How Leper Colonies Worked

Leprosy, also known as Hansen's disease, used to mean a one-way ticket to banishment. But once medicine trained its sights on wiping out what might be the most ancient disease to afflict humans, it has become treatable and even accepted.

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Episode Transcript

Speaker 1 (00:01):
Welcome to Stuff You Should Know from House Stuff Works
dot com. Hey, and welcome to the podcast. I'm Josh Clark,
There's Charles W. Chuck Bryant, there's Jerry should Know. Okay, unclean? Unclean?

(00:21):
What is that from? I think that's what people with
leprosy were. They had to say, They had to like
ring a bell and say unclean when they walked through
town to people would avoid them. I knew about the bell. Yeah,
I think they would have to say unclean. Early sets
the story I heard man alive. Yeah, so he says
it all. It really does. Leprosy sinks stigma. Yeah, well yeah,

(00:46):
Handsome's disease. I think is the preferred term for it
these days, is it? Uh huh? I knew what was
called that, but I have like every article I saw,
I didn't even mention that. I don't know it's I
don't know who it's who's preferring it. Mr Hanson, I
guess whoever he is. Well, he's a nineteenth century I think,

(01:07):
um Swedish or Danish physician, the guy who just who
who discovered the actual bacteria that that does it. Yeah,
because we're talking leprosy and it's a bacterial infection after all. Yeah,
I think when folks hear the word leprosy or lepro colony,
they a lot of times may not even know what

(01:28):
the heck it is. And um, yeah, I guess we
should start off with just talking about the disease a
little bit. Yeah, it's an ancient disease. I actually found
something from um the beginning of two fourteen, and they
discovered a new a new form of leprosy, new to humans,
but it's actually very old. But the the fact that

(01:50):
they can take this new form, the newly discovered form,
and compared to the one we've known about for centuries. Um,
they actually found that the fact that they diverged so
long ago makes them suspect that it's possible that leprosy
Hanson's disease is the oldest infectious disease to humans around. Really. Yeah,

(02:16):
they think that it definitely originated in Africa, that it
traveled out with humans in However, many waves that went
out of Africa spread around the rest of the world.
And one of the tell tale signs that it's extremely
old is that it only infects humans. As far as
we know, it doesn't infect any other animals except supposedly armadillos,

(02:40):
and they think that armadillos caught it from humans is
recently as a hundred or two hundred years ago. Well,
that's why if you're gonna see leprosy in the United States,
you're probably gonna find it in Texas or Louisiana because
the armadillos. Yeah, crazy weird, there is leprosy here, I guess. Um,
I bet most people think that it's not in the
United States at all, but um, it is. It's super rare. Uh.

(03:03):
The CDC says they get about a hundred new cases
a year in the US um, which is super super low,
and only about twenty to forty of those are people
born um in the United States, like usually the other
forty eight I guess are bringing it in from another
country and have it for years without knowing it. Because

(03:28):
leprosy generally takes four to six years to manifest itself.
I've seen ten to twenty. Well, I mean it can't
take that long, but generally four to six years, which
is a big problem because first of all, it's it's rare.
But even in the parts of the world where it's
not all that rare, like you can be infected with leprosy,

(03:48):
like you said, for many, many years. And even if
you do start to show symptoms, they don't just automatically
point to leprosy. They can be skin rashes, respiratory problems
or something like that. So by the time a doctor says, oh,
you have Handson's disease, you're in big trouble. Or it
used to be the case. Yes, but now it is

(04:11):
completely curable, which is great news. UM. It is also
not contagious at all, hardly UM. Human beings have a
natural immunity. So the the biblical times of uh of
in in the Middle Ages where lepers were uh and
we'll get to all this, but when they were thought
like if you come anywhere close that you're going to

(04:32):
get this dread of disease, it's never been true. Yeah.
The thing is is as ancient as leprosy is. UM.
They still don't know exactly how it's transmitted. They assume
that it's transmitted like most other bacterial infections, like either
through um saliva or mucus, through a sneeze or something
like that, um or through cracks in the skin, and UM.

(04:55):
I saw both that it's either very hard to catch
or it's not that already catch I saw that it
doesn't live outside of the human body for very long,
or it can still remain potent in um, like just
basically on some sort of surface or whatever. Yeah. Um,
but that that the last idea that it doesn't serve,

(05:17):
that it doesn't stay active outside the human body for
very long, is supported by the fact that they've never
been able to come up with the leprosy vaccine because
it can exist outside of the human body, which is
another idea or another reason why they think it's a
very ancient human disease because it's specifically tailored for humans.

(05:37):
And do you know how how it works? Yeah? Sure,
Well you want to talk about how it actually what
it is, and then how it affects you. Well, it
is their little microbes called Microbacterium lepray l e p
r a e, their little tiny rod shaped microbes, and

(05:58):
they infect the body, and you will get skin sores
and nerve damage and muscle weakness, and you're you're gonna
not be able to feel pain, which leads to more problems,
like you will end up getting amputations because of gang
green because you injured your toes or your your hands
and you don't even know it. Yeah, Um. And the
way that it does that on a cellular level is

(06:21):
the um. The leprosy Bacterium hijacks what are called your
schwan cells, your schwan cells. Um. They typically make some
sort of fatty coating for um muscle and nervous system tissue,
right okay. And it turns schwan cells into stem cells,

(06:43):
which is pretty magical if you ask me, and it says,
go forth and go infect um the muscle tissue of
this human and let's see what we can do. So
like again, it's basically perfectly tailored to infect and hijack
the human body and affect you in all these horrible,
terrible ways. Like it shortens your fingers is one of

(07:07):
the symptoms, meaning that they just kind of start going
back like pencil nubs that have been sharpened too many times. Yeah,
it was. If you're a Biblical scholar, you have seen
the word leprosy a lot in the Bible. But um,
it didn't necessarily mean this specific disease. It could have
been a variety of things like eczema or cirrhosis. Because

(07:29):
the word leprosy in the King James Bible in Hebrew. Uh,
Sarah could be a host of diseases that kind of
make you look gnarly on the outside. But there is
a passage in at least in Um I think Leviticus,
which is old man, yeah uh, and it says that

(07:52):
you Hebrews are supposed to keep an eye on anybody
who has a skin sore, and if that skin sore
starts to spread, that person the leper in there to
live outside of camp. There's kind of an early understanding
of contagious disease. Yeah, they didn't necessarily know what it
was or what was going on, but they knew enough

(08:12):
to say, you who hang out over there, right, because
we've seen before that if people with hands the disease
hang out with everybody else, other people can catch it. Yeah.
And that was the beginning of what would end up
being leper colonies. And we'll talk about that a little
more right after this break. So at first there were

(08:40):
no leper colonies per se. They were generally just shuttled
to the outskirts of the city or camp in London.
Queen Matilda and one one one eight uh founded I
guess a camp that people could still come back into
t own and like beg for money and stuff, but

(09:03):
they were always to go back to their camp at
the end of the day. Yeah, just you know, just
basically open land. It wasn't necessarily like some awful place
to be UM. A lot of times, like these wealthy
landowners would endow this land to keep these people there. Yeah,
the because they were sequestered or ostracizeders just kept outside. UM.

(09:26):
People with leprosy effectively formed subculture or um a subset
of the population. So you would have, like say in
a medieval town, like the Jewish section and the the
um lepers section, and then like the uh the blacksmiths
or whatever, and the executioner had to stay outside of town.

(09:48):
So they were just like the right and they were
but I mean, they were like a a subset of
society UM. And they were very frequently the butt of
all sorts of reigns of terror. Like people would be like, well,
everybody's getting sick, so somebody poisoned the wells and it

(10:09):
was probably the lepers, and then the lepers all the
lepers would be rounded up and killed. So lepers UM
definitely were subjected to execution. As recently as I think UM,
I saw the nineteen thirties and in nineteen thirty seven
in China, soldiers were like hunting down lepers and executing
them for being lepers. Yeah, I mean, I think we've
talked about this a lot on the show. People fear

(10:31):
what they don't understand as a society, and they didn't
understand leprosy. They didn't know where it came from. They
thought it might be hereditary, they thought it was super contagious,
like just touching someone would infect you and so uh
and just because of the appearance that someone with leprosy
would have it, you know, they didn't want to see them.
They wanted them away so they couldn't be infected, and

(10:52):
so they didn't have to look at it, right. Okay.
So the thing is is, up until the nineteenth century,
basically all the they were a subset of society. They
were still technically part of society. Lepers were even though
they lived on the outskirts away from town, they were
still part of society. In the nineteenth century, there was
a movement to basically say, like, we don't want you

(11:12):
to have anything to do with us any longer, Like
you go over there, like you're not a part of
our society any longer. You're your own thing, just go
away forever. And there was actually a law in Illinois,
I guess in Chicago and ordinance. It was called an
ugly law. Yeah, and eight one. Uh said, Uh, any

(11:33):
person whose disease are deformed so as to be unsightly
or disgusting object has to stay away off the streets
and away from public places. Yeah, because that's how they
talked in Chicago. So I know, so I've seen Saturday
a lot before. Uh So, no longer are you allowed
in town to beg for thing like, Yeah, we we

(11:54):
decided like we don't want to look at you any longer,
so you are not a part of our culture any longer.
And that was in Chicago alone. This this happened elsewhere.
There was an outbreak in um the eighteen fifties in Hawaii,
and the Hawaiian government said, um, yeah, I think we're
going to finally just say you guys can't be part

(12:16):
of our culture any longer. And so they made leprosy
a crime. So if you had leprosy, you were a criminal,
and therefore you could be excommunicated, ostracized, banished as under law. Yeah,
that was when it was Hawaii was an independent monarchy.
And uh, in eighteen sixty five they passed the Act

(12:38):
to Prevent the Spread of Leprosy. And like you said,
they might as well have been they were criminals. Um.
And as the article opens up in eighteen seventy nine,
they describe a night in January where they police officers
rounded up a bunch of people with stricken with leprosy
and basically sent them off on a boat to Kalapapa Peninsula.

(13:03):
And so this is your new home and you're not
ever gonna leave. So it makes the the analogy of
a prison. But uh, it points out that even in
a prison you can get visitors and you may get
out one day when your sentence runs out. If you
have leprosy, you could not have any contact and you
were there for life, very very messed up. Yeah, and

(13:23):
that apparently for leper colonies that were run like prisons,
where the patients were treated like prisoners. Yeah, they weren't
being attended to like a hospital. No, it was like
you're in jail. Yeah. Uh. That there was a particularly
difficult for say, like the warden of the jail because

(13:43):
you couldn't you couldn't use the same kind of carrots
and sticks that you could on a typical prisoner because
there was no hope that you were ever going to
leave the leper colony. And that was part of the point,
like it was your relationship with so ide at large
was severed and you were never coming back. Kids were

(14:04):
taken from their families um at very young ages, like
knowing that they were never going to see them again. Yeah.
This one guy. That was a quote from a superintendent
of a South African leper colony on Robin Island. His
name was sp Imp and he said in his notes
in the eight nineties, you cannot starve them, you cannot

(14:25):
flog them. All you can do is deprived them of
their liberty, which is really sad. You know. So a
lot of a lot of places set up actual prisons inland,
but a lot of countries said, yeah, that island over
there that nobody wants, you're gonna make that a leper colony.
So there were places in the Caribbean and the Indian Ocean,
in the Pacific um off of South Africa, like you

(14:48):
just said. But one of the most famous leper colonies
of all time was that one. I think it's colat
Papa Papa if I know my native Hawaiian, and it
would be Ka Papa Peninsula on Molokai. And in eighteen
sixty six, a year after they enacted that um leprosy

(15:09):
criminal Code in Hawaii, they set it up. And it
was different because you didn't need any fences or walls
or anything like that, just the natural surrounding of the place.
It was a peninsula, so it's surrounded on three sides
by water. And then it just so happened that on
that fourth side that was connected to land, there's a
sheer two thousand foot cliff. So they were trapped. They

(15:31):
were trapped, but they were trapped in paradise and it
had an effect. It had a different effect it did,
and we will talk about that effect right up with
this break. So, Josh, you were talking about the different
effect that uh, this leper colony in Hawaii had because
it wasn't it was Hawaii after all. Yeah, you know,

(15:52):
I I don't want to make light of it. But
it was a nice place. It was very fertile. Um,
they grew vegetables. Um, they had a lot of food supplies.
Local fruits were rampant, and um. There was a Belgian
born Roman Catholic priest name Reverend Joseph da Voster who
went by Father Damien, and he really made a huge

(16:12):
difference in the life of these people. Um tried to
make it as normal sort of like a village as
he could. You know, they built the schools, they built
um churches. Uh. He started choirs and planted trees, started
a band. So he gave these people a life like
as much of a normal life as they could have.
He treated them like people, which like human beings yeah,

(16:34):
um so. And not just human beings, but also people
who had an infectious disease like patients. Yeah, patients who
um could still walk and talk and move around and
and needed some sort of distraction or some sort of fulfillment.
Father Damien came and and and gave this to these people.
He also badgered the government for money, which was good

(16:55):
because they actually had an advocate for the first time.
It was basically like the Fifth Avenue or Regulars, but
on the leprec Colony in Hawaii, Yes right. Unfortunately, very sadly,
Father Damien himself got leprosy and died at the young
age of forty nine and eight eighty nine, but he

(17:15):
was canonized as a saint SAT hundred and twenty years
later during the Big SAT sweep of oh nine. So
that was that's a pretty neat ending to that story
for him. Um and that the Lepred Colony and Kalaupapa Peninsula.
And I'm proud of myself for saying that one. Right
that is now a national park. It was created or

(17:36):
turned into a national park in nineteen eighty. But the
crazy thing is there's still people that live there, at
least as recently as two thousand three. What do you
mean people that live there, like people with rosy Um.
There's a guy I saw, I guess in two thousand three.
There were a lot of people that were that were
told they could leave or something. I think they were

(17:59):
just waiting for the last generation to die out. And
they said, you know what, we've got this thing kind
of licked here in the United States. So if you
guys want to leave, go ahead. And some people said,
I've spent my literally my entire life here. I don't
want to leave. This is my home. So it's a
national park with inhabitants, which is rare. Yeah, that's a

(18:21):
good point. Uh. In the nineteen twenties in the US,
UM we started to change our tune a little bit,
and the U. S. Public Health Service said, you know what,
let's start a leper colony in Carville, Louisiana. It's actually
a hospital of sorts where we treat these people and
try and make their life better and defined try and
find a cure, which is I think what directly led

(18:43):
to the first drugs in the nineteen forties being established,
one called promn um that apparently is a pretty nasty
way to treat it because the injections were so painful,
but it was a good start. So UM it was painful,
apparently they figured out but it wasn't antibiotic that did work,

(19:04):
and they figured out that if you added it to
a cocktail of other drugs, Apparently it was easier to
take um because it was in pill form, I think
is what they changed it to in the fifties where
sixties um, and then they added it to other drugs
because the the bacteria was starting to get resistant to

(19:25):
this antibiotic alone. They came up with a cocktail in
the sixties or seventies and now have a regiment that
can cure cure um leprosy in six months. And it
all came out of this leopro colony at Carville, Louisiana,
And there's a really really neat documentary called Triumph Fat
Carville about that, about how this place in Louisiana was

(19:47):
the place where humanity licked leprosy. And it's Carver Louisiana
is named after James Carville's family, and he's in it.
He talks a lot about it. Yeah, he grew up
like down the road from it. I could listen to
him talk just that accent, for sure, I love it.
But apparently like there was this kind of open secret
that uh inhabitants would just leave every once in a while,

(20:09):
and there was like a bar nearby where they would
go and like drink beers and everything. They just sneak
out and sneak back in drunk, like in the fifties
or whatever. For everybody has kind of left them alone,
and they did their own thing and domentary. It took,
obviously a cure um for leprosy to begin to change

(20:30):
the the stigma, and that I did start to turn
on that stigma in the nineteen sixties and lepro colonies
started to close one by one. Um. I think in
Japan there were one of the last nations to quarantine patients. Uh,
they ended it in nine. I think in Romania there

(20:50):
is still one colony where supposedly there were a few
elderly patients still there. But Indias, where it's a huge problem,
still not a huge problem, but the biggest problem. Well,
there's a lot of debate over just how big of
a problem leprosy is. Apparently the World Health Organization has said, uh,

(21:12):
we basically want to eradicate leprosy, and so a lot
of people accuse them of fudging the numbers. Is one
doctor put it like the best way to eradicate a
diseases to stop reporting. So there's between say, I think
the World Health Organization says a hundred thousand, two hundred
fifty thousand new cases a year, and this one doctor,
who admittedly has to do with this um leprosy vaccine, uh,

(21:38):
says no, I think it's more between like a million
and two and a half million new cases a year.
Those are new cases. Yeah, I thought there were less
than two hundred thousand. Period. The reporting is all over
the place, and it's questioned. That's all I can say
about that. India, Brazilian, Indonesia the top three countries and
I know that in India. Um, there's a colony in

(21:59):
Casturba gro Um near New Delhi, and it's it's still
has that stigma there. Uh. There there are people there
that are curative leprosy that stay there because their families
don't want them back. Um, if you have leprosy, you
are still likely to be ostracized away from your family
because it has They just think it reflects badly. If

(22:20):
you have like a boy and a girl and the
boy has leprosy and the girl doesn't like that, girl
won't even be able to find a husband because the
brother in law has leprosy. So they're still sending them
behind closed doors, which is super sad because it's just
a disease like any other and it's very treatable. It's
because of the stigma of how it makes you look,
you know. Uh. And I saw this thing that was

(22:43):
an inmate in an Ohio prison this week that was
just treated for leprosy. Uh. He was just discharged from
Ohio State Medical Center, House State University Medical Center, the
Ohio State Medical Center, and he was just treated for
like a few days. Apparently, once you start this drug cocktail,

(23:04):
they can cure you in six months. But you're not
even infectious after like a few days of it. So
they put him back into prison and he he had
it before he you know, he had had it for years. Uh, man,
how did you get it in Armadillo or something? Now
he was he was from I think of Micronesia, so
he they think he got it there, brought it over here,
didn't know he had it. Uh, ended up in jail

(23:26):
and make sure it's what he's in jail for. Man,
But um, not for having leprosy. I know that. Not
not in the US, buddy. But they basically said, all right,
you're going back to jail. Not nothing to worry about
going back to prison. He was like, uh great, Yeah,
and I'm sure the prisoners are probably worried because they
don't listen to this podcast. Yeah, well some of them do.

(23:47):
It's probably working in his advantage. Yeah, like stay away
from that guy. Yeah, unless he's sad and lonely, then
that's different. So if this kind of got to you
and you want to do something World Leprosy Days January,
that's right, we're a little early. We're kicking off World
Leprosy Day in November. And if you want to know

(24:08):
more about leprosy or Handson's disease. You can type either
one of those in the search part. How stuff works
dot Com will bring up this article. Since I said
that it's time for listener mail, I'm gonna call this
one hit drummer. Hey, guys, I have no idea how
I missed your one Hit Wonder podcast from a while
back until now, but it brought back a lot of memories.

(24:30):
I was in a band called SR. Seventy one, which
you may remember, had a hit called right Now, which
reached number two on the Billboard Modern Rock Charts in
two thousand and generally inescapable that summer. There are definitely
some mixed feelings on the subject, but I'd have to
say having had one hit is better than having none.
Uh do you know the song? I went and listened.

(24:51):
I looked it up, and I did not recognize it.
I didn't either, and that's because I don't listen to
the radio. Same here, man, and in two thousand, I
wasn't listening the radio. Um, but it seemed like a
very two thousand sort of song when I heard it.
You know, it fit that time period. Oh yeah, and
the video too. Yeah. Then the dudes here, I worked
on a lot of videos like that at the time, like, uh,

(25:14):
it seemed like there was like a lot of street
party in and skateboarding and like, uh, you know, a
lot of that going. Although I got a brief, small
taste of the sweetness that is fame, it was enough
to make me realize that what I thought I wanted
wasn't very satisfying. The upside was having plenty of stories
to tell. Unfortunately. I keep a tour journal containing details

(25:35):
that have mostly been lost from memory. Late night TV,
daytime talk guest spots on short lived TV shows, uh,
several incredible gigs can't forget the forty what Club It Happens?
An amazing trip to Japan and one of the strangest
experiences ever on German MTV. They make for some great
life experiences that helps me see marketing for what it
is in all its forms. The major label recording experience

(25:57):
and the constant touring were beneficial from a musical standpoint,
although playing the same bunch of tunes every night quickly
became maddening. And I'm happy to know that I don't
want to be on the Merry Go round of or
tour bus rolling Petrie dish gross unless I'm the one
running the show. Thanks for a great show, Please keep
at it. There's so much to know. And that is

(26:18):
Dan Garbon and that's when to grow on. Formerly of
sr see and Uh, I emailed him see if you
care to say what he's doing now? And I didn't
hear back from him, but I think he let's make
some of the up. Yeah, okay, I think he's still
drumming and then like teaching, and um, I think he
has a recording studio. I think he's taken like that
road instead of the drudgery of the tour bus. Are

(26:41):
you making all that up? No? No, no, I think
that's real. What is that? Based on his Wikipedia page?
Oh okay, I was gonna say, what else would I
find it? I don't. I thought you were just making
it up and would admit it. No. Thanks a lot, Dan,
that's pretty cool man. Um, if you had a one
hit wonder, would you have? No, you wouldn't have when

(27:02):
you'd be a one hit wonder, right, and your name
is not Lue big fake lou Bega. Man, we'd love
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(27:30):
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