It was one of the most dreaded of diseases. It disfigured its sufferers almost beyond recognition. It was a scourge of humankind for thousands of years, and was considered incurable. Because of fear of contagion and the belief that the sickness was a punishment from God, victims throughout the centuries were removed from the "civilized" world, forced into isolation, and stigmatized for life.
Leprosy was not known in Europe until after the Romans invaded Egypt and carried the disease back to Italy. From there the Roman invasions took the disease into Germany and beyond. By 550 C.E. leprosy reached far way Ireland. Incidence of the disease grew enormously during the Crusades. It affected huge populations in northern Europe, possibly a quarter of the population at one time. That percentage was drastically reduced by the Black Plague, which killed many people already infected and weakened by leprosy. Throughout the ages, little progress was made in the welfare of those afflicted. Few physicians would treat leprosy patients. Their care was left to priests and other religious workers. Although medical science continued to advance, there was little improvement in the care of leprosy patients. Many were doomed to die in grim isolation.
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The Disease Invades Hawai'i
It is not known when or precisely how leprosy arrived in the Hawaiian Islands, but it was detected as early as the 1830s. Leprosy cut across all populations in the islands, but Hawaiians were particularly vulnerable to introduced disease, having no immunities. By the mid-nineteenth century, the Hawaiian people suffered death and disfigurement at alarming rates. People afflicted with leprosy usually had short life spans, falling victim to other opportunistic diseases.
Fearing further spread of the disease, the Kingdom of Hawaii took action by authorizing the setting aside of land for confining leprosy patients. The police and district justices were required to arrest any persons suspected of having leprosy. In Honolulu, the Kalihi Hospital and Detention Station opened in November 1865 for initial evaluation and treatment. People with advanced cases of the disease were sent to the remote, isolated north shore of Molokai. By 1900, the number of new patients in the islands began a slow decline, a trend that continued until the 1940s, when it was determined that the disease was not spreading in the general population.
Science Finds a Cure
In 1873, the same year Father Damien arrived at Kalaupapa, a breakthrough discovery was made by Dr. Gerhard Armauer Hansen in Norway. He identified the cause of leprosy – a simple bacterium. Today this bacillus is known as Mycobacterium leprae. The bacillus attacks the nerves and causes severe damage to the skin and eyes. Untreated patients suffer from a loss of feeling, and muscle paralysis, most often in the feet and hands. The discovery that leprosy was caused by a microorganism was the first step in treatment of the disease. It also led to social changes because the disease was no longer thought to be hereditary, or weakened the belief that people with the sickness were being punished by God. Over the years many "cures" were identified and tested. Hawaii was the focus for much of this research, with the federal government even building an entire facility devoted to finding a cure.
Despite the promise of Goto baths and chaulmoogra oil, a real cure wasn't discovered until the 1940s when sulfone drugs were developed at the US Public Health Service National Leprosarium in Carville, Louisiana. Leprosy is now known in the United States and other nations as Hansen's disease in an attempt to eliminate the centuries-old stigma. The disease is transmitted generally by direct, person-to-person contact, usually repetitive, over a prolonged period of time. However, it is one of the least contagious of all communicable diseases, and only about 4-5% of the world's population is even susceptible to it.
The World Health Organization estimates there are approximately 1.15 million registered cases of the disease in 55 countries around the world. Today at Kalaupapa and in Honolulu, people who are registered with the State of Hawaii Department of Health Hansen's disease community program continue to receive treatment for the effects of Hansen's disease. They have seen major changes in the level of knowledge about the disease, drug treatments, and in society's attitudes. Around the world, public education, acceptance within communities, and patient demands for their human rights lead the continuing effort to end discrimination.