Humanitarian quarantine in practice: medicine, religion and leprosy in New Caledonia.

Medicine and religion worked in close synchronisation during the leprosy outbreak of New Caledonia (1890-1950). Once isolation of leprosy-affected people became mandatory doctors and missionaries came together to promote a particular form of medical practice that tied charitable zeal with cutting-edge medical research, developing a sophisticated set of medical practices that catered for the soul as well as the body. Such practices went hand-in-hand with ideas developed by doctors in the earlier stages of the epidemic about the way in which the disease had entered the Kanak (local Melanesian) population. Doctors and missionaries admitted that immoral colonial channels had upset the delicate balance of local social and biological rhythms. Yet they also believed that the highly contagious nature of the outbreak was linked to the inferior state of Kanak. This paper aims to highlight the way in which the leprosaria system in New Caledonia represented a double-edged moral high-ground within the French medical colonial narrative. It tracks the complex way in which emotionally charged arguments about contagion, science and spirituality constructed an ideology of humanitarian quarantine which was used to justify a highly aggressive form of medical biocontrol.

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.

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.

The leprosy asylum in India: 1886-1947.

Writing against a historical practice that situates the leprosy asylum exclusively within prison-like institutions, this article seeks to show the variation in leprosy asylums, the contingencies of their evolution, and the complexity of their designs, by devoting attention to the characteristics of the leprosy asylum in India from 1886 to 1947, in particular to the model agricultural colony. Drawing upon the travel narratives of Wellesley Bailey, the founder of the Mission to Lepers in India, for three separate periods in 1886, 1890-91, and 1895-96, it argues that leprosy asylums were formed in response to a complex conjunction of impulses: missionary, medical, and political. At the center of these endeavors was the provision of shelter for persons with leprosy that accorded with principles of good stewardship and took the form of judicious use of donations provided by benefactors. As the Mission to Lepers began to bring about improvements and restructuring to asylums, pleasant surroundings, shady trees, sound accommodation, and good ventilation became desirable conditions that would confer physical and psychological benefits on those living there. At the same time, the architecture of the asylum responded to economic imperatives, in addition to religious and medical aspirations, and asylums moved towards the regeneration of a labor force. Leprosy-affected people were increasingly employed in occupations that contributed to their sustenance and self-sufficiency, symbolically reincorporating the body damaged by leprosy into the economic world of productive relations.

[Neurological diseases in late 19th century Taiwan--medical reports of the Chinese Imperial Maritime Customs].

Western medicine was introduced to Taiwan in 1865 when Dr. James L. Maxwell, a missionary doctor of the English Presbyterian Church, established a hospital in nowadays Tainan. The period of the missionary medicine lasted for over 30 years until Japanese took over. During this period, however, official records of diseases in Taiwan that were based on Western medicine were scanty or not available. Fortunately, port surgeons stationing respectively in Tamsui and Kelung in the north and in Takow and Taiwan-fu in the south reported semi-annually diseases seen in the ports, foreign communities and missionary hospitals that they volunteered to work. The diseases reported by port surgeons were either cases or summary of cases with classification and statistics. Their medical reports covered from 1871 to 1900. The data show that neurological diseases and/or disorders in the late 19th century Taiwan were uncommon, comprising only 2-3% of total diseases. The data further show that common neurological diseases were leprosy, opium smoking, syphilitic dementia (GPI), paralysis, hysteria, neuralgia, epilepsy, mania, sciatica, meningitis and ataxia. Stroke was uncommon while Parkinson's disease and Alzheimer's disease were not mentioned, indicating that neurological diseases related to old age and neurodegeneration were not yet a threat to health. Similarly, headache, insomnia, anxiety and depression, hallmark of functional disorders of the modern society, were also not mentioned, suggesting that these disorders were indeed rare or did not cause sufficient concern for patients to seek help from doctors of Western medicine.

Global and local contexts: the Northern Ogoja Leprosy Scheme, Nigeria, 1945-1960.

Deriving funding from missionary sources in Ireland, Britain and the USA, and from international leprosy relief organizations such as the British Empire Leprosy Relief Association (BELRA) and drawing on developing capacities in international public health under the auspices of WHO and UNICEF through the 1950s, the Roman Catholic Mission Ogoja Leprosy Scheme applied international expertise at a local level with ever-increasing success and coverage. This paper supplements the presentation of a successful leprosy control program in missionary narratives with an appreciation of how international medical politics shaped the parameters of success and the development of therapeutic understanding in the late colonial period in Nigeria.

"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.

The papers of Stanley Browne: leprologist and medical missionary (1907-1986).

This article elaborates a significant archival acquisition that supplement the collection documents related to the life and work of Stanley George Browne held at the Wellcome Library for the History and Understanding of Medicine in London, specifically his work in the Belgian Congo (from 1936 to 1959), at Uzuakoli in Nigeria (1959 to 1966), in London with the Leprosy Study Centre (1966-1980), and also in his international capacity as leprosy consultant. It also briefly refers to an endangered collection of documents, photographs, files and correspondence held in a small museum in Culion Sanatorium, The Philippines. This research is part of the International Leprosy Association Global Project on the History of Leprosy. Its results can be accessed at the site http://www.leprosyhistory.org

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.

The evangelical uses of leprosy.

The history of leprosy treatment among the Karo of Sumatra illustrates how leprosy afforded missionaries an evangelistic opportunity, and how that opportunity eroded in the twentieth century with changing therapies for the illness. Because it symbolized Christian charity, leprosy care drew donations and support for the missionary movement of the nineteenth century. In Karoland, as elsewhere, leprosy patients were attracted to the missionaries' religion because therapy entailed separation from kin and community and then incorporation into a new kind of community, an asylum, where the authority structure, the dispensation of resources, and the constructed spaces of everyday life made the idea of a supreme deity an experienced reality. When therapies of leprosy shifted to an out-patient system, one of the older missionaries to the Karo struggled to maintain control of the leprosarium that had been one of the few pockets of conversion in this mission field.

[Biwasaki Leprosarium--a century of dedication].

Biwasaki Leprosarium, or Biwasaki Tairo Hospital, was established by Father Jean Marie Corre, a French Priest, in 1898. He was born in Brittany France, 1850. After being ordained to the priesthood, he came to Nagasaki, Kyushu, in 1876. He was just twenty six years old. He was greatly moved at the sight of the Hansenites and other sick people around the Honmyoji Temple in Kumamoto, Kyushu, which is one of the well-known temples in Japan. They were making a bare living by the charitable contributions of the pilgrims who visited the Temple, in those days. Fr. Corre moved from Nagasaki to Kumamoto. First, he built a church in Tetori, Kumamoto, and rented a house near the Honmyoji and began to look after the needs of the Hansenites. In 1896, he bought a large lot at Biwasaki in the Shimasaki area, Kumamoto, where is not far from Honmyoji. He remodeled some houses into the so-called sanatorium and started to accommodate those suffering from Hansen's disease. At the outset, he had the cooperation of nuns and church workers to look after the patients' needs. Furthermore, Fr. Corre appealed to Rome for the help and/or support in 1898 in order to expand this kind of project, and five nuns were dispatched in the following year from the Franciscan Missionaries of Mary in Rome. And since then the sisters have devoted themselves assiduously and faithfully to help the Hansenites as far as possible and they are still doing this. However, in 1963, a fire broke out from one of toilets and made a clear sweep of the whole building.(ABSTRACT TRUNCATED AT 250 WORDS)

The contribution of medical missionaries to tropical medicine. Service-training-research.

Medical missionaries, historically the pioneers in introducing Western medicine into many tropical countries, are today responsible for a significant proportion of health care in several of those countries. Illustrating his theme with references to personal experiences in the former Belgian Congo, the author enlarges on the organization of a church-related comprehensive health care programme based on a chain of rural health centres and satellite dispensaries that brought curative and preventive medicine to the whole population within the area covered. Trypanosomiasis was eradicated, yaws and tuberculosis controlled, cerebral malaria eliminated, worm-loads reduced and nutrition improved. Leprosy was treated within the integrated service as soon as the sulphones became available. Medical auxiliaries and nurse-midwives were trained practically to tackle the local problems. Students from many missions over a wide area went into government, mission and company employ after training. Research concentrated mainly on the solution of pressing local problems, such as onchocerciasis and leprosy, but incidentally investigated interesting clinical phenomena.