers from public view: campaigns targetted anyone “looking ugly”. Towards the end of the century, colonial science considered leprosy a hereditary disease of tropical subjects, and therefore undeserving of the colonial government’s limited resources. The leprosariums were emptied. At the start of the 20th century, a growing understanding that leprosy was spread by a bacillus caused a panic that leprosy might spread from the tropics to the colonial metropole. The mixed emotions of pity, fear and revulsion associated with management of the disease intensified, and fed into broader debates on colonial policy. The experts were unsure, and resources were never forthcoming, and despite a view that “bacteria are the same everywhere”, Dutch leprosy treatment in the East Indies mobilized traditional healing practices and relied on home care. Leo van Bergen’s detailed, attentive study to changing policies for treatment and prevention of leprosy (now often called Hansen’s disease) is fascinating medical history, and provides a useful lens for understanding colonialism in Indonesia.

This is a cultural history of borders, hygiene and race. It is about foreign bodies, from Victorian Vaccines to the pathologized interwar immigrant, from smallpox quarantine to the leper colony, from sexual hygiene to national hygiene to imperial hygiene. Taking British colonialism and White Australia as case studies, the book examines public health as spatialized biopolitical governance between 1850 and 1950. Colonial management of race dovetailed with public health into new boundaries of rule, into racialised cordons sanitaires .

From 1906 to 1925 Quail Island, in Lyttelton Harbour, was the site of New Zealand’s leprosy colony. The colony began by accident, as it were, after the discovery of a leprosy sufferer in Christchurch. As further patients arrived from across the country, it grew into a controversial and troubled institution – an embarrassment to the Health Department, an object of pity to a few, a source of fear to many. This remarkable narrative reveals a little-known aspect of New Zealand’s past, shedding light on the treatment of some of society’s most marginal, unfortunate and isolated people. Written in lucid, compelling prose, The Dark Island heralds the arrival of a significant historical voice.

In 1872, Ralph Waldo Emerson wrote, "Science does not know its debt to imagination," words that still ring true in the worlds of health and health care today. The checklists and clinical algorithms of modern medicine leave little space for imagination, and yet we depend on creativity and ingenuity for the advancement of medicine—to diagnose unusual conditions, to innovate treatment, and to make groundbreaking discoveries. We know a great deal about the empirical aspects of medicine, but we know far less about what the medical imagination is, what it does, how it works, or how we might train it. In The Medical Imagination, Sari Altschuler argues that this was not always so. During the eighteenth and nineteenth centuries, doctors understood the imagination to be directly connected to health, intimately involved in healing, and central to medical discovery. In fact, for physicians and other health writers in the early United States, literature provided important forms for crafting, testing, and implementing theories of health. Reading and writing poetry trained judgment, cultivated inventiveness, sharpened observation, and supplied evidence for medical research, while novels and short stories offered new perspectives and sites for experimenting with original medical theories. Such imaginative experimentation became most visible at moments of crisis or novelty in American medicine, such as the 1790s yellow fever epidemics, the global cholera pandemics, and the discovery of anesthesia, when conventional wisdom and standard practice failed to produce satisfying answers to pressing questions. Throughout the eighteenth and nineteenth centuries, health research and practice relied on a broader complex of knowing, in which imagination often worked with and alongside observation, experience, and empirical research. In reframing the historical relationship between literature and health, The Medical Imagination provides a usable past for contemporary conversations about the role of the imagination—and the humanities more broadly—in health research and practice today.