Isolation, Control and Rehabilitation: A Social and Medical History of Leprosy Treatment and Leprosaria in Cameroon, 1916-1975

The purpose of this study was to examine the role of mission-operated leprosy settlements or leprosaria in the treatment, control and rehabilitation of leprosy victims in the part of Cameroon that was formerly under British administration between 1916 and 1975.

Disease control was a major social and welfare problem in former European colonies and protectorates in Africa. Colonial administrations grappled with the duality of providing basic sanitation and healthcare to the population as well as institute measures to prevent the outbreak or spread of infectious diseases. Leprosy constituted one of the infectious diseases that threatened the social, cultural, economic and political boundaries in colonial and postcolonial Cameroon. Despite the long and challenging history of disease in the country and Africa in general, African countries still grapple with the problem of managing highly-stigmatized infectious diseases suggesting the need to interrogate past disease control measures in order to inform and direct measures at tackling contemporary challenges. Public health stakeholders in Africa continue to isolate patients of stigma-related disease which often lead to deleterious effects on the original goal of disease control.

This project examines the place of leprosy settlements in the interconnection of the policy of isolation in the control, treatment and rehabilitation of victims of leprosy. In the literature on the social history of medicine in Africa, the agency of the patients is often neglected, if not silent. This study analyzes the policy of custodial care in the control and treatment of leprosy in former British Southern Cameroons and West Cameroon. It describes the agency of patients in the effective operation of leprosy settlements and implementation of leprosy control policy. It also analyzes the economic, socio-cultural and religious tensions that ensued as a result of the adoption of patient isolation as the main measure at controlling leprosy. Finally, the study describes experience of patients in the settlement, and how that experience and encounter with leprosy transformed the lives of patients.

Data for the study was collected with the use of archival documents and oral interviews. The study demonstrates that until the establishment of leprosy settlements in the 1950s, the adoption and implementation of the policy of isolation against leprosy was misguided and half-hearted. Without the intervention of Christian missionary organizations, the problem of leprosy might not have been arrested. It also brings to fore the agency of patients in the negotiations and execution of public health policies and regulations in both colonial and postcolonial Cameroon. The sustainability of the welfare policies depended largely on the goodwill and resilience of patients underscoring the agency of patients in the negotiation of power relations between Europeans and colonial peoples on the one hand, and patients and healthcare providers on the other. Lastly, changes in the political dispensation, anti-leprosy policy and benign neglect led to the deterioration and ruin of leprosy settlements and their feeder clinics.