South Africa
History of Leprosy in South Africa
During the fifteenth to eighteenth centuries leprosy spread through Africa downwards from the East.
It is thought that the first report of a case of leprosy was made in 1756 in the district of Stellenbosch. A Commission was appointed. It recommended that people affected by leprosy should not be allowed to mix with others, a resolution which was passed in August 1756.
In 1891 the Leprosy Suppression Act was passed in South Africa and it became compulsory for every one with leprosy to be hospitalised. Leprosy was declared a notifiable disease in South Africa in 1921. Hospitalisation for leprosy ended in 1977 when Westfort, the last institution specialising in care of people affected by leprosy, was closed.
South Africa had fewer than one case of leprosy per 10,000 population in 1924. Since then leprosy care has been integrated into the general health care services at the primary health care level. The National Department of Health of the Government of South Africa and The Leprosy Mission Southern Africa take care of leprosy control together. Health care workers carry out passive case detection at primary health care clinics, district and provincial hospitals. Knowledge of health workers on leprosy is maintained to ensure early diagnosis and treatment of the disease through in-service training, leprosy seminars and symposia, leprosy video presentations at primary health care clinics and leprosy posters and leaflets displayed at primary health care clinics and other health care facilities.
The majority of leprosy patients are located in the provinces of kwa Zulu Natal, the Eastern Cape and Mpumalanga. There are currently around 50 new cases a year. However, about 40% of new patients have grade two disabilities. The Leprosy Mission Southern Africa estimates that approximately 3,000 people need medical and social care for a disability due to leprosy, although the disease is no longer active.
Robben Island
Many people with leprosy voluntarily went to Robben Island, where people with chronic diseases and mental illnesses had previously been housed.
The Cape of Good Hope enacted compulsory segregation for people affected by leprosy in 1884 and began to force them to go to Robben Island in 1892. Whereas the Cape of Good Hope census of 1891 had recorded 625 people with leprosy, 3,000 people were discovered with leprosy at the time of enforcement. Patients were segregated by race. It is known that conditions for white people were better.
For many of those who were sent to Robben Island, the deepest cause of bitterness was being compulsorily confined to such a desolate spot. They were not used to being surrounded by water. They were cut off from their children and could not know what they were doing. From the lighthouse they could see Cape Town, their only view of civilisation. Some tried to escape. A few succeeded. Some killed themselves. Others ignored the regulations.
In 1931 the last people affected by leprosy, who had been forcibly held on Robben Island, left.
A Brief Chronology of Events Related to Persons Affected by Leprosy on Robben Island:
http://www.aifo.it/english/resources/online/books/leprosy/lep-chronology-robbenisland.pdf
Robben Island and Leprosy Historical Sites: http://www.aifo.it/english/resources/online/books/leprosy/lep-historical-robbenisland.pdf
Africa Leprosy Congress, Johannesburg, 31st January – 3rd February 2005
Presentations made during this Congress of the International Leprosy Association can be accessed through the AIFO website:
http://www.aifo.it/english/resources/online/books/leprosy/ila-africa05/ila.htm
Reflections on the ILA African Leprosy Congress
Paul Saunderson & Ruth Leekassa
Lepr Rev (2005) 76, 108-111
http://www.lepra.org.uk/LR/June05/147353.pdf
Leprosy, Stigma, Identity and Human Rights: The Experience of Leprosy in the Era of HIV/AIDS, Robben Island, 4th – 6th February 2005
Individuals from 16 countries whose lives have been directly affected by stigma, either as a result of leprosy or HIV/AIDS joined in discussions with historians specialising in the fields of leprosy, HIV/AIDS and human rights.
A record of the meetings reported in the International Journal of Leprosy:
http://www.leprosy-ila.org/leprosyjournal/pdf/73/i1544-581X-73-4.pdf
Quotations of participants affected by stigma:
http://www.idealeprosydignity.org/newsletter/vol10-1/Vol10-1RobbenIsland.pdf