Medicine: Survival of a Dark Age

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The leper colony on the Hawaiian island of Molokai was a place of horror when Father Damien de Veuster, a Belgian Catholic priest, landed there in 1873. The victims of leprosy lived in primitive huts or roofless stone buildings; they died without medical care in an empty room furnished only by their waiting coffins. In his 16 years of heroic service on Molokai, which ended with his death from leprosy in 1889, Father Damien made many improvements, including a water system built largely with his own hands. Now the colony, located at Kalaupapa, has a 60-bed hospital, four doctors, a movie theater, beauty shop, Lions Club, American Legion post, Boy Scout troop. The patients, whose only diversion when Father Damien arrived was getting drunk on the juice of the ki tree, have dances and picnics; they learn rug-weaving, block-printing, sewing, raise food under the supervision of the University of Hawaii agricultural extension service.

Nevertheless, Kalaupapa, operated for the last 84 years as a self-supporting isolation colony, has fallen behind the times. Hawaii's bumbling Governor Ingram M. Stainback, onetime lawyer from Tennessee, now calls it "a blot upon Hawaii's good name." Last week he asked the Territorial Legislature to erase the blot by closing out the colony at Kalaupapa. There are now only 248 patients there; at the peak, in 1890, there were 1,100. Compulsory segregation of leprosy patients at Kalaupapa is, said Governor Stainback, "an expensive and useless cruelty ... a survival of a dark age of ignorance and unreasonable fear," since the disease is not highly infectious. Stainback did not say what would happen to the patients if the colony is abolished. Best guess was that they would be sent to the Kalihi receiving station on the island of Oahu, held until doctors found out whether it would be safe to release them. While he was on the subject, Hawaii's governor asked that the name "leprosy" be taken out of the statute books, replaced by "Hansen's disease."*

Governor Stainback had a point. Actually, leprosy is considered less infectious than tuberculosis. But Hawaiians preferred to go slow. Said Harry A. Kleugel, head of the Hawaiian Board of Hospitals: "We should be wary of jumping into something new when the present operation is showing results." Five bills were introduced after the Governor's message, but none was for immediate action. One asked for a survey of leprosy in Hawaii and a report to the next session; another asked for more research. The others would make life easier at Kalaupapa by such details as allowing photographs to be sent home (now only scientific pictures may go out).

In Washington, U.S. Public Health Service officials had no plans for abandoning the only leprosarium on the continental U.S., at Carville, La. (390 patients). All states, except New York and Massachusetts, require isolation of leprosy victims. Patients are discharged when twelve monthly tests show no evidence of the leprosy bacillus. There is still no specific cure, but sulfone drugs like promin and diasone (close chemical relatives of the sulfas) speed up the time when patients can be released as noninfectious.

* Named for the Norwegian physician, Gerhard Armauer Hansen, who isolated the bacillus.