Leprosy (Hansen’s Disease) is one of the oldest diseases known to humankind, and the first human bacterial pathogen to ever be discovered. Early records with clinical descriptions of the disease, skeletal remains, and genomic studies have allowed scientists to date what is believed to be leprosy as far back as 1500 BC in Egypt, 600 BC in India and 500 BC in China. Later, following Alexander the Great’s exploration of India in 62 BC, the disease then appeared in Greece and Rome, and has since reached every corner of the globe.
Despite its long-recorded history in civilization, the scientific cause of the disease wasn’t discovered until 1873, when Norwegian doctor Henrik Armauer Hansen first discovered the bacteria (Mycobacterium leprae) under a microscope. This slow-growing bacteria attacks peripheral nerves, affecting the skin, nasal mucosa, upper respiratory tract, and eyes, and can result in permanent nerve damage and disability if not properly treated.
As the disease causes severe disfigurement and physical deformities amongst those affected, it has been very stigmatized in societies around the world. Feared to be highly contagious, individuals with leprosy were given special clothing and bells to warn others of their presence. They lost their legal status, were ostracized from their communities, and were sent to separate hospitals and to live in leper colonies away from the rest of society. Leprosy was not a diagnosis; it was a death sentence.
Perhaps instigating this severe castigation from society is the link that existed between leprosy and religious sin. In Jewish tradition chronic skin disease was linked to ceremonial uncleanliness. Shintoism in Japan uses the same word for leprosy and sin. China linked the concept of personal guilt to the presence of repulsive skin diseases. Feng shui connected leprosy to the embodiment of evil. In Hindu the disease was a form of divine punishment. In medieval times the church held leper masses in which they declared the diseased officially dead as far as they were concerned.
Currently, research indicates that prolonged, close contact over the course of months is needed with someone with untreated leprosy to spread the disease, 95% of all people have a natural immunity to the disease, and there is an effective, multi-drug treatment regime. The advancements made over the past few centuries has given Leprosy full potential for eradication.
Still, there are an estimated two million people around the world permanently disabled due to Hansen’s disease. Every day, nearly 600 more people are diagnosed and start treatment for leprosy. Despite all of these scientific advancements, what has proven to be much more impactful about the disease (making eradication so much more difficult) are the social consequences that come with the diagnosis.
Even in recent years, the stigma has not gone away. In 1937, 80 victims with leprosy were shot and thrown into a pit in China. In 1957, a mob in Korea beat 10 patients to death. In India, the Motor Vehicles Act of 1939 forbade those with leprosy from obtaining drivers’ licenses, and until recently, Indian Christian, Muslim, and Hindu marriage acts included leprosy as a grounds for divorce. In some places, such as Taiwan and until recently Japan, people could still be found living in leper colonies, a present-day symbol of the long-embedded oppression of this group.
That being said, and in light of World Leprosy Day, substantial progress has been made that should be acknowledged. Since 1995, the WHO (World Health Organization) has provided MDT (Multi-Drug Treatment) free of cost, and the number of endemic countries has dropped from 122 to nine in 2003. More than 16 million leprosy patients have been treated over the past two decades, and the number of active cases has dropped by almost 90%. While there is still work to be done, the accomplishments made for this age-old disease warrant celebration.
Moving forward, equally as important as the continued funding and commitment to treatment programs, is the continued commitment to stopping the discrimination and stigmatization of those affected by leprosy. By raising awareness of the disease amongst health professionals, governments and community members, we can end the centuries-old social stigma attached to the disease and bring visibility to this long-forgotten population.