Western Ideology and Leprosy: The Influence of Social Injustice

When we first think of leprosy, our mind most likely goes to this being a disease of the past, a historical issue that no longer needs to be discussed since Western medicine has developed a cure. However, leprosy remains a constant issue to this day. Leprosy is caused by Mycobacterium leprae, and is a disease that mainly affects the skin, peripheral nerves, mucosa of the upper respiratory tract, and the eyes. The disease can be treated if it is caught in the early stages, and disability can be prevented (WHO). Leprosy has been treated in multiple ways throughout the past, however it was not until the 1940s when medicine became advanced enough to provide successful results. The World Health Organization launched its 'Global Leprosy Strategy 2016–2020: Accelerating towards a leprosy-free world' to reinvigorate efforts for leprosy control (WHO). According to the World Health Organization, leprosy is no longer considered a public health problem due to the fact that it has a registered prevalence of less than 1 case per 10 000 within a population (WHO). Although the causes and physical affects of leprosy have been widely discussed, they will not be discussed in detail within this proposal for issues of saving space and time.

The aim of this paper is to understand how Western political ideologies and medicinal movements have impacted the understanding of leprosy, and how this understanding promotes social injustice on those who still suffer from the disease. By focusing on the connection between politics, medicine, nationhood, and modernity, the hope is to gain an understanding as to how policies and aid have been formed. Policies and aid have generally been formed through a colonial, academic voice, and sometimes exclude the voice of those directly affected. The stigma surrounding chronic and infectious diseases adds a level of fear and superstition that affects the decisions made. There have been numerous publications within this field of study that focus on the stigma attached to leprosy and how it affected individuals once the disease was evident. However, these articles have a focus on the history of leprosy and the segregation that occurred. Leprosy is still a modern concern, despite it no longer being a public health issue, and although leprotic islands are no longer used as a form of isolation, individuals diagnosed with leprosy still suffer the social stigma associated with this disease. And it is their voice that has been ignored throughout the centuries.

Reviewing case studies of leprosy in the past as well as more modern cases must be undertaken in order to fully under the history of the disease. This will be done using sources such as Barrett, Buckingham, Cueto, Edmond, Kakar, Le, and Navon. These articles will be used as example case studies from multiple locations around the world in order to understand how Western ideologies within politics and medicine has affected the social context attached to leprosy. They all have a common theme of the voice of those affected versus voice of the academy. They discuss the origins of leprosy, how those infected were viewed by the public, and how they were treated throughout the years (before and after a cure was discovered). Historical references on the impacts of the colonial world will also be used to understand how colonialism has impacted the policies and stigmas associated with leprosy. Worboys argues that one reason treatment programs began in areas affected by leprosy is tied to the idea that scientists and colonialists wanted to consolidate imperial rule and promote trade. Yet this focus has broadened over the years to view the use of medicine as a tool of the empire that was used as a focus of colonial rule. Medicine within colonies developed as both a mission and a mandate: “the missions of spreading Christianity and introducing modern (“scientific”) rationality, and the mandate of consolidating colonial rule and promoting health of indigenes”. Edmond argues that leprosy became an imperial problem, and that the government that had colonies with leprosy had a list of questions they needed answered. These questions included: “causation, transmission, inherent character, and spread. Was it contagious or hereditary? Were all races equally vulnerable? Did segregation prevent its spread? Was it really increasing?”. These questions imply the need to analyze, measure, and categorize not only the disease, but those both infected and not infected. We see a scientific discourse pushed by colonialism spread over the centuries.

Understanding leprosy fully involves more than simply looking into its history. Leprosy has moved beyond just a question of health, and we must investigate a multitude of pressures. By incorporating articles focusing on the study of imperial medicine, 21st century plagues and global studies, the aim is to look more broadly at the factors that articles with a focus on leprosy discuss but do not go into detail on. Generally, medicine is discussed in a way that allows us to understand which treatments have been used over the centuries, and authors provide a history of this. However, we need to investigate this relationship of medicine, colonialism and imperialism concerning leprosy. Wells discusses a wartime shift in medicine after World War Two, and how there was a change in the institutional landscape of international public health. It is this shift, but focused solely on the study of leprosy, that needs to be investigated. Reich argues that “the historical and current approach to the problem of leprosy has been little more than a policy of dealing with the symptoms and neglecing the disease”. Although his work was published in the late 80s, it is an argument that may still be made today. Staples points out that “there are important differences, both between official policy and its practical interpretation”. It is these differences that need to be investigated in more detail in order to determine how the impacts of Western ideologies have affected the social stigma and context attached to the understanding, the medicine, and the treatment of leprosy in the modern world. The reaction of those infected and how they viewed the use of Western medicine also needs to be explored.

Singer argues that there are correlations between poverty and social injustice regarding individuals being at a heightened risk for disease and illness. She states that there is “a biology of poverty and social injustice that puts subjugated populations at heightened risk. Although her work is in relation to global warming and twenty-first century plagues, it is a theory that can be connected to the ideologies and fears associated with leprosy as well. Something that needs to be explored more in depth. She argues that “syndemics are being identified around the world as researchers begin to focus on the nature of connections among diseases and the social context factors that foster disease interactions”, yet none of the case studies or examples referenced use a disease such as leprosy and how specific ideologies have influenced the social context factors in play. How would a chronic disease that can lay dormant within an individual affect populations that have increased over time? It is well known that populations are increasing and that there is a changing climate. These changes will have an impact on infectious diseases, so we must have a stronger understanding of all aspects of the disease increase it does grow and re-emerge within populations. These aspects will also include moving beyond the standard cause, transmission, and cure studies that are generally undertaken.

Leprosy has been written on since the first discoveries of the disease and continues to be written about throughout modern academia. The most common articles discuss the causes, transmissions, and origins of the disease. We also see many case examples of countries that have leper colonies and what was done to those infected. These include the causes and treatment as well, with some delving deeper into the social constructs that have affected individuals infected. However, more relationships between colonialism, imperial medicine, and social injustice need to be examined and understood. Leprosy still occurs today, and despite it no longer being a public health issue in many of the countries infected, it still holds a stigma. We need to approach and unpack this stigma, understand its origins, and provide a new voice for individuals suffering.

Works Cited

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• Buckingham, Jane. (2011). The Inclusivity of Exclusion: Isolation and Community Among Leprosy-Affected People in the South Pacific. Health and History, 13(2), 65-83. doi:10.5401/healthhist.13.2.0065
• Cueto, Marcos. (2004). Social Medicine and 'Leprosy' in the Peruvian Amazon. The Americas, 61(1), 55-80. Retrieved from http://www.jstor.org.proxy.lib.uwaterloo.ca/stable/4144593
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