From Colonial Legacies to Contemporary Realities: Leprosy in Ethiopia Since 1941

This study examines the historical trajectory and socio-economic impact of leprosy, also known as Hansen’s disease, in Ethiopia from 1941 to the present, tracing the transition from colonial-era medical legacies to contemporary public health realities. Employing a qualitative historical methodology, the research utilizes a systematic analysis of archival materials, government documents, and oral histories. Primary data was gathered through in-depth interviews with 22 interlocutors, including ten individuals who have completed multi-drug therapy (MDT) treatment of the disease, with findings triangulated against secondary literature to ensure historical accuracy. The findings reveal that the management of leprosy in Ethiopia was long shaped by early 20th-century models of institutional isolation, which reinforced the profound marginalization of rural communities. Beyond the physical burden of the disease, the study highlights a persistent legacy of psychological distress and social ostracization. The disfiguring nature of leprosy facilitated a “social death” for many, characterized by exclusion from religious ceremonies and communal life. Economically, this stigma institutionalized a cycle of poverty, giving rise to a distinct marginalized class—often referred to as Hamina or Lalibela who were forced into professionalized begging due to systemic exclusion from the labor market. While the Ethiopian government has expanded modern dermatological and multi-drug therapy services since the 1950s, the current landscape is still defined by persistent stigma and socioeconomic fragility. The study concludes that addressing leprosy in the twenty-first century requires more than clinical intervention; it demands an integrated approach that deconstructs historical prejudices and mobilizes community institutions to achieve full social and economic reintegration for affected individuals.