Colonizing Leprosy: Imperialism and the Politics of Public Health in the United States

By Michelle T. Moran | Go to book overview

CHAPTER FOUR
Institutionalizing American Leprosy

At the beginning of the twentieth century, the Hawaiian leprosy institutions at the Kalaupapa settlement on Moloka‘i and the Kalihi station on O’ahu stood at the center of international debates regarding the treatment and research of the disease. At Kalaupapa in particular, health officials strove to create a state-of-the-art facility for investigating and applying Western medical techniques. The settlement’s predominantly Hawaiian patients and their allies, however, organized to assert their right to participate in shaping treatment and experimentation. The contests that unfolded reveal the degree to which the definitions of appropriate care and necessary research could differ dramatically between patients and medical practitioners. When U.S. health officials established an experiment station at the settlement, patients refused to participate in its activities, forcing the facility to close in 1913. These responses to Western medicine compelled public health officials to reconsider their assumptions about who made the most reliable research subjects and what location fostered the best environment for medical investigations.

After watching the U.S. experimental station fail in Kalaupapa, federal public health officials turned their attention to the mainland facility at Carville, Louisiana. Experiences in Hawai‘i still proved useful, as physicians and public health officials applied knowledge generated in the islands to the new national leprosarium. In Louisiana, they instituted bacteriological testing protocols, chaulmoogra oil treatments, and rigid regulations for stricter separation between medical personnel and patient living areas—all of which were earlier developed at Kalihi and Kalaupapa. Health officials also learned in Hawai‘i that patient mobility and loose administrative oversight could result in patients having the autonomy to refuse medical treatment and experimentation. They thus designed a more structured campus layout and more comprehensive techniques to control patients at the U.S. National Leprosarium in Louisiana.

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