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Personal and Professional Background
Published in James Chin, Jeffrey Koplan, The AIDS Pandemic, 2018
I was quite busy during my 2 years at the IMR in KL. Early on I made contact with Don Eyles who had by this time contracted with a Malay physician to help him with his field studies. We both had a good laugh about how I was able to get to KL and the IMR in spite of the miscommunications about government housing. I made contact with the leprosy expert (Dr. John Petit) assigned by the British Medical Research Council at Sungai Buloh Leprosarium that was about 25 km outside of KL to begin my genetic studies with the thousands of leprosy patients who were still living there. He welcomed my study and he provided me with the specific leprosy diagnosis/classification for each patient. There are two main types of leprosy and I was trying to find out if genetic factors might play a role in determining whether a leprosy patient developed lepromatous (multibacillary, the more infectious) or tuberculoid (paucibacillary, the less infectious) type of leprosy. I won’t go into details about my studies except to say that my genetic fishing expedition among several thousand leprosy patients did not find anything of significance. However, I was able to coauthor a paper with John Petit to document that G6PD deficiency did not significantly modify the course of leprosy or its treatment with sulfa drugs. I was also able to get my study of comparative tuberculin testing of schoolchildren published in the British TB journal Tubercle as well as several brief papers/notes on some of my genetic studies in Malayan aborigines.
The Age of the Asylum
Published in Petteri Pietikainen, Madness, 2015
Stripped to its bare essentials, this is what Foucault’s thought-provoking thesis says: when the state apparatus started to develop after the devastating Thirty Years’ War (1618–48), first in France, then elsewhere in Europe, the deviant groups began to be incarcerated in prisons, hospitals and mental asylums. And when leprosy ceased to be a European-wide epidemic, hospitals (‘leprosaria’) could be used for other purposes. Simultaneously, the attitude of western European elites towards madness began to change. In Foucault’s view, in the early modern era madness was still engaged in a creative dialogue with reason, but at the onset of the great confinement madness began to be considered a sheer negation of reason; it changed into ‘unreason’ or irrationality that called for isolation, disciplining and taming. Until the seventeenth century, madness had its own dimension of freedom and truth, and it occupied its own socio-cultural and intellectual niche. This all changed with the great confinement, when madness was ‘amputated’ – madness became a sheer nuisance and a potential threat to the social order. According to Foucault, the authorities wanted to suppress the voice of unreason and exclude the mad from the sphere of reason and order. The Age of Reason reduced madness to silence (Foucault 2006, 44).
The Campaign Against the Big Four Endemic Diseases and Indonesia’s Engagement with the WHO during the Cold War 1950s
Published in Liping Bu, Ka-che Yip, Public Health and National Reconstruction in Post-War Asia, 2014
Unlike the other three endemic diseases—malaria, tuberculosis, and yaws to a lesser extent—in directly causing the loss of economic productivity, leprosy was negligible in this regard. However, leprosy patients were stigmatized in Indonesia due to popular superstition. The social rehabilitation of such patients, therefore, was invested with symbolic significance for the Indonesian Ministry of Health, which aimed to transform Indonesia into a modern society based on the foundations of science. As the prevalence of leprosy across Indonesia was patchy—some villages registering a significantly higher prevalence than others (15.81 cases per 1,000 cases in some villages whereas none in others), epidemiological strategies for executing leprosy control across Indonesia varied considerably.49 Prior to 1956, leprosy patients were isolated in leprosaria and treated with chaulmoogra oil to minimize the transmission of infection. However, as leprosaria beds were in short supply, Indonesian physicians designed a two-pronged approach to leprosy control that was adapted to varying population densities across the archipelago: (a) detection of leprosy cases; and (b) breaking the chain of transmission of infection through the treatment of the patient with Diamine Diphenyl Sulphone (DDS). In densely populated areas, leprosy cases were detected by paramedical personnel and treated with DDS tablets whereas in areas where the population was scattered, the disease would be detected at polyclinics and treated using DDS injections.
Leprosy in skulls from the Paris Catacombs
Published in Annals of Human Biology, 2020
Patrícia D. Deps, Simon M. Collin, Sylvie Robin, Philippe Charlier
The Paris Catacombs, formerly limestone quarries, contain the remains of approximately six million people dating back to the 15th century, re-interred from central Parisian cemeteries during the late 18th century, up until 1860 (Figure 1). Leprosy existed in France since at least the Gallo-Roman era and was endemic until the 15th century (Rakoto-Ratsimamanga et al. 1970), and there is evidence that skeletons from at least two leprosaria were re-interred in the Catacombs: from the Saint-Lazare leprosarium that accommodated people affected by leprosy from the 9th to the 15th century (Pottet 1912), and a leprosarium probably attached to the convent at Rue de la Douai (Moller-Christensen and Jopling 1964). In 1964, Möller-Christensen and Jopling reported finding “no evidence” of facies leprosa in skulls from the Catacombs based on pathognomonic criteria comprising (a) atrophy of the anterior nasal spine either alone or combined with central atrophy of the maxillary alveolar process and (b) inflammatory changes in the superior surface of the hard palate (Moller-Christensen and Jopling 1964). To our knowledge, there has been no subsequent palaeopathological study of leprosy in human remains from the Catacombs. The aim of this study was to examine a sample of skulls from the Paris Catacombs for signs of leprosy based on a pragmatic combination of Moller-Christensen (1961) and Andersen and Manchester (1992) pathognomonic criteria.
Living with stigma: Voices from the Cured Lepers’ village in Ghana
Published in Social Work in Health Care, 2019
Cynthia Akorfa Sottie, Judith Darkey
After the introduction of Multi-Drug Therapy (MDT), the leprosarium was changed into a polyclinic and all the wards were subsequently closed. The leprosarium was turned into a polyclinic to integrate leprosy care into general medical care. Another reason for this integration was a reduction in the rate of newly reported leprosy cases to the leprosarium. Conversion of the leprosarium into a polyclinic and subsequent closure of the facility’s wards created difficulties for new leprosy patients who needed a place to live during treatment since their families rejected them. This meant that PCLs who were still living in the leprosarium had to vacate the premises. Instead of returning home, they settled around the polyclinic. The area they settled was later named Freetown. Freetown enlarged as the PCLs intermarried and had children. In addition, more people were left with the only option of making Freetown their home after receiving treatment.