Lepra: doença, isolamento e segregação no contexto colonial em Moçambique / Leprosy: disease, isolation, and segregation in colonial Mozambique

Resumo A partir de documentação produzida entre a primeira metade do século XIX e a primeira metade do século XX, prioritariamente relatórios médicos, o artigo aponta as concepções vigentes na comunidade médica colonial e entre as populações locais sobre a lepra, suas manifestações e seu enfrentamento. Enfoca as tensões quanto à prática de segregação dos leprosos e suas implicações sanitárias e sociais. Para compreender as raízes dos discursos e estratégias no meio médico português e colonial, recupera-se a trajetória das definições de isolamento, segregação, lepra e suas aplicações, ou ausência de referência, na literatura de missionários, cronistas e médicos em Angola e Moçambique a partir da segunda metade do século XVII.

Abstract Drawing on documents produced between the early nineteenth and mid-twentieth centuries, mainly medical reports, this paper indicates the prevailing conceptions in the colonial medical community and local populations about leprosy, its manifestations, and how to deal with it. It focuses on the tensions concerning the practice of segregating lepers and its social and sanitation implications. To comprehend the roots of the discourses and strategies in the Portuguese and colonial medical environment, the trajectory of the definitions of isolation, segregation, and leprosy are traced, as are their use in or absence from the writings of missionaries, chroniclers, and doctors in Angola and Mozambique as of the second half of the seventeenth century.

A Modern History of 'Imperial Medicine' Surrounding Hansen's Disease: Strategies to Manage Public Opinion in Modern Japanese Media.

The purpose of this study is to understand the reality of imperial medicine by exploring the strategic attitude of the Japanese authority targeting the public who were not patients of Hansen's disease. For this purpose, this study examines the mass media data related to Hansen's disease published in Korea and Japan during the Japanese colonial rule. Research on Hansen's disease can be divided into medical, sociohistorical, social welfare, and human rights approach. There are medical studies and statistics on the dissemination of medical information about Hansen's disease and management measures, the history of the management of the disease, guarantee of the rights of the patients and the welfare environment, and studies on the autobiographical, literary writings and oral statements on the life and psychological conflicts of the patients. Among existing research, the topics of the study on Hansen's disease under the Japanese colonial rule include the history of the Sorokdo Island Sanatorium, investigation on the forced labor of the patients in the island, human rights violations against the patients, oral memoirs of the patients and doctors who practiced at that time. All of these studies are important achievements regarding the research on the patients. An important study of Hansen's disease in modern Japan is the work of Hujino Utaka, which introduces the isolation of and discrimination against the patients of Hansen's disease. Hujino Utaka's study examines the annihilation of people with infectious diseases in Japan and its colonies by the imperial government, which was the consequence of the imperial medical policies, and reports on the isolation of Hansen's disease patients during the war. Although these researches are important achievements in the study of Hansen's disease in modernity, their focus has mainly been on the history of isolation and exploitation in the Sorokdo Island Sanatorium and discrimination against the patients within the sanatorium, which was controlled by the director of the sanatorium. Consequently, the research tends to perceive the problem within the frame of antagonism between the agent of imperialism and the victims of exploitation by the hands of imperialism. Hence, it has limitations in that it has not fully addressed the problem of the people who were not Hansen's disease patients and as such, existed somewhere in between the two extremes in the process of administering medicine under the imperial rule. The purpose of this study is to identify the direction of imperial medicine in the history of Hansen's disease in Japan and to comprehend the characteristics of policy on Hansen's disease developed by Mitsuda Kensuke, who was behind the policy of imperial medicine, and examine the process of imperial medicine reaching out to the people (of Japan and its colonies). To achieve the goal, this study explores how the agent of imperial medicine gain the favor the public, who are not Hansen's disease patients, by means of the mass media. Specifically, this paper examines data in the Japanese language related to Korean patients of Hansen's disease including the mass media data on Hansen's disease in the source book titled The Collection of Data on Hansen's Disease in Joseon under the Colonial Rule(8 volumes) compiled by Takio Eiji, which has not been studied until now. It also reviews the cultural and popular magazines published in Japan and Joseon at that time.

Leprosy: disease, isolation, and segregation in colonial Mozambique. / Lepra: doença, isolamento e segregação no contexto colonial em Moçambique.

Drawing on documents produced between the early nineteenth and mid-twentieth centuries, mainly medical reports, this paper indicates the prevailing conceptions in the colonial medical community and local populations about leprosy, its manifestations, and how to deal with it. It focuses on the tensions concerning the practice of segregating lepers and its social and sanitation implications. To comprehend the roots of the discourses and strategies in the Portuguese and colonial medical environment, the trajectory of the definitions of isolation, segregation, and leprosy are traced, as are their use in or absence from the writings of missionaries, chroniclers, and doctors in Angola and Mozambique as of the second half of the seventeenth century.

Leprosy in Eastern Nigeria and the social history of colonial skin.

To the historian, the 'historical' experience of leprosy control is not simply a backdrop to contemporary patterns or problems in disease control. The control of leprosy has been enacted in different ways in localities, territories and states across the world. The specific clinical, political, and institutional choices made in leprosy control have been highly significant in shaping attitudes and approaches to leprosy. The term stigma has a history of usage, contention and re-definition. Stigma, then, is a product of its intersecting social, economic, and medical contexts. In order to capture the degree to which stigma associated with leprosy has mutated and changed over time, this article concerns itself specifically with the colonial experience of leprosy, with a focus on the formerly leprosy-endemic area of southeastern Nigeria (known as the Eastern Region, or Eastern Nigeria) in the last quarter century of colonial rule ending in 1960. The article examines how leprosy was presented, identifying some of the forms in which ideas of stigma and taint with respect to leprosy were communicated. It goes on to examine how leprosy was encountered as a medical problem in Eastern Nigeria, placing leprosy in the context of skin diseases most commonly encountered by colonial medical services. It concludes by demonstrating how leprosy was understood, looking briefly at local and biomedical means of identifying and combating these diseases, and the meanings of these diseases in the rapidly changing contexts of mid- and late-colonial rule and the onset of Nigerian Independence in 1960.

[A history of malaria in modern Korea 1876-1945].

Although it is not certain when malaria began to appear in Korea, malaria is believed to have been an endemic disease from ancient times. It was Dr. H. N. Allen (1858-1932) who made the first description and diagnosis of malaria in terms of Western medicine. In his first year report (1885) of Korean Government Hospital he mentioned malaria as the most prevalent disease. Very effective anti-malarial drug quinine was imported and it made great contribution in treating malaria. After Japan had annexed Korea in 1910, policies for public health system were fundamentally revised. Japan assumed control of Korean medical institutions and built high-quality Western hospitals for the health care of Japanese residents. The infectious diseases which were under special surveillance were cholera, typhoid fever, dysentery, typhus, scarlet fever, smallpox, and paratyphoid fever. Among chronic infectious diseases tuberculosis and leprosy were those under special control. Malaria, however, was not one of these specially controlled infectious diseases although it was widely spread throughout the peninsula. But serious studies on malaria were carried out by Japanese medical scientists. In particular, a Japanese parasitologist Kobayasi Harujiro(1884-1969) carried out extensive studies on human parasites, including malaria, in Korea. According to his study, most of the malaria in Korea turned out to be tertian fever. In spite of its high prevalence, malaria did not draw much attention from the colonial authorities and no serious measure was taken since tertian fever is a mild form of malaria caused by Plasmodium vivax and is not so much fatal as tropical malaria caused by P. falciparum. And tertian malaria was easily controlled by taking quinine. Although the majority of malaria in Korea was tertian fever, other types were not absent. Quartan fever was not rarely reported in 1930s. The attitude of colonial authorities toward malaria in Korea was contrasted with that in Taiwan. After Japan had set out to colonize Taiwan as a result of Sino-Japanese war, malaria in Taiwan was a big obstacle to the colonization process. Therefore, a lot of medical scientists were asked to engage the malaria research in order to handle health problems in colonized countries caused by malaria. Unlike the situation in Taiwan, malaria in Korea did not cause a serious health problem as in Taiwan. However, its risk was not negligible. In 1933 there were almost 130,000 malaria patients in Korea and 1,800 patients among them died of malaria. The Japanese Government General took measures to control malaria especially during the 1930s and the number of patients decreased. However, as Japan engaged in the World War II, the general hygienic state of the society worsened and the number of malarial patients increased. The worsened situation remains the same after Liberation (1945) and during the Korean war (1950-53).

Leprosy and the elusive M. leprae: colonial and Imperial medical exchanges in the nineteenth century.

In the 1800s, humoral understandings of leprosy successively give way to disease models based on morbid anatomy, physiopathology, and bacteriology. Linkages between these disease models were reinforced by the ubiquitous seed/soil metaphor deployed both before and after the identification of M.leprae. While this metaphor provided a continuous link between medical descriptions, Henry Vandyke Carter's On leprosy (1874) marks a convergence of different models of disease. Simultaneously, this metaphor can be traced in popular medical debates in the late nineteenth century, accompanying fears of a resurgence of leprosy in Europe. Later the mapping of the genome ushers in a new model of disease but, ironically, while leprosy research draws its logic from a view of the world in which a seed and soil metaphor expresses many different aspects of the activity of the disease, the bacillus itself continues to be unreceptive to cultivation.

The first international leprosy conference, Berlin, 1897: the politics of segregation.

The present paper examines the first attempts to internationalize the problem of leprosy, a subject hitherto overlooked by historians of imperialism and disease. The last decade of the nineteenth century saw many in the 'civilized countries' of the imperialist West gripped by a paranoia about an invasion of leprosy via germ-laden immigrants and returning expatriates who had acquired the infection in leprosy-endemic colonial possessions. Such alarmists clamoured for the adoption of vigorous leper segregation policies in such colonies. But the contagiousness of leprosy did not go unquestioned by other westerners. The convocation in Berlin of the first international meeting on leprosy revealed the interplay of differing and sometimes incompatible views about the containment of leprosy by segregation. The roles of officials from several countries, as well as the roles of five protagonists (Albert Ashmead, Jules Goldschmidt, Edvard Ehlers, Armauer Hansen, and Phineas Abraham) in the shaping of the Berlin Conference are here examined.

Beyond quarantine: a history of leprosy in Puerto Rico, 1898-1930s.

From biblical times to the modern period, leprosy has been a disease associated with stigma. This mark of disgrace, physically present in the sufferers' sores and disfigured limbs, and embodied in the identity of a "leper", has cast leprosy into the shadows of society. This paper draws on primary sources, written in Spanish, to reconstruct the social history of leprosy in Puerto Rico when the United States annexed this island in 1898. The public health policies that developed over the period of 1898 to the 1930s were unique to Puerto Rico because of the interplay between political events, scientific developments and popular concerns. Puerto Rico was influenced by the United States' priorities for public health, and the leprosy control policies that developed were superimposed on vestiges of the colonial Spanish public health system. During the United States' initial occupation, extreme segregation sacrificed the individual rights and liberties of these patients for the benefit of society. The lives of these leprosy sufferers were irrevocably changed as a result.

"Essentially Christian, eminently philanthropic": the Mission to Lepers in British India.

The early history of the Mission to Lepers in India is an interplay between politics, religion, and medicine in the context of British imperialism. The Mission pursued the dual but inseparable goals of evangelization and civilization, advancing not only a religious program but also a political and cultural one. These activities and their consequences were multi-faceted because while the missionaries pursued their religious calling, they also provided medical care to people and in places that the colonial government was unable or unwilling. Within the context of the British imperial program, the work imparted Western social and cultural ideals on the colonial populations they served, inculcated patients with Christian beliefs, and provided medical care to individuals who had been expelled from their own communities. Physical healing was intimately tied to religious salvation, spiritual healing, and the civilizing process.

[A study on the measures against Hansen's disease during the Colonial Korea].

In order to evaluate the measures taken against Hansen's diseases during the colonial era in Korea, from 1910-1945, I analyzed both Korean and Japanese materials and carried out field research. The Korean government-general established a hospital in 1916 and executed measures against Hansen's disease. These efforts can be divided into three periods. At first they started as a part of colonial policy. Then, in the middle period, with the change of Japanese policy on Hansen's disease, a Korean association was established and the Hansen's Disease Prevention Act was issued in Korea, aiming at the compulsory isolation of lepers. In the later period, during the war, the inmates were forced into an extremely severe environment and deprived of their human rights. My study shows that their policies changed greatly with the passage of time. Though they started them to relieve the suffering of the lepers in the beginning, they turned to be compulsory isolation of the patients in the later period and to the violation of their human rights.

The colonial world as mission and mandate: leprosy and empire, 1900-1940.

The history of medicine in twentieth-century empires has been dominated by studies of "imperial tropical medicine" (ITM) and its consequences. Historians have been fascinated by the work of medical scientists and doctors in the age of high imperialism, and there are many studies of medicine as a "tool of empire." This paper reviews work that explores colonial medicine as a broader enterprise than ITM in three spheres: missionary activity, modernization, and protection of the health and welfare of indigenous peoples. To illustrate the themes of mission and mandate, it discusses the development of policies to control leprosy in the tropical African and Asian colonies of Britain in the first half of this century, especially the work of the British Empire Leprosy Relief Association (BELRA). Although BELRA's efforts did little to change imperial medical and health agendas, they had an important impact locally and ideologically, and show how closely interwoven the themes of Christian caring, medical humanism, colonial development, and welfare policy had become by the outbreak of the Second World War.

[Discourse on the social illness: leprosy in the Viceroyalty of Nueva Granada in the transition from the 17th to the 18th century (Spanish)]. / Discurso sobre una enfermedad social: la lepra en el Virreinato de Nueva Granada en la transicion de los siglos XVIII y XIX.

The significance of leprosy in the Viceroyalty of Nueva Granada in the transition from the 17th to the 18th century is analyzed. In addition, we analyze treatments recommended by physicians in the viceroyalty, which were closely related with the etiology and pathogenesis which all doctors attributed to Saint Lazarus's disease. The diversity of opinions led to different therapeutic measures, not only with regard to alleviating the patient's symptoms, but also with a view to preventing it to spread to the rest of the population. As a guiding theme we use the theories defended by the most representative physicians in the viceroyalty, and the views of patients themselves and the society they lived in.