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

By Michelle T. Moran | Go to book overview

CHAPTER FIVE
Leprosy and Citizenship

Patients and officials in both Hawai‘i and Louisiana recognized that questions of American identity and citizenship lay at the heart of leprosy regulation. Ideas about how those questions should be addressed, however, differed considerably at the two locations, revealing the degree to which imperialist beliefs and attitudes continued to influence medical policies at both Kalaupapa and Carville throughout the 1930s and 1940s. As the early decades of leprosy management had revealed, medical officials at each institution regularly looked to the other for approaches on how to manage and treat the disease, but they also assumed that the mainland and the Hawaiian Islands contained two very different kinds of patients. The patients themselves, particularly at Carville, challenged the right of these officials to shape leprosy policy unilaterally, but their arguments had the unforeseen consequence of further dividing the two communities.

Health officials in Hawai‘i perceived the management of leprosy as an avenue for demonstrating their ability both to contain the threat of contamination posed by an undisciplined Hawaiian population and to groom their charges as future citizens of a full-fledged U.S. state. They portrayed themselves as selfless stewards of the Hawaiians, whom they coached in proper Western attitudes toward the disease. At the same time, they tried to show how they effectively policed and controlled “deviant” Hawaiian bodies, bodies that threatened to reproduce both themselves and the disease and thus create a new class of dependents who would burden the state. Conceptions of citizenship proved more problematic for U.S. public health officials at Carville. On the one hand, officials embraced the notion that mainland patients could be expected to conform to the discipline of a modern U.S. medical facility in ways that Hawaiian patients could not. On the other, the need for surveillance and order at a modern medical institution and the mental and physical incapacitation that presumably accompanied the

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